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The Increasing Nursing Home People
Approximately 1 . 5 million Americans live in 16, 700 nursing facilities.
About 5% of persons sixty-five and older are in a medical facility at any one time.
An estimated 43% of 65 year olds will use nursing facilities at some point in their left over years.
90% of the nursing facility population is over the age of 65.
Greater than 35% of the nursing facility people is over 85.
75% of medical facility residents are women.
II. The Nursing Home Client
Medical facility residents are among the most weak members of our society.
Typically have persistent disability beyond others of similar age.
Often lack a family member in order to care for them or provide help when needed.
Are usually female.
Beyond actual disabilities, are more likely to have deteriorating intellectual functioning.
Often have multiple diagnosis of serious illness, disability or impairment.
3. Nursing Home Reform – The
Congressional reports and media accounts over the last 30 years have documented recurring substandard care in nursing facilities.
Groups such as the Long Term Care Ombudsman Program (Federally Mandated per forty two U. S. C. § 3027(a)(12) and National Citizens Coalition with regard to Nursing Home Reform have driven new standards.
In 1983, the particular U. S. Department of Health and Human Services commissioned the Start of Medicine to study nursing home care and to recommend improvements.
In 1986, the Institute of Medicine published its study which discovered nursing care facilities to be “grossly inadequate” and “appallingly bad”. Market abuse of residents was observed.
In 1987, Congress passed specific standards for nursing facilities that will participate in Medicare and Medicaid applications. (Omnibus Budget Reconciliation Act of 1987, 42 U. S. C. § 1396. )
Federal plus State regulatory agencies are with each other responsible for monitoring residents care plus ensuring that substandard care is upgraded.
Generally, states have contracts with Federal governments to survey nursing facilities to determine whether they meet minimal government quality standards.
Each state taking part in Medicare/Medicaid is required to pass laws contouring to those established by the Federal government.
IV. The Need for More Reform ( and Lawsuits)
Enforcement of minimum requirements for nursing facility care continues to fall short.
Generally, the enforcement associated with minimum standards system is under well staffed.
Even if the enforcement of Federal plus State regulations were effective, the system is generally not designed or meant to monitor and ensure compliance in person cases.
In 1995, Consumer Reviews reported that approximately 40% of most facilities certified by the Healthcare Funding Administration had repeatedly violated Federal standards of the previous four years.
Billions of tax dollars are invested annually on damage resulting from bad care, such as treating Decubitus Ulcers (bed sores), hydrating residents who should not have become dehydrated, treating broken bones sustained by patients walking unassisted or otherwise abused, etc .
V. Standards Applicable to Nursing Services
Federal Nursing Home Reform Changes to OBRA 1987/ “Nursing Home Reform Act” (42 U. S. C. § 1396)
Federal Applying Regulations – – Requirements intended for Long Term Care Facilities (42 D. F. R. § 483. 1-75)
Federal Implementing Regulations – : Survey and Certification of Long-term Care Facilities (42 C. Farreneheit. R. § 488. 300-335)
“Accepted professional standards and principles that will apply to professionals providing services in this facility” (42 C. F. L. § 483. 75)
Georgia regulation O. C. G. A. 31-8-100 et seq.
Rights to notice of rights.
Rights to specific information (ie. Daily rates, monthly rates, facilities basic services, directly to inspect copy of non-medical records kept by facility, etc . )
Rights to non-discriminatory admission.
Rights to care, treatment, and providers (“With reasonable care and skill”; in compliance with applicable legal guidelines; without discrimination in the quality associated with service based on the source of payment; along with respect for the resident’s dignity plus privacy; etc . )
Rights in order to freedom from restraints, isolation or restriction.
Rights relative to pharmaceuticals.
Rights of citizenship.
Rights of personal choice.
Rights to personal property.
Rights to physical management.
Rights in relation to transfer or discharge.
Use of Condition or community Ombudsman.
Actions with regard to damages.
VI. General Theories associated with Liability and Specific Standards
At fault failure to provide an adequate number of medical personnel (nurses and nursing assistants).
Failure to ensure that competent nursing workers are hired and monitored all through their employment.
Negligence in not being able to adequately plan individualized take care of residents.
Negligence in failing to continuously assess each resident plus notify the attending physician when necessary.
Negligence in failing to keep an adequate and effective record-keeping program to accurately document clinical situations and progress of residents.