Nursing Homes Abuse Blog - By Jonathan Rosenfeld

A private ambulance was recently stolen from a Chicago nursing home resulting in a six car accident with multiple injuries.  The ambulance was taken from Clark Manor Nursing Home located on the 7400 block of North Clark Street and was driven north on Chicago Avenue into Evanston where the the ambulance was involved in a crash.

According to Evanston Police Commander, Tom Guenther, there were several injuries due to the ambulance crash.  "He just kept going at a high rate of speed.  He was driving erratically and it is possible the driver was impaired," Guenther added.

Witnesses said the driver of the stolen ambulance activated the sirens and mars lights on the vehicle as it erratically.  "He ran the red light and just plowed through three cars," said Robert Skertich of Chicago.

No nursing home residents where in the ambulance at the time of the crash.  The suspect is in custody of Evanston Police as he awaits formal charges.

Read more about this Chicago ambulance crash here.

Ambulance Responsibility For Injuries Sustained In Crashes

When evaluating cases relating to injuries sustained in an ambulance collision, it is important to know: the purpose for operating the ambulance, what entity was operating the vehicle and if the sirens and flashing lights were engaged at the time of the crash. These factors will help in making a determination if 'tort immunity' applies to the case or if the case can proceed under a general negligence theory.

"Tort immunity' refers to laws that insulate government entities and their employees from liability.  The reasoning behind 'tort immunity' is that the services provided are so essential to the public's well-being, that the government and its agents should not be held responsible for mere negligence.  Rather, in many cases involving government entities, an injured party must establish a higher standard of conduct, 'willful and wanton', to successfully recover.

Most nursing home residents are transferred from the facility to doctors appointment or medical procedures via ambulance.  As lawyers who are accustomed to handling injuries that occur during the transportation of elderly people, we can evaluate your situation and help make a determination how best to proceed and under what potential theories to maximize you recovery.  You can always speak to our injury lawyers for a free consultation and learn more about your rights.  All consultations are kept in the strictest confidence.

Nursing Homes Abuse Blog Related Entries

Transportation In & Out Of Nursing Homes: Ambulance Responsibility.

Medical Helicopter Safety

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Following on the widely publicized articles related to the increase in number of nursing home residents with mental disabilities, Jonathan Rosenfeld of the Nursing Homes Abuse Blog was quoted in an article published in Lawyers USA written by Nora Lockwood Tooher  .  Here is a copy of the article.

Criminal offenders and mentally ill residents are fueling an increase in patient-to-patient assaults at nursing homes, according to experts.

This growing violence is sparking a rise in civil lawsuits by families of patients who have been assaulted by other residents, according to several elder law specialists.

In a recent survey, Wes Bledsoe, founder of A Perfect Cause, a nonprofit nursing home residents' advocacy group in Oklahoma, found 1,600 registered sex offenders in nursing homes.

The organization has also documented more than 60 rapes, murders and assaults committed by criminal offenders in nursing homes.

"It's a huge problem," Bledsoe said. "The issue of nursing homes being dumping grounds is nothing new, and certainly for years we've had nursing homes serving not only the disabled and the elderly, but more people with mental illness, behavioral problems, drug rehabbers, alcohol rehabbers and criminal offenders being placed in these facilities by state agencies." See Rising Nursing Home Violence Spurs Increase In Lawsuits.

While there are no official figures on the numbers of mentally ill and criminal offenders being housed in nursing homes, a recent report by the Associated Press estimated that nearly 125,000 young and middle-aged adults with serious mental illnesses lived in U.S. nursing homes last year.

Eric Carlson, a staff attorney at the National Senior Citizen Law Center in Los Angeles, said nursing homes that are having trouble filling their beds sometimes "start looking for residents, and get those residents from bad sources."

Often, the staff is not aware of a resident's violent past. And because of health care privacy laws, the facility is not allowed to disclose information about a resident to other residents, Bledsoe noted.

Families often become aware that another resident has a history of violent behavior after their loved one is assaulted, he said.

"People are being raped, physically assaulted and murdered," he said.

An Oklahoma nursing home, Whispering Pines, recently closed after its Medicare and Medicaid funding were discontinued in the wake of abuse allegations raised by Bledsoe's group.

Bledsoe is seeking legislation in Oklahoma that would require all abuse allegations to be reported to police.

He has lobbied successfully for legislation in Oklahoma that authorizes a long-term care facility for sex offenders so they won't be put into nursing homes with other residents.

Preventable injuries

Jonathan Rosenfeld, a plaintiffs' lawyer with Rosenfeld Injury Lawyers in Chicago and author of the nursinghomesabuse blog, said it's not just young mentally ill residents or those with criminal records who act out violently in nursing homes.

"The reality is that in addition to the young people who've got some violent tendencies, there are older people who have similar violent tendencies who are inter-mixed with the general population," he said.

While some facilities have separate Alzheimer's or dementia wards, many allow disturbed older residents who are prone to violence to mingle with other residents, he said.

Rosenfeld said that once a nursing home becomes aware that a resident has behaved violently or has a propensity toward violence, the facility has an obligation to take steps to protect others.

"Certainly, it's one of the most preventable areas of injuries and harm to nursing home residents," he said.

Carlson agreed: "You're prevented from saying, 'Look out for that guy,' but it doesn't eliminate a facility's obligation in making admission decisions and in monitoring residents."

After witnessing a co-worker verbally abuse of a handicapped resident at Montrose Health Care Center in Montrose, IA, Lora Washburn, did the correct thing and reported the incident to the facility's administrator.  Or did she?  Not satisfied with the nursing home administrator's failure to respond to the situation, Washburn filed a complaint with the state documenting the abuse. Days after the complaint was made to state authorities, Washburn was accused of trying to intimidate co-workers and was fired from her position.

In another incident involving an Iowa nursing home employee, Janice Rardin, the Director of Nursing at the Evangelical Free Church Home, was terminated from her job after filing two complaints of suspected abuse with state authorities.  The alleged abuser was the facilities administrator.  Rardin allegedly overhead the administrator telling an attorney for the facility that he intended on firing her for making the report.  The attorney alleged told the administrator to hold off on Rardin's termination dispel any talk of retaliation.

Iowa, like 44 other states, requires nursing home employees to report suspected abuse of residents to authorities.  If nursing home employees fail to report the abuse they face potential licensing sanctions and fines.  Despite documented cases of known abuse by nursing home workers, no nursing home employees in Iowa have been prosecuted for failing to report abusive situations in the past ten years.

In addition to losing their livelihood, terminated whistlerblowers also face the reality that nursing homes rarely are prosecuted for terminating a mandatory reporter.  If a facility is prosecuted, the facility will likely only be prosecuted for a simple misdemeanor. 

John Judisch, a former Polk County prosecutor who now works for the state inspections department, said he does not recall ever getting complaints from whistle-blowing caregivers who were fired. "I'm not naive enough to think that sort of thing has never happened," he said. "But if they don't come forward, we're not going to hear about it."

Clearly, until stronger laws are on the books to protect nursing home employees who report instances of physical and psychological abuse, few employees can afford to risk the potential fallout from retaliation from administrators.  In reality the biggest losers in this situation are the residents of nursing homes and assisted living facilities around the country who are at risk for being trapped in abusive situations with little chance of assistance.

Read more about this incident involving whistle-blowing in a nursing home setting here.

Falls are a common problem facing elderly people in and out of nursing homes.  By some accounts, every elderly person in America will fall at least one time over the course of the next year.  Many of these falls will cause injury and some will even cause death.

In the case of falls occurring in the nursing home setting, many clients and their families focus their attention on tying a specific number of falls to a facilities responsibility.  Truth be told, there really is no magic number when it comes to identifying a specific number of falls after which a nursing home or hospital becomes responsible.

Rather, in determining a nursing home's fall related liability, it is important to determine not just the actual number of falls that occurred prior to the injury causing fall, but to look at the situation as a whole.  Taking a look at the residents 'fall-risk assessment' completed by the facility on admission should help determine what safeguards should have been in place to prevent falls.  In the case of multiple falls, it is important to look to see if a new assessment was completed after each fall.  Put another way, there is no magic number of falls for imputing responsibility on the part of a facility.

While in the fall mode, I came across this article regarding a lawsuit filed against a nursing home for failing to take precautions before a resident fell and died from her injuries.  The lawsuit alleges that Windsor Chico Creek Care and Rehabilitation Centers failed to implement fall precautions for a woman who was admitted to the facility following a back injury that made her susceptible to falls.

The woman's husband filed a nursing home lawsuit claiming that the facilities negligent conduct resulted in the woman falling from her bed and fracturing her hip. The woman subsequently underwent surgery for the hip fracture and contracted aspiration pneumonia during her recovery that ultimately caused her death.

The lawsuit alleges that despite the facilities own orders for safety precautions, Windsor Chico Creek Care and Rehabilitation Center failed take the following precautionary measures to prevent the woman's fall from occurring:

• Failed to use guardrails on the bed
• Failed to use an alarm system to alert staff if the woman fell from her bed
• Failed to used a lowered bed style to minimize the risk of falling from an elevated height
• Failed to hire an adequate number of staff to provide assistance

In this case, should the allegations proved to be true, this facility faces liability even though no prior falls took occurred.  The lawsuit also names Helios Healthcare LLC, the owner of Windsor Chico Creek as a co-defendant in the case.

Related Nursing Homes Abuse Blog Posts

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Study Links Medication Use With Falls

A nursing home cook and nursing assistant have been fired following the death of a 54-year-old schizophrenic patient at a California nursing home.  The incident took place at the Raintree Convalescent Hospital.  Despite the fact that Raintree documented the patient's swallowing problems and ordered all food to be sliced or pureed to accommodate his swallowing problems, the man was served whole meatballs.

According to a an investigation by the California Department of Public Health, the man stumbled out of his room, pale and unable to speak after he was served whole meatballs.  A nurses attempt to do the Heimlich maneuver on the man was unsuccessful and he was pronounced dead a short time later at an area hospital.

This is a case where the facility admits that its staff failed to follow standing orders with this patient.  According to Antonio Sandoval, assistant administrator at Raintree Convalescent Center, the cook and the nursing assistant ignored the residents care plan when they served whole meatballs to the man for lunch.  "Neither of them did their job." he said.

This incident resulted in an $80,000 fine against the facility.  Further, this reinforces Raintree's poor Medicare rating.  Raintree received just one out of five stars according the Federal nursing home rating system.

Related Nursing Homes Abuse Blog Posts

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In 2005 the State of Illinois closed down Emerald Park Healthcare Center due to serous safety violations and 'gross mismanagement'.  At the time, the man responsible for running the Evergreen Park, IL facility was Yousef A. Meystel. 

A state prosecutor claimed Meystel was one of 'one of the reasons the place in in the position it is in.'  During Meystel's tenure, the nursing home received 168 violations-- many for serious safety issues including: letting residents wander from the facility and housing unregistered sex offenders.  The conditions were so poor that a Judge ordered Meystel to stay away from the facility.

Since his Emerald Park days, Meystel has formed YAM Management and operates eight nursing homes in Illinois.  The most recent addition tot he YAM empire is The Plum Grove of Palatine.  On March 1st YAM took over the daily operations of the nursing home.

The change in management concerns the some residents and their families. According to Ronald Porep, who has a parent living at Plum Grove, "As a family we are concerned about the quality of care the new owners will provide.  We want to know if and how good quality care for my mom will be guaranteed.  We are also concerned about any planned rate increases."

YAM is operating Plum Grove with the goal of taking control of ownership of the facility in the future.  Illinois law does not prohibit ousted nursing home administrators from running other facilities or from taking an ownership role.  Medicare currently rates Plum Grove 4 out of five stars.  We will keep an eye on this facility and notify blog readers if this rating changes.

Read more about the change of operations at this Chicago nursing home here.

Yes.  In nursing home negligence cases, if Medicare and/or Medicaid paid any medical expenses on your behalf, the agencies are entitled to be reimbursed. Federal laws impose a Medicare and/or Medicaid lien on all injury-related cases involving a recovery from a third-party.

Because many nursing home residents are recipients of Medicare and/or Medicaid, it is important to understand that these agencies have an automatic right to get reimbursed from a recovery from a third-party (any party that may have caused the injury).  Lawyers who handle nursing home negligence cases should be able to help determine what benefits Medicare / Medicaid paid on your behalf.  Moreover, lawyers handling nursing home negligence cases should give you an exact figure as to how much money Medicare and/or Medicaid is receiving from a recovery.

Resource

Third Party Liability in the Medicaid Program

Lexington Care Center of Lake Zurich, Illinois has been named in nursing home negligence lawsuit filed in Cook County.  The lawsuit alleges Chicago nursing home failed to monitor an 83-year-old resident who was a known high fall risk.  The woman allegedly fell five times from February through August, 2007.

The fifth and final fall at Lexington resulted in a fractured hip that required surgery.  Unfortunately, the woman remained at Lexington for five days before the staff transferred her to a hospital for x-rays and medical treatment.  Unhappy with the care Lexington provided, the family chose an alternative facility for the woman's medical care following her discharge from the hospital. Read more about this nursing home lawsuit against Lexington Care Center of Lake Zurich here.

Nursing Home Falls

More than 1,800 people die each year in nursing home falls.  All health care professionals in the nursing home setting must work together to help encourage nursing home safety.  Nursing homes are required to conduct a fall-risk assessment for every resident to determine who may be at risk for falls.  This puts the staff on notice as to who may need special attention and sets forth what accommodations should be in place for each resident. 

Additionally, staff should always be on the lookout for residents who may require assistance getting about.  If residents have a history of falls, the facility should consider using alarms on chairs or beds to notify the staff when the person attempts to walk on their own.

Falls in nursing homes occur for a variety of reasons.  Some of the more common causes for falls  are:

• Muscle weakness and walking or gait problems
• Hazards in the nursing home- wet floors, poor lighting, improper be heights, improperly maintained wheelchairs, equipment left out of place
• Medications-  Drugs that effect the central nervous system, such as sedatives and anti-anxiety drugs (psychoactive drugs)
• Improperly fitting shoes or incorrect walking aids
• Frequent use of restraints

Lexington Health Care

Lexington Health Care is a large company housing more than 3,000 people in the Chicago-area.  Lexington operates 21 nursing homes under the the names: Lexington Health Care Centers, Lexington Retirement Centers and Merit Home Health Care.  There are ten health care centers in:

• Bloomingdale
• Chicago Ridge
• Elmhurst
• LaGrange
• Lake Zurich
• Lombard
• Orland Park
• Schaumburg
• Streamwood
• Wheeling

Amy Quaintance Vega's great-grandmother was beaten to death by another resident with a violent history.  Since then, Amy has taken it upon herself to spread the word of not only what happened to her great-grandmother, but to help improve nursing home safety for others.  Here is her well-written petition.  Please take a moment to show your support for this case and sign the petition to end nursing home abuse.

On November 9, 2006, my great-grandmother, Bernice Mayeaux, was brutally beaten to death inside of the Pontchartrain Health Care Center in Mandeville, Louisiana. Karoline Glover, who had a violent history at the center, used the handle of a drawer to repeatedly hit Bernice. The day before she murdered Bernice, she struck a resident with her fist during a dispute over a cup of coffee. Instead of confining Karoline Glover to an isolated section of the home, the staff decided to move her into the room of a bedridden, ninety-five year old woman. Recovering from a broken hip and complications from a viral infection, Bernice was unable to move nor call for help during the time of the attack.

This horrific incident has produced an outpouring of support, sympathy and concern from people all across the country. The signatures below are proof that the people of the United States share the same common cause: ultimately ending abuse in nursing homes and protecting those who are unable to protect themselves.

We, the people, are demanding that, first and foremost, this “health care center” be extensively investigated and dealt with accordingly, in order to ensure that the health and well being of the residents are of top priority.

Lastly, we are dissatisfied with the quality of care that these insufficient establishments are administering to their residents. We insist that you, our Representatives, enforce rigorous laws that include, but are not limited to:

• Protecting the well being of the residents in the homes

• Strict and unwavering expectations of those employed at the homes

• Implementation of thorough background checks, not only on all employees of the nursing home, but also on all potential residents of the nursing home.

• A fully staffed establishment at all shifts where the ratio of caretaker to resident is one that can allow the resident to be in complete care and comfort at all times.

• Quarterly inspections from the state. The results of the inspections must be posted on the nursing home and state website, allowing all potential residents the opportunity of gathering as much information as possible. Should the nursing home fail any component of the state inspection on a quarterly basis, it will be made public.

• Last but not least, providing a clear and concise mission statement that all nursing homes are expected to abide by. The following declaration is a direct quote from the Pontchartrain Health Care Center: “The mission of our staff is to offer the highest quality of care for our residents within a clean, safe environment.” You can arrive at your own conclusion, based on the testimonial provided, whether or not this establishment stood by and supported their main cause and purpose.

The day of awakening for those who provide care for the elderly, particularly those whose family members have entrusted such care to be provided, is long overdue. The voices of those who find themselves in such helpless and uncontrolled situations are begging to be heard. Please allow this petition to serve as a united voice whose conviction is to demand and implement change as it relates to all issues surrounding nursing home care.

On February 2nd, Carrie 'Christine' Evans wandered from Primrose Villa Nursing Home just a few hundred yards to her death.  Officials from the North Carolina Medical Examiner's office concluded that Ms. Evans' death was due to a closed head injury after a fall.  The incident occurred less than 1/5 of a mile from the North Carolina nursing home.  There were similar episodes where Ms. Evans' wandered from the facility prior to this incident.

The investigation into Evans' death also confirmed the following:

• Primrose Villa had been visited by state inspectors 28 times in the past two years despite the fact that state law only requires quarterly inspections
• The facility failed to assume referral and follow-up to meet the health care needs of residents
• On the day of Evans' wandering from the facility, the door alarm was disengaged because a supervisor was not trained on how to operate it
• The staff failed to document falls and other injuries despite the fact that residents received medical treatment for the injuries

As a result of the Ms. Evans' death and the subsequent investigation, Primrose Villa faces two Type A penalties and potentially two Type B penalties.  A Type A violation is when a nursing home resident suffers serious physical harm and carries a potential fine of $20,000 per violation.  A Type B violation is given for an incident that impacts the residents quality of care but has not been corrected despite request from the state to do so.  Read more about this case of the death a North Carolina nursing home resident here.

Nursing home fines aside, I imagine a wrongful death lawsuit is in this nursing home's future.  If proven accurate, the fact that this facility was aware of Ms. Evans' propensity to wander from the facility yet failed to implement preventive measures is appalling.  This type of hap-hazard care needs to be prosecuted by public officials and private attorneys.

Nursing Homes Abuse Blog Entries On Wandering Nursing Home Residents

Nursing Home Negligence Lawsuit Filed After Man Wandered From West Virginia Facility

Man Wanders 20 Ft. From Chicago Nursing Home To His Death

How Much Freedom Should Assisted Living Facilities Give The Mentally Disabled?

When you become aware of mistreatment of a nursing facility it is important to get your loved one the medical treatment they need and then get into ‘fact collection mode’. In fact collection mode, you are beginning to collect information about the incident, acts of the nursing home staff and medical condition of your loved one. Doing some preliminary work before you meet with a lawyer will prove for a more effective meeting.

Don’t assume you will remember all facts regarding the incident. As time goes on, your memory will begin to fade. The following steps will help you organize your thoughts during a stressful time and to give an attorney the information he needs to work best on your behalf.

Despite the urge to block out the unpleasant facts and circumstances leading to an injury, much of the information listed below should be obtained as soon after an incident as feasible. The following information will prove to be valuable in both assessing the facilities responsibility and potentially as evidence to be used at trial.

Photographs- Take pictures of the physical injuries themselves, the area where the incident took place and if possible, the people involved. In cases involving particularly gruesome medical conditions (pressure sores, amputations, surgical wounds) no medical record can do justice to what your loved one experienced. Use a real camera as opposed to a camera-phone as the photos will be better quality.

Start Writing- Write down as much information about the incident or events as you can remember. Write some more. Details can be particularly helpful in the course of litigation as many nursing homes have high rates of employee turnover that can make obtaining information difficult. Concentrate on: names, dates, room numbers, names of facilities and medication dosages (if relevant).

Medical Chart- The medical chart from a nursing home and / or hospital is crucial to determining what a facility may have done or failed to do that resulted in injury or death. If your loved one sustained an injury that resulted in subsequent medical care at a hospital, these records will be important as well.

Chronology- This does not need to be one’s life story. However, if a condition developed over time or there are multiple facilities that may responsible for the injury or condition, it is important get the correct names and general dates of admission at health care facilities. The names of doctors who provided medical can be helpful as well.

Other Relevant documents: Healthcare Power of Attorney, wills, death certificates, pre-injury photographs, autopsy reports and nursing home inspection reports all can be helpful when meeting with an attorney. Bring them with.

There really is no such thing as providing a lawyer with too much information. An experienced nursing home lawyer will be able to sort through the materials and determine what information is relevant to your case. Further, a law office that regularly handles nursing home matters should be able to access much of the above information with the use of properly executed medical authorizations.

The bottom line is that you should not let your inability to access certain information delay from meeting your meeting with an attorney as soon as you are comfortable. Meeting with an attorney soon after an incident will provide the best opportunity to secure information relevant to your case.

I was forwarded this clip by several people following my post on new legislation that restricts the publics right to access nursing home inspections.  This law throws another hurdle at those who are victims of nursing home abuse and neglect.  Well said Keith!

Charges of first-degree rape by instrumentation have been filed against 94-year-old Lester Pendergast.  The charges stem from a September, 2008 incident when a witness caught Pendergast performing a sexual act on a 67-year-old at the Grace Living Center in Oklahoma.  A local hospital used a rape kit to confirm the sexual contact had taken place.

According to a statement released by the facility, “Grace Living Center of Edmond takes the responsibility to protect all residents very seriously. We discovered the incident and immediately took steps to provide for the safety and care of the residents; we reported the matter to the health department and police; and the male resident was promptly removed from the facility. We have cooperated fully with authorities throughout the investigation.”

A Perfect Cause, an organization dedicated to long-term care reform, believes it is in the best interest of other nursing home residents to publicly identify Mr. Pendergast as a sexual offender.  

Oklahoma is slated to be the first state in the country to open a special nursing home dedicated to housing sex offenders exclusively.  Read more about this nursing home rape here.

Sex Offenders In Nursing Homes

Currently, our nursing home system does little to prevent known sexual predators from becoming part of the general nursing home population.  As we can see by this case, age does not take away violent tendencies.  

In order for nursing home residents to live safely, nursing homes should take preventative measures: conducting background screens of all residents, refusing to accept known sex offenders as residents, keeping younger nursing home residents away from the older ones and providing adequate supervision.

According to Kathleen Dugan of The Lebanon Daily News, common signs of sexual abuse include:

Physical signs of sexual abuse:

• Bruising on inner thighs
• Genital or anal bleeding
• Sexually transmitted disease
• Difficulty walking or standing
• Pain and/or itching in the genital area
• Exacerbation of existing illness

Emotional signs of sexual abuse:

• Scared or timid behavior 
• Depressed, withdrawn behavior
• Sudden changes in personality
• Odd, misplaced comments about sex or sexual behavior
• Fear of certain people or of physical characteristics

Related Nursing Homes Abuse Blog Posts On Sex Abuse:

New Nursing Home To Be Built For Sex Offenders 

Alzheimer's Patient + Sex Offender= Trouble 

Solution To Sex Offender Problem- Separate Them

Following an appeal by a nursing home operator based on an excessive verdict, an Appellate Court has ordered a re-trial of the punitive damage aspect of a nursing home negligence case.  The case was originally tried in Warren County Circuit court and a jury awarded $4.1 M in compensatory damages and $29.8 M in punitive damages.  

The nursing home negligence lawsuit was brought by the daughters of Cheatum Myers, an 88-year-old man who allegedly died prematurely while he was a resident at a nursing home owned by National Healthcare Corporation, a Murfreesboro-based nursing home operator.  The family's lawsuit involved separate counts for negligence, medical malpractice and wrongful death.  

National Healthcare Corporation has 60 days from the entry of the Appellate Court's decision to file a motion to reconsider with the Tennessee Supreme Court.  National Healthcare Corporation is the 11th largest nursing home operator in the United States and currently houses over 9,000 elderly residents.  Read more about this nursing home negligence lawsuit here.

Punitive Damages

Punitive damages are damages not awarded in order to compensate the plaintiff, but in order to punish or deter the defendant and similar persons from similar behavior that harmed the plaintiff (injured party).  In most jurisdictions, plaintiffs must get permission from the court to pursue a claim for punitive damages.  There is no set limit or absolutely impermissible ratio of punitive damages to compensatory damages, though punitive damages with outrageously high ratios have been reversed by appellate courts.

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