The US, similar to several other developed countries, is currently experiencing an increased rate of the elderly population. Older people require specialized treatment, as most of them have various chronic illnesses. Nevertheless, the increased need for special attention has created a great business opportunity for nursing and residential homes. Residential facilities, including assisted living homes and independent living homes, are integral to the current US society as they address the needs of seniors who struggle to live a quality life as they age (Dyer, 2020; Harrington & Edelman, 2018). The significant role played by those facilities is evident in the rate at which assisted living facilities, and residential homes are increasing. Besides, those facilities have evolved to meet the expectations of the Baby Boomer generation, which are different from the previous generations.
A broad category of needs is provided under long-term care, and most of them focus on daily living activities such as bathing, self-feeding, dressing, continence, and transferring, which included functional mobility such as getting into and out of bed as well as walking. Long-term care also involves instrumental activities of daily living (IADLs), which assist seniors to live independently in their community (Tomioka et al., 2017). An example of IADLs is acute health care services provided by hospitals and residential facilities. Several risks are associated with delivering long-term care services, especially when dealing with the elderly (Harrington & Edelman, 2018; Tomioka et al., 2017). Most of them suffer from severe mental health conditions that can affect their judgment, thereby predisposing them to dangers. For instance, a patient suffering from dementia needs close attention lest they fall and suffer hip fractures and subject the residential homes to huge litigation claims (Dyer, 2020; Harrington & Edelman, 2018). Besides, various professionals that provide specialized treatment to residents can be accused of professional negligence, which can also result in losses due to court cases. Thus, this paper details three incidences that exposed long-term care facilities to greater risks.
A 97-Year Old Dementia Patient Falls During Transfer
Jane is a 97-year old female with a history of venous insufficiency and dementia. Although she can recognize familiar faces and even engage in communication with some people, she has difficulties with expressing herself. She relies on a caregiver as her interpreter when communicating with people who are not familiar with her condition. The client has been living in an assisted home facility for the previous ten months. She has mobility problems and relies on a caregiver for support when moving around. Someone must assist Jane during bathing and dressing, as she cannot do it on her own. The staff of the assisted living home implemented care-plan interventions, which included finding a known and consistent caregiver to assist her in daily activities and even convince the woman when she resists care procedures.
The regular caregiver had developed a good relationship with Jane, as she was happy and obedient and never resisted care being in the caregiver’s company. The family was happy with the way Jane was being handled at the facility until they received a call from the residential home, informing them that Jane had sustained a hip fracture from a fall. On that day, the regular caregiver had been transferred to another patient, and Jane was assigned a new caregiver who was not familiar with her condition. One morning, while in the company of the new caregiver, Jane resisted her transfer from the bed and swung at the caregiver. As a result, she fell and had her hip fractured. The assisted living facility took her to the hospital, whereby she underwent an open reduction and internal fixation surgery. The surgery seemed to be successful, and she managed her pain with a three times a day dose of oral acetaminophen at 1,000 mg. other medications that she used during her course of recovery included a morning dose of quetiapine 12.5 mg as well as an afternoon dose of 50 mg for “nondirectional dementia.”
Upon her discharge from the hospital, Jane was enrolled in physical and occupational therapy sessions, but she was again assigned to a new caregiver. She became resistant to participation, and she reportedly hit and pinched her caregiver on several occasions. Nevertheless, Jane’s physical mobility improved as she could take a few steps with the assistance of two individuals. Her younger brother visited her in the home and was concerned that her sister was not receiving appropriate care from the facility, as she was always anxious and unhappy. Besides, the younger brother was upset by the huge bills charged by the facility due to the complicated nature of her care. Also, they were concerned that the facility should have paid for the entire hospital bill as Jane sustained the hip fracture from the professional negligence of the staff in the assisted living home. As a result, the family sued the facility for negligence and non-delivery of care that was promised when Jane was admitted. The assisted living home paid the family a sum of $1.2 million after a long court case.
A Nursing Home Paid $2.4 million for Medical Errors
The absolute Nursing home offers various specialized treatments and services to different groups of patients. The facility is also home to at least 500 seniors, most of whom suffer from chronic age-related illnesses such as dementia, high blood pressure, diabetes, and cardiovascular diseases. John was admitted to the facility in June 2019 and was suffering from diabetes, dementia, and high blood pressure. Before his admission into the healthcare facility, John had suffered a heart attack, but an ambulance came on time to take him to a nearby hospital. He stayed in the hospital for four weeks when the doctors stated that he had fully recovered from the condition. The family became concerned that he could no longer stay at home as he might suffer a sudden heart condition and die. Thus, they believed that the nursing home was an ideal place for him as he could receive constant medical treatment in case of an emergency.
One evening, someone called the family from the nursing home, informing them that John had suffered a cardiac arrest in the morning and that a CPR resuscitation was unsuccessful. Post-mortem results indicated that John died from some medications that he had taken in the morning. The results concluded that the drugs that he used triggered a heart attack. The family sued the nursing home for medical errors. They argued that the doctors at the facility were aware of the history of the patient’s illness and that the physicians should not have prescribed the medication that killed him knowing its potential consequence.
The nursing home made several arguments in defense against the patient family’s case, but they failed to convince the court. The family won the legal case and was awarded $2.4 million by the court. The nursing facility had made several errors before this incident, but most of the cases were settled out in court. For instance, a family had accused the healthcare facility of failing to inform them that their relative had been admitted for a serious complication, and they needed urgent surgery. By the time that arrangements for the surgery were made, the patient’s condition worsened, and he died a few hours later. The family had complained about the facility’s negligence and failure to diagnose their relative on time. Witnesses had stated that the cancer patient had been screaming the entire night out of the pain that he was experiencing. However, doctors were not around, and the few available nurses could do nothing other than minor pain management assistance.
Despite knowing that they were at risk of litigation cases due to professional negligence, the nursing home had done little to seek insurance itself. By the time that the court stated that they must pay John’s family a sum of $2.4 million, the facility had been running on losses having secured a loan the previous year to expand its bed capacity. Thus, this incident illustrates that offering long-term care services is a delicate affair. Therefore, companies should have effective strategies to minimize risks and put in place measures that will cushion them against losses in case of the occurrence of a risk.
Dementia Patient Died in a Nursing Home
A significant portion of nursing home residents is there because they have dementia. Dementia is a syndrome that is characterized by loss of memory, thinking, and the ability to perform everyday duties. When someone has dementia, they need constant monitoring because they can otherwise put themselves and others in danger. Patients that have dementia have the risk of wandering off, and as such many nursing homes have implemented safety protocols to prevent such incidences. The protocols include:
- Door alarms that alert nurses and other caregivers if a patient is leaving a safe zone. Other types of alarms include wrist bracelets that sound alarms if the patient wanders off.
- Locked units that are designated safe places for residents to interact with others
- Resident tracking systems
- Search plans that can be rapidly deployed if a patient goes missing
- Supervision protocols that monitor the wellbeing and location of patients at given intervals.
All these and other protection systems and guidelines are supposed to work to protect from harm, still, they can fail in some cases. Exact this situation happened to a resident of a Northern Ohio nursing home who wandered off and was found dead in the early hours of the morning after spending a night in freezing temperatures. As reported, Campbell, the victim was able to get out of the nursing home because alarm bells at the facility failed to work. Caregivers were aware that when propped, the alarms failed to off, and this helped them to easily move around, but they never thought that patients too could prop the doors. The bracelet she wore also failed to sound an alarm. At the same time, two nurse aides lied in their report that they had checked on Campbell between 2 a.m. and 4 a.m.
Campbell was missing for about 8 hours before anyone took notice, by which time she had already succumbed to the sub-freezing temperatures. Following the incident, three staff members of the Pandora nursing home faced charges of involuntary manslaughter, gross negligence, and forgery. The nursing home was also not spared, as it ultimately bore the responsibility of keeping residents safe, maintaining safety equipment, and hiring a well-trained and professional staff. The healthcare facility paid a total of $2.2 million to the family of the deceased. Besides, the facility was compelled to demonstrate that they have implemented necessary policies to prevent similar incidences in the future or else get its operating license revoked.
This case illustrates how incompetent the staff was in the healthcare facility. Besides, the nursing home had not put in place effective patient safety management policies, which resulted in the death of Campbell. Other than relying on the alarm bells, they should have hired guards to protect patients at all times. It was also important for the organization to train its entire staff about their professional commitment and the consequences of their professional negligence. A well-trained healthcare worker understands their professional roles and would not work on assumptions such as believing that alarm bells would offer maximum security and patient safety.
Conclusion
Companies offering specialized long-term care services should know that they are operating in a high-risk business and that a poor risk management strategy could lead to significant losses. The three cases described in this paper indicate that several risks are associated with the delivery of long-term care services, especially when dealing with elderly or mentally ill patients. Most clients suffer from severe mental health conditions that can affect their judgment, thereby predisposing them to dangers. For example, a patient presenting with dementia must be given close attention to prevent them from falling and suffering hip fractures, which will subject the residential homes to court cases and huge litigation payments. Besides, different caregivers that provide specialized treatment to residents can be accused of professional negligence, which significantly affects the organization’s profitability.
The three case studies illustrate how strict the litigation fees are in the long-term care industry. Various strategies should be put in place to manage risks in this field. First, organizations should develop a strict work policy to hold their employees accountable. Secondly, companies operating in the long-term care delivery industry should insure themselves against professional negligence to minimize costs in case of a legal case. Long-term care involves offering a variety of services that are designed to meet the health and personal care needs of a person for a sustained period. Most of the services that are offered under long-term care are geared towards creating an environment where the patient can live independently and perform everyday activities with minimal help.
For insurers and hospitals, providing long-term care comes with inherent business risks given that it is the elderly, the disabled, and the terminally sick who are recipients of these services. Unlike other groups, the above group of patients is susceptible to all manner of contagions. In other words, the margin for error with these groups is very narrow. Here, we shall create three fictional incidences demonstrating such risks.
References
Dyer, C. (2020). Aging Out Arbitration for Wrongful Death Suits in Nursing Homes. Pepperdine Dispute Resolution Law Journal, 20(1), 42-59. Web.
Harrington, C., & Edelman, T. S. (2018). Failure to meet nurse staffing standards: A litigation case study of a Large US Nursing Home Chain. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 55, 0046958018788686. Web.
Tomioka, K., Kurumatani, N., & Hosoi, H. (2017). Association between social participation and 3‐year change in instrumental activities of daily living in community‐dwelling elderly adults. Journal of the American Geriatrics Society, 65(1), 107-113. Web.