With Federal and State laws mandating levels of care from nursing homes, the question most often raised is: « Why does abuse still exist inside our nursing homes? ».
Budgets & profits
Unfortunately, many times profits take a higher priority than patient care when it comes to nursing homes that are being run for a profit. Many nursing homes are run by large corporations that own multiple facilities across the United States. The individual home ends up being run from the board room rather than from a patient focus.
In addition, many of these nursing homes are budget or census driven. The administrators want to come in under budget to make more profits for the corporation. This desire for profits translates into less staffing; less training for the staff that they do have; less food – or a lower quality of food – for the patients; and less management and oversight. Therefore, there a conflict arises between saving dollars and providing good care.
Even an established system of « pool nurses or nurse’s aides » are difficult to find in nursing homes. Each nursing home should have some type of « pool » available to them in case of call-offs, holidays, etc. Why isn’t this system established’ It would cost more money. Instead, nursing homes run under-staffed. There would be a much higher level of care given to patients if adequate staffing were provided.
The effects of Understaffing
How understaffing effects malnutrition and dehydration
The medical director
In many instances, the Medical Director of a nursing home benefits from the amount of profit generated by the nursing home they manage. A moral and ethical conflict then arises for Medical Directors. They must choose between increasing the profit margins of their individual facilities or supplying more support staff for the care of residents.
Hospital care vs. profit
Sometimes patients don’t receive the hospital care they need because of profit concerns. This practice ranges from which ambulance service the nursing home calls, to whether or not a patient even goes to the hospital. Nursing homes may contract with an ambulance service that is further away from the home because they got a better deal on rates. Also, nursing homes don’t like to send patients to hospitals because they don’t receive any money for the time the patient is in the hospital. Also, the more skilled care needed for that patient, the more money the nursing home receives from Medicare.
In addition to financial gains, hospitals also immediately run lab reports on any patient that is admitted to their facility. These lab reports provide a snapshot of information about the patient. Along with impaired nutrition, a simple blood test can show if the patient has a low protein level, indicating malnourishment and thus, is prone to skin breakdown which results in pressure sores.
In a nursing home, the standard is a yearly complete blood count. Family members should ask the doctor to check blood work more frequently, especially if they are concerned if the patient looks like they are losing weight, has pale skin color, etc. Most nursing homes bring medical personnel in to the home to do the lab work and x-rays so that the patient doesn’t have to go to the hospital at all.
Unfortunately, nursing home abuse may occur because of the desire for profit. Those caregivers who work in nursing home facilities are often stretched beyond their ability. They try to do the best job that they can; but oftentimes, the lack of additional support restricts what they can do to help patients. Be sure to investigate any nursing home you are considering for your loved one.