The U.S. government’s 5-Star ratings of the nations nursing homes are in!

While these results are not as glamorous as the Oscars or the Grammys… okay, they are not glamorous at all, but they are significantly more meaningful than entertainment awards, and they affect more of us much more directly. Currently, about 7.5% of Americans currently live in nursing homes. With the current trends in costs of care, health concerns, and the number of aging Baby Boomers, it has been estimated that about 11 million people will be likely to require assistance in old age within the next 10 to 20 years. That makes it essential that we understand what makes a “good” nursing home or a “bad” nursing home, and how to find the good ones.

Every year the Centers for Medicare and Medicaid Services (CMS) publish the results of their 5-Star Quality Ratings of nursing homes. The Five-Star Quality Rating System was created to help consumers, their families, and caregivers compare nursing homes more easily, and help identify areas about which you may want to ask questions. Nursing home ratings are taken from three sources of data:

• Health Inspections. Onsite visits by a team of trained inspectors who check on the quality of care, inspect medical records, and talk with residents about their care. Inspectors also make sure that the nursing home meets federal quality processes.
• Staffing. This rating looks at the overall number of staff compared to the number of residents…as well as how many of the staff are trained nurses.
• Quality Measures. This measure rates how well a nursing home performs on 10 important aspects of care, such as how well the nursing home prevents and treats skin ulcers, and how well residents are helped in eating and dressing. While this sounds like a valuable measure, the data for Quality Measures are self-reported by the nursing home staff. This makes it the least objective measure, and the most likely to be inappropriately high.

Each of these areas is individually rated, and then these three ratings are combined to calculate an Overall Rating.

The lowest overall rating is awarded to homes “much below average” compared with others in their state, according to CMS. Among problems that can drop a rating: consistently dirty equipment and linens, mistreatment and unlicensed caregivers or specialists.

How to Choose a Good Nursing Home

USA TODAY Analyzes Ratings

The CMS Nursing Home Compare data only list the most recent star ratings, but it doesn’t provide a history for consumers. Now, USA TODAY prices an analysis of the ratings for more than 15,000 nursing homes over the past 3 years. Among their findings:

• Quality improved. There was a 5% decrease in the number of nursing homes with 1- or 2-star ratings; and there was a 5% increase in the number of 4- and 5-star rated facilities.
• Some of the worst stay bad. 564 nursing homes received 1-star ratings in each of the rating periods during the past three years.
• Two-thirds of these low-performing facilities are for-profit organizations.

Here’s how to see specific nursing home ratings from the past three years:

• Go to the USA TODAY ratings page here:  USA TODAY Nursing Home Ratings
• On the upper right corner of the chart at the top of the page, enter the state you would like to search.
• On the lower right side of the chart, you can narrow your search by entering a specific term, which can include a city name, part of the name of the nursing home, a street name, etc.
• To see a comparison of all three years’ ratings, click the “+” sign to the left of the nursing home name and address.

ADDITIONAL RESOURCES

USA TODAY article: Fewer seniors live in nursing homes

To see the full reports AND to search for specific nursing homes by name or location, see the Nursing Home Compare page here: Nursing Home Compare

To see the HensonFuerst video about how to choose a good nursing home, click here: How to Choose a Good Nursing Home (and Avoid the Bad Ones)

Every year the Centers for Disease Control and Prevention (CDC) recommends that everyone 6 months old and older get a yearly influenza vaccine. And this is especially true for people over age 65, who are at greater risk of serious complications from the flu compared with young, healthy adults. In the United States, it’s estimated that 90 percent of seasonal flu-related deaths and more than 60 percent of flu-related hospitalizations occur in people 65 years and older. This is because our immune defenses become weaker with age.

The most vulnerable are elderly people who live in nursing homes. They fall within the vulnerable age category…plus they often have other, quite serious illnesses. In addition, institutions in general are hotbeds of person-to-person transmission of contagious viruses. According to an article by Dr. Robert Booy, Professor and Head of Clinical Research at the National Centre for Immunisation Research and Surveillance at the University of Sydney, Australia:

Flu outbreaks in nursing homes can lead to pneumonia, stroke and heart attacks among elderly residents. Staff are a major potential source of infection, but only around one in five get an annual flu shot. Ensuring more get vaccines, and that doctors intervene early when an outbreak occurs, may be the key to saving lives.

PREVENTING INFLUENZA

According to American Family Physician, the primary method of preventing flu is the influenza vaccine:

A number of studies have also shown that nursing homes with high rates of vaccinated residents have fewer outbreaks of influenza than nursing homes with lower vaccination rates. A similar correlation exists among the staff members of nursing homes. The higher the proportion of staff receiving the influenza vaccine, the lower the incidence of influenza among staff and residents during an outbreak. In addition, vaccination of both residents and staff can lead to herd immunity. To achieve this goal, the vaccination rate among residents and staff should exceed 80 percent.

If you choose to get vaccinated, here are some facts you need to know:

• Influenza season runs from October through May.
• It takes about two weeks for vaccines to take effect, so to be protected for the whole season, vaccines should be given before October.
• Even though it is ideal to be vaccinated before October, flu season’s peak is between the end of December and March. You can still have protection even if you’re not vaccinated until February.

DO NOT get vaccinated if:

• You have previously had a severe reaction after a flu shot. Talk to your doctor about options.
• You have ever had Guillain-Barre. Talk with your doctor about options.
• If you have any severe, life-threatening allergies, especially allergies to eggs. Talk with your doctor about options.
• If you currently have a moderate or severe illness. Your immune system is already dealing with healing an illness, and you won’t want to challenge it additionally with a vaccine. Talk with your doctor about options.

TREATMENT

There are two main types of antiviral medications that can minimize the symptoms of flu:

1. ion channel activity blockers, which include Symmetrel (amantadine) and Flumadine (rimantadine), are effective only in treating Type A influenza;
2. neuraminidase inhibitors, which include Relenza (zanamivir) and Tamiflu (oseltamivir), are effective and treating both Type A and Type B influenza viruses.

All these medications are only available by prescription. No matter which flu-fighting medication your doctor chooses, it must be taken within two days of the start of the illness—later than that, and they will have no effect. That’s why it is important to recognize and report flu symptoms immediately. This is no time to try to “tough it out”—see a doctor as soon as you feel “flu-ish.”

SYMPTOMS:  INFLUENZA VS THE COMMON COLD

The difference between the symptoms of flu and the common cold isn’t a matter of degree. The medical journal American Family Physician provides detailed information so you don’t have to be confused anymore:

• SYMPTOM ONSET
  • Flu:  abrupt. Some people can tell you the exact hour they fell ill with flu.
  • Cold: gradual.
• FEVER
  • Flu: common, 100 to 104 degrees F
  • Cold: uncommon
• MUSCLE PAIN
  • Flu: severe and common
  • Cold: uncommon
• JOINT PAIN
  • Flu: severe and common
  • Cold: uncommon
• LOSS OF APPETITE
  • Flu: common
  • Cold: uncommon
• HEADACHE
  • Flu: severe and common
  • Cold: uncommon, or mild
• COUGH (DRY)
  • Flu: severe and common
  • Cold: mild to moderate
• FATIGUE
  • Flu: common, lasting 2 to 3 weeks
  • Cold: mild, short-lasting
• STUFFY NOSE
  • Flu: occasional
  • Cold: common
• SNEEZING
  • Flu: occasional
  • Cold: common
• SORE THROAT
  • Flu: occasional
  • Cold: common

CONTAINING OUTBREAKS

Recognizing an influenza outbreak in a nursing home can be difficult because the clinical presentation of flu can vary in this population of patients. Symptoms in a nursing home resident may range from the classic influenza symptoms mentioned above to a simple functional decline.

Anytime a nursing home resident presents with influenza-like symptoms or another respiratory illness, the possibility of an influenza outbreak should be considered, and then confirmed by laboratory testing. The general process is to:

• Isolate residents with flu or suspected flu;
• Isolate residents taking one of the ion channel activity blockers, because they may shed medication-resistant virus;
• Offer to vaccinate unvaccinated residents and staff;
• Encourage sick staff to take time off work to avoid infecting residents;
• All staff and physicians should wear masks and wash hands frequently.

If your loved one is in a nursing home during a flu outbreak, you can do your part, too. Talk with your doctor about whether receiving a vaccine is a good idea for you. If you feel sick, don’t visit the nursing home to avoid infecting this fragile population. Wear a face mask if you do visit, even if you are healthy. Question the staff about how the outbreak is being handled, and what specifically is being done to keep your loved one safe.

Flu season is stressful for everyone, but nursing home residents most of all. The best news is that by June, it will all be over.

RESOURCES

To read the CDC’s information sheet, click here:  What you need to know about the 2011-2012 influenza vaccine

To read the article in American Family Physician, click here:  Influenza in the Nursing Home

To read Dr. Robert Booy’s article, click here:  Protecting our elderly

WRAL reports that Hill Forest Rest Home in Chatham County (Goldston, NC) had its license suspended today after an on-site visit found that conditions presented:

“…an imminent danger to the health, safety and welfare of the residents, and … emergency action is required to protect the residents,” officials [from the Adult Care Licensure Section of the Division of Health Service Regulation] said in a letter to Warren Gold, administrator of Gold Care Inc. in Rocky Mount, which runs the retirement home. [from WRAL.com]

The 24 residents of the facility are being relocated.

According to the news report, Hill Forest has a long tradition of substandard care. In 2008 and 2009, inspections turned up several violations, including lack of food for the residents. In March 2010, its license was revoked, but residents remained because the owner of Hill Forest Rest Home appealed the decision.

WRAL’s article makes it sound as though things went from bad to much, much worse:

An April inspection found moldy showers, roaches and flies in the kitchen, residents using bed sheets to cover windows for privacy and bathroom doors propped open, according to state Department of Health and Human Services records. A follow-up inspection in June found violations of fire and electrical codes and exterior doors that didn’t lock properly, records show.

If the June violations of fire and electrical codes didn’t cause an immediate shut-down of the facility, it makes one wonder what the inspectors found this time around.

People in nursing homes, rest homes, retirement homes, and assisted nursing facilities deserve the best care a society has to offer, not the worst. Residents and their families should never have been subjected to this kind of a nightmare…one that lasted, presumably, for several years. It’s shameful that Warren Gold and Gold Care, Inc., seem to have put playing the system above caring for senior citizens.

Stories like these are exactly why HensonFuerst Attorneys spend every day fighting for the rights of abused and neglected elderly residents. Thousands of other seniors are stuck in homes just like Hill Forest, individuals who are at the mercy of the facilities they live in. People who need someone to stand up for their rights…and their basic human dignity.  The HensonFuerst nursing home abuse team provides a voice for those who cannot always speak up for themselves, and for families who don’t know how to make things better for their loved ones.

If you suspect abuse or neglect at any long-term care facility, please don’t hesitate to contact our office. We’ll walk you through your options, and help you take legal action to get your loved ones to safety. Our phone lines are open 24 hours a day, 7 days a week, so someone is always here to answer your call (1-800-4LAW-MED). You can also visit our Nursing Home Abuse webpage:  HensonFuerst Nursing Home Abuse page.

Remember, if you have questions, the attorneys of HensonFuerst have answers.

The North Carolina Board of Nursing has issued a new statements designed to clarify the scope of practice for nurses.

These position paper provide guidelines about what the standards for competent care are for LPNs and RNs. Topics include what to do when assessing a patient, planning for a client’s needs, implementing the plan, evaluating outcomes, recording data, collaborating with others, and counseling the client and/or the client’s family.

Click the links to read the papers:

Position statement for RN practice.

Position statement for LPN practice.

While these papers are intended for nurses, everyone with a loved one being cared for by nurses should review them to make sure that competent care is being delivered. If you wonder how your nurse is following through on the guidelines, ask. Good care starts with good communication.

On the other hand, if it becomes clear that your nurse is not competent, or if you suspect that your loved one is being abused, talk with someone further up the chain of command–the head nurse or facility coordinator. If you believe that your loved one is in immediate danger, it is better to be safe than sorry:  call 911.

And finally, if your loved one has been injured by abuse by a long-term care facility and you want to explore your legal options, call the HensonFuerst Nursing Home Abuse team–we’re here 24 hours a day, 7 days a week. You can reach us at 1-800-4LAW-MED. If you have questions, HensonFuerst has answers.

Today, June 15, is the 5th annual World Elder Abuse Awareness Day.

Sponsored by the International Network for the Prevention of Elder Abuse (INPEA), the first Awareness Day in 2006 involved several hundred organizations and governmental bodies throughout the world, on all seven continents. Their core message is this:  Never ignore elder abuse.

Throughout the world, abuse and neglect of older persons is largely under-recognized. It is an unspoken problem. Unfortunately, no community or country in the world is immune from this costly public health and human rights crisis.

Elder Abuse Facts

According to the World Health Organization, the elderly are especially at risk of abuse in institutions such as hospitals, nursing homes, and other long- term care facilities. In a survey in the United States, for example, 36% of nursing home staff reported having witnessed at least one incident of physical abuse of an elderly patient in the previous year, 10% admitted having committed at least one act of physical abuse themselves, and 40% said that they had psychologically abused patients.

Abusive acts include physically restraining patients, depriving them of dignity and choice over daily affairs, and providing insufficient care (for example, allowing them to develop pressure sores).

Signs and symptoms of abuse include:

• delays between injuries or illness and seeking medical attention;
• implausible or vague explanations for injuries or ill-health, from either patient or caregiver;
• differing injury accounts or case histories from patient and caregiver;
• frequent visits to emergency departments because a chronic condition has worsened, despite a care plan;
• laboratory findings that are inconsistent with reported treatment.

The HensonFuerst nursing home abuse team has seen first-hand the abuses that can be heaped on the elderly. Just a few months ago, six residents of the Britthaven of Chapel Hill nursing home were given overdoses of morphine, and one resident died. They were all in the Alzheimer’s unit, which means that they were helpless to know what was going on… helpless to fight back.

Stories like that are what keep HensonFuerst fighting against elder abuse every day of the year.

WRAL.com reports that registered nurse Angela Almore was indicted on a charge of second-degree murder for the death of an Alzheimer’s patient at Britthaven of Chapel Hill nursing home. Almore is also charged with six counts of felony patient abuse, and is being held in the Orange County jail under a $500,000 bond.

In February, nine Alzheimer’s patients tested positive for powerful opiate medicines, the kind used to control pain. Six of the patients were hospitalized, and one patient–Rachel Holliday–died.  At the time of her death, Ms. Holliday had a blood morphine level of 50,000 ng/ml… even though she had not been prescribed morphine.

HensonFuerst is relieved to know that the investigation into patient abuse at this nursing home will continue, and that an arrest has been made. Our nursing home abuse lawyers are continuing their own investigation of this incident. There are many more questions to be answered….

To read the full WRAL story, click here: Murder Charge at Britthaven of Chapel Hill. And if you have questions about what you can do about suspected cases of nursing home abuse, contact our Nursing Home Abuse team–if you have questions, HensonFuerst has answers.

Every now and then, a story comes our way that makes us wish we could give out awards. Today, in the category of “It’s a Step in the Right Direction,” the winner is: Milwaukee, Minnesota for giving jail time to Karen Mason. This criminal was CEO, administrator, and part owner of Havenwood Nursing and Rehabilitation Center in Milwaukee, which closed in 2005 after a raid by state and federal regulators. According to Milwaukee Magazine’s NewsBuzz, the regulators discovered that nursing home residents were denied baths and clean sheets, and one resident jumped to his death after staff failed to report his threats of suicide.

Mason pleaded guilty to felony charges of abuse and theft (she was accused of taking more than $1 million that was supposed to be used for patient care), and was sentenced to 15 months in jail. This week, she was sentenced to two years in federal prison for tax evasion.

As a firm that fights daily to see that nursing home residents are treated with care and respect, HensonFuerst is relieved to see justice served. We are certain that this former CEO is not the only nursing home owner to take these types of harmful liberties, and we look forward to the day when the elderly are no longer seen as easy targets for abuse. To read more about nursing home abuse, visit our Nursing Home Abuse web page.

The Health Care Reform Act provides some much needed relief for victims of nursing home neglect and abuse.

In recent years, many nursing home chain operators have avoided responsibility for injuries and death caused by their neglect. They have done so by setting up multiple dummy corporations and other legal entities to  siphon cash away from the holder of the nursing home license and make sure it has no assets a judgment creditor could collect. The licensee is typically an assetless entity, with  no employees and no liability insurance… and the real estate and earnings are owned by other entities controlled by the same folks who control the licensed home.

After Congress got wind of this practice, the Nursing Home Transparency Act was passed as part of the Health Care Reform Act.   Once the act’s provisions take effect, nursing homes will have to disclose everyone who has their hands in the till or owns or controls  the home or related entities.

To read the bill click here:  Nursing Home Transparency Act

The lawyers of HensonFuerst are dedicated to fighting nursing home abuse and neglect. We are happy that nursing home residents and their families may soon be assured that they will have access to all financial information of the facility… not just the “poor us, we’re broke” information that disreputable facilities have been able to get away with.

If you suspect that someone you love has been the victim of nursing home abuse and want to learn about your legal options, please call the compassionate lawyers of HensonFuerst. We’re here to help.

New Haven, Connecticut–home to Ivy League Yale University–is also the location of the latest example of how disgusting and neglectful a nursing home can get. According to a story by a Connecticut NBC affiliate, the Department of Public Health held a surprise inspection of The West Rock Health Care Center. Everyone was surprised when inspectors found:

“Linens that were worn thin and brown; boxes of medical records soaked in pooling water; and a nurse who cleaned an open ulcer with the same ‘fecal smeared washcloth’ used to clean the patient.”

In addition, residents were not given medications on time, and slept on beds that were “unmade and with an accumulation of soiled sheets.”  In all, there were 37 pages worth of violations.

The nursing home was shut down.

Reaction of the owner, Anthony Pinto? “This is a travesty,” he said, referring to the closing. He believed everything “was correctable.”

Except you can never correct for the pain and indignity already suffered by the residents, or the extra infections that might have already occurred due to such unclean conditions. HensonFuerst believes that our senior citizens deserve the highest of care, not the lowest. We fight everyday to keep nursing home residents from becoming victims of this type of abuse and neglect.

If you have a loved one in a nursing home, visit often… talk with staff about concerns you might have… and make facilities take responsibility for proper treatment of your relative. If you believe abuse has already taken place and have questions about what additional action you can take, call us. At HensonFuerst, if you have questions, we have answers. (HensonFuerst: www.lawmed.com; 1-800-4-LAW-MED)

The SmartMoney Magazine website published an eye-opening list of “10 Things Nursing Homes Won’t Tell You,” which was adapted from a book by Jonathan Dahl and the editors of SmartMoney.  Everyone related to a nursing home resident should visit the site, read the list, print it, study it, and post it somewhere visible.

So I don’t give everything away, I’ll include 5 items here (with our own commentary).

1. “We’re careless about the drugs we give out.” Some nursing homes have been cited for unnecessary drug use, use of antipsychotic medications among residents who are not psychotic, and overdosing residents so that they are easier to care for. We have seen this locally, when Britthaven of Chapel Hill nursing home was reported to be the subject of investigation when residents were given narcotic medications without a prescription, leading to the death of one patient.
2. “If it’s not in the care plan, we’re not gonna do it.” The federal government requires a care plan for each resident, which outlines how the resident should be cared for. Even if something is on the care plan, nursing homes can neglect the promised duties… but if a particular aspect of care is not on the plan, forget about it. Don’t assume anything.
3. “‘Neglect’ is our middle name.” When nursing home residents are neglected, they can suffer from dehydration, pressure sores, malnutrition, disease, and sometimes death.
4. “We use physical restraints on your loved ones.” Restraints are allowed as a method of last resort to keep a loved one safe or protect others. But that doesn’t mean that use of restraints isn’t abused, and can lead to depression, agitation, bruising, and other physical problems.
5. “Fines? Go ahead–give us your best shot.” When a nursing home doesn’t meet standards, it can be fined… but that doesn’t mean that the money will ever be collected. The facility can appeal the the citation and fine, or find other ways to avoid paying. Plus, corporations that own and operate nursing homes at the highest levels (because there are often shell companies that are the “face” of each facility) are usually so flush with cash that a little fine is barely noticed.

Want to read the rest of the list? Check out the original article here: SmartMoney Magazine.

HensonFuerst is an avid supporter of nursing home residents and their families. Our lawyers have been involved in some groundbreaking litigation that have made residents safer, and we continue to work for the benefit of the “little guy” against corporations who abuse and neglect senior citizens. If you think your loved one is being abused in a nursing home and you don’t know what to do, contact HensonFuerst. If you have questions, we have answers.