A national, privately-owned nursing home chain advertised its services with glossy brochures, showing its smiling staff serving 5-star dinners to happy residents in immaculate dining halls. Pictures of nurses out of central casting were seen providing “concierge” medical care to healthy residents in beautiful bedrooms. The goal, of course, was to induce residents and their families to believe that top-notch service was provided. Both private insurance and taxpayer-funded Medicare was happily accepted. In reality, residents who were unable to feed or care for themselves routinely went without adequate nutrition and basic healthcare. In one instance, a diabetic patient died because he was not given a snack by a poorly trained and overworked nursing assistant. A subsequent lawsuit by Williams Elleby Howard & Easter attorneys revealed the chain had a pattern of staffing shortages and inadequately trained staff that repeatedly resulted in substandard care. After fighting hard to obtain internal records, the chain was required to turn over emails and memos that showed the profit motive behind these staffing shortages. “[R]esearch findings consistently show higher staffing levels are related to higher quality of care,” However, “under current government prospective payment systems, nursing homes make choices on how to allocate their resources. About 70% of nursing homes are for-profit facilities with an orientation to maximizing profits for owners and shareholders.” Failure to Meet Nurse Staffing Standards: A Litigation Case Study of a Large US Nursing Home Chain . Providing substandard care including minimum staffing for residents, especially to increase profits, is illegal. Under federal regulations, nursing homes are required to:
- Provide nursing care to all residents on a 24-hour basis in accordance with resident care plans.
- Have a “licensed nurse to serve as a charge nurse on each tour of duty… and licensed nurses have the specific competencies and skill sets necessary to care for residents' needs, as identified through resident assessments, and described in the plan of care.”
- The facility must meet or exceed a minimum of 3.48 hours per resident day for total nurse staffing including a minimum of 0.55 hours per resident day for registered nurses 2.45 hours per resident day for nurse aides; and
- aides must be “able to demonstrate competency in skills and techniques necessary to care for residents' needs, as identified through resident assessments, and described in the plan of care.”
- Did the harm result from a violation of a federal or state regulation;
- Was there a pattern of such violations;
- Was there a profit motivation behind the violations?