The absence of a national database that collects and compiles data about elder abuse and the lack of standardized data reporting and collection across states only intensifies the difficulty of assessing the full extent of abuse and neglect in America’s nursing homes. Coupled with the underreporting of such events, as Beasley Allen previously discussed, many nursing home residents are forced to suffer in silence.
Research and anecdotal evidence including two high-profile incidents that occurred during recent hurricanes, as described by Beasley Allen, however, should serve as a wake-up call to the country’s aging population, their caregivers, and especially nursing home regulators and owners.
For example, the Nursing Home Abuse Center reports that in “[a] study of 2,000 nursing facility residents an abuse rate of 44 percent and a neglect rate of 95 percent” were indicated. Similarly, a 2014 report from the Department of Health and Human Services (HHS) Office of Inspector General (OIG) showed that 33 percent of nursing home senior residents experienced adverse or temporary harm events, and 59 percent of those incidents were preventable. Infections and physical abuse round out the top causes of such events. And, according to CNN, sexual abuse is also a growing concern for those in nursing homes and long-term care facilities (LTCFs).
The Centers for Disease Control and Prevention (CDC) says that infections are a major cause of hospitalization and death for residents in LTCFs. It explains that 1 million to 3 million infections occur in LTCFs every year and cause as many as 380,000 deaths annually. All of which could be prevented with the proper precaution, attention, and care by nursing home staff.
However, the Journal of Gerontology & Geriatric Research (JGGR) says that 90 percent of the facilities are understaffed and cannot provide adequate care to the residents. Infection control professionals warn that the problem has become even more serious because one out of four nursing home residents is colonized with drug-resistant bacteria, such as E. coli., according to Science Daily. It cites a study released in May by the American Journal of Infection Control, which discovered the significant presence of drug-resistant bacteria in nursing homes and warned that it “demonstrates the need for heightened infection control prevention and control measures in nursing homes.”
The JGGR also says that one out of three U.S. nursing homes is cited every year “for causing serious bodily injury or death to a resident.” In February, a federal jury awarded the families of three deceased nursing home patients $5.2 million in compensatory and punitive damages after finding Blue Ridge Health Care Center, Care Virginia Management LLC, and Care One LLC responsible for the deaths, Law360 reported.
The wrongful death lawsuit claimed that patients were able to remove ventilator or tracheostomy tubes repeatedly without medical staff intervention. The alarms on the tubes that were to alert medical staff of removal “were either turned off automatically or manually by staff.” Additionally, patients suffered multiple falls and developed numerous infections because of substandard care.
In March, Alabama Attorney General Steve Marshall indicted three former Cherokee County nursing home employees, charging them each with one count of second-degree elder abuse/neglect, AL.com reported. An 84-year-old woman confined to a bed suffered from approximately 100 ant bites when she was left unattended for hours at the Cherokee Health and Rehab nursing facility in Centre.
Although the employees recorded that they entered the woman’s room to check on her several times, surveillance video revealed that none of the nurses checked on her for 11 hours. The nursing home reported the incident and an investigation revealed the intentional neglect likely contributed directly to the resident’s injuries.
The dire results from the lack of comprehensive national reporting and monitoring are best demonstrated through the woefully inadequate sexual abuse data in nursing homes. Although there is no national, uniform system for tracking sex abuse allegations, the Administration for Community Living has collected 20,000 complaints of sexual abuse in the last 20 years, according to the Miami Herald, but it is far from complete. Further, all forms of abuse are lumped together and sexual abuse is not categorized separately. The lack of data, especially detailed data, makes it difficult to prevent and respond to the abuse when it occurs.
Additional systemic deficiencies further complicate the efforts to protect residents.
Federal funding and other business incentives entice nursing home owners to conceal abuse. Residents’ aging and health issues often reduce their credibility as witnesses. Botched investigations, including mishandled or destroyed evidence and “half-hearted investigations by facilities and regulators,” also leave residents defenseless against sexual predators masquerading as caretakers.
In its review of state and federal data, CNN found that “more than 1,000 nursing homes have been cited for mishandling suspected cases of sex abuse.” It also found that “nearly 100 of these facilities have been cited multiple times during the same period.”
CNN highlighted several cases of sexual abuse, including that of an 83-year-old Walker Methodist resident in Minnesota – Sonja Fischer. Fisher could not speak, move or even cry out when she was raped by George Kpingbah, who was a certified nursing assistant at the facility. It wasn’t the first time he was investigated for sexual assault allegations while working at Walker Methodist. Kpingbah was suspended three previous times by the facility while it investigated the accusations. One investigation took place just seven months before Fischer was raped. Yet, neither the facility nor state investigators substantiated any of the prior incidents, and, therefore, the law prohibited the state from revealing Kpingbah’s identity. Fischer’s family had no way to know she was in danger.
“She was as vulnerable as an infant when she was raped,” Maya Fischer told CNN of her mother.
Another unsettling and growing concern for residents and their loved ones regarding sexual abuse is the misuse of cell phones and other tech devices as well as social media. A survey by the public interest group ProPublica identified 65 cases of nursing home and assisted living facility employees posting unauthorized photos and videos of residents on social media since 2012.
The Centers for Medicare and Medicaid Services is working with state health departments to ensure all nursing homes have policies that protect residents from such violations. Yet, the issue remains unregulated, and while forced arbitration clauses remain on the bargaining table for the nursing home industry, residents and their family members and caregivers have little recourse to hold bad employees and facilities accountable.
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If you need more information on nursing home litigation, contact Alyssa Baskam at 800-898-2034. Alyssa handles nursing home litigation for our firm, and she will be glad to talk with you.
Visit BeasleyAllen.com on Oct. 17 for the final installment in our Nursing Home Series.
Nursing Home Abuse Center
Department of Health and Human Services Office of Inspector General
Center for Disease Control and Prevention
Jere Beasley Report
Journal of Gerontology & Geriatric Research