Happy Memorial Day From The Nursing Homes Abuse Blog. Visit Your Elders!

Before you head out the door for a barbecue, take a few moments and give thanks to those in the armed services who sacrificed on our behalf. 

Given the Memorial Day Holiday, I guess it was sort of sickenly ironic that I saw a story regarding the financial exploitation of a patient in a Florida VA nursing facility today.

After stealing a credit card from an 89-year-old resident at Haley's Cove and heading out for a shopping spree, Tampa police arrested Maxima Jackson.

Ms. Jackson was arrested after someone reported her whereabouts to police after recognizing her photo from a bulletin distributed by police. Jackson is charged with grand theft and exploitation of the elderly.

Read more about this episode of financial exploitation of an elder here.

Pharmacist Sentenced To Home Confinement After Re-Packaging Drugs For Nursing Home Patients

Pharmacists play an essential role in the well being of nursing home patients by filling physicians prescriptions and in many cases keeping track of all the medications each patient takes to assure there are no contraindications in mixing different drugs. 

Obviously, keeping track of medications is an difficult but important job.  Perhaps the first step towards assuring the safety of nursing home patients who are reliant on prescription drugs is for a pharmacist to assure that the drug contained within a package really is what it should be.

An Illinois pharmacist who repackaged drugs bound for nursing home patients will be spending time on 'home confinement'.  Pharmacist, Ted Thalmann of the The Medicine Shoppe in Edwardsville, IL pleaded guilty earlier this year to a charge of misbranding a drug. 

Thalmann admitted to repackaging bulk prescription drugs packed by a manufacturer into smaller blister packs that were labeled with the wrong expiration date.

In addition to six months of home confinement, Mr. Thalmann was also sentenced to perform 250 hours of community service in pharmacy field and ordered to pay a $2,000 fine.

Read more about this case of intentional deceit by a pharmacist here.

Pharmacist Malpractice?

In the above situation, no patients were injured as a result of Mr. Thalmann's greed--  and that really is what it boils down to.  I'm sure that the individual packaging commanded a premium over the bulk medication.

Greed issues aside however, pharmacist role in dispensing medication is frequently an under-appreciated, yet crucial job.  Too often, even seemingly small and unintentional errors result in patient injury or death due to pharmacy errors such as:

  • Failure to advise or warn or potentially dangerous drug side-effects
  • Improperly filled prescriptions
  • Incorrect labeling of medication
  • Incorrect medication dosage
  • Filling multiple medications with known adverse reactions
  • Failing to provide adequate instructions regarding use of a drug

Related Nursing Homes Abuse Blog Entry:

Improper Drug Dosage, Wrong Medication, Interactions With Other Drugs.... May Be The Result Of Pharmaceutical Malpractice

Nursing Home Injury Laws:

Medication Errors

Nursing Home Patients Involved In Automobile Accidents: Who's To Blame?

If you were playing a word association game, I bet you'd be hard pressed to combine nursing home patients and car accidents!  While the terms may mix like oil and water in many contexts, in my world as a nursing home lawyer I frequently see the two intermixed-- and the the results certainly don't favor the patients.

In my nursing home ligation practice, I see many cases where nursing home patients are horribly injured in car accidents either as pedestrians or as passengers.  While most think about nursing home patients passing time in an idyllic setting, the truth is that there is a significant portion of the nursing home population that leaves the facility for their personal recreation, visit with doctors or tend to personal business. 

Because auto accidents make up a significant number of accidents for nursing home patients, I plan on going into the three major categories of automobile injury cases affecting nursing home patients and the respective liability issues for both driver and nursing facility.

As I see it, nursing home patients are involved in injuries due to: other drivers (pedestrians), passengers in vehicles or in the case of dementia or Alzheimer's patient-- wandering from the facility.

Elderly pedestrians involved in auto accidents

Many nursing homes are located in metropolitan areas where vehicle traffic is heavy.  Though the centralized location may be convenient for family and visitors, busy city environments are particularly dangerous to elderly nursing home patients who walk or roll along the street in wheelchairs.

The constant traffic and rapidly changing traffic controls can be substantial obstacles for everyone, but particularly those with special needs such as elderly people with assisted walking devices or diminished hearing or eyesight. 

Several years ago, my office represented an elderly man, who happened to be a nursing home patient, who was struck by a truck making a right-turn as he made his way to a convenience store literally located across the street from the nursing home.  The man suffered severe orthopedic injuries to his legs-- bilateral femur fractures and de-gloving injuries when he was thrown from his electric wheelchair and run over by the rear wheels of the truck. 

Though the man's family initially contacted us as a perspective negligence claim against the nursing home where he resided, we quickly learned that the truck-driver was really the one who was responsible for accident and the man's injuries.  In the course of litigation, the truck driver acknowledged that he was unable to see the elderly man due to the height of his truck and the relatively low height of the electric wheelchair-- despite the fact that that the man was in the cross walk and obeying the traffic signal.

Pedestrians have the right of way

Most jurisdictions have traffic laws that give pedestrians-- even those with physical disabilities-- the right of way when sharing the road with automobiles.  In this context, the driver of the vehicle is usually the one primarily responsible for resulting injuries especially if the pedestrian was obeying the traffic signals.

In some circumstances following a collision with a pedestrian, an assertion may be made by the offensive driver that the person was too old or had diminished senses.  In my experience, such arguments typically backfire-- badly. 

Not surprisingly, in most elderly-pedestrian vs. auto collisions, I see the real fault falling lying on the drivers who fail to keep a proper look out or who refuse to wait the literal seconds it takes for a person to get out of harms way.

Liability of nursing home or driver?

In situations where a pedestrian really has no business walking around unassisted, there may be a cause of action against the facility where he or she resided for the facilities failure to provide assistance.

However, if a nursing home patient is capable of appreciating the risks associated with walking around, they certainly should be entitled to do so.  

Particularly with elderly pedestrians, the resulting injuries sustained in automobile accidents can be devastating.  Unlike similar accidents occurring in a younger population, older people tend to heal-- far slower and require much more extensive care.

As lawyers who have championed the rights of the elderly for more than 30 years, we have developed a unique perspective on the overall effects of injuries on aged bodies.  In many respects our appreciation for the severity of the injuries sustained by the older population has resulted in verdicts and settlements admired by our peers in the legal community.

If you or a elder was involved in an auto accident, I invite you to speak with our elder law attorneys to discuss your legal options.  All consultations are free of charge and completely confidential.  (888) 424-5757

Resource articles:

Accidents involving older people: a review of the literature
JM Lilley, T Arie, CED Chilvers - Age and Ageing, 1995 - Br Geriatrics Soc

Toleration of head injury by the elderly
LA Amacher, DE Bybee - Neurosurgery, 1987 - journals.lww.com

Injuries in restrained motor vehicle accident victims
GW Hendey, SR Votey - Annals of emergency medicine, 1994 - Elsevier

Injuries to the elderly in the traffic environment
H Sjögren, U Björnstig - Accident Analysis & Prevention, 1991 - Elsevier

Illinois Attorney General Continues To Keep Nursing Homes On Their Tippy Toes With Spot Raids

For the 11th time this year, Illinois Attorney General Lisa Madigan gathered 14 police officers and and state officials to conduct an unannounced sweep of an Illinois Nursing Home.  The sweep was conducted to assure that the facility was complying with state and federal regulations.

This time, the nursing home sweep took place at Golden Moments Senior Care Center in Jacksonville, IL.  During the three hours officials spent at Golden Moments they inspected the facility and review patient files. 

The sweep revealed that most patient files were in proper order and patients were receiving proper care.  However, the sweep did reveal that the the facility failed to conduct 'risk assessments' for three convicted sex offenders housed at the facility.

Though no specific reason was cited by officials in making organizing this raid, Golden Moments has a history of providing questionable patient care including an episode where a 74-year old patient choked to death on food.  The incident resulted in a $50,000 fine against the facility.

According to Cara Smith deputy chief of staff for the Illinois Attorney General, "We've been looking for ways of improving safety for vulnerable adults.  These sweeps are important to send a message to the facilities and the residents that the agencies are working together to ensure safety."

Read more about these Illinois nursing home raids here.

I applaud the Attorney General's decision to step-up random checks on Illinois Nursing Homes.  Certainly, these random inspections will hopefully keep operators on their toes and perhaps provide the added incentive to improve patient care.

While governmental inspections such as this are certainly important, I strongly encourage all families and patients to report episodes of poor care to neglect to officials at the department of health in the state where the nursing home is located. 

In many situations, an inspection triggered by a complaint to a department of health can not only provide answers to how an incident may have occurred, but also trigger an appropriate penalty against the facility should the findings merit such action.

Our sister site, Nursing Home Injury Laws, provides a compilation of contact information for the Department of Health in every state should the improper nursing care be suspected.

Related:

Golden Moments Senior Care Center Continues To Accumulate Fines Related To Providing Poor Care To Its Patients

42 Illinois Nursing Homes Cited In 4th Quarter of 2009 For Violations Related To Patient Care

Demented CNA Gets 60 Year Sentence In Criminal Case Involving Sexual Assault Of Nursing Home Patients

Justice was recently served in the criminal prosecution of a CNA accused of sexually assaulting four patients at National Health Care in Bristol, VA.  James Wright will serve 60 years in prison for the sexual assault of the patients he was responsible for caring for.

Earlier, Mr. Wright entered an Alford plea to the four counts of sexual battery he was charged with.  Under the terms of the Alford plea, the convicted person acknowledges that the prosecutors evidence is sufficient for a conviction-- yet the accused never actually admits guilt.

In dispensing the 60-year sentence, Circuit Judge Larry Kirksey sentenced Mr. Wright to 20 years less than he could have under the maximum sentencing guidelines.  Nonetheless, Judge Kirksey had harsh words for the the defendant.

"This is no doubt an indescribably despicable criminal act, Judge Kirksey said before sentencing.  "Certainly, as a certified nurses aide, you understand the position of trust...you were placed in by these women and [their] families."

My take:

Certainly, renegade employees make their way into all types of businesses and maybe cause harm to the company or the other employees.  However, when a real deviant-- such as James Wright-- makes his way into a nursing home and has his way with multiple patients, over an extended period, I think its time to look up the food chain towards management's oversight of employees.

Thankfully, an investigation by the state licensing board arrived at a similar conclusion and reprimand the former director of nursing and other executives who were working at the facility during the time of these heinous acts.

No matter how many laws we throw at nursing homes obligating them to conduct criminal background checks and screening techniques, it will always remain the responsibility of nursing homes to keep tight reigns on all employees-- especially those working with the most susceptible.  Hopefully, cases like this will be a wake-up call for all facilities to keep the reigns taught.

Related:

Nursing Home Spotlight: NHC Healthcare, Bristol, VA

Nursing Home Operator And CNA's Named As Defendants In Civil Lawsuit After Sex Abuse Scandal

Sexual Assaults In Nursing Homes, Not Exactly A Pleasant Topic-- But Is An Issue That Needs Attention

The Real Devastation Associated With Sex Abuse In Nursing Home Will Never Be Known As Most Acts Go Unreported & Unprosecuted

Nursing Home Spotlight: Manorcare of Rolling Meadows


Manorcare of Rolling Meadows is a large, 155-bed, two-star (below average) Medicare rated nursing home facility. On December 31, 2009, the Illinois Department of Public Health (IDPH) fined Manorcare of Rolling Meadows $10,000 for fourth quarter Nursing Home Care Act violations relating to the area of nursing.   (see other stories on “HCR Manorcare”)

During a complaint investigation on October 29, 2009, IDPH investigators investigated two residents’ physical abuse by a staff member. (see “Nursing Home Abuse” and “Elder Abuse”) The nursing home’s failures put residents in immediate jeopardy until the accused staff member was finally terminated. 

All residents have the right to be free from abuse (verbal, sexual, physical, and mental), corporal punishment, and involuntary seclusion. However, not all nurses and staff members employed by nursing homes abide by this rule. Unfortunately, there are too many stories and cases of abuse by staff, including the abuse by one certified nurse aid (CNA) at Manorcare of Rolling Meadows. 

On September 9, 2009, Manorcare initiated an investigation into the alleged abuse involving a 64 year-old female resident suffering from a right craniotomy (removal of a piece of person’s skull) because of a tumor, history of agitation, irritability, and combativeness.

During the September 9th nursing home survey, a nurse noticed that the resident’s finger was swollen and bruised; the finger was x-rayed but no fracture was found. The resident told the nurse that two female CNAs had harassed her by holding her down, twisting and wiggling her finger, and telling her they were stronger than she was. 

The nursing home’s investigation revealed that one of the nurses had witnessed another nurse get upset with the resident because she had gotten scratched when the resident was resisting. The nurse then wrapped the resident’s hand with a washcloth and told her not to fight her. 

The resident’s care plan acknowledged that the resident was often resistive to care from staff and the care plan addressed this problem (approach resident in gentle manner, explain what you are going to do, re-approach later and/or differently if resistant). Clearly, that is not how the resident was treated by the nurse in question. On September 11, the nurse was fired because of the allegations of abuse. The nurse, who witnessed the abuse but failed to report it to administration, was also fired. 

There was another incident of abuse involving the same CNA who was fired that was not reported until the day the investigation was initiated to look into the allegations of abuse discussed above. In this case, another CNA witnessed the same CNA, who had held down the resident in the incident discussed above, hold down a different female resident’s hands and then slapped the resident’s hand because the resident pinched the CNA’s hand. 

This resident also had a specific care plan to address the resident’s resistance to treatment and care (resident can be verbally and physically aggressive to caregivers by biting and scratching). The care plan indicated that nurses should approach calmly, maintain distance until resident is calm, and if resident is resistive to return at a later time. Again, the CNA in question clearly did not follow the care plan. Instead, the CNA resorted to retaliatory behavior. To make matters even worse, the resident who was slapped is unable to communicate and, therefore, couldn’t even offer a statement to investigators. 

The nursing home administration did not investigate this allegation of abuse until four days after the incident. Administrative staff said that the allegations could not be substantiated because there was no redness or change in resident’s mood, even though the abuse was reported by another staff member. 

However, the CNA who allegedly abused this resident was fired for allegations of abuse that were substantiated regarding another resident. However, it seems alarming that a delayed investigation that returned no physical indicators of abuse could clear the CNA of wrongdoing, especially in a situation where the resident is noncommunicative. 

An earlier complaint investigation on August 12, 2009 looked into the fall and injury of a resident. The resident in question was a 100 year-old female resident, who was admitted to the facility with syncope (temporary loss of consciousness) with fall, brain tumor, anemia, hypertension, CRF (chronic renal failure), osteoporosis, and osteoarthritis of knees. She was admitted to the nursing home facility after suffering injuries after a fall at home that required hospitalization. 

Upon being admitted to Manorcare, the resident was assessed as a risk for fall due to history of falls, weakness, impaired balance and mobility, brain tumor, and forgetfulness. Physical therapy evaluation revealed that she required two people (maximum assistance) to help during toilet and transfer needs, and that she had an unsteady gait and was considered a falling risk. 

A nurse left this resident alone, sitting on the toilet, despite being aware that the resident needed assistance during toilet needs. Not unexpectedly, the resident fell and hit her head, resulting in a head contusion and cut, requiring her to be transferred to the ER. This resident never should have been left alone because she was a high risk for fall because of compromised medical condition and forgetfulness that she required assistance during transfers. 

The 100 year-old female resident died only four days after her fall. In the days between the fall and her death, she was noted to be lethargic and less responsive. The cause of death was ruled to be from the brain tumor which could have also affected her responsiveness. Regardless of the cause of death, in the days before her death, this resident suffered from a preventable fall and head injuries due to the nursing home’s lack of supervision for a resident who was a known fall risk. 

The nursing home must ensure that the resident environment remains free of accident hazards and also ensure that each resident receives adequate supervision and assistance to prevent accidents. In the case of the female resident discussed above, the nursing home failed to meet this standard of care.

The nursing home’s failures resulted in the injury and abuse of several of its residents. It is only natural that family members of other residents at Manorcare would be worried about the well-being of their loved ones and the quality of treatment they are receiving. If you or a family member suffered from an injury while a resident at Manorcare of Rolling Meadows, you may be entitled to compensation. 

Thank you to Heather Keil, J.D. for her assistance with this Nursing Homes Abuse Blog Entry

Sources:

IDPH: Manorcare of Rolling Meadows

IDPH: Manorcare of Rolling Meadows – Fourth Quarter Violations

Medicare Nursing Home Compare: Manorcare of Rolling Meadows

HCR ManorCare: ManorCare Health Services – Rolling Meadows

Nursing Home Abuse Blog: HCR Manorcare

Nursing Home Abuse Blog: Nursing Home Abuse

Nursing Home Abuse Blog: Elder Abuse

Court Determines Nursing Home Corporation Can't Be Criminally Prosecuted For Employees' Negligent Conduct

The collective negligence of multiple nursing home employees does not impute criminal conduct on the part of the corporate owner according to a recent ruling made the Supreme Judicial Court-- the highest court in Massachusetts.

The decision stems from the death of a 74-year-old patient at a MA nursing home owned by Life Care Centers of America.  Despite the patient's extensive history with respect to wandering from the facility, the facility failed to take basic precautionary measures that would likely prevented the wheelchair-bound patient from falling down a set of stairs to her death.

An investigation into the patient's death concluded revealed that there were no physician orders for a device called a WanderGuard in the patient's chart.  Had the WanderGuard been administered to the patient, she would not have been unable to literally wheel herself out the front door of the facility in her wheelchair.

"The Commonwealth is attempting to promote conduct that is no more than negligent on the part of one or more employees into wanton or reckless conduct on the part of the corporation," Justice Judith Cowin wrote in the majority opinion.

As a lawyer, I certainly respect the wisdom of this court.  However, as an advocate for victims of nursing home abuse and neglect, I find that too often corporate nursing home owners foster a culture where patient-care is an after thought and paying civil claims is simply a way of doing business.  

I certainly admire Attorney General Martha Coakley's desire to pursue this type of simply wrong conduct criminally.  Perhaps laws need to be stiffened to force nursing home operators to regain control over their staff.

Life Care Centers of America operates more than 200 skilled nursing homes, assisted living facilities, retirement living communities, home care services, and Alzheimer's centers.

Read more about this important decision regarding nursing home care here.

Related:

Investigation Concludes: Most Nursing Home Administrators Are Never Disciplined For Poor Care

Lawsuit Claims That Nursing Home Failed To Intervene In Case Involving The Sexual Abuse Of A Patient

"Life Care Center" Permitted To Accept New Patients After State Finds Poor Living Conditions

Feeding Tube Mishap Results In Patient Death & Large Nursing Home Fine

An improperly inserted nasal feeding tube was the cause of an 84-year-old's death in a California Nursing Home according to an investigation completed by the California Department of Health.  

Investigators from the department determined that the nursing home patient died from aspiration pneumonia after insertion of a feeding tube because the nasal feeding tube was incorrectly inserting into his lungs rather than his stomach.

As a result of this nursing error, a $100,000 fine was imposed against Hancock Park Rehabilitation primarily due to the staff's failure to check to follow protocols related to assuring proper feeding tube placement. 

"By providing nursing facilities it licenses with consequences for substantiated violations, CDPH strives to protect the health and safety of vulnerable individuals," according to a CDPH statement. "The citation process is part of CDPH's ongoing enforcement efforts to improve the quality of care for residents of the state's approximately 1,400 skilled nursing facilities."

Hancock Park Rehabilitation Center has a history of prior nursing violations.  In 2006 and 2008 the facility received multiple violation related to improper patient care. Read more about this feeding tube complication here.

Feeding Tubes In Nursing Home Patients

Feeding tubes may be necessary for patients who are unable to chew or swallow or food. Like all medical treatments, feeding the insertion and maintenance of feeding tubes requires the expertise of medical professionals. 

Nursing home patients with NG-Tube's (Nasogastric Tube, placed through nose) are particularly as risk for aspiration pneumonia.  Primarily due to the increase in feeding tube patients, the number of hospital admissions related to aspiration pneumonia has increased 76% from 1991 to 1996.

In order to minimize the chance of feeding tube complications, nursing home staff should take care to monitor the food given to residents who have difficulty swallowing. Generally, thicker, cooler liquids are easier to swallow. Thin liquids, including water, can be dangerous because they are difficult to control within the mouth. Straws can help a person swallow by limiting the amount of liquid that can be taken at a time and directing the liquid to the back of the mouth.

It is of utmost important that staff take the necessary time during feedings to minimize trauma to the patient and assure safety.

Related:

Nursing Home Staff Must Pay Special Attention To Avoid Complications When Caring For Patients Dependent On Feeding Tubes

Feeding Tubes May Be Over-Used In Dementia Patients

Elderly Patients Are At Higher Risk For Developing Aspiration Pneumonia When Facilities Fail To Account For Patient Needs

Failure To Follow Doctor's Orders Results In The Choking Death Of Hospital Patient

City Of Chicago Recruits Ombudsmen To Improve Nursing Home Care For Patients

If you're looking for a great way to get involved in improving the quality of nursing home care, I suggest becoming part of the ombudsman program in your area.  

Ombudsman provide a vital link between nursing home patients and facility staff.  Unlike complaints made to a state's department of health which tend to be serious in their nature, ombudsman are a conduit to resolving many commonly encountered problems that may be addressed relatively easily.

In addition to resolving grievances and answering questions, ombudsman can also help improve patient safety when they notice abusive care or dangerous living conditions at a facility.

In Chicago, The Chicago Department of Family and Support Services (DFSS) announced a new initiative to recruit volunteer ombudsman to fill the important position.  

"It is estimated that nearly 60 percent of residents in Long Term Care facilities never receive a visitor," said Mary Ellen Caron, Ph.D., commissioner of Chicago Department of Family and Supportive Services.  "Becoming a Volunteer Ombudsman allows Chicagoans the opportunity to improve the quality of life for seniors in their community by providing support and friendship to individuals who have limited resources."

Ombudsman can serve patients in the nursing homes within their community or in any area of the city they choose after they complete a training program and become certified by the Illinois Department on Aging.  Coursework will include:

  • An overview of the aging process and the people who live in nursing homes
  • Federal and state regulations of Long Term Care facilities
  • Residents' rights
  • An overview of the organizational structure of the long term setting
  • Communication and interviewing techniques
  • Principals for reporting poor care

If you are interesting in becoming active in this very worthwhile program, call (312) 744-4016 or visit www.cityofchicago.org/fss.

Resources:

The National Long-Term Care Ombudsman Center

How can nursing home ombudsmen help with problems encountered in a long-term care facility?

Are nursing home patients protected under federal law?

Nursing Home Watchdogs: Ombudsmen

 

Nursing Home Spotlight: Lexington of Elmhurst


On November 17, 2009, the Illinois Department of Public Health fined the Lexington of Elmhurst nursing home $25,000 for fourth quarter Nursing Home Care Act violations relating to the area of nursing. The nursing home’s failures resulted in several residents suffering from preventable injuries. Lexington of Elmhurst is a large, 145-bed, one-star (much below average) Medicare rated nursing home facility located in Elmhurst, IL. 

A September 2009 survey conducted by the Illinois Department of Public Health (IDPH) revealed numerous deficiencies including failure to implement measures to reduce the risk of falls for four of fourteen residents in the sample who were identified to be at risk for falls. These included failures to:

  • Supervise a female resident who had been identified as a wanderer with an unsteady gait, analyze and evaluate the cause of her multiple falls and injuries,
  • Implement a care plan to assist and supervise her,
  • Develop individualized interventions based on her needs,
  • Ensure that staff are adequately trained to transfer three other residents and deal with resident behaviors and develop care plans to prevent incidents and accidents, and
  • Ensure that the nursing home has a system in place to ensure that these incidents did not involve abuse. 

Elderly nursing home residents are particularly susceptible to dangerous falls because of reduced mobility, lack of balance, poor eyesight, weakness, weak bones, and other underlying conditions. As you age, your bones weaken and break more easily.  

So, even minor falls can pose a major risk for the elderly. (See “Nursing Home Patients with Osteopenia May Suffer More Severe Injuries During Falls” and “Osteoporosis Puts Nursing Home Patients at a Heightened Risk for Fractures Related to Falls”). Therefore, nursing homes must take extra precautions to reduce the risk of dangerous falls. 

A female resident suffered from multiple falls and injuries while in residence at Lexington of Elmhurst because the facility failed to take necessary preventative measures despite being aware that she had an unsteady gait, did not use assistive device to walk, held onto rails in hallway, had impaired safety awareness, and also had periods of agitation and wandering. 

The facility’s only preventative measures included supervision / assistance when walking, using caution when transporting resident, and providing close supervision when resident was agitated or anxious. However, the facility failed to implement the measures that they did have in place, resulting in the resident suffering from numerous falls and injuries. 

This resident’s care plan noted numerous incidents and falls:

  • 11/10/08 – resident noted on floor in hallway
  • 11/11/08 – noted on floor in her room
  • 12/14/08 – noted on floor in dining room
  • 1/10/09 – remains at risk for falls
  • 4/04/09 – assisted on the floor
  • 4/08/09 – noted on the floor
  • 4/16/09 – two falls within the last two weeks (confused with periods of agitation, wandering, unsteady gait, may be difficult to direct, impaired safety awareness)
  • 5/09/09 – slid out of wheelchair

On April 13, 2009, nursing home staff noticed that the resident had bruising on her upper arm and shoulder with swelling, pain, and inability to lift hand. X-rays revealed that the resident was suffering from a fracture of the upper arm/shoulder. Despite noting a fall on April 8, Nineteen days later, her shoulder fracture worsened into a comminuted fracture (or multi-fragmentary fracture), where the bone actually splits into multiple pieces. 

A second resident was first admitted to the nursing home because of a head injury caused by a fall at home. He was later readmitted to the facility for an elbow fracture that occurred as a result of another fall at home. On August 7, 2009, the resident was found lying on the floor calling for help. He suffered from a fracture to the left thigh bone (femur) and abrasion to the right side of the head and right knee. 

There was no analysis/investigation of how this fail occurred because the fall committee did perform an evaluation since they were only aware of one previous fall. However, the resident had suffered from two previous documented falls. While the facility did in fact document two prior falls, the nursing home facility failed to analyze/investigate the resident’s injuries, which means that no additional preventative measures were put in place to prevent future injuries and his plan of care was never updated. This kept the resident at risk for future possible falls, which could lead to more severe injuries. 

Yet another resident suffered from two fall incidents and also suffered from a large bruise of unknown origin. One fall occurred in the shower, when the resident was actually being washed by a Certified Nurse Aide (CNA). The resident sustained a two inch laceration to the back of head. The facility again failed to analyze the falls or the bruise of unknown origin, which left the resident at risk for future falls. 

Lexington of Elmhurst failed to provide the best possible care for its residents when it failed to investigate the falls of multiple residents. The facility did not implement any additional precautions to reduce these residents’ risk of dangerous falls, which put their safety and well-being in danger. These failures raise doubts about the level of care that other residents are receiving. 

If you or a family member suffered from an injury while a resident at Lexington of Elmhurst, you may be entitled to compensation, especially when the facility failed to take steps to prevent easily preventable injuries. 

Sources:

Lexington Health Care: Lexington of Elmhurst

Illinois Department of Public Health: Lexington of Elmhurst

IDPH: Lexington of Elmhurst – 4th Quarter Violations

Medicare: Nursing Home Compare – Lexington of Elmhurst

Nursing Home Abuse Blog: Nursing Home Falls

Less Patients, Happier Staff, Healthier Patients. Research Shows Less May Acutally Be More When It Comes To Patient Loads For Nurses

Without proper staffing, even the most modern nursing homes are nothing more than buildings with beds.  Knowledgeable and plentiful staff has always appeared to improve patient morale, but a new study determines that added staff may actually save lives.

The Journal of Health Services Research compared the outcomes from 1.1 million people who had general surgical procedures performed at more than 800 hospitals in California, New Jersey and Pennsylvania.  Of the three states, patients in California fared the best.

It's not just the warm weather in California that improved the heath of surgical patients.  Turns out, the patients in California tended to receive more attention from nurses than the patients in other states. Nurses in California medical-surgical units are limited to caring for 5 patients at a time compared with similar facilities in New Jersey and Pennsylvania where nursing loads tended to be more than 6 patients.

When analyzing death rates of surgical patients, researchers concluded that the California regulations would have improved the survival rates of patients.

According to Linda H. Aiken, professor of nursing and director of the Center for Health Outcomes and Policy Research and University of Pennsylvania, "Nurses are the surveillance system right at the bedside; they are the first to see something and mobilize a rescue."

In addition to the improved patient survival rates associated with the limited number of patients, the study also reported that California nurses had higher rates of jobs satisfaction and were more likely to remain in the profession.

Staffing & Nursing Home Care

In an age whee we see nurses caring for upwards of 20 patients during a shift.  Yes, more than 20! I doubt we're going to see nursing home chains rushing to implement 5:1 patient staffing ratios anytime soon.  However, this study is important for that fact that once again we see that staffing levels are extremely important to patient safety and well being. 

Related Nursing Homes Abuse Blog Entries

More Staffing & Stiffer Fines. Welcome To The New Way Of Doing Business For Illinois Nursing Homes?

Long-Term Care Hospitals: More Profit, Less Staff

Under-staffing At Nursing Home Blamed For Pressure Ulcer, Infection & Subsequent Death

Are Nursing Homes Required To Have Certain Numbers Of Staff?

Leaders Speak Out Regarding Nursing Home Care

If you haven't checked out our most recent series of interviews with various thought leaders in the nursing home industry, here's a chance to look at what they had to say regarding the what the industry is doing correctly and how it can improve.

I've learned a from these folks!  I look forward to future rounds of similar interviews.  If you've got ideas let me know.

The View Of Nursing Homes From The Eyes Of A Patient

Nursing Home Insights From The Director Of A Therapeutic Recreation And Activity Consultant

Insight On The State Of Nursing Homes From The Director Of Michigan Disability Rights Coalition

Thoughts On Nursing Home Care From A Nursing Home Psychologist

State Of Nursing Homes From A 'Nursing Home Reform Activist'

Nursing Home Impressions From A Healthcare Marketing Expert

Insight On The Nursing Home Industry From A Registered Nurse

 

The Real Devastation Associated With Sex Abuse In Nursing Home Will Never Be Known As Most Acts Go Unreported & Unprosecuted

The overwhelming majority of sex abuse cases involving nursing home patients go unreported to authorities and hence un-prosecuted according to a recent news story on the topic by WKYC, a Cleveland, OH television station.

In evaluating the sex abuse complaints made to the Ohio Department of health, the regulatory agency for nursing homes, just a handful of the 324 complaints made regarding rape and sexual abuse of patients in nursing homes and other long-term care facilities resulted in a conviction. 

One of the biggest hurdles for prosecutors of sexual abuse cases is the victims inability to testify. According to Ohio Attorney General Richard Cordray, "[i]t's hard to get victims who can hold up on the stand.  It's hard to verify when some of the elderly victims (are abuse because) their memories aren't good'"

Residents in long-term care families are usually victimized by staff at the facility or by their fellow residents.  Thankfully, most states utilize criminal background checks to screen all employees prior to hire.  Unfortunately, few states -- and even fewer nursing homes conduct background checks on new patients. 

The reality is that it is very much in the hands of the nursing homes as to how they wish to tackle problems involving sex crimes in their facilities.  Unlike the investigation of a crime in other situations, it is almost completely up to staff at the facility to report the act in the first place.  Unfortunately, by the time authorities are called in vital physical evidence may have been intentionally or unintentionally destroyed or altered further compromising the investigative process.

Unfortunately, the same hurdles that apply to the prosecution of criminal cases are presented in civil lawsuits against facilities where a sexual assault may have occurred.    As a lawyer who has worked on cases involving sexual abuse at various institutions, we are very much reliant on the physical evidence gather by police during an investigation in order to prove our case.  Further, civil cases can be difficult because you generally must prove the facility had actual or constructive notice of the offender's conduct to recover damages against the facility itself.

Recognizing Sexual Abuse

Families and caregivers can be extremely important in identifying situations where sexual abuse may have occurred.  Unlike other types of trauma, where the injury may outwardly manifest itself, cases involving sexual abuse tend to be subtle.

If you suspect something is wrong, it very well maybe and the situation should be reported to law enforcement immediately.  The following are signs of sexual abuse that merit further investigation:

  • Sudden emotional withdrawal
  • Unusual behavior around certain staff or patients
  • Bloody clothing or bed sheet
  • Sexual transmitted disease
  • Sudden aggression or outbursts

Related:

Sexual Assaults In Nursing Homes, Not Exactly A Pleasant Topic-- But Is An Issue That Needs Attention

CNA Charged With The Rape Of An Elderly Woman In An Assisted Living Facility

Nursing Home Operator And CNA's Named As Defendants In Civil Lawsuit After Sex Abuse Scandal

Lawsuit Claims That Nursing Home Failed To Intervene In Case Involving The Sexual Abuse Of A Patient

Did Assisted Living Facilities Neglect Result In Patient's Impacted Bowel & Death?

Well, according to a Tennessee jury, the answer to the above question is a resounding 'yes'!  Evidence was presented to the jury regarding the circumstances that led up to the death of a resident at Celebration Way, a Tennessee assisted living facility in 2004 due to an intestinal obstruction and sepsis.

Among the claims presented by the family of the deceased was that the facility was so understaffed that they could not provide adequate care for the woman.  This claim was substantiated at the trial against the facility when it was demonstrated that despite orders for 60 doses of MiraLax, a laxative, the facility administered just 16 doses in the months leading up to the woman's death.

After a two week trial, the jury awarded substantial damages to the woman's family against: the administrator of the facility, director of nursing, Americare Systems, Inc., Shelbyville Residential LLC and Celebration Way.

Read more about this wrongful death lawsuit against an assisted living facility here.

Understaffed Nursing Homes

As lawyers who tend to see the results of things gone bad, I can attest to the problems under-staffing results in.  In some situations, staff are responsible for caring for more than 30 patients per day.  When the stresses put on nurses reach this level it is essentially impossible for them to adequately perform their job. 

Corners begin to get cut.  Not necessarily out of maliciousness or laziness-- but because there simply is not enough time in the day to perform the tasks they are responsible for.  The end result is that patients to not get the care they require and consequently get neglected or hurt.

In most situations, I point blame at the management who make a conscious decision everyday to strip staffing levels to the bare-bones in order to maximize the profitability of their facilities.  Hopefully, when courageous juries, like the one above, start sending messages in the form of large verdicts, operators will begin to change the way they do business.

Related:

Early Detection Is The Key Element To Successful Sepsis Treatment

Failure To Monitor Bowel Movements In Nursing Home Patients Can Lead To Impacted Bowels

High Staff Turnover Rates Plague Most Nursing Homes

Authorities Investigate North Carolina Nursing Home After Lab Test Determines Patient's Death Related To Morphine Overdose

Officials at the North Carolina Bureau of Investigation are looking into the nursing care provided to patients at the Britthaven of Chapel Hill nursing home after laboratory tests confirmed that the death of an Alzheimer's patient may have been related to a morphine overdose.

The investigation was triggered after the blood lab results determined that an 84-year-old patient at the facility had 'toxic' levels of morphine in her body at the time of her death. 

Lab results revealed that the nursing home patient had morphine levels of more than 50,000 nanograms per milliliter at the time of her death.  Putting that number in perspective, federal regulations concerning employment screenings categorize lab result over 2,000 nanograms per milliliter as 'positive'.

What makes this matter particularly alarming is the fact that no physician ever ordered morphine for this patient and other patients in the Alzehimer's units at Britthaven similarly tested positive for morphine without any physician orders.

This incident is not the first time investigators have questioned the care provided to patients at the Chapel Hill, NC nursing home.  Britthaven has the dubious distinction of earning a spot on the government's 'Special Focus Facility' list after regulators found multiple safety violations in 2008 and 2009.

Morphine Use In Nursing Homes

Morphine is a powerful narcotic pain reliever that is made from opium.  Like most powerful narcotics, morphine can only be prescribed by a physician and must be carefully dispensed in order to avoid addiction and overdose.

Particularly in the elderly, morphine dosages must be strictly adhered to in order to prevent overdoses which can easily kill a patient due to the cellular changes the drug brings about in the body that alter breathing patterns.

Britthaven operates many nursing homes, assisted living facilities and rehabilitation centers in North Carolina, Kentucky and Virginia. 

Related:

Medication Errors: Nursing Home Injury Laws

'Significant Medication Errors' Discovered In Nursing Home Following Investigation Related To Patient Injury & Death

Improper Drug Dosage, Wrong Medication, Interactions With Other Drugs.... May Be The Result Of Pharmaceutical Malpractice

Nursing Home Patients Continue To Receive Drugs Associated With Known Dangers

Nursing Home Spotlight: Fairview Nursing Plaza, Rockford, IL

On October 28, 2009, the Illinois Department of Public Health (IDPH) fined Fairview Nursing Plaza (a large, 213 bed “skilled and intermediate care facility” located in Rockford, IL) $10,000 for fourth quarter nursing home violations.  These violations included Nursing Home Care Act violations involving improper and inaccurate documentation of diabetes treatment and monitoring, and failure to immediately arrange for ambulance transport for a diabetic resident suffering from diabetic ketoacidosis. 

Also in October 2009, IDPH fined Fairview $10,000 for violating the Nursing Home Care Act (for a Type “A” Violation relating to the area of nursing).  A survey conducted on September 28, 2009 revealed that documentation for insulin dependent diabetics was not always complete and accurate.  This finding was confirmed by the facility’s own Director of Nursing.  The facility failed to properly and accurately document blood glucose levels and scheduled doses of insulin for insulin dependent diabetics residing in the facility. 

Diabetes (Type 1) can be a difficult disease to manage.  It requires careful screening of blood sugar levels, proper nutrition, and insulin shots.  There are many diabetes related complications, and the best way to reduce the risk of complications is to keep blood sugar level close to normal most of the time.  Fairview’s failure to properly document blood sugar levels and treatments put all of its diabetic residents at increased risk of diabetes complications. 

The nursing home failed to immediately arrange ambulance transport services for one diabetic resident with sustained elevated blood glucose levels, resulting in him suffering from diabetic ketoacidosis (too little insulin in your body).  The nurse reported that she checked the resident’s blood glucose levels hourly between 7:45 - 11:30 AM. 

Despite “HI blood glucose results” (> 525 mg/dl), the nurse did not notify a doctor sooner because she thought he was ok, even though the resident was showing signs of confusion, limp limbs, and being unstable sitting in a chair.  (see “Diabetic Ketoacidosis is an Under-Appreciated Danger Facing Many Nursing Home Patients”)  The nursing home’s failures directly endangered the life of this resident, and also call into question whether the nursing staff was properly monitoring other diabetic residents. 

Diabetic ketoacidosis is a very serious complication of diabetes.  Because sugar can no longer enter cells to provide energy, your blood sugar rises, and your body breaks down fat for energy.  This produces ketones, which are toxic, and if left untreated, it can be fatal.  Symptoms include: excessive thirst, frequent urination, nausea and vomiting, abdominal pain, loss of appetite, weakness or fatigue, shortness of breath, fruity-scented breath, and confusion. 

Fairview has a history of higher than average Health Deficiencies.  The Medicare Nursing Home Compare gave Fairview Nursing Plaza an overall rating of one out of five stars, which is much below average rating.  Health Inspections rating was one star (20 Health Deficiencies between 12/1/08 – 2/28/10.  Nursing Home Staffing rating was also only one star.  Quality Measures rating was four stars.  Between 12/1/07 and 11/30/08, the facility received 19 Health Deficiencies. 

The recent health violations at Fairview call into question whether the facility’s residents, especially its diabetic residents, are receiving proper care and treatment.  Diabetes is only one common condition affecting older nursing home residents.  Many common diseases and conditions require close supervision and monitoring to prevent dangerous complications and ensure proper medical care. 

SIR Management Inc.

Fairview Plaza Nursing Center is a facility operated under the control of S.I.R. Management, Inc. S.I.R. Management is a health care consulting company located in Lincolnwood, Illinois, which consults to several Nursing Facilities (Nursing Homes) in the Chicagoland area, including:

  • Columbus Park Nursing and Rehabilitation Center
  • Elmwood Care
  • Maplewood Care
  • Neighbors Rehabilitation Center
  • Regency
  • Albany Care
  • Greenwood Care
  • Decatur Manor
  • Rock Island Nursing & Rehabilitation
  • Wilson Care
  • Bryn Mawr Care

Sources:

Fairview Plaza Nursing Center

Medicare: Nursing Home Compare – Fairview Nursing Home

Illinois Department of Public Health: Fairview Nursing Home

IDPH: Fairview Nursing Home – 4th Quarter Violations

Mayo Clinic: Diabetic Ketoacidosis

Nursing Home Abuse Blog: Diabetic Ketoacidosis is an Under-Appreciated Danger Facing Many Nursing Home Patients

 

Happy Mother's Day From The Nursing Homes Abuse Blog

The Nursing Homes Abuse Blog wishes everyone a very happy mother's day 2010! Best wishes to all mothers, grandmothers and mothers-to-be.  Take some time out of your day and call or visit your mother where ever she may be. 

Police Use Taser On Unruly Child At Day Care Center. Isn't This Child Abuse?

I frankly did a double-take when I saw the news clip below from an Indiana day care center.  In an age where children are no doubtedly exposed to too much violence, I was shocked that these Indiana Police Officers used their taser on a 10-year-old child at day care center.  Sure, the boy may have been unruly, but doesn't this seem like excessive force?

As an injury lawyer who works on day care injury cases, I can only hope that this boy makes a full recover from both the physical and psychological trauma he surely must have endured in this matter.

 

Related:

Children In Day Care Are Susceptible To Many Of The Same Problems Our Elderly Nursing Home Patients Encounter

Sexual Abuse Of Children By Caregivers: A Varied & Widely Unknown Impact

Seeking Wound Care Professionals For New Bed Sore Treatment Resource

If you are a wound care professional with experience treating decubitus ulcers, please send me your information for addition to a new area of our sister website, Bed Sore FAQ.  Bed Sore FAQ is a compilation of commonly asked medical and legal questions regarding bed sore care and the corresponding legal rights of those who may have developed a wound during an admission to a nursing home or hospital.

Updated regularly, here is a sampling of the topics discussed at Bed Sore FAQ: prevention, treatment, research, stages of bed sores, debridement, sepsis, infection and lawsuits.

We are in the process of compiling a national database of doctors, nurses and medical facilities that concentrate in wound care. If you are interested or know of a colleague who is, kindly forward me the following information:

  • NAME:
  • FACILITY:
  • ADDRESS:
  • TELEPHONE:
  • FAX:
  • WEBSITE:
  • AREA OF CONCENTRATION:

Bed Sore FAQ is an established resource for families and individuals suffering from bed sores. Getting quality and prompt medical attention for bed sore treatment not only improves the quality of life, but also saves lives.  In the spirit of assisting those in need, we invite wound care professionals to participate in our new endeavor to make quality wound care more accessible.

Nursing Home Patients With Osteopenia May Suffer More Severe Injuries During Falls

Bone health is a serious concern for older adults. As you age, your bones get weaker as they lose their internal support structures. Older, weaker bones are more susceptible to serious bone breaks (fractures) because they have lower levels of important minerals including calcium and phosphorous. 

Osteopenia is a lower than normal peak bone mineral density (BMD). While not as severe as osteoporosis, it does increase your risk for osteoporosis. Bone mineral density is an indicator for how strong and healthy your bones are. BMD peaks in your late 20s to early 30s, after which it starts to decline. If your BMD is between 1.0 and 2.49 standard deviations below the average peak BMD, you suffer from ostenpenia. 

Women have a lower peak BMD than men and menopause causes hormone changes that speed up the loss of bone mass, which increases their risk of developing osteoporosis and osteopenia. In the United States, about 30% of Caucasian postmenopausal women in the United States have osteoporosis, and 54% have osteopenia.

For older adults, proper bone health is not just a matter of maintaining overall health; proper bone health can also affect mobility and independence. It is never too late to take steps to improve or maintain good bone health in order to prevent dangerous fractures. These lifestyle changes include:

  • Receiving proper levels of calcium in your diet (maybe including a calcium supplement combined with vitamin D)
  • Not using tobacco products (they can weaken bones)
  • Not consuming excessive amounts of alcohol
  • Exercising and remaining active (bone forms in response to stress, so weight-bearing exercises are good choices)
  • Taking caution to avoid dangerous bone breaks
  • Getting early treatment for eating disorders (low body weight can increase the risk of hip fracture)

Osteopenia does not have any symptoms, but doctors can diagnose low BMD with a bone density scan. This can help you and your doctor decide if bone strengthening drugs are an appropriate treatment option. Many women who have menopause also have osteopenia. 

Some doctors recommend osteoporosis medicine including Fosamax, Boniva, or hormone therapy right away to prevent further bone loss. However, as with any medication, these drugs have side effects and associated risks. Other doctors recommend that you exercise and take calcium. And, some researchers caution that many younger postmenopausal women are taking drugs that they don’t need because osteopenia is just a risk marker for osteoporosis. 

The World Health Organization developed a tool that helps predict a person’s overall risk of major fracture over the next 10 years by factoring in a variety of risk factors including: age, bone mineral density test results, family history of osteoporosis, use of oral steroids, whether or not you have rheumatoid arthritis, and whether or not you smoke. And, the National Osteoporosis Foundation revised its treatment guidelines as follows: drugs should be considered for postmenopausal women and men age 50 and older who have a 10-year probability of a major osteoporosis-related fracture ≥ 20% or a 10-year probability of hip fracture of ≥ 3%. 

If you or a family member is a nursing home resident it is important to ensure that you are receiving adequate calcium in your diet and proper activity and exercise to promote bone formation. Also, if you have risk factors for osteoporosis, you should have a bone mineral density test performed in order to determine your chances of developing osteoporosis and suffering dangerous bone breaks. Your bones are an important factor in maintaining independence and mobility, and nursing homes should ensure that you maintain proper bone health. If you are worried that a family member not receiving proper nutrition or BMD testing, it is important to talk with the nursing home staff as soon as possible to address the problem. 


Sources:

WebMD: Osteoporosis Health Center - Osteopenia

University of Washington: Department of Radiology – Osteopenia

U.S. News: Health – Grappling with a diagnosis of Osteopenia

Better Bones: Rethinking Osteoporosis

Pub Med: Vitamin K deficiency and osteopenia in elderly women with Alzheimer’s disease

JAMA: Osteopenia and Preventing Fractures

Troubled Illinois Nursing Home Says Adios To Federal & State Funding After Authorities Find Ongoing Problems. Is Their Nursing Home License Next?

Sometimes change is a good thing-- especially when it comes to poorly performing nursing homes.  Too often, poorly performing nursing homes get stuck in a rut, simply because there is little incentive to change. 

However, after three inspections where nursing home inspectors noted 'serious problems' at Fox River Pavilion, the facility has been stripped of its Medicare and Medicare funding.  Although Fox River may still have a nursing home license, when a facility loses its ability to accept governmental funding, it effectively forces the facility to rely solely on 'private pay' patients. 

Relying exclusively on 'private pay' patients effectively forces facilities to immediately correct their dangerous procedures or close their doors as most nursing homes rely on approximately 90% of their funding from the government.  Nonetheless, the facility can still legally operate.

Fox River Pavilion nursing home has been repeatedly cited for events involving improper supervision of aggressive, mentally ill and suicidal patient.  Recent problems at the Aurora, IL nursing home include:

  • More than 20 minutes in delay to provide medical attention to a patient who died from a heart problem following a fight with another patient at the facility,
  • The sexual assault of a disabled woman who was a resident at the facility
  • Failing to monitor a 48-year-old mentally challenged resident who ate latex gloves, napkins and toilet paper

Yanking a nursing home's license may seem extreme situation and perhaps even considered an over-reaction by some.  Nonetheless, as a nursing home lawyer who has witnessed repeated episodes of patient injury at facilities with a troubled record related to patient care, I firmly believe this intervention has likely prevented more tragedies at this nursing home.

Related:

Feds Yank Funding From Another Chicago Nursing Home With A Troubled Past

First Quarter 2009 Illinois Nursing Home Violators Released

State moves to pull nursing home's license, Beacon-News, April 28, 2010

Study Links Commonly Prescribed Osteoporosis Drugs To An Increase In Hip Fractures

A recently presented study at the annual conference of American Academy of Orthopedic Surgeons conclusively demonstrates that post-menopausal women who take a drugs to slow bone loss --- osteoporosis-- may be at a heightened risk for hip fractures.  Bisphosphonates, as the group of drugs is commonly known, include brand name medications such as: Actonel, Boniva, Fosomax and Reclast.

While the drugs are commonly prescribed to maintain bone strength in older women, the study demonstrated that when the drugs are taken for more than 5 years, the incidence of hip fractures begins to increase in the group of women who take the drugs compared with women who were not taking the drugs.

"These drugs are good drugs.  They strengthen bone and protect you from fractures for a while.  But in some people that can become deleterious after a period of time," according to Melvin Rosenwasser, chief of orthopedic trauma surgery at Columbia Medical Center in New York.

At this point, the FDA has not reviewed the studies nor has the agency issued any recalls with respect to the drugs involved in the study.  Rather, if you are taking any of the aforementioned drugs, you should discuss the use with your doctor and make a determination as to what works best for your situation.

Read more about the study linking osteoporosis drugs with hip fractures here.

Hip Fractures In The Elderly

As a nursing home lawyer, I have worked on many cases involving hip fractures as a consequence of falls.  Unfortunately, hip fractures typically require surgical repair in order for the patient to regain any quality of life post-fracture.  An estimated 300,000 people undergo surgery for hip fractures every year.

Most hip fractures fall into two categories:

Femoral Neck Fracture

A femoral neck fracture occurs when the ball of the ball-and-socket hip joint is fractured off the femur. Treatment of a femoral neck fracture depends on the age of the patient and the amount of displacement of the fracture.  A partial of full hip replacement may be necessary in patients who sustain a femoral neck fracture because of diminished blood flow makes healing of the area affected by the fracture unlikely.

Intertrochanteric Hip Fracture

An intertrochanteric hip fracture occurs just below the femoral neck. These fractures are amenable to repair more often than femoral neck fractures. The usual surgical treatment involves placement of a plate and screws to stabilize the fracture as opposed to a partial or complete hip replacement.

Hip fracture surgery complications

The good news is that modern medicine is capable of treating many types of hip fractures.  However, data has shown us that many elderly people have an incredibly difficult time recovering from hip fracture procedures.  In fact, an estimated 30%+ of people over 60 will die in the year following their procedure. 

All this means that nursing homes and other care facilities should take all possible efforts to implement fall prevention programs to reduce the risk of falls in their patients.

Related Nursing Homes Abuse Blog Entries:

Bone Fractures In The Elderly Require Special Attention To Improve Recovery & Prevent Complications

Nursing Home Staff Must Take Precautions While Moving & Transferring Disabled Patients To Minimize Risk Of Dropping

Nursing Home Patients Have More Post-Surgical Complications Than Their Peers

A Video Diagram Of A Hip Replacement Surgery

New Court Decision Allows Nursing Home Negligence Action To Proceed Against Facility Administrator

Childs v. Pinnacle Health Care, LLC is a wrongful death and nursing home negligence case that was filed against Pinnacle Health Care, the nursing home corporation, and Carolyn English, its director of nursing. Pinnacle Health Care, LLC is a nursing home located in Waukegan, IL. 

The trial court dismissed with prejudice the three counts against the director of nursing because the allegations were limited to her role as the director of nursing and were premised on the Nursing Home Care Act (210 ILCS 45), which provides that only licensees and owners of nursing homes can be held liable under the Nursing Home Care Act. 

However, the Illinois Second District Appellate Court reversed the trial court’s dismissal of these counts and ruled that the dismissal was improper because the negligence allegations involved professional negligence under the Healing Arts Malpractice Act (735 ILCS 5/2-622) and were independent of the Nursing Home Care Act. 

This case centered on the death of Dorothy Jones, who was a resident of Pinnacle Health Care before her death. Ms. Jones was admitted to nursing home in July 2002 when she was no longer able to walk as a result of her multiple sclerosis. Upon being admitted, Ms. Jones did not suffer from any skin impairments. 

Pinnacle personnel categorized Ms. Jones to be at high risk for developing pressure sores during skin assessments performed between January 2005 and October 2006. Despite this risk assessment, Ms. Jones developed 16 pressure sores during her residency at the nursing home. 

In October 2006, one of Ms. Jones’ pressure sores became seriously infected and began bleeding, requiring her to be transferred to a nearby hospital. The hospital documented her injuries as follows:

  • A sacral pressure sore that was so large, deep, and infected that liquid stool was seeping out of her vagina
  • A scalp pressure sore that appeared to reach down to the skull
  • A left leg pressure sore that exposed her tendons
  • Pressure sores on her ears, which exposed cartilage. 

Also, prior to Ms. Jones’ transfer to the hospital, she had developed multiple severe urinary tract infections, symptoms of recurrent infection, and severe respiratory problems. Ms. Jones died from respiratory failure on October 6, 2006, only two days after being admitted to the hospital. 

Clearly, to say that Ms. Jones suffered from nursing home abuse and neglect is an understatement. Pressure sores are very serious and, in most cases, preventable.  How the nursing home and its personnel allowed her to develop pressure sores in the first place and their subsequent failure to treat them is unacceptable and horrifying. This case at least makes it possible for all responsible parties to be held liable: the nursing home corporation, and more importantly, the director of nursing in her professional capacity. 

Sources:

Illinois Courts: Childs v. Pinnacle Health Care, LLC

Illinois State Bar Association: Childs v. Pinnacle Health Care

Illinois General Assembly: Nursing Home Care Act (210 ILCS 45)

Illinois General Assembly: Healing art malpractice (735 ILCS 5/2-622)

Trust Your Instinct When Placing A Child In Daycare With Potential Hazards

Recently, we settled a claim on behalf of a 11-month-old girl who fell from a high chair at a daycare center--- a mere four days after she began attending the facility.  The young girl slipped down from the chair and sustained a laceration and fracture to her face. 

An investigation by the state regulatory agency revealed that the high chair the girl was using was missing a crucial strap to ensure that the infant could sit securely without the risk of slipping out of the bottom.  The investigation further revealed that an employee at the facility had requested a replacement high chair three months before the incident occurred.

Should this type of incident been prevented?  Of course! 

While daycare facilities should (and usually do) maintain their facilities in the safest manner possible, I feel strongly about parents conducting regular safety inspections of their own. 

Certainly, it is not realistic to think that all daycare accidents can be avoided, but looking over the facility on a regular basis may help protect your child and his or her peers.  Should you notice a problem, alert the staff immediately.

The following are commonly encountered problems in daycare facilities that deserve immediate attention to prevent injury to children:

  • Broken or defective chairs, tables, ladders and toys
  • Slamming doors
  • Defective door locks
  • Dangling window drape pulls
  • Missing or damaged protective mats under climbing equipment
  • Unprotected sharp corners
  • Small toys or parts that pose a choking hazard to infants and young children
  • Flaking paint
  • Unguarded radiators
  • Missing window screens / unguarded windows
  • Protruding screws or nails from toys, lockers or hardware
  • Dirty areas
  • Inappropriate or mismatched equipment -- particularly adult sized chairs and ladders in the room

Rosenfeld Injury Lawyers regularly represents children injured in a day care or babysitting facility.  If you believe that your child's injury is indeed related to poor care at a facility we invite you to discuss your legal options with our child injury attorneys.

Related:

Child's Death At Day Care Demonstrates Need For Tighter Regulations

Preventing Institutional Child Abuse By Carefully Selecting A Facility

Understanding The Regulations Pertaining To Day Care Facilities Is Crucial To Protecting Your Child

Toddler Receives Burns In Daycare Due To Caregiver's Poor Judgment

Nursing Home Injury Laws Establishes Itself As A Trusted Resource For Families Seeking Information Regarding Their Legal Rights

Since its inception, Nursing Home Injury Laws has become a trusted resource for caregivers and families seeking reliable information in a time of need.  Nursing home injury laws provides a comprehensive compilation of state-by-state nursing home contacts, a glossary for common legal terms, resources and legal information should the need arise.

In addition to important links to important developments within each state, Nursing Home Injury Laws provides has important information on the following commonly encountered nursing home injuries:

Continue to check out Nursing Home Injury Laws on a regular basis as more information continually gets added.

About Jonathan Rosenfeld

Photo of Jonathan Rosenfeld

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

Read More

Subscribe

Add this blog to your feeds or subscribe by email using the form below

Concerned about a loved one? Talk with an attorney today.

Bed Sore FAQs

Frequently asked questions on bed sore prevention, treatment and legal rights of those who have been neglected.

View FAQs