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Analysis of Pittsburgh’s nursing homes

Published on March 11th, 2009

Pittsburg Tribune Review had an article discussing the failures of Pittsburgh’s nursing homes.   The article mentions several examples such as one resident cried out for water before going to the hospital with dehydration; another broke an eye socket when a wheelchair rolled down a ramp and crashed; a patient died when workers improperly adjusted a breathing tube; two were so malnourished that they weighed less than 80 pounds each;  a resident did not get a hair wash for nearly four weeks;  and another was told to "go in your pants" when requesting help with going to the bathroom.   These are common complaints at all nursing homes around the country due to understaffing, burn-out, and lack of training.

Those cases and more were drawn from a Tribune-Review analysis of state surveys conducted at 118 nursing homes in Western Pennsylvania over the past three years.  Inspectors cited homes for 3,798 deficiencies, and in 33 cases, found serious lapses posing "actual harm" or "immediate jeopardy," under federal definition.  Among the deficiencies, inspectors noted hundreds of incidents that caused pain or discomfort for nursing-home residents. Those violations have the "potential for more than minimal harm." They include failures to treat skin ulcers or to help patients eat when they can’t feed themselves.  Most often, problems related to quality of care or unsanitary conditions.

Rosalie Kane, a professor of public health at the University of Minnesota, said that the quality of life for nursing-home residents has not improved — even if surveys don’t find as many alarming violations.  "Those surveys don’t make nursing homes better over time," Kane said. "They just represent the lowest common denominator keyed to issues that are considered unacceptable."

The Trib’s review followed the November arrests of five employees at Kane Regional Center in Glen Hazel, who were charged with abusing and tormenting a 94-year-old Alzheimer’s patient. More than 2,800 complaints of abuse or neglect of nursing home patients are substantiated each year, according to the inspector general for the Department of Health and Human Services.

Nursing homes do not spend enough money on staffing required to ensure adequate care.  Nursing home staff members decide whether residents’ preferences are met. Too much of nursing home operations revolve around what’s convenient for staff, not patients.

Nursing home staff and inspectors should ask residents whether they participate in meaningful activities, whether they have opportunity to have private conversations, and what they like or don’t like about the food.

Under federal law, state health inspectors must survey nursing homes at least once every 15 months and whenever they receive a complaint. Often, homes are cited for a serious deficiency only after a patient is seriously harmed.

 

Joe Pioletti
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