In a recent issue of the Canadian Journal on Healing, the Canadian Association on Gerontology conducted “A Survey of Nursing Home Organizational Characteristics Associated with Potentially Avoidable Hospital Transfers and Care Quality in One Large British Columbia Health Region.” The researchers first examined previous studies on avoiding hospitalization in nursing home patients, which have shown that transfers to hospitals often lead to a decline in quality of life for the patient, and that skilled nursing facilities with the proper resources are often better equipped than hospitals to treat certain conditions. However, not all nursing homes are prepared to treat your loved one in the case of an emergency. In this study, the researchers aimed to identify the specific conditions that are required in order for nursing homes to be more effective than hospitals in treating patients. The survey was organized with various questions surrounding some main themes.
The first category of questions analyzed staffing. The study showed that higher levels of staffing were directly linked to lower levels of hospitalizations. Direct care staff members were considered to include registered nurses (RNs), licensed practical nurses (LPNs), and care aides. The results of the study also emphasized communication between staff, particularly care aides. Despite the fact that they usually engaged in the most contact with patients directly, care aides were often excluded from everyday decision-making processes concerning patients.
While most facilities employed all three types of direct care staff, the presence of non-nursing staff, such as dieticians and rehabilitation and activities directors, varied. However non-nursing staff are also very necessary to provide your loved one with the quality of care that he or she needs. For example, a dietician should be present during mealtimes, to ensure that your loved one is receiving the proper nutrients to support his or her health, and to prevent the possibility of malnutrition.
The study also took note of each facility’s nursing hours per patient per day, which shows the importance of adequate staffing. On average, nursing hours per patient per day was calculated to be 3.17. However, according to California state law Health & Safety Code §1276.5-1276.65, the minimum staffing level is 3.2 nursing hours per patient per day. It is important not only to ensure that your loved one’s rights are not being violated and that the care facility is fulfilling staffing level requirements, but also that they are receiving high-quality care from well-trained professionals.
The second theme of survey questions focused on physician care. The results of the survey showed that continuity of care contributed to lowering the amount of hospitalizations. When a patient is continually examined by the same doctor, the physician establishes a familiarity with the patient’s medical history and is better able to treat the patient effectively, thus avoiding unnecessary hospitalizations. However, we must warn you to be cautious with who and what you believe because nursing homes have an incentive to manipulate their patients’ diagnoses. While upcoding is advantageous because it involves reporting more serious health conditions to receive more funding from the government, downcoding, which involves intentionally underestimating the seriousness of a condition, is also beneficial for the nursing home because it reduces the facility’s liability. Therefore, if you sense that something is wrong, it is important for you to get another doctor’s second opinion.
The third type of questions analyzed palliative care. All too often, nursing homes neglect patients whom they perceive are dying and leave them to suffer in the last days of their lives. In other cases, the facility often instigates a transfer of the patient to a hospital, so that he or she can die there. However, nursing homes can usually provide better, more comfortable end-of-life care than hospitals, and those with palliative care standards, which are pre-signed orders from a certified physician, usually involving the prescription of narcotics to ensure a death void of as much suffering and pain as possible. Although most of the facilities had updated palliative care orders, a significant 22% of nursing homes did not have any form of palliative care at all. Therefore, you should take the precautions to ensure that palliative care orders exist for your loved one in the necessary cases.
If you feel that your loved one is not receiving a high quality of care in his or her skilled nursing facility, contact us today to see how we can help attain the rights to which he or she is entitled.