Neglect and Poor Care Linked to Urinary Tract Infections in Nursing Homes

Urinary Tract Infections, or UTIs, are a common complaint among families with a mom or dad in long-term care.  UTIs can be dangerous.  First, UTIs can become a serious infection if untreated.  However, UTIs also lead to falls, because UTIs cause people to feel as if they have to go to the bathroom constantly – a problem when someone with dementia forgets to ask for help to go to the bathroom.  This problem is made worse by the fact that UTIs can also cause people who have no cognitive problems to exhibit signs of dementia, like having hallucinations.

Aggravating the diagnoses of a UTI is the fact that a recent study has linked UTIs in New Jersey nursing homes to a failure to administer medications and poor supervision.  A recent study written about in McKnight’s, a long-term care publication, reported the findings published in Geriatrics. You can read the full article here.

The study, conducted by the University of Colorado College of Nursing, confirms what many of us practicing in this field know – that UTIs may be evidence of poor care and neglect.  UTIs are many times caused by improper cleaning after toileting and being left in a diaper for too long.

If a loved one is experiencing recurrent UTIs, demand a care planning meeting.  Find out why the UTIs are happening and what is being done to prevent them. If you or a loved one are dealing with issues due to poor care, contact Stark & Stark today for your free consultation.

Rating the Nursing Homes in New Jersey and Pennsylvania

The official U.S. government website for Medicare provides a tool that allows consumers to compare information about nursing homes. It is called Nursing Home Compare, and contains quality-of-care information on every Medicare- and Medicaid-certified nursing home in New Jersey and Pennsylvania.

The tool creates that information based on the “skilled” care that nursing homes provide, which is care given when you need skilled nursing or rehabilitation staff to manage, observe, or evaluate your health status. For example, skilled care includes intravenous injections and physical therapy.

The “Overall 5-Star” Rating System

To rate the nursing homes, the tool uses an “Overall 5-Star” rating system. It assigns 1 to 5 stars, with more stars indicating better quality, across three “domains.” Those domains include: (1) Health Inspections, (2) Quality Measures, and (3) Staffing. The tool reports the ratings in table or profile form. Here is example of a nursing-home profile:

The Domains

The tool generates the rating for the  Health Inspection Domain based health-inspection ratings from the three most recent annual-comprehensive inspections, and inspections instigated in response to complaints in the last three years. It places more emphasis on recent inspections.

It generates the rating for Quality Measures Domain by combining the values on 9 out of 19 Quality Measures. Some of those measures include, for example:

  • the percentage of long-stay high-risk residents with pressure ulcers;
  • the percentage of long-stay residents experiencing a fall with major injury; and
  • the percentage of long-stay residents who self-report moderate to severe pain.

The tool derives those values from clinical data that nursing homes regularly report on a form called the Minimum Data Set.

And finally, the tool generates the rating for the Staffing Domain based on (1) the Registered Nurse (RN) hours per resident day, and (2) the “total staffing” hours per resident day. Total staffing includes: RNs, Licensed Practical Nurses, Licensed Vocational Nurses, and Certified Nurse Assistants. Nursing homes report staffing hours, which are from a two-week period just before the state agency conducts an inspection, to the New Jersey or Pennsylvania state-inspection agency. The agencies, in turn, report those data on Nursing Home Compare.

At Stark & Stark, our nursing-home negligence lawyers dedicate their entire practice to prosecuting nursing-home negligence lawsuits. We highly recommend the Nursing Home Compare tool when trying to assess a nursing home’s quality.

Water’s Edge Nursing Home and Liberty Royal Rehabilitation and Health Care Center on the CMS Special Focus Facility List

A very convenient tool for concerned families to evaluate nursing homes is the “Medicare Compare” website.  Included within this is a section that designates what are known as “Special Focus Facilities.”  A Special Focus Facility represents the bottom 1% or 2% of all nursing homes in the country which have demonstrated not only under-performance, but whose corporate practices have demonstrated a significant danger to members of our community who entrust them to care for their loved ones. http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/Downloads/SFFList.pdf

In order to become a Special Focus Facility, a nursing home must demonstrate a significant period of time of a failure to comply with all the safety rules and regulations promulgated by the Federal government to protect their elderly residents and a failure to address concerns expressed by State and Federal surveyors. Currently, New Jersey has two special Focus facilities.  These are Water’s Edge Rehabilitation in Trenton, New Jersey and Liberty Royal Rehabilitation and Health Care Center, in Tinton Falls, New Jersey.

Consumers should carefully think twice before entrusting a loved one with a facility with this dangerous designation, although many of the better nursing homes in New Jersey have been Special Focus Facilities and have ostensibly cleaned up their act. That is, the Special Focus Facility program is one which works.  Many well meaning organizations take this designation quite seriously and improve their conduct.  However, some facilities have been forced to close their doors because of this designation.  As bad as that seems to many of the residents, it is unquestionable that the Special Focus Facility designation and the hard work of surveyors protects residents whose lives are placed at risk because of dangerous corporate conduct.

Front-Line Healthcare Workers: The Most Important Resource in Delivering Quality Care

Nursing homes, in New Jersey and Pennsylvania, must maintain enough nursing staff to provide nursing care, and related services, to their residents to maintain the residents’ physical, mental, and social well-being.

In facilities across New Jersey and Pennsylvania, front-line workers make-up the primary healthcare personnel responsible for delivering that care and service to the resident. Those workers include, at a minimum, certified nursing assistants (CNA) and licensed practical nurses (LPN): They are, undoubtedly, the most important resource that a nursing-home facility can provide to ensure that elderly residents receive quality care.

But recently, more than fifty front-line workers picketed outside the Castle Hill nursing home in Union City and the Harborview nursing-home in Jersey City, because, among other things, they are upset that those facilities have failed to provide enough personnel to deliver quality care to the residents: In other words, the workers believe that those facilities—which are owned and operated by Alaris Health—have been operating in a way that endangers the residents’ well-being.

Facilities, in New Jersey and Pennsylvania, that fail to provide enough nursing personnel for delivering quality care, knowingly place residents at risk for neglect and abuse. For example, understaffing can impair a facility’s ability to deliver critical and labor intensive nursing care such as frequent and regular turning and repositioning residents to prevent debilitating pressure ulcers from developing.

And indeed, recently, a front-line worker of the Castle Hill nursing-home in Jersey City stated that “caring for 13 people at one time is just too much.” Furthermore, the Castle Hill and Union City nursing-homes front-line workers believe that Alaris Health is waging “an aggressive campaign against workers” during a time when “the current staffing levels are below state and national average.

No one ever expects a family member or friend to endure neglect or abuse in a nursing home. However, despite federal and state regulations, nursing-home residents often suffer the negative effects stemming from nursing-home facilities that violate those regulations.

When someone you care about has endured nursing-home negligence or abuse, the problems can seem overwhelming. Stark & Stark’s Nursing Home Litigation Group will advise you of your loved one’s legal rights, and will aggressively prosecute a claim whenever our investigation reveals any instances of negligence or abuse.

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