According to government projections, the number of older Americans who rely upon nursing homes, alternative residential care, or home care services is steadily increasing. The Centers for Disease Control and Prevention predicts that this group will increase from approximately 15 million in the year 2000 to around 27 million by 2050. Since these vulnerable, often frail older people rely on others for health care, personal care, and supportive services, nursing home understaffing can drastically affect patient care, and it’s all too common.
The Expected Makeup of a Nursing Home Staff
It takes a variety of personnel to ensure that residents are properly cared for. This can include registered nurses (RNs), licensed practical nurses (LPNs), licensed vocational nurses (LVNs), certified nursing assistants (CNAs), physical therapists (PTs), and others, such as janitors, cooks, and office personnel. Every nursing home in the country is required to report its staffing hours to its state survey agency. While staffing hours is an important number because it shows the total number of hours worked divided by the total number of residents, it does not necessarily reflect the level of care given to any particular resident or even the general level of care on a given day.
Federal regulations require that nursing homes have at least one registered nurse on duty for eight hours each day and a registered nurse, licensed practical nurse or licensed vocational nurse on duty 24 hours per day. State laws can impose additional staffing requirements, but this varies from state to state. In addition to those nurses, nursing homes use certified nursing assistants to provide care to patients on a 24/7 basis. Depending upon the needs of the residents of a particular facility, physical therapists and other medical providers may also need to be on staff regularly.
Registered nurses have at least two and sometimes as many as six years of education in the nursing field. They assess the needs of nursing home residents. Licensed practical nurses and licensed vocational nurses are required to have about one year of training in nursing prior to working in a nursing home. They work with registered nurses to plan, implement, and evaluate residents’ care. Certified nursing assistants must complete a competency evaluation or nurse assistant training. They work under the direction of registered nurses and licensed practical nurses and assist residents with daily living activities, such as hygiene and grooming, dressing, eating, and going to the bathroom.
Why Staffing Level Reports May Not Reflect Quality of Care
When considering the reported staffing level of a nursing home, it is important to remember that a nursing home that appears on paper to be fully staffed may be quite different in reality. There are several reasons for this. First of all, nursing homes self-report their numbers to the state, and mistakes or even intentional misinformation may be included in the reports filed with the government. Secondly, the staffing numbers, even if accurate, represent at most the two-week period leading up to a nursing home’s inspection by the state.
Especially in for-profit nursing facilities, there is a financial incentive to understaff because paying for a full and well-trained staff is one of the largest expenses of a nursing home. When owners cut staff in order to increase profits, it takes a heavy toll on residents. Just a few of the many problems that residents can suffer from understaffing include bedsores, muscle atrophy, psychological stress, malnutrition, nutritional deficiencies, improper timing or dosing of medications, falls, bruises, and infections. Furthermore, residents in understaffed facilities are sometimes given sedatives and other psychotropic medications that they do not need so that they will make fewer demands on staff.
If You Have Concerns About a Family Member’s Care
When a nursing home understaffing becomes chronic, there is no question that patient care suffers. Serious injuries and even wrongful death can result. If you suspect that your loved one has suffered abuse, neglect, or mistreatment while a resident at a Kentucky nursing home, the experienced nursing home litigation attorneys at English, Lucas, Priest, and Owsley can review your case to determine the likelihood of a successful lawsuit against the facility. To schedule an appointment, call us at (270)781-6500. We are currently reviewing cases throughout Kentucky, including Bowling Green, Owensboro, and Elizabethtown.
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