Information and Lawsuits Involving Nursing Home Chains

lonely-empty-wheelchair-nursing-home-chainNursing home care is an area where there is often a fundamental conflict between the interests of the nursing home owner and those of the resident and their family. Many of the nursing homes in existence provide excellent care for their residents, while at the same time, managing to return profits to their owners. Unfortunately, some nursing homes view anything that is expended on resident care as something that cuts into the profits for the owners. This is something that families who are struggling to find the right solution to the needs of their loved one should not have to worry about but now need to consider.

Statistics on Nursing Home Ownership

According to the Centers for Disease Control, there are approximately 15,600 nursing homes in the United States with a total of 1.7 million beds. In 2015, expenditures on long-term care reached approximately $225 billion. Nearly 70 percent of these nursing homes have for-profit ownership.

Approximately 52 percent of all nursing home beds belong to chains. The largest chains have experienced growth in recent years as they have taken over failing smaller chains. In 2011, the top ten largest chains controlled a combined total of approximately 2,000 nursing homes. The number has grown since then.

Deteriorating Quality of Care in Nursing Homes

The quality of care that is provided in nursing homes has deteriorated in this century. The United States Government Accountability Office has documented that the number of customer complaints about nursing homes has grown dramatically between 2005 and 2014. For example, the number of consumer complaints about nursing homes in California has more than tripled in that timeframe from 1.1 complaints against each home to five annually. On a state-by-state basis, there have been an increase in the number of complaints filed in 33 of the 50 states.

There are several disturbing trends that have become apparent in nursing home care. One of these trends is an increase in private equity ownership of nursing homes. While there is nothing that makes these transactions illegal, the practical impact can have bad consequences for residents and their families. When these transactions occur, the owners of the nursing home seem to answer first to the investors and second to the residents’ needs. In this context, the nursing homes engage in transactions with related parties that are designed to increase profits for the investors. At the same time, the nursing homes then claim that they are experiencing financial difficulties.

Nursing homes that are owned by private equity as well as by large chains have often been accused on cutting back staffing in order to enhance their profits. Adequate staffing is at the heart of operating a nursing home, since facilities must provide help for those who cannot help themselves. There have been numerous lawsuits against nursing homes for injury to residents that could have been avoided had the nursing home made sure that there was enough staff on hand. Instead, some nursing homes consciously try to keep staffing to a bare minimum to inflate their profits. Some states have tried to increase the minimum staffing levels required, but have experienced fierce pushback from nursing homes. There have been a number of class action lawsuits against nursing homes for inadequate staffing, especially in California.

Problems in care delivery are typically more acute at the larger nursing home chains. A 2011 study from the University of California at San Francisco showed that the ten largest nursing home chains had the lowest level of staffing in the nursing home industry. The study found that non-profit and government-owned homes had far higher levels of staffing that homes owned by large chains. Staffing levels tend to be predictive of several other vital issues including the number of deficiencies that each home has on its inspections as well as the health of the residents. The study also found that the number of deficiencies in nursing home chains that were purchased by private equity funds increased after the transaction.

How Staffing Levels Affect Nursing Home Care

Low staffing levels flow through to a number of areas that affect the resident’s daily life and overall health. Each of these areas has been the subject of lawsuits against the nursing home. For example, pressure ulcers is one of the most common grounds in lawsuits against nursing homes. This condition, otherwise known as bedsores, results when residents are left in one position for too long. When residents have been diagnosed as at risk for pressure ulcers, nursing home staff should shift their position every two hours. If not, the skin breaks down. When pressure ulcers are not treated properly, they can result in acute infections. When nursing homes do not have enough staff, there is nobody that can move the residents, resulting in higher incidents of pressure ulcers.

Also, nursing homes that are understaffed experience falls by their residents at a higher rate. There have been lawsuits against nursing homes that have alleged that understaffed homes have attempted to move residents with one CNA as opposed to the two that were required by the resident’s care orders. There have been other lawsuits against nursing homes that have alleged that residents suffered injury when their call light went ignored and they tried to move themselves when they were unable.

Further, understaffed nursing homes tend to make mistakes in other areas, such as the resident’s care. Sometimes, this means that nursing homes fail to follow physician’s orders with respect to the medical care. Other times, it means that residents are at higher risk of infection because showers are not given and catheters are not changed. While greater staffing does not prevent all errors and omissions, there is a strong correlation because homes that are adequate staffed and homes that are fully compliant with nursing home regulations.

What You Can Do If You Suspect Injury or Abuse of a Nursing Home Patient?

When your loved one has suffered an injury at a nursing home due to problems such as these, you do not simply have to accept it and move on. You can retain a lawyer and file a claim against the nursing home, especially when the injury suffered by your loved one occurred at a facility that is chronically understaffed. You may be eligible for compensation from the nursing home for the harm that your loved one has suffered.

Nursing Home Abuse & Neglect Resources
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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