Groups » Learning the Signs of Negligent Elder Care in Long-Term Care Facilities

As the Baby Boomer population demographic inches closer to the mean age of seventy years, the way in which we think about caring for seniors will need to change. Never in the history of the U.S. has there ever been a large cohort that has challenged the health care system in the same way, simply due to the volume of citizens who will rely on home care or long-term care facilities within the next seven to ten years.

As resources are already strained and massive restructuring is taking place within the American healthcare system, including the implementation of Electronic Health Information Exchange, the availability of spaces for institutionalized care will matter as much as the quality of care that each patient can expect to receive. We discuss one of the biggest concerns that we all have for family members (and for our own future retirement needs), as we review the contributing factors that precipitate abuse and neglect of seniors in healthcare settings.

How Many Senior Americans Require Nursing Home Care?

In 2010, one in eight people over the age of eighty-five years resided full-time in a nursing home or long-term care facility.  Only one percent of seniors aged 65 to 74 required institutionalized care, but in 2012, there were 1.4 million Americans in nursing homes.

Can American’s Pay for Their Nursing Home Needs? Finance Increases Risk Factors

Did you know that in the United States, in the year 2000, spending for older adults aged 65 or older accounted for 57 percent of Medicaid funds? That was sixteen years ago, before the first Baby Boomers began to consider retirement and their long-term care needs. If demand exceeds availability, and more pressure is placed on institutions for senior healthcare as well as home based or community care, will the instances of elder abuse, neglect, or mistreatment rise?

Less than ten percent of Americans receive Medicaid coverage for assisted living, which means that costs will be covered by private insurance (where the senior has planned and paid for it) and out-of-pocket cash payments for treatments and extended care. The U.S. Department of Health and Human Services shared average costs based on a survey of fees for long-term care facilities conducted in 2010:

  • An average rate of $205 per day or $6,235 per month for a semi-private room in a nursing home.

  • An average rate of $229 per day or $6,965 per month for a private room in a nursing home.

  • Approximately $3,300 per month for an assisted living, one-bedroom convenience unit.

  • $67 per day for an adult enrolled in a day health care center (while caregivers are at work).

  • $21 per hour and up for the services of a home health aide.

The pressure of finding affordable care and the scarcity of funding through Medicaid or personal finance options will place more seniors at risk of neglect, abuse, and early mortality.

Healthcare Fraud and Abuse

Even when you have selected and financed a quality long-term care facility for your family member, he or she can still be susceptible to abuse and neglect, as victims of healthcare fraud. One of the more alarming trends in America is overcharging or overbilling for health or therapeutic services, which are never delivered to the patient. Families who do not visit frequently would not be aware, and seniors who have dementia or other cognitive or communication impairments may not be able to communicate the lapse in service.

In 2015, two psychologists were charged for fraudulently billing Medicare $25 million dollars for administering psychological and cognitive tests on nursing home residents which were not required, or tests that were never conducted at all. Beverly Stubblefield, Ph.D., and John Teal, Ph.D., collected fees from nursing homes in Louisiana, Mississippi, Alabama and Florida. Psychological tests are often administered to tailor a care plan that addresses emotional needs for quality care, including tests and treatment for depression.

Billing for undelivered services, accepting kick-backs from suppliers and service providers, over-medicating patients (to subdue them), or under-medicating patients (to save on prescription expenses) are common methods that unscrupulous healthcare facilities use. These choices are illegal, and jeopardize the health and safety of senior residents.

Do You Know How to Spot Abuse?

It can be hard for family members and caregivers to catch an abuse in progress, and often, it is the sum of months of observation before something is reported. It is hard to believe that medical professionals would be capable of risking the lives of patients, and often, families lean toward the healthcare provider’s side of the story until the evidence becomes difficult to ignore.

Here are some of the warning signs that families should be aware of, and act on sooner rather than later, as they may indicate fraudulent activities and inadequate care, and even violence and bullying in the long-term care facility:

  • Bruises and pinch marks in hidden areas, including the chest, the backside, the shoulder, and other areas typically hidden by clothing.

  • Nervousness and anxiety demonstrated by the senior. Fearfulness of being left alone and repeated crying.

  • Theft of objects from the senior’s room, including jewelry and other valuables.

  • Systemic weight loss.

  • Sleeping problems and nightmares.

  • Verbal abuse, disrespect or ridicule from healthcare workers to the senior.

  • Impatience, rough handling, and aggressive demeanor from care workers.

  • Sadness, lethargy, noticeable change in mood, anger, or aggression from the senior family member.

Families that suspect that fraudulent activities, theft, verbal, physical, or sexual abuse of residents is occurring should collect evidence, including video, photos, and interview with the patient(s) to substantiate the claim and suspicions. The presence of bed sores, according to nursing home negligence attorney in Illinois and elder care advocates, can be an indication of inappropriate care plans, or neglect.   Legal action can be taken against a long-term care facility, if abuse and fraud is proven in a court of law.

Protect your family member by being present to his or her needs, and visiting regularly.  If able to communicate fully with you, provide him or her with a phone or device to page you directly, should there be any problems or concerns with the care. Remember that for most seniors, being abused is something that is humiliating to them, and they do try to dismiss it or hide it from family. Ask questions, be attentive, believe them, and always investigate any claim of abuse.

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