Criminal Charges May Be Forthcoming Against Assisted Living Facility That Failed To Obtain Medical Care For Injured Patient

Even after tending to bleeding on the jaw of a resident at their facility following an altercation with another resident, staff at Sky West Assisted Living Center failed to seek out any outside medical attention for the resident.  It wasn’t until the resident’s family insisted that the resident be taken to a hospital was it discovered that the man’s jaw was fractured in five places, his eye socket was broken and he had fractures in his cheek bone.  Shortly after medical attention was obtained, the injuries claimed the life of the man.

While a grand jury investigation has cleared the other patient involved in the altercation of any wrong doing, attention is now being focused on the assisted living facilities actions--- or perhaps more accurately—inactions in the days following the melee at their institution.  In addition to failing to provide medical care, an investigation into the skirmish revealed the following concerning facts:

  • The patient’s wife was told by staff that her husband’s injuries amounted to no more than a ‘cut on the lip”
  • There is no evidence to substantiate that the owner of the facility was timely notified following this incident
  • Evidence suggests that the facility attempted to conceal the extent of the patients injuries by sedating him and positioning him in his bed in a manner to make his injuries appear less severe than they actually are

Officials from the Texas Department of Aging and Disability have already cited Sky West for their inattention to the patient’s injuries and failing to summon the care of a doctor, but now state prosecutors are analyzing the circumstances to determine if the ALF’s actions have criminal consequences. 

While we can debate the reasonableness of the grand jury’s decision not to pursue charges against the individual involved in the altercation, I certainly hope that the individual employees involved in this incident get prosecuted to the fullest extent of the law.  As caregivers to a particularly vulnerable group of people, staff at Sky West--- and all facilities caring for the elderly, have a responsibility to both accurately inform patient's families regarding the extent of injuries and to obtain medical treatment in a timely manner.  

Related:

Nursing Home Responsible For Choking Death Of Patient

Neglect alleged at assisted living facility, Amarillo.com November 16, 2011

Delayed Medical Attention To Blame For Death Of Nursing Home Patient

Some Nursing Homes Seem To Have A 'Wait And See' Approach When It Comes To Getting Medical Treatment For Their Injured Patients

Popularity Of Assisted Living Facilities Continues To Expand

alf.jpgWe spend quite a bit of time discussing nursing home care and the legal obligations of facilities to provide skilled nursing care under federal and state regulations.  While nursing homes are medical facilities with very specific obligations set forth under the law, assisted living facilities are a completely separate entity that needs to be clearly distinguished form nursing homes.

The department of Health and Human Services estimate that close to one million people currently live in the more than 38,000 assisted living facilities scattered across the country.  According to some experts, the number of assisted living residents may soon surpass the number of people living in nursing homes over the next decade.

Because assisted living facilities are an quickly evolving segment of the senior care market, their role remains somewhat of a mystery to many. I came across Dave Carpenter’s article “Assisted living options: What you need to know” which does a great job enumerating responsibilities and information about assisted living facilities in a clean and articulate manner.  Below is an except from Dave’s recent article.

  • What they are

Assisted living facilities are residential communities that offer different levels of health or personal care services for seniors who want or need help with some daily activities — anything from cooking to transportation to dressing and bathing.

What they’re not is nursing homes that address major medical needs. They are designed to provide a home-like setting for residents who want to live independently with minimal assistance.

  • Who lives there

The average age of residents in assisted living facilities in 2009 was about 87, according to the National Center for Assisted Living, an organization representing long-term care providers. Three-quarters of the residents are female. They stay at the assisted living residence for an average of about 28 months, and the majority then move on to a nursing facility.

  • Services provided

Services offered vary widely but typically include 24-hour emergency care, some medical services and help with medications, limited assistance with personal care, meals, housekeeping, laundry, transportation and recreational activities. Large facilities may have private apartments as well as shared and private rooms. 

  • First steps

AARP suggests checking with a state or local agency on aging, the yellow pages, the Assisted Living Federation of America and the American Association of Homes and Services for the Aging, as well as with friends, neighbors and books on retirement.

If looking on behalf of your parents, check your own local neighborhoods first. Most residents of assisted living facilities in urban areas who have children live within five to seven miles of them, according to Eichelbaum.

  • Finances

The cost of assisted living facilities varies greatly depending on size, location and services. The median rate for a private room is $3,261 a month, or just over $39,000 a year, according to Genworth Financial Inc., which compiles an annual costs survey among long-term care service providers. If you need a home health aide on top of that, the median cost nationwide is $19 an hour.

Neither Medicare nor health insurance policies pay for assisted living. Medicaid covers only some services, and not in every facility or every state.

Long-term care insurance may cover most of the costs, depending on your policy. But if you haven’t bought coverage well ahead of time, you may not be eligible and able to afford it.

AARP says four out of five residents pay for assisted living out of pocket. Veterans who need assistance can qualify for up to $1,949 a month if married, $1,644 if single or $1,055 for surviving spouses through the Aid and Attendance Pension.

  • Alternative option

There are three basic types of living options for seniors as they age: independent living, assisted living and skilled nursing. To avoid needing to move every time more assistance is needed, continuing care retirement communities are worth considering. They offer a variety of services for all three levels within one community. But this tiered approach is expensive. Entrance fees can range from $100,000 to $1 million, and monthly charges can range from $3,000 to $5,000, increasing as needs change. 

  • Advance preparation

Do the research before you have an immediate need. Having an idea of the cost and availability of options in your community is essential. If local facilities aren’t appropriate or affordable, it may be worth considering relocating to a community with one that fits you or your parents better.

It’s probably too late for your elderly parents to obtain long-term care insurance, but getting it for yourself in your 50s or early 60s is an important step to finance your own future care in an assisted living facility or elsewhere.

Getting siblings to agree ahead of time to a plan for an aging parent and how to finance it is important too, says Amy Goyer, AARP’s family expert. “If you wait until the crisis time, often the burden just falls on who’s closest,” she says. “That can be much harder and unfair for some family members.”

Spurred by Herald Report, Florida Cracks Down on 17 Assisted Living Facilities



                                                                 

[Photo Caption: In 2004, dementia sufferer Stowman Cox wandered from the Beckett Lake Lodge in Clearwater. His body was later found face-down in a lake, torn apart by alligators. (Photo Courtesy of the Miami Herald)]

An investigation by the Miami Herald into conditions at dozens of assisted living facilities has prompted a crackdown by Florida’s state regulatory agency, the Agency for Health Care Administration (AHCA).

“They’re finally doing what they should have been doing,” said Dan Reiter, a state ombudsman.

Over the course of a year, Herald reporters found deplorable instances of abuse and neglect at facilities across the state, including:
  • Scores of residents from Dunedin’s Rosalie Manor wandering the streets
  • Staff at Miami’s Angelica Gardens locking a 72-year-old resident in a closet without air conditioning
  • A 98-year-old Living Legends resident being sent to the hospital with two black eyes, a fractured neck
And many, many more....

“It was almost subhuman,” said Albert “Doc” King, a former resident of Shalom Manor Retirement Home in Lauderhill. King claims that residents were often mistreated, and that medicine frequently disappeared.

In Florida, assisted living facilities (ALFs) commonly admit both the elderly and the mentally ill. The Herald attributes the AHCA’s widespread lack of oversight, in part, to growing numbers of both populations. It also attributes the failure in oversight to low standards required for potential ALF operators.

“To open a home for people with mental illness, administrators need only a high school diploma and four days of training - far less than other major states,” the Herald says.

A third reason could be the scores of new ALFs opening across the state. According to the Herald, more than 550 new homes opened in the past five years, bringing the total number of ALFs to 2,850 in Florida.

After reading the Herald investigation, I find it truly shocking that Florida hasn’t yet overhauled its requirements for ALF operators. Clearly, the lack of knowledge about elder care - combined with purely greedy intentions - has put thousands of residents in grave danger. Despite having some of the toughest elder abuse laws in the country, Florida still has a long way to go before all its residents are safely cared for.

Please Note:

Facilities mentioned in the Herald report include:

All America in Hialeah
Arlington House in Palatka
Angelica Gardens in Miami
Beckett Lake Lodge in Clearwater
Briarwood Manor in Lauderhill
Clare Bridge of West Melbourne
Emeritus at Crossing Pointe in Orlando
Edwinola Retirement Community in Dade City
Escondido Palms in Tampa
Hampton Court in Lauderhill
Hillandale in New Port Richey
Isabel Adult Care III in Miami
Living Legends Retirement Center in Deerfield Beach
Munne Center in Miami
Nueva Vida in Miami
Park of the Palms in Keystone Heights
Pleasant Manor in Plant City
Rosalie Manor in Dunedin
Shalom Manor in Lauderhill
Southern Oaks Retirement Center in Wauchula
Sunshine Acres Loving Care in Caryville

Related:

Neglected to Death: Part I Miami Herald, May 2011

Neglected to Death: Part II Miami Herald, May 2011

Neglected to Death: Part III Miami Herald, May 2011

How to Choose an ALF (Florida Department of Elder Affairs)

Task Force to Seek Reform of ALF Industry Miami Herald, August 2011

Facilities Need To To Ensure That Dangerous Materials Are Properly Safeguarded To Prevent Injuries

detergent.jpgDepending on the individual, even the most mundane parts of a long-term care facility can pose a risk of harm.  While we normally associate an injury at a long-term care facility with an error committed by staff or a faulty device, many facilities-- and particularly those that care for the developmentally disabled--- need to take precautions to make make sure potentially dangerous materials are kept securely out of reach of the residents.

Patients with developmental disabilities and other conditions like Alzheimer's or dementia are most at risk for episodes of self-inflicted harm-- be it intentional or not. 

Consequently, facilities that care for these people must take additional precautions that go beyond merely keeping some of these materials out of sight.  Because many of these people remain vigorous and able-bodied, facilities should ensure that potential dangerous materials are kept in a sure area and train staff on this potential threat to resident safety.

Tragically, an episode involving a developmentally disabled man at a Washington Assisted Living Facilty made headlines when he died after drinking laundry detergent.  The Seattle Times reported that the 30-year-old man was transferred to a community living program months before the deadly incident where he was to be supervised by an organization that concentrates in caring for those with disabilities.  It was also reported that this man lived alone.

Presently officials with The Department of Socials Health Services and local police are investigating the circumstances surrounding this incident.

While we await the results from this investigation, I'm sure that authorities will focus both on this man's background with respect to any similar incidents in the past as well as why a potentially deadly poison was so accessible. Hopefully this agency will take a second look at the way it care for people with similar disabilities an implement much stronger safeguards to prevent similar incidents from occurring in the future.

Related:

Brookdale Assisted Living Facility Fails To Learn From Mistakes: Dementia Patient Dies After Ingesting Detergent

Are Group Homes A Viable Alternative To Nursing Homes?

Dementia Patient Found In Freezer At Assisted Living Facility: An Isolated Event Or Real Cause For Concern?

Acute renal failure following detergent ingestion (pdf) Singapore Med J 2009; 50(7) : e256

What you don't know may hurt or bankrupt you. Why are some assisted living facilities hesitant to disclose alternative care options?

A new law recently went into effect in Minnesota that requires all people seeking to enter an assisted living facility to receive a consultation about the \various care options to them-- aside from care at an assisted living facility. 

Originally proposed by Governor Mark Dayton, the policy was tailored by the state's Health and Human Services Committee (HHSC), with the primary goal of providing cost savings to the state.  Within the first two years of the program, state officials believe it may save the state $3.8 million.

According to chairman of the HHSC, Jim Abeler, the state has a real interest in educating people about different types of care alternatives.  Abeler fears that people many not have a full understanding of how expensive the care can be during a long-term stay. "The backstop for people paying cash when they go broke is the state." Further reasoning, "[s]o we're on the hook for the choices people male about how people spend their money in their long-term care."

Not surprisingly, the program is opposed by several assisted living facilities and trade groups who claim that the new law is overly burdensome and interferes with personal decision making of the individual.  

"We completely oppose it.  It's really government overreach - telling a person a person who wants to use their own private dollars how they have to use those dollars," according to Eric Schubert, vice president of communications and public affairs at Ecumen assisted living.

Incidentally, Minnesota has already adopted a similar preadmission consultation for people seeking admission to nursing homes in the state.

As an attorney involved in long-term care litigation, I strongly support this law and wish other states would adopt similar measures.  Of course, the transition to an assisted living facility or nursing home is indeed a significant change, but too often-- I find families confused about the real impact of both the economic and the legal implications of their decision.  In addition to a frank discussion about the cost of care, I also hope this this program provides information about what the care limitations are at each living arrangement (group home, assisted living or nursing home).

Read more about this law impacting Minnesota assisted living facilities here.

Related Nursing Homes Abuse Blog entries:

7 Steps To Reduce The Stress Associated With Moving To A Nursing Home

More Regulations In Store For Assisted Living Facilities In Georgia

In Rare Move, State Moves To Close Assisted Living Facility Following Discovery Of Abuse & Neglect

Family Claims Assisted Living Facilities Neglect Resulted In Death Of Mentally Disabled Woman

10 Steps To Help Find The Best Assisted Living Facility For You

assisted living facilty.jpgAn emerging trend in the field of senior care involves the emergence of living facilities that provide an alternative to nursing homes. 

Assisted living facilities have been popularized because they provide residents with assistance with basic daily living needs such as: meals, cleaning, bathing and socialization.  However, it is important to remember that unlike nursing homes, assisted living facilities can not provide medical care.

Like living facilities of all types-- and for all ages, a little leg work is necessary to help distinguish the good from the inferior. 

As someone who frequently receives inquiries from individuals and families regarding the selection of these facilities, I was happy to see a very informative article to help families with many of the difficult decisions they encounter when placing a loved one.  

The following suggestions are from Kimathi Lewis' article "Ten Tips For Finding the Right Assisted Living Community" that recently appeared on CascadePatch.com.  I hope you find these as valuable as I did.

1) Know what you or your family member needs

An honest assessment of you or loved one’s physical and mental needs is important. Perhaps a doctor’s input can help. But the assessment should include whether they can bathe and dress on their own? Do they need help with their medications? Do they need laundry and/or housekeeping assistance?

2) Understand the pricing and what it includes or excludes.

What happens to the charges if your loved one needs more care and services? How much notice will they give if the monthly fee will increase? Are meals, laundry and housekeeping included in the monthly fee? Are there extra fees for medication reminders or assistance? Are there any entrance fees or move-in fees? Are there any additional fees for cable or local phone services? Ask staff if there are any charges that you haven’t asked them about. Also ask them what happens if your family member runs out of private funds.

3) Observe the staff and find out about their credentials and training.

During the tour, watch how the staff interacts with the residents. Do they know their names and talk with them respectfully? Ask the administrator about the hiring process. Is staff given background checks? Is there on-going training and education after they are hired? Is there a licensed nurse on-site 24/7 or just on call? What is the staff to resident caregiver ratios?

4) Understand how the community handles increased level of care needs.

Regulations are sometimes broad in assisted living, so find out how the facility evaluates resident’s needs and how often. How is that information communicated back to you and how quickly? What additional services do they have available when the need arises? What kinds of conditions would require your loved one to transfer to a nursing home or other level of care? If a move is necessary, how much notice would they give you?

5) Investigate the opportunities for socialization and recreation.

Some residents have physical challenges that can lead to isolation, find out if the staff provides adequate opportunities for socialization. When you are touring these facilities, observe if there are any group activities or events. Are residents participating? Ask to see the events calendar and find out about planned activities for the year. Are there opportunities for residents to go on shopping trips to area malls or out to local restaurants? Does staff go along to assist residents who need extra help? The evening meal is often an important part of the day for assisted living residents. Observe a meal. Do residents seem to be socializing and enjoying the dinner?

6) Find out about health-related activities.

Some residents have dietary needs that require special meal plans. Find out the facility will accommodate those needs. Are there exercise programs that are geared towards a resident’s specific needs? Are their opportunities to exercise their mind and what programs do the facility provide for mental stimulation.

7) Assessing the facility’s environment

In light of the need for support, is the location convenient for family and friends to visit? Is the facility located in a safe neighborhood? Is there a nearby hospital? Is there a physician that makes rounds onsite? If not, how far away is to a physician’s office? Does the facility seem clean and well-maintained? Is the facility handicap-accessible? Are there features like handrails in the hallways and elevators if the community has more than one floor? Are there handrails in the bathrooms? Is there a walk-in shower? Is there room for a wheelchair? How far is the walk from suites to the common areas such as the dining room, kitchen and activities areas? Is there a 24-hour emergency response system? Ask to see it and be sure it is accessible in the bathroom as well as the main living and bedroom areas of the apartment. Are there smoke alarms and sprinklers in the suites and throughout the community? Are residents allowed to decorate their suites as they like including hanging pictures on walls?

8) Assessing the facility’s programs

Some residents seek out daily devotions. Is there a room allotted for church or daily devotion? Are events and activities planned for evenings and weekends too? Are there intergenerational events planned with local schools, scout troops, and youth organizations? Are there additional fees to participate in daily programs? Are there planned outings to weekly community events? Is the transportation that takes residents on outings handicapped accessible?

9) Assessing the facility’s dining

Take the time to check out the weekly menu and find out if all three meals are included in the monthly fee? Are beverages and healthy snacks available all day long? Does a dietician help in menu planning? Does the dining room and kitchen look and smell clean? Are tables and chairs clean and in good repair? Can the community accommodate special dietary needs? Is the dining room easily accessible to those with wheelchairs? Are there staff members available to help escort residents to the dining room at meal time? Observe a meal and note if there is additional staff to help accommodate the increased physical needs assisted living residents sometimes require.

10) Assessing the facility’s residents

Perhaps, the best way to find out the intimate details of a facility is to talk to residents and their families. Introduce yourself to family members you see arriving and departing as you tour. Ask them how long their loved one has lived there? What do they like and dislike about the community? Introduce yourself to residents you pass on the tour. Ask them how long they’ve lived there and how they like it. Ask current residents what they like and don’t like about the community. Pay attention to the appearance of current residents. Do they seem cared for and well-groomed?

Related Nursing Homes Abuse Articles

Breakdown In Care At Assisted Living Facility Proves More Deadly Than Patient's Dementia

Can Legislators Keep Up With Alternative Senior Living Arrangements?

Are Tougher Rules Called For At Assisted Living Facilities?

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

Admissions To Emeritus Assisted Living Facility Suspended After State Finds Problems With Patient Care

For the second time this year, Massachusetts officials have suspended new admissions to an assisted living facility after they discovered problems that could jeopardize patient safety.  Last week, the state's Executive Office of Elder Affairs banned Emeritus at Farm Pond from admitting new patients after multiple deficiencies were discovered during an inspection of the facility.

According to the senior executive director at the facility, Brian Beausoleil,  the concerns centered around: the timing of resident care assessments, management of medication inventory, evaluation of response time to emergency calls and evacuation planning. 

The terms of the suspension require Emeritus to submit a corrective plan as to how the facility will address the violations.

Accord to Mr. Beausoleil, this is an "isolated situation".  But no need to worry about this situation...

We look forward to receiving a clean survey report in a few weeks so that we may return to business as usual.

Business as usual?

Situations such as this make me question the safety of patients at this facility--- now and in the future.  Surely, a written plan of correction can be prepared and submitted to officials in short order, but doesn't it take some time to train staff?  

Am I the only one who views Mr. Beausoleil's comments as a bit dismissive of the underlying safety issues?  Here we have a leader at the facility seemingly more concerned about resuming 'business as usual' when there are apparent problems that threaten his residents.  With leadership such as this, I fear that this corrective plan is nothing more than window dressing on an underlying problem.  

Related:

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

Wrongful Death Lawsuit Alleges That An Emertus Assisted Living Facilities Gross Neglect Of Dementia Patient Results In Death

Maybe The Negative News Headlines Are Beginning To Get Inspections Of Long-Term Care Facilities Ramped Up

State suspends certification of Framingham assisted living facility, The MetroWest Daily News by Scott O'Connell August 9, 2011

Breakdown In Care At Assisted Living Facility Proves More Deadly Than Patient's Dementia

For three years, the family of 85-year-old Aurora Navas ( a dementia patient) unsuccessfully sought information about her drowning death at an assisted living facility in Florida.  Even after pleading with regulatory agencies for an investigation into why their mother drowned, their pleas for the details surrounding their mother's death fell on deaf ears.

Then, in the wake widely publicized investigative report from The Miami Herald concerning the lack of investigations into injuries and deaths at assisted living facilities throughout the state, an investigation into the suspicious death was initiated.

The investigation recently completed by the Department of Children & Families cites many errors made by the adult care facility that collectively contributed to Ms. Nava's drowning death in a pond adjacent to the facility.   Despite claims from the facility that all elopement precautions were in place at the time of Ms. Navas' death, state investigators uncovered the following:

  • Broken surveillance cameras
  • Sleeping staff
  • Out of order door alarms
  • Unlocked gate leading to a pond

While I'm sure this family is saddened by the blatant safety lapses discovered by state investigators, I hope that the findings bring some closure to this tragedy.  If anything positive can come of this tragedy, I hope that these findings reinforce the need for timely investigations on the part of regulatory authorities.  How many other untold tragedies were perpetuated upon innocent people at this ALF during the three years following Ms. Navas' death?

Related:

Family Sues Florida Nursing Home For Death Of Wandering Resident

Assisted-living facility blamed in woman’s drowning death, Miami Herald, July 16, 2011

Abuse & Cover-Up At Assisted Living Facility Caring For the Disabled

Abuse & Cover-Up At Assisted Living Facility Caring For the Disabled

Two caregivers responsible for caring for a mentally and physically disabled man face criminal charges following an intensive police investigation that points the finger at them for his death at Richmond State Supported Living Center in Fort Bend County (Texas).  An autopsy of the disabled man, revealed that he died from blunt force trauma to his abdomen.

Prosecutors believe that the caregiver responsible for providing non-medical care to the man struck him in the stomach in the early morning hours of October 8th of last year. A nurse who was scheduled to make regular checks on the disabled man-- and reported to officials that she apparently had done so-- later confessed that bed checks never took place.

The non-medical caregiver has been charged with intentional injury to a child/elderly/disabled person and can face 5 to 99 years if convicted.  The nurse is charged with injury to a child/elderly/disabled person with criminal negligence and may face jail time of up to two years.

Related:

Caregivers Must Exercise Patience When It Comes To Caring For Alzheimer's Patients

Group Homes Plagued By Patterns Of Abuse & Lack Of Employee Accountability

Nursing Home Cover-Up: NY Aides Lied About Doing Their Jobs

Nurse Charged With Rape Of Disabled Patient

More Regulations In Store For Assisted Living Facilities In Georgia

New regulations passed by the Georgia General Assembly may help clarify the services that assisted living facilities in Georgia can provide to their residents.  Recognizing an ambiguity in the laws applicable to assisted living facilities, Georgia legislators drew upon similar regulations from Maryland, North Carolina and Oregon to create a more clear cut list of services that assisted living facilities within the state can and cannot provide.  

Among the new rules for assisted living facilities in Georgia:

  • Certified medication aides will be allowed to help residents with their prescriptions
  • More non-ambulatory will be permitted to remain at assisted living facilities as opposed to being transferred automatically to nursing homes
  • Private-pay assisted living facilities will face different regulations than their publicly funded counterparts

As the distinctions between assisted living facilities, group homes and nursing homes get clarified, facilities will be given an opportunity to phase in the new regulations over an extended period of time.  Most of the new assisted living regulations will be put into full effect next year.

As alternative care facilities take on a larger role in the care of our seniors, I am glad to see the new regulations proposed.  If nothing else, hopefully the new regulations will help families learn the specific types of care each facility can provide in a clear-cut manner.

Read more about the new regulations applicable to assisted living facilities in Georgia here.

Can Legislators Keep Up With Alternative Senior Living Arrangements

IowaFor some senior living operators, it seems like the regulatory laws that apply to their facilities are simply too burdensome.   After all, operators of nursing homes and assisted living facilities are subject to laws that are designed to protect their predominately elderly residents from harm.  It goes without saying that complying with some of these laws can be difficult.

Acknowledging these difficulties, some assisted living operators have elected to evade some of the laws by morphing their facilities into something new and different--- and not subject to the regulations applicable to them.

One of the largest operators of assisted living facilities, Assisted Living Concepts, has grabbed news headlines when they announced that they were going to reorganize some of the assisted living facilities that they operate in Iowa and begin to operate them as 'senior housing communities' where they simply own the building, but utilize the services of a different company to provide health care services to the residents.

On the surface, the change in operating procedure may seem like little more than a corporate shakeup, but a closer look quickly reveals the real intention behind the change is to evade the pesky regulation applicable to the the operation of an assisted living facility. 

Turns out, despite its massive operation, Assisted Living Concepts wasn't so good at safely operating their facilities.  At its Dubuque facility, Iowa officials found numerous problems including:

  • Poorly formed care plans
  • Unreported resident injuries
  • Medication errors
  • Staff that were inadequately trained to care for patients
  • Neglect

All told, the (former) assisted living facility was fined more than $65,000 for its violations. 

Recognizing this legal loophole, the Iowa legislature has drafted legislation that attempts to hold facilities-- regardless of their title-- responsible for their care of their residents.  

As we begin to see the proliferation of alternative type senior housing arrangments, it is crucial that legislatures take a proactive approach to the regulation of the facilitiles that operate under misleading titles.  Let's see if other states have the foresight to identify this developing issue in the senior care industry.

Related:

Who Needs To Abide By Regulations? All Troubled Assisted Living Facilities Need To Do Is Re-Organize In Order To Avoid Compliance With Safety Laws

Dubuque facility headed to court over fines, Des Moines Register by Clark Kaufman, June 11, 2011

Another Iowa Assisted Living Facility Chooses To Abandon Its License

Pesky Government Regulations No Problem For Assisted Living Facility In Iowa

Another Assisted Living Patients Wanders From Facility To His Death

Free Web Directory - Add Your Link
The Little Web Directory

Dallas Sherwood StevensIt's a pretty thin line many assisted living facilities must walk between giving their patients freedom to go as they wish and protecting them from--- well,... themselves.  

Today, I'm noticing that there are many assisted living facilities that simply view monitoring their patients as an afterthought and many residents who likely require supervision aren't getting as much as they require for their optimal functioning.

Sure making a determination as to: how, if, or when an assisted living resident can leave the facility is not easy. Yet, there may be no more important decision when it comes to the safety of assisted living patients. Certainly, as residents needs change, the staff needs to reconsider the safeguards it has in place for the patient as well.

I began thinking of this balance between giving patients freedom and ensuring their safety when I read about a man who wandered from a North Carolina Assisted Living Facility to his death.  Just one day after Dallas Sherwood 'Sweet' Stevens walked from Aversboro Assisted Living Center, he was found dead in a small pasture. 

Reports of his death indicate that 62-year-old Stevens had a cognitive impairment  and required medication.  Yet the Aversboro facility allowed the man to stay at their facility which was known to have an 'open door' policy, referring to the ability of residents to come and go as they wish.

Certainly, no one wants to unnecessarily restrain a person against their wishes, but it seems like the facility is certainly in a better position to assess the needs of a patient than any one else. 

And one more thought...

Civil liability issues aside, when it comes to situations where a patient wanders from a nursing home or assisted living facility, I strongly feel that the facility should bear the costs associated by law enforcement when they conduct extensive searches for missing patients.

In the case of the search for Mr. Stevens, a Silver Alert was issued and more than 50 law enforcement officers and police equipment were diverted in the search for Mr. Stevens.

Related Nursing Homes Abuse Blog Entries:

Nursing Home Patient Dies When Struck By Car In Busy Street. What Was He Doing There?

Lack Of Door Alarms Allows Assisted Living Patient To Wander To Her Death

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

Woman Dies From Hypothermia After Wandering From Assisted Living Facility

In Rare Move, State Moves To Close Assisted Living Facility Following Discovery Of Abuse & Neglect

Texas, like many states, is usually somewhat hesitant to close down assisted living facilities.  After all, the closures impose a level of stress on residents whom must find an alternative living arrangement. Similarly, the closures are generally accompanied by a good deal of criticism from the owners of the facility itself. 

However, sometimes enough is just enough at dangerous facilities simply cannot be given further opportunities to improve without further jeopardy to the people who live there.  For just the fifth time in the last five years, the Texas Department of Aging and Disability Services found such horrendous living conditions they were forced to order a Corpus Christi assisted living facility to close.

On April 15th, Texas officials ordered Affordable Quality Care Assisted Living Facility to close following confirmation of residents who were repeatedly abused and neglected.  Citing information gathered from facility employees and general observation by state investigators, the state's report chronicled horrendous care such as:

  • Patients forced to wear soiled diapers around their necks
  • Patients left unattended on toilets for hours on end
  • Incontinence pads pinned to clothes
  • Staff roughly handling patients in wheelchairs
  • Patients with unknown and undocumented injuries
  • Unlabeled medications

As a lawyer who litigates matters involving the negligence of assisted living facilities, I hope more states begin to flex their regulatory muscle when it comes to the regulation dangerous assisted living facilities, group homes and residential care facilities for the elderly.  Certainly, the transition to other facilities may not be easy for the patients, but when dangerous conditions abound, enough is enough.

Related:

Unlicensed Chicagoland Retirement Home To Shut Its Doors

When It Comes To Governmental Oversight, Assisted Living Residents Are On Their Own

Hypothermia Confirmed As Cause Of Death In Nursing Home Wandering Case

Nursing Home Injury Laws: Texas

State says abuse found at assisted living facility, AP Texas News,, May 6, 2011

Unsanitary Working Conditions Results In Substantial Fine Against Assisted Living Facility

OSHA, the governmental agency responsible for ensuring safe working conditions, has imposed a substantial fine against a Chicagoland assisted living facility due to health and safety concerns.  The Chicago Sun Times reported that Paradise Park faces 17 safety violations and $72,000 in fines that center around the way the facility handled a 2010 incident in which a nurse practitioner was stuck with a dirty needle after tending to a resident.

OSHA was critical of the way the facility both handled the way it disposes of medical supplies and how it reacted to the incident.  Amongst the safety violations, Paradise Park was found guilty of:

  • Failing to immediately test the blood of an individual involved in a needle stick incident
  • Failing to ensure that the results of blood tests were communicated to the nurse practitioner involved in the incident
  • Failing to provide a hepatitis B vaccine to the employee within 10 days of her exposure
  • Inadequately training employees about safety in the workplace

Given the opportunity of these dangerous conditions to cause serious harm to employees, I am certainly glad that OSHA got involved.  However, while employee safety is indeed important, what about the safety of the residents at this facility.  How many of them were potentially exposed to contaminated needles as a result of this sloppy care?

Related:

Dirty Needles May Be Cause Of Hepatitis B Outbreak In Nursing Home

Are Tougher Rules Called For At Assisted Living Facilities?

An Inspirational Tale: Daughter Doesn't Let Chicagoland Assisted Living Facility Push Her Around

Are Tougher Rules Called For At Assisted Living Facilities?

Perhaps some of the most some of the biggest drawbacks with assisted living facilities—and other alternative senior housing arrangements came to light recently when six people at a North Carolina assisted living facility died from hepatitis after staff used dirty syringes to administer drugs such as insulin.

Officials from the North Carolina Department of Health have confirmed that unsafe diabetes care practiced by staff at Glen Care of Mount Olive was to blame the patients deaths.  It was estimated that needles used to test patients’ blood sugar levels were reused by staff at the facility, which resulted in the hepatitis outbreak.  Further, none of the staff involved in the incidents had taken any training course related to infection control.  Nor, were there any regulations requiring them to do so.

Unlike nursing homes, where laws generally specify who may administer drugs, at assisted living facilities and other types of non-traditional senior living arrangements, few laws address how drugs are to be administered to patients.

In fact, assisted living facilities (and other types of residential care facilities for the elderly) are not permitted to render any type of medical care.  Rather, when and if a patient requires medical attention it is the duty of the facility to either relocate the individual or seek outside medical care.

As evidenced by the situation in North Carolina, some assisted living facilities are squirming around regulations restricting medical care, by asserting that the administration of medications to patients is not ‘medical care’.  Because assisted living facilities aren't medical facilities and thus cannot employ nurses or other formally trained medical staff, some facilities have implemented the use of medication aides.

After obvious lapses in basis sanitation, North Carolina legislators are now introducing legislation that would impose stricter training and higher performance standards for medication aids and others who provide medication to people in assisted living facilities.  The bill introduced by Representative Jennifer Weiss would impose requirements such as: 

  • Competency requirements for adult care medication aides
  • Specialized infection control guidelines
  • Authorize state human services inspectors to review assisted living facilities on an annual basis or needed to insure the requirements are met
  • All new employees of assisted living facilities would be required to take an infection control class beginning in 2013

The Growth of Assisted Living Faculties Needs to Be Accompanied By Regulation

As the cost of long-term care continues to climb, assisted living facilities, group homes and residential care facilities for the elderly have become increasingly popular as less costly alternatives to nursing homes.  While many of these facilities do provide emotional support and assistance with daily living needs, other facilities need to be reminded of their limits with respect to providing medical care for people.

As we see by the situation at this North Carolina assisted living facility, even relatively basic medical care does require specialized training of staff.  Hopefully, the new legislation will take hold to protect these particularly vulnerable people and will draw attention importance of intensified regulation of these living arrangements.

Related:

Dirty Needles May Be Cause Of Hepatitis B Outbreak In Nursing Home

Investigation Determines Serious Safety Violations At Sunrise Assisted Living Facilities That Threaten Patient Safety

Are Group Homes A Viable Alternative To Nursing Homes?

Are seniors in residential care facilities and other alternative living arrangements at risk for developing bedsores?

Jury Blames Assisted Living Facility For Fall-Related Death Of 99-Year-Old Woman

Perhaps one of the more frustrating aspects of my job is attempting to convey the value of a senior’s life to a defense lawyer, insurance carrier or jurors.  Particularly, when evaluating the value of a nursing home or assisted living case, I find that people generally have a difficult time appreciating the significance of life’s later years.

Sure we can look at seniors and say, “Hey, he’s just an old geezer, maybe he had a another couple of decent years in him?  What’s the big deal if he died today or tomorrow?”

Alternatively, I suggest the value of our later days, months, and years really have more significance and value as many seniors gain a new perspective on life only when seeing the inevitable coming their way.

A Florida jury obviously acknowledged life’s significance when they blamed an assisted living facility for the untimely death of a 99-year-old resident at the facility—yes, that's correct 99! 

The Miami Herald reported that the family of Francis Tremblay was awarded more than $2.3 million in a wrongful death lawsuit against the facility.  In particular the lawsuit centered on the fact that Living Legends Retirement Center (Florida) failed to protect Ms. Tremblay for repeated falls. 

In all, Ms. Tremblay fell almost one dozen times at the facility prior to a fall-related incident, which ultimately claimed her life after suffering from various fractures and cuts. 

While I imagine the defense lawyers for the assisted living facility cautioned the jurors about the fact that Ms. Tremblay far exceeded her life expectancy, the jurors must obviously have been angered by the fact that employees at the facility reportedly expressed their safety concerns regarding the repeated falls to the deaf ears of the facility administrators.

While the award cannot change the care that was provided to Mr. Tremblay, I hope that this award serves somewhat of a reminder that our seniors—even the very senior seniors deserve to be treated with dignity and respect.

Related Nursing Homes Abuse Blog Entries:

Florida Nursing Home Accused Of Abuse

Family Sues Florida Nursing Home For Death Of Wandering Resident

Inspection Report Confirms Unsanitary Living Conditions In Florida Nursing Home

Nursing Home Injury Laws: Florida

Rosenfeld Injury Lawyers: Nursing Home Injuries

Wrongful Death Lawsuit Claims That Assisted Living Facility Failed To Care For Vulnerable Patient

The family of a resident at a Wisconsin assisted living facility has filed a lawsuit against the facility and it parent company, Assisted Living Concepts LTD, in relation to the events leading up to her death in 2010.  In particular, the lawsuit claims that Marilyn Brown was admitted to Cedar Gardens in July, 2008 for assistance with her dementia and repeated urinary tract infections.

Over the course of her stay at the assisted living facility, the staff gradually provided less and less assistance for Ms. Brown's daily living needs.  In addition to lack of daily care, the lawsuit further claims that the staff at the facility failed to properly supervise Ms. Brown which resulted in multiple falls.  It was a fall in December, 2009 that resulted in fractures to her hip and shoulder that lead to Ms. Brown's death shortly thereafter.

Despite Assisted Living Concepts ongoing profitability as a chain of assisted living operators (having more than 34% increases in quarterly profits compared with last year), the lawsuit alleges that the company fails to pass along adequate funds for the facility to hire and train sufficient staff to ensure the safety of its residents.

As a lawyer who commonly represents the elderly in lawsuits against assisted living facilities and nursing homes, I frequently attribute the poor care to the facilities parent company that frequently makes a conscious decision to cutting staffing levels to a bare-boned levels.  I frequently see facilities hiring the least qualified staff and continually paying them far lower wages than they would make in other settings.

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

Related:

Assisted Living Fall Leads To Wrongful Death Lawsuit

Hours After Admission To Illinois Nursing Home For 'Respite Care', Resident Fractures Hip

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

Class Action Lawsuit Against Skilled Healthcare Seeks Damages For Chronic Understaffing Of Nursing Homes

Nurse & Assisted Living Facility Operator Charged With Abusing Patients At AZ Assisted Living Facility

Despite a barrage of emergency calls to the Phoenix Police Department regarding suspicious injuries and wandering patients at several assisted living facilities in the Phoenix area, no action was taken by the Department of Health Services to investigate into the real source of these problems.

Melissa PachecoThat it is, until recent investigations at the facilities that revealed conditions that were so pathetic, that that assisted living facilities were shut down and the operator of the facilities was arrested.  

Melissa Pacheco was recently arrested and charged with 69 counts of abusing vulnerable adults who were living at three assisted living facilities she owned.

In addition to physically disgusting problems discovered at the facilities such as: broken plumbing, urine and feces on the floors, along with bug infestations.  In addition to the horrid living conditions, investigators found more disturbing conditions on the patients living in Pacheco's facilities.

Many of the physically disabled and mentally challenged patients were found to have:

  • Open wounds
  • Dehydration
  • Untreated medical complications
  • Untreated fractures

Sadly, despite the deplorable living conditions and patients with suffering from obvious neglect, employees at the facility never stepped forward as they feared they would lose their job if they reported the conditions to authorities.

While I certainly can appreciate the fear of losing a job in this rough economy, I find the failure of the staff at these facilities to report the dangerous conditions and visibly injured patients to authorities inexcusable.  As caregivers who deliberately ignored these conditions, I hope the Attorney General prosecutes these people to the fullest extent for not ensuring the safety of their patients.

Related:

Nurse Charged With Sexually Abusing Two Nursing Home Residents

Caregivers Charged With Abusing Elderly In New York Nursing Homes

Nurse Charged With Abuse & Neglect After Abandoning Residents At Assisted Living Facility

Nightmare Nurse Arrested on 69 Counts of Abusing Vulnerable Adults, by James King Phoenix New Times February 10, 2011

Nursing Home Injury Laws: Arizona

An Inspirational Tale: Daughter Doesn't Let Chicagoland Assisted Living Facility Push Her Around

horzin bayThere’s an inspirational story in the Chicago Tribune for families who have loved ones in nursing homes and assisted living facilities and feel as though the facilities are taking advantage of a captive audience—particularly in a financial sense.

The article chronicles the troubles encountered by Laura Merens, who’s 89-year-old father died shortly after arrangements had been made for him to live at an assisted living facility in the Northern Suburbs of Chicago.  Sadly, Ms. Merens’ father was never able to enjoy the $6,876 for  ‘arrangements’ his daughter had arranged for him at The Park of Golf Mill in Niles, IL. 

However, like many nursing homes and assisted living facilities, The Park required extensive pre-payment for services such as: food, apartment, and recreational activities. 

Never having utilized any of the benefits--- over ever stepping foot in the facility for that matter-- Ms. Meren’s requested a refund of the pre-paid services from The Park’s parent company, Horizon Bay Retirement Living.  Despite several requests for re-payment of expenses, the facility was unwilling to refund any of the expenses--- that is until Ms. Meren’s got the Problem Partners involved.

Shockingly, once the publicity that accompanies a large newspaper columnist’s request for a refund came along, a refund check was issued to Ms. Meren for a substantial portion of her payments. 

Surely, as consumers, people at nursing homes and assisted living facilities deserve to get their monies worth.  Hopefully, this story will serve as an inspiration for others to keep pursuing facilities that fail to act in an ethical manner and take advantage of a captive audience.

Related:

Daughter battles assisted-living facility after father dies, by Jon Yates Chicago Tribune February 6, 2011

Lawsuit Ensues After Housekeeper Brutally Attacks Assisted Living Patient

Is it too much to ask for a safe place for our loved ones to live?  Sure expansive bathrooms and gourmet food are nice, but at the very least, shouldn't we be able to expect a safe environment free from violence?

Yet as an assisted living lawyer, I continually see elderly people in nursing homes and assisted living facilities becoming victims of violent attack both at the hands of fellow residents as well as rogue staff.  In many cases, the violent acts are particularly disturbing because some of the offenders have absolutely no business even walking in the vicinity of the facility due to prior bad acts.

A recent violent episode at a North Carolina assisted living facility made headlines after the victim of a violent attack filed a lawsuit against the facility.  The victim of the attack and person initiating the lawsuit is suing Galloway Ridge Retirement Community claiming the facilty should have done a better job screening their staff.

Specifically, the lawsuit alleges that facilities failure to do an accurate background check of a housekeeper prior to hiring her would have avoiding the incident altogether.  In 2007 incident the resident was allegedly attacked by the Galloway Ridge housekeeper after she confronted the woman about allegedly stealing money from her account.  The attack left the resident with a fractured skull and a traumatic brain injury.

Related:

Another Sexual Assault Of A Nursing Home Patient At The Hands Of A Convicted Felon

Do Former Inmates Deserve To Be Living In Nursing Homes?

Patient Beaten To Death At Nursing Home With Long History Of Safety Violations. Should This Facility Really Be Considered A Skilled Nursing Facility Or Simply A Haven for Thugs?

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

Woman sues Chatham County assisted living facility after beating

Nursing Home Injury Laws:North Carolina

Judge Denies Assisted Living Facilities Request For Arbitration In Wrongful Death Lawsuit

Like all families placing a loved one in a nursing home, Erik and Ronald Kuentzel wanted the best for their mother after selecting Sunshine Villa Assisted Living Facility (Santa Cruz, California) for their mother's residence. 

With a known desire to walk, combined with the fact their their mother had dementia, the brothers knew of the importance of keeping close tabs on their mothers whereabouts.  In fact, the brothers purchased a device, known as a WanderGuard, from Sunshine Villa to help the facility keep tabs on their mother's whereabouts.  

Just hours after her admission to the facility, the elderly woman wandered from the facility.  She was found dead, three days later due to hypothermia.

After initiated a wrongful death lawsuit against the facility for their outstandingly neglectful care, the assisted living facility filed a request to have the matter resolved via binding arbitration.  

Recently, Santa Cruz Superior Court Judge Timothy Volkmann denied the assisted living facilities request, holding that due to the fact that the admission contract between the patients family and the facility did not require binding arbitration as claimed by lawyers for the facility.

My condolences go out to this family and I wish them the best in their lawsuit against this facility. 

Related:

Dementia Patient Found In Freezer At Assisted Living Facility: An Isolated Event Or Real Cause For Concern?

State Steps In After Second Episode Involving Patient Elopement At Same Facility

Chicago Nursing Home Lawyer, Jonathan Rosenfeld, Interviewed Regarding Preventing Patients From Wandering

Sunshine Villa, Sued for wrongful death, thwarted in request for arbitration, The Mercury News February 8, 2011 by Jondi Gumez

Lack Of Door Alarms Allows Assisted Living Patient To Wander To Her Death

Another unnecessary death of an assisted living patient grabbed my attention in Greensboro, North Carolina.  News reports indicate 85-year-old Edith Purvis walked out the side-door at a Loyalton Assisted Living facility on December 24th.  She wasn't discovered missing until staff at the facility conducted a routine bed check.

Ms. Purvis wasn't located until several hours later when staff at the facility found her body close to the door she is believed to have exited from.  Despite efforts to resuscitate her, Ms. Purvis was pronounced dead upon arrival at Moses Cone Hospital.  Her death was primarily related to exposure to the freezing temperatures.

An investigation into the incident is underway by the North Carolina Department of Health and Human Service.  However, at this time, it is apparent that the facilities failure to equip exterior doors with a device known as a door alarm, allowed Ms. Purvis to exit the facility without the knowledge of the staff.  If the investigation by North Carolina Officials confirms the initial situation, it may face up to $20,000 in fines.

Wandering Cases

Wandering cases involving a death or severe injury to a patient at a nursing home or assisted living facility are a real tragedy simply because most cases could have been prevented with relatively basic safeguards.

When it comes to caring for people with dementia, many of which are able-bodied and active, facilities need to accurately asses if their facility is really capable of caring for them in the first place.  In order to provide a safe atmosphere for dementia and Alzheimer patients facilities need to have:

  • Door / Window alarms
  • Keep dangerous materials safe guarded
  • Have a system to track patients whereabouts
  • Train staff regarding how to re-direct patients

Related:

Swallowing Foreign Objects Is No Laughing Matter For Dementia Patients In Nursing Homes

$821,000 Awarded To Family Of Deceased Assisted Living Patient Who Wandered From Facility

State Steps In After Second Episode Involving Patient Elopement At Same Facility

Officials investigate death at assisted-living community, by J. Brian Ewing, News-Record, January 8, 2011

Do You Want An Assisted Living Facility Opening In Your Neighborhood?

The above is a question essentially posed to residents of a Gurnee, IL subdivision where Theresa Bicok wishes to operate a home-based assisted living facility out of her 6,000-square-foot home for up to 24 residents.

For the past several years, Ms. Bicok has operated an unlicensed assisted living facility out of her suburban Chicago-land home without much fanfare.  The village wasn't notified of the unlicensed facilities existence until paramedics were called to the home following the death of one of Ms. Bicok's residents.

In order for the home-based assisted living facility to continue to operate, the village board must grant Bicok a zoning variance that Mayor Kristina Kovarik is hesitant to do,

But [with 24 residents] you've literally taken a mini-sunrise assisted living and plopped it into a residential neighborhood

While I certainly appreciate the need for more alternative living arrangements for the elderly, I strongly support regulation of the facilities by state and local governments.  Too often we see residents becoming injured or grossly neglected at facilities out of the government's control.  In this circumstance, it is important for the board to evaluate the impact of this facility not just on the neighborhood itself, but also the safety of the people who may be living there.

Related:

Who Needs To Abide By Regulations? All Troubled Assisted Living Facilities Need To Do Is Re-Organize In Order To Avoid Compliance With Safety Laws

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

Another Iowa Assisted Living Facility Chooses To Abandon Its License

Board agrees to postpone vote on unlicensed assisted living home in Gurnee subdivision Trib Local, by Megan Craig 

Who Needs To Abide By Regulations? All Troubled Assisted Living Facilities Need To Do Is Re-Organize In Order To Avoid Compliance With Safety Laws

As we’ve discussed on several occasions, there has been a noticeable trend by senior care facilities to re-organize themselves into different entities in order to avoid regulations applicable to the particular facility.

For example, nursing homes are subject to an extensive list of federal and state regulations regarding the type and method of care provided to patients.  Assisted living facilities on the other hand are primarily controlled by each state.  Other types of care facilities such as group homes and independent living facilities remain fairly unregulated for the most part.

While the regulations help ensure safety of patients, they can make it more difficult for facilities to operate—particularly if they are not following the rules.

Out of Iowa, a prime example of an assisted living facility making the transition to an unregulated group home made headlines after an administrative judge ordered the facility to pay more than $75,000 in fines related to poor care.

On nine occasions in eight months, inspectors found repeated violations at Dubuque Retirement Community.  Each visit found problems related to:

  • Inadequate care plans
  • Unreported resident injuries
  • Inadequately trained staff
  • Medication errors

In addition to appealing the fines, the facilities owner, Assisted Living Concepts, asserted that many of the alleged medication errors were not really errors at all.  Rather, Assisted Living Concepts claimed that the medications were accurately administered, but were never charted.

In addition to ordering the assisted living behemoth to pay the fines imposed, Judge John Priester rejected the arguments regarding patient charting.  “Documentation errors are the same as medication errors,” Priester added.

Still unsatisfied the judges ruling, the assisted living operator did what it is entitled to do under the law, and abandoned the assisted living licenses altogether--- and thereby avoid the scrutiny of inspectors and administrative judges alike.

Now Assisted Living Concepts will operate Dubuque Retirement Community and the four other assisted living facilities it operates in Iowa: Allen House in Atlantic, Swan House in Carroll, Amelia House in Council Bluffs and Floyd House in Sergeant Bluff as unregulated boarding houses.

This re-categorization is completely legal. Legislation to restrict the re-categorization of assisted living facililities into group homes / boarding houses was abandoned earlier this year.

My take:

The re-categorization of nursing homes and assisted living facilities into other entities is certainly a loophole that needs to be carefully evaluated by legislators as many of these facilities continue to provide services to vulnerable groups under the guise of a different entity.  Certainly as we need to re-examine the applicable rules and regulations that apply to all elders to ensure their safety is not compromised by corporations seeks to avoid compliance.

Related:

Judge rules Dubuque care facility must pay $75,500 by Clark Kaufman Des Moines Register November 21, 2010

Another Iowa Assisted Living Facility Chooses To Abandon Its License

Pesky Government Regulations No Problem For Assisted Living Facility In Iowa

Iowa Nursing Home Cited For Inadequate Care Of Pressure Sores

Brookdale Assisted Living Facility Fails To Learn From Mistakes: Dementia Patient Dies After Ingesting Detergent

poisoning.jpgIn 2008 authorities from Florida regulatory agencies warned Homewood Residence, a Brookdale Senior Living facility, to secure areas of its kitchen and other areas of the facility that were accessible to residents with dementia.  

The warning came after dangerous products such as: coffee pots, curling irons and chemical products were found unsecured at the facility.

Two years later-- not much has changed at this Brookdale assisted living facility.

Authorities found similar problems during the investigation of the death of a 93-year-old resident at the facility. The elderly man was able to access the unsecured dishwasher and access the area where the detergent was stored and ingested it.  

Eighteen hours later the man died from complications related to the chemical burns in his esophagus.

As a result of this incident, Brookdale has agreed to pay a $7,500 fine and re-implement guidelines regarding the storage of chemicals and cleaning products.  Last year, Homewood Residence paid  fines of $3,000 fine when 10 residents at the facility contracted norovirus and $1,500 following the development of bed sores on on resident.

Safety For Dementia Patients

Many dementia patients lack the ability to appreciate danger to themselves or the people in their surroundings.  Making matters even more difficult is the fact that many dementia patients remain physically strong even as their mental faculties decline.

Consequently, nursing homes and assisted living facilities need to secure their facility as though they were caring for a toddler.  All patient rooms and common areas should be evaluated on an ongoing basis to ensure that dangerous objects are removed.

Access to areas where patients need not access-- kitchens, utility areas and laundry rooms should be secured to prevent dementia patients from accessing powerful machinery.

Related:

Delray Beach assisted living facility fines in residents poisoning death, South Florida Sun-Sentinel, November 13, 2010 by Jon Burnstein

Assisted Living Facility Submits Corrective Plan After Dementia Patient Falls From Window

Even The Most Mundane Parts Of A Nursing Home Can Turn Deadly Without Proper Staff Supervision

Nursing Homes For Alzheimer's Patients. What To Look For?

Sunrise Targets Veterans Who Qualify For Government Benefits For Assisted Living

veterans.jpgFirst of all, a very respectful happy Veteran’s Day to all members of our armed service.  Certainly, the contributions and sacrifices made in defense of our country deserve the support and admiration from all citizens.

In the spirit of Veteran’s day, I though it would be appropriate to discuss a recent article I came across in the Chicago Tribune which highlights a marketing campaign by Sunrise Assisted Living focused at getting Veterans--- or perhaps more accurately funds from Veterans benefits—into their Chicagoland Assisted Living facilities.

According to the article, many vets and their spouses are entitled to benefits to help offset the expenses related to senior living.  Under the “Aid and Attendance” program seniors are entitled to up to $2,000 per month for assisted living expenses.

I’m sure out of the kindness of their hearts (and perhaps and desire to get access to the steady stream of government money) Sunrise has invited elderly Veterans to their Chicagoland facilities to receive a special gift for their services and to learn more about the program.

Sunrise is a major player in assisted living facilities in Chicago. Here are the Chicagoland Sunrise facilities:

  • Sunrise of Lincoln Park
  • Sunrise of Wilmette
  • Sunrise of Park Ridge
  • Sunrise at Fountain Square in Lombard
  • Sunrise of Willowbrook
  • Sunrise of Highland Park
  • Sunrise of Palos Park
  • Church Creek in Arlington Heights
  • Sunrise of Glen Ellyn
  • Sunrise of Bloomingdale
  • Sunrise of Schaumburg
  • Brighton Gardens of Wheaton
  • Sunrise of Buffalo Grove
  • Sunrise of Naperville
  • Sunrise of Flossmoor
  • Sunrise of Naperville North
  • Sunrise of Barrington
  • Brighton Gardens of St. Charles
  • Sunrise of Gurnee
  • Sunrise of Crystal Lake

Assisted Living Facilities

Assisted living facilities can be worthwhile living arrangement for seniors who require more assistance with daily living needs, yet may not require skilled nursing care provided at many nursing homes.  In addition to assistance with some chores and meals, assisted living facilities are also very attractive from a price perspective compared to facilities that provide medical care.

Related Nursing Homes Abuse Blog Entries:

Nursing Home Negligence Lawsuit Claims Sunrise Senior Living Failed To Supervise Resident During Field Trip

Investigation Determines Serious Safety Violations At Sunrise Assisted Living Facilities That Threaten Patient Safety

Sunrise Cited For Neglect After Assisted Living Facility Fails To Provide Timely Treatment For An Injured Resident

Hepatitis Blamed For The Death Of Four Residents At Assisted Living Facility

Screen shot 2010-10-20 at 8.37.38 PM.pngA Hepatitis B outbreak at Glen Care of Mount Olive (North Carolina), an assisted living facility, has claimed the lives of four elderly residents.  Another younger patient, still remains hospitalized for medical complications related to hepatitis B.

As officials from the department of health look into how these assisted living residents contracted this strain of hepatitis, they are asking officials at the facility to vaccinate other residents to prevent further hepatitis outbreaks.

Hepatitis B is far more contagious than other strains of hepatitis and can survive on surfaces longer than other viruses .  While fairly uncommon amongst patients in nursing homes and assisted living facilities, hepatitis can be particularly deadly for elderly people with compromised immune systems.

Symptoms of hepatitis include:

  • Fever
  • Extreme fatigue
  • Loss of appetite
  • Vomiting
  • Dark urine 
  • Yellowish skin

Hepatitis B is generally thought to be transmitted via sexual contact or dirty medical equipment.  Dirty conditions in medical facilities is believed to contribute to the more than 12,000 cases of Hepatitis B contracted on an annual basis by health care workers. 

Once infected with Hepatitis B, there are four FDA approved medications that can be used for treatment.  The approved medications include:

  • Alfa Interferon
  • Lamivudine
  • Adefovir dipivoxil
  • Baraclude

As officials from the North Carolina Department of Health continue to seek the source of this Hepatitis B outbreak at an assisted living facility, my guess is that the investigation will ultimate demonstrate that sanitation problems at the facility caused or certainly contributed to this outbreak.

Related:

State investigating hepatitis deaths at assisted living center WRAL.com, October 19, 2010

Hepatitis B, E Medicine Health

Hepatitis B, Treatment & Drugs, Mayo Clinic

Medical Facilities Can Reduce The Incidence Of Infection By Taking Some Basic Precautionary Steps

Wrongful Death Lawsuit Alleges That An Emertus Assisted Living Facilities Gross Neglect Of Dementia Patient Results In Death

window.jpgA wrongful death lawsuit has been filed against Ridgeland Assisted Living (Mississippi) and its parent company Emeritus Corporation following an incidnet at the facility when a dementia patient fell from a second story window.

The lawsuit, filed by the daughter of the deceased resident, claims that despite multiple assurances from the facility, they failed to supervise and provide necessary safguards to keep the 83-year-old safe.

According to the lawsuit (see PDF version below: Diane Phillips individually and on behalf of the wrongful death benefitiaries of Merle Fall v. Ridgeland Assisted Living LLC and Emeritus Corp.), Ms. Fall was admitteded to Ridgeland on February 25, 2010 with known problems related to Alzheimer's / dementia and a history of wandering from home.

Also at the time of admission, Ms. Phillips was assured by an employee of Ridgeland, Ashley Martin, that the facility was capable of safely caring for her mother and the facility would take the necessary steps to keep her mother safe.

Three days later, Ms. Phillips visited her mother to find her in a filthy condition with dirty clothes and was also informed by Ridgeland staff that her mother attemped to climb out of her second story room.  Again, Ridgeland assured Ms. Philips that it was capable of safely caring for her mother and they would take the necessary safeguards-- such as installation of window locks-- to keep her mother safe.

windowlock.jpgDepsite the assurances of safety, Merle Fall fell from a second story window on March 6, 2010-- just weeks after her previous attempt to get out of the window.  Ms. Fall sustained mutiple injuries including: a compound fracture of the left ankle and a subdural hematoma.  On March 9, 2010, Ms. Fall died from her injuries at a nearby hospital.

In addition to seeking compsatory damages of atleast $500,000, the Complaint also seeks punitive damages from each defendant for their reckless conduct in failing to take the necessary safeguards to protect an exceptionally vulnerable senior.

The Complaint is filed by my colleage attorney Philip Thomas.  Interestingly, at the time this lawsuit was filed, this Emeritus facility failed to provide Ms. Fall's medical records as they were obligated to do under Mississippi law when presented with a valid request.

Broken Promises

Too often facilities--- nursing homes and assisted living--- put their census numbers ahead of the patient's well-being.  As Philip does a nice job of articulatinging this lawsuit, he specifically names the Emeritus employee who assured the family that their loved one would be well cared for.

Time will tell, but if the allegations made in this complaint prove to be true, there certainly appears to be circumstnaces necessary to incite a jury to award substantial punitive damages due to both the facilities gross negligence and outward assurances.

Related:

Diane Phillips, individually and on behalf of the wrongful death benefitiaries of Merle Fall, deceased v. Ridgeland Assisted Living LLC and Emeritus Corp. (PDF)

Man Falls From Fourth Floor Window To His Death At Alden Nursing Home

Assisted Living Facility Submits Corrective Plan After Dementia Patient Falls From Window

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

Rather Than Improve Poorly Performing Nursing Homes, Why Not Just Re-Categorize Them?

As Assisted Living Facilities Add Skilled Nursing To Their Repertoire, Is This Really A Move To Improve Patient Care Or Simply An Attempt To Cover More Of The Market?

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

 

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

Many assisted living facilities and other nursing home alternative facilities have done very well financially--  playing into the stigma associated with nursing homes that many people hold.  While nursing homes may receive a fair amount of bad press, they provide essential medical services for millions of patients. 

The level of care offered at assisted living facilities simply is not intended to take the place of the skilled nursing care offered in nursing homes.

Unfortunately, I've seen too many assisted living facilities fail to accurately inform families about the limitations in care that they offer.  In most cases, it is up to the assisted living facility to inform families about the type of care they can provide and to do an assessment of each patient's realistic care needs.

I feel strongly that assisted living facilities have an implicit duty to advise families if they can not care for their loved ones.  By accepting and retaining a patient, the facility implies that they are capable of safely caring for the person.

Over the years, I've seen the line distinguishing patients who require skilled nursing care provided in a nursing home vs. non-skilled assistance provided at an assisted living facility get blurry-- very blurry especially with patients who are particularly reliant on facilities for most of their daily living needs.

Many dementia patients require extremely high levels of care, yet many assisted nursing facilities (alf's) insist that they are capable of caring for them. 

The ability of assisted living facilities to care for an dementia patient will likely get called into question after 90-year-old man (with dementia) wandered from a Sierra Oaks Assisted Living facility in Pennsylvania.  Ten days after the man wandered from the facility, police located the man's body.

Could this have happened in a nursing home?

Of course.  Unfortunately, nursing home patients wander from facilities fairly frequently.  However, nursing homes are more likely to have staff in place and specialized equipment than assisted living facilities.

Situations, such as the wandering incident above, really should force families to re-evaluate the best living arrangements for their loved ones.

Related Nursing Homes Abuse Blog Entries:

Woman Dies From Hypothermia After Wandering From Assisted Living Facility

Family Sues Florida Nursing Home For Death Of Wandering Resident

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

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

Assisted Living Facility Submits Corrective Plan After Dementia Patient Falls From Window

Forest Heights Senior Living Community has submitted a corrective plan to North Carolina officials after L'Wella Ervin, a 72-year-old dementia patient at the facility, fell to her death from a third floor window last year.  Ms. Ervin died from multiple fall-related injuries at Wake Forest Medical Center shortly after staff at the assisted living facility found her on the ground.

According to Jim Jones, a spokesman for the North Carolina Division of Health Service Regulation, the facility submitted a corrective plan after the officials investigated the incident and found multiple state and federal violations relating to patient care.

According to the assisted living facilities corrective plan:

  • Staff must check on all patients at least every two hours
  • Staff must know each patients specific care needs

In order to assure that the facility is correctly implementing is corrective care plan, regulators from the state will make unannounced visits to the facility.  Read more about this corrective care plan at a North Carolina Assisted Living Facility here.

Forest Heights Senior Living Community in Winston-Salem, North Carolina, is owned by Five Star Quality Care. Five Star is a healthcare and senior living services provider that operates independent and assisted living facilities, skilled nursing facilities, rehabilitation hospitals, institutional pharmacies and outpatient health rehabilitation clinics throughout 30 states.

Am I missing something?  Why doesn't this corrective care plan implement special screens on on the windows to prevent similar incidents from occurring?  Similarly, shouldn't this facility consider housing their dementia patients on the ground level of the building?

Related:

Nursing Home Fails To Intervene In Case Involving Dementia Patient With A Known Suicidal Propensity

Chicago Nursing Home Lawyer, Jonathan Rosenfeld, Interviewed Regarding Preventing Patients From Wandering

Man Falls From Fourth Floor Window To His Death At Alden Nursing Home

What Can Nursing Homes Learn From Jails?

Nursing Home Injury Laws

In times of need, locating necessary information regarding the legal rights and resources for nursing home patients can be difficult and imposing.  In this respect, we are proud to introduce a new resource for patients, families and practitioners looking for a concise compilation of information regarding nursing home laws.  Nursing Home Injury Laws, provides every states':

Additionally, we will be posting regular updates regarding important developments relevant to nursing home care within each state.  Here is a link to Nursing Home Injury Laws.

Investigation Determines Serious Safety Violations At Sunrise Assisted Living Facilities That Threaten Patient Safety

The Georgia Department of Human Resources has been busy investigating serious safety infractions at several Sunrise Senior Living facilities in the Atlanta, GA metro area.  According to an investigation initiated by CBS Atlanta News, problems abound at this national chain of assisted living facilities.

CBS Atlanta News began to scrutinize patient care at Sunrise facilities after a scabies outbreak at Sunrise in Dunwoody.  The television station's investigation further revealed:

Brighton Gardens of Dunwoody; Staff at Brighton Gardens were cited for failing to follow protocol for emergency situations after staff failed to implement CPR for an unresponsive patient who wished to be resuscitated.  State authorities imposed a $1,000 per day fine against the facility until changes were made.

Sunrise of Decatur: Georgia investigators fined the facility $601 after they determined the facility failed to provide protective care and watchful oversight of a patient.

Brighton Gardens of Vinings; The assisted living facility was fined $300 for failing to provide individual residents with protective care and watchful oversight.

Although many assisted living facilities provide similar care as their nursing home counterparts, in many states they still remain loosely regulated.  Hopefully, as more information regarding safety violations becomes public, there will be a demand for increased regulation and transparency. 

Related:

Nursing Home Negligence Lawsuit Claims Sunrise Senior Living Failed To Supervise Resident During Field Trip

Assisted Living Fall Leads To Wrongful Death Lawsuit 

Nursing Home Sued Following Death Of Resident In Fall

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

Family Claims Assisted Living Facilities Neglect Resulted In Death Of Mentally Disabled Woman

The family of a 51-year-old woman with cerebral palsy has brought a lawsuit against the assisted living facility where she was a patient.  The lawsuit alleges that Country Crossing Assisted Living Facility (Georgia) failed to properly care for the mentally disabled woman during the course of her four year stay and intentionally hid her physical condition from her family.

The wrongful death lawsuit alleges that the assisted living facilities neglect resulted in severe malnourishment and advanced pressure sores.   Quoting a nurse who used to work at the facility, the lawsuit further alleges that the facility failed to train new employees and keep records related to the patients medical treatment.

A Georgia jury will soon decide if the allegations of poor care are indeed true as the case is set to go to trial in the Walker County Courthouse.  Read more about this lawsuit against a Georgia assisted living facility here.

My take on this lawsuit:

As a personal injury lawyer who is involved in many cases involving claims against nursing homes and assisted living facilities, I imagine that this assisted living facility will claim that the woman's family failed to properly look after her.  While this claim may seem cold-hearted (and it is), jurors typically have a difficult time awarding money to an estranged family.  

Litigation issues aside, I strongly believe that patients receive superior care when their family actively participates in their care and visits on a regular basis.  Like it or not, staff notice a families presence and tend to provide more care to the patients with an active group of visitors.  

Related Nursing Homes Abuse Blog Entries:

Despite Their Avoidability, Bed Sores Continue To Plague Nursing Home & Hospital Patients In All Demographics

Grim Details Emerge Regarding Malnutrition In Kentucky Nursing Home

Wrongful Death

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

Families looking for facilities to care for their loved ones in North Carolina may begin having an easier time selecting an adequate adult day care, assisted living facility (ALF) or residential care facility for the elderly (RCFE) after the state implements a new rating system.  Similar to the well-publicized Medicare-rating system for nursing homes, North Carolina will rate assisted living centers and adult group homes on a four star system.

Unlike a current three-star system currently in place, the four-star system is intended to more accurately categorize facilities according to the quality of the care they provide.  Additionally, the newer rating system is intended to penalize facilities for providing inadequate care for stemming from problems such as medication errors and patient wandering.

Not surprisingly, some industry groups believe the new rating system may not provide a complete picture of each facility.  In this respect, I could not agree more.  No rating system-- no matter how well conceived-- can take the place of an in person visits (and preferably visits).  

Nonetheless, I certainly am a fan of any system that can help families with the difficult decision of what facility to select for a loved one.  As a lawyer who handles cases involving abuse and neglect in a group home setting, I wish other states would implement more intensive regulations of these facilities to protect our elderly population.

Read more about the new rating system for group homes here.

Related:

Are Group Homes A Viable Alternative To Nursing Homes?

Nursing Home Rating System Reveals Inferior Care Provided At For-Profit Facilities

What Is It Like To Live In A 1-Starred Nursing Home?

One year after the implementation of the Medicare nursing home rating system, where do we stand?

Golden Living Partners With Microsoft To Help Manage Patient Medical Records

Have you ever tried to read a nursing home patient's chart?  Were you able to read everything?  If so, please shoot me an email, because I surely have a difficult time sorting through many entries in charts.

A new collaboration between Golden Living and Microsoft may help to improve not just the legibility of medical records, but also aid in transmission of individuals medical records from one provider to another.  The system known as Microsoft Amalga Unified Intelligence System (UIS) stores each patients medical records on-line to allow ease of access by both the patient and subsequent health providers.

"The use of Microsoft Amalga allows the bridge of information between the various care settings and build a robust view of the patient across the enterprise no matter where they've been," said Brad Savage, a senior vice president and chief information officer for Golden Living.

Given the complexity of many nursing home patients' medical records, I'm all for any tool to help assist medical professionals with their treatment.  Especially, in situations involving critical care, where a patient may be unconscious or uncommunicative, this new technology may prove to be a literal life safer.

Read more about this new technology here.

About Golden Living:

Golden Living is a national company that provides medical care in a variety of settings.  In particular, Golden Living strives to serve people:

  • Recovering from Joint Replacement Surgery
  • Recovering from a Stroke
  • Progressive Dementia or Alzheimer's Disease
  • Assistance with Activities of Daily Living
  • Managing a Chronic Disease
  • Declining Health that Requires Long-Term Care
  • Managing a Terminal Illness

There are more than 300 Golden Living nursing homes and assisted living centers located in more than 20 states. 

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

After discovering multiple health and safety problems, Florida officials have suspended the admission of new residents to Emeritus at Crossing Pointe-- a Florida Assisted Living Facility.  

A September inspection of Emeritus revealed:

  • 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 documented findings above, come on the heels of a suspected Norovirus outbreak in August at the facility.  The outbreak originated in the facilities cafeteria and sickened 19 residents and two staff members.

In response to the recent findings, management of Emeritus at Crossing Pointe recently held a meeting for residents and their families.  According to acting executive director, Pam Campbell, the identified conditions by inspectors are "not what Emeritus stands for" and calls findings "very sad for us."

Rest assured, once the state lifts the suspension on new admissions, Ms. Campbell says her facility is prepared.  "We're ready for them any day."  

Great.  

I find it difficult to believe the Ms. Campbell-- or any manager in her position-- is capable of turning around such a troubled facility so quickly.  The reason the state's inspection report listed such extensive violations is because Emeritus allowed a culture of poor patient care to exist.  My guess is that until management decides to delve deeply into these problems and evaluate each employees role in this neglect, it is only a matter of time before more problems surface.

Emeritus Corporation

Emeritus Senior Living is part of the Emeritus Corporations, a publicly traded company based in Seattle.  Emeritus Senior Living operates more than 300 assisted living, Alzheimer's care, and retirement communities across the country.

Resources:

Report: Patient at South Orange County assisted-living facility died after she wasn't given her medicine, Orlando Sentinel, November 15, 2009

We're fixing problems, assisted-living manager tells residents, Orlando Sentinel, November 17, 2009

Assisted Living Employee Pleads Guilty To Manslaughter Charges After Resident Dies From Burn Injury

Alvador Thompson, a nurses aide who poured scalding oatmeal into the mouth of a disabled patient has pleaded guilty in response to the involuntary manslaughter charges filed against her by the Montgomery County District Attorney.  

This incident at an assisted living facility caught national attention not only due to the fact that an aide failed to check the temperature of the food she was serving to a disabled resident, but also due to the fact that despite the severe burns on the man's lips, tongue, mouth and throat, the facility waited almost half a day to get medical attention for the injured man.  Also, Cambridge Brightfield, the Pennsylvania assisted living facility, failed to notify state officials of the resident's injury.

The elderly man received hospital treatment for his injuries, but was discharged back to Cambridge Brightfield where he died two weeks later.

In several months, Ms. Thompson will return to court for her sentencing.  Pennsylvania categorizes involuntary manslaughter as a misdemeanor which carries a maximum penalty of 2 1/2 to 5 years in prison and a $10,000 fines.

Cambridge Brightfield's provisional license was revoked by the Department of Public Welfare after authorities learned of this burn injury and two other incidents where residents were found unresponsive and required hospitalization.

As far as I can tell, no fine or corrective changes were ordered by Pennsylvania officials.  The fact that no severe penalties were ordered leaves me wondering, what real incentive is there for assisted living facilities to clean up their act?   It is always easy to blame the individual involved in a particular incident, yet the reality is that the management and owners of this assisted living facility are the ones to blame as they typically fail to train many staff members to look out for situations such as this.  As long as our society gives a mere 'slap on the wrist' to facilities that allow this type of treatment to exist we can expect more unfortunate situations such as this to continue.

Read more about this tragedy at a Pennsylvania assisted living facility here.

Related Nursing Homes Abuse Blog Entries:

Can Assisted Living Facilities Adequately Care For Alzheimer's Patients?

Criminal Charges Filed Against Assisted Living Employee In Relation To Resident Suffering Burns While Eating

Man Chokes To Death While Left Unattended At Nursing Home

Another Iowa Assisted Living Facility Chooses To Abandon Its License

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

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

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

Read the details regarding this Iowa facility here.

Another Assisted Living Resident Beaten To Death By His Peer

 

Dispatcher: "Catawba County 911..."

Caller: "Yes... I need an ambulance at the Walden House. One of the residents beat one of the residents in the head. I need one right now ASAP!"

Caller: "We looked out and he was beating this one resident in the head. Blood is everywhere."

Dispatcher: "Okay, Ma'am."

Caller: "Oh my God!"

The above is the transcript from Catawba County 911 Center following the discovery of the graphic beating of 70-year-old Ronald Simmons by employees at an assisted living facility that were folding laundry nearby to where the crime occurred.  Simmons was a resident at Walden House Living Center in Hickory, NC.  Apparently Simmons was followed outside by 43-year-old Dennis Scherzer, where he repeatedly struck him in the head just feet from the entrance to the facility.

Authorities pronounced Simmons dead at the scene from an obvious head injury.  Scherzer was taken into custody and charged with murder.

The most obvious question is: where is the staff supervision in situations like this?  Regardless of the type of facility, nursing home or assisted living-- the facilities have a duty to look after their residents.  If they can not adequately provide adequate care-- and protection-- they should not accept care of the individual.  

Read more about this murder at a North Carolina assisted living center here.

Related Nursing Homes Abuse Blog Entries:

Update On Chicago Nursing Home Murder

Nursing Home Rapist In Custody

No Remorse From Admitted Elder Abuser

Three Employees At Assisted Living Facity Disciplined For Their Failure To Report Missing Nursing Home Resident

An investigation into the death of a 93-year-old man at a New York assisted living facility revealed that three employees at the facility acted improperly when they failed to document that the man was missing from his room.  Turns out-- the man had either jumped or fallen to his death from his second floor room.  The incident occurred on February 17th at Dosberg Manor, part of the the Weinberg Campus.  The man's dead body was discovered the following day on the ground outside his room.

An investigation into the death by the New York Health Department determined employees at the facility acted improperly in the hours following the man's death.  The following omissions were noted in the department's report:

  • At 9:40 that evening an employee was called into the man's room by his roommate to shut an open window.  Despite the fact that the employee noticed the man's glasses and a walker parked adjacent to the open window, the employee failed to look further into the man's whereabouts and lied to investigators about seeing the man in his room.
  • At 11:00 p.m. another employee at Dosberg failed to investigate the fact that the man was missing from his room, choosing to assume that man was in a hospital.
  • A third employee who made midnight rounds noticed that the man was missing-- yet failed to notify authorities.
  • Medical records indicate that staff helped the man take his medication at 6:30 a.m. on February 18th although by that time the man's dead body had been outside for over 11 hours.

As a result of the Department's findings, a new policy has been implemented by Dosberg Manor to ensure the whereabouts of all residents and the employees who were involved in the errors cited above will be disciplined.

Read more about the investigation of this missing nursing home resident here.

Nursing Homes Abuse Blog Posts On Missing Nursing Home Residents

Nursing Home Negligence Lawsuit Claims Sunrise Senior Living Failed To Supervise Resident During Field Trip

What Can Nursing Homes Learn From Jails?

Police Dog Finds Resident Who Went Missing From Chicago Nursing Home

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

A mentally and physically disabled woman walked out of an Maple Crest Manor, an assisted living facility in St. Louis, MO,  and unknown to the facility boarded a bus to Chicago, IL.  The woman left the assisted living facility for what the staff suspected would be 'a long walk'.  After several hours passed without sight of the woman, the facility contacted the woman's legal guardian who then alerted police.

Chicago police called local Missouri authorities after finding the woman's name on the national database for missing and endangered people.  The woman was brought by authorities safely back to the facility in St. Louis.  No charges were filed against the assisted living facility or the legal guardian.  

Authorities report the woman has the mental capacity of a 7-year-old.  This begs the question: Would you let your 7-year-old walk around unsupervised?  Clearly, this incident should have been prevented with the adoption of a more restrictive leave policy for residents.  

Read the full story regarding this incident involving elopement at an assisted living facility here.

Assisted Living Fall Leads To Wrongful Death Lawsuit

The family of an assisted living resident has filed a wrongful death lawsuit against the facility. 83-year-old, Luveda Fern Kessler, fell and cut her leg as she got out of bed at her Laguna Hills assisted living apartment. Ms Kessler did as she had been told to do: Press a personal emergency response call button, according to a recent lawsuit filed by her family.

The assisted living employee waited 24 minutes before calling 911.  During the 24 minutes Ms. Kessler lay bleeding and unassisted with any staff.  By the time the paramedics arrived, Ms. Kessler lay on her stomach, non-responsive. She was later pronounced dead at a local hospital.

Villa Valencia did not report the Aug. 23, 2007, incident to the state.  The incident led to a wrongful death lawsuit filed in Orange County Superior Court last month against Villa Valencia and its owner, Sunrise Senior Living Inc.  "They let my mom bleed to death,'' said Kessler's daughter, Joanne. "I thought that was the best place for her. … Her death was completely preventable."

Assisted living facilities are not intended to provide the same level of care as nursing homes.  Nonetheless, assisted living facilities are required to conduct assessments as to residents medical needs and provide assistance to residents who require it.  In this case, not only was there not a nurse to provide help, there was no staff to provide basic life saving assistance.  Read more about this incident involving assisted living under-staffing here.

Here is a transcript of 911 call regarding Kessler's injury, which was made at 1:57 a.m. Thursday Aug. 23, 2007.  The family should use this as evidence of the assisted living facilties neglect in court.

911:Fire emergency.

Caller:Yes, I have a resident in Villa Valencia and she fell off the floor - - she is bleeding on the floor.

911:Okay what is the address, please?

Caller:It's 25, sorry hold on - - - get that address for me quick - - just a moment - - are you there?

911:Uh-huh.

Caller:Hello?

911:Yes.

Caller:Oh, it's - - can you hear me?

911:I can, go ahead.

Caller:24552 Paseo de Valencia.

911:OK, which room number?

Caller:Sunrise, it's 226 A building.

911:Room number 226 in Building A.

Caller:Yes, 226.

911:OK, and the telephone number you are calling me from, please?

Caller: Pardon me?

911: The telephone number, please.

Caller:The phone number for here?

911: Yes, the one you are calling me from.

Caller:949-581-67 - -

911:No, the number you are calling me from, ma'am.

Caller:OK, I'll have to get her number.

911:Is there a nurse with the patient?

Caller:No, there's not a nurse here right now.

911:Who's with the patient?

Caller:I'm with the patient right now, and I don't know her direct number, I'm using the number for the - -

911:OK, I have help on the way for you. How old is she?

Caller: I don't know her age right now - -

911:- - give me your best guess.

Caller: Can you - -

911:- - give me your best guess.

Caller:Around 81.

911:81. Is she conscious?

Caller: She's conscious.

911:Is she breathing OK?

Caller: She's breathing. Get her …for me quick.

911: OK. And what is she - - she fell off the bed?

Caller:Yes, she fell off the bed.

911:And she's bleeding from where?

Caller: Her foot. She always has problems with her foot.

911:OK, are you able to control the bleeding (2:15) with some pressure.

Caller:I'm trying to find it right now.

911:You're trying to find what right now?

Caller: The bleeding, where it's coming from.

911:OK.

Caller: I just walked into the room not too long.

911:OK.

Dispatch:This is 18 we don't need to go, right

911: No.

Dispatch: All right, I'm going to disconnect.

911:All right. Thanks.

911:What you need to do is find several clean, dry cloths, apply direct continuous pressure to her foot

Caller: Yeah, OK.

911: - - to control the bleeding. Are you able to do that for me?

Caller:Yes, yes.

911: OK. All right, we should be there in a few minutes if anything changes (2:45) call us right back.

Caller: OK.

911:Thank you.

Caller:Bye-bye.

Sun Rise Senior Living is a publicly traded company that runs 445 senior centers internationally including 23 in Illinois.

14th Annual National Assisted Living Week

Mark your calenders... September 7-13 , 2008 marks the 14th annual National Assisted Living Week. This year's theme is 'Filling Life With Love.'  The event is dedicated to promoting the role of assisted living plays in the caring for our nations seniors with disabilities.  There are over 1 million seniors and disabled people living in 38,000 assisted living facilities around Chicago and the entire country.  As an alternative to nursing homes, assisted living facilities are dedicated to enhancing resident's emotional, intellectual, physical, social and spiritual well being with as much independence as possible.  Assisted living facilities are subject to similar regulations as nursing homes.

The event is sponsored by The National Center For Assisted Living (NCAL).  NCAL represents 2,500 non-profit and proprietary facilities dedicated to the care and services for the disabled and elderly.

About Jonathan Rosenfeld

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

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