Choosing a nursing home is a significant decision for families, yet some overlook the red flags. Selecting the right nursing home requires thorough due diligence to avoid potential abuse and neglect. While federal resources such as Care Compare and Medicare's Nursing Home Lookup provide ratings and metrics for facilities, it's also important to read online reviews and conduct in-person tours when looking for a place where your loved one can truly thrive, not just survive.
What are common red flags to watch for in nursing homes?
While choosing a nursing home, watch for signs that indicate poor care. Recognizing these red flags can prevent loved ones from ending up in unsafe environments. Keep these issues in mind during your visits:
High rates of infection
Infections are a leading concern in nursing homes and affect millions of residents each year. Common infections include COVID-19, MRSA, pneumonia, urinary tract infections, and C. difficile. These infections spread through the air, contact, and contaminated surfaces.
When visiting a facility, observe the staff’s hygiene practices, such as hand washing and wearing gloves. Poor handwashing and hygiene habits among staff put residents at risk for severe infections.
Long response times
Call lights allow residents to request help, report pain, or address emergencies. The Centers for Medicare and Medicaid Services require all nursing home residents to have their call lights within reach. If residents can’t access their call lights, they can’t access the care they need.
During a tour, take note of how quickly staff respond to call lights. While response times may vary during busy periods, unanswered calls throughout the day and night could indicate that the facility is understaffed or unresponsive.
Shortage of staff
Staffing levels are one of the most important aspects of nursing home care. Short staffing can lead to an increase in:
- Bedsores
- Infections
- Pain mismanagement
- Overuse of antipsychotic medications
- ER visits and hospitalizations
Adequate staffing reduces these risks and ensures better care. During your visit, ask about the daily time each nurse spends with residents. Staffing ratios aren’t one-size-fits-all, but higher levels of care generally mean more staff per resident.
High staff turnover impact
High turnover among nursing aides affects the quality of care. According to research, turnover in nursing homes often exceeds 100% annually. This means most aides leave within a year, which causes disruptions in resident care. Nurse aides provide day-to-day support, and high turnover disrupts relationships with residents. When aides change frequently, they don’t get to know each resident’s specific needs, moods, or routines.
Check if the nursing home has a plan to maintain care continuity despite turnover. Ask questions such as:
- How often do you replace aides?
- How many permanent aides do you have?
- Do you have medical staff available overnight?
Lack of resident social engagement
Social interaction keeps seniors engaged and improves their quality of life. Inactivity and loneliness can harm physical and mental health, which makes social engagement a necessity, not a luxury. When visiting, pay attention to the availability of activities, including exercise, arts and crafts, and group dining. Observe if residents are participating in activities or sitting idle. Also, check if outdoor space is available and secure. Fresh air and nature play a big role in resident well-being.
Poor nursing home quality
State inspections of nursing homes provide insight into the facility’s quality and past performance. Nursing homes must undergo annual inspections by state agencies to confirm compliance with health and safety standards. These inspections also respond to complaints from residents or family members. Ask the facility for a copy of their most recent state inspection. Red flags include repeated violations, unresolved complaints, or citations for abuse.
Unresponsiveness among residents
Unresponsive residents can signal that a facility has misused antipsychotic medications to control behavior. While these medications may be necessary for some residents with psychiatric needs, some nursing homes use them as chemical restraints to manage challenging behaviors. Ask the staff how they handle residents with dementia or difficult behaviors. Do they offer psychiatric evaluations, or do they resort to medications too quickly?
Lack of cleanliness
Cleanliness goes beyond appearances; it’s a matter of health and safety. Unclean rooms increase the risk of infection and show poor organizational practices. Look for signs of neglect, such as unemptied trash, soiled linens, or clutter on the floor. Older adults have weaker immune systems, making them more susceptible to germs.
During your visit, take note of resident rooms, common areas, and hallways. A clean facility suggests that the staff takes pride in their work and prioritizes the health of their residents.
Poor food quality
Proper nutrition is a must-have for seniors, who often have dietary restrictions or health conditions that require specific diets. Nursing homes should provide healthy meals that cater to residents’ needs, such as low-sodium or lactose-free options.
When touring a facility, observe the quality and variety of food being served. If the food looks unappetizing, residents may skip meals, which can lead to malnutrition or weight loss. Ask if a facility accommodates special dietary needs and how they ensure balanced meals.
Staff attitude
A respectful, compassionate staff provides better care and reassures family members. When visiting, pay attention to how staff interact with residents and answer questions. An attentive staff that listens and communicates well shows that the facility values each resident’s well-being.
Consider asking the following questions:
- Have you noticed any changes in my loved one’s comfort or health?
- How does my family member stay active when I’m not here?
- What’s your approach if my loved one becomes distressed?
Having a “no lift” policy
Some nursing homes adopt “no lift” policies, which prevent staff from moving fallen residents. Instead, they call 911 for assistance to avoid liability for potential staff injuries. However, these policies can delay care for residents and strain local emergency services.
Ask if the facility has fall prevention strategies, such as bed alarms or patient lifts. Fall-prevention practices, such as scheduled rounds and safe lifting equipment, reduce falls without compromising resident care.
What should I do if my loved one has experienced nursing home abuse or neglect in Alabama?
Has your loved one suffered from neglect or abuse in an Alabama nursing home? The warning signs are often subtle at first, but they can lead to life-threatening complications. At Shuttlesworth Law Firm, P.C., we have seen firsthand how nursing home negligence destroys families. We refuse to let these facilities escape accountability for their unacceptable treatment of our most vulnerable citizens.
We're committed to holding negligent nursing homes accountable, and our case results prove it:
- $1.2 million after a nursing home's failure to provide oxygen resulted in a resident's death.
- A $500,000 settlement after staff mistakenly treated a resident as DNR, leading to her death.
- $425,000 for neglect, resulting in malnutrition, dehydration, and fatal sepsis.
Get an experienced Alabama nursing home abuse and neglect attorney to investigate every detail of your case and fight tirelessly for the justice your family deserves. We work on a contingency fee basis, which means you pay nothing upfront, and we only get paid if we win your case.
To schedule a free and confidential consultation, contact us online or call our Birmingham law office today.
"From the beginning of the case to the very end, Perry, Misty, and the staff kept us fully informed of the process. They were very helpful, thoughtful, compassionate, and knowledgeable. If you're in need of a great attorney, I recommend Shuttlesworth Law Firm." — Sandra C.
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