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Understaffing in Kentucky Nursing Homes

As reported nationally, the number one overriding problem in Kentucky nursing homes is understaffing. Understaffing, as you can imagine, leads to all sorts of bad outcomes.

When a Medicare eligible patient is admitted, the Nursing Home typically reports to Medicare the needs of the patient. This includes staffing needs. This generates a score for the patient and the higher the score, the higher the reimbursement to the Nursing Home for that patient.Nursing-home-resident2.jpg

The problem is many for-profit homes do not staff the nursing home consistent with the actual needs of the patients. After reviewing employee timesheets, I've seen cases where there was one aid assigned to as many as 15 patients. That is simply a disaster waiting to happen.

I've handled cases where under staffing has led to fatal medication errors, severe and fatal dehydration, and falls leading to fatalities. In one case, my client laid on the floor of her room for 2 hours with a fractured hip after falling from her bed without any alarms or aid. She was discovered by the cleaning crew.

In another case I represented the family of a woman that was given very high dosages of coumadin for nearly a month without testing despite a doctor's order in her file to lower the medication and test regularly. The staffing was so thin there was no consistent care or communication within the facility. She unfortunately bleed out internally and passed away. She was originally only admitted to rehab from a surgery.

In Kentucky over the past three years, there have been 4,465 cited deficiencies amounting to $9,420,000 in fines and there are only approximately 287 homes in Kentucky. But when you really dial down on that data, you see the same pattern. Understaffing in large for-profit chain nursing homes. It is undoubtably the root cause of most of the injuries I see.

Despite the mountains of data that point to understaffing as the root cause of many of these examples, Frankfort has refused to address the root cause and instead continually tries to protect and insulate the Nursing Home industry. For example, the now ill fated Medical Review Panel law. All this has done is create a broken layer of government bureaucracy slowing a family's access to the court system.

In my opinion, a fairly sensible step forward is to enact state required minimum staffing requirements consistent with the home's reporting to Medicare. This would be for RNs, LPNs, or CNAs. In other words direct care to the patient. Kentucky is one of 14 states that does not require direct care minimum staffing. Unfortunately, past efforts to pass such legislation have fallen short.

The industry has known about this problem for decades. In a 2000 Congressionally ordered study data revealed that over 91% of all Nursing Homes had nurse aide levels below the minimal recommended level. The report recommended homes have one nurse's aide for every five or six residents from 7 a.m. to 11 p.m. instead of 1 aide for every 8 to 15 residents like I've seen repeatedly in cases. In response many states enacted minimum requirements while Kentucky has remained silent.

I also think it is important to note that in the vast majority of cases, the nurses and aids who work in these facilities are good hard working people and entered this profession to help people. However, the deck is severely stacked against them when their corporate employers chose to cut corners.

It is time Kentucky's legislature step up and address the root cause of the problem.

Christopher W. Goode, is a national recognized trial attorney and founder of Goode Law Office PLC. While his practice is diverse, he is committed to only representing injured individuals from automobile collisions to nursing home neglect and abuse to product liability claims. He is a past president of the Fayette County Bar Association and is a frequent speaker on legal topics. Chris currently serves as a District Vice President for the Kentucky Justice Association. He can be reached at [email protected] or www.goodelawyers.com. 

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