Epidemic of Nursing Home Abuse Endangers Seniors

This week, the New York Times reported that 90 percent of all nursing homes have been cited for violating federal health and safety standards. Even worse, 94 percent of all privately-owned facilities were cited for such violations. It is clear that nursing home abuse and neglect has become an epidemic, and anyone with a loved one in a nursing home needs to be aware of this issue.

Nursing home residents’ rights are guaranteed by the federal 1987 Nursing Home Reform Law. The law requires nursing homes to “promote and protect the rights of each residentâ€?.  Yet, as the New York Times recently made clear, nursing homes are not doing enough to protect their residents.

The National Center on Elder Abuse estimates at least one in 20 nursing home patients has been the victim of negligence and or abuse, though it concedes that the number is probably higher. According to the National Center’s study, 57% of nurses’ aides in long-term care facilities admitted to having witnessed, and even participating in, acts of negligence and abuse.  Data from the U.S. Centers for Disease Control and Prevention show that nursing home neglect played role in the deaths of nearly 14,000 nursing home patients between 1999 and 2002.

The New York Times report detailed a study conducted by the inspector general of the Department of Health and Human Services.   According to the inspector general, more than 1.5 million people live in the nation’s 15,000 nursing homes. To participate in Medicare and Medicaid, facilities must meet federal health and safety standards. These programs cover more than two-thirds of nursing home residents, and cost taxpayers more than $75 billion per year.

According to the inspector general’s report, in the past year, poor nursing home conditions were the subject of 37,150 complaints. Of those, 39 percent were later substantiated by inspectors, and at least 20 percent involved the abuse and neglect of patients.  What’s more, 17 percent of nursing homes had deficiencies that caused “actual harm or immediate jeopardyâ€? to patients, the report said.

About two-thirds of the nation’s nursing homes are owned and operated by for-profit companies. Non- profit organizations own 27 percent, while government entities own and operate 6 percent. Of the facilities owned by non-profits, 88 percent were cited for violations, while 91 percent of government-run institutions received citations. According to the report for-profit nursing homes averaged 7.6 deficiencies per facility, while not-for-profit and government homes averaged 5.7 and 6.3, respectively.

To protect a loved one living in a nursing home, it is important to understand what constitutes nursing home abuse and how to spot it. The most common type of nursing home abuse is neglect. Understaffing at nursing homes is the main culprit behind this kind of abuse. Evidence of nursing home neglect includes bedsores and stiff joints, as well as signs of depression. A patient who appears over medicated or is needlessly sedated could be a victim of nursing home neglect.  The smell of urine or feces and poor personal hygiene are hallmarks of this problem.  Extreme unexplained weight loss in an otherwise healthy resident can also be a sign of abuse. And if visitors are made to wait while the staff readies a patient to see them, - or does not allow the visit at all - neglect could be the reason.

Nursing home neglect is as much a crime as any other form of abuse. Nursing home neglect robs patients of their dignity, and it can be deadly. Neglected nursing home patients have been known to wander away from facilities, and sadly some of these patients have died of exposure. Other unattended patients have been allowed to die as a result of undetected internal bleeding or other ailments that could have been corrected with proper medical care.

Physical abuse is an unfortunate fact of life in many nursing homes. Nursing home staff are often guilty of this crime, but abuse among residents is not unheard of. About 2500 cases of physical abuse by nursing home staff are being reported each year.  While physical abuse encompasses crimes like battery, it also includes placing a patient in excessive restraints or physically confining residents for no valid reason.  Over-medicating patients simply to keep them quiet, or withholding medical care are also forms of physical abuse.

And sadly, sexual abuse also occurs in nursing homes. Again, both staff and other residents can be guilty of this type of abuse. According to a 1996 Medicaid Fraud Report, 10% of all physical abuse cases in nursing homes are of a sexual nature. Sexual elder abuse is defined as non-consensual sexual contact of any kind with a nursing home resident. Sexual contact with any person incapable of giving consent is also considered sexual elder abuse.

Often, nursing home sexual abuse goes undetected. Sadly, the physical and cognitive impairments common among nursing home patients make it impossible for them to fight off sexual assailants or report sexual abuse. Some physical signs of nursing home sexual abuse bruising around breasts, upper abdomen, or inner thigh; is often evidence of inappropriate touching or worse. Signs that a nursing home resident has been the victim of a sexual assault include bleeding from the vagina or anus; the presence of a sexually transmitted disease; troubles walking or discomfort when sitting; and irritation or itching in genitals.

If nursing home abuse is suspected, immediate action must be taken. Call 911 if a resident appears to be in immediate danger, otherwise, report the situation to an administrator. All nursing homes are required to have formal complaint procedure and a staff person who is designated to review grievances. Submit specific information about your complaints and attempts to resolve them. If the situation is not resolved, then the problem should be reported state agency charged with overseeing nursing homes.  It may be necessary to remove a resident from a deficient nursing home if the problem is not corrected. In many cases of suspected nursing home abuse and neglect, it can be helpful to retain an experienced elder abuse lawyer to take action on a loved one's behalf.