February 2008 my mom
a short time she found it
more and more difficult to walk and so the hospital advised she go for
rehabilitation at a nursing home for a few weeks, before she would
home to us. So began the search for a nursing home and rehabilitation
It quickly became clear to me that my mom and other people in need
probably fair better very slowly crossing the street at a red light. My
sounds pretty drastic, doesn't it? Well my research left me in a fatal
dismay and disgust. This is my research study about Nursing Homes /
mom stayed one night in the nursing home which was recommended by the
My brother stayed with my mom for the one night she was there. They
thing in the morning after my brother relentlessly all through the
asking for water for my mom which she never received.
are between 16,000 and 18,000
nursing homes / rehabilitation centers in the U.S. I randomly selected
nursing home from each of the fifty states. As you read the
sure you will agree that the state of nursing homes is beyond belief,
anything we care to imagine, and yet, here it is! Still, I did wonder
could be that in my random selection I picked the worst. I wish I could
that this is what happened. Caring for another should be so simple,
for those people who chose to be in a caring profession. Shame on them!
find yourself in such a situation, you will have to choose one. Ask
Ask many questions! Make the nursing home aware that you are aware! You
stay on top of it! Be relentless! There isn't any other choice! This is
truth about elder care!
in Nursing Homes and Rehabilitation Centers
the reports I researched, there are 1,710 deficiencies in the 50
(one from each state).
home had multiple deficiencies, some more than others. Some nursing
repeating the same deficiencies.
nursing homes did not follow all laws and professional
staff did not allow the residents to refuse treatment or
refuse to take part in an experiment.
did not allow the residents the right to choose
activities, schedules and health care according to their interests,
and plan of care.
staff did not tell the residents completely about their
nursing homes did not honor all of the residents' rights
as residents of the nursing homes and as citizens or residents of the
doctors did not always see the care plan at every visit
and make notes about progress and orders in writing. They did not visit
residents regularly, as required. They did not keep accurate and
medical records, and did not provide written records when residents
transferred or discharged. In addition, they did not keep residents'
and medical records private and confidential. Also, clinical
not kept safe, so that it would not be lost, destroyed or used by the
residents were not allowed to easily see the results of
the nursing homes' most recent survey. They did not listen to the
family groups or act on their complaints, or if they did act, it was
residents did not have privacy in their bedrooms.
staff did not send and promptly deliver unopened mail to
staff did not properly hold, secure, manage and provide
proof of residents' personal money which was deposited with them. In
they did not quickly give the residents' personal money to the heads of
her estate after the resident's death.
nursing homes did not post nurse staffing information.
nursing homes did not set up a group who would be
legally responsible for writing and setting up policies for leading and
the nursing homes. They did not have a panel of people to review and
quality. They did not hire a properly licensed administrator.
staff did not administer care in a way that led to the
highest possible level of well-being and quality of life for the
Also, they did not provide care in a way that would make residents have
and self-respect. In addition, the care both inside and outside of the
homes did not meet professional standards of quality. They did not use
registered nurse at least 8 hours a day, 7 days a week. They did not
enough nurses to care for residents in a way that would maximize
They did not get proof that nurse aides had the training and skills
State requires, and in fact, did not make sure that the nurse aides had
skills to be able to care for residents. They did not review the work
nurse aide every year; or give regular training for the nurse aides.
staff did not tell or put in writing to the residents or
their representatives, how long the nursing homes would hold the
when he or she temporarily left the facility.
Neglect, Mistreatment, Isolation and Physical Restraint
nursing homes did not protect residents from all abuse,
neglect, mistreatment or isolation. In fact, they actually hired people
a legal history of these atrocities, so then, of course, when there
occurrences, they did not report them. The nursing homes also used
residents did not have a complete care plan that
would meet all of their needs, with timetables and actions that could
They did not have a complete care plan within 7 days of their
there was a care plan, it was not prepared with the care team,
primary nurse, doctor, resident or resident's family or representative.
also, if there was a care plan, it was not followed.
- The staff did not tell the residents about
benefits: eligibility, services covered, and how to apply. They also
give the residents the names and addresses of State groups that could
- The staff did not always give or get lab tests,
or other tests to meet the needs of residents. They did not quickly
doctors the results. They also gave tests without the attending doctor
them. In addition, they did not keep signed and dated reports. In
residents did not get dental care.
- The nursing homes did not help residents who
care for themselves with eating/drinking, grooming and hygiene. And for
residents who could care for themselves, they did not receive
to be able to continue with their self-care.
- The staff did not give proper treatment to
with feeding tubes to prevent problems (such as aspiration pneumonia,
vomiting, dehydration, metabolic abnormalities, and nasal-pharyngeal
and help restore eating skills, if possible.
- The staff did not give residents proper
prevent new bed (pressure) sores or heal existing bed sores.
- The staff did not properly care for residents
special services, including: injections, colostomy, ureostomy,
tracheostomy care, tracheal suctioning, respiratory care, foot care,
- The staff did not immediately tell the resident,
and a family member if there was a major change in resident's
health, or if there was a need to alter treatment significantly.
- Residents who entered the nursing homes without
catheter were then given a catheter, even when it is was unnecessary.
- Residents with reduced range of motion did not
treatment and services.
- The staff did not give residents enough fluids
them healthy and prevent dehydration.
- The nursing homes did not have a program to keep
infection from spreading. In fact, when residents were sick, they were
apart from well residents. They did not clean and store sheets, towels
other linens in a way that prevented the spread of infection. The
did not get rid of garbage properly, and there was not a program to
prevent/deal with mice, insects, or other pests. Not surprisingly,
members did not wash their hands when needed.
- At least once a month, the nursing homes did not have a
licensed pharmacist check the drugs that the residents were taken. The
did not have drugs and other related products which were needed every
staff did not keep residents free from drugs. The staff did not
drugs and other similar products. The staff did not make sure that
were safe from serious medication errors, such as, the rate of
errors (wrong drug, wrong dose, wrong time) was 5% and higher.
took drugs were given too many doses, or took medications for too long
of time. The staff did not make sure that the use of drugs was
watched, however, when they did watch, they did not stop or change
cause unwanted effects.
- The nursing homes did not develop/implement
procedures for the administration of immunizations.
- The staff did give the right treatment and
residents who had mental or social problems adjusting. They did not
that residents didn't become withdrawn, angry or depressed if these
did not exist before.
- The staff did not provide social services for
- The nursing homes did not have adequate and
sound and lighting in all areas.
- The nursing homes did not have areas which were
- The nursing home did not provide needed
- The nursing homes did not use properly trained paid
feeding assistants. They did not provide licensed nursing supervision
feeding assistants. They did not properly monitor the feeding of its
They did not store, cook, and give out food in a safe and clean way.
not stop employees, who had a disease that could spread, from having
contact with residents or food.
- The staff did not provide 3 meals daily at
times. They did not serve breakfast within 14 hours after dinner. They
offer a snack at bedtime each day.
- The staff did not prepare food that was
appetizing, tasty, attractive, well-cooked, and at the right
did not offer other nutritional food to residents who would not eat the
served. They did not make sure that residents were well nourished and
their nutritional needs were met.
- The staff did not screen residents when they are first
admitted to send them to an area with special care for people with
developmental disabilities or mental illness, if needed.
- The staff did not make a complete assessment
covered all questions for areas that are listed in official
did not make sure that all assessments were accurate, coordinated by an
done by the right professional, and were signed by the person
They did not do the resident's assessment every 3 months, or do a new
assessment after any major change in residents' physical or mental
- The nursing homes did not have a detailed, written plan
for disasters, emergencies and evacuations, and they did not train all
employees on what to do.
- The emergency lighting in the nursing homes did
at least 1 ½ hours.
- The nursing homes areas were not free of dangers
residents had accidents. The staff did not immediately tell a doctor
family. They did not have firmly secured handrails on each side of
- The nursing homes did not have rooms that can be
unlocked from inside without a key.
- The nursing homes did not have proper exit
did not have properly located and lighted "Exit" signs, and proper
backup exit lighting. The exits were not accessible at all times and
from obstructions. The exits did not allow residents to escape the
They did not have any signs that stated exit doors were to be kept
- The nursing homes did not keep all essential
- The nursing homes did not have properly
- The nursing homes did not have properly
piped-in oxygen systems.
- The nursing homes did not have properly
electrical wiring and equipment, and a separate and independent backup
electrical power source.
- The nursing homes did not have proper medical
storage and administration areas.
- The nursing homes did not have weekly
monthly testing of generators.
- The nursing homes did not have proper power
life support equipment.
- The nursing homes did not have enough outside
- The nursing homes did not have heating and
systems that were properly installed according to the manufacturer's
- The nursing homes did not have enough backup
supplies for important areas of the nursing homes.
- The nursing homes did not have a working call
available in each resident's room or bathroom and bathing area. They
not have a private telephone available for use.
- The nursing homes did not have properly
hallway dispensers for alcohol-based hand rub.
- The nursing homes did not have emergency showers.
- The nursing homes did not have linen or trash
properly sized and located
Homes and Other Elder Care Links
nursing homes did not have fire safety features required
by current fire safety codes.
nursing homes used construction type and materials which
were not approved.
nursing homes were not designed, built, equipped, or
well-kept to protect the health and safety of residents, workers, and
nursing homes did not have portable fire extinguishers,
and an approved fire extinguishing system.
nursing homes did not properly maintain smoke detectors
and have automatic smoke detection system in all hallways.
nursing homes did not have proper fire barriers,
ventilation and signs for the transport of oxygen.
nursing homes did not have an approved back-up procedure
for a faulty fire alarm system. The installation, maintenance and
program for fire alarm systems in the nursing homes was not approved.
not have fire alarm systems that could be heard throughout the facility.
nursing homes did not have properly working alarms on
sprinkler valves. The automatic sprinkler system connected to the fire
system in the nursing homes was not approved, and maintained in working
They did not have back-up procedures which were not in place for faulty
automatic sprinkler systems.
nursing homes did not have constructions that would
resist fire for one hour. They did not have two-hour-resistant firewall
common walls. They did not have fire-resistant interior walls. They did
have fire-resistant room wall surfaces.
nursing homes did not have smoke barrier doors that
could resist smoke for at least 20 minutes. They did not have walls or
that would prevent smoke from passing through and would resist fire for
least one hour. The corridors and hallway doors did not block smoke.
were not separated from common areas by walls constructed to limit the
nursing homes did not have proper stairway enclosures
and vertical shafts.
nursing homes did not have proper construction of ducts
through walls designed to prevent smoke passage.
nursing homes had at least two remote exits on each
floor or fire section of the building which were deficient.
nursing homes did not post no-smoking signs where oxygen
was used, and where smoking was not permitted or allowed. They did not
ashtrays where smoking was allowed.
nursing homes did not restrict the use of highly
flammable materials including curtains.
nursing homes did not restrict the use of portable space
nursing homes did not have externally vented heating
guides are to help you make the best possible decision about the care