Nursing Homes in Arizona

According to Medicare.gov, Arizona has 143 nursing homes. While 89 (62%) of these facilities rank average or above on the level of care they provide, the remaining 54 (38%) have below-average and much below-average ratings. This substandard level of care falls below the acceptable rating allowed by federal and state regulators at Medicaid and Medicare.

Many families face the difficult decision to place a loved one in a nursing home, independent living center, senior living community, or memory care.

Unfortunately, neglect, abuse, and mistreatment of the elderly are common occurrences in Arizona nursing homes. Many facilities lack quality care, failing to ensure that the patients receive their necessities, including food, water, shelter, medical care, and hygiene assistance.

Some nursing home residents are dealing with Alzheimer's, dementia, or other issues that require memory care. Other patients are mobility challenged due to paralysis, aging, or other conditions requiring around-the-clock assistance.

Fortunately, state and federal regulators routinely inspect long-term care facilities to identify any violations of established regulations, rules, and protocols. If an inspector intervenes, they typically identify the violation, impose monetary fines, and enforce compliance. Unfortunately, this typically occurs after someone is severely injured or killed.

Below is just a small sampling of some of the problems occurring at nursing homes in Arizona.

Failure to Protect Residents From all Forms of Abuse

Abuse and mistreatment can happen at any nursing home, even in Arizona's nicest and cleanest facilities. Statistics by the National Center on Elder Abuse indicate that upwards of 10% of all patients in nursing facilities have experienced abuse. The information below concerning the different types of abuse that occur in nursing facilities includes:

• Failure to ensure one resident was free from abuse from another resident. The deficient practice by the nursing staff could result in the potential for further resident-to-resident abuse. (Desert Haven Care Center)
• Failure to ensure that one resident was free from sexually inappropriate behavior by another patient. The deficient practice had the potential to cause further abuse. (Desert Highlands Care Center)
• Failure to ensure one resident was free from neglect and another from verbal abuse by a staff member. (Desert Islands Care Center)
• Failure to ensure an assisted device was in good repair and staff possessed the competency to use the assistive device resulted in a resident sustaining an injury from a fall. (Providence Place at Glencroft)

Failure to Protect Residents from Accident Hazards

Accidents can occur from exposure to hazards in the facility when employees and the nursing staff fail to follow protocols to create and maintain a safe environment. Residents can be exposed to harmful chemicals, dangerous conditions, broken equipment, and other hazardous situations. Some violations involving accident hazards in Arizona nursing homes include:

• Failure to ensure that one of its residents was free from hazardous conditions when their left foot became entangled in a bath blanket while being transported by a certified Nursing Aide resulted in a heel bone fracture. (Archie Hendricks Senior Skilled Nursing Care Facility)
• Failure to ensure infection control standards were followed regarding using PPE (personal protective equipment) at wound care to avoid spreading infection. (Desert Haven Care Center Skilled Nursing Facility)

Failure to Implement and Follow Infection Protection Protocols

Nursing home residents can develop septic shock (sepsis), a severe bacterial infection in the bloodstream that can travel throughout the body and cause life-threatening conditions. If the nursing staff failed to follow infection protection protocols, their lack of care could expose every resident in the facility to significant harm. Arizona investigators imposed monetary fines and cited numerous nursing facilities for violating infection protocols, including:

• Failure to ensure the contaminated water was processed appropriately and did not increase the risk of transmitting infections and diseases to residents and staff (Aspire Transitional Care of Phoenix, AZ)

Failure to Ensure Residents Receive Proper Treatment to Prevent Bedsores

Any resident can acquire a pressure sore while residing in the nursing facility if the staff fails to follow the established standards of care. The licensed nurses must assess the resident’s skin weekly or daily and take appropriate measures if any sore, compromised skin lesion or wound begins to develop or worsens. The inspectors have cited Arizona nursing homes for facility-acquired bedsores, including:

• Failure to ensure one resident with pressure ulcers receives consistent treatment and services. The nursing staff’s deficiency could result in further pressure ulcer development or complications with pressure ulcer healing. (Allegiant Healthcare of Phoenix)

• Failure to ensure pressure ulcer prevention measures were implemented, including weekly assessment and wound measurements involving a resident with a deteriorating pressure wound. (Archie Hendricks Senior Skilled Nursing Care Facility)

Failure to Provide Every Resident an Environment Free of Unnecessary Physical Restraints

Nursing homes can only use physical restraints on residents if the physician ordered the restraint by following established federal and state regulations. Unfortunately, some staff members will restrain victims for control or convenience against established laws. One nursing home was cited for its failure to follow the law involving restraints:

• Failure to ensure that risks and benefits were explained before the use of physical restraints was used for one resident. The nursing home failed to ensure that the physical restraints were ordered and monitored according to state law. (Allegiant Healthcare of Phoenix)

• Failure to ensure that a resident was not physically restrained when they failed to apply a vest positioning device correctly. The resident did not receive ongoing reevaluation when staff cured the best behind the resident placing the patient at risk for injury. (Doctor Guy Gorman Senior care home)

Abuse and Mistreatment at Nursing Homes in Arizona

According to the National Center on Elder Abuse, approximately one in ten Americans aged 60+ have experienced some form of elder abuse. Nursing home abuse is often the result of staff members or other patients mistreating residents.

Common types of mistreatment in nursing homes, skilled nursing facilities, independent living centers, and memory care units include:

Physical Signs of Abuse

Any unexplained bruises or injuries at various stages of healing might indicate physical abuse, as would any unexplained fracture, laceration, or welt. Additionally, if your loved one appears to be afraid or hesitant around certain staff members, it could indicate that those individuals are physically abusing them.

Emotional Signs of Abuse

Just as physical abuse can leave visible marks on the body, emotional abuse can leave visible marks on the mind. If your loved one seems withdrawn, anxious, or depressed, this could be a sign that they are being emotionally abused.

Additionally, if they seem unusually argumentative or agitated, these could also be symptoms of emotional abuse. In extreme cases, emotional abuse can even lead to suicidal ideation. If you see any of these signs in your loved one, it's crucial to take action immediately.

Sexual Signs of Abuse

Sexual abuse is any non-consensual sexual contact, which might involve touching and non-touching behaviors, such as forced nudity or voyeurism. If your loved one reports unwanted sexual contact or behavior, this is an immediate red flag that they are being sexually abused in their nursing home. Other signs of sexual abuse include:

• Sexually transmitted diseases (STDs) or genital infections
• Unusual bruising or bleeding in the genital area
• Sudden changes in mood or behavior

Signs of Financial Exploitation

Any employee, staff member, family member, visitor, or resident with unauthorized access to the patient’s financial information, bank accounts, credit cards, or cash is financial abuse. All nursing homes and caregivers must protect their residents from financial exploitation.

Negligent Behavior in Nursing Homes in Arizona

Unfortunately, negligent behavior in nursing homes is not uncommon. If your loved one has been the victim of negligence in a nursing home, what you do next could protect them from further mistreatment.

Warning Signs of Negligence in Nursing Homes in Arizona

A few warning signs may indicate that your loved one is being neglected in their nursing home. If you notice any of the following signs, it is crucial to take action and investigate further:

• Sudden weight loss
• Bedsores
• Unsanitary living conditions
• Lack of medical attention
• Signs of physical or emotional abuse

What to Do If You Suspect Negligence

If you suspect that your loved one is being neglected in their nursing home, there are a few steps you can take. Try to talk to your loved one about your concerns. They may be experiencing neglect but are too afraid or embarrassed to tell you.

If your loved one is not able or willing to talk to you about the situation, you can also try talking to the staff at the nursing home. If you are not getting the necessary answers or information, you can contact an attorney specializing in elder abuse cases.

The Use of Physical Restraints in Skilled Nursing Homes in Arizona

Skilled nursing facilities (SNFs), senior living communities, and independent living centers provide care for patients who require assistance with activities of daily living such as bathing, dressing, feeding, toileting, transferring, or walking.

The number of SNF beds has increased dramatically over the last decade, from 2 million in 2000 to 4.5 million in 2015. This increase in capacity has led to overcrowding at some facilities, resulting in poor quality of care.

Physical restraints are commonly used to prevent falls and other injuries in older adults. They are also used to manage agitated behavior and reduce aggressive behaviors. There are several types of restraints, each with risks and benefits that can only be applied with legal authorization and the client’s expressed written informed consent.

The decision to restrain residents should be individualized, considering their medical condition, level of agitation, and safety concerns. Using a physical or chemical restraint may be illegal without proper authorization. Typical forms of the illicit use of restraints include:

• Oversedation: Administering unauthorized sedatives to control residents is not only unlawful but also dangerous, as it can lead to respiratory problems, falls, and other injuries.
• Restraining residents in chairs or beds for extended periods can lead to skin problems and pressure ulcers. Refusing to allow residents to move around freely can lead to agitation and discomfort.

Other forms of abuse and neglect in Arizona nursing homes include:

• Lack of Proper Nutrition and Hydration: Not providing residents with proper food and water can lead to malnutrition and dehydration.
• Stress and Anxiety: Putting unnecessary pressure on residents to comply with rules can lead to feelings of anxiety and stress. Blaming residents for mistakes or accidents can make them feel ashamed and guilty.
• Ignoring Requests: Ignoring residents' requests or needs can make them feel ignored and worthless.
• Verbal Abuse: Yelling or screaming at residents can cause them emotional distress.
• Inappropriate Touch: When residents are touched in a way that is inappropriate or uncomfortable can be considered sexual abuse.
• Withholding necessary medication or treatments in nursing homes in Arizona can be dangerous and potentially life-threatening.
• Abandonment: Telling skilled nursing residents that their family members have abandoned them can cause them great emotional pain. Also, when the nursing staff leaves a resident for long periods of time and they do not provide them with the proper care and attention they need, it can lead to a fear of abandonment.
• Visitors: Allowing unsupervised visitors into the long term care facility can put residents at risk of abuse or exploitation.

Severe Falls in a Skilled Nursing Home in Arizona

Nearly all patients residing in nursing homes in Arizona are at increased risk of falling without proper assistance, ongoing supervision, and routine monitoring. Patients with disabilities, including those requiring memory care, are especially vulnerable to falling in the facility when unsupervised.

Contributing factors that can lead to a slip and fall include

• Lack of supervision: When the nursing staff fails to assist or supervise a resident that needs to be regularly monitored, this can often lead to severe falls.
• Poorly-maintained premises: If the nursing home is not well-maintained, with loose carpets and poor lighting, this can also lead to residents falling.
• Inadequate staffing: If the nursing home is understaffed, this can lead to residents not being properly supervised, resulting in falls.
• Lack of training for staff: If the staff are not adequately trained in handling residents at risk of falling, this can lead to falls.
• Inappropriate furniture placement: Furniture in the way or an inappropriate place can often lead to skilled nursing residents tripping and falling.
• Poor nutrition: If a resident is not getting the right nutrients, they may become weak and more likely to fall.
• Medication errors: A medication given incorrectly or the dosage is incorrect as a part of medical care can lead to falls if the drug causes imbalance.
• Dehydration: If a skilled nursing resident is not getting enough fluids, they may become dehydrated, causing dizziness and lack of coordination, leading to falls.
• Age and frailty: As people age, they become frailer and are more likely to fall.
• Mental health issues: If a resident has a mental health issue, they may become confused or uncoordinated and more likely to fall

Why Skilled Nursing Care Homes Must Implement an Infection Prevention and Control Program

According to data, the median monthly cost of a private room in an Arizona nursing home is more than $8000 a month. Receiving the best senior living home care in a community facility requires creating a safe environment free of accident hazards, infections, and abuse.

Unfortunately, Arizona patients receiving medical care Are at risk of acquiring severe infections, including Methicillin-resistant Staphylococcus aureus, Clostridium difficile, Norovirus, and others. Any caregiving facility providing medical care and hygiene assistance must develop and implement an infection prevention and control program that prevents the spreading of infection and other contagious diseases.

However, despite an ineffective program, infections are still a severe concern in every home care environment. Contributing factors that often lead to the spread of infection throughout the facility include:

• Failing to Wear Personal Protective Equipment (PPE): The nursing staff must follow infection protocols when caring for residents on isolation precautions to ensure that the staff does not become infected, which includes wearing gloves, gowns, and masks when necessary.
• Not Washing Hands: Nursing staff must wash their hands after every patient interaction to prevent the spread of infection.
• Not Sanitizing Equipment: Skilled nursing staff must sanitize all equipment after every patient interaction, including glucometers, to maintain a sterile environment.
• Not Disinfecting Floors: Nursing staff must disinfect floors after every nursing home care patient interaction to avoid spreading infection.
• Not Disinfecting Bed Rails and Tabletops: Nursing staff must disinfect bed rails after every patient interaction.
• Not Cleaning Patient Rooms: Facility employees must clean patient rooms regularly.
• Allowing Patients to Touch Supplies: Patients should not be allowed to touch supplies to avoid cross-contamination.
• Not Changing Linens Frequently Enough: Dirty linens can lead to cross-contamination and create an ideal bacteria breeding ground.
• Not Vaccinating Staff: Staff must be vaccinated against common viruses and bacteria, including the Covid-19 vaccine.

Why Medicare Says All Facility-Acquired Bedsores Are Preventable in Nursing Homes in Arizona

The Centers for Medicare and Medicaid Services (CMS) recognizes all facility-acquired pressure ulcers as preventable events that never should occur. Nursing homes must follow established protocols when providing skin care and pressure ulcer treatment to avoid a declining bed wound.

Unfortunately, bedsores still occur in senior living centers, assisted living facilities, and nursing homes in Arizona. Contributing factors that lead to an acquired pressure wound include:

• Failure to Perform Daily Skin Assessments: Caregivers must perform skin assessments on every resident with a high risk of developing pressure wounds to detect early signs of bedsores.
• Not Changing Bed Linens Frequently Enough: Bed linens should be changed daily to prevent the accumulation of moisture and bacteria.
• Allowing Residents to Remain in the Same Position for Too Long: Skilled nursing residents should be repositioned every two hours to avoid pressure ulcers.
• Not Providing Appropriate Mattress and Bed Surface: A firm, supportive mattress is necessary to prevent pressure ulcers from developing.
• Failing to Use Pressure-Relieving Devices: Pressure-relieving devices, such as foam wedges and pillows, should be used regularly to reduce pressure on the skin.
• Ignoring Risk Factors for Bedsores: Certain risk factors, such as obesity and diabetes, can increase the chances of developing a pressure ulcer.
• Not Immediately Treating Infections: Infections can delay healing and increase the risk of developing bedsores.
• Not Assessing Wound Healing Progress: Nurses should assess wound healing progress regularly to ensure that the wound is healing correctly.
• Allowing Foreign Objects Into the Wound: Objects like hair strands and dirt can impede the healing process and lead to infection.

Resources:

• Statistics on Nursing Home Falls | CDC
• How to Report Nursing Home Issues | Medicare