Healthcare Compliance Perspective – Abuse and Neglect:
Compliance Officers should be aware of real or perceived inadequate staffing issues that could lead to resident abuse and neglect. They also need to be familiar with the hiring practices used by their company to make sure that people who are hired are competent to do their jobs. An accompanying problem when things go badly is the potential for covering-up the inability to provide quality of care which may lead to submitting claims for sub-standard quality of care and potential violation of the False Claims Act.
State inspections of an Iowa nursing home from December 2017 to March 2018 resulted in the nursing home being accused of hiring inept caregivers who neglected residents with serious and critical illnesses and who did not provide prescribed pain medications to the residents. Consequently, the state placed sanctions and levied $45,750 in fines on the facility.
The written reports of the inspectors cited several instances of neglect. For example, one of the residents went without any staff response for 12 hours even though he was exhibiting signs of respiratory distress. This neglect was alleged to be the cause of his death. Another resident’s physician had ordered specific monitoring for the resident because he was complaining of feeling badly and calling out for help. Yet, the staff ignored the resident and this inattention was thought to have possibly played a role in this resident’s death. A third death involved a resident who had back surgery, but the staff did not assess and respond to the man’s need for pain medication. While the resident’s physician indicated that the man would have probably died anyway, the failure to provide pain medication was concerning.
The inspectors also noted in their reports that during the time they were in the facility, staff did not respond to the residents’ call lights for over 33 minutes. There were also several other incidents cited that involved negligence in the care of the nursing home residents.
A former nurse at the facility, “who admitted to failing to treat a resident’s wounds,” said the facility was inadequately staffed. She also accused the administrator of asking her to indicate that treatments had been done on a resident’s record when they were not done. The administrator denied this.
It was noted that the state’s $45,750 in fines is being held in suspension. This usually means that the Centers for Medicare & Medicaid Services (CMS) will probably penalize the nursing home for the same infractions as the state.
