insufficient care

[pickledpepperRN]

http://www.contracostatimes.com/mld/cctimes/content_syndication/local_news/7768929.htm

Posted on Thu, Jan. 22, 2004

Nursing home probe finds insufficient care

By Randy Myers

CONTRA COSTA TIMES

SAN FRANCISCO - Surprise inspections at 112 state nursing homes reveal that while most facilities meet state and federal standards, they are frequently riddled with serious problems that could jeopardize the health and security of residents.

A two-year investigation conducted by the state Attorney General's Office found the biggest failure was in meeting a state mandate requiring that caregivers provide at least 3.2 hours of care each day.

Sixty-eight percent of those facilities flunked that task. Attorney General Bill Lockyer attributes that failing, which he considers the most bothersome finding, to companies trying to cut costs.

"That makes for more profit but means more neglect for the care elderly people deserve," he said at a Wednesday news conference at a San Francisco senior center.

"Operation Guardians" targeted 16 counties between April 2001 and March 2003. Each team was comprised of two special agents, an investigative auditor, a nurse evaluator, a fire inspector and a medical doctor specializing in geriatric medicine. The program was launched in 2000 to address concerns about the quality of care in the state's 1,400 nursing facilities.

Teams dropped in unannounced at 13 facilities in Alameda County and four in Contra Costa County. Alameda has 70 licensed care facilities, Contra Costa has 28. The operation also resulted in 38 unannounced revisits.

Other deficiencies the investigation revealed included fire safety violations, substandard maintenance and overall inadequate care, ranging from failing to document and update patients' files to not reporting alleged abuse.

An attorney for the California Advocates for Nursing Home Reform hailed the report and said nursing assistants need to log more training hours before getting certified. More time is required to become a hair stylist than a nursing assistant, attorney Prescott Cole said.

Inspectors' photos illustrated the most deplorable conditions. The images showed a festering ulcer that had gone untreated on a patient's heel, rotten food in a refrigerator, ants and other signs of vermin found on floors, improperly stored combustible oxygen tanks and a battered chair used by residents that had the words "psycho seat" scrawled on it.

These images, like the investigation itself, offer glimpses, not the day-to-day realities of residents' lives, said Benson Nadell, a nursing home advocate. He recalled hearing from a family member about a resident's request for water going unheeded.

"It's like a series of snapshots ... but we don't have a movie yet," he said.

The inspections netted two felony convictions, one of a nurse who stole narcotic pain medicine and the other for an administrator-in-training in Napa who stole $49,000 from residents and their families.

Lockyer said the Attorney General's Office hopes to pursue more criminal and civil lawsuits in the future, and to fund another operation. The investigation cost $1 million, he said.

"We'll sue them, whether big or small, if they're abusing their residents," Lockyer said.

Since 1999, there has been a 749 percent increase in criminal filings and 574 percent boost in criminal convictions of nursing home abuses, he said.

Reach Randy Myers at [email protected] or at 925-977-8419

[jemb]

a two-year investigation conducted by the state attorney general's office found the biggest failure was in meeting a state mandate requiring that caregivers provide at least 3.2 hours of care each day.

okay, i guess i've had an attack of stupid, but what does that mean? i got hung up trying to make sense of it.

i'm not familiar with ltc mandates, and even after reading it several times, i can't figure out whether it means 3.2 hours per caregiver per day (shift or 24 hr?), per resident per day ( per shift or all shifts?), or per all caregivers per shift or 24 hrs?or some other combination that i'm not considering?

(per resident per 24 hours seems the most likely, sad though it is.)

[pickledpepperRN]

originally posted by jemb

(per resident per 24 hours seems the most likely, sad though it is.)

you are correct. that is it.

this means all caregivers too. many facilities wrongly count the don who in some cases has no patient contact.

plus they averaghe so when one resident gets more time, others get even less.

imagine these patients were not even receiving the low minimal average hours of care!.

ps: the meal and break time is counted as care hours too!.

many facilities are stingy with linens so it is impossible to keep people clean.

[Speculating]

Originally posted by spacenurse

You are correct. That is it.

This means all caregivers too. Many facilities wrongly count the DON who in some cases has no patient contact.

Plus they averaghe so when one resident gets more time, others get even less.

Imagine these patients were not even receiving the low minimal average hours of care!.

PS: The meal and break time is counted as care hours too!.

Many facilities are stingy with linens so it is impossible to keep people clean.

How do they keep getting away with not providing 3.2 hours of direct care a day? And, providing anything short of that amount of care would almost be abandonment in my view. If you do the math with one nurse assistant and one nurse per shift, you could only take care of 15 pts. every 24 hours. I'm acute care not longterm, but from many of the posts I read here the nurses are taking on a much bigger load than 15 pts. They must be counting the guys in the kitchen, security, environmental, and maintenance as pt care providers too!