St. Louis Post-Dispatch Series Looks at Patient Neglect in Nursing Homes Nationwide

The St. Louis Post-Dispatch on Sunday began a weeklong series of articles examining the "quiet epidemic" of nursing home patients who die from neglect traced to their caregivers. For the series, called "Neglected to Death," the Post-Dispatch reviewed government documents and court records and interviewed about 700 nurses, doctors, patient advocates, death investigators, nursing home operators and prosecutors (AP/Spokane Spokesman-Review, 10/15). The following are summaries of the articles published to date:

• "Thousands Are Being Killed In Nursing Homes Each Year": Thousands of nursing home patients die each year as "victims of premature and preventable deaths," the Post-Dispatch reports. According to data from the CDC's National Center on Health Statistics, starvation, dehydration or bedsores were listed as the cause of death on 4,138 of 500,000 nursing home death certificates in 1999. However, the number of such deaths "is much higher," according to investigators who compared nursing home patient medical records with their death certificates. In addition, the Post-Dispatch reports that cases of nursing home neglect are "rarely detected by government inspectors, investigated by law enforcement, appraised by medical examiners or prosecuted by anyone" (Schneider/O'Connor, St. Louis Post-Dispatch, 10/13).
  


• "Small, Overworked Staffs Are Trigger For Patient Neglect": Many of the preventable deaths of nursing home patients occur because there "simply are not enough nurses and aides" to provide proper levels of care, the Post-Dispatch reports. Nine out of 10 nursing homes do not have enough employees to adequately care for their patients, according to a recent HHS report, which also found that most facilities need to increase their staff by at least 50%. However, staff expansion is difficult because the jobs do not pay well and are thought of as "unpleasant and demeaning." In addition, the nursing home industry says facilities must "employ skeleton staffing" because they do not receive adequate funding from the government (O'Connor/Schneider, St. Louis Post-Dispatch, 10/14).
  


• "Many Nursing Home Patients Are Neglected Even After Death": Nursing homes responsible for preventable deaths usually receive only "paltry civil penalties," which act as a "minimal deterrent" for providing inadequate care, the Post-Dispatch reports. Increasingly, prosecutors want to file criminal charges against nursing home employees who neglect patients; some law enforcement officials believe that such action should be classified as homicide. However, many prosecutors and district attorneys are reluctant to bring criminal charges against workers involved in preventable deaths because of the lack of evidence in such cases (Schneider, St. Louis Post-Dispatch, 10/15).