IDPH has cited Vandalia Rehabilitation & Health Care Center for failing to have enough staff on hand to meet the care needs of the residents.
Nursing homes are regulated by both the federal government and the State of Illinois. Both have regulations regarding minimum staffing levels. The state regulation sets a mathematical formula for the minimum number of staff required, and it is rare to see nursing homes out of compliance with that regulation. The federal regulation is a more flexible but demand standard. It requires nursing homes to have enough trained staff on hand to meet the care needs of the residents on a 24/7 basis.
One of our core beliefs is that the root cause of many of the catastrophes that befall nursing home residents is actually due to understaffing of the nursing home – the staff simply does not have the ability to provide the care and critical thought the residents require because they are stretched so thin due to the choices that management made in how to staff the nursing home.
With that said, it is exceedingly rare for a nursing home to be explicitly for understaffing a nursing home, but that is what happened here. The local ombudsman received a call from the residents complaining that there was only one nurse and one CNA on duty caring for twenty-five residents. Upon arriving at the facility, the ombudsman found that the complaints from the residents were accurate. The appearance and odor of the residents demonstrated that they were not being showered on any regular basis or provided incontinence care in a timely way.
Proving good care in a nursing home is a labor-intensive business, and without having adequate staff on hand, residents get placed at risk of harm in multiple ways:
- Residents who require the help of a mechanical lift for transfers might receive manual transfers rather than with the use of the lift or have a single staff member operate the lift when doing so is a two-man job;
- Residents who are risk for nursing home falls due to musculoskeletal issues and some degree of cognitive impairment will not receive the supervision called for under federal regulations to prevent falls;
- Residents who suffer from incontinence will not receive timely incontinence care, placing them at higher risk for developing bed sores;
- Residents who have a care plan which calls for turning and repositioning as means of preventing bed sores will not get the necessary turning and repositioning, increasing the chances of getting bed sores;
- Residents who already have bed sores will not receive dressing changes and other care necessary to promote healing and prevention of infection;
- Residents who are experiencing some change in condition are less likely to have the staff recognize it. The staff are the eyes and ears of the doctor and understaffing can lead to a delay in notifying the doctor of a change in condition;
- It increases the chance that medication errors will occur;
- Residents may not receive their meal trays and needed fluids in a timely way, increasing the odds that residents will suffer from malnutrition and dehydration, with all of the complications that follow from that;
- Residents are unlikely to receive the care called for in their care plans;
- Residents who are risk of choking may not receive the supervision they need while eating, increasing the risk of a nursing home choking accident;
- And the list goes on ….
None of this is to serve as a criticism of the staff who stayed on trying to provide care for the residents in that nursing home. When the nursing home is chronically understaffed, they are really fighting a losing battle and deserve more help from management to provide the residents with the care that they are entitled to.
COVID has obviously made operating a nursing home harder than it used to be, but management must find a way to provide the necessary care to residents. One of our core beliefs is that nursing homes are built to fail due to the business model they follow and that unnecessary accidental injuries and wrongful deaths of nursing home residents are the inevitable result. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.
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