Nursing Home Abuse
As your loved ones age, it is important to understand the different living arrangements offered for dependent adults and the elderly. The following is a brief overview of the types of facilities available to the elderly and the services they typically offer:
Residential Care Facility for the Elderly (RCFE):
Residential Care Facilities (commonly known as assisted living facilities) are geared toward the elderly who are unable to live by themselves, but who do not need 24-hour nursing care. It is often the first step that an elderly person will take from their home as they begin to require assistance with their daily living. RCFEs are not considered medical facilities or licensed healthcare providers and are not required to have any licensed medical professionals on staff. Generally, RCFEs are not covered by the government, and residents are required to privately pay to live at the facility.
Residential Care Facilities are designed to allow residents who are 60 years and above, the opportunity to maintain autonomy while providing room, board, housekeeping, supervision, and assistance with basic activities like personal hygiene, dressing, eating and walking. Facilities will typically have one nurse on staff to provide medications for residents to self-administer.
Residential Care Facilities for the Elderly must meet care and safety standards set by the State and are licensed and inspected by the Department of Social Services.
Skilled Nursing Facility (SNF):
Skilled Nursing Facilities differ from residential care facilities because the residents are more dependent on the facility for care and assistance with daily living. They are staffed with licensed nurses and are required to notify the patient’s attending physician, dentist, podiatrist, or other medical professional if there is a change in condition, such as a fall, a choking episode, or the development of pressure sores.
The care provided at skilled nursing facilities is meant to provide 24-hour nursing assistance for elderly or dependent adults in order to provide a safe environment for rehabilitation. The government does provide some Medicare coverage for qualifying residents at an SNF. In order to qualify for Medicare coverage, a potential resident must have had a qualifying 3-day stay at an acute hospital and may be covered for a benefit period of up to 100 days. Any stay in excess of the 100 day period must then be paid by the resident unless there is a subsequent qualifying hospital stay which initiates another 100-day coverage period.
Skilled Nursing Facilities are considered healthcare providers and are required to document all clinical notes and keep track of the nursing services provided. Upon admission, a care plan for the resident is created based upon the elder’s special needs. The nursing staff is required to provide the services that are outlined in the plan. Each resident has access to a skilled nurse, a physician, dietary specialist, pharmacy, and activity program. If a physician is not available when something happens, the facility is required to make arrangements for emergency care of the resident.
It is important for families to be involved in the care of their elderly loved ones as they require more nursing support because it becomes more difficult for them to communicate their concerns. If you believe that the needs of your loved one are not being met, you can request that the facility take another assessment to update their care plan.
Home Health Care:
Home Health Care is another option for the elderly who are not capable of living on their own but do not necessarily require the 24-hour attention of a skilled nursing facility. A physician’s recommendation is required for Home Health Care to provide nursing care in the elder’s home on a regularly scheduled basis. The role of a Home Health Care Nurse is to provide nursing care required of Registered Nurses in the home setting. Home Health Care Nurses provide an array of specialized services which can include taking vitals, changing colostomy bags, etc.
A patient may qualify for coverage of Home Health Care services under Medicare if they are over the age of 65 and financially qualify. Home Health Care nurses must also follow strict guidelines in maintaining their scheduled visits, keeping a record of services performed, following physician’s orders, and reporting any changes in condition.
Activities of Daily Living:
Most of us don’t think twice about doing our daily life routines, i.e., getting out of bed, walking to the bathroom, brushing our teeth, and eating breakfast. These simple activities we do without much thought or effort are called Activities of Daily Living, or ADLs. In other words, Activities of Daily Living are basic personal tasks we do in our everyday life.
What are Activities of Daily Living?
Activities of Daily Living are generally grouped into the following categories:
Washing – the ability to shower, bath, brush teeth, brush hair, shave
Dressing – ability to select the appropriate outfit, dress, and undress
Feeding – ability to feed oneself
Toileting – ability to use the toilet
Transferring – the ability to get in and out of bed, on and off a chair,
Mobility – ability to walk, ambulate, propel oneself in a wheelchair
What we take for granted some struggle with doing and require assistance. Difficulty in performing Activities of Daily Living may be caused by a person’s health, medical condition, advanced age, or memory loss.
If Activities of Daily Living has become increasingly difficult for you to do on your own, you may consider getting help. Depending on your level of need, options you may consider are in-home caregivers, Assisted Living Facilities, or occupational therapy.
Assessing Your Level of Need
To help you determine your level of need, you may use the following chart designed by PBS.org.
If you or a loved one resides in a residential care facility for the elderly or a skilled nursing facility, and the facility has not provided the basic services described above, you may have a claim for elder abuse. Contact our office today to learn more about how our attorneys can help (714) 549-0333.