Nursing Homes in Virginia

According to Medicare.gov, there are 288 nursing homes in Virginia. Data reveals that 142 (49%) nursing facilities rank at or above the national average in their healthcare services. The remaining 146 (51%) nursing homes rank below average or much below average according to the Centers for Medicare and Medicaid Services (CMS) acceptable standards.

It's a sad fact that nursing home abuse and neglect are all too common in our society. Every year, thousands of elderly people are injured or even killed due to abuse or neglect by caretakers in nursing homes nationwide.

According to the National Center on Elder Abuse, it is estimated that 1 in 10 adults over the age of 60 has experienced some form of elder abuse. Nursing home abuse and neglect are serious problems in the United States and those with loved ones in nursing homes must be aware of the signs.

The elderly are often neglected in Virginia nursing homes. They may be left unattended for hours, even days, at a time. Their needs aren’t always met, and their food isn’t always nutritious.

Below is a small sample of serious violations occurring at Virginia nursing homes, assisted living communities, and rehabilitation centers.

Failure to Protect Every Resident from All Forms of Abuse, Including Physical and Sexual Assault, Physical Punishment, and Neglect by Anybody

Nursing home abuse and neglect can include physical and sexual assault, punishment, or negligence. Abuse can take many forms, such as slapping, hitting, pushing, or kicking. It can also include sexual abuse, such as unwanted touching or rape.

Neglect can involve leaving a person alone for long periods, not providing necessary medication or nursing home care, or failing to clean up excrement and other body fluids. Punishment includes withholding food or water, refusing to change bedding or verbal abuse.

Recent citations and violations involving long-term care facilities and nursing homes in Virginia abusing or neglecting residents include:

• Failure to ensure two residents were free from abuse involved one patient who was intentionally restricted from movement when the staff tied them in a top bedsheet and tied the corners to the bed frame and rail. The other patient was mentally and verbally abused by the registered nurse, who threatened a 30-day notice of discharge. (Autumn Care of Suffolk)
• Failure to ensure a resident was free from abuse, separated, and protected from another resident after a sexual encounter between both parties that was followed by a separate incident of sexual assault two weeks later. (Consulate Health Care Center of Windsor)
• Failure to implement a facility abuse policy for one resident with an injury of unknown origin who sustained a bruise. (Rose Hill Health and Rehabilitation Center)
• Failure to timely report misappropriation of a resident’s property to the appropriate state survey agency. (Wonder City Rehabilitation and Health Care Center)
• Failure to implement their abuse policy regarding employee screening involving 15 caregivers who did not have a criminal background check within the first 30 days of hiring and professional license verification. (Battlefield Park Healthcare Center)
• Failure to prevent abuse for one resident after a nurse aide left the patient on the floor after a fall and closed the room door in December 2021. (Beaufont Rehabilitation and Health Care Center)
• Failure to implement the facility abuse and neglect policies for newly hired employees by not conducting criminal background checks. (Choice Healthcare of Roanoke)

Failure to Provide Every Resident an Environment Free of Accident Hazards and Provide Adequate Supervision to Prevent Avoidable Accidents

Nursing home residents are susceptible to various preventable accidents. One of the most common types of preventable accidents in nursing homes is slip and fall accidents.

These accidents can often be prevented by taking simple safety precautions, such as ensuring that residents do not have any obstacles or spills on the floor that could cause them to slip. In addition, residents should be monitored to ensure that they are not in danger of falling, for example, if they are unsteady on their feet.

Recent citations and violations involving accident hazards in nursing homes in Virginia include:

• Failure to mitigate a known accident hazard for one resident who was not assisted with dressing and found to be half-dressed, lying across the bed with one of the port caths from the catheter site removed, leading to the patient’s death by exsanguination (severe blood loss). (Emporia Rehabilitation and Health Care Center)
• Failure to provide supervision to prevent accidents/falls for one resident at high risk for falling that had recorded eight falls in the past 30 days. (Emporia Rehabilitation and Health Care Center)

Failure to Provide and Implement an Infection Prevention and Control Program

Nursing home residents risk spreading deadly diseases if an infection prevention and control program is not implemented. A study by the Centers for Disease Control and Prevention found that failure to properly disinfect medical equipment led to the spread of bloodborne pathogens, including hepatitis C and HIV, in nursing homes.

Another nursing care study found that staff members' lack of hand hygiene significantly contributed to the spread of healthcare-associated infections, such as MRSA and C. difficile.

Recent citations and violations involving deadly infections and viruses in nursing homes in Virginia include:

• Failure to ensure that one resident was wearing a facial covering as part of a source controlled being transferred from one room to another on different hallways during the time of Covid-19 restrictions. (Autumn Care of Suffolk Nursing Home)

Failure to Provide Appropriate Pressure Ulcer Care Prevent New Ulcers from Developing

Nursing home residents are particularly vulnerable to pressure ulcer infections, also known as bedsores, due to their age and frailty. These debilitating and often deadly infections can be caused by licensed and registered nurses failing to follow pressure ulcer protocols, including proper wound care, nutrition, and hydration.

Pressure ulcers form when there is constant pressure on an area of skin, often caused by sitting or lying in the same position for a long time. This pressure cuts off the blood supply to the skin, leading to tissue damage and potential infection.

Left untreated, pressure ulcers can quickly become infected and lead to sepsis, a potentially deadly condition that occurs when the body's immune system goes into overdrive in response to infection. In severe cases, sepsis can result in organ failure and death.

Recent citations and violations involving deadly infections and viruses in Virginia nursing homes include:

• Failure to provide necessary long-term care and services to prevent the development and promote healing of a facility-acquired pressure injury after the staff failed to identify the wound and notify a physician of healing decline before it was identified as an unstageable pressure wound. (Consulate Health Care of Windsor)
• Failure to assess and provide personal care/treatment to pressure ulcers for one resident with pressure ulcers and no physician order care or treatment. (Albemarle Health & Rehabilitation Center)
• Failure to provide care and services per professional standards for a resident with significant pressure injuries on the left foot and big toe with medical records that failed to identify if care had been given. (Ashland Nursing and Rehabilitation Center)

The Dangers of Malnutrition and Dehydration in Nursing Homes

You might picture a nursing home as a warm and inviting place where your elderly loved ones can receive the care and assistance they need. However, you might not realize those nursing care facilities and assisted living communities can be dangerous places. One of the biggest dangers facing residents of nursing homes is the risk of malnutrition and dehydration.

What is Malnutrition?

Malnutrition is a condition that occurs when a person does not consume enough nutrients or consumes too many nutrients. Malnutrition can lead to several serious health problems, including weakness, organ damage, and even death.

One of the most common forms of malnutrition is protein-energy malnutrition (PEM), which is caused by a lack of calories and protein. PEM can cause muscle wasting, organ damage, and developmental delays in children. In adults, PEM can weaken the immune system, making it more difficult to fight off infection.

What is Dehydration?

Dehydration occurs when a person loses more fluids than they take in. Dehydration can cause serious health problems, including electrolyte imbalances, hypotension, heat stroke, and kidney failure.

Dehydration is particularly dangerous for elderly people because they are more likely to have underlying medical conditions exacerbated by dehydration. For example, dehydration can worsen arthritis pain, constipation, and urinary tract infections. Dehydration can also increase the risk of falls and fractures.

How Common are Malnutrition and Dehydration in Nursing Homes?

According to the Virginia Department of Social Services (VDSS), malnutrition and dehydration are unfortunately common in nursing homes. A study published in the Journal of the American Geriatrics Society found that 35% of nursing home residents receiving long-term care services were dehydrated, and 23% were malnourished.

Another long-term care study found that 37% of nursing home residents were at risk for dehydration, and 60% were at risk for malnutrition. The study also found that nursing home patients and home health care residents who were dehydrated or malnourished were more likely to be admitted to the hospital or die than those who were not dehydrated or malnourished.

The risks associated with malnutrition and dehydration are clear; both conditions can lead to serious health problems or even death. If you have a loved one living in a nursing center, it's essential to be aware of the signs and symptoms of these conditions to ensure they receive the treatment they need to ensure their well-being.

Why Nursing Home Bedsores Are Common

Nursing home residents often develop bedsores when the nursing staff does not adequately monitor them. Bedsores (pressure ulcers) are lesions that can form on the skin when a person is sitting or reclining for an extended period.

Bedsores are a common problem in nursing homes and can be very difficult to treat. If they are not caught and treated early, they can become infected, leading to other health complications. In some cases, bedsores can even be fatal.

Nursing residents develop bedsores through the nursing staff’s negligence by:

• Failing to readjust a mobility-challenged resident at least once every 90 minutes: Some disabled, elderly, and paralyzed residents require assistance to readjust their body weight to eliminate restricted blood flow to the skin, which could lead to developing a pressure wound.
• Not providing enough staff to properly attend to all residents: It can result in residents not being turned or repositioned often enough, leading to the development of pressure sores.
• Allowing residents to sit or lie in their feces and urine can cause skin breakdown and increase the likelihood of developing bedsores.
• Not cleaning bedridden patients regularly: Bed sores can form when dirt, sweat, and other fluids build up on the skin.
• Not using pressure-relieving mattresses and devices: Pressure-relieving devices help distribute the resident's weight evenly, preventing the development of pressure sores.
• Not providing nutritional support: Malnutrition can weaken the immune system, making it more difficult for the body to fight against infection and leading to bedsores.
• Not treating existing bedsores: Bedsores left untreated can become severely infected and lead to death.
• Ignoring signs of developing bedsores: Early recognition of pressure ulcers is key in preventing them from worsening.
• Applying treatments incorrectly: Incorrect treatment of pressure ulcers can delay healing and lead to infection.
• Not providing enough water or fluids: Dehydration can increase the risk of developing a pressure sore.
• Keeping patients in uncomfortable positions: It can cause unnecessary stress on certain muscles and blood vessels, developing a pressure sore.
• Allowing patients to wear wet clothing or bedding: Wearing damp clothing or bedding can cause skin irritation and increase the likelihood of developing bedsores.
• Not providing adequate cushioning for wheelchair users: Wheelchair users risk developing pressure sores without proper cushioning.
• Placing medical equipment on patient's skin: Medical equipment left in contact with a patient's skin for an extended period can cause skin breakdown and lead to the development of bedsores.

The best way to prevent bedsores is by monitoring the residents closely and turning or moving them often. The nursing staff should also be aware of the risk factors for developing bedsores, such as being overweight or having diabetes.

Resources:

• Claims & appeals | Medicare
• Pressure Sores | Johns Hopkins Medicine

Virginia nursing homes and skilled nursing facilities that accept Medicare funding: