More Staggering Statistics: Confronting the Epidemic of Elder Abuse

The abuse and neglect of our eldest generation in nursing homes is a pervasive problem, and no part of the country is immune to it. In fact, even some homes receiving the highest possible ratings have been found to be the setting for some of the more heinous stories of abuse.  For example, in early April the son of a 78 year old resident at Prentiss Center for Skilled Nursing Care on Cleveland’s West Side placed a camera in his mother’s room to substantiate his suspicion that his mother was being abused.[1]Prentiss routinely receives five-star rating by the Center for Medicaid and Medicare Services. So why is this such a problem? Why are our mothers and fathers being abused in facilities meant to be a place of rest; a bastion of safety for those who can no longer depend solely on themselves?

Why it happens:

The unfortunate reality is that the vast majority of workers at most nursing facilities are under-paid and over-worked. Many work long hours and are paid just over minimum wage. Exacerbating the situation further is the fact that working with the elderly and infirm can be a very trying experience.

In a capitalistic society such as ours we would be naïve to think that money did not play a major role in this situation as well. The simple fact is it costs less to hire and staff a facility with Certified Nursing Assistants (CNA) rather than Registered Nurses (RN). This fact is evident here in Michigan where our nursing facilities are above the national average in CNA hours per resident per day (national average=2 hours 24 minutes, Michigan average 2 hours 30 minutes). Obviously this isn’t a substantial difference, but a difference nonetheless. The CNAs assist residents with activities of daily living, i.e., eating, grooming, hygiene, dressing, transferring, and toileting.

The overuse and underpaying of Nursing Assistants, the frustration associated with caring for the elderly and infirm, and the resulting low employee morale are leading to an increased risk in injury for residents. The percentage of Michigan nursing facilities with deficiencies[2], as of 2009, was at 97.7%; a staggering statistic. Again, this problem is not unique to Michigan. In fact, the national average for facilities with deficiencies in 2009 was 93.4%.

The Road Ahead:

As alluded to earlier, assisted living and long-term care facilities have not been immune to the economic downturn. The dire financial straits these facilities have found themselves in have lead to cuts in pay for employees, increased rent to residents, or in many cases both. The primary payer for nursing home residents? Private payers make up an insignificant portion at 20%. Medicare and Medicaid, however, account for a combined 80%. Threatening to exacerbate what is already a dire situation are proposed cuts to Medicaid, which accounts for 62% of the combined 80%. Perhaps the more effective route, as opposed to outright cuts, would be to eliminate waste. Nowhere is that waste more apparent than in the fact that Medicaid is currently reimbursing nursing facilities for legal fees, even when they lose! Legal fees are currently an allowable cost under Medicaid and are included in a nursing home’s per-bed, per-day reimbursement.

All political discussion of the best path forward aside, the bottom-line is the situation in nursing facilities is critical and on the precipice of getting worse if cuts are made to the primary source of their funding.

What Should You Do?

If you have a loved one in a nursing facility you must educate yourself as to the signs of abuse. If you notice:

– Unusual or unexplained injuries (cuts, bruises, burns)

– Appearing disheveled or poorly cared for

– Pressure or bed sores

– Unnecessary Confinement

– Dehydration or malnutrition without a medical cause

– Confusion or Helplessness

– Strange and inconsistent explanations for injuries

– Hesitation to talk openly

Contact The Hone Law Firm immediately. Make sure that your loved one is being treated with the dignity that they deserve.



[1]– Investigator: Hidden camera catches nursing home abuse, June 28, 2011

[2] Given to nursing facilities for problems which can result in a negative impact on the health and safety of residents. The Centers for Medicare and Medicaid Services define “actual harm” as a “deficiency that results in a negative outcome that has negatively affected the resident’s ability to achieve the individual’s highest functional status.


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