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Nursing Home Abuse Rising Across Nation

Abuse: Violations mount as long-term care facilities have a hard time finding and keeping good help.


WASHINGTON — As baby boomers age and more families turn to long-term care for seniors, an increasing number of older Americans living in nursing homes is being subjected to physical and verbal abuse, according to a government report released Monday.

During a two-year period ending in January, more than 30%, or 5,283, of the hursing homes investigated were cited for abuse, according to the review, which was requested by Rep. Henry A. Waxman (D-Los Angeles). Nearly 10% of the abuses resulted in serious injury or death, the report found.

The figures represent a continuing increase in nursing home abuse nationwide, lawmakers and health-care officials said. The percentage of nursing home violations has risen every year since 1996, the report found, with more than twice as many homes cited for violations in 2000 as four years ago. The study marks the first time officials have studied the problem by comprehensively evaluating reports from state inspectors, officials said.

In California, more than 40% of the state's 1,352 nursing homes were cited for abuse, according to Waxman's office. In Los Angeles County, 37% of 424 homes were cited.

"The senior citizens who live in nursing homes are frail and vulnerable," Waxman said. "They deserve to be treated with respect and dignity--not to live in fear of abuse and mistreatment."

At a news conference Monday, Waxman--the highest-ranking Democrat on the House Government Reform Committee--announced the proposed Nursing Home Quality Protection Act, which would seek to stem abuse and neglect. The bill would increase funding to nursing homes; set mandatory nurse staffing levels; impose stricter sanctions on subpar homes; require criminal background checks on employees; and increase Internet access to records of nursing home conditions.

The report details a range of abuses, including instances of nursing home residents being punched, kicked or choked by staff members. Other abuses included untreated bedsores, inadequate medical care, malnutrition, dehydration and inadequate sanitation and hygiene. Some residents also complained of workers groping and sexually assaulting them.

The report cites specific examples of abuse where patients were either physically or verbally degraded, including several in California: In February of last year, at a nursing home in Pomona, a resident was pushed to the ground by a staff member who kicked her in the side and face. And at a home in Santa Monica last August, a male staff member approached a 90-year-old female resident, exposed himself and made a lewd comment.

The Department of Health and Human Services estimates that nearly half of all people who live to age 65 will reside in a nursing home at some point in their lives, said Rep. Brad Carson (D-Okla.), a sponsor of the measure. There are 1.5 million residents in U.S. nursing homes--a figure expected to increase to 6.6 million by 2050.

Nancy Walker, a certified nurse's aide at the Trinity Hill Health Care Center in Hartford, Conn., said the majority of nursing home workers don't abuse patients. But, she said, long hours and a patient-to-staff ratio that is too high contributes to the problem.

Walker, who said she witnessed four instances of physical abuse on her job, added that when she started as a nurse's aide 19 years ago, she received up to six months of training before working with patients. Now, she said, many new staff members are allowed to work with residents after only a few weeks of training.

Minimal training isn't the only problem contributing to shoddy patient care, health-care workers said. Many nursing homes lack money to provide for residents' basic needs, forcing some nurses to dip into their own pockets to pay for supplies. Retention and recruitment of caregivers has been an increasing problem as more potentially skilled workers shun the $8 average hourly wage for more lucrative jobs in other medical fields. In order to fill empty slots, many nursing homes are forced to hire staff who may only be looking for short-term employment or who have criminal records, health care professionals said.

Alan DeFend, of the American Health Care Assn. in Washington, said his organization and others have encouraged the government to provide more money for homes to hire staff and buy more equipment and supplies.

"It costs more to take care of a Medicaid patient than the government reimburses," DeFend said.

Waxman noted that the proposal would seek to increase funding. '

Many Americans who are now in nursing homes "helped our generation when we needed their help," Waxman said. "Now it is our turn, and our obligation, to make sure they can live safely and without fear."

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