Earlier this month, the U.S. Centers for Medicare and Medicaid Services (CMS) announced that they would be making sweeping reforms to the standard of care required in our nursing homes and long-term care facilities. These changes will include increased training for caregivers to address patients with dementia or behavioral issues, enhanced nutrition guidelines and requirements, and stricter attention to prescription drug interactions and supervision. One such prescription drug which requires immediate attention is Coumadin (warfarin), which has recently been outed as a major source of nursing home injuries and deaths by a report published by the non-profit group ProPublica in a Washington Post article.
According to the ProPublica report, at least 165 residents of nursing homes in the United States suffered a serious injury or even died as a result of a failure to monitor their Coumadin dose between 2011 and 2014. Coumadin is a commonly prescribed blood thinner designed to reduce the likelihood of a stroke or heart attack caused by a blood clot. While Coumadin has been relied on for decades, the drug must be carefully monitored to ensure that a patient gets neither too much nor too little. The Washington Post article explains this delicate balance, stating, “too much (of a blood thinner), and you can bleed uncontrollably; too little, and you can develop life-threatening clots.”
The ProPublica numbers regarding Coumadin adverse events in nursing homes may be shocking to many, but the truth is that the number of nursing home injuries and deaths attributed to poor monitoring of Coumadin doses is likely much higher. This is because many nursing homes fail to report Coumadin injuries to the federal government, and family members of nursing home residents may not be aware of the cause of their loved one’s severe bruising or death. The American Journal of Medicine published a study in 2007 where researchers claimed that up to 34,000 residents of U.S. nursing homes may be harmed by poor Coumadin dose monitoring every year.
Last year, CMS stated that they were aware of serious issues with Coumadin monitoring in our nursing homes and that they would work to improve this situation. However, few true changes have been observed thus far, and many hope that the recently announced updated regulations will be a positive first step in addressing Coumadin injuries and deaths in nursing homes.
If your loved one is in the care of a nursing home and is prescribed Coumadin or another anticoagulant, it is your right to request documentation of regular blood tests to monitor his or her dose. If you believe that your loved one may the victim of nursing home abuse or neglect, please contact an experienced attorney to learn more about your rights and how we will defend them.