Neglect and abuse in America’s long-term care facilities is a problem that’s gone too far. Today, 1 out of 3 nursing facilities are home to victims of physical, psychological, sexual and verbal exploitation. Sadly, many of these instances go unreported – but even documented cases are increasing every year.
However, the search for solutions continues. In recent months, 2 new regulations have been set in motion to curb the abuse epidemic affecting thousands of our nursing homes.
New Regulations: Ending Substance Abuse and Hospitals’ Silence
This month, a state-wide change was announced in Massachusetts. In light of the state’s opioid crisis, regulators have ordered nursing homes to begin stocking an overdose-reversing drug, naloxone.
This new rule acknowledges the fact that there are many patients in nursing homes battling addiction, including addiction to opioids. Opioid – a drug that killed 1,600 people in Massachusetts last year – is commonly used in these facilities for pain relief.
Previously, few nursing homes were interested in making substance abuse treatment a priority. However, substance addiction has become a prominent problem in nursing homes due to lack of treatment and staff training. And owing to the stigma attached to substance abuse – despite the surgeon general arguing that substance use disorders are medical conditions – it can be tough to find nursing homes for some patients.
Meanwhile, for Massachusetts and the rest of the United States, a new rule was drafted by the Obama administration in October to improve transparency between hospitals and their patients. Up until now, hospitals haven’t provided recommendations for nursing homes, as Medicare has strict rules on restricting patients’ choices. But new regulations aim to prompt hospitals to begin disclosing this information.
The rule states that hospitals “must assist the patients, their families, or the patient’s representative in selecting a post-acute care provider by using and sharing data.” In other words, hospitals must share which homes have poor quality ratings or public health violations.
Some hospitals, like certain ones in Massachusetts, have already started endorsing hospitals despite Medicare regulations. But most others are left lagging, not willing to risk being cited by Medicare for violating rules. Because of the resulting uncertainty that patients face in finding a suitable home, there is no telling whether they’ll end up somewhere with a history of poor – or even abominable – standards of care.
The Continuing Problem of Nursing Home Abuse
Residents of nursing home facilities are currently subject to an appallingly high likelihood of suffering mistreatment. A study released earlier this year reported that 5,283 facilities in the U.S. were cited for almost 9,000 instances of abuse over a 2-year period – and, again, these are just reported cases. These cited homes accommodate around 550,000 people: vulnerable citizens often unable to defend themselves from harm.
Common examples of what patients are at risk of facing are severe bed sores, infections, malnutrition, and insufficient staff – and this is only the tip of the iceberg. Some patients are viciously attacked, manipulated, humiliated, and overmedicated by nursing home staff, which can result in anything from serious illness to avoidable death.
The Future Is Still Uncertain
What makes the matter even more disgraceful is the motivations behind allowing the abuse to continue. The biggest factor? Cash. Not only does nursing home abuse often stem from a lack of regulation or appropriate staff training, but the fact that many for-profit nursing homes are run by money-driven corporations that prioritize profits over patient well-being. Because of insufficient Medicare funding levels, nursing assistants are paid $7-$9 per hour while for-profit facilities find any way they can to boost their bottom line.
The New Regulations Soon to Come
The Obama administration hasn’t yet announced when the new rule for hospitals will be finalized – and time is of the essence. If the draft isn’t enacted before the end of President Obama’s term, accountability falls into the hands of President-elect Trump, who plans to be frugal in passing new federal regulations.
But the positive effects brought about by this new rule and pushing substance abuse treatment could be crucial for the future of America’s nursing home problems. With hospitals having the freedom to provide their patients with more guidance, and with staff activity kept in check, elders will be empowered to make informed decisions about where they receive care. At a minimum, they’ll have a chance to guarantee the standard of care they deserve.
