Nursing Homes Abuse Blog - By Jonathan Rosenfeld

Ahhh, the power of home-videos!  Of course most of us acquire video camera with the hopes of capturing our babies first steps or our parents' silver anniversary, yet this clip highlights how powerful this little piece of technology is when it comes to capturing everyday life.  

Here, Todd Mobbs again documents the living circumstances of his father while a resident at Hancock Park Rehabilitation Center in Los Angeles, CA.  True, we could listen to him describe the situations his father dealt with, but the video component certainly is powerful.

This video, and Todd's other compilations, demonstrate that everyday people can and should document what their loved ones are experiencing as nursing home patients.  If you see unsanitary living conditions or physical evidence of abuse or neglect, I strongly suggest taking all measures to document your experiences.  Even if the matter is not legally pursued, spreading the word about these situations will enhance future living conditions for us all.

Resources:

Hancock Park Rehabilitation Center- Surveys, California Health Facilities Information Center 

Just Do It. Photograph Everything, Nursing Homes Abuse Blog

What Steps Should I Take Before Meeting With A Nursing Home Lawyer? Nursing Homes Abuse Blog

A grand jury indicted, Douglas Harris, following allegations relating to the financial exploitation of a mentally disabled resident at the nursing home where he was a social worker.  According to the Tennessee Bureau of Investigation (TBI), Harris was director of social work at Brookhaven Manor.  During a period between November, 2007 and March, 2008 Harris unlawfully persuaded the resident to give him: a $20,000 check, cash, and a luxury van.

A statement from a TBI spokesman reads, "Harris was employed as the director of social work at Brookhaven nursing home located in Kingsport Tennessee when he obtained property and cash from a resident of the facility who was incapable of making financial decisions."

The grand jury indicted Harris on the criminal charges related to his financial exploitation of July 14th and he was arrested shortly thereafter by authorities.  Currently, Harris is free on bond and has an arraignment set for September 11th in Sullivan County Criminal Court.

Read more about this financial exploitation at a Tennessee nursing home here.

Financial Abuse In Nursing Homes

Financial abuse is the most common type of abuse in the elderly population.  Financial abuse is generally considered to be the theft or conversion of money or other property by caregivers, relatives, or other people the elderly person trusts. Many cases of financial abuse remain undocumented because those initiating the fraud have become sophisticated in evading authorities. 

For example, parties involved in financial abuse may sign over the title to the older person's home or other assets to the abuser and then sold. Other examples of financial abuse include unauthorized removal of funds from: checking, savings, and investment accounts. Another major area of financial abuse amongst the elderly is the alteration of wills.

If you suspect financial abuse, notify authorities immediately before the property or funds are forever lost.

St. Martha Manor is a smaller 57 bed nursing home located in the north side of Chicago.  According to the government’s Medicare website, the facility received only one out of five stars, which is a much below average rating.  In the past year, the nursing home had seven health deficiencies, which is one less than the average number of health deficiencies in Illinois and in the United States.  The seven health deficiencies in the past year are an improvement from the eleven health deficiencies reported the previous year. 
 
Federal law requires nursing homes to report and investigate any acts or reports of abuse, neglect, or mistreatment of residents.  In this respect, St. Martha Manor failed to investigate a resident’s injury of unknown origin when a resident was sent to the hospital with leg swelling and pain and was diagnosed with a broken leg.  The assistant director of nurses at the facility confirmed that no investigation of the injury was performed, and the injury was not reported to the Illinois Department of Public Health.  Also, on several occasions, potentially dangerous medication errors were committed when the facility failed to administer medications in a timely manner.
 
Federal law also requires nursing homes provide the necessary care and services necessary for each resident to maintain the highest quality of life possible.  The facility failed to provide necessary services to a resident with a seizure disorder, leading to recurrent and increasing seizures, some of which resulted in injuries.  Laboratory results showed that anti-seizure medications were not given in high enough doses to control the seizures, and there was no change in anticonvulsant medications even though the resident continued to have seizures.  With another resident suffering from cellulitis (infection of the leg), the staff failed to properly elevate the leg and even left the leg uncovered without a dressing.  The resident had to be taken to the hospital because the infection worsened because the patient was allowed to touch the wound. 
 
The nursing home is required to make sure that the nursing home area is free of dangers that cause accidents.  One survey revealed that two of the twenty four residents sampled failed to receive necessary assistance during transfers to prevent injury.  One resident, who is dependent on staff for all activities of daily living, was supposed to be transferred with assistance to promote safety; however, after being transferred from bed to a chair, the resident fell and suffered a cut to the forehead requiring stitches.  On another occasion, a resident wandered into the parking lot and attempted to exit the fenced area.  While outside the facility, the resident cut his leg and injured his foot.  During this incident, the door alarms failed to alert the staff of the resident’s movement. Additionally, on other occasions, the following accident hazards were reported: standing water, janitorial equipment left unsupervised and missing floor tiles.
 
The nursing home has an obligation to give residents proper treatment to prevent new pressures sores or heal existing pressure sores.  Pressure sores (also known as bed sores, pressure ulcers or decubitus ulcers) are a very serious concern, especially for residents requiring prolonged bed rest, or with limited mobility and weakness.  Nursing home staff must turn residents who are bed ridden or have prolonged bed rest often enough so blood can circulate to areas that are under pressure.  The facility failed to follow a doctor’s order for treatment of pressure sores and also failed to provide pressure sore treatment on several dates.
 
Part of the nursing home’s obligation to protect its resident includes preventing resident elopement.  The facility failed to do this when it allowed a resident to leave the facility undetected, leading to the resident being in immediate jeopardy and requiring the police to locate the missing resident.  This elopement occurred because the resident was not properly monitored by staff even after being identified as an elopement risk. 
 
The nursing home failed to provide an effective pest control program to prevent rodents from entering the building.  Upon inspection, the surveyor observed a door in the laundry room with holes in which rodents could enter.  Then, during a group meeting, it was confirmed that mice had been observed in the building and even in resident rooms. 
 
St. Martha Manor failed to provide housekeeping and maintenance services necessary to maintain an orderly, sanitary, and comfortable interior as evidenced by unsanitary storage of care equipment and furnishings in poor condition.  Also, in the central nursing supply, expired supplements were stored alongside supplement that was not expired.  Additional supplies including Styrofoam cups were also stored on the floor in an unsanitary manner.
 
Furthermore, St. Martha Manor received only two out of five starts for its nursing home staffing.  The nursing home provides less resident nurse hours per resident per day (53 minutes) than both the national average (1 hour 18 minutes) and the Illinois average (1 hour 12 minutes).  The facility also provides less certified nurse aid hours per resident per day (1 hour 34 minutes) than both the national average (2 hours 18 minutes) and the Illinois average (2 hours).   
 
The many health deficiencies and low staffing levels substantiate St. Martha Manor's low Medicare rating.  If your family member is a victim of poor care at St. Martha Manor, I would honor the opportunity to discuss your situation.  As always, our legal services are completely free if there is no recovery for you.  Speak to our experienced nursing home lawyers today. (888) 424-5757

Authorities are now looking into how 85-year-old, Edna May Sides, managed to wander from Hillside Plaza Nursing Home without the knowledge of nursing home staff.  On July 15th, Sides dead body was found a short distance from the facility.   

Right on the heels of Dubuque Retirement Community, formerly Iowa's largest assisted living center, Jefferson Point Assisted Living Center has announced it will no longer operate as an 'assisted living facility'.  Operators of Jefferson Point will now operate the facility as an apartment complex.  Residents who require medical assistance may elect to remain in the building and pay for 24-hour medical care.

Jefferson Point has a history of failing to meet minimum standards of care and has received multiple fines from Iowa regulators. Ann Martin of the Iowa Department of Inspections and Appeals believes these assisted living centers' actions legal but unprecedented.  According to Martin, there will be no oversight of the centers' care of their residents.

I hope the current residents and families at these facilities appreciate the impact of these changes.  With no regulation or oversight, the residents are essentially at the mercy of these operators when it comes to the quality of care provided.  My guess is that these Iowa facilities may be starting a dangerous trend with respect to the de-regulation of assisted living facilities across the county.

Read the details regarding this Iowa facility here.

Nursing home attorney, Jonathan Rosenfeld, of Rosenfeld Injury Lawyers was recently interviewed by Mywebtimes.com regarding "How to detect nursing home abuse" related to the LaSalle County Nursing Home sex abuse scandal.  Here is an excerpt from the interview:

Q: In a nursing home abuse situation, who is usually the abuser?

A: Most involve residents victimizing residents, rather than staff victimizing residents. Some cases also involve visitors victimizing residents.

Q: What challenge do investigators face in gathering evidence?

A: The victim is usually disabled or suffering from Alzheimer's disease and thus unable to help investigators. In the case of the La Salle County Nursing Home, the Illinois Department of Public Health was fortunate enough victims were able to respond to questioning. The state usually does a good job of investigating. Abuse happens more than people realize.

Q: What is the typical reason abuse goes unchecked?

A: Short staffing. The facility may meet guidelines for proper number of staff, but it may not be what's really enough. It's dollars and cents. If they hire one or two more, they go over budget.

Q: What else creates an environment for abuse?

A: When a facility has young and old residents and the young are permitted to mix freely with the old. Another source of trouble is that a number of registered sex offenders have been found living at nursing homes. Also putting residents at risk are unsupervised visitors.

Q. What are signs of nursing home abuse?

A.Physical, mental and sexual abuse are forms of abuse encountered by nursing home residents across the country.Remember, you know your loved one better than anyone else. If you suspect mistreatment or abuse immediately report the situation to local police and/or ombudsmen. The reality is that most episodes of elder abuse go unreported.

The following situations warrant further investigation:

• Unexplained bruises, cuts, burns, sprains, or fractures.
• Bed sores.
• Frozen joints.
• Unexplained venereal disease or genital infections, vaginal or anal bleeding.
• Bloody clothing.
• Sudden changes in behavior.
• Staff refusing to allow visitors to see resident or delays in allowing visitors to see resident.
• Staff not allowing resident to be alone with visitor.
• Resident being kept in an over-medicated state.
• Loss of resident's possessions.
• Sudden large withdrawals from bank accounts or changes in banking practices.
• Sudden loss of appetite.

Q. Are bedsores an unavoidable part of living in a nursing home?

A. No! Bedsores, also called pressure sores or decubitus ulcers, are preventable — with proper screening, early detection, and staff involvement. Bedsores are a widespread problem in nursing homes and hospitals. The development of bedsores in nursing home patients is really a reflection of poor nursing care than an inevitable part of of the aging process.

Bedsores likely will develop if the nursing home and its staff do not make bedsore prevention a top priority. Nursing homes must do a thorough assessment of residents on admission and on a regular basis during their stay. Following the assessment, the nursing home should develop a comprehensive care plan that specifies what precautionary measures should be in place.

The nursing home plan should include considerations to monitor each resident's hydration, nutrition, and hygiene. Early signs of bedsores should be identified by the nursing home staff and treatments should implemented. Unattended, bedsores can quickly become infected leading to sepsis, limb amputation and even death.

A nutritious, balanced, and appetizing diet is important for all nursing home residents.  But it becomes essential for those suffering from pressure sores.  This is because a person with pressure sores needs to consume more calories per day that their healthy counterparts. 

Facilities need to calculate each patient’s total energy expenditure (TEE) in order to meet their nutritional needs.  TEE is composed of three components:

• basal metabolism, that is the number of calories needed to maintain a body at rest, which depends on age, sex, and body size;
• voluntary activity such as exercise; and
• energy expended to consume and metabolize food.

In times of injuries and stress, a body’s metabolic rate may increase, which in turn requires additional calories to compensate.  The extra calories provide the energy for the body to react to the stress of injuries and heal wounds.  So, while a normal person may need only 25-30 kcals per kilogram per day, a person with moderate illness or injury needs 30-35 kcals/kg, and a person with critical injury or illness needs 35-40 kcals/kg.  

Proper treatment for pressure sores must involve an assessment by a qualified dietitian who can figure out how many calories the patient should be consuming in order to heal and the best way to help the patient get the necessary calories from a balanced and appetizing diet.

Many facilities overlook, this crucial component to healing pressure sores.  Using the above nutritional guidelines, patients with advanced pressure sores would require the following daily caloric intake:

• 100 lbs.: 1,587 - 1814 daily caloric intake
• 150 lbs.: 2,381 - 2,721 daily caloric intake
• 200 lbs.: 3,175 - 3,628 daily caloric intake

In most cases, facilities must provide additional snack and nutritional supplements in order for patients to achieve this level of calorie intake.  If facilities fail to provide adequate levels of nutrition, the pressure sores are like to to advance and additional complications may develop.

Source: Nancy Collins, PhD, Rd, LD/N, FAPWCA, Why Calories Count: Proper Nutrition Fuels the Wound Healing Process.

Westshire Nursing and Rehab Center (“Westshire”), a massive 485-bed facility located at 5825 West Cermak Road in Cicero, Illinois, was recently cited by the IDPH and fined $35,000.  Westshire was last cited by the IDPH in November 2007 for endangering residents by inadequately supervising a resident accused of sexual assault on another resident.  

The IDPH conducted the most recent investigation in January 2009 and released the results as part of its first quarterly report of 2009.   The investigation revealed that Westshire failed to adequately monitor, treat, and prevent pressure sores in multiple residents, often resulting in painful deterioration of the residents’ condition. 

The investigation also documented several residents whose nutritional needs were not being fully monitored or met, sometimes resulting in a resident’s significant weight loss.  The report also expressed concern that the facility lacked basic hygiene supplies to enable staff to wash their hands effectively.  The IDPH ordered implementation of preventive measures for pressure sores, updated physician evaluations of certain residents’ conditions, and enhanced monitoring strategies for pressure sores and nutritional needs.  Westshire has requested a hearing.  

The U.S. Department of Health and Human Services, which operates a “five-star” rating system for nursing homes, gave Westshire a below-average overall rating of “two-stars.”  Significantly, Westshire earned just one-star in the area of health inspections due to the immediate jeopardy to residents’ health and safety from bed sores and actual harm to residents from a failure to give each resident appropriate care and services.  

If you are concerned about the treatment of a resident at Westshire Nursing and Rehab Center, call us at (888) 424-5757 for a confidential consultation.

Warren Barr Pavilion is a large 221 bed nursing home facility located in the near north side of Chicago.  According to the government’s Medicare website , the facility received only two out of five stars, which is a below average rating.  This is in large part to the facility’s high number of health deficiencies.  In the past year, the facility had eleven health deficiencies, which is higher than both the average health deficiencies for both nursing homes in Illinois and across the United States.  The facility’s most significant health deficiencies were improper care and services and risk of falls/accidents. 

The nursing home has an obligation to provide a safe and secure facility for its residents and to provide proper care and supervision to maintain the health of its residents.  According to the survey reports, the facility received multiple violations for:

• Failing to investigate injuries
• Allowing residents to develop pressure sores
• Discrepancies in prescribed feeding for a feeding tube
• Improper resident supervision
• Expired medication
• Falling to correct fall hazards
• Resident elopement
• faulty alarms for residents with wandering tendencies
• Dirt and debris in the facility

The numerous deficiencies reported in these surveys calls into question the ability of this facility to properly care for its residents.  The elderly are particularly vulnerable to improper care, which can lead to serious injury and even death. 

Pressure sores are a very serious medical condition, especially for residents requiring prolonged bed rest, or with limited mobility and weakness.  Nursing home staff must regularly turn this bedridden group in order to ensure proper blood circulation.  Federal regulations require nursing homes to provide residents proper treatment to prevent new pressures sores or heal existing pressure sores. 

According to a recent survey at Warren Barr, one resident was admitted to the nursing home with Dementia with Depression and was dependent on staff for all activities of daily living.  The patient developed a Stage 1 pressure sore on the right buttock and had been placed in a chair without a pressure relieving device because the nurse did not notice the pressure sore. 

Federal laws also require nursing homes to give each resident care and services to maintain the highest quality of life possible.  In the case of Warren Barr, the facility failed to meet this requirement when one patient had to wait nine days for treatment of a toe infection.  The facility waited until the podiatrist’s next scheduled facility visit, rather than calling the podiatrist’s office for immediate treatment.   The podiatrist stated that the facility should have called his office for an immediate visit to avoid/prevent complications, especially because the patient suffered from diabetes.   

Survey results also demonstrate Warren Barr failed to follow its own abuse policy regarding investigation for an injury of unknown origin.  This investigation requirement is in place to prevent nursing home injury and abuse. Staff members failed to investigate an injury (skin tear on the leg) suffered by a resident with Dementia.  When questioned, the certified nurse aid was unable to provide more information about the skin tear.   Yet, no inquiry was made concerning this injury.

The elderly are particularly vulnerable to injuries resulting from falls.  As such, the nursing home must ensure that the nursing home area is free of accident/fall hazards.  During one site visit to Warren Barr, the facility failed to provide adequate supervision to a resident who required extensive assistance and had a doctor’s order for fall precautions.  On this occasion, the resident was left sitting nude on a toilet while a certified nursing assistant was getting the resident dressed.  The staff member accidentally locked the resident in the bathroom without any supervision, and the resident was left alone in the bathroom for three whole minutes while a key was located.  In other residents’ rooms, the inspector noticed old newspapers on top of the heater, expired drops of nasal drops, and a radio cord that created a potential tripping hazard. 

Nursing homes are required to minimize the risk of resident elopement.  Warren Barr Pavilion failed to adequately monitor and supervise one resident suffering from Alzheimer’s and Dementia, who had been identified by the facility as an elopement risk because of a prior elopement incident.  As a result, the resident left the facility without being noticed by the staff despite wearing an electronic monitoring device.  The electronic monitoring device failed to activate/alarm when the resident passed through the sensor at the entrance of the building because of system malfunction.  Thankfully, the police were able to locate the resident only three blocks away from the facility.  Nonetheless, elopement is an extremely serious danger that puts the residents in immediate jeopardy. 

The nursing home has an obligation to give proper treatment to residents with feeding tubes to prevent problems.  During one site survey, the nursing home failed to ensure that two of seven residents in the sample who were on feeding tubes received the correct type of formula and the correct amount of feeding as prescribed by the physician.   During the period of observation, two patients received significantly less formula than prescribed; each discrepancy was equivalent to over an hour of feeding time missed. This seemingly minor oversight, puts these residents at risk for malnutrition and dehydration.

Nursing homes have an obligation to prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.  On several occasions, the staff at Warren Barr Pavilion served food to patients that was not maintained at proper temperatures (hot foods are maintained at 135 degrees F).  During a residents interview, residents complained that food was often cold upon delivery.  A review of the resident council minutes showed that residents had been complaining about cold food for the past six months.  In addition, several family members had complained about the cold food. 

This two-star rated facility has many deficiencies, which might be a troubling sign that nursing home residents might not be receiving the proper care and attention they need and deserve.   

A nursing home negligence lawsuit was recently filed against Central Baptist Village, a Chicago-land assisted living facility, for the alleged mistreatment of a disabled husband and wife who were both residents in the facility..  The lawsuit, brought by the couples guardian, claims employees at Central Baptist Village physically assaulted the wife on several occasions between December, 2008 and February, 2009.  Additionally, the lawsuit claims the staff administered the wife's medication to the husband from October, 2008 through February, 2009 resulting in over-medication.  The lawsuit against Central Baptist Village seeks more than $200,000 in damages.

Central Baptist Village is a multi-need facility located at 4747 N. Cranfield Avenue in Norridge, IL. The facility has been providing care for more than 100 year and operates as a not-for-profit nursing facility. 

Read more about this lawsuit against this Chicago nursing home here.

In Grammer v. John J. Kane Regional Centers, the Third U.S. Circuit Court of Appeals ruled that nursing home residents can bring civil rights actions under 42 U.S.C. Section 1983.  This new cause of action allows residents to challenge the quality of treatment received by bringing a civil rights claim.   

Grammer v. John J. Kane Regional Centers further ensures that nursing home residents receive quality care.  This is very important because the elderly are particularly susceptible to abuse and neglect in many state and county run nursing home facilities.  

As an attorney who frequently encounters situations involving mistreatment of people in nursing homes, I would be happy to discuss the prospective implications of this case with you or your family. (888) 424-5757

Special thanks to Heather Keil, J.D. for her research regarding this important development in nursing home case law.

Here's a video that was sent to me by a client who has a case against Kindred Los Angeles.  Kindred L.A. has a history of problems relating directly to patient care.  Although this video is disturbing, it demonstrates the severity of the the poor care at this facility.

According to California Department of Heath surveys, Kindred has been continually cited for neglecting patients.  For example in 2008, Kindred L.A. was cited four times by the Department of Health for allowing residents develop advanced pressure sores at the facility.

 Resource:

California Department of Health Inspection / Complaints for Kindred Los Angeles

Related Nursing Homes Abuse Blog Entries

State Inspectors Find Safety Violations In Indiana Nursing Home

Caring For The Elderly Pays... Especially If You Own The Nursing Home

Where Will Nursing Home Residents Go When Medicare Closes Dangerous Facilities?

Here's a suggestion for nursing home owners, who wish to ensure the safety and privacy of their patients--- take your employee's cell phones away from them. While 'on the job' there is no use for them other than a source of distraction and an invasion of privacy.

The most recent situation involving inappropriate use of a cell phose comes from Kentucky.  A CNA at Dawson Pointe Nursing Home was indicted by a grand jury on charges of video voyeurism and adult abuse following two episodes where she took videos of a naked resident.  State officials cited Dawson Point for improper cell phone use earlier this year.

Why on earth are do facilities allow CNA's and other nursing home workers to carry personal cell phone in the first place?

Read more about the invasion of privacy at a Kentucky nursing home here.

Effective July 1, Golden Living is out of the nursing home business in Arkansas.  The 14 nursing homes and independent living facilities have been sold to Capital Senior Care Ventures, a subsidiary of health-care behemoth Capital Funding Group.

The sale marks a growing trend in the nursing home business of bringing mega-companies to manage and operate individual nursing homes.  Frequently, the parent companies have no experience providing healthcare to seniors.

In the case of Capital Senior Care, by the companies own admission, they "acquire and construct skilled nursing facilities in order to lease and ultimately sell them to high-quality operators.  Capital Senior Care Ventures provides its operators with the opportunity to own the facilities they operate much faster than most traditional REIT or similar financing by allowing the operators to purchase the facilities on a 'flip' within two to five year time frame.  This structure has been a popular option to many operators who are looking for ownership without a large capital investment."

Sounds to me like an investment--- and there's nothing wrong with making money-- so long as it doesn't come at the expense of patient care.  Let's monitor these facilities as they make the transition to a new owner.

Read more about the sale of these Arkansas nursing homes here.

Nursing Homes & REIT's

A real estate investment trust (REIT) is a legal entity that may only invest in real estate.  REIT's have become a popular investment tool due to its favorable tax status.  Under the REIT umbrella, a company must be in the business of holding real estate, derive the majority of its income from real estate and pay its shareholders at least 90% of its taxable income.  In the area of nursing home litigation, REIT are increasingly used as an attempt to sheild nursing home owners from responsibility. 

In December 2008, the Illinois Department of Public Heath (IDPH) completed a survey of Rockford Healthcare & Rehab Center, located at 1920 North Main Street in Rockford, Illinois.  Finding significant problems with the facility, it issued a notice of a Type A violation and a fine of $15,000.

IDPH found that Rockford Healthcare & Rehab Center failed to monitor residents who were at risk for pressure sores or to follow physician directions for care of pressure sores.  As a result of their failure to implement prvention techniques, some residents suffered from worsening conditions and developed new pressure ulcers during their admission. 

The IDPH also faulted the facility for inadequate supervision.  On one occasion, two residents wandered off without the knowledge of staff after the residents got into an elevator with a visitor and walked straight past a receptionist who assumed the residents were also visitors.  One resident was found outside the building, smoking a cigarette.  The other resident, a woman with Alzheimer’s who was known to be a wanderer, had left the facility and was found walking along a four-lane state highway without a coat on a rainy night when the wind-chill temperature was just 29 degrees.

Rockford Healthcare & Rehab Center is a for-profit nursing home with 97 Medicare/Medicaid-certified beds.  The U.S. Department of Health and Human Services, which operates a “five-star” rating system for nursing homes, gave the facility a below-average overall rating of “two-stars.”  It gave just one-star in the area of health inspections, noting that 62 health deficiencies were found in December 2008 (the Illinois average is eight health deficiencies).  Of particular concern are findings of immediate jeopardy to resident health and safety from treatment and prevention of pressure sores, “dangers that cause accidents,” and the absence of a doctor as a medical director and of a group to review and ensure quality. 

If you are concerned about the treatment of a resident at Rockford Healthcare & Rehab Center, call us at (888) 424-5757 for a confidential consultation.

Related Nursing Homes Abuse Blog Entries

Who Regulates Nursing Homes?

First Quarter 2009 Illinois Nursing Home Violators Released 

Government Report Confirms Pressure Ulcers Harm All Nursing Home Residents; Regardless Of Race, Sex or Age