Jonathan Rosenfeld's Nursing Homes Abuse Blog : Jonathan Rosenfeld's Nursing Homes Abuse Blog | Lawyer & Attorney : Strellis & Field Law Firm | Bed Sores, Senior Neglect, Elder Abuse, Sexual Abuse: Chicago, Illinois

It never fails to amaze me.  Frequently, when I tell people about some of the cases I work on involving bed sores, I only to get a 'so what?' reaction from them.  Are the people who surround me heartless?  Maybe some of them (just joking, honey)?  Nonetheless, the reality is that most people have no idea what a bed sore truly is or the catastrophic consequences that my arise after a person develops them.

When people actually see the gruesome photos of rotting flesh on a person's backside hear about the ongoing medical procedures that are necessary to heal the wound, they begin to understand the real impact of this medical condition.

Along these lines, an obviously compassionate jury in New York awarded the family of a man who succumbed to infection following the development of bed sores almost $19 million.  The New York Post reported that the Brooklyn jury's award was comprised of $3.75 for the man's pain and suffering and a hefty $15 million in punitive damages.

According to the man's daughter's Margaret Whitehurst, the man rapidly declined during his nine month admission to Brooklyn Queens Nursing Home.  "He walked in on two legs and a cane.  He was 237 pounds.  When we got him back, he was 148 pounds and had holes all over his body."

In addition to hearing testimony regarding severe bed sores (also called: decubitus ulcers, pressure ulcers or pressure sores), the jury also heard from an expert witness who testified about how the nursing home altered the man's medical records to make it appear as though he entered the facility with bed sores.

Not having any firsthand knowledge of whether the nursing home made any offer to settle the case prior to trial, I can only assume the offer was insignificant.  I'll bet this facility is now re-thinking its decision to avoid responsibility for the death of this patient.

Read more about this nursing home lawsuit here.

Related:

Lawsuit Claims That Nursing Home's Negligence Resulted In Patient's Decubitus Ulcers

Lawsuit Alleges: One Week In The Nursing Home Results In Significant Deterioration Of Pressure Sores & Sepsis

Nursing Home Negligence Lawsuit Claims New York Facility Allowed Advanced Bed Sore To Develop In Rehab Patient

Big Verdicts Against Nursing Homes

What should I do if my family member develops bed sores during an admission to a nursing home?

Resource:

Nursing Home Injury Laws

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In cases involving nursing home abuse and neglect, filing a complaint with a state agency regarding the incident can be incredibly important with respect to getting answers about how an incident occurred and securing valuable information should the matter be litigated in the future.

John Kormanik who produces an excellent Nursing Home Abuse Advocate Blog, recently made some extremely useful suggestions before initiating the complaint with your state agency.  Here are John's suggestions:

• Provider / Facility Name and City
• Name of Patient/Resident
• Detailed Statement of Care Provided And Any Negative Outcomes
• Names of Witnesses
• Your Name and Contact Information; unless you wish to remain anonymous.

Of course, if I may add my own two cents, I would add the follow:

Report the incident as soon as feasible

Reporting an incident as soon after it occurs provides investigators with the best opportunity to access records, witnesses and staff with knowledge.  In many circumstances, facilities have such high staff turnover that, a witness to an incident may be long gone-- within months of an incident.

Be as succinct at possible

After fielding calls all day, do you really think the men and women on the other end of the line want to hear all the details of your favorite sushi restaurant or how Grandma Sue is a huge Cubs Fan?  

Seriously, report the information that is relevant to the event and stop.  Too much information will just detract from the seriousness of your complaint.

Above all, I strongly encourage people to report all situations involving questionable care or injury to your state's department of public health or ombudsmen program.  

Related:

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

Nursing Home Watchdogs: Ombudsmen

Where To Report Elder Abuse

Ombudsmen In Nursing Homes

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Like many families, Kenneth Gall sought a sense of closure with respect the circumstances surrounding his mother's death after she sustained an injury during her admission to Presbyterian Homes of Arden Hills.  Unfortunately, more than a year after his mother's death, questions still remain as to the facilities role in the matter-- and how a disabled, primarily bed-bound-woman managed to fracture her neck while admitted to a nursing home.

Was it due to a fall?  Was the fracture related to violence?  Did Mrs. Gall get entangled in a bed rail?

What is known is that 91-year-old Gladys Gall died about two weeks following an incident in which she sustained a unusual type of fracture in her neck called a hangman's fracture and died from complications shortly thereafter.  

The circumstances surrounding Mrs. Gall's death were investigated by the Minnesota Office of Health Facility Complaints (OHFC) and a determination was made by the agency that the incident was due to mistreatment.  The state even consulted with a neurosurgeon who opined that the nature of Mrs. Gall's injury could only be caused from severe trauma.

Now however, after the nursing home appealed the states findings and presented evidence from their own investigation, the state has changed its findings relating to improper care from 'substantiated' to 'inconclusive'.

The role of state investigations into injury or death in a nursing home

Most states have agencies (usually associated with their health department) to investigate suspected mistreatment of patients in a nursing home.  Investigators can quickly access the patient's chart and interview employees and other patients who may have knowledge of the incident.  While certainly not always perfect, the investigations typically provide much sought after information to families asking 'how' and 'why' an incident occurred.

In most jurisdictions, the state investigative findings and the reports generated are not admissible in court proceedings related to a nursing home negligence lawsuit.  Nonetheless, the information contained within the investigative report can be invaluable in the course of litigation.

In the case of Mrs. Galls death, I humbly suggest to her family to seek out an experienced lawyer to prosecute this matter and give them more information relating to the circumstances of their loved ones death.

Read more about this suspicious death in a Minnesota nursing home here.

Related:

Nursing Home Cited For Mistreatment Of Resident Following Investigation Of Resident's Fractured Neck

Falls Amongst The Elderly Can't Be Ignored

Nursing Home Watchdogs: Ombudsmen

Nursing Home Inspectors Miss Major Problems

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On October 16th, the Nebraska Supreme Court ruled that an arbitration agreement between a nursing home and one of its residents was invalid because the resident’s son did not have the authority to sign a voluntary arbitration agreement on her behalf. 

Frank Koricic lived with his elderly mother, Manda Baker, and assisted her in her activities of daily living.  Ms. Baker was originally from Croatia and had limited ability to read, speak, or understand English.  Because of a decline in health, Ms. Baker was admitted to the Beverly Hallmark nursing home (now doing business as Beverly Enterprises) in Omaha, Nebraska. 

Upon admission, her son, Frank, signed several documents on her behalf, including an optional arbitration agreement (“Resident and Facility Arbitration Agreement”).  This arbitration agreement was not a condition of admission and provided that all claims or disputes arising out of any services or health care provided by the nursing home facility would be resolved exclusively by binding arbitration. 

In 2007, Ms. Baker allegedly sustained injuries as a result of nursing home negligence while in residence at the Beverly Hallmark.  Ms. Baker later died in September 2007.  Frank, Manda’s next of kin and trustee of her estate, filed suit against Beverly Enterprises, alleging negligence, breach of contract, and breach of fiduciary duty. 

Beverly Enterprises moved to dismiss the case and compel arbitration under the arbitration agreement that Frank had signed at the time of his mother’s admission.  Frank argued that the facility could not enforce the agreement because he, not his mother, had signed the arbitration agreement.  The district court ruled that that the arbitration agreement was valid and enforceable against Ms. Baker’s estate because she had authorized her son to sign medical authorizations for her.   

The Supreme Court reversed and remanded the decision of the district court, concluding that Ms. Baker’s son did not have authority to sign the arbitration agreement because it was not a condition of admission.  Frank had actual authority as his mother’s agent to sign medical documents for her.  Frank also had actual authority to sign the paperwork required for her admission to the nursing home facility. 

However, the arbitration agreement was optional and not required for Ms. Baker to reside at the facility.  Therefore, Frank did not have actual authority to sign the arbitration agreement. 

The Nebraska Supreme Court also determined that Frank did not have apparent authority to sign the arbitration agreement because there was no evidence that Ms. Baker knew Frank would be asked to sign an arbitration agreement, or that she indicated to any staff members that she authorized Frank to sign such an agreement, or that she later ratified the agreement. 

Furthermore, a reasonable person should not have expected an arbitration agreement to be included in the nursing home’s admission documents.  Thus, the nursing home facility was not justified in relying on Ms. Baker’s authorization of her son to sign admission papers as authority to bind her to an arbitration agreement.  The Nebraska Supreme Court reversed the trial court’s order to dismiss Frank Koricic’s complain and remanded the case for further proceedings.   

This decision could affect the validity of optional arbitration agreements where surrogates sign nursing home admission materials, depending on the extent of the surrogate’s authority to sign documents on the resident’s behalf. 

Thanks to Heather Keil, J.D. for her assistance with this article.

Sources:

Frank Koricic v. Beverly Enterprises, Nebraska Supreme Court, 2009

Related Nursing Homes Abuse Blog Entries:

Landmark Nursing Home Arbitration Award May Cause Facilities To Re-Evaluate Patient Care

AARP Joins Fight To Preserve Right To Jury Trial

Should You Give Up Your Right To Trial?

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Today, the Illinois Nursing Home Task Force will hold its second meeting regarding patient safety. The task force will hear testimony from: patients, elder care advocates and senior service providers with the goal of re-evaluating current nursing home policies, improving coordination between state agencies and to consider nursing home alternatives for people with special needs.

The task force was recently formed in response to a Chicago Tribune series of articles chronicling the safety problems in Illinois nursing homes.   The series detailed how many seniors in nursing homes suffer serious injury or death from an un-regulated group of younger patients with psychiatric conditions and criminal records.

The task force is headed by Michael Gelder, an adviser to Governor Pat Quinn.  "All of us have a role to play in ensuring the safety and well-being of nursing home residents, and we urge the public to join us in this critical work," added Gelder.

The meeting will be held today at 10 a.m. in Room 16-503 at the Thompson Center, 100 W. Randolph Street, Chicago.  The meeting will be broadcast on the Internet here.  Lastly, you may leave comments and recommendations regarding Illinois Nursing Homes at the newly formed Nursing Home Safety website.

The group is scheduled to complete a report by January 31, 2010.

Read more about this nursing home meeting here.

Related:

At least 50 Convicted Sex-Offenders Living Freely In Illinois Nursing Homes

Young, Mentally Ill Residents Pose Significant Threat To Nursing Home Residents

Murder At All Faith Pavilion

Autopsy Confirms Man Was Murdered In Chicago Nursing Home

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Many elderly people suffer broken bones during admissions to nursing homes due to; falls, being dropped, or perhaps improper care from staff.  Regardless how the fracture occurred, a fractured bone in the elderly must be timely identified and treated.

What is a fracture?

A fracture is a broken bone that requires medical attention. Fifty percent of women over age fifty and twenty-five percent of men over age fifty will suffer from an age-related bone fracture sometime in their lifetime.

Elderly people are particularly susceptible to broken bones because as bones age, they lose the ability to resist the formation and growth of cracks that can lead to bone breaks because they cannot withstand as much pressure as younger bones.  Unfortunately, as we age, our bodies ability to heal fractures is compromised.

Nursing home staff can take steps to help maintain bone health in elderly nursing home residents:

• Regular exercise
• Adequate amounts of calcium
• Adequate amounts of vitamin D (essential for calcium absorption)

Osteoporatic Nursing Home Patients and fractures

Elderly nursing home residents who have osteoporosis (porous weak bones) or other conditions that lead to weakened bones or decreased bone density are at risk for bone fractures. Weak bones have low levels of calcium, phosphorous, and other minerals in the bones, which makes people more susceptible to fractures because the bones are more brittle. 

Women suffering from osteoporosis are twice as likely to suffer from bone fractures than men with osteoporosis.  Fractures from osteoporosis are most common in the spine and hips (bones that directly support your weight), and the wrists from bracing. Therefore, nursing home staff should take extra precautions to prevent falls and provide adequate nutrition to maintain the well-being of residents.

Diabetic Nursing Home Patients and fractures

Many nursing home residents also suffer from diabetes. A recent study suggests that there is an association between a drug introduced in the 1990s to help treat type 2 diabetes (thiazolidinediones) and bone fracture. The increased risk of fracture increased as the duration of the drug treatment increased and was observed in both men and women. Therefore, nursing home residents who have been treated with this drug also might have a further increased risk of bone fractures. 

Medical treatment for fractures in the elderly

Treatment for bone fractures depends on the location of the break. For most fractures occurring in the arms, legs, hands, and feet, the initial treatment is splinting the injured limb and immobilizing the joints above and below an injury to prevent movement at the fracture site. Then, the splint is removed and replaced by a cast. 

Some breaks might also require surgery in order to properly align bone fragments, increase stability, and ensure that bones will heal properly. Some fractures might also require metal hardware (pins, plates, or rods) to hold the bones in place. Older adults heal slower than younger people, which can cause additional complications and mobility issues for nursing home residents. 

How we can help

Depending on the circumstances regarding the fractured bones, the medical facility may be responsible for the damages relating to the fracture.  In many cases, we have successfully recovered damages for our clients', medical bills, medical equipment, pain and disability.  If you believe that a nursing home is responsible for your broken bone, we would be honored to speak with you to discuss your legal rights. (888) 424-5757

Resources:

Mayo Clinic: Fractures

Lawrence Berkeley National Laboratory: Why Older People Suffer More Bone Fractures

Science Daily: Risk of Bone Fractures Associated with Use of Diabetes Drug

Related Nursing Homes Abuse Blog Entries:

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

Fall In Stairwell Results In Paralysis-- And Ultimately Death Of Chicago Nursing Home Resident

Nursing Home Sued After Resident Fractures Both Hips In Separate Falls

Nursing Home Cited For Mistreatment Of Resident Following Investigation Of Resident's Fractured Neck

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The most dangerous part of the day for many nursing home patients may be getting out of bed in the morning.  When staff fail to supervise or provide proper assistance to nursing home patients during transfers, patients are at risk for falls or being dropped by staff.

Disabled nursing home patients and those with physical limitations must be carefully monitored to avoid injuries while being transferred from one device to another.  Some of the commonly encountered situations where patients are injured include:

• Bathing: facilities failing to provide assistance or provide specialized bathing equipment including chairs, stands and grips
• Transfer into and out of bed
• Failing to take extra-precautions with patients who may have uncontrolled muscle movement: many times these patients require special restraints during transfers
• Failing to take patient medications into the equation: some commonly prescribed medications can make patients dizzy or cause blood pressure spike or drops when patients are moved
• Failing to engage locks on wheelchairs
• Allowing patients to wear socks or improper footwear during transfers
• Failing to monitor patients with walkers

Although facilities like to claim that these incidents are isolated events, a dropped patient is usually indicative of poor staff training and chronic under-staffing.  Most of these transfer-related incidents occur due to:

• Poorly trained staff: Some facilities do not properly train staff in how to use equipment
• Under-staffing: Facilities sometimes to not have enough man power to safely perform transfers as they were intended
• Wrong equipment: facilities must have the proper equipment for the job
• Faulty equipment: facilities must keep equipment in proper repair.  This includes getting replacement parts from the manufacturer
• Failing to provide timely assistance to patients who request it

Cases involving injury or death during transfer are particularly important to investigate as quickly as feasible after the incident in order to preserve the condition of equipment and to obtain statements from witnesses others who may have knowledge of the event.  

If your loved one suffered an injury or died as a result of a fall or being 'dropped' by staff, we would honor the opportunity to speak with you.  Our nursing home litigation team is always available for consultation. (888) 424-5757

Related Nursing Homes Abuse Blog Entries:

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

Nursing Home Cited For Mistreatment Of Resident Following Investigation Of Resident's Fractured Neck

Faulty Handicapped Lift Blamed For Nursing Home Death

Improper Transfer Leads To Fall & Ultimately Death Of Rehab Patient

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The results from a five-year study addressing the ability of care-givers and family to perceive pain in nursing home patients has revealed both parties fail to accurately assess chronic pain levels. In reaching this conclusion, researchers in the Netherlands studied 174 nursing home patients with and without cognitive impairments.  The study also concluded that family members were better at accurately assessing pain levels in their loved ones compared with nursing home staff.

Perhaps most disturbing, the study concluded most nursing home patients suffer from pain-- even while resting.  When researchers questioned resting patients, most scored their pain as four out of 10, compared with a median pain assessment of zero by family and caregivers.

Study author, Dr. Rhodee van Herk summarizes the findings well,

"Our study shows that nurses and relative find it hard to accurately assess pain in nursing home residents, especially if the resident has a cognitive impairment, such as dementia or is unable to speak. Pain seemed to differ, not only on an individual basis but also in different daily situations.  It is clear that pain at rest is a particular issue that needs addressing as residents rated this much higher than caregivers and relatives.  Using a simple pain intensity scale, like the zero to ten scale employed in our study, is clearly not enough.  We would like to see nurses use a combination of the existing pain scale, together with multidimensional pain observational scales to judge how much discomfort a patient is experiencing."

Nursing Homes Duty To Provide Pain Relief

Nursing homes have an obligation to provide pain relieving measures to their patients. While certain medical conditions such as bed sores (decubitus ulcers, pressure ulcers or pressure sores) may cause staff to implement pain relieving measures, staff must be diligent to look for signs of distress in patients with less visible condition that require pain relief.  

In particular with disabled nursing homes patients, staff should take note of patients facial expressions, involuntary motor actions, moans and changes in behavior as potential indicators that the patient may indeed be suffering and contact a staff physician.

Pain relief is required pursuant to federal regulation of nursing homes.  F-Tag 309 (Quality of Care) requires nursing homes to provide 'necessary care and services to attain or maintain the highest practical physical, mental and psychological well being, in accordance with the comprehensive assessment and plan of care.'

Although the term 'highest level of practicable care' is fairly vague, proposed interpretive guidelines to F-Tag 309 provide more specific guidance for providing pain relief.

Recognition and Management of Pain

In order to help a resident attain or maintain his or her highest practicable level of well-being and to prevent or manage pain, to the extent possible, the facility:

• Recognizes when the resident is experiencing pain and identifies circumstances when pain can be anticipated;
• Evaluates the existing pain the cause(s), to the extent possible; and 
• Manages or prevents pain to the extent possible, consistent with with the resident's goals, the comprehensive assessment and plan of care, and current clinical standards of practice.

As a nursing home attorney, I consistently see facilities that fail to provide compassionate pain relief. Many times I will see a written description of an obviously painful medical condition, yet the Medication Administration Record indicates the staff failed to notify the attending physician and no pain relief was provided. 

Source:

van Herk et al, Assessment of pain: can caregivers or relatives rates pain in nursing home residents? Journal of Clinical Nursing, 2009; 18 (17): 2478 DOI:

Related Posts:

Nursing Home Patient With Broken Hip Sits In Pain. Why Federal Law Requires Staff To Administer Pain Medication

Fentanyl Overdose Leads To 1.6M Nursing Home Settlement

Woman Poses As Nurse To Steal Medication From Nursing Home Residents 

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

-Carol, Beachwood, Ohio

Every state is required to have a long-term care ombudsmen program as set forth by the Federal Older Americans Act.  In the long-term care setting, ombudsmen act as patient advocates to help families find facilities that meet resident needs, address problems encountered in long-term settings and inform patients of their legal rights.

Most people utilizes ombudsmen services when they encounter a problem at a facility such as a resident injury resulting from abuse or neglect.  In this context, an ombudsman can help in the investigation of the incident and resolve problems with the facility.  

In many cases, the information provided by a nursing home ombudsman may substantiate an episode of poor care.  This information may be helpful in determining how an incident occurred and if the matter should be pursued as a nursing home negligence lawsuit.  Even in cases where there are findings of improper care, most jurisdictions prohibit ombudsmen reports from being introduced into civil lawsuit.  

If you have a question regarding nursing home care or seek more information regarding a nursing home injury, the ombudsmen program is a great resource to help provide you with more information. Unless you give ombudsmen specific permission to share your information with the facility, all personal information will be kept confidential.

Resource:

National Long Term Care Ombudsman Resource Center- provides contact information for ombudsman in every state.

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I guess when it comes to elder care, many problems encountered by residents in U.S. nursing homes sadly seem to make their way across the border to our friends in Canada. The recent news report of an elderly Canadian nursing home resident who fell and fractured her hip-- yet sat for days without medical attention or adequate pain medication is an unfortunate story unnecessarily repeated on a daily basis at nursing homes across the world.

In the U.S., upon learning of a fall or other injury, the nursing home staff must conduct an assessment to ensure no injury was sustained.  In cases where there is an apparent injury, the staff physician should alerted immediately as to the incident.

Once a physical assessment has been completed, federal law requires nursing homes to provide pain medication to the resident as soon as feasible.  As recipients of Medicare funding (the overwhelming majority of nursing homes) must comply with F-Tag 309 pertaining to Quality of Care:

Each resident must receive and the facility shall provide the necessary care and services to attain or maintain the highest practiceable physical, mental and psychological well-being, in accordance with the comprehensive assessment and plan of care.

Although the above language can be generally interpreted to included pain management for nursing home patients, CMS has proposed interpretative guidelines that undeniably require nursing homes to provide sufficient pain management:

Recognition and Management of Pain

In order to help a resident attain or maintain his highest practiceable level of well-being and to prevent or manage pain, to the extent possible, the facility:

• Recognizes when the resident is experiencing pain and identified circumstances when pain can be anticipated;
• Evaluates the existing pain and cause, to the extent possible; and
• Manages or prevent pain to the extent possible, consistent with eh resident's goals, the comprehensive assessment and plan of care and current clinical standards of practice.

Unfortunately, many nursing home residents needlessly suffer from acute (falls) and chronic medical conditions (pressure sores) due to facilities failure to properly follow CMS regulations.  On the surface, this omission may simply be a violation-- but when a resident sits without medical attention with a broken hip or open wound these violations represent a complete lack of compassion and destruction of the quality of life.

Related Nursing Homes Abuse Articles

How Many Falls Is Enough To Impose Responsibility On Nursing Home?

Study Links Medication Use With Falls

Nursing Homes Curtail Use Of Physical Restraints With Residents

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A nursing home negligence lawsuit has been filed against Stearns Nursing and Rehabilitation Center after a 95-year-old resident fell on multiple occasions and suffered hip fractures. The lawsuit alleges that the facility failed to implement fall precautions despite the fact the facility knew the resident suffered from Alzheimer's, was generally confused and considered to be a 'high fall risk'.

The lawsuit claims, Stearns suffered multiple falls resulting in injuries during her admission from May 25th through July 7, 2007. In particular, the lawsuit alleges the following specific incidents:

• On May 27, the resident wandered the hallways, unattended, and fell fracturing her left hip.
• On June 6, while left unattended in a wheelchair and with a shut-off personal alarm, she fell out of the wheelchair.
• On June 15, the resident pulled herself out of her wheelchair and roamed the hallways un-assisted and fell, fracturing her right hip

The lawsuit is pending in Madison County Circuit Court.  Read more about this lawsuit against Stearns Nursing and Rehabilitation Center here.

Nursing Home Falls

More than 1,800 people die each year in nursing home falls.  All health care professionals in the nursing home setting must work together to help encourage nursing home safety.  Nursing homes are required to conduct a fall-risk assessment for every resident to determine who may be at risk for falls.  This puts the staff on notice as to who may need special attention and sets forth what accommodations should be in place for each resident.

Additionally, staff should always be on the lookout for residents who may require assistance getting about.  If residents have a history of falls, the facility should consider using alarms on chairs or beds to notify the staff when the person attempts to walk on their own.

Falls in nursing homes occur for a variety of reasons.  Some of the more common causes for falls  are:

• Muscle weakness and walking or gait problems
• Hazards in the nursing home- wet floors, poor lighting, improper be heights, improperly maintained wheelchairs, equipment left out of place
• Medications-  Drugs that effect the central nervous system, such as sedatives and anti-anxiety drugs (psychoactive drugs)
• Improperly fitting shoes or incorrect walking aids
• Frequent use of restraints
• Inadequate staffing levels that fail to provide sufficient assistance to residents

If your loved one sustained a fall during a nursing home admission, our nursing home litigation team will provide a free case analysis to determine if a lawsuit against the facility is warranted.  Why not put our experience advocating on behalf of the elderly to work for you today?

Related Nursing Homes Abuse Blog Entries

How Many Falls Is Enough To Impose Responsibility On Nursing Home?

Nursing Home Cited For Mistreatment Of Resident Following Investigation Of Resident's Fractured Neck

Falls Amongst The Elderly Can't Be Ignored

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A recently disclosed Minnesota Department of Public Health report concluded the Good Samaritan Society of Albert Lea was guilty of 'neglect' due to its delay in providing medical treatment to a resident who fell during a transfer from her bed to her wheelchair.  The episode took place on November 21st when a worker at the facility improperly used a Sabina lift to move a resident with dementia into a wheelchair.  During the transfer, the resident fell and fractured her hip.

A 'care plan' specifically stated that the resident was to wear shoes or gripper socks during transfers. At the time of the incident, the resident was wearing stockings that "enabled her feet to slip from the base of the lift, causing her to fall onto her right hip," according to the state's investigative report.

The resident involved in the incident suffered a stroke prior to her admission and was unable speak and was dependent on the staff for daily living activities.  Despite the resident's disabilities, six staff at the facility were aware of the resident's fall and the possibility of her injury because she was behaving differently after the episode-- yet no medical attention was provide for more than 19 hours after the fall occurred.

The morning following the incident, the resident was transferred to a hospital where and x-ray confirmed the woman's hip was indeed fractured.  The hip fracture required surgery.

Good Samaritan terminated the employee who was operating the lift and the nurse-supervisor following their own investigation into the matter.  According to the nursing home's own investigation, the employee responsible for the lift also failed to provide 'satisfactory' care to two other residents in the days following the lift incident.

Read more about this nursing home injury during a transfer here.

Transfers In Nursing Homes

A 'transfer' in a nursing home setting generally refers to moving a patient from a bed to a wheelchair. Transfers are usually done two ways: using nursing assistants or mechanically (Hoyer / Sabina lift). The type of transfer depends mainly on the patients physical condition.  If a patient is capable of providing some assistance, a staff lift (one or two person transfer) is generally done.  However, if a patient is paralyzed or suffers from physical disability, the use of a mechanized lift may be required to safely transfer the patient.

The choice of how to transfer a patient from a bed to a wheelchair is up to the facility.  A determination of the type of transfer should be part of the evaluation when a person is admitted to the facility and for quarterly reviews of nursing home patient needs.  It is crucial for the staff at the facility to use the properly predetermined transfer technique or the nursing home resident is at risk to injury. 

If you or a relative sustained an injury during a 'transfer' to wheelchair, walker or toilet, there is a strong likelihood the staff responsible for supervising made an error.  We have handled many similar lift-related injury cases.  Put our experience to work for you.  To speak with our team of nursing home attorneys, call (888) 424-5757.

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Falls are a common problem facing elderly people in and out of nursing homes.  By some accounts, every elderly person in America will fall at least one time over the course of the next year.  Many of these falls will cause injury and some will even cause death.

In the case of falls occurring in the nursing home setting, many clients and their families focus their attention on tying a specific number of falls to a facilities responsibility.  Truth be told, there really is no magic number when it comes to identifying a specific number of falls after which a nursing home or hospital becomes responsible.

Rather, in determining a nursing home's fall related liability, it is important to determine not just the actual number of falls that occurred prior to the injury causing fall, but to look at the situation as a whole.  Taking a look at the residents 'fall-risk assessment' completed by the facility on admission should help determine what safeguards should have been in place to prevent falls.  In the case of multiple falls, it is important to look to see if a new assessment was completed after each fall.  Put another way, there is no magic number of falls for imputing responsibility on the part of a facility.

While in the fall mode, I came across this article regarding a lawsuit filed against a nursing home for failing to take precautions before a resident fell and died from her injuries.  The lawsuit alleges that Windsor Chico Creek Care and Rehabilitation Centers failed to implement fall precautions for a woman who was admitted to the facility following a back injury that made her susceptible to falls.

The woman's husband filed a nursing home lawsuit claiming that the facilities negligent conduct resulted in the woman falling from her bed and fracturing her hip. The woman subsequently underwent surgery for the hip fracture and contracted aspiration pneumonia during her recovery that ultimately caused her death.

The lawsuit alleges that despite the facilities own orders for safety precautions, Windsor Chico Creek Care and Rehabilitation Center failed take the following precautionary measures to prevent the woman's fall from occurring:

• Failed to use guardrails on the bed
• Failed to use an alarm system to alert staff if the woman fell from her bed
• Failed to used a lowered bed style to minimize the risk of falling from an elevated height
• Failed to hire an adequate number of staff to provide assistance

In this case, should the allegations proved to be true, this facility faces liability even though no prior falls took occurred.  The lawsuit also names Helios Healthcare LLC, the owner of Windsor Chico Creek as a co-defendant in the case.

Related Nursing Homes Abuse Blog Posts

Nursing Home Sued Following Death Of Resident In Fall

Woman Dies From Brain Bleed Following Unsupervised Fall

Study Links Medication Use With Falls

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A fire in a Russian nursing homes claimed the lives of 23 of its residents.  Nursing homes in the United States are required to install automatic sprinkler systems over the course of the next five years per orders from the Centers For Medicare.  Further, nursing homes must have an operable, battery powered smoke alarm in each room.  Hopefully, these fire prevention tools will help ensure the safety of nursing home residents.

Recent Nursing Home Abuse Blog posts on nursing home fires:

Burns In Nursing Homes

Ohio Nursing Home Fire Sparks Interest In Resident Safety

Resident Who Smoked & Used Oxygen Is Suspected Of Starting Fire In Assisted Living Facility

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On December 18th, the Justice Department's Civil Rights Division, released a 45-page report relating to numerous conditions and practices that violate the 'constitutional and federal statutory rights'  of the residents at the William F. Green Veterans Home.  The report follows an inspection, interviews and document review by officials of the Alabama Veterans Home.  The  federal report, authored by acting Assistant Attorney General Grace Chung Becker, concludes residents at the facility 'suffer significant harm and risk of harm from the facility's inadequate medical and nursing services.'

In particular, the report identifies the following problems relating to improper patient care:

• Inadequate nutrition and hydration
• Improper use of psychotropic medication
• Inadequate pressure sore treatment
• Inadequate restorative care and specialized rehabilitation services
• Failure to protect residents from harm due to falls
• Failure to investigate allegations of resident abuse
• Inappropriate use of restraints

Human Management Resources has had the contract to staff Alabama's three veteran's home since 2004. In 2007, an Alabama Department of Public Health inspection revealed staffing violations and the company was downgraded to probationary status.

Despite the reports of serious safety violations, no immediate penalties have been implemented.  'Scot Montrey, a spokesman for the Justice Department's Civil Rights Division says, "It is quite possible that some remedies will already be under way.  "Our next step ... depends on the level of cooperation we receive, but typically we reach some kind of settlement rather than having to file a lawsuit."

Read more about these allegation of improper nursing care here.

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Lawmakers in Tennessee are attempting to limit the rights of those injured due to nursing home abuse & neglect.  Under a bill proposed by State Senators Jim Tracy (R-Shelbyville) and Randy Rinks (D- Savannah), nursing home residents injured or killed due to a facilities poor treatment would be limited to a recovery of $300,000 in non-economic damages.  The bill would also place a cap on punitive damages against nursing homes of $600,000.

This protectionist legislation would provide little incentive for poorly equipped nursing homes to 'clean up their act.'  Taking the decision making process away from a jury of one's peers sets a dangerous precedent in an industry riddled with problems related to patient safety.  Read more about this potentially dangerous development impacting Tennessee Nursing Homes here.

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The Portland nursing home director who blatantly disregarded a resident's severe injuries has been sentenced to 19 months in prison.  Susan Ruddell, was found guilty of criminal mistreatment for her role in a 2006 incident where a nursing home resident was dropped on the ground and ignored for five days before she was taken to a hospital despite visible fractures to her legs. The resident died shortly after the incident from complications related to her injuries.  See the full report of this Portland nursing home director's sentencing here.

Too often meager fines are imposed on facilities that provide poor nursing home care.  The fines are little more than a slap on the wrist to the nursing home owners and administrators.  Hopefully, this case was serve as a wake up call to nursing home administrators though out the country that that they may be held criminally responsible for mistreatment and abuse of their residents.

Read about the Nursing Homes Abuse Blog's earlier report on this case of nursing home abuse here.

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Capital Care Center, an Illinois nursing home, has been fined by federal health officials for failing to prevent an dementia resident from tumbling down an unsecured stairway in his wheelchair. Illinois Department of Public Health reports claim Alfred 'Stan' Catherwood, a World War II veteran, suffered from dementia and was considered a high risk for wandering from the nursing home.

Despite being a 'high risk' for wandering, the nursing home allowed Mr. Catherwood to sit strapped into his wheelchair near a second floor stairway.  The stairway was unequipped with a key-code lock or automated alarm.  Without knowledge of the nursing home staff, Catherwood entered the stairway and fell down weight stairs.  Mr. Catherwood fractured his neck and facial bones in the fall.

As a result of this incident, Capital Care Center received a $3,500 fine for failing to provide adequate supervision.  Following this incident, nursing home officials also installed a keypad lock on the door and posted signs encouraging visitors and staff to make sure doors remain locked behind them.

Once again, this incident demonstrates how simple precautions can ensure a safe nursing facility. Too often nursing homes fail to take basic steps to protect their residents.  In this case, the nursing home staff redirecting a dementia patient when he is in harm's way and installing a $10 safety device would likely have prevented a serious injury to this elderly man.  Read more about this serious nursing home injury at an Illinois nursing home here.

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Unsatisfied with the nursing home's explanation for the dozens of bruises on their 84-year-old grandmother, the family of Armeda Thomas, an 84-year-old resident at Madison Manor Nursing Home decided to place a video camera in the disabled woman's room.  The video tape confirmed that Thomas was the victim of physical and verbal abuse from the staff at the facility.  The video revealed the following evidence of abusive behavior on the part of nursing home staff:

• Failed to bathe Thomas
• Failed to feed Thomas. 
• Taunting and mocking the disabled woman
• Pulled residents out of bed by their neck
• Let Thomas lay on the floor for an hour before any aid was provided

Following the discovery of the videotaped abuse, the Attorney General began a criminal investigation which revealed the nursing home failed to investigate injuries of 'unknown origin' to 17 cognitively impaired residents at the facility.  Kentucky nursing home investigators issued a Type-A citation to the nursing home determining the conditions at the facility posed immediate danger to the residents. 

According to Kentucky nursing home records, the facility has corrected the violations posing immediate jeopardy to residents and is working to correct the less serious violations.  Madison Manor is part of the Richmond Health and Rehabilitation Complex and is owned by Extendicare, a national nursing home operator.

Although the nursing home employees behavior is inexcusable, blame for this barbaric treatment also falls on Extendicare.  The fact that there are multiple episodes of abusive behavior can only mean that Extendicare has failed to provide adequate training and supervision for its employees.   

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"Are there limits on the compensation the victim of nursing home injury can recover?" Asks Nancy of Palos Heights, Illinois with a pending claim against a Chicago nursing home involving her fathers wandering from a nursing home.

No.  There are no monetary limits on the damages available for victims of nursing home abuse and neglect.  You are entitled to whatever a judge or jury determines to be fair and reasonable compensation.  A jury may award damages for both past and future: medical expenses, pain and suffering, disability and loss of a normal life.  In the case of wrongful death, a jury may award damages for loss of society to the family of the deceased.

However, there are important issues that impact the amount of compensation an injured person or the estate of deceased person may receive.  The first hurdle involves nursing homes with no liability insurance.  With a weak economy and some large verdicts rendered against them, some nursing homes have decided to go 'naked' with respect to liability coverage for claims and lawsuits brought against them.

The result of having no liability insurance (or in some cases limited insurance coverage) ultimately means that the injured party is limited in his recovery.  Unless a nursing home or assisted living facility is part of large corporation, it is difficult-- if not impossible, to collect on a judgment involving an entity with no insurance coverage.  Put another way, a large judgment may be worthless if the nursing home is unable to satisfy it.  Many individual nursing home owners have established complex systems of ownership that limit the owners personal liability.

In cases of uninsured or under-insured nursing homes, settlements may still be arranged.  Most settlements with nursing homes having limited or liability insurance represent a compromised result--generally less than the full value of the claim. 

Most people never inquire about a nursing home's insurance coverage until it is too late.  In addition to researching facilities track record with respect to complaints and lawsuits, it is also advisable that an inquiry be made with respect to the insurance coverage for a particular facility.  Why not learn as much as possible about the facility responsible for the care and safety of your loved one?

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A faulty handicapped lift is being blamed for the death of a Canadian nursing home resident.  According to the coroner, the LIKO 102EE mechanical lifting device malfunctioned during operation at the Leisureworld Caregiving Center (O'Conner Gate) in Toronto.

This particular lift is widely used in Canada and throughout the United States.  There are 12 reports of LIKO lifts malfunctioning since 2005 in the United States.  This lifting device is used to transfer people with limited mobility from bed into their wheelchairs.

Coroner Jim Edwards recommends the lifts be removed from nursing homes until the manufacturer can correct the problem.  The Swedish manufacturer has agreed to replace specific model lift.  Injuries occurring during the transfer of patients are some of the most frequently encountered amongst both nursing home residents and staff.  Nursing home should make sure their staff are properly trained in the use of all lifting devices and manual lifting techniques to assure resident safety.
 

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In situations where there has been a specific incident involving a serious injury or abuse, the nursing home resident themselves or their family will seek out the advice of a nursing home attorney for representation.

The majority of nursing home neglect cases are far more subtle and many people are hesitant to seek out an attorney.  The best rule of thumb is to trust your instinct.  If something doesn't seem right--it's probably not.  Because most cases of nursing home neglect involve ongoing mistreatment, it is important to contact an attorney when you begin to suspect the nursing home may be treating your loved one improperly. 

Pay attention to the physical signs.  Most elderly are hesitant to report situations involving nursing home abuse or neglect and may be scared to confront the people responsible for providing their care.  Patterns of injury should not be tolerated.  Repeated falls, bruising, cuts or infection deserve to to investigated as they are easily preventable situations that are indicative of staffing problems at a facility.

Statute of limitations, or specific time allotments, govern how much time one has to bring a lawsuit against the nursing home or long-term care facility.  Statute of limitations may provide years for pursuing a cause of action.  However, the sooner an attorney is contacted, the sooner an investigation can be started to determine what may have caused the injury or abuse.  Many cases involving nursing home abuse, neglect or injury require the review of extensive medical records and expert witness consultation--time consuming practices to say the least. 

Even in situations where there may seem to be a lack of evidence to prove neglect on the part of the nursing home, an experienced nursing home attorney will be able to sort through the evidence and determine if there is a case and how to proceed.  Most nursing home attorneys work on a contingency fee, meaning they only receive a fee if they are successful in obtaining compensation for the injured party.  No out of pocket expenses are required on behalf of the client. 

There has been a recent trend, in some situations involving severe injury, where the nursing home or hospital may seem to take responsibility for an injury.  Representations may be made by the staff at these facilities that they will 'do whats right' to remedy the situation.  Don't be lulled into believing this song.  Rarely --if ever -- do these individuals really have the interests of the injured party in mind.  Moreover, without the consult of an attorney well versed in what damages an injured person is entitled to receive, the nursing home or hospital will use its uneven bargaining position in its favor.

If you or a loved one suspect the nursing home, long-term care facility, home nurse or hospital may have caused or contributed to an injury or situation involving abuse, why not speak to an attorney who has your interests in mind without any charge to you?

Resource:

Nursing Home Injury Laws

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Another crisis is about to grip our country.  As we attempt to get a over our finances, a nursing shortage is beginning to effect patient care and seems to be a problem that will plague us for many years to come.  Nurse Tom reports that nursing shortages in hospitals and nursing homes are an ever increasing problem for patient safety.  The safety problems created by under-staffing have become an even bigger problem for hospitals has they can no longer receive Medicare and Medicaid reimbursement for event determined to be preventable or commonly referred to as 'never events.'

How extensive is the nursing shortage?

In 2007, a survey completed by the American Hospital Association found that hospitals require an additional 116,000 RN's to fill immediate vacancies. Statistics from Flotsam and Jetsam Blog report current nursing shortages at 14% of hospitals where there is a severe vacancy.  By 2025 the nursing shortage is expected to increase to 500,000 RN's- the most highly trained nurses.

Increased liability risk for hospitals and nursing homes

"As I see it, nursing is the most important area to focus on when it comes to preventing hospital mishaps," according to Tom Sharon, creator of the Legal Nurse Consultant website.  Hospital Corporation of America is currently facing a class-action lawsuit claiming the company engaged in systematic under-staffing of RN's throughout all of its hospitals.  The lawsuit claims that the 'systematic under-staffing' places patients at increased risk for complications such as infections, bedsores and death. 

Nurses are on the front lines of responding to patient needs.  If nurses are not there to attend to patients it is no secret that serious medical problems may go unattended.  A new wave of lawsuits is being filed against hospitals for under-staffing.  It is increasingly becoming not a question of what was done improperly, but a question as to what medical treatment was not provided.

A cure for the nursing shortage

There is no immediate cure for the nurse shortage problem.  The Registered Nurse Safe Staffing Act, recently introduced federal legislation, would ensure that each hospital generate a staffing system that ensures appropriate number of registered nurses on each shift and in each unit of the hospital.  

Other ideas include using volunteers to help with basic tasks such as monitoring patients in waiting areas and hospital rooms to make sure nothing happens while they are recovering form a procedure or waiting to see a doctor.  As nurse Tom says, 'There's no skill to that. Just sit there and watch to prevent falls."

The nursing shortage's impact on nursing home

Residents of nursing home will likely see a bigger impact that other medical care recipients.  Many skilled nurses who currently work in nursing home will be sucked out of those facilities and into higher paying nursing positions in hospitals.  A nurse in a hospital may earn several times what the pay rate for nurses is in a nursing home.  Unfortunately, until a priority is placed on providing quality nursing home care, there will likely be a continued correlation between inadequately staffed facilities in incidents involving nursing home injury and neglect.

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Eyes On Living had an interesting blog post recently 'Florida Nursing Home Abuse Lawsuits Increasing Thanks To Aggressive Lawyers.'  The article is a little tongue in cheek with respect to how attorneys want to help victims out of the kindness of their own heart, but the author does acknowledge that lawsuits filed in states with a substantial elderly population has actually improved the quality of nursing home care.

This got me thinking about the impact of nursing home litigation has on the overall care received by nursing home residents.  Do nursing home lawsuits have an impact on the quality of nursing home care?  The answer, in my eyes, is a resounding 'yes'. 

Sure, we all hear about juries awarding people with superficial injuries large awards and the recipients going out and spending their awards on lavish things.  The reality of the overriding majority of nursing home injury cases, it that many of these people have been downright neglected or abused and their lives have been forever changed by the acts of nursing homes for the worse.

For many victims of nursing home abuse and neglect their golden years have become anything but happy and satisfying.  Too often, the lives of seniors have been cut short or painfully altered by the acts of facilities that were intended to care for them.  

The purpose of the Nursing Home Care Act in Illinois is similar to laws in place in Florida and Texas--it is intended to help residents of nursing homes and other long-term care facilities from being taken advantage of and ultimately injured.  These laws also allows for attorneys to recover their legal fees if they are successful in their case against the nursing home.

Bad nursing homes are being forced to change their ways.  Many facilities that once cut corners with respect to patient safety can longer do so or they face claims and lawsuits for serious injury.  If improving patient safety and care means that some facilities are forced to close their doors, in the long run we all will be better off.  

Excuse me while I go look look for a billboard...

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We recently discussed how the Metron Nursing Home in Allegan was losing its Medicare and Medicaid funding due to multiple violations in patient care.  Now, more information has come to light about the the Michigan Attorney General's investigation and the forced sale of the facility.  Two nursing home residents at Metron of Allegan died after nursing home workers failed to administer oxygen. 

The incidents follow a similar 2005 incident when, Sarah Comer died at the Metron of Big Rapids. The death of Comer lead to a lawsuit against the nursing home.  In the course of litigation, allegations of nursing home workers covering up Ms. Comer's death began to surface.  The workers were alleged to have conceived of a story to suggest that Ms. Comer died from caused unrelated to the negligent administration of oxygen.

The facility was recently found to be in violation of 11 safety violations partially consisting of:

• Failure to provide oxygen, resulting in two deaths.
• Failing to prevent resident-on-resident physical and sexual abuse.
• Failing to investigate a resident who eloped from the facility.
• Failing to provide pain medications prescribed by doctors.

Prior to losing its Medicare and Medicaid funding, Metron has has ample warning to correct the consistently poor care served to its residents: Metron has been under state oversight for two years, fined over $300,000.00 for heathcare citations and had its facility in Kalamazoo closed when inspectors found serious violations relating to patient care.  It seems that for the good of all residents at Metron facilities, they should be shut-down for good.

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The Legal Medicine Blog written the Dan Frith and Lauren Ellerman commented on a recent incident involving a Colorado nursing home's failure to provide assistance to a nursing home resident using the the bathroom.  Firth and Ellerman get at the meat of the issue with respect to many nursing home falls and scores of nursing home injuries--not enough nurses.

Sure shiny, pretty facilities are nice, but when evaluating facilities, the most important criteria in the selection of the facility is if the facility has enough staff.  Not just nurses, but also nurses aides, physical therapists, maintenance personnel and even cafeteria workers are all important to the providing quality patient care.  Adequate staffing provides ample manpower to properly look after nursing home residents. 

A nursing home staff member must provide assistance, not only in skilled nursing care, but also in looking after residents basic needs goes far in prevention of incidents which may harm residents and eventually cost the facility in litigation expenses.  As the Legal Medicine Blog points out you should ask to see staffing polices when selecting a nursing home and don't be shy about speaking to the residents about their experience.  If the facility will not let you speak to residents, thank them for their time and leave right away.

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The Senate Finance Committee passed the Patient Safety and Abuse Prevention Act, S. 2838 which notably abolishes mandatory arbitration clauses and establishes a nationwide system of background checks to stop convicted felons from working in nursing homes and other long-term care facilities.

The bill is now going before the full Senate.  The legislation puts in place a system of background checks and encourages federal and state coordination. It will utilize the FBI’s national database and state police records in order to effectively screen potential care-givers for criminal history. The criminal background checks will prevent common incidents involving: sex abuse, physical abuse and neglect. 

Nursing home arbitration clauses have been a sneaky secret inserted into admission documents for unsuspecting nursing home residents and their families.  The arbitration clauses attempt to force cases involving nursing home injury or death to be resolved before an arbitrator as opposed to being able to have their case heard in court.  In many circumstances the arbitrators are actually paid by the nursing homes--hardly impartial.

The Watchdog Blog and specifically blog authors, David Arkush and Christine Hines did a nice job describing how the nursing home industry did its best to misrepresent the importance of a right to jury trial for nursing home cases.  Arkush and Hines sum it up best when describing the intentions of nursing home owners attempts to continue with mandatory arbitration, 'We're corporate lobbyists fighting for the right to neglect or abuse elderly nursing home residents with impunity.  Our corporate clients want to make millions in profits without worrying about being held accountable if they hurt people.'

Call your senator and tell him or her to vote to support the Fairness In Nursing Home Arbitration Act.

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The Green Meadows Health Care Center in Louisville, Kentucky has lost its Medicare and Medicaid funding after repeatedly putting their residents at risk for danger and not investigating resident injuries.  No specific act of wrong doing is cited in the denial of government funding.  Rather, the nursing home  has received numerous type 'A' citations.  Type 'A' are the most serious and are dealt out when a nursing home resident's safety is endangered. 

Nursing homes rely almost completely on government payment to operate.  Once Medicare and Medicaid funding is lost, most nursing homes must close their doors.  Most nursing homes rely on government funding for 80-90% of their budget.

The situation at Green Meadows demonstrates the importance of making complaints regarding dangerous nursing home care.  Making a complaint with your state regulatory agency not only helps with determining the cause of nursing home abuse or neglect, but it also creates a record for future use  in screening facilities by others.  Facilities that receive ongoing complaints are subject to having their licenses pulled and government funding withheld.  If you believe that a nursing home in your area is putting the safety of residents at risk, look at the link here to learn to file a complaint against the facility using your state's nursing home ombudsman and investigators.

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A Scottsdale, AZ nursing home resident died after in the burn unit of an area hospital.  According to reports, the 89-year-old woman died after she apparently set herself on fire while smoking on a patio.  The woman was left unattended while the woman's caretaker was in the kitchen at the facility.

When paramedics arrived at the nursing home, they found that the victim was burned when her dress caught on fire.  The resident told paramedics that she was outside smoking and tried to burn off a loose thread on her dress with a lighter.  Apparently the dress caught fire and she received 3rd degree burns over 40 to 50 percent of her body.

Nursing homes have responsibilities to properly supervise their residents.  Moreover, they must have policies to aid in resident safety.  In addition to the fact that this woman was left unattended, she also was in possession of a cigarette lighter.  Lighters are one of the most common sources of injury to nursing home residents.  Nursing homes should have strict smoking policies in effect--banning the possession and use of cigarette lighters. 
 

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The Milwaukee Journal Sentinel, is running a series of articles documenting some of the problems with nursing homes and other long-term care facilities in Wisconsin.  After reading the articles, it is apparent that the quality of care nursing home residents receive is deteriorating.  The need for additional regulation of the nursing home industry is apparent.  The 20 year old laws (1987 OBRA) regulating the industry are not producing the results for which they were intended.

Some of the more striking statistics identified in the articles, include:

• Most nursing home staff positions have high turnover-- some nursing positions have more more than 200% annual turnover
• Bad care in corporation owned nursing homes is more widespread than ever:
  • 401 Number of nursing homes in Wisconsin
  • 56 Number of residents who died in cases in which a nursing home was cited since 2005
  • 359 Number of residents injured in homes from 2005 to 2007
  • 262 Number of homes cited for serious violations in 2005-'07*
  • 109 Number of nursing homes owned by out-of-state companies
  •  $8.7 million Fines issued by state regulators since 2005
  • $3 million Amount of those fines yet to be collected
• Current training requirements for nurse aids is a joke.  Barbers and beauticians need more training than nursing assistants, state records show.
  • Nursing assistants must get 75 hours of classroom and practical instruction to be state certified. People who style hair for a living need 648 hours of theory and 1,152 hours of practical instruction. The training requirements for certified nursing assistants have not changed since 1987, authorities said.

The authors identified the five most common types of serious safety violations in nursing homes from From 2005-’07:

    1. Failure to provide quality care (mostly nursing care and pain management)
    2. Failure to prevent or treat pressure ulcers
    3. Failure to prevent accidents or provide a safe environment
    4. Failure to notify a physician after significant change in a resident's condition
    5. Failure to promptly report alleged abuse or neglect

Ultimately, all safety issues in nursing home are the result of inadequate care and under-staffing.  Most nursing homes are designed to provide 24 hour care to their residents.  Facilities that have higher ratios of nurses to patients tend to provide superior care to their residents.  If there is one criteria to check when evaluating multiple nursing homes facilities, it is to look into the number of nurses on staff and the ratio of nurses to patients.

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• Require nursing home owners to have minimum insurance of 1 million per occurrence
• Allows the Illinois Department of Public Health to revoke nursing home license for owners without the necessary coverage
• Provides a penalty for facilities without coverage as 'Type A' violation under the Nursing Home Care Act
• Forces disclosure of each nursing home's insurance policy to the public
• Forces a nursing home licensee to pay 3 times the actual damages, or $500 whichever is greater (rather than the actual damages) and costs and attorney's fees to a resident whose rights have been violated

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