Medicare has reported that in 2014-2015, its inspectors found 2,027 problems at New Jersey’s 364 nursing homes that accept Medicare and Medicaid patients. According to the data, each nursing home has on average at least four reported problems related to residents’ health. However, because some nursing homes do not accept Medicare/Medicaid patients and because not all problems are reported or found upon inspection, this number reveals only a piece of the information related to problems in nursing homes.
Typical New Jersey Nursing Home Problems
A variety of problems often arise in a nursing home. Recognizing them is the first step to getting help.
Labor costs are usually the greatest expense for a nursing home owner. As a result, under staffing is a recurring problem in nursing homes. As nursing homes seek to increase profits by accepting sicker and sicker patients, for whom Medicare/Medicaid pays at a higher rate but who require much higher levels of care, the problem of under staffing will only become worse. Overworked or under trained staff also increase the likelihood of abusive or neglectful treatment, or harsh methods of controlling residents. None of this is acceptable or permitted.
Denial of Access
Being denied access to your loved one can sometimes occur even though the law bars nursing homes from restricting visiting hours for friends and family. You must be allowed entry. Do not let anyone tell you otherwise.
Under the laws governing nursing homes, restraints are only permitted to treat medical conditions or symptoms with the consent of the resident (or resident’s family if they are incompetent), and can never be used as discipline or for the staff’s convenience.
Similarly, behavior-modifying medication can be inappropriately used to control residents’ behavior, particularly when the staff is overworked. Medication can never be administered without consent and cannot be used merely to make the patient easier to control. If you do not know why, you should ask why your loved one is receiving medication, especially medicines that affect his or her mental state, such as Lorazepam (also known as Ativan).
Medical Abuse and Neglect
Nursing home residents often face neglect when their medical or dental needs are ignored or under-treated. Nursing home residents are entitled to appropriate care for all of their conditions. Not addressing these health issues is medical malpractice and abuse. Common medical problems that can arise for nursing home residents include bedsores, weight loss, frequent falls, unexplained bruising, dental neglect, and decline in cognitive abilities.
Nutrition and Dehydration
Elderly and infirm residents of nursing homes frequently need help in eating meals or even drinking water. If the staff at the nursing home is not paying enough attention, your loved one can become malnourished or dehydrated, or both, which can be life-threatening. When you visit, find out if your loved one is losing weight, watch how much of a meal he or she eats, look for dry lips, papery skin, or changes in wakefulness or fatigue.
Safety problems are another worrisome concern in nursing homes. Residents may not receive help when they ring for it, they may not receive the assistance they need, resulting in falls, and they may be placed in unsafe and dangerous conditions when lifts are used incorrectly, fire exits are not marked, and residents are not supervised properly.
Other problems can include the overuse of feeding tubes, an unwillingness to accommodate patients’ preferences and requests, and resident-to-resident abuse.
How to Handle Problems
Once you’ve identified a concern, you want to get it resolved as quickly as possible.
Nursing homes must prepare Care Plans that detail exactly the type of individualized care needed for each resident. Care Plans are to be prepared within seven days of admission and must be updated at least every three months or whenever the resident undergoes a material change in condition. It is important that family attend all care plan meetings. Making sure that your loved one has an appropriate Care Plan is the first step in resolving problems.
Every family should have one member to serve as the family point person who communicates directly with the administration at the nursing home. Any problems or concerns should immediately be reported to the nursing supervisor and if the appropriate resolution does not happen, to the administration. Every nursing home must have a formal grievance procedure you can follow. The staff social worker can often be helpful in resolving problems, but the most important resource is your self through asking questions, showing up at varied times of day, and visiting often.
If you are denied entry or access to your resident, contact the supervisor immediately and demand entry. Let the administration know if this is not resolved.
Nursing homes are required to be properly staffed. If you feel the nursing home is not adequately staffed or that staff members do not provide adequate care, it is reasonable to make a request in writing to the administration so that your concerns are documented. You can also raise your concerns at a family council meeting. If your concerns are still not being addressed, contact your local long-term care ombudsman. In Bergen Couny, Hackensack or other parts of New Jersey, you can reach the Nursing Home Problems Ombudsman at a Toll Free Intake Line: 1-877-582-6995 or by email to email@example.com
Restraints and Medication
If restraints are recommended for your family member, ask to see the doctor’s order and find out if consent was obtained. Ask what other alternatives are available. Refuse to agree to this type of abuse unless it is absolutely necessary, and if it is used against consent, report it. If medication is suggested to control your resident’s behavior, ask to see the order and the medical condition it is meant to treat. Find out what the alternatives are. If medication is used without consent, report it.
Safety concerns should be immediately reported to a supervisor and should be immediately responded to if a resident is in danger. Be sure to notify the administration of your concerns and get in touch with the ombudsman or the Department of Health if safety concerns remain unaddressed.
Talk with staff about other concerns, such as eating habits, schedules and personality conflicts. If your family member is at risk from another resident, insist that the situation be immediately rectified with supervision or room changes. Feeding tubes may only be used with consent. Ask for information about alternatives and the effectiveness of feeding tubes.
How to Report Problems
The first step in resolving problems is to report them within the nursing home. Immediately express a concern to the supervising nurse on duty. Follow up to make sure your concerns are addressed. If not, make a formal complaint to the nursing home administration, as per their grievance procedure. If your concerns are still not resolved, you should make a complaint to your long-term care ombudsman. The New Jersey Office of the Ombudsman for the Institutionalized Elderly investigates allegations of abuse and exploitation of residents of long-term care facilities who are 60 years of age and older. You can also file a complaint with the New Jersey Department of Health at 1-800-792-9770 The next step is to contact your attorney if there is ongoing abuse or neglect.
The bottom line is that if you have any concerns at about nursing home neglect or abuse, you should speak up and try to have the nursing home address your issues. If someone you care about has been a victim of nursing home abuse, contact Hackensack, NJ based Gartenberg Howard LLP. Our attorneys have years of experience fighting nursing home abuse and are ready to help you. We know the law and how to make the law work for you and your family. Call us today at 201-488-4633.