Nursing_Homes

Nursing homes also referred to as skilled nursing facilities or long term care facilities are home to approximately 5% of the older population. The nursing home industry is growing at a fast pace and will continue to grow since there are approximately 72 million baby boomers in the United States that may need this type of care in the future. There are over 16,600 nursing homes in the United States. These facilities include a diverse mix of patients that fund their stays through private pay, private health insurance, and Medicaid or Medicare programs. Kentucky has over 23,000 people who live in nursing homes, which is a figure that is projected to increase over the next several years. A senior citizen (65+) has about a 1 in 4 chance of spending time in a nursing home before the end of their life. Nursing homes provide around the clock care for people who are unable to care for themselves. Although the majority of nursing home populations consist of the elderly, there is also a mix of patients who are there for short-term rehabilitation services. These patients are typically recovering from an illness, surgery or injury and need therapy before returning to independent living. Rehabilitation services are performed by a variety of therapists, including physical, speech and occupational. Nursing home staff members consist of facility administrators, administrative staff, bedside caregivers (doctors, nurses, LPN’s, CNA’s and therapist) and ancillary staff (dietary personnel, housekeeping, etc.). Staffing regulations fluctuate state to state, however, federal law requires all nursing homes to provide at least one RN for at least 8 straight hours a day, 7 days a week, and either an RN or LPN/LVN on duty 24 hours per day. According to the US Bureau of Labor Statistics, there are about 3 million people who are employed in nursing facilities throughout the United States. Wages for employees vary tremendously, but the majority of resident care is performed by a Certified Nursing Assistant whose average hourly wage is in the $10 - $14 per hour range. Quality of care is always a concern for residents in nursing facilities since the patient load is usually high and the skill level of the primary caregiver (CNA) is usually low. Many residents require extremely labor intensive care, which includes help getting up and down, going to the restroom and feeding themselves. The Center for Medicare and Medicaid Services (CMS) is responsible for enforcing federal regulations and quality standards for nursing facilities. Nursing homes are subject to annual inspections by state surveyors to ensure compliance with state and federal standards and to verify proper use of Medicare and Medicaid funding. Inspections are conducted on-site by trained state personnel and typically include observation, interviews with residents and staff, and review of records. All deficiencies discovered by surveyors are recorded and the facility is given a limited number of days to make appropriate corrections. Facilities who do not comply are subject to lose government reimbursements. All surveys are published and available to the public. Due to the extreme physical nature required to care for people in nursing homes and the close proximity of the living environment, nursing homes are conducive to high numbers of employee work related injuries, illnesses and hazards. Worker Illnesses MRSA is a common bacteria that is resistant to antibiotics. This infection is very common among patients that have a weak immune system, such as those in nursing homes. Due to the high number of bed sore and wound care cases in nursing homes, the clinical staff is highly susceptible to this disease if proper preventative procedures are not used. The most effective way to prevent the spread of this disease to healthcare workers is to establish care procedures, which include the use of proper medical supplies such as rubber gloves, protective garments and frequent hand washing after patient treatment. Injuries Nursing homes are among the top 10 industries for back and neck injuries, which accounts for high numbers of absenteeism, workers compensation claims, and professional who are unable to fully perform their jobs for long periods of time. The cost associated with back and neck injuries in the healthcare industry are estimated to be $20 billion annually. According to the Bureau of Labor Statistics, higher rates of musculoskeletal injury have been reported among nursing home workers compared with rates among workers in other occupations. This is primarily attributed to the amount of patient lifting, the size of the typical patient and the lack of proper equipment to assist healthcare professionals. The most effective way to prevent these types of injuries is to provide workers with the proper lifting equipment and/or adequate staff to help so that there is more than 1 person responsible for patient movement. Hazards Physical abuse by patients in nursing homes is another risk to healthcare workers. This is due to the number of patients that have dementia. According to a recent study, 59% of CNA’s in long term health facilities report being assaulted once a week by patients. Less experienced nurses are subjected to abuse more than experience nurses. The most effective way to avoid physical abuse by patients is to understand the disease process that is causing the behavior, know the patient behaviors and attempting open, gentle communication so the patient does not get startled. Shift Work Providing healthcare in nursing home is a twenty-four hour operation. Providers at all levels are needed every day all the time, there are no days off. It is not a typical nine to five occupation. Those who choose to come into this field have an understanding that they will be required to work shift work, holidays, weekends and possibly swing shifts and extended work weeks. Working shift work without the extra shifts that are most generally required plays a huge toll on an individual’s body and mind. Those who worked more than 40 hours per week were 28% more likely to report that patients occasionally/frequently received the wrong medication or dose. The best way to resolve these issues is to add more providers to cut down on the hours worked for each individual.