Nursing Home Lawsuits: Do they represent isolated events or are they representative of poor care?

court houseOne of the most frequent claims I hear from nursing homes and hospitals concerning pending litigation is how the lawsuits are simply isolated events and are not really indicative of the type of care that they provide to their patients.  

While such claims may indeed be very true at some facilities, the reality remains that rarely do facilities have their inferior care targeted upon one patient.  Rather, I tend to see patterns of poor care and mistakes scattered amongst multiple patients at a facility.

I recently read an disturbing article concerning the history of dangerous care provided to patients at Heartland of Charleston Nursing Home in West Virginia.  The facility (which happens to be part of nursing home giant ManorCare) has received a good deal of negative publicity in the past few months after the family of a neglected patient received a monumental $90.5 million verdict in compensatory and punitive damages for the dehydration death of their loved one.

While verdicts on the scale of the Heartland case are fairly rare, Zac Taylor of the West Virginia Gazette uncovered a fairly extensive list of problems at the facility that makes it appear as though patients--- past and present-- may be similarly mistreated.  

When analyzing inspection reports from the Heartland facility over the past several years, recurring patient safety problems and sanctions including:

  • A resident, labeled as a fall risk, was found face down on the floor six hours after she was admitted. Nurse's aides had placed a fall mat on one side of the woman's bed. She would have struck a tile floor had she rolled off the other side, the report states.
  • One resident had an unnecessary catheter for more than two months, while two more residents were not given proper treatment after doctors had declared them incontinent. The inspector found that one of those residents had been sleeping on a bed with a large wet ring stretching across the bottom sheet.
  • Some residents were taking medications they did not need. According to the report, nurses continued to give one resident "sliding scale" insulin doses despite a pharmacist's recommendation to stop. The pharmacist noted that the resident's blood sugars were in "excellent control, " and detailed the facility's need to closely monitor the resident's future insulin intake. Staff had not checked the resident's hemoglobin levels in months, according to the report.
  • Nurses found one resident on the floor at least five times in two months. In January, the elderly patient fell twice in a span of about 12 hours. Staff labeled some of the falls as "attention-seeking behaviors," according to the inspector's notes.
  • Inspectors found that the home's medications were not properly labeled.
  • One resident lost seven pounds in three days because staff had failed to provide dietary supplements a doctor had prescribed.
  • A resident with a right hand muscle contracture (a permanent shortening of a muscle or joint) was not fitted with a device designed to help minimize the loss of range of motion. The resident's care plan noted a need for the device in February -- four months before the June inspection.
  • Nursing staff took 10 to 20 minutes to answer several residents' call lights.
  • One nurse's aide was fired after intentionally unplugging a resident's call light. Administrators did not report the incident to Adult Protective Services within the required time frame.
  • Since 2006, federal authorities revoked Heartland's medicare funding three different times and imposed $232,375 in fines related to violations

We will likely hear much more about the Heartland verdict in the coming months and years as the case goes though the appeals process.   For the average nursing home patient and their family, this verdict should serve as a reminder that there may be similar stories of inferior care and neglect behind the headline grabbing reports.  As caregivers, it is important to fully investigate such claims....because they just might be true.

Related Nursing Homes Abuse Blog Entries:

Jury Blames Manor Care Nursing Home For Dehydration Death Of Patient

What's In A Name? Are Large Nursing Home Chains Intentionally Attempting To Deceive The Public When It Comes To Corporate Ownership?

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

Big Verdicts Against Nursing Homes

How Much Money Does Manor Care Really Make?

profits.jpgWe’ve had a lot of discussion regarding the sizable nursing home negligence verdict in West Virginia against Heartland of Charleston and the parent company HCR Manor Care.  If you haven’t heard about this landmark nursing home verdict, jurors awarded $91.5 million to the family of a patient at the facility who died shortly after her admission to the facility from complications related to dehydration and pressure sores.

After unsuccessfully arguing that the verdict should be reduced based upon West Virginia’s caps on non-economic damages in medical malpractice cases, lawyers for the nursing home behemoth have now taken a position that a judge should substantially reduce the verdict or order a new trial based upon errors made during the course of the original trial.

In particular, lawyers for Manor Care claim that the company is a far less profitable organization than was alleged at trial by lawyers representing the patient’s family when seeking punitive damages. 

Unlike compensatory damages that are intended to compensate an individual or grieving family for their loss, punitive damages are literally intended to punish the company for its conduct.  In order assure that a reasonable punishment is imposed, most jurisdictions allow the jury to take into account the companies profitability—so theoretically, an commensurately appropriate punishment could be imposed against a mega corporation or small business.

In the Manor Care trial, lawyers claim that the $4 billion that the company was alleged to have pocketed in annual profits was merely its gross revenue and the real income was approximately $75 million.

While the actual amount of the Manor Care’s profits may appear to be an inconsequential mathematical exercise, the issue does highlight the complexity of many nursing home operations and the difficulty in understanding the financial structure behind many facilities.

Nursing home operators routinely have multiple derivative companies that may be responsible for the operation of the facility, the real estate that the facility sits on and staffing at the facility.  While the entities may look to be independent, a closer examination can typically reveal that they are essentially the same with individuals holding positions at the allegedly separate companies.

Albeit on a massive level, the real profitability of Manor Care’s operations should be examined by a forensic accountant to determine the path of funds that the company pulls in and where the money goes.  Given the large discrepancy between the alleged profits in this matter, I suspect that there is a lot more to this situation than is readily apparent.

Related:

Nursing home's earnings misrepresented during trial, lawyers argue, WVgazette.com November 6, 2011

$5 Million In Punitive Damages Awarded To Widow In Bed Sore Case Against Nursing Home & Hospital

New York Jury Punishes Nursing Home Where Man Develops More Than 20 Bed Sores

Nursing Home Injury Laws: West Virginia

Appeal Involving $91.5 Nursing Home Negligence Verdict Tests Definition Of 'Healthcare Provider'

It’s probably not all that surprising that when a corporation is hit with a massive verdict, they instantly begin to look for ways to reduce or eliminate their payments.  Recently, we discussed how a West Virginia jury awarded more than $90 million in damages to the family of a patient whom was neglected at a Manor Care facility in the state. 

The case centered on the care provided to a patient with dementia during a three-week admission in 2009.  The lawsuit alleged--- and the jury apparently agreed--- that the care was so inadequate that it caused her death shortly after discharge.

During the trial, much of the case centered on the lack of basic care provided to the woman in terms of inadequate food and water.  Such basic measures were to be provided by nurses’ aides at the facility as opposed to physicians and other more credentialed nursing home employees.

The specific title of each employee who provided care will take on more significance as they are scrutinized according to the state's medical malpractice statute.  Under the terms of legislation passed in 2003 by the West Virginia legislature, victims of medical malpractice are limited in their non-economic damages (pain and suffering) to $500,000. 

While we await some clarification as to the applicability of the medical malpractice statute on this particular case, this certainly highlights the complexities involved in nursing home litigation.  As a nursing home lawyer, I am always reminded how important it is to both thoroughly understand and apply all applicable laws in order to provide the most advantageous set up for every client.

Related:

Lawyers gear up for appeal in $91.5 million Charleston nursing home case The Charleston Gazette, August 21, 2011

Nursing Homes Can Avoid Lawsuits By Properly Doing Their Jobs

Will The Huge Nursing Home Verdicts Effectively Tighten The Screws On The Nursing Home Industry?

Juries Sending A Message To Nursing Homes

Jury Blames Manor Care Nursing Home For Dehydration Death Of Patient

After just two hours of deliberation, a West Virginia jury has awarded a family of a deceased woman $91.5 million in damages against Heartland of Charleston, a Manor Care facility.  The verdict is comprised of $11.5 million in compensatory damages and $80 million in punitive damages against the facility.  The nursing home lawsuit alleged that Heartland's failure to provide life's elemental needs--- food and water-- contributed to her death just weeks after her initial admission.

Allegations of nursing home neglect

Like many families coping with a family member's declining health, Tom Douglas knew it was time for his mother needed additional care that a skilled nursing facility could allegedly provide.  After recognizing that he was having difficulty caring for his mother at home, he sought out a facility that was uniquely equipped to care for her various ailments including: Alzheimer's, Parkinson's and dementia,

While he waiting for space to open at an Alzheimer's facility, he temporarily placed his mother at a facility for which he intended to be a short term stay.  In September, 2009 Tom placed his 87-year-old mother, Dorothy Douglas, into Heartland of Charleston for a short-term admission.

Within three weeks, Ms. Douglas' physical and emotional condition rapidly declined.  During her stay she was transformed from a woman who was capable of walking, talking and generally recognizing her family to a shadow of herself. 

By the time space had become available at the facility Ms. Douglas' family had selected for her care, she had lost 15 pounds and was on the brink of death.  In fact, a day after her transfer Ms. Douglas was taken to a nearby hospital where she died.

Damages intended to punish the facility

Like some states, West Virginia allows families to recover both compensatory damages and punitive damages against nursing homes and other medical facilities responsible for the injury or death of a family member.  In this case, lawyers for the family argued that Manor Care's under-staffing and high staff turnover were the underlying reasons for Ms. Douglas' rapid decline and eventual death.

According to news reports of the trial, former Heartland workers testified that it was physically impossible for them to care for their patients due to their extraordinary workloads.  Similarly, documents produced by Heartland demonstrated that staff turnover was 112% during the year Ms. Douglas was at the facility.

My take

At some point, even the largest corporations need to take notice of the fallout from their actions.  As the largest (and likely most profitable) nursing home operator, Manor Care needs to acknowledge that there are consequences for their actions. 

Even as the the giant of the nursing home industry, ($4 billion in annual revenue and more than $8 billion in assets), when verdicts this size come down, the company surely must taken notice.  Surely, verdicts such as this send a message to the decision makers that inadequate care is simply not acceptable.  Even when the human impact of their poor care is removed from the equation, poor care is simply bad business.

Related:

Care home's neglect was fatal, lawyers argue Charleston Gazette, by Zac Taylor, July 26, 2011

Heartland must pay $91.5M in fatal neglect case Charleston Gazette, by Zac Taylor, August 5, 2011

What's In A Name? Are Large Nursing Home Chains Intentionally Attempting To Deceive The Public When It Comes To Corporate Ownership?

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

Investigation Into Nursing Home Resident's Death In Van Accident Begins

handicapped van.jpgIn some respects, nursing home patients are at a far greater risk for injury when they engage in non-traditional nursing home activities outside of the confines of the facility-- compared with the day-to-day care they typically receive in the course of their daily programs. 

While nursing home employees may receive a good deal of training when it comes to day-to-day care of patients, in other aspects of patient care there maybe less emphasis on training--- and consequently an increased liklihood of patient injury.

The transportation of patients into or out of the nursing home is indeed a crucial part of the care of many patients and facilities must remember their obligation to provide skilled nursing care doesn't exempt them from providing quality care for their patients just because they are on a van.  

While the obligation to ensure safe transportation indeed falls on the shoulders of the nursing home pursuant to both federal and state laws, at some nursing homes transportation safety is still very much an afterthought.  

Especially for disabled nursing home patients who rely exclusively on the assistance of staff, even minor accidents with minor impacts --- or sudden stops-- can result in a patient getting violently ejected from their wheelchair and thrown into other patients or the floor of the vehicle.

Having represented families after patient has suffered an injury or dies in a nursing home van accident, I've noticed a number of commonalities when it comes to the cause of these incidents.  Many nursing home van incidents derive from:

  • Inadequately trained drivers
  • Improperly licensed drivers (in some states)
  • Old equipment and wheelchair lifts
  • Broken or missing restrain belts
  • Inappropriately outfitted vans-- without handicapped access or restraints

While there are few statistics regarding the number of nursing home patients injured or killed in vehicles operated by nursing home (or assisted living) employees, I suggest that the number is far higher we'd believe--- or needs to be with the implementation of basic safety precautions.

Just recently, a patient at Heartland Health Care Center- Kalamazoo (A ManorCare facility in Michigan) died from injuries related to a handicapped van accident.  Though the specifics of the incident have not been revealed, the elderly patient was being taken to a dental appointment in the nursing home's van when the driver hit a curb.

As this incident gets evaluated by authorities, they will likely look at how the patient was restrained and the type of training this driver had.  Depending on the level of culpability on the part of the facility and driver, criminal charges may also be forthcoming.

Related:

Nursing Home Patients Transported In Vehicles Are At Risk For Injury When Safety Is An Afterthought

Traffic Accident Fatality Costs Iowa Nursing Home $10,000 In Fines

Nursing Home Patients Injured After Driver Of Van Fails To Secure Their Wheelchairs

Medicare Standards Require Nursing Home Patients To Be Transported Safely

State to investigate nursing home resident's traffic death, July 9, 2011 Detroit Free Press

Learning About Your Nursing Home: Court Websites

law and justice.jpgSome days my law office gets bombarded with inquires from families wanting to know nothing more than if the facility they are considering placing their loved one in has been sued before.

After all, if a facility has been repeatedly sued, do you really want your family member there?

Though I am familiar with the litigation history at some facilities--- and certainly don't mind sharing my knowledge-- I usually direct the families towards the local courthouse-- or better yet -- the court's website. 

Since most nursing home negligence lawsuits are filed in state court, you first of all may want to look in the court within your county.  Lawsuits are considered public records and most courts freely allow the public to access individual files pertaining to lawsuits.

Better yet, today many state and federal courts have on-line databases where you can review court information from your home. 

Tips:

  • Even if you think you know the name of the nursing home, check your state's secretary of state website and / or department of health to confirm the legal entity that owns / operates the facility.  You will not get an accurate court record, if you do not look up the correct entity!
  • Input the name of the nursing home where it says 'Defendant'-- this is the party getting sued
  • Don't expect to get all the specifics surrounding the lawsuit.  Many jurisdictions do not require all documents to be filed with the court
  • Don't expect to find out how much every case was worth.  Many nursing home lawsuits are resolved for 'confidential' amounts prior to trial
  • Some cases are settled prior to filing of a lawsuit-- there is no public record for these cases

Below is a sampling of the lawsuits filed against nursing home behemoth ManorCare in Cook County (Chicago), IL.  This list was compiled using the Cook County Court's website, and for accuracy sake, you may wish to pull the actual court file to confirm the accuracy of this compilation.

Lawsuits Filed Against ManorCare In Cook County, IL (as of 1/1/11) Since 1997

  • 172 lawsuit filed where ManorCare is a named defendant
  • ManorCare Oak Lawn – 2 lawsuits
  • ManorCare OakLawn East – 1 lawsuit
  • ManorCare OakLawn West – 6 lawsuits
  • ManorCare Hinsdale – 7 lawsuits
  • ManorCare Skokie – 1 lawsuit
  • ManorCare Homewood – 6 lawsuits
  • ManorCare Elk Grove Village – 3 lawsuits
  • ManorCare Palos Heights – 5 lawsuits
  • ManorCare Palos Heights West – 1 lawsuit
  • ManorCare South Holland – 8 lawsuits
  • ManorCare Naperville – 1 lawsuit
  • ManorCare Normal – 1 lawsuit
  • ManorCare Wilmette – 2 lawsuits
  • ManorCare Northbrook – 2 lawsuits
  • ManorCare Arlington Heights – 1 lawsuit
  • ManorCare Libertyville – 1 lawsuit

Related Nursing Homes Abuse Blog Entries:

ManorCare Facility Named In Nursing Home Negligence Lawsuit After Patient Fractures Leg

Family Awarded $546,000 In ManorCare Lawsuit

Chicagoland Manor Care Facility Named In Wrongful Death Lawsuit

HCR ManorCare Sells Nursing Home Properties To Real Estate Trust For $6.1 Billion

HCR ManorCare, the nursing home behemoth that operates 338 nursing homes, assisted living, and other types of senior care facilities in 30 states has agreed to sell the properties to HCP Inc.  Under the terms of the $6.1 Billion deal, HCP will become owner of the facilities and lease the properties to HCR ManorCare who will continue to operate the facilities.

In 2007, Carlyle Group purchased HCR ManorCare for $6.3 billion and remains one of the largest corporations in the nursing home industry.

The deal remains one of the largest REIT deals conducted in the last few years.  The acquisition of the ManorCare properties will expand HCP's role in the senior housing market as it currently owns 250 facilities.

The rush to cash-in on nursing homes

The influx of corporate owners and operators has become a relatively recent phenomenon as various types of investors seek to capitalize on the aging population.  According to reports from Bloomberg, health care is the single largest U.S. based on gross domestic product.   Health-related costs are expected to continue to rise 5.1% over the next year.

Though I would never begrudge an individual or company from making a decent living, I fear the the influx of corporate nursing home owners and operators will continue to result in deteriorating care provided to patients in need as moguls evaluate new ways of deriving more income from facilities.

Related:

ManorCare Nursing Homes In Chicago: How Does Your Facility Compare?

Corporate Ownership Putting Profits Over People

What's In A Name? Are Large Nursing Home Chains Intentionally Attempting To Deceive The Public When It Comes To Corporate Ownership?

HCP and Carlyle's ManorCare in $6 billion asset deal December 14, 2010 Yahoo

ManorCare Facility Named In Nursing Home Negligence Lawsuit After Patient Fractures Leg

A nursing home negligence lawsuit has been filed by an elderly woman who claims she was injured due to improper care by the staff at ManorCare at Elk Grove Village.  As reported on Trib Local Schaumburg, the nursing home lawsuit alleges that the patient fell as staff were transferring her from her bed to a wheelchair.  As a result of the fall, the woman sustained multiple fractures in her leg.

In addition to negligence allegations, the lawsuit further alleges that ManorCare violated Illinois' Nursing Home Care Act when they improperly transferred a frail patient.

Dropped Patients

Many nursing home patients are completely dependent on staff for transfers to and from different equipment throughout the day.  It is important that nursing homes fairly assess all patients and determine the level of assistance required based on the patients level and strength and mobility as well as the patient's physical size.

Further, it is important that staff adhere to the specifications set forth in the patient's care plan be it a one, two or three person assist.  Unfortunately, many staff feel obligated to attempt to do patient transfers without the assistance of their peers due to under-staffing by facilities.

If your family member or friend has sustained an injury during a transfer into or out of a bed, wheelchair, walker, geri-chair or toilet, the incident may give rise to a claim for damages against the facility.  By contacting your state's health department or other agency that regulates nursing homes, soon after the incident, an inspection may be done in a timely manner to determine why the incident occurred.

Related Nursing Homes Abuse Blog Entries:

ManorCare Nursing Homes In Chicago: How Does Your Facility Compare?

65 Illinois Nursing Homes On Second Quarter Violation List

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

Safe Transfers

Illinois Department of Health: ManorCare Of Elk Grove Village

Family Awarded $546,000 In ManorCare Lawsuit

The Chicago Tribune recently reported on a jury verdict where the family of a deceased nursing home patient was awarded $546,000 in a lawsuit brought against Friendship Manor Care in Grinnell (Iowa) and Midwest Ambulance Services of Iowa.  

The lawsuit was brought about by a 2009 incident in which an elderly patient was being brought out of the ManorCare facility and fell from a gurney due to cracks on the pathway on the nursing home property.

The fall resulted in the man striking his head on the pavement and lapsing into a coma from his head injuries.  Several days later the man died.

The Iowa jury apportioned fault as follows: Friendship Manor Care 90%, Midwest Ambulance Service of Iowa 10%.

This lawsuit highlights the need to conduct a thorough investigation of every potential nursing home negligence case to determine who the potential parties may be.  In some cases, all parties may not be readily apparent and an investigation may be necessary to evaluate the culpability of responsible parties.

Related Nursing Homes Abuse Blog Entries:

Nursing Home Operators May Be Responsible For Injuries Due To The Negligent Removal Of Snow & Ice

Chicagoland Manor Care Facility Named In Wrongful Death Lawsuit

ManorCare Nursing Homes In Chicago: How Does Your Facility Compare?

ManorCare Nursing Homes In Chicago: How Does Your Facility Compare?

Picture 17.pngSince 2007, ManorCare has become one of the largest nursing home operators in the world controlled by a private equity company: Carlyle Group.  ManorCare has a formidable presence in Chicago with more than 20 facilities within a 30-mile radius of the Chicagoland area.  

Across the board, ManorCare facilities in Chicago rank well with an average rating of 3 out of 5-stars according to Medicare's Nursing Home Compare site.  

While no ManorCare facilities currently operate within the Chicago confines, there are Manor Care nursing homes scattered amongst the following popular Chicago-land suburbs:

  • Hinsdale
  • Kankakee
  • Palos Heights
  • Libertyville
  • Highland Park
  • Normal 
  • Westmont
  • Oak Lawn
  • Homewood

The overall quality of ManorCare facilities vary considerably by location.  According to the most recent Medicare surveys, Manor Care facilities in the Chicagoland area rate on both the high and low-end of the rating spectrum.

 

HIGHEST RATING: 5/5 Stars

Heartland Health Care Center – Riverview

500 Centennial Drive

East Peoria, IL 61611

309-694-0022

 

Heartland Health Care Center – Henry

1650 Old Indian Town Road

PO Box 215

Henry, IL 61537

309-364-3905

 

LOWEST RATING: 1/5 Stars

ManorCare Health Services – Kankakee

900 West River Place

Kankakee, IL 60901

815-933-1711

 

Below is a listing of Chicagoland ManorCare facilities with location, telephone and overall Medicare rating.

Related:

Chicago Nursing Homes Not Making The Grade

What's In A Name? Are Large Nursing Home Chains Intentionally Attempting To Deceive The Public When It Comes To Corporate Ownership?

Huge Nursing Home Verdict Tossed Out Because Parent Company Did Not Have Adequate Control Over The Facility

Nursing Home Spotlight: Manorcare of Rolling Meadows

Chicagoland Manor Care Facility Named In Wrongful Death Lawsuit

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Chicagoland Manor Care Facility Named In Wrongful Death Lawsuit

A recently filed wrongful death lawsuit alleges that ManorCare's Hinsdale, IL facility was negligent in caring for a 74-year-old patient at the facility.  According to the lawsuit, filed in Cook County, the patient died from acute renal failure that was brought about by severe dehydration within 30 days her he admission to the facility due to the fact that the facility failed to monitor the patients fluid intake and output.

Acute Renal Failure

Many people use acute renal failure interchangeably with kidney failure.  Either way, acute renal failure may result after a patient has been denied adequate fluid intake.  In the nursing home setting, I frequently encounter cases where patients suffer various types of injuries simply due to the fact that the facility is not keeping them adequately hydrated.

Particularly in the elderly, it is extremely important for staff to monitor the needs of each patient.  Medications, incontinence, and body composition are all factors that play into how much fluid each patient requires to function optimally.

In some situations, where a patient has a history of dehydration or urinary tract infections (UTI's), a physician may order the staff to keep specific tabs on fluid intake and urine output to assure the patient's health doesn't deteriorate.

However, even without specific physician orders relating to monitoring such specifics, there are many obvious indications that a patient may not be getting sufficient fluids.  Common signs of dehydration include:

  • Sunken eyes
  • Cracked lips and tongue
  • Ashen skin coloring
  • Lack of urine and / or very strong smelling urine and darkly colored urine
  • Rapid weight loss

Certainly, nursing home staff should be focused on preventing this relatively preventable medical complication and take steps necessary to prevent it.  If you have a situation that you believe is related to dehydration, I would be happy to discuss your legal options.  As always there is never a charge for a consultation.

Related:

Acute renal failure of medical type in an elderly population (PDF) Nephrology Dailysis Transplantation (1998)

Dehydration and the Elderly, Illinois Counsel on Long-Term Care

Hinsdale nursing home sued over resident's death, Mysuburbanlife.com September 2, 2010

Nursing Home Spotlight: Manorcare of Rolling Meadows


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sources:

IDPH: Manorcare of Rolling Meadows

IDPH: Manorcare of Rolling Meadows – Fourth Quarter Violations

Medicare Nursing Home Compare: Manorcare of Rolling Meadows

HCR ManorCare: ManorCare Health Services – Rolling Meadows

Nursing Home Abuse Blog: HCR Manorcare

Nursing Home Abuse Blog: Nursing Home Abuse

Nursing Home Abuse Blog: Elder Abuse

Nursing Home Spotlight: Heartland Of Springfield Nursing Home, Springfield, OH

Heartland of Springfield Nursing Home is a large 126 bed nursing home located in Springfield, Ohio.  According to the government’s Medicare website, the facility received only one out of five stars, which is a much below average rating.  In the past year, the nursing home had eighteen health deficiencies, which is eleven more than the average number of health deficiencies in Ohio and ten more than in the United States.  The number of health deficiencies has increased in the past year, especially in the area of quality care.  

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

  • Ensure that the facility remains free of accident hazards
  • Provide medically-related social services to attain or maintain the highest well-being of each resident
  • Develop a comprehensive care plan for each resident
  • Ensure that residents who enter the facility to not develop pressure sores and treat existing pressure sores
  • Provide routine and emergency drugs to residents
  • Provide services to maintain good nutrition, grooming, and personal and oral hygiene

The facility failed to provide medically-related services to maintain the highest practicable well-being of a resident when it failed to monitor the mental status of a resident who was at risk for side effects of her medications for depression.  On another occasion, the Licensed Practical Nurse (LPN) changed the dressing on a resident’s leg wound without pre-medicating him, causing the resident pain. 

On another occasion, the facility failed to develop an effective care plan for a resident who required above the knee amputations due to complications involving diabetes mellitus.  The facility failed to address the resident’s psychosocial needs regarding his feelings of loss and phantom pain.  Another resident who was on a feeding tube suffered a decline in status, becoming non-verbal.  The facility failed to update his care plan since the decline in his status, despite the fact that he could not hold a conversation. 

Heartland of Springfield failed to prevent residents from developing pressure sores when a resident suffering from Parkinson’s disease developed a Stage 2 pressure sore on her right heel.  Also, the doctor’s order for a thick pad to be placed under the heel to relieve pressure was not observed by the facility’s nursing staff.

Heartland of Springfield also failed to ensure that hazardous materials were secured.  An inspector noted that a cigarette and lighter were left on the counter at the nurses’ station, while several residents were in the area.  The facility’s policy required that the lighter be secured.  Also, the beauty salon was left unlocked with no one present.  A container of disinfectant was left out on the counter, which can cause eye damage and skin irritation. 

On several occasions, the facility failed to ensure that drugs and supplies were properly stored and maintained.  In the medication room, the inspector discovered expired blood collection tubes, expired catheters, and medication carts covered in a dried and sticky residue. 

The many health deficiencies cited in the past year contribute to the one star rating for the facility. Heartland of Springfield, is owned and operated by nursing home giant HCR ManorCare

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Huge Nursing Home Verdict Tossed Out Because Parent Company Did Not Have Adequate Control Over The Facility

Yesterday, we discussed the nursing-home-name-game, how large nursing home chains attempt to shield themselves from liability by creating a complex array of subsidiary companies and messy corporate structures. 

Today, we are seeing the fall-out created by this complicated game of corporate re-organization-- how despite that fact that a large corporation makes decisions with respect to operation of a facility, and even derives profits from the facility, it can evade responsibility by re-arranging its corporate structure.

In 2007, a New Mexico jury rendered a large verdict ($53 million) against ManorCare after they heard how Barbara Boxer, a patient at a ManorCare subsidiary was ignored by staff as she suffered from gastrointestinal bleeding.  The trial revealed that not only did employees at the nursing home fail to administer any treatment, but they attempted to cover up the situation by removing the bloody sheets-- with the tell tale signs that they had watched a lady bleed to death-- before notifying the ladies family.

Despite the fact that Boxer was a patient at a ManorCare subsidiary, a nursing home negligence lawsuit was brought against the parent company-- ManorCare exclusively.

In overturning the trial court verdict, the Appellate Court reasoned that the court erred in finding that ManorCare was the 'employer' of the nursing home's staff.  The large damage award ($3.2 million compensatory damages and $50 million in punitive damages) was never even addressed by Appellate Court in its decision.

While we can simply say that the New Mexico Appellate Court made a bad ruling with respect to the rights of injured nursing home patients, this decision will only encourage nursing home giants to rearrange their companies into smaller subsidiaries-- only to protect the parent company from liability.

The family of Mrs. Boxer intends on bringing this case before the New Mexico Supreme Court.

Read more about this important nursing home decision here.

What's In A Name? Are Large Nursing Home Chains Intentionally Attempting To Deceive The Public When It Comes To Corporate Ownership?

One of the things I do each morning is to look through my google reader account to see the new updates regarding nursing home news and information.  Today, I glanced through the news stories to find another unfortunate report regarding the alleged abuse of a patient at an Ohio nursing home.  You can read about this report of nursing abuse here

As I read the article, where abuse was alleged to have occurred at Heartland Lansing Nursing Home, I realized how deceptive the names of nursing homes can be to the general public.  In the case of Heartland, it is part of the nursing home behemoth, HCR Manor Care

Yet by looking at the name alone most people, including most of the residents at the facility, likely have no idea that Heartland Lansing Nursing Home is actually owned by ManorCare.  Further confusing the matter is that ManorCare operates nursing homes around the country under the Heartland, ManorCare and Alden Courts surnames.

Why don't large nursing home chains want to lend the parent companies name to individual facilities? 

I am open to ideas, but I firmly believe large nursing home operators carefully name (and re-name) facilities with the intent of shielding the parent company from possible liability in the case of an injury or death.  Additionally, these knock-off names are also used to give an appearance that many of the facilities are small mom-and-pop operations as opposed to being operated by a health care conglomerate controlled with decision makers thousands of miles away.

The name-game gets much more complicated when it comes to other national nursing home chains.  For example, Kindred operates 14 nursing homes in Ohio all with different names and all without any signal to the pubic that Kindred owns and operates these facilities.  

While I may be making a big deal about the names of nursing homes, the fact is that the names are crucial when it comes to naming responsible entities in a legal proceeding.  In this respect, there can be little doubt that a number of lawsuits get dismissed or a parent company evades responsibility because the name of the facility where the alleged negligence occurred throws off the injured party.

The corporate ownership behind the names can be even more complex and confusing.  Many corporate owners have split up all aspects of the daily operation of nursing homes into different entities and --- you guessed it--- all with different names.  In some cases of corporately owned nursing homes, parent companies have successfully evaded responsibility for the actions of their employees by hiding under these shell companies.

All this is to say, is that many nursing home operators have become extremely sophisticated when it comes to using 'legal loopholes' to avoid responsibility for specific acts.  Consequently, a thorough examination of each nursing home's corporate structure must be analyzed prior to initiating any legal proceeding.

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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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