Thursday, March 6, 2014

How Many Elderly and Disabled People Have to Be Injured and Die Before Advocates Act? Information Bulletin # 386 (3/2014) Here’s a surprise for elderly and disabled advocates: nursing homes are really dangerous places for people who live in them. For a number of years, there have been numerous federal government reports of injuries, physical abuses, and deaths of residents of nursing homes. We have reported on these reports quite often. See for example Information Bulletins “How Many more Disabled People Must be Injured in Nursing Homes;” “Disabled People and Physical Restraints in Nursing Homes;” “Abusing Drugs in Nursing Facilities;” “States ‘Miss’ (i.e., Fail to Report or Protect” People in Nursing Homes Who Are in Active Harm or Immediate Jeopardy.” Guess what? Another HHS Report, this one from the Office of Inspector General, and it’s entitled “Adverse Events in Skilled Nursing Faculties….” (OEI-06-11-00370). If anyone really cares, and sometimes we are not sure, here are some of the Findings: • 22% of the residents experienced “at least one adverse event during their stays.” • 79% were serious enough to require either prolonged nursing facility stay or hospitalization for acute level care. • 14% required “intervention to sustain the resident’s life.” • 6% “contributed to or resulted in resident death.” These total 22% “adverse events” include a shocking array: 37% related to medication (e.g., medication-induced delirium, excessive bleeding due to medication, hypoglycemia related to medication); 37% related to ongoing resident care (e.g., falls or other trauma with injury, dehydration, acute kidney injury, exacerbation of preexisting conditions resulting from an omission of care, pressure ulcers); and 26% related to infections (e.g., aspiration pneumonia, urinary tract infections). An extraordinary number of these “adverse events” are acknowledged to be “clearly preventable” or “likely preventable.” Even if our public officials do not care about these “adverse effects” to elderly or disabled people, they should (maybe) care about, at the least, financial costs of these “adverse events.” Here’s a quick breakdown – an additional $58 m in hospitalization costs for “adverse medication events,” $67 m in hospitalization costs for “adverse resident care events,” and an additional $83 m in hospitalization costs related to “adverse infection events.” Do our State and federal officials care that these costs for these hospitalizations were “clearly preventable” or “likely preventable”? The public reaction, your State’s reaction and especially the elderly and disabled advocates’ reaction sounds like “ho hum:” another report confirming the valueless lives of elderly and disabled people. KY, LA and SC had the largest number of “serious deficiencies per nursing home.” Some other big winners include AR, FL, GA, Il, IN, MI, MS, NC OK, WI, which had a large number of “total serious deficiencies.” What about the nursing facilities paying, at least, monetary fines for these “adverse events”? The “average fine” varied from a low of $1,559 to a high of one State at $38,851 and a major outlier of $70,872. Quite a number of “average fines” were in the range of under $10,000 (21 States). That’s chump change for nursing homes, far lower than even Medicaid reimbursement. Yes, despite the enormous progress we have made to increase home and community-based services, advocates for the elderly and disabled people have done a terrible job ending nursing home institutionalization. We know nearly all nursing home residents could be cared for in their homes with appropriate services. Get that word out! We’ve been afraid to point out how really dangerous nursing homes are! We need to post signs that say “Beware. Nursing Homes May Be Dangerous to your Health and Life. Avoid at ALL Cost.” Steve Gold, The Disability Odyssey continues Back issues of other Information Bulletins are available online at with a searchable Archive at this site divided into different subjects. Information Bulletins will also be posted on my blog located at To contact Steve Gold directly, write to or call 215-627-7100. Ext 227.

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