According to Medicare.gov, there are 519 nursing hospitals in Indiana. Of these nursing homes, 292 (56%) rate average or above the national average for quality of patient services. However, the remaining Indiana nursing homes (227 - 44%) have below-average and much below-average ratings. These below-average ratings fall below the acceptable rating allowed under federal and state regulations.
Nursing homes are one of the most common residential health care facilities for elderly people, with an estimated 4.5 million residents living in nursing homes across the United States.
According to the National Association of State Directors of Aging Services, an average of 5 percent of these residents in nursing homes experience some form of physical, sexual, psychological, financial, or drug/alcohol-related mistreatment at least once during their stay.
Elderly people receiving nursing care are among America's most vulnerable populations. They're susceptible to abuse and neglect and don't always receive proper medical attention. Sadly, many staff members fail to provide adequate nursing care, resulting in severe injuries and death.
Abuse and Neglect in Indiana Nursing Homes
According to the National Center on Elder Abuse, roughly half of all nursing homes residents are physically abused. The CDC (Centers for Disease Control and Prevention) reveals that one in every four residents in nursing homes experienced neglectful treatment.
Many nursing home staff members lack proper training and aren't adequately supervised. Additionally, some nursing home staff members aren't licensed. As a result, these issues exacerbate the problem because most state laws don't require background checks when hiring people who work in residential care centers.
Some examples of abuse, mistreatment, and neglect documented in nursing homes in Indiana include:
Failure to Protect Residents in Skilled Nursing Facilities From all Forms of Abuse and Neglect
Abuse and neglect can lead to serious health issues for elderly residents in nursing homes. These issues include malnutrition, dehydration, preventable bed sores, poor personal hygiene, and unsanitary conditions. These issues may be hard to spot if they're not obvious.
CMS and the Indiana Department of Health cite the following nursing homes in Indiana with violations and penalties:
- Failure to ensure the resident was free from abuse by another resident resulted in fractured bones in the left foot after the patient pulled her chair and another resident pushed her. (Brickyard Healthcare – Bloomington Care Center)
- Failure to prevent verbal abuse of a cognitively impaired resident by a contracted staff member after a Qualified Medication Aide reported that a housekeeper used inappropriate language toward the resident and refused to clean her room. (Brickyard Healthcare – Muncie Care Center
- Failure to ensure a patient with dysphagia and at risk for choking received supervision while eating choked and died. (Cardinal Care Strategies Skilled Nursing Facility
- Failure to ensure a resident was free from abuse by another patient resulted in an emergency room visit due to a facial laceration requiring medical adhesive (wound glue) on the forehead laceration. (Core of Bedford Skilled Nursing Facility)
- Failure to ensure residents were free from verbal abuse, involving five patients, including one incident where a CNA into the room that was really close to the patient said "I don't like you" before the resident responded that she did not like her either before the CNA responded, "F*** you. (Diversicare of Providence Rehabilitation Center)
- Failure to ensure residents were free from abuse related to a cognitively impaired male resident inappropriately touching three female patients, including inappropriate sexual gestures toward staff and residents. (George Ade Memorial Health Center)
- Failure to ensure a resident was free from abuse regarding the placement of a newly admitted patient with a history of physical aggression in a room with a resident with a history of invading peers' personal spaces, resulting in emotional distress and an emergency room visit with a contusion of the occipital region of the scalp. (Harrison Terrace Skilled Nursing Facility)
- Failure to prevent sexual and physical abuse resulted in a female resident being physically and sexually abused by a male resident. (Westpark Healthcare Center)
- Failure to ensure staff to resident abuse did not occur and failed to ensure staff immediately intervened at the time abuse did occur when a nurse pulled the resident to the floor, dragged the resident 20 feet in her room, closed the door, and left the resident on the floor while advising other staff members not to go it to the private room. (Lake Pointe Village Skilled Nursing Home)
- Failure to protect residents in a secured unit from abuse related to a patient with physically and sexually aggressive behavior led to exhibiting symptoms of unprovoked physical aggression to peers and staff. (Majestic Care of West Allen)
Indiana Nursing Home Injury Laws
The Adult Protective Services Act is the governing authority of law intended to protect Indiana nursing home residents. The law sets forth the specific procedure that one should initiate when it is believed that a resident is an "endangered adult" who is the victim of exploitation, abuse, or neglect.
The procedure requires that the witness file a complaint with law enforcement or another reporting agency, cooperate with the agency to obtain protective services for the endangered adult, and comply with notification requirements.
This Act maintains that caregivers have a legal duty to report an endangered adult when they have reason to believe that the adult is endangered.
The individual who files a complaint regarding a resident who is the victim of abuse, neglect, or exploitation is also given immunity under the Adult Protective Services Act. The only individual who may not claim immunity is the one against whom the complaint is filed.
Family members and staff workers can also use a toll-free report hotline in Indiana to report any abuse, neglect, or exploitation incidents. The toll-free hotline in Indiana is 1-(800)-992-6978. Complaints of abuse must be made as soon as possible so that an endangered adult can receive protective services.
Understand the Rights of Nursing Home Residents
Family members should know that nursing home residents are granted a broad scope of rights under federal laws. The Nursing Home Reform Act of 1987 provides numerous rights for residents, including the right to:
- Be free from chemical or physical restraints.
- Be treated with dignity and the right to receive basic necessities of life.
- Use self-determination in medical procedures
- Be free from abuse and neglect.
- Communicate freely with others
- Participate in the development of a long-term care plan
- Be fully informed of changes in a care plan and the right to privacy
Negligent Caregiving at Indiana Nursing Homes
According to the Centers for Medicare and Medicaid Services (CMS), every facility-acquired pressure ulcer (bedsore, pressure wounds, pressure sore, decubitus ulcers) is preventable. Typically, bedsores develop through nursing home negligence when the staff fails to follow established skincare protocol.
The leading contributing factors to developing pressure wounds in nursing homes in Indiana include:
- Lack of Repositioning: Many mobility-challenged residents need assistance in readjusting their body weight at least once every 90 minutes to alleviate pressure on a body part that restricts blood flow, nutrients, and oxygen.
- Incorrect Bed Sizes: Nursing home staffs often place bedridden residents on inappropriately sized mattresses, leading to uncomfortable pressure points and skin breakdowns.
- Limited Mobility: Residents unable to reposition themselves on their own are often neglected by nursing home staff, resulting in the development of pressure ulcers.
- Poor Nutrition: Malnourished residents are more susceptible to developing pressure ulcers due to a weakened immune system.
- Inadequate Staffing Levels: Nursing homes that operate with skeleton crews are more likely to neglect residents and develop pressure ulcers.
- Untreated Infections: Pressure ulcers can easily become infected when not properly treated, putting residents at risk for further health complications.
- Excessive Heat and Moisture: Nursing homes that do not maintain a comfortable temperature and humidity level can cause excessive sweating and skin irritation, leading to pressure ulcer development.
- Incontinence: Residents unable to control their bladder or bowels are often left sitting in their own waste, which can develop pressure ulcers.
- Lack of Hydration: Dehydrated residents are more likely to develop moisture-related skin problems, which can lead to pressure ulcers.
- Late Diagnoses: Pressure ulcers that go untreated for an extended time can become severely infected and even lead to death.
- Poor Wound Care Practices: Improper wound care techniques can cause further damage to already injured skin, leading to the development of pressure ulcers
- Failing to Utilize Assistive Devices: Using low air loss mattresses and pillows to offload pressure on the skin can alleviate many problems that lead to bedsores.
Nursing Home Negligence Leads to Severe Falls Involving the Elderly and Disabled
Nursing home abuse and neglect lead to severe falls involving the elderly and disabled. These falls can cause serious injuries, including broken bones, head injuries, and even death.
According to the Indiana State Department of Insurance, falls in nursing homes in Indiana are one of the leading causes of injury and death for those residing in nursing homes.
Many times, nursing home falls are the result of negligence on the part of the staff that:
- Fail to provide adequate supervision or assistance to residents
- Not provide necessary safety features in the home.
- Not responding quickly enough to a fall or emergency
Contributing factors that lead to most falls at nursing homes in Indiana include:
- Inadequate Handrails: If no handrails are present in areas where residents are walking, they can easily lose their balance and fall. This is especially true if the person is walking on an uneven surface or if they are elderly and have a difficult time balancing properly.
- Lack of Supervision: If staff members are not paying close attention to residents, they may not notice when someone is losing their balance or starting to fall. This can result in a severe fall that causes serious injuries.
- Improperly Cushioned Floors: The floors should be cushioned to help prevent residents from slipping and falling. If the floors are not properly cushioned, it can lead to serious falls.
- Improper Lighting: If the lighting in a nursing home is inadequate, it can be difficult for residents to see where they are going. This can lead to falls, especially if there are any obstacles.
- Uneven Surfaces: Nursing home surfaces should be stable and sturdy so that residents do not lose their balance and fall. If the surfaces are unsteady, it can lead to dangerous falls.
- Not Providing Mobility Assistance: Some residents may need help getting up and walking around, but if they do not receive this assistance, they may fall down instead. Staff should always be available to assist residents who need help moving around.
- Not Checking Bedsores: Bed sores can form when a person is confined to bed for an extended period of time. If these sores are not checked and treated, they can become infected and lead to a fall.
- Allowing Too Much Weight on Mattresses: When mattresses are overloaded with too much weight, they can sag in the middle. This can cause residents to trip and fall when getting out of bed.
- Not Fixing Loose Carpet: Loose or wrinkled carpets can easily cause someone to trip and fall. Nursing homes should ensure all mats are tightly secured and free from wrinkles.
- Poor Lighting: Dim lighting or no lighting can create dangerous walking conditions, leading to falls. All common areas in nursing homes should be well-lit for the safety of all residents.
- Clutter in Hallways and Rooms: Clutter in hallways and rooms can create tripping hazards for residents. Nursing homes should keep all hallways and common areas clear and free from any obstacles or hazards.
- Unsafe Furniture: Nursing homes should regularly check all furniture for safety hazards such as sharp edges or protruding screws. Faulty furniture can easily cause residents to trip and fall.
- Improperly Secured Rugs: Rugs not adequately secured can easily slip out from under someone's feet, leading to a dangerous fall. Nursing home facilities should make sure all rugs are correctly fastened in place.
- Wet Floors: Wet floors can be extremely slippery, especially when wet shoes are worn. Nursing homes should ensure that all floors are kept dry at all times.
- Using Inappropriate Footwear: Wearing the wrong type of shoes on wet or slippery surfaces can often lead to fall accidents. In nursing homes, it is important for staff to enforce a dress code that requires appropriate footwear for the environment.
- Not Training Staff Properly: Some falls occur due to negligence by staff members who are not adequately trained to safely care for elderly residents.
You may be entitled to compensation if you or a loved one has been injured due to a nursing home fall. Contact an experienced attorney today to discuss your case.
Reasons Caregivers Abuse Residents by Physical or Chemical Restraints In a Skilled Nursing Facility
Nursing home staff may use unauthorized physical and chemical restraints to control residents. Physical restraints such as handcuffs, belts, or ropes restrict a person's movement.
Chemical restraints are medications that restrict a person's movement, such as antipsychotic drugs. Unauthorized physical and chemical restraints may be dangerous and may cause serious harm to residents.
The staff may use unauthorized restraints for various reasons, including:
- To Keep Residents from Leaving the Facility: Some staff may feel it is necessary to restrain residents to keep them from leaving the facility.
- To Keep Them from Getting Hurt: Staff may feel it is necessary to restrain residents to keep them safe from harming themselves or others.
- To Keep Them from Acting Out: Staff may feel it is necessary to restrain residents from acting out or being disruptive.
- To Control Their Behavior: Staff may feel it is necessary to restrain residents to control their behavior.
- To Reduce Their Anxiety: Staff may feel it is necessary to restrain residents to reduce their anxiety.
- To Protect Other Residents: Staff may feel it is necessary to restrain residents who are dangerous to other residents.
- To Avoid Having to Deal with Challenging Behaviors: Staff may find it easier to deal with challenging behaviors if the resident is restrained.
- Out of Fear of Lawsuits: Staff may fear lawsuits if a resident injures themselves while unrestrained.
- Out of Fear of Being Sued: Staff may be afraid of being sued if they use unauthorized physical or chemical restraints on a resident.
- Because They Don't Know any Better: Staff may not know that using unauthorized physical or chemical restraints is against the law and can lead to lawsuits and criminal charges.
Implementing Infection Protocols to Maintain a Safe Environment
Long-term care staff must establish an infection prevention protocol to prevent the spread of disease. Healthcare-associated infections (HAIs) are a severe problem in Indiana nursing homes and can lead to increased resident morbidity and mortality. Some common HAIs include pneumonia, urinary tract infections, and skin infections.
Indiana nursing staff can prevent the spread of disease by implementing standard precautions, such as hand hygiene, gloves, and masks when necessary. They should also ensure that all residents are up-to-date on their vaccinations and that all surfaces are regularly cleaned and disinfected.
Infection protocols typically involve:
- Maintaining a clean environment: The Indiana nursing home should be clean and free of clutter. Floors, walls, and furniture should be regularly cleaned and disinfected.
- Disinfecting hands: Nursing staff should disinfect their hands before and after contact with residents.
- Sanitizing equipment: Equipment such as wheelchairs, walkers, and bedpans should be sanitized after each use.
- Cleaning linens: Dirty linens should be removed immediately and replaced with fresh ones
- Handling laundry: Laundry should be handled to minimize the spread of infection.
- Preventing cross-contamination: Staff should take precautions to prevent infection from one resident to another.
- Reporting outbreaks: Staff should report any outbreaks of infection immediately.
- Educating residents and families: Residents and families should be educated about how to prevent the spread of infection.
If a resident develops an infection, nursing home staff should isolate them from other patients and promptly report the infection to the local health department.
Regulations Can't Stop Abuse at Nursing Homes in Indiana
It is appalling that nursing home abuse and neglect still occur even though there are federal regulations all nursing home facilities must fall. Unfortunately, these heinous crimes often go unreported, and the victims are often too intimidated or ashamed to speak up, leaving many vulnerable to mistreatment and abuse, especially the elderly and disabled.
There are several reasons why abuse still occurs in Indiana nursing homes despite regulations. One reason is that staff members may not be properly trained to identify and report abuse. They may also be unaware of proper procedures for preventing and responding to abuse.
Another reason is that long-term care facilities may not have adequate policies and procedures to ensure residents' safety. And finally, some nursing home facilities may be more interested in profits than in providing quality care for their residents.
Abuse can take many forms, including:
- Physical abuse: Nursing home staff or other residents may physically abuse nursing home residents, often causing serious injury.
- Sexual abuse: Nursing home staff or other residents may sexually abuse nursing home residents, often causing physical and emotional damage.
- Financial exploitation: Nursing home residents may be financially exploited by staff or other residents, often resulting in loss of money or property.
- Emotional abuse: Nursing home residents may be subjected to emotional abuse by staff or other residents, which can cause lasting psychological damage.
- Social isolation: Nursing home residents may be isolated from their families and friends, leading to loneliness and isolation.
- Lack of appropriate clothing: Nursing home residents may not be dressed appropriately for the weather or the season, which can lead to discomfort and health problems.
- Limited access to recreational activities: Nursing home residents may not have access to recreational activities, which can lead to boredom and frustration
Accident Hazards
Injuries and fatalities in nursing homes often result from preventable accidents. Many hazards exist in these settings that can lead to severe injuries and even death. Some contributing factors leading to accident hazards in Indiana nursing homes include:
- Unsafe Equipment: Heavy equipment that is not adequately secured can easily fall on residents, causing serious injury.
- Poor Lighting: Dimly lit areas can easily cause residents to trip and fall.
- Cluttered Hallways: Residents can easily trip over cords and cables in the hallways.
- Poor Maintenance: Flooring that is wet or uneven can easily cause senior living home residents to slip and fall.
- Inadequate Staffing: Not enough staff members on duty can lead to a delay in responding to an accident or injury.
- Lack of Training: Staff not properly trained in responding to an accident may not know what to do in a crisis.
- Limited Accessibility: Long-term care facilities not accessible to people with disabilities can easily lead to accidents for those residents.
- Poor Communication: If staff members are not properly communicating with one another, it can lead to confusion during an emergency.
- No Emergency Plan: If there is no emergency plan in place, it can be difficult for staff members to know what to do in the event of an accident or injury
Resources:
Skilled nursing homes in Indiana that accept Medicare funding:
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