Nursing Homes Abuse Blog - By Jonathan Rosenfeld

In a world full of crazy people, some have managed to infiltrate the world of nursing homes.  While occurrences involving the sexual abuse of nursing home patients are certainly not a common place occurrence, the incidents do occur--- yet too often they are brushed aside by nursing home staff whom may attempt to hide the incident out of embarrassment or perhaps at the request of nursing home management.

Regardless of the underlying reason, failing to report mistreatment of nursing home patients is unacceptable-- and illegal.  Laws applicable to nursing homes require facilities to: 1)  protect patients from harm and 2) to report allegations of misconduct to appropriate state agencies.

Omissions made with respect to both of the above obligations landed Hazard Nursing Home of Kentucky in a potentially troublesome situation.  During the course of litigation on an unrelated wrongful death case, several nursing home employees disclosed at their depositions that they witnessed an 88-year-old woman get sexually assaulted on multiple occasions by other nursing home patients.  When the incidents were reported to nursing home supervisors, they instructed the staff not to take any action because there was no 'harm' to the patient (who happened to be disabled).

As a result of the nursing home employees testimony, both a civil lawsuit has been initiated by the woman's family as well as an investigation has been triggered by Kentucky officials.

Hopefully, these recent actions will improve the care provided to all patients at this facility.  Traumatic events, such as this, involving mentally and physically handicapped patients can be particularly troublesome to identify and provide treatment for. 

In several cases I have worked on regarding sexual assaults of the disabled, we have worked with experts in the fields of psychology and trauma to attempt to more accurately convey the full impact of the event to both defense lawyers as well as potential jurors.  In some circumstances, these experts can help explain the trauma when the victim of the assault may not be able to do so.

Knowing the telltale signs of sexual abuse:

For caregivers, knowing the signs of potential sexual abuse is important in order to prevent further mistreatment of the patient as well as others in the facility.  Common signs of sexual trauma include:

• Fear of certain people
• Difficulty walking or standing
• Change in behavior, such as crying or withdrawal
• Bleeding in the genital area or anus
• Bruising in the inner thigh
• Sexually transmitted diseases
• Pain in the genital area
• Depression
• Unusual discussion regarding sexual issues

Related:

When Bruises Can't Speak For Themselves: The Difficulty Proving Abuse Of Disabled Nursing Home Residents

Nurse Charged With Rape Of Disabled Patient

Nursing Home Fails To Report Suspected Sex Abuse To Authorities

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

A failure to protect: Sexual abuse in nursing homes, Kentucky.com July 25, 2010

Last fall, we discussed the problems state inspectors found at Emeritus at Crossing Pointe, a Florida nursing home, that posed an immediate threat to resident safety.  During an inspection at the nursing home, inspectors discovered:

• An 82-year-old patient who died after staff failed to provide her heart medication for four days
• Inaccurate resident counts by facility managers
• Residents with infected bed sores (also called decubitus ulcers, pressure ulcers or pressure sores)
• Neglected patients- some Alzheimer's patients had toe nails so long that they curved around their toes
• Falsified medical records
• Staff administering the wrong medications to patients that resulted in injury

The living conditions were so poor that Florida officials banned the facility from accepting new patients.

Now, it seems Emeritus officials have officially thrown in the towel at this facility.  After months of attempting to improve the living conditions at the facility, Emeritus officials have elected not to re-new the facilities nursing home license.  Now, the skilled nursing facility will transition to a 'senior housing' facility. 

Although the change in facility designation may seem like a minor change, the reality is that the change in designation of the type of facility is significant from a regulatory standpoint.  As a senior living facility, the facility will no longer be subject to any of the regulation imposed by the state of Florida on nursing homes such as inspections.

No word yet as to whether the Emeritus Corporation will retain control over the facility as it transitions to a less structured care environment. 

As a nursing home lawyer, I continually see poorly performing facilities attempt to re-name, re-organize and re-categorize themselves as problems arise.  In some cases, the re-vitalization of the facility provides a fresh start.  Unfortunately, most situations involving freshening up sub-par facilities simply means a change in window dressing.  Too often, I see these re-newed facilities continue with the pattern of poor care that got them in trouble originally. 

Consequently, it is important for families to learn as much as they can about nursing homes and assisted living facilities before placing a loved one there.  In addition to researching the corporation itself, it is important to ask direct questions to administrative staff regarding the history of the facility.

Read more about this Florida nursing home here.

Related Nursing Homes Abuse Blog Entries:

Admissions Suspended At An Emeritus Assisted Living Facility Following The Discovery Of: Medication Errors, Bed Sores & Falsified Medical Records

Another Iowa Assisted Living Facility Chooses To Abandon Its License

Pesky Government Regulations No Problem For Assisted Living Facility In Iowa

Now That We Rate Nursing Homes, Is It Time To Rate Other Adult-Care Facilities?

What causes bed sores?

I received a lot of emails from families who were concerned about the safety of their loved ones following our recent Nursing Homes Abuse Blog entry regarding the lack of national regulation of nurses.  Our blog entry was based on an in depth report regarding nursing regulation that appeared in a ProPublica series on poor care provided by nurses with a blemished record of providing quality patient care. 

The articles highlight the problems associated without a centralized database regarding nurses backgrounds and whether they have been disciplined in one state-- only to legally find work in another.

Thankfully, ProPublica reporters Charles Ornstein and Tracy Weber did a great service compiling information on nurse regulation on a national level.  The duo's compilation contains links to the following information:

• License look-up page
• Whether the states has a free on-line license look-up
• Free disciplinary documents on-line
• Contact information regarding obtaining medical records
• Lists of disciplines nurses by state

While the information contained in this link can not eradicate poor nursing care, providing transparency on nurses background may help prevent additional situations involving abuse or neglect.  

Nonetheless, should you have further concerns regarding the staff at a nursing home or hospital, don't be shy about reporting the individual to the head of the facility or to law enforcement officials.  Thankfully, most staffing issues can be resolved in this matter-- before further intervention is necessary.

Below is a map that appeared in the ProPublica series.  The purple states allow free retrieval of license look-up on line.

Loopholes in a reciprocity program amongst 24 states that allows nurses from one state to transfer to another may be putting a tremendous number of nursing home and hospital patients at risk for receiving poor care-- or perhaps more accurately downright dangerous care.

A recent USA Today article "Bad nurses able to keep working in other states" highlights the problems associated with the lack of a national database to keep track of nurses with blemishes on their records.  The article chronicles how some nurses legally obtain work in one state when they may have been disciplined for poor care in another.

The 24-state pact was originally intended help under-utilized areas of the county get the nurses when they need them--- without the nurses having to obtain licensing from the state board.  However, it seems like the dangers associated with states almost blindly allowing nurses to transfer into their state are alarming. 

In particular, there are multiple episodes where nurses have admitted and/or been disciplined in the following circumstances:

• Stealing patients medicine
• Medication errors
• Providing negligent medical care
• Neglected patient needs
• Physically abusing patients
• Failing to register as a convicted sex offender

Certainly, after reading this article, you will likely be left with a similar impression to myself that there needs to be a national tracking system for nurses and all health professionals who may have reciprocity rights that allow them to transfer from one state to another. 

However, until such a system is put into place, I firmly believe it is the responsibility of individual facilities (and staffing agencies) to provide qualified staff at their facilities to assure proper care and patient safety.  In my opinion, these responsibilities are non-delegable and when a facility fails to uphold their end of the bargain and a patient suffers harm they certainly expose themselves to civil responsibility.

Related Nursing Homes Abuse Blog Entries:

Temp Workers Becoming An Increasing Threat To Nursing Home Patients' Safety

Failure To Conduct Adequate Pre-Employment Criminal Background Search Costs Assisted Living Facility $750,000

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

Why Would Anyone Want To Work In A Nursing Home?

Barry Community Care Center is a 75-bed nursing home located in Barry, IL. On January 22, 2010, the Illinois Department of Public Health (IDPH) fined Barry Community Care Center $35,000 for violations in the area of policy and procedure. Even with this significant fine, Medicare rated the facility as a three-star or average nursing home facility, with only one health deficiency between February 2009 and April 2010.

This episode demonstrates that even well-regarded skilled nursing facilities can have very serious problems for patients. Barry Community Care Center’s single deficiency involved its failure to provide each resident the care and services required to achieve or maintain the highest quality of life possible, which resulted in immediate jeopardy to resident health or safety. 

This example serves to reinforce how important it is to thoroughly research a potential nursing home because looking at the total number of health deficiencies is not enough. Not all health deficiencies are equal with regard to the level of harm presented to residents. In this case, the facility’s deficiencies and violations were very serious, resulting in the choking death of one resident. (See other Nursing Homes Abuse Blog articles on choking)

A survey conducted by IDPH on November 25, 2009 revealed that Barry Community Care Center failed to provide adequate supervision to a resident during mealtime, which resulted in the resident choking on food. Then, the nursing home did not call 911 for another hour, which led to the resident’s death at the hospital later in the day. 

The resident was known to have impaired cognition and limited range of motion for neck, arm, and hand. The facility’s care plan for the resident required one person to physically assist and supervise with meals. 

On September 26, 2009 at 1:00 pm, the resident was found in her room with a half-full plate of food from lunch in front of her. The resident was having trouble breathing and her face was ashen. A Licensed Practical Nurse (LPN) was called to the resident’s room. The nurse increased the oxygen and encouraged resident to cough. The resident coughed out some food but became too weak to continue. At that point, the nurse began to suction the resident while another nurse called the physician and power of attorney (POA). When the POA arrived, she requested that the resident be sent to the emergency room (ER). 

The ambulance was called at 1:56 pm, almost one hour after the facility found her having trouble breathing and choking on her food. When the ambulance took the resident to the hospital at 2:27, the resident had a rapid pulse and was still having trouble breathing. When the ambulance arrived at the hospital at 2:41 pm, the resident was unresponsive, suffering from major respiratory distress. The resident died at the hospital with a diagnosis of aspiration pneumonia (inflammation of the lungs from breathing foreign matter into your lungs), atrial fibrillation (irregular, rapid heartbeat), hypertension (high blood pressure), Type 2 diabetes, and history of chronic obstructive pulmonary disease (COPD). (See “Elderly Patients Are At Higher Risk for Developing Aspiration Pneumonia When Facilities Fail To Account For Patient Needs”)

The facility never should have left the resident alone with her food tray, especially because the resident’s care plan called for her to have someone assist her with eating and drinking. In addition, the staff knew that the resident had trouble eating her breakfast on the morning of her death. One of the nurses had to physically remove pieces of egg and toast from her mouth before returning the resident to her room. Furthermore, the nurse should have immediately called 911 when she found the resident choking on food and having difficulty breathing. 

The choking death of the resident at Barry Community Care Center is a sad reminder of how quickly a nursing home resident can suffer injury, or in this case, death, when they do not receive proper care and supervision. It took only 30 minutes for the resident to choke on food, when she should have had a staff member helping her eat, which would have prevented her death. 

Thanks to Heather Keil, J.D. for her assistance with this Nursing Homes Abuse Blog entry

Sources:

Illinois Department of Public Health: Nursing Homes in Illinois Quarterly Report

IDPH: Barry Community Care Center

IDPH: Barry Community Care Center - Quarterly Report

Nursing Homes Abuse Blog: Elderly Patients Are At Higher Risk for Developing Aspiration Pneumonia When Facilities Fail To Account For Patient Needs

Nursing Homes Abuse Blog: Choking

Choking Death Just Latest Problem At California Nursing Home

As we age, our bones become weaker and are more susceptible to dangerous bone breaks. This is because older bones form small cracks more easily, which makes bone breaks more likely. 

In order to prevent dangerous bone breaks-- and to help determine fractures that may be the result from situations involving nursing home abuse-- it is helpful to understand the types of fractures and what causes them. Common types of bone fractures include:

• Stress fracture
• Spontaneous fracture
• Compression fracture
• Traumatic fracture

Stress Fracture

Stress fractures are actually tiny cracks in bones caused by overuse and repetitive motion. They occur mostly commonly in the lower-legs and feet because these are weight-bearing bones. Stress fractures may be barely noticeable at first, but the swelling and pain will intensity as they worsen. Therefore, it is important to receive proper care and treatment to prevent the stress fracture from becoming more serious. 

As with most bone breaks, osteoporosis or weak bones increases your chance of suffering from painful stress fractures. And, to further complicate matters, a study indicated that some post-menopausal women who take biophosphonate drugs such as Actonel, Boniva, Fosomax, and Reclast might actually have a higher risk for hip fractures. (See “Study Links Commonly Prescribed Osteoporosis Drugs To An Increase in Hip Fractures”) It is important to discuss any new medications with your doctor, who will help you weigh the benefits and risks of drug treatment. 

In a nursing home setting, staff members should be aware of the signs of stress fractures, so a resident’s care plan can be altered to prevent further damage and alleviate pain. Signs and symptoms are swelling and pain, especially in the lower legs and feet. Nursing home staff or doctors use x-rays to diagnose stress fractures. 

Early treatment of stress fractures is important, so the cracks do not worsen. Treatment includes reduced activity until the bone has a chance to heal. However, some stress fractures are harder to heal and are prone to re-injury. Therefore, it is important that nursing home staff monitor the resident’s injury to ensure that proper healing occurs.

Spontaneous Fracture

Spontaneous fractures (also known as compression fractures) are bone breaks that occur without trauma in what seem like normal bones. The spine and hips (bones that directly support your weight) are the bones most likely to be affected by spontaneous fractures. Older bones are more vulnerable to compression fractures because they lack the internal support structures to withstand impacts and pressure. Osteoporosis (weak and brittle bones) is the most common cause of spontaneous fracture. 

A 10% bone mass loss in the vertebrae can double the risk of vertebral fractures and a 10% loss of bone mass can increase your risk of hip fracture (2.5 times greater chance of hip fracture). Hip fractures are one of the most common injuries for elderly people. They usually occur because of a fall and can cause serious and even life-threatening medical complications. 

While walking exercises are often valuable tools to help maintain health (bone health) and promote strength, strenuous walking exercises can contribute to spontaneous hip fractures. Therefore, it is important to personalize individual walking plans for elderly residents according to their bone health, which can be determined by BMD (bone mineral density) tests. 

Hip fractures usually require surgery to realign the bones, often with surgical screws, metal rods, or plates. Then, after surgery the main focus is on controlling pain and preventing infection. The best thing to do after hip surgery is to start moving around as soon as possible. This helps reduce recovery time and prevent dangerous complications such as blood clots, lung congestion, and pressure sores. 

Oftentimes, a walking aid (walker, crutches, or cane) is used in the months following surgery. Physical therapy will help the resident regain their strength and independence. However, many elderly nursing home residents are never as independent as they were before their hip fracture. And, if the resident makes no improvements, physical therapy is often cut short. 

Elderly persons can also suffer from compression fractures in their spine, which occur when the vertebrae (back bones) become so weak that they compress or collapse. Again, osteoporosis is the main cause of vertebral compression fractures. A compression fracture of the spine can cause severe pain and a stooped posture or even a hunchback (kyphosis). While this type of compression fracture will often heal on its own after 8-12 weeks, previous spinal compression fractures increase your chance of suffering from additional compression fractures of the spine. 

Trauma Fracture

Elderly people are susceptible to dangerous falls because of poor balance and coordination, weakness, changes in gait, poor vision, illness, medications that cause sleepiness or dizziness. Over 11 million people over the age of 65 suffer dangerous falls every year. That is an astonishing one out of every three senior citizens. 

Your wrists and hips are the bones most likely to break if you suffer from a fall. Your wrists are susceptible to breaks from bracing yourself with your hands as you fall. And, your hips are more susceptible to breaks because as you age your bones (especially your hips) are less able to withstand impacts, and your hips often receive the brunt of the impact when you fall. 

After an accident or fall, nursing home staff members will examine the injured area to look for bone breaks, cuts, bruising, or other signs of injury. The staff will ask questions and investigate how the injury occurred. This investigation into the cause of the fall is very important to protect the resident and prevent future falls. 

If the resident lost consciousness, this could be a sign of a more serious condition, such as a stroke or heart attack. In the case of a possible bone break, the resident will be treated by a physician who will determine whether x-rays are necessary. The doctor will use a splint or case to immobilize bone breaks that occur on the arms, legs, hands, and feet.  However, as discussed above, hip fractures usually require surgery and post-operative physical therapy to help improve mobility. 

Understanding the significance of each type of fracture

Understanding the different types of bone fractures can help prevent dangerous bone breaks by avoiding dangerous situations and taking preventative measures. Nursing home facilities are required to keep the facility free from accident hazards and take preventive measures to prevent dangerous falls. 

Each resident should have an individual care plan specifically tailored to their strengths and weaknesses in order to provide the best care possible. If you or a loved one suffered a dangerous bone break while a resident at a nursing home facility, you may be entitled to compensation. 

Sources:

Nursing Homes Abuse Blog: Study Links Commonly Prescribed Osteoporosis Drugs to an Increase in Hip Fractures

Merck: Fractures

Amherst Bulletin: When Seniors Fall, Perilous but Preventable

e-Medicine: Lumbar Compression Fracture

Mayo Clinic: Stress Fractures

Journal of Orthopedic Surgery: Strenuous walking exercise and spontaneous fracture of the femoral neck in the elderly

Medicine Net: Fracture

WebMD: Understanding Fractures

Pub Med: Spontaneous fracture – multiple causes

One of the emerging trends I've noticed in the senior care industry is how many assisted living facilities have added skilled nursing care to the services offered by the facility.  Many facilities promote the additional skilled nursing care as an 'aging in place' alternative to an undesirable re-locating to a different facility when the need for more intensive care arrives.

While the combination of skilled nursing facilities coupled with assisted living facilities may be useful in some circumstances, there are times where facilities seem to shuffle patients around to take advantage of the less structured care standards in assisted living facilities. 

In some of our cases, I've seen patients transferred back-and-forth from an assisted living portion of a facility to a skilled nursing section several times within a month.  In situations where there may be ongoing negligent care, it can be difficult to ascertain where the inadequate care originated. 

While the distinction between skilled nursing vs. assisting living may seem irrelevant, it is very important for purposes of establishing the appropriate standard of care in the course of litigation.

This issue came to mind after reading an article about an Ohio assisted living facility received a donation for the addition of skilled nursing beds at the same facility.  Below is a short video of the news story.

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

Admissions Suspended At An Emeritus Assisted Living Facility Following The Discovery Of: Medication Errors, Bed Sores & Falsified Medical Records

Now That We Rate Nursing Homes, Is It Time To Rate Other Adult-Care Facilities?

Assisted Living Facilites Need To Re-Evaluate If They Are Capable Of Caring For Dementia Patients

There's been a lot of talk about a recent jury verdict against Hillcrest Nursing Home, a Kentucky facility, after a patient fell while attempting to transfer herself to the toilet-- and there should be, the jury hit the facility with a $7 million dollar verdict.

The incident involved a patient who was 67-years-young, who was admitted to the nursing home for rehabilitation following a knee surgery.  Perhaps due to the woman's youthful appearance, the nurses aide told the woman that she was busy and she could use the toilet herself.  It was during the unassisted transfer to the commode, that the nursing home patient fell and severely injured the surgically repaired leg.  The leg was so severely injured that it had to be amputated following the fall.

However, as a nursing home lawyer, I am drawn to the common fact pattern that forms the basis of the lawsuit as opposed to the end result.  I see many nursing home and hospital patients suffer needless injuries in the bathroom primarily due to two reasons: 1) the staff fails to provide assistance to the patient to get them on to the toilet and 2) the staff leave the patient on the toilet without any supervision.

Of course no one wants to needlessly invade another person's privacy, but when it comes to patients who require assistance, patient safety must trump expectations of privacy. 

Even when relatively healthy patients can seemingly navigate their way from their bed to the bathroom and place themselves on the toilet, staff must strictly adhere to the doctors orders when it comes to assistance.

Much more so than in other areas of medical facilities, I tend to see patients suffer injuries in the bathroom due to:

• Changes in their blood pressure when getting out of bed or from a wheelchair
• Lack of stability devices within the bathroom-- guardrails, hand grips
• Staff slow to respond to patients requests to use the toilet
• Inadequate staffing levels at facilities to provide the level of patient assistance set forth in a patients care plan
• Staff that ignore physician orders with respect to assistance when it comes to bathroom use

I guess the moral of all this is that while patient privacy certainly has a place, when it comes to using the restroom, don't be shy about asking for assistance--- you just may need it.

Related:

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

Nursing Home Waits 19 Hours To Provide Medical Treatment To Resident Who Fractured Her Hip During Sabina Lift Transfer

Falls In Nursing Homes Are A Serious Threat To The Safety Of Many Patients

Inadequate Training Of Medi-Car Staff Exposes Seniors To Unnecessary Risk During Non-Emergency Transportation

I guess there's probably a lot a screaming and yelling going on at the Skilled Healthcare Group (SKH) headquarters in California.  Perhaps the anger derives from the miserable looking financial chart for the company showing a whopping 75% decline in price per share in one day!

Another portion of the companies anger is probably being misdirected at the lawyers who defended the company in a class action lawsuit brought against Skilled Healthcare based on systematic under-staffing at 22 nursing homes owned by the corporate giant.  Really, the only people to blame are the managers in the company who intentionally chose to limit that staffing at their facilities.

After hearing months of evidence regarding staffing levels at the nursing homes operated by Skilled Healthcare, the jury awarded the maximum amount permissible under the California Health and Safety Code--- a whopping $671 million to the members of the class. 

The massive jury award is hardly an arbitrary number.  Rather, the compensatory damages were awarded based on a statutory violation of $500 per-patient per-day at the 22 subject facilities for not providing that state minimum staffing of 3.2 hours for each patient living at the nursing homes on a daily basis.

In addition to the compensatory damages, the lawsuit also seeks punitive damages against Skilled Healthcare.  Unlike compensatory damages, punitive damages are intended to punish the wrongdoer for their acts.  The punitive aspect of the lawsuit will move forward in the coming weeks.

I'm sure that it will take some time before any of the plaintiffs involved in this case receive any portion of the recovery, this verdict will likely force nursing home operators to re-evaluate the way they operate and the decisions they make with respect to staffing levels at their facilities. 

Sadly, when facilities are short staffed, nursing home patients suffer.  Under-staffing in nursing homes continually contributes to incidents of nursing home abuse and neglect. 

Dare I say that this verdict may improve the quality of life-- not just for patients at Skilled Healthcare facilities-- but countless other who suffer from systematic under-staffing at other facilities across the country?

Related:

Class Action Lawsuit Against Skilled Healthcare Seeks Damages For Chronic Under-staffing Of Nursing Homes

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

Poor Training & Under-Staffing Blamed For The Death Of A Nursing Home Patient Who Died From Injuries Sustained After She Was Dropped By A CNA In A Minnesota Facility

A Recipe For Danger: Nursing Shortage Could Reach 1M By 2020

Minimum Nurse Staffing Ratios

WBBM Newsradio is reporting on a tragedy that occurred this past weekend at a Chicago Nursing Home.  On Sunday evening, a 51-year-old woman who was a patient at Warren Park Nursing Pavilion was taken to Saint Frances Hospital when she was discovered unresponsive in a bathtub at the facility. 

Authorities at Saint Frances pronounced the woman was dead upon her arrival at the hospital.  An autopsy performed by the Cook County Medical Examiner determined that the woman died from drowning.

Chicago police detectives are currently investigating this matter to determine more information about the drowning.

While certainly not a common occurrence in nursing homes and assisted living facilities, many patients-- particularly those suffering from mental and physical disabilities-- are at risk for downing during bathing or recreational activities.  In order to minimize the risk of drowning, staff should identify those who may be at risk an provide supervision to prevent drownings.

Nursing home injuries, such as this downing, deserve to be investigated by the Illinois Department of Health (IDPH).  Many times, investigations completed by IDPH are extremely useful in the prosecution of civil lawsuits against the facilities.  The IDPH has investigated other incidents at Warren Park, you can view some of the findings here.

Related:

Jean Engstrom, 51, Dies in Tub Drowning Incident at Rogers Park Nursing Home, My Fox Chicago, July 5, 2010

Sadly, at a time when many are feeling severe financial strain, some nursing home operators and employees are turning to another source of potential income-- stealing state and federal funds intended for nursing home patients.

The most recent case of stealing or Medicare fraud-- which is essentially what most of these cases come down to because that is where most funds derive-- comes from Missouri.  Connie Jean Beckerman, the former bookkeeper at Perryville Nursing and Rehabilitation Center, pleaded guilty to: forgery, stealing by deceit, and abuse of a person receiving health care-- all felonies.

The criminal acts were perpetuated between September 2007 and October, 2007 put more than $14,500 in Ms. Beckerman's pocket.

While Ms. Beckerman's profit may seem like small potatoes, these criminal acts must be fully prosecuted to the fullest extent possible in order to deter other acts from occurring at the facility and others.

Read more about this case of financial fraud in a nursing home here.

Related Nursing Homes Abuse Blog Entries:

When The Going Gets Tough, Some Nursing Homes Turn To Medicare & Medicaid Fraud

If I Work In A Nursing Home Where I Suspect Fraud, Can I File A Qui Tam or Whistleblower Lawsuit?

An article published in the Las Vegas Sun, painted an unfortunately common set of circumstances; an overweight patient goes into a hospital for a medical procedure-- only to acquire pressure sores during their stay.  Sure, the same scenario can (and most certainly does) occur with people of average stature, but there definitely is a disproportionate number of obese patients who enter a hospital or nursing home only to develop a lingering souvenir.

The sun article concentrates on 60-year-old Tyrone Bush, a maintenance man, who was admitted to Desert Springs Hospital for a quadruple heart bypass surgery in 2008.  It was during Bush's recovery at the hospital, that he developed multiple bed sores (or pressure sores, pressure ulcers, decubitus ulcers) on his buttocks. 

More than two years later, Mr. Bush continues to be plagued from the wounds and requires extensive medical treatment for them including doctors visits and debridement procedures-- where the dead skin is removed to allow the new skin to grow over the open wounds.

Not surprisingly, the hospital where the wounds developed blames the wounds on Mr. Bush himself, implying that the wounds were unpreventable given his size.

Large Patients & The Development Of Bed Sores

Let's face it, obesity is an epidemic.  By some accounts, more than 40% of the adult population is obese.  However, the same preventative techniques for 'average' patients most definitely applies to their larger counterparts.

Regular relief of pressure for the body is the most important preventative measure to prevent development of bed sores in all patients-- particularly the immobile.  When it comes to a larger patient, simply saying the patient is too big to move is not appropriate.  Rather, if one person can not safely move the patient, two, three or even four staff members should be summoned for assistance.

Related:

What can hospitals do to reduce the rate of bed sores in their facilities?

What is ‘turning’ and why is it important to prevention of bed sores?

If a lawsuit or claim is filed against a facility where a person developed bed sores, what type of damages is the person entitled to?

Where can I learn more about the laws applicable to people who develop bed sores in nursing homes or hospitals?

Bed Sores, Nursing Home Injury Laws