Why Do Nursing Homes Conduct Evaluations Before Admission?

Choosing a long-term care facility for a loved one is a decision that carries profound emotional and practical implications. Families trust these facilities to provide compassionate, personalized care tailored to their loved one’s needs. Central to this process is the pre-admission evaluation – a critical step that ensures a nursing home can safely meet the unique needs of each resident. When done properly, these evaluations help create a secure and dignified environment for residents. However, when skipped or poorly conducted, the consequences can be devastating and can result in serious injuries or even the death of a nursing home resident.

At John J. Malm & Associates, our award-winning Illinois nursing home abuse attorneys bring over 90 years of combined litigation experience to nursing home negligence cases, and we are committed to holding negligent facilities accountable and ensuring justice for residents and their families.

The Purpose of Pre-Admission Evaluations

Pre-admission evaluations are not just procedural; they are a legal and ethical obligation for nursing homes. These assessments align the resident’s needs with the facility’s capabilities, ensuring appropriate care from the start. Evaluations serve three main purposes:

1. Developing Tailored Care Plans: Every resident has unique medical conditions, mobility challenges, dietary restrictions, and emotional needs. A detailed evaluation allows the facility to create a personalized care plan that ensures each resident’s safety, comfort, and well-being.

2. Identifying Risks: Pre-admission evaluations help identify potential risks, such as:

• Falls: Assessing mobility limitations and implementing safety measures like grab bars and bed alarms.
• Medication Complications: Identifying interactions or adverse effects from prescribed medications.
• Nutritional Issues: Understanding dietary needs to prevent malnutrition or dehydration.

By anticipating these risks, facilities can take proactive steps to mitigate harm.

3. Meeting Legal Obligations: Illinois law, under the Nursing Home Care Act, requires nursing homes to provide adequate care for residents. Conducting pre-admission evaluations ensures facilities meet this duty and avoid admitting individuals whose needs they cannot safely accommodate.

Medicare’s Requirements for Pre-Admission Evaluations

Medicare regulations require nursing homes to conduct a comprehensive evaluation for each resident upon admission to ensure their specific needs are met. This process includes using the Resident Assessment Instrument (RAI) and the Minimum Data Set (MDS) 3.0, tools mandated by the Centers for Medicare & Medicaid Services (CMS) to assess areas such as physical health, cognitive capabilities, medication needs, and risk factors like falls or infections. These evaluations form the foundation for individualized care plans, which must be updated regularly to reflect any changes in the resident’s condition.

The Preadmission Screening and Resident Review (PASRR), as required by Medicaid, further ensures that residents with serious mental illnesses or intellectual disabilities are placed in appropriate care settings and receive necessary services. Failure to comply with these requirements can result in penalties for nursing homes and long-term care facilities, including the loss of Medicare or Medicaid funding. By adhering to these regulations, facilities not only meet their legal obligations but also safeguard the safety, dignity, and well-being of their residents.

Key Areas Assessed During a Pre-Admission Evaluation

A thorough pre-admission evaluation assesses various aspects of a resident’s health and daily needs. These areas guide the development of care plans and safety protocols:

1. Fall Risk Assessment: Falls are a leading cause of injury among the elderly, especially at nursing homes. Evaluations of nursing home residents should include:

• Mobility limitations and the use of assistive devices.
• A history of falls or injuries.
• Medications that may increase dizziness or sedation.

2. Medication Management: Many residents require complex medication regimens. Pre-admission evaluations review:

• Current prescriptions and potential drug interactions.
• Whether the resident needs assistance with administration.
• Coordination with pharmacies for timely and accurate delivery.

3. Bathroom and Hygiene Support: Proper hygiene care is essential for dignity and health of nursing home residents. Assessments determine:

• Whether the resident can use the bathroom independently.
• Requirements for incontinence care or catheters.
• Risks of infections or skin breakdown.

4. Dietary Needs: Nutrition is critical for maintaining health in a nursing home. Evaluations examine:

• Dietary restrictions for conditions like diabetes or heart disease.
• The ability to eat independently or need for feeding assistance.
• Risks of choking or aspiration during meals.

5. Cognitive and Emotional Health: Cognitive and emotional assessments identify:

• Memory and decision-making abilities.
• Mental health conditions like anxiety or depression.
• Behavioral challenges such as wandering or agitation.

6. Medical History and Current Conditions: Understanding a resident’s medical history ensures the facility can provide appropriate care and coordinate with healthcare providers.

Why Comprehensive Evaluations Are Essential

Skipping or inadequately conducting pre-admission evaluations can lead to significant risks for both residents and facilities.

1. Safety Risks: Without a clear understanding of a resident’s needs, facilities may fail to implement necessary safety measures, leading to falls, medication errors, or infections.

2. Insufficient Care: Facilities unprepared to meet a resident’s needs risk neglecting their care, causing physical and emotional harm.

3. Legal Consequences: Failing to conduct proper evaluations exposes nursing homes to lawsuits for negligence, often resulting in significant financial and reputational damage.

What Families Should Look for During the Nursing Home Admission Process?

Families play a crucial role in ensuring their loved one receives appropriate care. During the admission process, ask these key questions:

1. How Does the Facility Conduct Evaluations?

• Are assessments done in person?
• Do they consult with physicians and review medical records?
• Are risks like falls, malnutrition, and medication interactions addressed?

2. What Resources Does the Facility Offer?

• Are specialists available for conditions like dementia or mobility impairments?
• What is the staff-to-resident ratio?
• Are emergency protocols in place?

3. How Is the Care Plan Developed and Updated?

• Are families involved in care planning?
• How often is the care plan reviewed?
• How does the facility communicate changes in the resident’s condition?

Case Spotlight: Justice for an 83-Year-Old Nursing Home Resident

At John J. Malm & Associates, our Illinois elder abuse lawyers have seen the devastating consequences of nursing home negligence. In one case, an 83-year-old woman suffered a severe injury just hours after being admitted to a facility—a tragedy that could have been prevented.

The Incident

Despite being a known fall risk, the resident received no pre-admission evaluation or safety precautions. Hours after her arrival, she attempted to get out of bed to use the bathroom. Without assistance or safeguards like bed alarms or grab bars, she fell and fractured her hip, requiring emergency surgery and months of rehabilitation.

“Our clients could not accept that their mother suffered such a devastating injury only hours after her admission, on her very first night there. They were heartbroken and turned to us to seek justice for her.” Naperville nursing home negligence attorney John J. Malm.

The Facility’s Failures

Our investigation uncovered critical lapses:

• No Fall Risk Measures: Essential precautions like bed alarms and grab bars were missing.
• Lack of Supervision: Staff failed to monitor her movements.
• Understaffing: The facility lacked sufficient personnel to assist residents.

The Outcome

We secured a confidential settlement, covering:

• Medical expenses and long-term care costs.
• Pain and suffering endured by the resident.

This case highlights the critical role of pre-admission evaluations in preventing harm and protecting residents. Families deserve accountability, and we are here to ensure justice.

The Risks of Skipping Pre-Admission Evaluations

When facilities neglect pre-admission evaluations, residents face preventable harm, including:

• Increased Fall Risks: Mobility-impaired residents are more likely to suffer injuries.
• Medication Errors: Overlooked interactions or missed doses can lead to severe complications.
• Nutritional Issues: Unaddressed dietary needs can result in malnutrition or dehydration.
• Cognitive and Emotional Challenges: Residents with dementia may lack supervision or stimulation, increasing risks of wandering or agitation.

How John J. Malm & Associates Can Help

At John J. Malm & Associates, we are dedicated to protecting the rights of nursing home residents and holding facilities accountable for negligence. Our DuPage County nursing home abuse attorneys have extensive experience investigating and litigating these cases, providing families with compassionate support and expert legal representation.

Why Families Trust Us

• Thorough Investigations: We review medical records, facility procedures, and staff actions to uncover negligence.
• Proven Results: Our attorneys have secured significant settlements for victims of nursing home neglect.
• Compassionate Advocacy: We understand the emotional toll these cases take on families and provide personalized guidance.

“When nursing homes fail to conduct proper evaluations, or fail to follow through with necessary supervision and protection, they not only endanger their residents but also breach the profound trust that families place in them to provide safe and compassionate care. These evaluations are more than a procedural step; they are both a legal obligation and a moral responsibility to safeguard the safety and well-being of every resident.” – Naperville nursing home abuse and neglect attorney, John J. Malm

Contact the Top-Rated Illinois Nursing Home Abuse and Neglect Lawyers at John J. Malm & Associates

Pre-admission evaluations are vital to ensuring that nursing homes can meet the unique needs of their residents. These assessments protect residents by addressing risks, tailoring care plans, and ensuring facilities are prepared to provide proper care. Families must remain proactive during the admission process, asking critical questions and advocating for their loved one’s safety.

If your loved one has suffered due to nursing home negligence, the top-rated Naperville injury attorneys at John J. Malm & Associates are here to help. With offices in Naperville and St. Charles, we are dedicated to protecting the rights of nursing home residents throughout Illinois. Contact us today for a free consultation and let us fight for the justice your family deserves.