Hip Fractures And Some Unsettling Statistics

Hip fractures are a frequent result of falls in nursing homes.   In fact, an elderly person living in a nursing home is more likely to sustain a hip fracture while at the facility than they would living independently.  Most hip fractures require surgery.  The type of surgery required depends on where the break is and how bad it is. Your doctor may put metal screws, a metal plate, or a rod in your hip to fix the break. Or you may need to have all or part of your hip replaced.

The outcome for nursing home residents who sustain a hip fracture are disappointing:

  • 17% to 33% mortality rate for the year following the fall
  • 25% to 33% of residents are unable to walk following surgery and physical therapy
  • Up to 15% of hip fracture patients suffer from pressure sores

Nursing homes must take the risk of falls and hip fractures seriously.  The best prevention of a hip fracture is for a nursing home to identify residents who may be at risk of falling and to have adequate staff in the facility to provide assistance to residents. 

If you or a loved one has suffered a fall in a nursing home and sustained a hip fracture, the facility is responsible for damages from the initial fall, all subsequent medical care and decay in physical conditions.

Transportation In & Out Of Nursing Homes: Ambulance Responsibility.

Unfortunately for many nursing home residents, their trip to the nursing home or out for a doctor's appointment can be riddled with problems during transport and is a frequent source of injury (while being transported via: ambulance, medicar or medivan). 

Like nursing homes themselves, ambulances and paramedics are regulated by Medicare.  Ambulances and their crews must also comply with state and local laws.  Ambulances transporting nursing home residents must:

  • Be capable of transporting people for in acute medical conditions
  • Must contain: stretcher, linens, emergency medical supplies, oxygen equipment, warning sirens, 2-way voice radio or wireless telephone
  • Must be staffed by trained personnel

Ambulances and their crews must trained to deal with a variety of both critical and non-critical situations.  Nonetheless, common ambulance / paramedic injuries include:

  • Dropping patients
  • Medication errors
  • Untimely response time for critical incidents
  • Failure to follow protocol for specific incidents
  • Failure to have required equipment
  • Failure to properly make initial assessment
  • Failure to monitor vital signs
  • Helicopter accidents
  • Automobile accidents
  • Wheelchair-lift incidents
  • Physical abuse

If you believe you or a family member is a victim of paramedic negligence, you should contact an attorney who concentrates in cases involving paramedic / ambulance injury to learn your rights under Federal and State law.

Nursing Homes Learn Valuable Lessons From Hurricane Katrina

 In anticipation of the arrival of Hurricane Gustav, nursing homes throughout Louisiana are evacuating.  All nursing homes must have evacuation plans on file and conduct rehearsals for situations like this.  Best wishes to all in Gustav's path.

 

Why Didn't I Think Of This?

As a father of an active toddler, I am well versed in the importance of keeping close tabs on him at all times.  We keep a video monitor on him to make sure he doesn't harm himself.   Video monitoring has even gone to the streets in Chicago where police can monitor street traffic in crime ridden areas.

The time has come for monitoring to take the jump to nursing homes.  "Granny Cams" as Attorney David Terry describes in the Nursing Home Abuse Lawyer Blog would be an important part of protecting our nursing home residents from nursing home abuse from nursing home employees and co-residents.

While cameras have caught abusive workers in the act, utilizing video technology as a regular part of nursing home care seems the a reasonable thing to do.  I join David's endorsement of installing 'granny cams' to safeguard nursing home residents. 

Hey David, can I get a cut of Granny Cam's royalties?

Girls Gone Wild In Minnesota Nursing Home

I came across this article regarding the abuse of Alzheimer's patients at a Minnesota Nursing Home --the extent of mistreatment makes me sick.  According to a Minnesota Department of Public Health report, 15 residents of the Good Samaritan Society Nursing Home fell victim to ongoing physical and psychological abuse of 4 teenage nursing assistants.  Since the results of the investigation have been disclosed, the employees have been terminated.

The employees were terminated party due to cooperation of a 5th teenage girl implicated in the investigation.  According to the teenage girl, the foursome victimized residents suffer from dementia or related disorders such as Alzheimer’s disease. The report alleges the following incidents of physical abuse and neglect:

  • spitting in mouths
  • poking breasts and nipples
  • putting fingers in mouths
  • touching and tapping genitals
  • sticking rear ends in faces
  • rubbing buttocks
  • rubbing penises
  • touching perinea
  • anal insertion
  • holding residents down
  • teasing residents

This story is important because it demonstrates a culture of neglect that has developed in many nursing home.  The fact that multiple employees were involved in this incident makes me very skeptical that the nursing home administrator knew nothing if this criminal behavior.  Adding fuel to the fire, an employee told investigators that two of the girls had been “bragging about this for the past one to two months.”

There are 230 Good Samaritan Society locations nationwide, with several across Minnesota. Its full name is the Evangelical Lutheran Good Samaritan Society, but it is not part of the Evangelical Lutheran Church of America. The nonprofit company is based in Sioux Falls, S.D.

Indiana Hospital Errors Increase 24% In The Past Year

According to the Indiana Department of Health, the number of reported hospital errors rose from 85 in 2006 to 105 in 2007. 

Indiana hospitals and surgury centers must report any of the 27 avoidable medical errors from a list compiled by National Quality Forum, a non-profit group dedicated to improving health care.  Some of the medical errors reported include:

Robert Wachter, a professor of medicine at the University of California-San Francisco, said it is difficult to evaluate hospitals in the early years of medical error reporting systems such as Indiana's.  He said jumps in errors could be from more accurate reporting or from more actual errors.   Wachter said he was skeptical of hospitals that reported no errors.

I would guess that the number of reported medical errors is extremely low.  Some hospitals in the Chicago, Illinois have greater number of medical errors than the entire state of Indiana.  Nursing home residents should be aware of hospital problems because nursing homes will frequently send residents to a hospital if their condition worsens or the facility is unable to care for them.

Read more about the Indiana Medical Errors in this Chicago Tribune article here.

Nursing Home Injury Laws: Indiana

Government Pays $3.2M Annually To 'Crack House' Nursing Home

Despite conditions that would make most fraternity houses seem like the Ritz, Westside Health Care Center and The Terrace at Westside in Ohio continues to receive government payment for providing substandard services in a physically dangerous setting. 

Authorities have long been aware of problems at Westside, yet the facility continues to operate with government funds.  Ohio health inspectors have more than 200 pages of violations at the facilities from 2003 through 2008 and extensive monetary fines slapped on the owners, yet the dangerous conditions  remain. 

A police raid on the facility on March 13th revealed conditions that made the City Council take notice and suggest residents find new places to live.  The police raid found the following physical problems  with the facility and nursing home staff:

Facility Problems

  • Fire doors tied shut
  • Mold on walls
  • Cigarette butts in walkways
  • Soiled mattresses
  • Roach infestation
  • Uncleaned vomit

Staff Violations

  • Allowing residents to smoke near oxygen tanks
  • Storing medication improperly
  • No psychological training for staff caring for residents with psychological problems
  • No first aid training
  • No fire drill training
  • 20% medication error rate

Nursing homes and long-term care facilities that receive Medicare and Medicaid funding must be in compliance with federal regulations.  I guess the government is giving Westside a freebie?  Read more about the nursing home violations at Westside here.

 

What Were These Nursing Homes Thinking?

There are many daily occurrences that occur in nursing homes that beg the question: what in the world were they thinking?  Everyday we hear about tragic incidents that are preventable not only with proper medical training, but plain old common sense. 

Some recent stories make me question the intelligence and sincerity of the people who work in nursing homes.  I mean everyone knows that: people need water, if you leave people laying in bed for days they will develop bedsores, sexual predators probably shouldn't be living amongst around the elderly, a bed-bound person will have a difficult time running out during a fire and nursing home residents require ongoing care.

Lara Pettiss Harrill of the South Carolina Nursing Home Blog, drives home nursing home residents' needs for basic care in her recent post on a Belleville, Illinois nursing home resident who filed a lawsuit after he contracted gangrene on his penis.  Ms. Harrill sums up the nursing home care issues faced by residents who suffer from nursing home neglect on a daily basis;

'Bottom line is, this gentleman was in a nursing facility, presumably because he needed nursing care - presumably because he needed assistance with activities of daily living, like bathing, dressing and using the bathroom.  What on earth were the employees doing (or not doing) that they could miss something like gangrene . . .'

The above situation further demonstrates a culture of neglect that has developed in many nursing homes where employees willingly ignore critical health problems and hope the worker on the next shift does the routine work they should have done.  Gangrene does not develop overnight.  Dare I say to the entire staff at the Calvin Johnson Care Center, 'what were you thinking?'

We All Need Water

Dehydration is a common problem amongst nursing home residents.  Dehydration occurs when you do not drink adequate fluids or you lose fluids due to: sweating, vomiting or diarrhea.  If an elderly person becomes dehydrated they are susceptible to cramps, organ malfunction, pressure sores and even death.

Older people are particularly susceptible to dehydration because many elderly have the following conditions:

  • Decreased thirst
  • Kidneys that do not work well
  • Choose to avoid liquids because of incontinence
  • Have difficulty holding a glass
  • Pain urinating
  • Take medications decreasing urine output
  • Inability to regulate body temperature
  • Diabetes
  • Inability to communicate

Signs of dehydration include:

  • Dark yellow urine
  • Sunken eyes
  • Ashen skin
  • Dry skin
  • Bleeding gums
  • Urinary tract infection
  • Weight loss

It is the nursing home's responsibility to properly hydrate all residents.  Nursing home staff should monitor the amount of fluids consumed by each resident on a daily basis.  If a nursing home allows a resident to become dehydrated they are guilty of nursing home neglect.

 

 

 

 

Packing On The Pounds Won't Kill You--Only Makes Elderly's Lives Less Enjoyable

An article published in the Journal of American Geriatric Society says that although seniors may inceasing in size, they continue to have increasing longevity.  After analyzing data from 4,000 senior citizens in England, the analysis determines that amongst the elderly there is not a corelation between obestiy and mortality rates.  The mortality rates increase only amongst the most severely obese.

The news is not all good for over-weight elders.  According to the article, over-weight senior suffer from decresed mobility and difficulty performing daily living activities.  The extra pounds have a dramatic impact on seniors in nursing homes and long-term care facilities.  Over-weight nursing home residents are at increased risk for development of pressure sores, diabetes and other medical complications.

Read more about the study on overweight elders here.

Sex Crimes Land Utah Nursing Home Worker In Jail

Jacob Mut Bolith, was sentenced by a Utah Judge to 15 years in jail and to pay restitution for the sex crimes he committed on nursing home residents. Bolith plead guilty to second-degree felony forcible sex abuse of an 85-year-old woman in a nursing home where he was employed.

Bolith's attorney Clayton Simms asked the Judge to sentence his client for 365 days in addition to the 389 days he has already served. He asked for leniency because Bolith is a Sudanese refugee who was displaced from his home and spent time in Ethiopia and Kenya before he came to the United States. Consequently, he said, Bolith had a difficult childhood that may have led to his behavior, despite Bolith learning English and getting his certified nursing assistant license to better his life.

Simms took issue with the pre-sentence report that said there was sexual penetration — he said there was only fondling and touching and Bolith's patients misunderstood his intentions. However, Simms said his client takes full responsibility for his actions.

Crimes like this are universal in any language and should not be tolerated anywhere.  I hope Utah has a law similar to Illinois that prevents convicted felons from working in nursing homes.  Read more about this case of nursing home sex abuse here.

Failure To Provide Medication Is A Common Error In Nursing Homes

Failure to provide medication is a common problem facing nursing home residents.  Many situations involving failure to provide medication result from problems with the transition of a resident's medical charts from a hospital or facility where they were prior to their admission to the nursing home.  Nonetheless, nursing homes have a responsibility to provide quality care to their residents.  This includes conducting an assessment upon admission to assure all medical needs are met.  

Yesterday's blog entry on the untimeliness of administration of medication reminded me of a case my office is working on.  In our case, a Chicago-area nursing home failed to provide insulin to our diabetic client for several months.  As a result of this nursing home neglect, our client went into Diabetic Ketoacidosis.  Diabetic Ketoacidosis, is a life-threatening condition that develops when diabetics do not get enough sugar into their cells.  The lack of sugar results in the development of fatty acids which cause chemical imbalance.  

Diabetic Ketoacidosis can be detected by monitoring the level of sugar in the blood and urinalysis. Diabetic Ketoacidosis may also be accompanied by:

  • Flushed, hot, dry skin
  • Blurred vision
  • Lack of interest in usual activities
  • Drowsiness
  • Rapid breathing
  • Breath smelling of vinegar or alcohol
  • Loss of appetite
  • Confusion

If the Diabetic Ketoacidosis is left untreated, the condition may cause brain damage or death.  Unlike other situations involving medication errors, injuries due to failure to administer medication are completely preventable and result from nursing home staff neglect

Power Of Attorney For Healthcare

Most people use Power of Attorney and Power of Attorney for Healthcare interchangeably.  A Power of Attorney delegates who you wish to make healthcare decisions should you become unable to do so.  You may specify what life extending procedures, if any, you desire.  You may further specify the dates which the Power of Attorney is to become effective or terminate.  Many hospitals and nursing homes require a Power in order to obtain medical records for a disabled family member.

Here is an Illinois Power of Attorney.  This form must be witnessed and notarized.

Study Shows Errors In Timing Of Administration Of Medication In Assisted Living Facilties

According to a new study published in the Journal of the American Geriatrics Society, the likelihood of a medication error is low.  The authors of the study looked at 12 long-term care facilities in 3 states.  The results of the study are surprising considering that many long-term care facilities use aides who no formal training in the administration of medication.  Among the studies findings are:

  • Overall error rate of 28.2%
  • Timing errors were the most common (70.8%).  The resident did not receive the medication within an hour of the scheduled time.
  • Wrong dosage 12.9% of the time
  • Skipped dosage 11.1% of the time
  • Extra dosage 3.5% of the time
  • Unauthorized drug 1.5% of the time
  • Wrong drug .2% of the time

None of the timing errors were related to medications where timing is critical to the health of the resident.  Medications such as insulin and warfarin must be administered very consistently in order to avoid serious physical injury to the individual. 

Once the 'time' factor was removed from the study, results show that medication errors were made 8.2% of the time. 

Where else would an 8.2% error rate be acceptable?  Can you imagine a bank teller with an 8.2% error rate in giving out cash.  How long would a bank keep a person like that around? 

Read more about medication errors in assisted living facilities here.

Murderer Assigned To Do Community Service In Nursing Home

Many states, such as Illinois, have passed laws to prevent convicted criminals from working in nursing homes.  Their violent backgrounds, put the most susceptible elderly at risk.  In a new twist, this news story uncovers the facts that a convicted murderer was assigned to work at a nursing home as part of her 'work release' program.  This story further demonstrates the importance of monitoring all people who enter nursing homes.  Protection of nursing home residents can only be assured when all people entering a facility are carefully monitored.   What is your facilities policy with respect to volunteers and visitors?

Scabies Outbreak In Pennsylvania Nursing Home

Fifteen residents of the Gallagher Center of Saint Mary's Home in Erie, PA have developed what physicians believe was scabies, a contagious skin infection caused by skin mites. An unknown number of staff and patients' family members also developed the condition.  The first case was reported in the spring, though most cases were reported in June and July according to the facility.  The original patient was treated by a dermatologist, but other cases followed.

Once the the nursing home realized that it was dealing with a scabies outbreak, every patient in the 39-bed Alzheimer's unit examined. The nursing home also ordered the entire unit disinfected, including patients' beds three straight days.  Scabies is usually not a dangerous condition, but it can lead to painful skin infections. It is spread by skin-to-skin contact and by sharing towels or bed sheets.
  Scabies is commonly treated with the prescription drugs permethrin (Elimite, Acticin) and crotamiton (Eurax).

Failure To Clean Trach Tube Leads To Lawsuit

The parents of a 49-year-old nursing home residents have filed a wrongful death lawsuit against  Aldercrest Health & Rehabilitation Center in Seattle the death of their for their daughter.  The woman who had suffered a stroke, which led to a tracheotomy.  The woman's family selected Aldercrest because staff at the facility made assurrances of providing skilled, high quality care, and a tour that showcased a pleasant exercise room and a bedroom with a pretty comforter.

But less than 24 hours after their daughter was admitted, her tracheal tube clogged with mucous, causing oxygen loss and brain damage.

Aldercrest is owned by Extendicare Homes Inc. based out Milwaukee-based Extendicare of violating consumer-protection laws by advertising "quality standards above government regulations" and failing to deliver. The lawsuit highlights problems long known by local advocates and health officials regarding Extendicare, one of the largest nursing-home chains in North America. The company runs 268 facilities for up to 30,000 residents.  Nearly all of Extendicare's homes, which can accommodate up to 1,500 people, have higher-than-average scores for health deficiencies found by state inspectors.

"They're bad news," said Louise Ryan, the state's long-term care ombudsman. "They are a very troubled corporation. It's just very sad that they are as bad as they are."

Read more about this incident of poor nursing home care here.

Woman Poses As Nurse To Steal Medication From Nursing Home Residents

A woman accused of sneaking into Beaverton's Maryville Nursing Home has been arrested.
Theresa Kim Smith is a certified nursing assistant in the Portland area and someone the police listed as “a person of interest” in a reported theft of Fentanyl pain patches.  The suspect woman posed as an employee at the Maryville Nursing Home on three separate occasions, but no motive was suspected at the time. Tips from the public led police to interview Smith, and the stealing Fentanyl patches from residents could be a possible motive.

Smith, who works at the Care Center East Nursing Home in Portland, is suspected of stealing the pain patches from multiple nursing home locations.  The Oregon State Board of Nursing has been conducting its own investigation into Smith’s reported Fentanyl thefts and has suspended her CNA certification.  Read more about the posing nurse here.

Is the staff turnover at nursing homes so great that the people who actually work at the facilities can not recognize a new face?  Perhaps equally frightening is how lazy these facilities are when it comes to securing such a dangerous drug like Fentanyl.  The authorities should investigate the self-serving Fentanyl incident.

2 Residents Fall From Wheelchairs With 2 Days At Nursing Home

One resident died after rupturing a blood vessel in his brain and fracturing his neck following his wheelchair tipped--anti-tipping devices were not in place.  A second resident fell forward in her wheelchair and struck her head on the floor resulting in a concussion and laceration requiring stitches-- a prescribed waist restraint was not in place.  The similar incidents occurred within 48 hours of each other at the same nursing home.

What makes these unnecessary events so disturbing is that they occurred within days of each other--these are not isolated incidents.  The events have prompted inspections by state nursing home inspectors.  Pennsylvania Health Department, director of nursing-care facilities Bill Bodner, sums the situation up well, 'the crux of our concern is the fact that in each case, there was miscommunication between the physician and nursing staff, and no clear plan of how the staff should treat these patients.'

Blame for these incidents falls squarely on the shoulders of nursing home staff.  Nurses and other nursing home workers are trained not only to follow physician orders, but also must provide resident care as new needs arise.  The above incidents are not the result complicated medical orders, rather they result from the most basic failures on the part of nursing home staff--failure to open their eyes.  Read more about the failure of nursing home staff to prevent falls here.

Nursing Home Injury Laws: Pennsylvania

Caught On Tape: 90-Year-Old Man Beaten By Home Nurse

Think the term 'nursing home abuse' is made up by lawyers?  Cameras don't lie...

 

Employee 'Quiets' Man With Pillow

Forget about asking a nursing home resident to be quiet or actually attending to what may resident needs- just stick a pillow on their face and hope that quiets them.  That is the approach used by Jesse Bodey, an employee at Life Care nursing home used with an 85-year-old man when he was screaming in the nursing home.  Witnesses say Bodey then placed a pillow over the patients head. A co-worker reported the incident, but when the supervisor checked on the patient, the pillow was gone.

The staff at the home told Police that Bodey wasn't trying to suffocate the patient. They say he was trying to quiet him down but went about it in an unorthodox way.  Bodey is facing several charges, including one count of reckless endangerment and two counts of offensive touching. He is out on bond. No court date has been set. He has been suspended without pay from the nursing home. The staff says the patient is doing okay.  Read more about this case of nursing home abuse here.

You've got to hand it to this guy, he did a nice job fabricating a story to get himself out of murder charges.  What would have happened if he would have spent more time 'quieting' the patient?

Big Verdicts Against Nursing Homes

Nursing home owners take note: no longer can providing poor care to elderly nursing home residents be part of 'doing business.'  Take a look at some recent jury verdicts involving nursing home abuse and neglect.  Imagine the owner of a nursing home writing these types of checks....

  • $324,000,000 Texas, Over $300 million in punitive damages for the death of elderly patient due to malnourishment and infected decubitus ulcers.
  • $90,000,000 Texas, For the death of 90-year-old nursing home resident.
  • $79,000,000 Arkansas jury award
  • $54,000,000 New Mexico, Nursing home resident died from internal bleeding without any assistance from the nursing home staff.  The staff reportedly attempted to cover up the incident by removing the blood sheets.
  • $33,900,000 Tennessee, Nursing home resident developed pressure sore and urosepsis.  Additionally, resident fell at the nursing home and broke his hip.  The resident walked on the broken hip for 7 days before any x-rays were taken.
  • $20,000,000 Kentucky, Jury awarded $1.2 million in compensatory damages and $18.8 in punitive damages to the family of an 84-year-old lady who cries in pain went unresponded to by nursing home staff for hours prior to her death.  An autopsy demonstrated the woman had a bowel obstruction.
  • $19,000,000 Texas, Nursing home failed to protect family member from self-inflected abuse and from the abuse of other residents.
  • $13,000,000 Delaware, Elderly lady walked into nursing home's freezer and found 4 hours later by nursing home staff.  Lady sustained frostbite to her hands, face, fingers, and toes.  She died 24 days later from pulmonary embolism.
  • $6,000,000 Texas, Woman died when she became entangled in the restraining belt of a wheelchair.  The woman's family alleged that the facility failed to properly position her in the wheelchair and failed to monitor her.
  • $4,000,000 Kentucky, Doctor and nursing home failed to monitor a patient's lithium dosing causing toxicity and ultimately death.
  • $2,900,000 Illinois, Facility failed to clean and suction nursing home resident's trach tube for 5 days, causing it to become obstructed.  The decedent suffered from respiratory arrest and went into a coma for 2 days before expiring. Nursing home admitted liability and case was tried on damages only.
  • $2,000,000 California, Facility failed to provide end of life pain relief.

If you believe you are the victim of nursing home abuse or neglect, it is important to seek the advice of an experienced nursing home lawyer soon after the incident.  Important information may be lost if they is a delay in investigating the incident.  Most nursing home lawyers do not charge for any consultation.

 

Nursing Home Crimes Go Unreported

In order for authorities to prosecute people charged with committing crimes they must have evidence.  In some cases authorities can rely on physical evidence to prove their case.  The most effective evidence comes in the form of testimony from crime victims- the people who can describe what happened to them and what the perpetrator looked or might have said.

What happens if the victim is unable to testify?  Unfortunately, the chances of the assailant walking free increase substantially.  Further, when a crime occurs within the confines of a nursing home or long-term care facility has little incentive to report the crime to authorities.

This is where nursing home advocate Wes Bledsoe wants to step in.  Bledsoe is the founder of  A Perfect Cause, a non-profit organization dedicated to increasing public awareness of  unreported rapes, robberies, and attacks involving vulnerable nursing home residents. 

Bledsoe is getting involved in a case involving a 41-year-old man who was raped at the Oak Hills Living Center in Jones, Oklahoma.  The victim suffered from Pick's Disease, a deterioration of the brain, and is unable to describe the crime.  Although the nursing home was aware of the crime, the case was not reported to law enforcement agencies.  Bledsoe says the man was attacked, raped, neglected and abused when he lived at the center from August of 2007 through February of this year.

This story demonstrates the importance of families becoming actively involved in the care of their loved ones in nursing homes, hospitals and long-term care facilities.  No one can look after a loved one 24 hours a day, however regular visits with your loved one allow detection of any improper treatment early on before it becomes an ongoing problem.  If you suspect an incident involving a violent crime or nursing home neglect, report the situation to your state ombudsman or health agency.
 

Michigan Court Dismisses Charges Against Nursing Home Workers Playing With A Corpse

Criminal charges were dismissed against three employees at Cherrywood Nursing and Living Center in Sterling, Michigan.  The Michigan Court of Appeals dismissed the misdemeanor patient abuse charges that the employees were originally charged with.  The court reasoned that the deceased nursing home resident could not be categorized as a patient because she was dead. 

In 2004, the nursing home employees were ordered to get the body of a deceased nursing home resident ready for transport to a funeral home.  The threesome told the corpse to 'wake up' and took photographs of each other with the corpse. Read more about this incident of corpse abuse here.

The women were fired for their behavior, but alarmingly, the Macomb County Department of Community Health did not revoke their licenses, even though the facility was cited for violation of patient dignity. 

Man Loses Testicle In Belleville Nursing Home

A lawsuit was recently filed against Calvin Johnson Care Center in Belleville, Illinois.  The lawsuit claims that while Fred Moss was admitted to the facility for long-term nursing and rehabilitation, the facility failed to supervise him and was neglectful in their treatment.  As a result of the nursing home neglect, Mr. Moss contracted cellulitis and gangrene in his scrotum and penis which ultimately required the removal of his testicle.   A copy of the lawsuit is here.

My guess is that the man in this lawsuit was catheter dependent. Many nursing home residents are incontinent and have catheters for discharge of urine.  Catheters require ongoing maintenance.  For example, nurses must clean and empty the catheter several times per day.  Further, if a nursing home resident has a Foley Catheter it must be removed and changed at regular intervals.  Failure to properly clean and maintain a catheter may result in a urinary tract infection and ultimately surgical removal of a testicle.

 

Surprise! Large Nursing Home Chains Put Profits Over The Care Of Residents

According to federal data, large, for-profit nursing home chains have lower staffing levels and higher rates of serious patient-care violations than independently owned facilities.  A Connecticut newspaper analyzed two years of inspection and ownership data from the Centers for Medicare and Medicaid services, comparing corporate owned nursing homes to their privately owned counterparts, the results are striking:

  • 16% fewer registered and licensed nurses at corporate owned facilities
  • 30% higher rate of patient harm at corporate owned facilities
  • The five largest chains had a 42% higher incidence of serious deficiencies which could result in serious patient harm
  • 70% of all nursing homes are owned by chains (2 or more facilities with the same owner)

Unlike nursing home homes with owners who actually run their nursing homes on a day to day basis, corporately owned nursing home owners are unlikely to be anywhere near the facility they own.  Further, many 'chain nursing homes' are run by parent companies by managers who have no previous health care experience and who may have entered the nursing home industry solely as a business venture.

Toby Edelman, a senior policy attorney with the nonprofit Center for Medicare Advocacy sums it up best, "Ownership is certainly a factor" [in quality of care.]  Ownership is one more criteria to look at when selecting a nursing home.

Woman Dies From Brain Bleed Following Unsupervised Fall

Everyday nursing home residents fall.  Much like a toddler learning to walk, some falls are unpreventable.  Nursing home residents remain the highest risk for falling and getting injured compared with any other demographic.  The most fall prone must be identified identified by the nursing home staff.  Identification of individuals who are at 'high risk' for falling is only part of the solution.

After reading this newspaper article of a Montana woman who fell four times during a 35 day stay at a nursing home, I was reminded of how important is is for nursing homes to have adequate fall protection in place.  Despite the fact that this resident had a medical history which put her at high-risk for falls, the facility did not take precautions.  Moreover, the facility had three opportunities to put fall prevention measures into effect before the last episode when the resident fell and suffered a cerebral hemorrhage. 

The Montana woman's husband and family have filed a lawsuit against the nursing home, drawing attention to the underlying cause of the woman's death- poor staffing.  The lawsuit claims the facility did not have an adequate number of staff and did not properly train them. 

For high-risk residents, nursing homes must have adequate fall prevention measures in place.  The best fall prevention is to provide adequate number of nursing home staff to supervise residents.  While federal and state laws may specify minimum staffing ratios, the fact remains that may nursing home residents who are at high risk for falling need significantly more attention than the bare-bones staffing requirement.  Nursing home residents with dementia, Alzheimer's and low-blood pressure are particularly susceptible to falls.

According to Charlene Harrington, a University of San Francisco California professor, who has studied nursing home staffing, 'only 5 percent of nursing homes around the U.S. have adequate staffing."  What will happen to the 95% of nursing home residents, who are exposed to chronic under-staffing, poor employee training and high staff turnover?

Unsupervised Nursing Home Resident Dies From Burns

A Scottsdale, AZ nursing home resident died after in the burn unit of an area hospital.  According to reports, the 89-year-old woman died after she apparently set herself on fire while smoking on a patio.  The woman was left unattended while the woman's caretaker was in the kitchen at the facility.

When paramedics arrived at the nursing home, they found that the victim was burned when her dress caught on fire.  The resident told paramedics that she was outside smoking and tried to burn off a loose thread on her dress with a lighter.  Apparently the dress caught fire and she received 3rd degree burns over 40 to 50 percent of her body.

Nursing homes have responsibilities to properly supervise their residents.  Moreover, they must have policies to aid in resident safety.  In addition to the fact that this woman was left unattended, she also was in possession of a cigarette lighter.  Lighters are one of the most common sources of injury to nursing home residents.  Nursing homes should have strict smoking policies in effect--banning the possession and use of cigarette lighters. 

Nursing Home Rapist In Custody

40-year-old, Roberto Cruz Recendes, was extradited to the United States and placed under arrest for the 2002 beating and rape of a 94-year-old woman in a Palo Alto assisted living center, according to Palo Alto Police.  The arrest stems from a May 10, 2002 incident at an assisted living facility.   Police responded after a resident reported she had been beaten and raped by an intruder, agent Dan Ryan said.  Recendes lived near the facility at the time of the incident and since relocated to Mexico.

Currently, Recendes is charged with one count of sexual assault during the commission of a burglary and one count of elder abuse with great bodily injury, according to Ryan. He is being held in the Santa Clara County main jail without bail.  Read more about this case of elder abuse here.

It is great that law enforcement officials were able to work together to track down this guy.  The question remains: Was this incident preventable in the first place?  The answer most likely is a resounding 'yes.'  Nursing homes and assisted living facilities have a duty to provide safe environments for their residents.  This includes screening all people who enter the facility, securing all windows and doors and most importantly--carefully monitoring the residents.

Report Documents Problems With Nursing Home Oversight

AAHSA (American Associate of Homes and Services for the Aging) has released a new report titled: 'Broken and Beyond Repair: Recommendations to Reform the Survey and Certification System.'  The  report documents the problems with the inspection system for nursing homes.  The report calls for an independent panel to come up with standardized criteria for both the inspection of nursing homes and for the inspectors themselves.  As a temporary fix, the report makes 31 recommendations to improve nursing home care until an independent panel can be established.

"We have to break the cycle of fear that paralyzed us all: consumers fear nursing homes, nursing homes fear the state, states fear the federal government, the federal government fears Congress and Congress fears voters," says Larry Minnix, AAHSA president.

The real problem with the system is its enormity of regulations placed on all parties involved in the nursing home industry.   Like our tax system, regulators tend to pile additional rules and regulations on an already overwhelmed system.  No nursing home worker could possibly digest all applicable regulations and still do their job.  While rules and regulations are certainly essential to provide quality care for the elderly, before placing additional regulations on a system it is better to take a step back and look at how to cure the current problems. 

World's Tallest Woman Dies In Nursing Home

7-foot-7, Sandy Allen, the world tallest woman died yesterday in an Indiana nursing home.  Sandy Allen was 53-years old.  Ms. Allen received care at Shelbyville Nursing Home for medical conditions related to her extreme height.  Poor circulation in her legs caused Ms. Allen to rely on a wheelchair for getting about.  Although Sandy Allen weighed just 6.5 pounds at birth, she developed quickly.  By the age of 10, she was 6 feet 3 inches.  By the time Ms. Allen was 16, she was 7 feet 1 inch.  Read more about the world's tallest woman here.

 

Maggots In Open Wounds In At Florida Nursing Home

A man admitted to Azalea Court Nursing and Rehabilitation Center for rehab for a broken leg, soon realized he was getting more than rehab at the facility he chose to help him- maggots.  The maggots were seen in an open wound during a dressing change.  Azalea Court's complaint and inspection reports from the past several years did not reveal any glaring problems. Investigators from the State Attorney’s Office visited Tuesday.  Read more about the maggots here.

This is a prime example of neglect nursing homes.  Nursing homes are required to provide the best care possible for their residents.  The failure to clean and open wound is a clear case of patient neglect.

Related:

Nursing Home Injury Laws: Florida

Nusing Home Supervisor Admits To Abusing 100 Residents

John Riems, a former nursing home supervisor at Conrad Care and Rehabilitation Center in Ohio. During questioning by prosecutors, Reims admitted to abusing nearly 100 patients during his 22-year career at nursing homes.  Reims is under investigation from an original charges involving the allegations of abuse involving a 55-year-old blind man and a partially paralyzed man in his 80's.  Fourteen more felony counts have been filed against Mr. Reims since the investigation began-- 12 counts of rape and two counts of felonious sexual penetration.  Read more about this Ohio nursing home story here.

I certainly believe in 'innocent until proven guilty,' but with this type of evidence against him, it certainly looks like Mr. Riems at the very least neglecting his nursing responsibilities and at worst perpetrating disgusting crimes against innocent elderly.  In Illinois, nursing home's must screen all employees to prevent any person with a criminal record from interacting with the nursing home residents.

65 Illnois Nursing Homes On Second Quarter Violation List

The Illinois Department of Public Health released is listing of nursing homes from the 2008 second quarter.  The listing has nursing homes that  the IDPH has determined to be in violation of the Nursing Home Care Act.  In some situations, IDPH has recommended decertification to the Director of the Illinois Department of Healthcare and Family Services, or the Secretary of the U.S. Department of Health and Human Services for violations in relation to poor patient care, pursuant to Titles XVIII and XIX of the Social Security Act.  Further, these facilities have 'type A' violations indicating that the conditions at the facilities pose imminent harm or death to the residents.

Do you or a loved one live at any of these facilities?  Many of these facilities frequently appear on the quarterly listing.  Here's the list:

1.    Aspire on Eastern
105 Eastern Avenue
Bellewood, Illinois  60104
  
2.    Asta Care Center of Bloomington
1509 North Calhoun Street
Bloomington, Illinois  61701

3.    Asta Care Center of Rockford
707 West Riverside Boulevard
Rockford, Illinois  61103    

4.    Auburn Nursing & Rehab Center
304 Maple Avenue
Auburn, Illinois  62615

5.    Bethesda Lutheran-Aurora
1480 Reckinger Road
Aurora, Illinois  60505

6.    Big Meadows
1000 Longmoor Avenue
Savanna, Illinois  61074

7.    Blue Island Nursing Home
2427 West 127th Street
Blue Island, Illinois  60406

8.    Bridgeview Health Care Center
8100 South Harlem Avenue
Bridgeview, Illinois  60455

9.    Brother James Court
2500 St. James Road
Springfield, Illinois  62707

10.    Chestnut Corner
905 West Chestnut Street
Louisville, Illinois  62858

11.    Diamond Development Co.
150 South State Rte. 45, Box 250
Louisville, Illinois  62858

12.    Clearbrook Center
3201 West Campbell Street
Rolling Meadows, Illinois 60008

13.    Crestwood Care Center
14255 South Cicero Avenue
Crestwood, Illinois  60445

14.    Danville Care Center
1701 North Bowman
Danville, Illinois  61832

15.    Davis House
4237 South Indiana Avenue
Chicago, Illinois  60653

16.    Ada S. McKinley Community Services, Inc.
725 South Wells, Suite !-A
Chicago, Illinois  60607

17.    Decatur Rehab & Health Care Center
136 South Dipper Lane
Decatur, Illinois  62522

18.    Petersen Health Operations, LLC
830 West trailcreek Drive
Peoria, Illinois  61614

19.    Fountains at Crystal Lake
1000 East Brighton Lane
Crystal Lake, Illinois  60012

20.    Sunrise IV Crystal Lake SL, L.L.C.
208 South LaSalle St., Ste, 814
Chicago, Illinois  60604

21.    Glenwood Healthcare & Rehab
19330 South Cottage Grove
Glenwood, Illinois  60425

22.    Golfview Developmental Center
9555 West Golf Road
Des Plaines, Illinois 60016

23.    Hammond House
6701 South Morgan
Chicago, Illinois  60621

24.    Ada S. McKinley Community Services, Inc.
725 South Wells, Suite 1-A
Chicago, Illinois  60607

25.    Helia Healthcare Of Energy – DD
210 East College
Energy, Illinois  62933

26.    IL Veterans’ Home at Quincy
1707 North 12th Street
Quincy, Illinois  62301

27.    Illinois Knights Templar Ha
450 Fulton Street, P.O. Box 49
Paxton, Illinois  60957

28.    Knox County Nursing Home
800 North Market Street
Knoxville, Illinois  61448

29.    Lakeview Living Center
7270 South Shore Drive
Chicago, Illinois  606049

30.    Progressive Housing, Inc.
2020 West War Memorial Drive, St. 103
Peoria, Illinois  61614

31.    LaSalle Healthcare Center
1445 Chartres Street
LaSalle, Illinois  61301

32.    MHC Illinois, Inc.
208 South LaSalle Street
Chicago, Illinois  60604

33.    Lexington Of Chicago Ridge
10300 Southwest Highway
Chicago Ridge, Illinois  60415

34.    Manorcare at Elk Grove Village
1920 Nerge Road
Elk Grove Village, Illinois  60007

35.    Manorcare at Peoria
5600 Glen Elm Drive
Peoria, Illinois  61614

36.    Manorcare at Palos Heights
7850 West College Drive
Palos Heights, Illinois  60463

37.    Maple Terrace
1510 North Fourth Street
Quincy, Illinois  62301

38.    Community Living Options, Inc.
285 South Farnham Street
Galesburg, Illinois  61401

39.    Meadows
3250 South Plum Grove Road
Rolling Meadows, Illinois  60008

40.    Mount Vernon Health Care Center
#5 Doctor’s Park
Mount Vernon, Illinois  62864

41.    Petersen Health Care II, Inc.
830 West Trailcreek Drive
Peoria, Illinois  61614

42.    Mosaic Living Center
7464 North Sheridan Road
Chicago, Illinois  60626

43.    Sheridan Springs, L.L.C.
7444 Long Avenue
Skokie, Illinois  60077

44.    Norridge Healthcare & Rehab Centre
7001 West Cullom
Norridge, Illinois  60706

45.    North Adams Home
2259 East 1100th Street
Mendon, Illinois  62351

46.    Oak Park Healthcare Center
625 North Harlem
Oak Park, Illinois  60302

47.    Odd Fellow – Rebekah Home
201 Lafayette Avenue
East Mattoon, Illinois  61938

48.    Pleasant View
500 North Jackson Street
Morrison, Illinois  61270

49.    American Health Enterprises, Inc.
606 Diamond Court
Morrison, Illinois  61270

50.    Provena St. Anne Center
4405 Highcrest Road
Rockford, Illinois  61107

51.    Randolph County Care Center
312 West Belmont
Sparta, Illinois  62286

52.    Renaissance At Hillside
4600 North Frontage Road
Hillside, Illinois  60162

53.    Rest Haven South Nursing Home
16300 Wausau Street South
Holland, Illinois  60473

54.    Ridgeland Nursing and Rehab Center
12550 South Ridgeland Avenue
Palos Heights, Illinois  60463

55.    Sangamon Care Center
2800 West Lawrence
Springfield, Illinois  62704

56.    Saint Clare Home
5533 North Galena Road
Peoria Heights, Illinois  61614

57.    OSF Healthcare System
St. Francis Lane
East Peoria, Illinois  61611

58.    St. Agnes Healthcare and Rehab Center
1725 South Wabash
Chicago, Illinois  60616

59.    St. Agnes Manor, Inc.
1541 North Wells Street
Chicago, Illinois  60610

60.    Stephenson Nursing Center
2946 South Walnut Road
Freeport, Illinois 61032
 
61.    Village Inn-Cobden
114 Ash Street
Cobden, Illinois  62920

62.    Westbury Care Center
1800 Robin Lane
Lisle, Illinois  60532

63.    Brookdale Living Communicaties of IL, DNC, LLC
330 North Wabash Avenue, Ste 1400
Chicago, Illinois  60611

64.    William L. Dawson Home
3500 South Giles Avenue
Chicago, Illinois  60653

65.    Woodstock Residence
309 McHenry Avenue
Woodstock, Illinois  60098

Most of the above violations were made following a complaint initiated by a resident or their family.  If you believe a facility is treating its residents improperly or the resident is at risk for harm make a report of the incident today.

 

Audio Recordings Used As Evidence In Conviction Of Health Care Worker

A former employee of a state-run group home for mentally disabled people was banned today from working in the health care industry after pleading guilty to a charge of negligent cruelty to a person. Gerald Guay,was sentenced by Judge Gary White in Superior Court in Hartford to a five-year suspended prison sentence, three years' probation and 100 hours of community service. White also ordered that Guay refrain from working in hospitals, nursing homes and other care-giving businesses.

"You can't work in health care at all," White said.

According to the Bloomfield Police Department's arrest warrant application, Guay tormented and tortured Christopher Stockton, a 38-year-old resident of the Brown Street home who has severe autism and other developmental disabilities, including an inability to speak.

According to the affidavit, Stockton's mother, Alice Stockton, first brought her suspicions to the attention of the state Department of Developmental Disabilities more than two years ago, when her son began to suffer seizures that coincided with the beginning of Guay's employment in the home.

Alice Stockton was told there was nothing that could be done because there was no proof of abuse, according to the affidavit. Eventually she began to periodically take an audio recording what was happening in the room that her son had to himself, according to the affidavit.

On Dec. 18, 2007, Alice Stockton activated the recorder in his room, but did not immediately listen to what transpired. Three days later, she picked up her son and brought him to her home in Windsor for the weekend. When she tried to brush his teeth, she noticed a laceration and a hematoma on the inside of his mouth, she told police.

On Dec. 23, Alice Stockton listened to the recording and heard Guay entering her son's room shortly after she left. In the recording, Guay is heard swearing at Christopher Stockton and threatening to "bash his head in" several times, according to the affidavit.

On the recording Guay can be heard, in an expletive-filled tirade, threatening to beat Christopher Stockton and make him eat the toilet if he doesn't stop flushing it, according to the affidavit.

Why didn't authorities act quicker in this situation?  The fact that Ms. Stockton brought evidence of her disabled sons injuries to authorities attention and without any results is sickening.  These prosecutors should look for another job if they put the burden of obtaining evidence in the hands of a disabled person's mother.

Read more about this incident here.

Related:

Nursing Home Injury Laws: Connecticut

Ohio Nursing Home Fire Sparks Interest In Resident Safety

The report of a fire at Jaycee Village Retirement Community, an Ohio Nursing Home, demonstrates the importance of fire safety in all nursing homes.  Although, no residents were injured, the episode demonstrates how a fire in a nursing home could severely harm residents who are unable to move quickly because they are bed-bound or in wheelchairs.

In June, 2008 CMS, the governmental agency regulating Medicare and Medicaid funded nursing homes, gave all nursing homes receiving federal funding five years to phase in the installation of sprinkler systems at their facilities.  According to a report from the Government Accountability Office, fire sprinklers can decrease the chances for fire-related death by 82%. 

Currently, all nursing home must have battery operated smoke alarms in all patient rooms and public areas.  Further, all nursing home receiving public payments are subject to random fire safety inspections. 

The Correlation Between Staff Satisfaction And Resident Care

It makes sense.  If members of the nursing home staff are satisfied with their job, treated appropriately, receive good job benefits, they will be happier and their happiness will likely be translated to better patient care.  On the other hand, look closely into the eyes of any employee at struggling company-- you can sense their stress, their frustration and their anger.  In this sense nursing home patients and staff have interests that are very much aligned with each other. 

In nursing home owner's desire to squeeze every cent of profit out of their facility, nursing home staff and residents are the ones who are ultimately harmed.  In some respects many nursing home residents and the people who care for them on a daily basis are very much in the same boat.  Just as a nursing home resident may likely have few alternatives to living out the remainder in an undesirable facility; many people employed by the nursing home have few alternatives as well.  For many nursing home workers, they have little or no education, many are immigrants who possess few job skills. 

Many of the nursing homes that frequently have episodes of patient falls, pressure ulcers, medication errors and physical abuse of residents also happen to be the facilities that pay their employees the least.  Is this a coincidence?

Clearly, if there really is a desire on the part of nursing homes to improve patient care, they should first look improving morale of the nursing home staff.   Give the staff a $1.00 per hour raise, pay them overtime, give them some flexibility in their schedule, throw in a benefit or two-- before you know it overall patient care may begin to improve. 

For a more information on the correlation between employee satisfaction and patient care look here.

The List Of 'Never Events' Grows

Effective 10/1/2008, hospitals and nursing homes will no longer be able to seek reimbursement from Medicare for medical conditions deemed preventable.  The Centers for Medicare & Medicaid Services is asking states to coordinate Medicare and Medicaid policies to prevent facilities from billing Medicaid for preventable medical errors for individuals who may be eligible for both Medicare and Medicaid.  Most nursing home residents are eligible for both Medicare and Medicaid.

The 'never events' is a listing of 28 categorized errors that CMS has determined to be clearly preventable.  CMS estimates that errors on the 'never list' account for $4.5 billion in annual Medicare charges.  The list is a step toward holding bad medical facilities accountable for the actions or neglect of their staff.  Without a never list, nursing homes and hospitals stand to actually benefit financially from rendering poor care.  Theoretically, a nursing home resident could develop a stage 4 pressure sore due poor care and the facility could submit months of wound care treatment (and bills) to Medicare for payment.  By category, here is the list of 'never events':

Surgical Events
  • Surgery on wrong body part
  • Surgery on wrong patient
  • Wrong surgery on patient
  • Foreign object left in patient after surgery
  • Post-operative death in normal health patient
  • Implementation of wrong egg
Product or Device Events
  • Death / disability associated with use of contaminated drugs
  • Death / disability associated with use of device other than as intended
  • Death / disability associated with intramuscular air embolism
Patient Protection Errors
  • Infant discharged to wrong person
  • Death / disability due to patient elopement
  • Patient suicide or attempted suicide resulting in disability
Care Management Events
  • Death / disability associated with medication error
  • Death / disability associated with incompatible blood
  • Maternal death / disability with low risk delivery
  • Death / disability associated with hypoglycemia
  • Death / disability associated with hyperbilirubinemia in neonates
  • State 3 or 4 pressure ulcers after admission
  • Death / disability due to spinal manipulative therapy
Environment Events
  • Death / disability associated with electric shock
  • Incident due to wrong oxygen or gas
  • Death / disability associated with a burn incurred within facility
  • Death / disability associated with a fall within facility
  • Death / disability associated with use of restraints within facility
Criminal Events
  • Impersonating a health care provider (i.e., physician, nurse)
  • Abduction of patient
  • Sexual assault of a patient within or on facility grounds
Clearly, the implementation of the 'never list' is a step towards better patient care.

Read McKnight's article on CMS's coordination of the 'never list' for Medicare and Medicaid here.
Look at CMS's letter to State Medicaid and Medicare directors concerning 'never events' here.

Jury Awards $2.1 Million To Family Of Dead Nurisng Home Resident

A Texas jury found CLC Richland Hills nursing home and its medical director responsible for the death of a 79-year old woman.  The woman entered the facility for rehabilitation following a fall.  During the course of her stay, she developed a urinary tract infection which went untreated by the nursing home staff.  Not only did the staff fail to follow proper protocol to prevent the urinary tract infection (uti), it also over-medicated the woman.  The staff admitted they 'dropped the ball'  to state nursing home inspectors. 

The woman's family will not collect much from the judgment.  According to the families lawyer, Geno Borchardt, 'bad nursing home operators and doctors who get overextended, its hard to hold them accountable.'

In addition the fact that a woman died needlessly, this story demonstrates the importance of mandatory insurance coverage for nursing homes.  In the instant situation, the nursing home owner was obviously making plenty of money as he owned 70 nursing homes.  Yet creative business planning and an antiquated system allows him to avoid paying a judgment for the death of his resident.

Read the full article here about this Texas nursing home.

Quarterly Review Of Illinois Nursing Homes Reveals Major Problems

The Illinois Department of Public Health has recently published its quarterly (April - June 2008)  report for Illinois Nursing Home receiving citations.  The report indicates findings of violations for nursing homes which were in violation of the Nursing Home Care Act.  The State of Illinois has recommended decertification of the facility to the Director of Illinois Department of Healthcare and Family Services, or the Secretary of the U.S. Department of Health and Human Services for violations in relation to patient care pursuant to Titles XVIII and XIX of the Social Security Act.

All of the facilities cited in the quarterly report have 'Type A Violations.'  A type A violation is the most serious licensure violation imposed by the state.  Type A violations pertain to situations where serious physical harm or death may result from the facilities conduct.

The links for the Second Quarter Results for the offending nursing homes are not working.  However, the links for the First Quarter Results are, among some of the low-lights findings from the First Quarter of 2008 are:

Ambassador Nursing Center: Chicago, IL, Type-A violation, $25,000 fine for allowing a cognitively impaired resident to smoke unsupervised outside.  While attempted to light a cigarette, the resident caught himself on fire and died.  The facility violated its own resident smoking policy.

Imperial of Hazel Crest: Evanston, IL, Type-A violation, $30,000 fine for failing to implement a program for prevention of bedsores.  The resident at issue developed a stage four pressure sore without any staff intervention.  The resident required hospitalization for treatment of the pressure sore and accompanying infection.

McAllister Nursing & Rehab: Tinley Park, IL, Type-A violation, $10,000 fine for an incident where the staff kicked an elderly resident in the knee.  The incident of physical abuse was admitted by the nursing home employee in an interview.

Pershing Convalescent Home: Berwyn, IL, Type-A violation, $20,000 fine failing to properly implement a fall prevention policy for residents.  An 85-year old was admitted to the facility with a history of falls and dementia.  The resident had 4 unwitnessed falls within a 3 month period.

Regal Health And Rehab Center: Oak Lawn, IL, Type A violation, $30,000 fine for consistently failing to provide care outlined in their resident assessments.  The state inspector noticed that several records were pre-dated--in other words the nursing home staff completed the medical chart indicating the care provided before it was actually done.  In several instances, the state investigator noticed residents with bedsores without dated wound dressings and residents sitting in soiled sheets with open wounds.

 Rest Haven South Nursing Home: South Holland, IL, Type A violation, $32,500 fine for failing to report and incident to a state agency for an incident where the resident fell out of bed and received a closed head injury.  Under the law, nursing homes must report incidents with injury to the department of public health within 24 hours.

Trinity Living Center #3: Joliet, IL Type A violation, $10,000 fine for an incident where the a nurses aide failed to call the paramedics or start CPR upon finding an unresponsive resident.

The above are just a sampling of violations for the quarter.  As you can see, these are major health and safety violations.  Will the fines against the facilities be enough to improve patient care? When deciding where to place a loved one for care, be on the lookout for the above facilities.

Get Out Of Here!

Evictions of nursing home residents are on the rise according to a recent article in the Wall Street Journal. As many nursing homes face budget cuts, they are seeking to reduce the number of Medicaid residents in favor of higher paying Medicare or self-pay residents that pay the facility a substantially higher daily rate.  Under federal law, nursing homes can only involuntarily discharge patients for the following reasons:
  1. If the resident is well enough to go home.
  2. Discharge the resident for care only available elsewhere.
  3. Danger to the safety of other residents.
  4. Danger to the health of other residents.
  5. Failing to pay bills.
  6. If the facility shuts down.
Most states provide little guidance for nursing home residents facing eviction.  Moreover, there is little guidance for what procedure residents can take to contest their evictions.  Even if a person can persuade the nursing home to continue to let them remain at the facility, it is probably not a good enviornment for the person to remain.  Think about it, would you really want to live in a place where it is obvious you are not wanted?  Will you really be receiving the most attentive care?  Is the staff really going to look out for your best interest.

If you are faced with eviction from your current facility it is best to contact your state ombudsman.

Sepsis

'Sepsis' is a bacterial infection in the bloodstream or body tissues commonly found in people with advanced bed sores (also referred to as pressure ulcer, decubitus ulcer or pressure ulcer).  In order to make a diagnosis of sepsis, at least two of the following must occur: a heart rate above 90 beats per minute, hyperventilation (more than 20 breaths per minute) and white blood cell count below below 4000 cells/mm.

Frequently, people use the term sepsis to describe 'severe sepsis' and 'septic shock.'  Severe sepsis is used to describe people who have organ dysfunction following a diagnosis of sepsis.  People diagnosed with septic shock have sepsis with hypo-tension (abnormally low blood pressure).

Sepsis is a common medical condition; it accounts for:

  • 1-2% of all hospitalizations
  • 25% of all intensive care visits
  • 10th most common cause of death

Causes

Exposure to different microbes (germs) can cause sepsis.  Sepsis is most commonly caused by bacteria, but it can also be caused by exposure to virus and fungi.  Many people develop sepsis after experiencing infections such as: pneumonia, meningitis, cellulitis, urinary tract infection.  Amongst nursing home residents, people who have pressure sores and amputations are particularly vulnerable.

Treatment

In order for treatment to be most effective, it must be implemented as soon as the diagnosis is made.  Generally treatment consists of antibiotics and surgical drainage.  Nutritional supplements are also suggested as treatment for sepsis.

Related:

Is sepsis related to bed sores?

Lawsuit Alleges: One Week In The Nursing Home Results In Significant Deterioration Of Pressure Sores & Sepsis

Alzheimer's Patient + Sex Offender= Trouble

This report of an Alzheimer's patient who was sexually assaulted by her co-resident (a registered sex offender) demonstrates the extreme vulnerability of nursing home residents with dementia and Alzheimer's.  Nursing home's must take extra precautions when handling Alzheimer's patients.  Unlike most nursing home residents, who are capable of most daily living needs, many with Alzheimer's are completely dependent on the nursing home staff for every need- feeding, bathing, medication and toileting.

What makes this story particularly disturbing is that the 'victim' of the sexual assault is probably incapable of identifying the perpetrator.  Consequently, there is a chance that this individual could commit a similar crime again against another nursing home resident.  Nursing homes must begin to take precautions to protect their residents

Safe Transfers

A 'transfer' in a nursing home setting generally refers to moving a patient from a bed to a wheelchair.   Transfers are usually done two ways: using nursing assistants or mechanically (Hoyer lift).  The type of transfer depends mainly on the patients physical condition.  If a patient is capable of providing some assistance, a staff lift (one or two person transfer) is generally done.  However, if a patient is paralyzed or suffers from physical disability, the use of a mechanized lift may be required to safely transfer the patient.

The choice of how to transfer a patient from a bed to a wheelchair is up to the facility.  A determination of the type of transfer should be part of the evaluation when a person is admitted to the facility and for quarterly reviews of nursing home patient needs.  It is crucial for the staff at the facility to use the properly predetermined transfer technique or the nursing home resident is at risk to injury. 

Below are videos demonstrating the proper transfer technique for both the 'manual' method and using a Hoyer lift.

 

 

 

Bar Coding To Reduce Mistakes With Administration Of Medication

A Kansas hospital is using a bar coding system- the same technology that allows grocery clerks to quickly scan bags of groceries-- to help with verification when administering medication at the bedside.

Many hospitals, nursing homes and long-term care facilities are quickly seeking new ways to cut down on the number of mistakes involving medication errors.  Following the lead of many health insurers, new Medicare rules will deny payment for avoidable errors made by hospitals and nursing homes.

Experts estimate that 40 percent of medication errors are made with the physician's written order. But another 40 percent are made at the point at which medication is administered.  "We know medication errors occur in hospitals... we want to cut down on that."  Jim Garrelts, a pharmacy director.

Unlike errors with physician orders, which pharmacists and nursing staff can potentially catch, there is little that can be done to prevent errors associated with errors made in the administration of medication.  This is where the bar coding system will have the biggest impact.  The bar coding system is intended to reduce medication errors with administration of medication.

With a bar code system, the nurses will scan the hospital id bracelet on the patient and the medication.  If there is any error with the type of medication or the dosage, the system will notify the nurse immediately.  The system provides one more opportunity to prevent human errors before a patient receives medication.

Hospitals and nursing homes that implement this system should be commended for their commitment to patient safety.  The facilities will likely reap benefits in a reduction of the number of claims associated with medication errors.  The National Hospital Association estimates that medication errors cost facilities between $5,000 and $7,000 per mistake.

Read more about the use of bar codes to prevent medication errors here.

Nursing Home Injury Laws: Kansas

Nursing Home Residents Expected To Shoulder More Financial Burden

Many disabled and elderly residents of New York will soon be expected to pay more personal funds toward their nursing home expenses.  The changes are being implemented to minimize government spending by reducing the number of people eligible for Medicaid.  Medicaid was originally conceptualized as a program to protect the poor and disabled.  As the population ages, many people are seeking benefits under Medicare that the system never considered-- middle class people living in nursing homes.

Qualifying for Medicaid is not easy.  A thorough background check is conducted for each recipient.  All assets must be disclosed- including, bank accounts, homes and even vacation homes.  If the Medicaid recipient has any assets to speak of, the assets must be 'spent down' their current assets in order to receive Medicaid benefits. 

The process of determining Medicaid eligibility is further complicated by marriage.  In many states, a spouse not living in a facility is considered to be a 'community spouse'.  The community spouse is generally entitled to keep a faxed amount of assets and keep a house and car. 

In, New York, close to 80% of the nursing home residents are recipients of Medicaid.  Nursing home residents who qualify for Medicaid receive substantial discounts for the  for the facilities.  At many nursing homes, the Medicare reimbursement rate is so substantially discounted, the facility actually loses money every day for each Medicaid patient it provides care to. 

In order to keep their facilities open, many nursing homes are asking for financial documentation when a person applies.  For more information on Medicaid funding look here.

How can we continue to foot the bill for 80% of the nursing home population? 

How Feasible Is Home Based Nursing Care?

We've heard how home based nursing home care may be a great alternative to nursing homes. How realistic is it for the disabled and elderly to rely on home-based nursing care in their own homes? Can we really afford to provide an in-home-nurse for each person who requests one?


Nurse's Aide Steals From Alzheimer's Patient

Latoya Johnson, a nurse's aide at an Elmhurst, Illinois senior care center was convicted by a DuPage County judge of stealing from an elderly Alzheimer's patient at the facility where she worked.  Consequently, Ms. Johnson was sentenced to six months in jail.  According to Assistant State's Attorney Mary Cronin, Ms. Johnson stole $18,000 from the patient after obtaining the bank account and bank routing number.  A family member of the nursing home resident, discovered the theft and reported it to authorities. In addition to the jail time, the 26-year-old Johnson also received nine months of work release, 300 hours of community service and four years of probation and to pay restitution. Read more about the financial exploit of the an elder here.

About Jonathan Rosenfeld

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Jonathan Rosenfeld is a lawyer who represents people injured in nursing homes and long-term care facilities.   Jonathan has represented...

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