Problems with Quality Care in Nursing Homes

January 9, 2012 0 Comments

According to the Department of Health and Human Services website, each year, more than 23,000 Arkansans receive services in long-term care facilities licensed and inspected by the Office of Long Term Care (OLTC). Long-term care facilities include: nursing facilities, intermediate care facilities for the intellectually disabled (ICFs), assisted living facilities, residential care facilities, adult day cares and, post-acute head injury retraining residential facilities. Nursing homes are expected to provide for social, dietary and medical care needs for their residents. If you are considering a nursing home, here are some things you should take into consideration.

According to medicare.gov there are 234 nursing homes available for review in their Nursing Home Compare database. Anyone can preview the ratings for these facilities online. It is very important to know about the facility you are considering because many times, nursing homes are more concerned about making a profit than they are about health-care. According to http://www.statehealthfacts.org, the percentage of Arkansas nursing homes in 2009 with deficiencies which posed a risk for negative impact on the health and safety of a resident was 97%. That same year, 32.5% of those nursing homes were found to have serious deficiencies that resulted in actual harm to patients. The average number of deficiencies at each Arkansas nursing home was 12.2 in 2009 for Arkansas and 10 for the U.S average.

Based on the Online Survey, Certification, and Reporting system (OSCAR), Centers for Medicare and Medicaid Services, and the U.S. Department of Health and Human Services, the percent of Certified Nursing Facilities with Top Ten Deficiencies in Arkansas, in 2009 are shown below:

  • Comprehensive Care Plans 7%
  • Unnecessary Drugs 20%
  • Clinical Records 9%
  • Pressure Sores 47%
  • Housekeeping 16%
  • Accident Environment 78%
  • Food Sanitation 52%
  • Quality of Care 60%
  • Professional Standards 2%
  • Infection Control 39%

Low staffing levels are one of the biggest concerns in nursing homes. In 2009 the average nurse hours per resident day in all certified nursing facilities in Arkansas for licensed nurses was 1.4.  There is no reason to excuse this because every nursing home in America that accepts government money in the form of Medicare or Medicaid must comply with state and federal regulations. Nevertheless, many for profit nursing homes across the country have a higher incidence
of understaffing because the lower management costs mean more profit. Distribution of Arkansas nursing homes according to www.statehealthfacts.org was 82% for profit compared to non-profit at 14% and government owned at 4%. Arkansas Certified Nursing Facilities that receive payments from Medicaid and Medicare as the primary Payer Source total 79%.

Most of the problems associated with nursing homes are almost always avoidable with scheduled and documented turning and repositioning, proper nutrition/hydration, and hygiene. Because of this, Arkansas has regulations that use a specific staffing formula that requires a certain number of staff members to be in the building based on the number residents in the building and the level of care they require. Problems in these categories are generally caused by serious deficiencies related to understaffing. The serious injuries that can occur as a result of this include pressure sores, resident weight loss, falls, infections, resident mistreatment, poor sanitary conditions and similar problems. For more information please visit www.statehealthfacts.org/about.jsp

Source information regarding top 10 deficiencies is available at http://pascenter.org.