Friday, November 18, 2011

Residents Rights in Nursing Homes

Federal Regulations (42CFR§483.10) require that in a nursing home setting: "The resident has a right to a dignified existence (see also §483.15(a) Dignity) self-determination, and communication with and access to persons and services inside and outside the facility. A facility must protect and promote the rights of each resident, including each of the following rights" 42CFR§483.10
Residents Rights are not only good medicine, they are mandated by Federal; and state laws and make up the Standard of Care in nursing homes.
These rights include the resident’s right to
• Exercise his or her rights (§483.10(a));
• Be informed about what rights and responsibilities he or she has (§483.10(b));
• If he or she wishes, have the facility manage his personal funds (§483.10(c));
• Choose a physician and treatment and participate in decisions and care planning (§483.10(d))
Other rights include:
§483.10(e) Privacy and Confidentiality
§483.10(f) Grievances
§483.10(g) Examination of Survey Results
§483.10(h) Work
§483.10(i) Mail
§483.10(j) Access and Visitation Rights
§483.10(k) Telephone
§483.10(l) Personal Property
§483.10(m) Married Couples
§483.10(n) Self-Administration of Drugs
§483.10(o) Refusal of Certain Transfers

Attorney Hamill has 34 years experience advocating for injured people including those who have suffered from nursing home neglect, abuse or wrongful death. The Hamill firm represents elders victimized by criminal assaults , bed sores, falls from Hoyer lifts, sepsis and malnutrition. For more information contact the Hamill group at (617) 479-4300 or use the firm's website contact form.

Wednesday, November 16, 2011

Admitting Past Felons into Nursing Homes

The Desmoine Register had this article the same day I wrote about placement of past felons in nursing homes and how they increase risk of crimes upon nursing home residents.
State officials say doctors did not view convicted sex offender William Cubbage as a sexual predator when they recommended moving him to an Iowa nursing home where he’s now suspected of sexually assaulting an elderly woman. At one time, a psychologist hired by the state believed Cubbage had victimized “a large number of female children” without being charged or prosecuted for those offenses, according to court records.
Two decades of sex crimes in nursing home abuse suspect’s past The Des Moines Register

With violent attacks by felons living in some nursing homes, some facilities are scrambling to comply with disclosure laws required in some states to notify state public health officials when they admit offenders. The number of felons reported to be living in the facilities increased last month in some states. Past reported felonious acts have included rape, theft, assaults, illegal drug use and violence. Some former felons also have serious psychiatric conditions.

Monday, November 14, 2011

Elder Pain Study Shows Disparity in Races

According to a study conducted to measure pain in elderly nursing home residents showed a marked disparity between racial groups:
- About one-quarter of all nursing home residents reported or showed signs of pain.
- Forty-four percent of nursing home residents with pain received neither standing orders for pain medication nor special services for pain management (i.e., appropriate pain management).
- Among residents with dementia and pain, nonwhite residents were more likely than white residents to lack appropriate pain management.
- a significantly greater proportion of residents without dementia reported pain compared with residents with dementia.

Over 40% of all nursing home residents with pain received neither standing orders for pain medication nor special services for pain management. Among residents with dementia and pain, there were differences in appropriate pain management between nonwhite and white residents, with nonwhite residents being more likely than white residents to lack appropriate pain management. Questions exist as to the disparity of adequate pain relief for non white residents. Is it because the facilities they are in are inferior and lack adequate resources?

Products - Data Briefs - Number 30 - March 2010

Sunday, November 13, 2011

Pressure Ulcers v Deep Tissue Injury vs Blisters ll

Afte publishing the post about Pressure Ulcers v Deep Tissue Injury vs Blisters I received an excellent email from Sue Hull, MSN, RN, CWOCN, who operates
"The reason DTI is discussed along with pressure ulcers in the NPUAP document is because it is caused by pressure. If it occurs while a person is a resident of a nursing home, it would indicate negligence in that the measures had not been taken to prevent pressure. I believe it is standard care that a pressure ulcer risk assessment is done on admission and at predetermined intervals thereafter in nursing homes (as in home health, where I work). Based upon the findings of the risk assessment, interventions are to be implemented to prevent skin breakdown. If DTI develops, something was missed in the process, or something is wrong with that particular nursing home's process.

If there were factors that truly did make the DTI unpreventable, those factors should be copiously documented. It should never be a surprise when a pressure ulcer develops. Eg. if a resident MUST have the head of the bed in a high Fowler's position to breathe, it should be heavily documented along with the skin assessment, and a sacral DTI should be watched for. It should not be a surprise.
Also, when there is DTI, it is not undectible, even in persons of color. There are changes, such as warmth, bogginess, blood filled blisters, and color changes. If boney prominence are routinely checked for these things, the DTI will be detected."
Thanks for your input Sue.