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What health reform means for the people of Illinois

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Thursday, January 5, 2012

The Affordable Care Act & Nursing Home Abuse

A Look at Nursing Home Abuse  

Elder abuse in nursing homes is largely due to the inadequate staff levels. According to a 2001 Health and Human Services (HHS) study, 90 percent of nursing homes are understaffed. Lack of adequate staffing is known to lead to:
  • An over-worked staff.
  • An under-trained staff.
  • High staff turnover.
  • Mistakes in patient care.
  • Inadequate time with patients. (Most nursing homes do not meet the federal government’s recommendation for 4 hours of patients care with every patient, daily.)
  • Staff exhaustion, burn-out and stress
  • Inadequate staff-to-patient ratios
  • Inadequate staff background checks.
Before the Affordable Care Act, the federal government did not require nursing homes to complete staff background checks. According to an HHS report:
  • 90 percent of nursing homes employ at least one staff member with a criminal background.
  • Almost 50 percent employ 5 or more staff members with at least one conviction.
  • 5 percent of nursing home staff members have at least one criminal conviction.
Ultimately, all of these are potential causes of abuse, and intentional and negligent neglect.

A Look at The Patient Protection and Affordable Care Act and Nursing Home Abuse

The Affordable Care Act (ACA) will affect nursing homes in a positive way and, if successful, curb the rate of abuse in these facilities. According to Families USA, the ACA will establish important programs, committees, and grants that will increase the effectiveness of the long-term care workforce and care. These numerous establishments aim to:

Improve the long-term facility workforce through:
  • Increasing the size of the long-term care workforce to meet the needs of long-term care residents.
  • Understanding and analyzing workforce supply and demand.
  • Encouraging people to enter the long-term care workforce.
  • Curbing the long-term care workforce’s staff turnover rate through retention efforts.
  • Improve the quality of staff training by educating staff about demanding resident conditions, such as dementia; proper ethics; the importance of reporting staff abuses of residentsm identifying signs of elder abuse and identifying administrative abuse.
Improve elder care by:
  • Increasing the at-home care and decreasing long-term care facility usage; at-home care is less expensive to state and federal governments
  • Increasing the knowledge of caregivers by providing resources concerning finances, care, etc.
  • Increasing consumer knowledge of nursing home facility deficiencies and staffing levels.
  • Improving long-term facility environments.
Decrease elder abuse through:
  • Increasing resources to increase how quickly elder abuse cases are investigated.
  • Establishing quality staffs through mandatory nationwide staff background checks and education.

Amber Paley, Blogger/Writer
Nursing Home Abuse.net


  1. Dementia care homes Kent
    The Cost-effective Care Act (ACA) will impact breastfeeding features in a optimistic way and, if effective, restrain the rate of mistreatment in these facilities.I wanted to thank you for this great read!!

  2. I would understand why many resort to taking care of their elders at home because of the increasing number of inefficient and incompetent nursing homes. Now I know why it takes years for my buddies to look for a reputable nursing home.

  3. I think the incompetence of some nursing homes lead our elders to think ahead and plan to stay on retirement communities Long Island instead. They'd rather be on themselves than to have someone who only works for money.

  4. A nursing home told my mom that the Affordable Care Act only allows them to keep 5 spots for people Medicare. So if my grandmother enters their nursing home with her own funds, but runs out of money, she could be kicked out of the nursing home if all 5 Medicare spots are taken. Is that really a provision of the ACA or is this person lying?

    1. Dear ShanBot - Thanks for your question. We are researching it and will get back to you soon.

      Stephani Becker
      Project Director, Illinois Health Matters

    2. Dear ShanBot,

      It doesn’t sound like you are getting accurate information from the nursing home. For one: Medicare does not pay for long-term nursing stays. It does pay for short-term rehab stays after an acute in-patient hospital stay. Should someone ‘run out of’ their own funds while staying in a nursing home, then they would probably qualify for Medicaid and Medicaid could pick up the bill (if they meet level of care eligibility).

      It’s possible the nursing home, in so many words, is telling you they don’t want Medicaid patients (due to low reimbursement). But as far as the Affordable Care Act goes, there is no restriction on it.

      We would recommend that you contact your local Area Agency on Aging (AAA). It sounds like you could benefit from a program called long term care “Options Counseling”. Here is a website where you can find the AAA in your area: http://www.cbrx.il.gov/aging/2aaa/aaa-main.htm.

      Please let me know if you have any concerns or questions.

      Stephani Becker

  5. Nursing Home Transparency Act explains the health care reform legislative package. And centers for Medicare and Medicaid services will required to collect and report data on the care workforce as well as turnover and long term care insurance cost estimate.

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