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Oversight and abuse in skilled nursing facilities

Caregiver’s are often asked to step outside their comfort zone, and perhaps now more than ever. In a recent Special Report published in the AARP Magazine caregivers, families, friends and the DSHS, along with lawyers were made aware of a practice in some skilled nursing homes which can and do have deadly results. In a place entrusted with our most dear and most fragile it may be hard to believe some of the actions or non-actions of those trusted to care for our friends and family. The article ‘Prescription for Abuse’ by Jan Goodwin, AARP July 2014 (; we hear of over medicated patients or improperly medicated patients due to several factors our now parents fought for in the 1960’s regarding Nursing Home Care.

Yes our parents and grandparents did get the physical clean-up and the visual patient care turned around to be humane and for the purpose of recovery, not warehousing, as the optimal goal of care. The article now brings back to light a situation which was fought for in the 1960’s and is still in practice only because it is an invisible abuse. Invisible because it is the use of prescription drugs and the side-effects of or wrong drug affect which hesitant the end of live. No it is not a killer walking the halls or a death angel, rather it is the lack of staffing and oversight, especially when doctors are only seeing these patients on an average of once every 3-6 months (rarely is the SNF employing a physician to be in house for care). Nurses are staffed at the lowest level (in some cases – only an (one) oversight nurse for two or more assisted livings; while CNA’s are dispensing medication (at least in two states).

At Care Conferences frequently, when an RN is present there still will not be a discussion of medication dispensing on a 24-hour basis and when it is the medication is frequently listed by the generic name which family or the acting DPOA do not know. Please take the time to read this article and should you have family or be the DPOA get involved, be active and if you still do not feel this is the correct answer step up and ask for more answers. Skilled Nursing Homes are licensed by DSHS, and although there is to be a ‘Survey’ regularly (usually yearly) this practice is on-going; however The Inspection Team (known as Survey Team) will have less than a week to look at not only patient medical records, but also all nutrition standards, Staffing records, any complaints which have been lodged and to meet with some of the residents. Be an advocate for the family and friends who require the care of these facilities.

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