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Proposed changes to nursing home regulations could increase injuries

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There are some proposed changes to the federal nursing home regulations which would reduce nursing homes' responsibilities and do away with multiple protections for nursing home residents. This could result in reduced standards for safety, quality care and rights, and lead to injury and wrongful death.

A common scenario in nursing home cases I have seen is the overuse and misuse of psychotropic/antipsychotic medications This is sometimes a problem because nurses in understaffed facilities want to reduce the care needs for high-need residents with behavior issues. So they over-medicate to sedate the resident, which is also known as the use of "chemical restraints." This over-medication can lead to a host of other consequences including dehydration, malnutrition, weight loss, pressure ulcers, infections like UTIs and sepsis, and death. The proposed regulations would change the current requirement for an evaluation by a doctor if the "as needed" use of such drugs are to be continued past 14 days. The change would allow the nursing home to rely on its own policies and procedures instead of involving a doctor, which leaves a lot of room for overuse and improper medication monitoring.

The proposed regulations would also reduce facility assessments from the current requirement of yearly assessments, to only every two years. These assessments are crucial to ensure nursing homes have adequate staff and resources to provide proper care to its residents.

One other proposal would reduce the involvement of Infection Preventionists. These are persons responsible the facility's infection prevention program. Currently the nursing home has to have an Infection Preventionist at least "part time," but the proposed changes would require the nursing home to only have one for a "sufficient time." This is very subjective and could allow nursing homes to have one for much less time.

These are not all of the proposed changes, but some that seemed particularly concerning for proper resident care. Less strict staffing and infection control assessments with more lax psychotropic drug use requirements would seem to increase the risk of injury and wrongful death in nursing homes. While these changes might make the operation of nursing homes easier for their owners, resident care will likely suffer. I suspect such changes will result in more calls to our offices here at Daniel Pleasant Holoman, with questions about nursing home negligence and wrongful death throughout Kentucky, North Carolina, Georgia and Tennessee.

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