Nursing Home Investigations, The Sad Truth

By Cheryl Yocum, JD

As our parents and loved ones get older and decline in health many of us are faced with a path of questions that become increasingly more difficult to answer. Does my mother or father need help around the house? Are they remembering to take their medicine on time? The questions progress over time to ones such as: Was this a one time fall or is their balance off to the degree they will fall often? Can a nurse who comes in once a day provide enough support? Do they need 24 hour care due to Alzheimer's or dementia or to make sure they get their medicine? None of us want to face these questions and our parents likely do not want us to have to face them either.

Many times we only hear about nursing homes when they are in the news when something has gone horribly wrong in the facility or when our loved one is about to be discharged from a hospital and we have only one or two days to locate the best place for our loved one. The hospital tries to help with their discharge planner and sometimes a representative of a local nursing home will come by to "sell" their facility. Make no mistake, the person visiting you or your loved one in the hospital is "marketing" their facility. It is their job to bring new residents into the nursing home and they will, many times, tell you what you want to hear.

As one who has investigated many elder abuse cases in nursing homes, I can tell you, the lack of staffing and lack of care at the administration and/or corporate level due to placing profits over resident care can be a deadly combination. There are some things you can do to help assure you are making the right decision of where to place your loved one.

First and foremost, visit the facility. How does it smell, not only at the entrance but by the kitchen, around the residents' rooms, the dining area, the therapy room. Where are the residents, in the activity area or simply parked outside their rooms sitting in wheelchairs? If you hear a resident calling out, do you see a staff member going in to check on the resident? When you hear a call light activated stop and watch to see how long it takes a staff member to respond. When they respond do they simply go in to turn off the light or do they take the time to take care of the resident? Do the carts the nursing assistant's use to carry the linens, towels, personal hygiene and adult briefs hold plenty of supplies? Go in to the facility after 8pm to see how things are different. Talk to the nursing assistants to see if they like working at the facility. Ask the nursing assistants how many residents they have to care for that shift. (Day shift will have fewer residents than night shift.)

Second, check with California Department of Health Services to see how the facility fared during its last inspection. (These results are found on several websites as well such as www.calnhs.org.) If there were deficiencies found, what was the nature of the deficiency? Was it one that involved the immediate safety of a resident or something less such involving record-keeping?

If you do suspect that your loved one has suffered from abuse in the nursing home, which can include neglect, contact the Ombudsman whose telephone number should be posted through out the facility. Speak to the Administrator about your concerns. Consider moving your loved one to a different facility. Consider contacting an attorney who specializes in handling elder abuse cases. Write down the names of the caregivers (RN's, LVN's, CNA's, therapists, etc) who provide care to your loved one - make sure to note this information for all shifts, not just day shift. Keep thorough notes about your loved one's diagnosis, treatment plan and what you actually see going on in the facility, especially as it relates to your loved one. If you do file a lawsuit or arbitration claim consider retaining an investigator who specializes in investigating elder abuse cases to help you.

Investigators are an integral member of the team in preparing and presenting an elder abuse case. Investigators can interview former employees of the facility to determine staffing levels, supply levels, budgetary constraints, and the care your loved one was actually receiving. The investigators of Gailey Associates, Inc. have investigated many elder abuse cases, know the questions to ask, where to look for the evidence and can assist your attorney in making the strongest case on your behalf.