According to the Office of Inspector General Report called Trends in Nursing Home Deficiencies and Complaints:

Survey and Certification Process All nursing homes that participate in Medicare and/or Medicaid must be certified as meeting certain Federal requirements. The Centers for Medicare & Medicaid Services (CMS) contracts with States to perform nursing home surveys before nursing homes may be certified. States must conduct these standard surveys at least every 15 months, and the Statewide average interval between surveys must be 12 months or less. Surveys are unannounced and may be conducted at any hour on any day. Surveys assess medical, nursing, and rehabilitative care; dietary and nutrition services; activities and social participation; and sanitation, infection control, and the physical environment.

Surveyors collect data from different sources. They conduct a medical record review based on a case-mix stratified sample of nursing facility residents. They also review plans of care to determine their adequacy, audit residents’ assessments, and review compliance with legal requirements concerning residents’ rights. In addition, surveyors observe facility operations and interview residents, family members, and staff to determine whether facilities are providing appropriate care.

CMS provides guidance on long term care facility survey procedures and protocols through its “State Operations Manual.” The Manual describes the intent of the regulations pertaining to nursing homes as well as the process for determining whether deficiencies have occurred and how to categorize them. Updates to the Manual are issued periodically.

Deficiencies. When a nursing home fails to meet one or more of the Federal requirements, surveyors cite a deficiency. There are 190 possible deficiencies, which fall into the categories listed in the box below.

Deficiency Categories
Resident rights Physician services
Admission, transfer, and discharge rights Rehabilitative services
Resident behavior and facility practices Dental services
Quality of life Pharmacy services
Resident assessment Infection control
Quality of care Physical environment
Nursing services Administration
Dietary services Laboratory and radiology services

Sources: 42 CFR § 483, subpart B; CMS “State Operations Manual,” Appendix PP.

Surveyors also decide the scope and severity of the deficiency based on a matrix that uses the letters “A” through “L.” See Figure 1 on the next page. The scope of the deficiency measures the number of residents potentially or actually affected by the deficiency. The scope rating has three different levels: isolated, pattern, and widespread. Isolated deficiencies occur when one or a very limited number of residents or staff are affected or the situation exists only occasionally. Pattern deficiencies occur when more than a very limited number of residents or staff are affected or the situation occurs repeatedly. Finally, widespread deficiencies occur when the situation is pervasive throughout the facility or potentially affects a large portion of the nursing home’s residents.

The severity rating measures the extent of the health and safety risk to residents. The most serious level, immediate jeopardy, occurs in “a situation in which the provider’s noncompliance with one or more of the requirements of participation has caused, or is likely to cause, serious injury, harm, impairment or death to a resident.” Immediate jeopardy requires the nursing home to take immediate corrective action. The three levels of deficiencies that are not immediate jeopardy are: (1) actual harm that is not immediate jeopardy; (2) no actual harm with a potential for more than minimal harm, but not immediate jeopardy; and (3) no actual harm with a potential for minimal harm.

Letter Grading System:
 Immediate jeopardy to resident health or safety J K L
 Actual harm that is not immediate jeopardy G H I
 No actual harm with a potential for more than minimal harm, but not immediate jeopardy D E F
 No actual harm with potential for minimal harm A B C

For the entire report see: Trends in Nursing Home Deficiences and Complaints
If you or a loved one has suffered an injury or abuse in a nursing home or other care facility that serves the elderly in Minnesota please contact our firm for a free consultation and information regarding the obligations of the facility and your rights as a resident or concerned family member. To contact Attorney Kenneth L. LaBore, directly please send an email to klabore@prslegal.com, or call Ken at 612-767-7503.

According to an article in the Irish Times; older patients discharged from hospital to long-term care in nursing homes live 30 months on average, the first study to examine survival in older patients admitted to nursing homes in the Republic has found.

The survival time of these frail elderly patients is just half that of a corresponding group who live in the community.

Dr Conal Cunningham, consultant geriatrician at St James’s Hospital, Dublin, and colleagues from the Mercer’s Institute for Research in Ageing followed 1,552 patients discharged from St James’s to nursing homes in 1997-2003. A random sample of 210 patients from the seven-year period was then chosen for detailed analysis.

The results, published in the current issue of the Irish Medical Journal, show the patients had an average age of 82 and almost one in three was female. On average, the patients studied lived for a further 30.3 months following transfer to a nursing home. This compares with a life expectancy of 67 months for an Irish man aged 82, with women of the same age expected to live for 85 months.

“As this period of study was associated with increasing privatisation of nursing home care in the Greater Dublin area, it is encouraging to note there was no significant association between survival and the public/private status of nursing homes,” the authors noted.

The proportion of patients discharged to private nursing homes rose from 25 per cent at the beginning of the study to 56 per cent at the end. But the authors said their study was not sufficiently powerful to compare outcomes in private versus public nursing homes.

Data from the US, Canada and the UK has shown that public nursing homes look after people with more complex problems and have higher staffing levels. Patients in public nursing homes are hospitalised less for dehydration and pneumonia, suggesting they may be a more appropriate choice for the long-term care of more frail patients.

The study found that 7 per cent of patients died within one month of admission to a nursing home, but this initial high mortality rate dropped with time spent in long-term care. Some 25 per cent of patients were dead one year post-discharge.

A Oregon Judge Gives a Nursing Home Director 19 Months in Prison for Neglecting a Nursing Home Resident

A Director of Nursing Suzanne Kay Ruddell in a Northeast Portland nursing home was given a sentence of 19 months in prison after she was found guilty of criminal mistreatment by a jury of a resident who suffered broken legs after being dropped. The facts in the case reviewed that the nursing home had failed to provide care for a woman for 5 days after she was dropped sustaining fractures to both legs. The family of the resident has also brought a civil suit against the facility.

For the rest of the story by Michelle Roberts, The Oregonian, see: 19 Months in Prison for Neglect of Nursing Home Patient

As an attorney who handles these types of cases I am glad to see that there are criminal charges brought in this case. The reality is that there are seldom criminal consequences for the serious abuse and neglect many residents endure in nursing homes and other elder care facilities throughout the country. Although the penalty seems very light for the seriousness of the crime, it may still act as a deterrent to other nurses and administrators running nursing homes.

If you or a loved one has suffered an injury or abuse in a nursing home or other care facility that serves the elderly in Minnesota please contact our firm for a free consultation and information regarding the obligations of the facility and your rights as a resident or concerned family member. To contact Attorney Kenneth L. LaBore, directly please send an email to klabore@prslegal.com, or call Ken at 612-767-7503.

According to Associated Press: State reports abuse in 2nd Minnesota nursing home

By MARTIGA LOHN – 3 days ago ST. PAUL, Minn. (AP) — An aide at a Minnesota nursing home was accused of tormenting six residents sexually, physically and emotionally for months before being fired, according to a state health department report released Wednesday. It’s the second recent investigation of nursing home abuse in the state.The report states that a female aide abused residents at Luther Haven Nursing Home in Montevideo for about six months before a nursing assistant told a supervisor in July what she had seen. The aide’s name was not disclosed.The case echoes another in Albert Lea in southern Minnesota, where six nursing assistants allegedly spit into the mouths of residents with dementia, poked their breasts and touched their genitals. Two female aides face criminal abuse and assault charges; four others were charged as juveniles for not reporting the alleged abuse.At the home in Montevideo, just west of Minneapolis, the aide probed the genitals of a resident with vulvar cancer, performed lap dances for two male residents and made sexual advances toward one of the men, including baring her breasts while getting him ready for bed, the Health Department report said.Five of the six victims have Alzheimer’s disease or other forms of dementia. The female victim with cancer died before the abuse was reported.Other allegations of maltreatment included dropping a resident about four feet onto a bed, slapping a resident while calling her names including a racial slur, and emotionally tormenting a resident by throwing stuffed animals the woman believed to be her children on the floor.The report said the home investigated the incidents and reported them to state authorities as soon as the abuse was revealed July 9. The aide was suspended that day and fired two weeks later.The aide was interviewed by the Health Department and denied the allegations.James Flaherty, an administrator at the home, didn’t immediately return a message left after business hours Wednesday.Authorities said charges against the former aide are unlikely because the victims’ dementia limits their ability to testify.

If you or a loved one has suffered an injury or abuse in a nursing home or other care facility that serves the elderly in Minnesota please contact our firm for a free consultation and information regarding the obligations of the facility and your rights as a resident or concerned family member.  To contact Attorney Kenneth L. LaBore, directly please send an email to klabore@prslegal.com, or call Ken at 612-767-7503