According to Medicare.gov, there are 923 skilled nursing homes in Ohio. Of those skilled nursing facilities, approximately 462 (50%) percent score above the national averages for quality of care, whereas 461(51%) percent fall below the national averages.
These poor scores fall well below the Ohio state and federal Medicaid and Medicare acceptable thresholds. Unqualified skilled nursing staff may not be trained well enough to provide adequate patient services. They might not even know how to take good patient histories.
Below is a small sample of the types of abuse, mistreatment, and negligence documented in nursing homes in Ohio.
Failure to Protect Residents in Skilled Nursing Facilities From all Forms of Abuse and Neglect
Neglect can occur when someone fails to provide the basic necessities required for survival. Abuse is when someone deliberately causes harm to another. It may include physical or sexual assaults, mental or emotional abuse, financial exploitation, abandonment, neglect, and other mistreatment.
There are still instances where mistreatment occurs in Ohio nursing homes, assisted living communities, long-stay health care facilities, and rehabilitation centers. These include physical and sexual abuse, neglect, and financial exploitation.
Many nursing home residents in Ohio experience serious health issues due to inadequate care. These include preventable bedsores, malnutrition, dehydration, unsanitized conditions, and poor personal hygienic practices. Some cases involving abuse at nursing homes in Ohio include:
- Failing to ensure patients were free from verbal abuse after a resident asked a Registered Nurse about medication and the nurse "cussed at him." (Astoria at Place of Cincinnati)
- Failure to report a potential occurrence of misappropriation of resident medications to the Ohio Department of Health, including the test results of a resident with documentation of receiving opioids but whose urine tested the negative presence of opiates. (Carecore at the Meadows)
- Failure to ensure a resident environment was free from accident hazards when their bed/air mattress was not properly sized to the bed frame. (Embassy of Logan)
- Failure to ensure that all smokers were supervised as assessed and failed to ensure patients returned smoking materials (cigarettes and lighters) to staff after breaks. (Gardens at Belden Village)
- Failure to prevent staff-to-resident abuse after an investigation revealed that a resident up in his wheelchair during the midnight shift called a Registered Nurse after noticing his urinary catheter leaked, when the RN replied that "she did not give a (expletive) what he needed, she was not changing him, and he could just sit at his (expletive). (Gardens of Belden Village)
- Failure to prevent an incident of neglect involving a cognitively impaired resident with bowel incontinence who had been placed on a bedpan putting pressure on a deep tissue injury. (Kent Healthcare and Rehabilitation)
- Failure to ensure long-term care patients were free from neglect by providing an ongoing and timely assessment resulted in immediate jeopardy and serious life-threatening harm when a resident pleaded to go to the hospital after experiencing abdominal pain and distention. (Laurels of Defiance)
- Failure to ensure a resident at risk for falls had care plan interventions and did not investigate the root cause of falls after an immediate jeopardy occurred when they did not transport the fallen resident to a local hospital after suffering a level II trauma malar fracture and rib fracture requiring surgery. (Majestic Care of Columbus)
- Failure to ensure a resident was free from neglect when staff did not respond timely and correctly to a medical emergency involving a resident who needed CPR after being found unresponsive. (Sanctuary at Wilmington Place)
- Failure to ensure nursing home patients were protected from mental abuse by staff resulted in actual harm when a staff member posted a video of a resident on social media (snap chat) of the patient sitting on the toilet with feces on her leg. (Shawnee Manor Nursing Home)
Nursing Home Falls
Nearly everyone residing in nursing homes, skilled nursing facilities and rehabilitation centers are elderly, disabled, or rehabilitating from an injury or surgical procedure. Many are mobility challenged, needing assistance and monitoring to ensure they do not fall when performing activities of daily living.
Data reveals that nearly all falls occurring in caregiving facilities result from substandard care by the nurses, certified nurse's aides, and licensed practical nurses providing care in a nursing home. The most common contributing factor leading to falls and Ohio nursing homes include:
- Staff Interaction: Staff interaction with residents can often lead to falls, as patients may become confused or disoriented after being spoken to abruptly or touched unexpectedly. Nursing homes should ensure that staff always interact with patients calmly and politely.
- Inattentive Staff: Nursing home staff must be attentive to residents' needs, especially those at risk for falls. Inattentive staff can lead to falls by not noticing when a resident needs help or by not providing timely assistance.
- Poor Lighting: Dim lighting or lighting that is not evenly distributed can create dangerous conditions and increase the risk of falls. Nursing homes should make sure that all areas of the home are well-lit.
- Cluttered Hallways: Cluttered hallways can create obstacles that patients may not see in time, leading to falls. Nursing homes should keep hallways and common areas clear and free of hazards.
- Incorrect Bed Heights: Incorrect bed heights can cause residents to fall out of bed or off the side of the bed. Nursing homes should ensure that beds are at the correct height for each resident.
- Improperly Fitted Mattresses: Improperly fitted mattresses can cause patients to roll off the bed or become trapped in rails and lead to serious falls. Nursing homes should make sure that mattresses are properly fitted for each resident.
- Lack of Handrails: Lack of handrails in nursing homes in Ohio can lead to falls, as residents may not be able to balance themselves without assistance. Nursing homes should install handrails in all common areas and in areas where patients are likely to need them.
- Slippery Floors: Wet or icy floors in Ohio nursing homes can lead to serious slips and falls. Nursing homes should take precautions to ensure that floors are always safe for patients to walk on.
- Poor Medication Management: Incorrect medication dosages or medications incompatible with one another can lead to severe falls. Nursing homes should have a system for verifying medication orders and ensuring that medications are properly administered.
- Limited Mobility: Limited mobility can make it difficult for nursing home patients to get around their homes safely, which can lead to falls. Nursing homes should provide assistance and equipment for patients with limited mobility.
According to the Ohio Department of Health, the skilled nursing staff must report every witnessed and unwitnessed fall occurring in a nursing home, documenting what happened during the event that led to any minor or major injury or death.
Keeping Nursing Home Residents Safe: The Improper Use of Physical and Chemical Restraints in Nursing Homes
According to the Centers for Medicare and Medicaid Services (CMS), nursing homes in Ohio must follow established protocols when using physical or chemical restraints, including obtaining informed consent from the resident or the resident's representative. Unfortunately, many nursing facility staff will use chemical restraints to over-sedate the resident for convenience.
The authorized and unauthorized use of physical and chemical restraints in a nursing facility might involve:
- Refusing to Cooperate: Staff who refuse to cooperate with patients can make them angry and frustrated, leading to tension and conflict.
- Time-consuming: It takes time to put on and take off restraints, which can interfere with other tasks that need to be done.
- Lack of Training: Some staff may restrain patients due to a lack of training on effectively dealing with difficult behaviors.
- Fear of Violence: Staff may restrain residents who they fear may become violent.
- Convenience: Staff may use restraints to control patients and make their work easier.
- Lack of Knowledge about Alternatives: Nurses and nurse aides may not know other ways to deal with difficult behaviors besides using restraints.
- Limited Resources: Staff may not have the resources necessary to deal with difficult behaviors without using restraints.
- Pressure from Management: Nursing home staff may feel pressure from management to use restraints to maintain control in the home.
- The Perception that Restraints are Safe and Effective: Nursing home staff may believe that restraints are safe and effective methods for dealing with difficult behaviors.
- The Belief that Restraints are Necessary to Prevent Injuries: Staff may believe that restraints are necessary to prevent patients from injuring themselves or others.
- Desire to Maintain Resident's Dignity: Staff may feel it is important to maintain the nursing home resident's dignity and not unnecessarily use physical or chemical restraints.
- Lack of Communication between Staff Members: Poor communication between staff members can lead to misunderstandings about why a nursing home resident is being restrained, which can lead to the use of unauthorized physical or chemical restraints.
Other nurses and nurse's aides in Ohio nursing homes may use physical restraints to ensure that a resident remains in place while seated in a wheelchair or bed. However, any unauthorized use of a restraint is illegal and must be reported to the proper authorities, including the Ohio Department of Health and local law enforcement.
Mandated Infection Protocols in Ohio Nursing Homes
The Centers for Medicare and Medicaid Services (CMS) and the Ohio Department of Health require all Ohio nursing homes to develop and enforce infection prevention and control protocols to eliminate the spread of infection and cross-contamination.
An effective infection prevention protocol in every individual nursing home can help eliminate highly contagious infections, including Methicillin-resistant Staphylococcus aureus, Clostridium difficile, Norovirus, and others.
The most effective procedures to prevent infection from spreading between patients and staff include:
- Hand hygiene: Nursing home staff should take precautions to prevent the spread of infection from one resident to another by washing their hands regularly and properly using soap and water or an alcohol-based hand sanitizer.
- Cleaning and disinfecting: Staff should clean and disinfect all devices and equipment that come into contact with patients, using appropriate cleaners and disinfectants.
- Personal protective equipment: Staff should wear gloves, masks, and other personal protective equipment when necessary to prevent the spread of infection.
- Safe food handling: Staff should take precautions to prevent the spread of infection from foodborne sources.
- Safe injection practices: Nursing home staff should take precautions to prevent the spread of infection from injection needles and other medical equipment.
- Respiratory hygiene and cough etiquette: Staff should advise patients to cover their nose and mouth when they sneeze or cough and to use a tissue if possible. They should also practice good respiratory hygiene by washing their hands often.
- Bed bugs: Staff should be aware of the signs of bed bugs infestation and take precautions to prevent the spread of these pests.
- Environmental cleaning: Nursing home staff should clean environmental surfaces (floors, walls, ceilings) regularly to prevent the accumulation of dirt and dust that can harbor bacteria."
Nursing Home Lawyers Serving Victims of Bed Sores, Pressure Sores & Decubitus Ulcers
While bedsores are common and persistent problems in nursing facilities, most can be prevented if the medical staff responds appropriately when a sore is detected. When the patient acquires any bed sore (decubitus ulcers, pressure ulcers, pressure sores) at the nursing facility, it can indicate neglect.
Families will often hire an Ohio bed sore attorney to take steps to stop the abuse, mistreatment, or neglect immediately.
Because the aging population in Ohio has risen significantly over the last few years, the need for nursing home beds has increased too. This is because many seniors living alone often cannot perform daily activities without assistance, are recovering from surgery, or have medical problems requiring constant monitoring.
While living as patients of a nursing home, their health care is placed in the hands of professional health care providers who hopefully are trained to provide basic needs, prescription medications, and medical requirements.
- Failure to Perform Daily Skin Assessments: The staff must perform a skin assessment on every patients with a high risk of developing pressure wounds to identify any redness, edema, lesions, or changes in skin temperature that may indicate the development of a pressure ulcer.
- Failure to Recognize and Respond to Skin Changes: Staff must be aware of normal skin changes and how to respond when they occur. Unusual skin changes should be reported to the physician immediately.
- Inadequate Documentation of Skin Assessments: Documentation of skin assessments must include the date, time, location of assessment, findings, and any interventions taken.
- Failure to Treat Ulcers Promptly: Pressure ulcers identified and treated early have a better prognosis than those allowed to progress.
- Use of Unapproved Products: Some products may be effective in treating pressure ulcers but have not been approved by the FDA for this use. These products may not be safe or effective and could delay wound healing.
- Incorrect Dressing Application: Improper wound dressing can lead to excessive moisture accumulation, maceration of the skin, and an increased risk of infection.
- Failure to Change Dressings as Required: A dressing should be changed when it becomes wet, soiled, or adhesive is no longer sticking to the skin.
- Lack of Adequate Staffing: Not enough staff can lead to delays in providing care, including wound care.
- Poor Nutrition and Hydration: Poor nutrition and hydration can slow wound healing.
- Pressure Ulcers Caused by External Devices: External devices such as casts, braces, or wheelchairs can cause pressure ulcers if they are not properly fitted or adjusted.
- Incontinence and Foley Catheters: Using a Foley catheter can increase the risk of developing a pressure ulcer.
- Pressure Ulcers Caused by Bed Sores: Bed sores can cause pressure ulcers when left untreated.
However, due to the demand for medical professionals in Ohio, the numbers of available registered nurses and nursing aides for hire are limited. Because of that, many nursing facilities are forced to hire unskilled and untrained caregivers, which often puts the resident's health at risk.
As a result, the patient's quality of life is often diminished, and their exposure to developing serious health issues is increased.
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When Abuse and Neglect Harms Residents in Skilled Nursing Facility
Each year, the Ohio Department of Health (ODH) investigates hundreds of allegations of abuse and neglect against residents in skilled nursing facilities (SNFs). In some cases, the abuse or neglect leads to serious harm, or even death, for the resident.
One study found that patients were harmed due to abuse and neglect in many ways, including physical injury, psychological distress, and even death. The data revealed that most residents abused or neglected did not receive appropriate care or timely medical attention.
In some cases, patients died directly from the abuse or neglect they experienced. The common types of abuse and neglect in Ohio nursing homes include:
- Physical abuse: Any hitting, slapping, punching, choking, tripping, or other physical harm can lead to emotional trauma, physical injuries, or death.
- Emotional abuse: Threatening patients, calling them names, or humiliating them can cause long-term psychological damage.
- Sexual abuse: Forcing nursing home residents to participate in sexual activities or touching them inappropriately can be extremely damaging.
- Financial abuse: Taking money or possessions from patients without permission or coercing them into signing documents they don't understand is a common form of abuse.
- Neglect: Failing to provide basic needs in Ohio nursing homes like food, water, clothing, and shelter can lead to severe health problems and even death.
- Medical neglect: Ignoring the rehab center residents' medical needs or providing inadequate care can cause serious illness or death.
- Unsanitary conditions: Allowing rooms and bathrooms to become filthy, not providing necessary personal hygiene items, and failing to change bedding can lead to infections and other health problems.
- Dangerous living conditions: Not having adequate safety features (like railings on stairs), not checking smoke detectors regularly, and using dangerous equipment can result in serious injury or death.
- Psychological abuse: Making fun of residents' appearance or behavior and threatening, or isolating them from friends and family can be just as damaging as any other type of abuse.
- Restricted freedom: Preventing residents from leaving the premises or going about their day-to-day lives without justification can be very harmful.
- Poor nutrition: Serving insufficient or unhealthy food can lead to malnutrition and other health problems.
- Inadequate staffing: Not having enough staff members on duty leads to longer waiting times for care, fewer opportunities for socialization, and overall lower quality of life for residents.
- Poorly trained staff: Rehab center employees who are inadequately trained in elder care can cause great harm through their actions (or lack thereof).
- Overuse of restraints: Restraining residents against their will for no valid reason is unethical and unsafe.
Resources:
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