I saw this story and thought of all the residents who suffered pain as a result of his intentional act. This is why supervision of nursing home employees is crucial.

A 40-year-old nurse who pleaded guilty to switching out painkillers meant for nursing home patients has been sentenced to just over five years in prison.

Michael Paul Smith of Falmouth was charged with tampering consumer products and health care fraud.  Smith may face mandatory exclusion from working in any federal health care program.

Prosecutors say he removed pills containing oxycodone and morphine by separating the cardboard backing from blistercards and substituted the pills for similar-looking medication nearly two years ago.

He was employed at the Odd Fellows Nursing Home in Worcester at the time.

I just read this article about staffing at night in hospitals.  It starts and ends with a particular incident at the Medical University of South Carolina’s children’s hospital.  This is a truly terrifying account of the lack of staffing in hospitals on night shift. 

Now take this same idea of less staffing to a nursing home setting.  In nursing homes, often the residents can’t speak for themselves, or they can’t make sense out of what’s going on around them – maybe they no longer know how or when to call for help.  And maybe they don’t know the difference when no one comes.  Add to that the number of residents that have no family to check on them during the day, much less at night.

As an example, we recently talked to a gentleman who was in a nursing home for a short time for rehab.  He said that night time was the worst part of it all.  He said that patients call for help half the night, and no one comes.  He said you can hear staff members talking and laughing, but they wait for hours to respond to call bells.  The fact of the matter is, there is no real supervision on night shift, and often the staff does whatever they want.  I know that this is not the case with all nursing homes, but I’ve heard that same story more than once, about more than one facility. 

In the article, a child died  – in large part because there was not good staffing at night.  This child died with his mother sitting beside him, unable to get help.

Put yourself in the position of a nursing home patient, who has no one sitting beside them trying to get help.  The staff is all they have.  That’s why staffing is such an important issue in medical facilities – and its not just about the quantity, its also the quality.

This article is worth reading, if for no other reason than to educate yourself about the dangers of night staffing in medical facilities.  We may all be there one day, or we may be able to help someone that is.

State and national organizations pushing for nursing home reform say life-threatening problems in facilities for the elderly usually are linked to inadequate staffing.

Nursing home residents have their needs ignored because staffers are overworked, according to top officials with the National Citizens’ Coalition for Nursing Home Reform in Washington, D.C., and Kentuckians for Nursing Home Reform, which has its headquarters in Lexington.

Serious problems have also occurred at Baptist Convalescent Center in Newport, where two patients became severely dehydrated, with one dying, and at Villaspring of Erlanger Health Care Center, which is under investigation by the Kenton County Commonwealth Attorney’s office. 

"Ninety-two percent of the nursing homes in the country are not staffed at a level that allows them to provide adequate care," said Alice Hedt, executive director of the national coalition, which is pushing federal legislation that would mandate specific staffing levels in nursing homes.

"Our main issue is staffing in nursing homes. It’s the basis for most of the abuse and neglect that we see," said Bernie Vonderheide, who heads the advocacy group in Kentucky.

Like the federal government, Kentucky has no specific staffing requirements that establish a ratio between the number of patients and the number of staff members that must be on duty to care for those patients, Vonderheide said.

"Kentucky is one of 13 states without staffing regulations. They follow the federal regulations that only say that you must have sufficient staff to provide adequate care. We say that they interpret these widely and wildly," Vonderheide said.

Thirty-seven other states have much more specific standards on staffing, he said.

Hedt testified before the Senate Special Committee On Aging on May 2 – roughly 20 years after passage of the federal government’s Nursing Home Reform Law. In her testimony, Hedt cited two studies that had been completed by the U.S. Department of Health and Human Services.

"These reports and other research show that below 4.1 hours of nursing care a day, residents will almost certainly be harmed – suffer from pressure sores, dehydration, malnutrition, fractures, infections and other conditions that cause pain, decline in functioning, avoidable hospitalization and death," Hedt told the committee.

The Baptist Convalescent Home in Newport received a citation from the state earlier in the week after a resident died two days after he was removed from the home suffering from dehydration.

See full article here

Two nursing home workers were fired this week after police said they were involved in "inappropriate activity." Police would not go into detail about what the two employees were accused of doing.

"We got a call from the nursing home I believe that there was some inappropriate actions and we took it from there," said Galion police Chief Brian Saterfield.

A representative from the nursing home said the two were immediately suspended and later fired following an internal confidential investigation.

Why can’t they disclose what these two cretins did to the poor residents?  Why the need for secrecy?

 U.S. Medicare Monday proposed a $690 million increase in payments to nursing homes. The 3.3-percent increase would go to nursing facilities that provide skilled nursing and rehabilitation care to Medicare beneficiaries, according to the Centers for Medicare & Medicaid Services.

Under the new payment schedule, called the skilled nursing facility prospective payment system, the daily rate for room, board, medical care and other expenses would be increased. Current payments are based on a 1997 market basket, but the proposal would update rates using a 2004 market basket.

Hopefully, this increase will lead to more staff who are better trained.

I recently read an interesting article about CNAs in nursing homes.  CNAs change adult diapers, clean soiled residents and help the elderly dress, eat and shower among other duties.  Unfortunately, these employees who handle so much of the daily, essential care needed by nursing home residents are underpaid.  The article states that the average pay for new CNAs is less than $8 an hour, only a dollar or so above minimum wage.

As a result of the low pay and demanding job description, CNA turnover is as high as 170 percent at some facilities.  Dale Patterson, vice president and chief financial officer of Evergreen Healthcare Management says about CNAs, "It’s hard work.  And on a relative scale (employees say) ‘I can flip hamburgers for the same pay or I can take care of old people with incontinence problems.’…So of course turnover is high."  Gary Weeks, executive director of the Washington Health Care Association industry group says that many CNAs qualify for food stamps and other public benefit programs.

Low pay for CNAs also means lower quality of care for residents in nursing homes.  Facilities with high numbers of Medicaid patients report "losing" money because of low government reimbursements for such patients.  Less revenue means lower pay.  These facilities spend an average of 44 fewer minutes on direct care of patients each day, they have more patients spending most of their day in bed and a higher percentage of patients with pressure ulcers.  This adds pressure to the nurses who end up overmedicating residents or using chemical restraints.  Larry Minnix, President & CEO of the American Association of Homes and Services for the Aging backs this theory up by stating "The best proxy for quality that we have is staffing."

Starting pay for a CNA in upstate South Carolina has recently been increased about $8.50 per hour.

SEIU Sold Out Nursing Home Workers and Patients

SANTA MONICA, Calif., April 11 /PRNewswire-USNewswire/ — The
Foundation for Taxpayer and Consumer Rights made public today internal
memos and agreements between Andy Stern’s Service Employees International
Union (SEIU) and nursing home operators that show just how Stern sold
nursing home workers out. The nursing home workers lost their rights to
strike, complain publicly about quality of care problems and improve their
pay and benefits under the secret Stern-backed agreements with nursing home
owners.
Nursing home operators got the unions’ lobbying clout for more Medicaid
dollars, for tort reform measures and against safe staffing requirements in
nursing homes. SEIU got the right to represent workers, if shoddily, and to
receive dues.
" Read More →

Rat dies in mouth of California nursing home patient

Staffing was so inadequate at a California senior center that a rat crawled into an Alzheimer’s patient’s mouth and died there before staff noticed, a lawsuit claims.

The lawsuit alleges that Paragon Gardens Assisted Living and Memory Care Community in Mission Viejo overbooked their facility to receive corporate bonuses, but cut back on staff to increase profits.

"The facility so literally ignored the needs of their residents … as to allow vermin in the form of a rat to become lodged in the mouth of Sigmund Bock and die therein," the lawsuit alleges.

Read More →