Differentiating Degrees Of Deficiency In Nursing Homes

Degrees Of Deficiency In Nursing HomesWhenever there is a state or Federal inspection of a nursing home for regulation compliance, there are bound to be some violations found. The magnitude of operation details that inspectors are grading is enormous. Even the most stringently run home is expected to have some violations. These reports and inspections are public record and families with loved ones in a nursing home should be keeping an eye their facility to see how they score.  However they need to differentiate between minute transgressions and the violations that can really matter.

Minor Violations Involving Nursing Homes

Although any violation of health or safety codes need to be corrected, some are less likely to cause harm to the residents at these homes. Many are also easily corrected. One alarm that is not working on a door is a violation and is a serious safety issue. However, getting that alarm fixed should be fairly quick. Keeping in mind that any violations should be fixed, these types of violations are not necessarily indications of neglect and abuse.

  • A plant or object that is put in an area where it may be tripped on
  • Call button not working in one room
  • Water temperature

On the reports, these items are graded on whether they are isolated incidences or widespread throughout the facility. They are also rated on level of harm.

Major Violations Involving Nursing Homes

The violations that are concerning are ones that are either widespread, meaning they are neglecting to provide that particular service throughout the facility, or ones that pose immediate harm to patients. While it may be minor for one door alarm to not be working, it is another thing for the system not to be working properly throughout the facility.

This is what they found at a facility that was inspected after a women’s death in 2011. Hattie Mae Chambers, who suffered from dementia, died after leaving the facility of her own accord on a hot summer day. She was found several hours later, deceased with a body temperature of 118 degrees. An inspection on the facility found that the door alarms batteries had not been checked, the entire system was not functioning correctly and one door had been voluntarily disabled.

Other major violations that should cause concern are:

  • Lack of criminal background checks on employees
  • Pressure sores and other ailments that may be signs of neglect
  • Restraints used on patients in either physical or medical form
  • Any violation where a patient was harmed

Although the inspection process is not perfect, it does give some useful information on how the facilities are being managed. However, it is doubtful that inspectors are going to witness the type of violations that are most severe such as abuse and neglect, but they may uncover signs that it may be happening.

Families of loved ones in nursing homes can use these reports as a guideline to choose a nursing home or keep an eye on one that is caring for a loved one, but nothing replaces doing their own research. The best way to know how a facility is treating patients is to be there often, at different times and make sure their loved one and other residents are receiving the care they deserve.


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Jonathan did a great job helping my family navigate through a lengthy lawsuit involving my grandmother's death in a nursing home. Through every step of the case, Jonathan kept my family informed of the progression of the case. Although our case eventually settled at a mediation, I really was impressed at how well prepared Jonathan was to take the case to trial. Lisa
After I read Jonathan’s Nursing Home Blog, I decided to hire him to look into my wife’s treatment at a local nursing home. Jonathan did a great job explaining the process and the laws that apply to nursing homes. I immediately felt at ease and was glad to have him on my side. Though the lawsuit process was at times frustrating, Jonathan reassured me, particularly at my deposition. I really felt like Jonathan cared about my wife’s best interests, and I think that came across to the lawyers for the nursing home. Eric