By Marc Zimet, Esq. of Jampol Zimet LLP
Despite the fact that nursing homes and long-term care facilities strive to provide the best care to their patients and residents, such facilities are exposed to a great risk of liability by employees who commit elder abuse. Elder patients are vulnerable and can easily fall victim to various kinds of abuse from employees, including physical and emotional abuse, neglect, and fraud. However, there are steps that nursing homes can take to reduce its risk of abuse.
Staff Screening: The first thing nursing homes can do to minimize its risk of abuse is properly and thoroughly screen its employees. Prior to hiring any employees, criminal background checks must always be performed and references should be inquired. Staff should also be screened for their suitability for the position. Individuals who have had substance abuse or domestic violence issues are not suitable. Furthermore, individuals who demonstrate a tendency to be controlling, lack empathy, or are not genuinely interested in the welfare of their patients may not be appropriate.
Patient/Staff Ratio: Research has demonstrated that homes with a low staff-to-patient ratio have the most occurrences of abuse. A high staff-to-patient ratio permits staff members to develop relationships with their patients thereby reducing the risk of abuse. Nursing homes can combat this risk by ensuring it has sufficient staff on hand to care for all its residents to prevent overwhelming staff from caring for too many patients. Facilities should also monitor and regularly screen its employees for burn-out and stress to ensure any problems employees may be having with their duties are addressed. Facilities should also regularly take patient satisfaction surveys of its employees. To help in preventing employee stress, facilities can increase pay and benefits, increase aides and/or assistant support staff, and provide strong leadership.
Policies and Training: All facilities should ensure clear policies against abuse are set forth in its employee handbook. Additionally, facilities should actively provide training to employees regarding abuse, its prevention, how to spot it,and how to report it. Employees reporting abuse should not be punished. Nursing homes should strive to create an abuse-free environment through creating a company culture that is anti-abuse. Employees should be trained in communication skills, anger management, and handling difficult patients. Employees lacking proper training and skills to handle difficult patients are more likely to become stressed and frustrated.
Address Complaints: Many homes who find themselves in litigation due to ongoing abuse of its patients could have prevented such abuse had it properly address complaints. Typically, there are warning signs of abuse that facility employees and/or supervisors fail to recognize and address. Complaints, even those of the smallest nature, should be taken seriously and thoroughly investigated. Supervisors should receive additional training regarding the intake of complaints, how to investigate such complaints, and how to manage a finding of abuse. Any complaint or grievance with an employee should be memorialized in writing and maintained in an employee’s individual file to create a clear record that can be reviewed. The accumulation of small complaints may suggest a larger problem with an employee.
At-Risk Patients: Research has shown that some patients are at greater risk for abuse than others. Those patients suffering from diseases that result in isolation, such as dementia, are at greatest risk. Patients who do not have family regularly visiting them, as well as those who have a higher degree of dependency on staff are also at greatest risk. Patients meeting these criteria should be monitored closely to ensure staff are properly caring for them.
While a nursing home may not be able to completely eliminate all risk of the occurrence of abuse, it can take many steps that will aid in its prevention. From thorough screening, training, and monitoring of employees to creating strong company policies and addressing complaints, a nursing home can take a proactive approach to managing its staff and reducing its exposure.
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