Nursing Home Negligence

Nursing Home Evaluation Criteria

Grading Nursing Homes

Nursing home abuse and neglect has become an all too common reality for some families. In order to more efficiently and accurately evaluate a potential or current nursing home arrangement, some qualitative and quantitative measures can be examined.

1. Percentage of residents with loss of ability in basic daily tasks. A lower score is better. Some loss of function is to be expected, but with large numbers of patients needing assistance, more staff members will be needed to care for these people over longer amounts of time.
   
2. Percentage of residents with bed sores. Lower is better. Sores can occur on elderly patients due to pressure or duration of time in one position. Note that some homes specialize in caring for bed or pressure sores, so the numbers may be normalized using a risk adjustment factor.
   
3. Percentage of residents in pain. A lower number is generally better. Obviously some patients may refuse pain medication, but the overall number could indicate a lack of comfort and lack of attention to physical conditions.
   
4. Percentage of residents in physical constraints. The daily number of patients who require restraints upon their mobility should be low. Restraint reduces strength and increases the chance that health will deteriorate. These devices should only be recommended by a doctor to prevent injuryor as a treatment for a medical condition.
   
5. Percentage of residents with infections. This number should be lower, but may or may not be an indicator of living conditions. Ask questions to determine which infections are controllable and which are unavoidable. 
   
6. Percentage of short stay residents with delirium. A sign of immediate medical attention, these patients require more care and fewer is better, often on a risk adjusted basis.
   
7. Percentage of short stay residents who walk as well or better than at arrival. The improvement of health to a state where walking comes easier or is better (more able) for the patient is an indicator of a nursing home's effort to improve and restore the health of residents.
   
8. Safety conditions: Fire exits, stairways, elevators, fire extinquishers, sprinkler system, number of patients to staff, heating, air conditioning, emergency assistance, water treatment and sewage/trash removal, etc. These factors should all be examined as well to ensure a patient's well being in the event of an accident or emergency.