Falls during hospital stays injured or killed at least 92 patients in Washington state last year. Preventing falls is an important facet of care, especially for patients in high risk groups. Age can be a contributing factor as well as medications. For instance, patients who are given Ambien are four times more likely to suffer a fall, and Ambien is just one of over a dozen medications the FDA warns may cause sleep walking.
Some hospitals use fall alarms to let staff know when a patient has gotten out of bed, but they aren’t foolproof, and unless there is a staff member available to answer to the sound of the alarm they are useless. They also are a stressor for patients when they sound for extended periods of time. Patients will beg for the alarms to be turned off after they are triggered and not shut off by staff.
Nurses unions are pushing for legislation to force hospitals to increase staffing. This would increase the care given to patients and help reduce errors and accidents like patient falls. Hospitals are fighting back however, saying they can reduce errors without hiring more workers. Last year, the hospital with the worst record for falls was bought by new owners. The new owners increased staff by more than 100 individuals and overhauled their safety procedures. Their fall risk fell by two-thirds after this change in procedure. See article at NPR.
National Conference of State Legislatures reported that more hospitals are disclosing their charges for services in an effort to be more transparent. One way to lower health care costs may be through greater price transparency of hospital procedures, which allows consumers to make smarter, cost-conscious decisions about their health care.
“In May, the Centers for Medicare & Medicaid Services released prices charged for 130 of the most commonly performed medical procedures (from visits to a health clinic to open heart surgery) at more than 3,000 hospitals—in all, more than 170,000 different billed charges. The data included both the list prices (as initially charged to private health insurance companies and the uninsured) and the discounted rate (paid by the federal government for Medicare patients).”
The data revealed that hospital prices can vary dramatically. The full report, by the Centers for Medicare & Medicaid Services, also found significant variations from state to state. The average cost of a joint replacement, the most common treatment for Medicare patients, ranged from $21,230 in Maryland to $88,238 in California.
Detailed price disclosure are a dramatic and informative tool, but it cannot lower costs or improve efficiency. Rates are set for each diagnosis as opposed to each separate service provided, such as sutures, an ultrasound, anesthesia, etc. This is to encourage hospitals to focus on controlling the overall cost of each episode of care rather than the myriad services required for one procedure.
Connecticut has taken an impressive step for elder care by signing into law a bill of rights for nursing home residents. Mary Frost, 73 year old habitual nursing home resident, spoke out against improper care and retaliatory lack of treatment in nursing homes. She talks about her experiences where she would complain and her food tray would be late or wouldn’t be brought in at all. She also details staff calling her names and not changing her diaper when she needed it. This new bill of rights is supposed to stop mistreatment of residents like Frost. Read more on this story here.
Here is an article talking about another rape of a resident at a nursing home. Where is the supervision? Where is the criminal background check? Wher eis the good ol fashioned judgment!?
Salt Lake Police arrested a worker at a nursing home today accused of raping an 85-year-old resident. Jacob Bolith was arrested on suspicion of rape. The CNA is accused of raping a patient at St. Joseph’s Villa nursing village July 1.
Police said Bolith has worked at various nursing facilities in the Salt Lake Valley over the past decade. Bolith told police that he faced similar accusations in the past, according to a probable cause statement released by the jail.
Johns Hopkins has recently released a study that indicates that patients that resided in long term care facilities within the last six months are more likely to be infected with drug resistant superbugs. There was no definitive explanation for the increased risk, but researchers believe that underlying illnesses and weakened immune systems in nursing home residents are a factor. Those residents who are wheelchair or bed -bound have an even higher risk of superbug infection – 22 times higher than patients who hadn’t resided in long-term care facilities. The problem with superbugs is that they can lead to dangerous bloodstream infections.
The result of this study, at least immediately for Johns Hopkins, is that all patients who have been in the long-term care stetting will be tested for superbugs, and will be treated as infected until the test results are in. In terms of nursing homes, this study shows how wide spread drug resistant bacterial infection has become, and indicates the need for better infection control in long term care facilities.
SHARON OSTROFF, Individually and as Power of Attorney for Lillian Restine,
Plaintiff, v. ALTERRA HEALTHCARE CORPORATION, Defendant.
CIVIL ACTION NO. 05-6187
UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF
2006 U.S. Dist. LEXIS 50730
July 25, 2006, Decided
Sharon Ostroff, individually and as power of attorney for Lillian Restine, her mother, filed suit against Alterra Healthcare Corporation ("Alterra") for personal injuries suffered by Restine while she was a resident at an assisted living facility operated by Alterra. Defendant moved to compel arbitration pursuant to a Residency Agreement signed by plaintiff Ostroff. In an Order & Memorandum dated June 7, 2006, the Court denied defendant’s motion to compel arbitration. Ostroff v. Alterra Healthcare Corp., F. Supp. 2d , 2006 WL 1544390 (E.D. Pa. June 7, 2006). In that Order & Memorandum, the Court held that the Residency Agreement was a contract of adhesion and thus procedurally unconscionable. Id. at *5. The Court also ruled that the Agreement was substantively unconscionable, because it severely restricted discovery available to plaintiff n1 and reserved access to the courts for defendant while requiring plaintiff to arbitrate all disputes. Id. at *8. Because the arbitration clause was procedurally and substantively unconscionable, the Court refused to enforce it. Id. Defendant has now filed a Motion for Reconsideration and to Vacate that Order of June 7, 2006. For the reasons below, defendant’s motion is denied.