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

The family of retired Judge John Philips has filed a nursing home negligence lawsuit against Prospect Park Residence alleging the facilities failure to treat the man's diabetes resulted in his death. According to the lawsuit, the staff failed to provide him with a specialized diabetic menu and failed to administer his insulin on a regular basis. 

According to Philips long-time friend John O'Hara, "He had diabetes that was supposed to be controlled.  They kept screwing up.  They killed him." 

The lawsuit seeks $10 million from this New York nursing home.  Read more about this lawsuit here.

Diabetic Nursing Home Patients

According to the American Diabetes Association, approximately 18.3% (8.6 million) of Americans age 60 and older have diabetes. The prevalence of the disease increases with age; an estimated 50% of all diabetes happens in those aged 55 and older. The risk of developing type 2 diabetes also increases with age.

Particularly in patients with type 2 diabetes, age causes a decline in insulin production and an increase in glucose intolerance. Older Americans are also more likely to have complicating conditions such as retinopathy, hypertension, ketoacidosis and kidney problems.  Nursing home staff should carefully monitor glucose levels and make every effort to timely administer insulin if necessary.

Related:

Diabetic Ketoacidosis Is An Under-Appreciated Danger Facing Many Nursing Home Patients

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After a one week stay at Caseyville Nursing and Rehabilitation, Theresa Mary Steiner's pressure sores significantly deteriorated to the point that she had become 'septic' according to a recently filed lawsuit.  The lawsuit claims that on December 12, 2008 Ms. Steiner was admitted to the facility with stage II pressure sores on her buttocks and early stage pressure sores on her heels.  Five days later, when Ms. Steiner was discharged, the pressure sores had advanced to stage IV and Ms. Steiner had become known as septic.  As a result of the sepsis, Ms. Steiner died.

The lawsuit further alleges that Caseyville Nursing and Rehabilitation was negligent in the following ways:

• Failing to screen Ms. Steiner on admission to the facility
• Failed to have adequate staff to treat Ms. Steiner's wounds
• Never developed a care plan for Ms. Steiner
• Never notifying Ms. Steiner's physician as to her condition

My take:

With the obvious disclaimer (I don't know anything about the case other from what is in the newspaper), it would appear as though the Ms. Steiner's family may have a difficult time winning their case. 

As the plaintiff in this matter, Ms. Steiner's family has the burden to prove their case.   Given the fact that Ms. Steiner enter the nursing homes with clearly form pressure sores and the wounds worsened in such a brief period of time, perhaps the damages was done by the time she had entered the facility?

Sepsis and Pressure Sores

With open wounds from pressure sores, bacteria can easily enter the bloodstream and cause and infection in the body.  When the infection progresses, it may cause sepsis. In order to make a diagnosis of sepsis, at least two of the following must occur: a heart rate above 90 beats per minute, hyperventilation (more than 20 breaths per minute) and white blood cell count below below 4000 cells/mm.

Symptoms of sepsis include:

• Fever
• Low body temperature (hypothermia)
• Loss of ability to appreciate surroundings
• Cool hands and feet
• Anxiety
• Shaking
• Organ dysfunction

In order to provide patients with the best chance of recovery, facilities should identify and treat patients as quickly as feasible. If not treated properly, many patients with sepsis die shortly after the condition develops.

Resources:

Is sepsis related to bed sores? Bed Sore FAQ

Nursing home blamed for resident's sepsis St. Clair Record, December 7, 2009

Sepsis Nursing Homes Abuse Blog August 7, 2008

Nursing Home Injury Laws

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One of the nursing home negligence cases my office is currently investigating involves the death of a man related to complications related to amyloidosis.  Turns out, the man was suffering from an advanced bed sore on his coccyx (also called pressure ulcers, pressure sores or decubitus ulcers) that had progressed so far that the bone in the area had become infected (osteomyelitis).

Elderly nursing home residents, especially those suffering from other diseases such as bed sores, have a higher risk of developing amyloidosis, a disease which can damage various tissues and organs.  This can cause dangerous complications in residents who are already weak from advanced age or underlying disease.

Amyloidosis is a group of diseases caused by abnormal deposits of amyloid protein (usually produced by cells in bone marrow) in the body’s tissues and organs.  The disease frequently affects the heart, kidneys, liver, spleen, nervous system, and gastrointestinal tract.  The amyloid protein can deposit in a localized area (localized amyloidosis) or affect tissues throughout the body (systemic amyloidosis).  Amyloidosis is diagnosed for testing for the amyloid protein in a biopsy of involved tissue. 

Systemic amyloidosis is classified into three major types:

• Primary (AL) amyloidosis
• Secondary (AA) amyloidosis
• Hereditary or Familial (ATTR) amyloidosis

Primary amyloidosis, the most common form of amyloidosis, occurs when a plasma cell in the bone marrow spontaneously overproduces a particular protein portion of an antibody.  AL can affect many areas (heart, kidneys, liver, spleen, nerves, intestines, skin, tongue, blood vessels) and can occur with bone marrow cancer (bone marrow cancer), but is a disease entity of its own.

Secondary amyloidosis occurs as a result of another illness (multiple myeloma, chronic infections including tuberculosis and osteomyelitis, or chronic inflammatory diseases including rheumatoid arthritis and ankylosing spondylitis).  It usually affects the kidneys, spleen, liver, and lymph nodes.  Treatment for AA is usually treating the underlying illness.

Familial amyloidosis is a rare form of inherited amyloidosis that is an inherited autosomal dominant disease (meaning that the offspring of a person with the condition has a 50% chance of inheriting it).  ATTR usually affects the liver, nerves, heart, and kidneys. 

The signs and symptoms of amyloidosis depend on the tissues or organs affected.  The symptoms result from abnormal functioning of the organs and tissues involved.  They may include:

• Swelling of ankles and legs
• Numbness or tingling in hands or feet
• Severe fatigue
• Weakness
• Significant weight loss
• Loss of appetite
• Shortness of breath
• Irregular heartbeat
• Diarrhea or constipation
• Protein in urine
• Feeling full quickly
• Enlarged tongue
• Difficulty swallowing
• Swelling
• Skin changes (thickening or easy bruising)
• Purplish patches around the eyes

 Risk factors for amyloidosis including:

• Age – older than 65
• Other diseases – having chronic infections or inflammatory disease or osteomyelitis
• Family history – history of amyloidosis
• Kidney dialysis – large, abnormal proteins can build up in the blood

The severity of the disease depends on which organs and tissues are affected.  The disease can result in dangerous complications including kidney damage, heart damage, and nervous system damage.  Kidney damage can result when amyloidosis affects the kidneys.  Kidney problems frequently translate to damage with the bodied blood filtering system, allowing protein to leak from the blood into the urine.  This may result in kidney failure. 

Heart damage can also occur when amyloidosis affects the heart.  This reduces the heart’s ability to fill with blood between heartbeats, meaning less blood is pumped with each beat.  Nervous system damage can also occur when amyloid protein deposits affect the nerves.  This can result in numbness, tingling, or difficulty controlling blood pressure. 

There is no cure for amyloidosis, but treatment may help manage the signs and symptoms of the disease, limit further production of amyloid protein, and treat any underlying disease.  Several treatments of primary amyloidosis are being studied including medicine and peripheral blood stem cell transplantation. 

Nursing home residents suffering from painful pressure sores are at an increased risk for amyloidosis.  Should a pressure sore patient develop amyloidosis, they run the risk of organ tissue damage and increased risk of amyloid protein deposits.  Also, paraplegic patients suffering from sepsis as a result of pressure sores also face complications stemming from amyloidosis. 

Sources:

Mayo Clinic: Amyloidosis

Boston University: Amyloid Treatment and Research Program

Amyloidosis Foundation

Pressure sores: aetiology, treatment and prevention (Colin Torrance)

Related:

Bed Sore FAQ

Bedsores: Are You At Risk?

In For Rehab. Out With Bedsores.

"The Nursing Home Says My Dad's Bedsores Were Unpreventable..."

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In defense of nursing facilities, any person can make an allegation that the facility provided abusive care.  Consequently, the unfounded allegations can and should be discarded. 

Nonetheless, when many people complain of poor care at the same facility--- and many of the allegations are substantiated, there should be real cause for concern.

CBS 2, a Chicago television station, recently reported on such a facility, Westmont Nursing & Rehab Center, in Westmont, IL.  In its report, CBS interviewed staff and family members who witnessed abusive situations such as:

• Failing to provide feeding assistance to patients who need help with meals
• Unexplained bruises
• Dirty living conditions
• Giving cold showers to difficult patients
• Staff 'throwing' patients into bed

Lest anyone suggest that the news reporter intentionally selected these people for her story to sensationalize a tragedy, the Illinois Department of Public Health investigated many of the allegations and confirmed mistreatment.  

Out of 31 investigations relating to abuse, the Illinois Department of Public Health substantiated 11 claims for poor quality care and one case of confirmed abuse.

Currently, Westmont Nursing & Rehab faces $200 per day in fines due to safety violations.

Time to look for another facility?

The thing that caught my attention regarding this story, is that many of the families who were interviewed for the story are not seeking another facility for their loved ones. In my humble opinion, for both safety and litigation-related reasons, they need to begin looking for alternative facilities for their loved ones. By keeping their family members at the nursing home, there is an implicit understanding that they approve of the care the facility is providing.  

Should a lawsuit against Westmont come along, the argument will certainly be made that by keeping their loved ones in the facility-- after they became aware of the suspected abuse-- that they somehow approved of the care.

Maybe I'm wrong, but I'll bet many jurors will buy into the nursing home's lawyers argument, 'If they thought the nursing home was doing such a bad job caring for their loved one, why did they keep them here?'

Related:

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

What Are Signs Of Nursing Home Abuse?

Just Do It. Photograph Everything

IDPH Surveys for Westmont Nursing & Rehab Center

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A nursing home negligence lawsuit has been filed against Brookdale Senior Living Center for failing to protect its patients.   Janice Maier's family brought the lawsuit against Brookdale after she was physically abused by an intruder to the Texas nursing home. 

A police investigation concluded that 25-year-old Daniel Villarreal pushed the back door of the nursing home open and entered Ms. Maier's room and began choking her.  Mr. Villarreal remains in police custody and has been charged with Injury to an Elderly Person, a 1st degree felony.

Ms. Maier is currently in intensive care at University Hospital.  Read more about this brutal attack of a nursing home patient here.

Brookdale Senior Living 

Brookdale is the nation’s largest owner and operator of senior living communities throughout the United States. Currently, Brookdale operates more than 548 senior living and retirement communities across the nation.  More than 50,000 seniors depend on Brookdale for their daily living needs.

Related:

Centenarian Murdered At Nursing Home With Troubled Past

Nursing Home Staff Does Nothing To Stop Known Molester From Assaulting Disabled Woman

Elder Abuse Is Widespread & Under-Reported

No Remorse From Admitted Elder Abuser

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As nursing home lawyers, one of the situations we commonly encounter involve relatively healthy people who enter nursing homes for rehabilitation due to an orthopedic or cardiac conditions--- only to encounter more problems during their admission to a facility.  In some of these situations, nursing home staff wrongfully assume that many of the prevention programs used for more disabled patients are not necessary.

What makes these type of cases particularly sad is to hear a family member describe the rapid decline in a loved ones physical and psychological condition within a short period of time.  In rehab admissions, no one ever suspects that ever suspects that their family member is potentially at risk for injury or illness due to the brief admission.

The New York Daily News reported on one of these situations where serious complications developed with a healthy patient who was admitted to a New York nursing home during a rehab stint.  In 2005 Vera Henry was admitted to Sutton Park Center For Nursing and Rehabilitation for therapy for her arm that she injured in a fall.  The admission was to last no longer than one month.

Apparently the Sutton Park staff failed to provide Ms. Henry with the therapy she was intended to receive.  During her stay Ms. Henry developed an advanced bed sore that ultimately became infected and caused her death.

Not only did the facility fail to provide the physical therapy and bed sore prevention programs, the facility failed to alert Ms. Henry's family or her physicians of the development of the wound.  The bed sore was not discovered until Ms. Henry's daughter, Patricia Henry, went to change her mother's clothes and noticed that an advanced bed sore had developed on her mother's tailbone.

"You could put your whole hand down in her back ," said Patricia Henry.  "You could see the bones and spinal cord.  It was like raw meat.  Mommy screamed until she could scream no more," she added.

Ms. Henry's family has filed a wrongful death lawsuit against Sutton Park Center for Nursing and Rehabilitation and its sister facility South Shore Medical Center.  The case is pending in Bronx Supreme Court.

Read more about this lawsuit against a New York nursing home here.

Related Nursing Homes Abuse Blog Entries

Nursing Home Owner Leave Resident On Bedpan for 24-Hours, Now Faces Jail Time

"The Nursing Home Says My Dad's Bedsores Were Unpreventable..."

In For Rehab. Out With Bedsores.

A Graphic Example Of Nursing Home Negligence: Amputation Of A Leg Due To Untreated Bed Sores

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One of the more tragic cases, my office is working involves a woman who developed pressure sores on her heels during an admission to a New Mexico nursing home.  Despite the fact that the woman was bed-bound, the facility took virtually no preventive measures to avoid pressure sores.

In fact, by the time the staff at the nursing home began to treat the wounds, much of her heels and feet were covered with necrotic tissue.  A systematic infection developed and both of the woman's legs required above-the-knee amputation to prevent the infection from spreading--- and probably save her life.

Pressure sores (also known as bedsores, pressure ulcers, or decubitus ulcers) are caused by pressure, which cuts off blood flow to parts of the body resulting in areas of injured skin and tissue.  The areas of the body most vulnerable to pressure sores are the heels, hips, and buttocks.  Persons who are bedridden, have limited mobility, or are confined to a wheelchair are especially at risk for pressure sores. 

As such, elderly nursing home patients are particularly vulnerable to pressure sores because of prolonged bed rest, limited mobility, and weakness.  Nursing home staff must turn residents who are bed ridden or have prolonged bed rest often enough so blood can circulate to areas that are under pressure. 

Pressure sores can be a very serious condition depending on how much skin and tissue is damaged.  Deep pressure sores can go all the way down to the muscle or even the bone.  Stage III pressure sores result when the tissue below the skin is damaged, causing a deep wound.  Stage IV pressure sores are the most serious pressure sores and involves destruction of large areas of skin accompanied by damage to the underlying muscle, bone, tendons, and joints.  If not treated properly, infection can set in and even require amputations.  Signs of infection include pus, bad smell, redness, swelling, tenderness, fever, and chills.

Surgical debridement (removal of damaged tissue) is one approach to treating serious pressure sores.  This process can be very painful because it involves using a scalpel or other instrument to remove all the dead tissue.  Some pressure sores reach a point where surgical repair is necessary.  The treatment usually involves harvesting tissue from another area of the body and using it to pad the wound.  In some situations, amputation is necessary. 

When pressure sores are not treated properly, tissue damage can spread and infection, including gas gangrene, can set in.  In severe cases (where surgical debridement, antibiotics, and oxygen treatment are unsuccessful), amputation of the limb might be required to prevent the infection from spreading further.  This is especially true in elderly people, especially those who are malnourished, because of poor blood flow. 

Amputation is the surgical removal of a limb or body part (arms, legs, feet, fingers, toes), usually to remove diseased tissue or relieve pain.  The amputation procedure is performed by an orthopedic surgeon in a hospital operating room under regional or general anesthesia.  The procedure varies depending on which limb is removed; however, all surgical amputations involve removing diseased tissue and constructing a stump, which will fit a prosthesis.  

The procedure for an above-the-knee amputation includes: first cutting the skin and muscle layers, then clamping the major blood vessels and cutting them, then cutting the bone with a bone saw, and finally, the muscles are stitched together over the bone and the skin is closed over the wound.   

The decision of how much of the limb to remove depends on how much tissue needs to be removed for proper healing, while saving as much of the healthy skin, blood vessels, and nerve tissue as possible for rehabilitative purposes.  One test that the surgeon performs to determine the health of the limb is the amount of blood flow to the affected region (measurement of blood pressure in the limb). 

As with other major surgeries, amputation carries with it the same risks including complications with anesthesia, blood loss, and blood clots; however, infection is the main complication following surgery.  Amputation is a painful procedure, requiring treatment with pain medication and antibiotics post-surgery, and a hospital stay ranging from five to fourteen days, absent further complications.  Following surgery, the newly formed stump must be moved often to encourage circulation, with physical therapy commencing as soon as possible. 

The rehabilitative process is a long process, especially for above the knee amputees.  The physical rehabilitation is often accompanied by grief counseling to help the patient cope with the sense of loss that comes with losing a limb.  Patients also often have phantom limb pain, which is very difficult to treat.  Amputation is a last resort for both physicians and patients, but in some cases, as with severe pressure sores (which are preventable), it becomes necessary.   

Resources:

MayoClinic.com – Pressure Sores

Merck – Pressure Sores

Encyclopedia of Surgery – Amputation

Vascular Web – Amputation

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I've noticed a trend amongst many nursing home negligence cases-- injuries occur at a disproportionately high rate within the initial admission period.  The most reasonable explanation for the heightened rate of injuries in during the initial admission period is most likely related with both the facilities unfamiliarity with the patient and vice versa. 

Nonetheless, a facility that claims they were 'simply unfamiliar' with a patient is probably a poor defense if a negligence claim were pursued.  Even before a care plan is developed, nursing homes must take reasonable steps to provide the highest feasible level of care for their new patients.  

In order to facilitate a smooth and safe transition to the nursing home, caregivers and family should make the needs of their loved ones known to the staff at the facility.  Providing the following information can be a valuable part of a transition:

• Provide staff with realistic assessment of the individual of assistance
• Let staff know about a sleeping and eating schedule
• Provide the facility with a list of all medications
• Provide staff with contact information for all physicians
• Let facility know of specific health concerns

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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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Some court decisions leave lots of room for future generations of law school classes to debate the subtleties of the Judge's wording.  Yet, other times the the court's action--without rendering an opinion-- can have equally powerful results. What could I possibly be inarticulately blabbering about?  

June 1st marked the deadline by which the U.S. Supreme Court could grant review of an Illinois Appellate Court decision nullifying nursing home arbitration arbitration agreements. Instead, the court decided to leave the Appellate decision untouched-- in essence giving its stamp of approval to a holding striking an appellate court decision that invalidated mandatory arbitration agreements in nursing home negligence cases.

In Sue Carter v. SSC Odin Operating Company, LLC, (885 N.E. 2d 1204, 319 Ill.Dec. 524 (2008), the daughter of a nursing home resident brought a wrongful death and survival cause of action under the Illinois Nursing Home Care Act against the nursing home where her mother was a resident.  Despite the fact that Ms. Carter executed a 'Health Care Arbitration Agreement' on her mothers behalf when she admitted her mother to the facility, the Appellate Court ruled that state law preserved her right to a jury trial. 

The nursing home operator appealed the Appellate Court decision, claiming the mandatory arbitration clause, pursuant to the Federal Arbitration Act, should overrule any state law as the federal legislation should take precedent.

Consequently, nursing home arbitration agreements in Illinois will likely be a thing of the past. Perhaps, this action by the court will dissuade other states from enforcing similar agreements.

Read more about this important case preserving nursing home resident rights here.

Nursing Homes Abuse Blog Posts On Arbitration Agreements

The Invalidity Of Nursing Home Arbitration Clauses

Are Trials Really That Important?

Michigan Court Strikes Nursing Home 'Arbitration Clause' And Allows Wrongful Death Case To Proceed In Court

AARP Joins Fight To Preserve Right To Jury Trial

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Even the most dedicated caregivers need relief.  Personal time for them to relax, and focus on their own well being is important not just for their personal needs, but also so they may provide the best care possible for their loved one.  In this situation, 'respite care' or temporary care can be useful or downright necessary. 

Despite its prevalence, I've noticed a troubling trend: new admitees to nursing homes (for short-term stays of 5, 10 or 15 days) tend to suffer serious injuries shortly after their admission.  When a new resident is brought into a new environment, it is difficult not only for the resident, but also the staff at the nursing home.  The situation is further complicated by the fact that many of the nursing home residents are unable to communicate for themselves and the staff is left to care for them with out a complete medical chart or complete instructions for care.

Despite the added stress on facilities, respite-care stays are becoming more popular as facilities look to increase revenues.  In these situations, the facility must get up to speed with the individual's medical needs immediately.  The staff must treat respite-care residents the same as the full-time residents.  

During one of these 'respite stays' an Edwardsville, Illinois man fell and fractured his hip just six and one half hours after he was admitted.  The incident took place at Rosewood Care Center in Edwardsville, IL. 

The man's family filed a nursing home negligence lawsuit against Rosewood, claiming that the facility failed to: provide sufficient assistance to prevent falls,  have properly operating call lights, and failed to follow state regulations regarding nursing home care.

The lawsuit alleged the man never recovered from his fractured hip and required a wheelchair and full-time nursing care for the remainder of his life. While the lawsuit was pending, the man died.  

Rosewood's attorneys claimed the facility violated neither state laws nor failed to comply with mandatory staffing levels.  Nonetheless, a Madison County jury sided with the deceased man's family and awarded them $149,000.  Read more about this Madison County, Illinois nursing home lawsuit here.

So the question remains, why are short-term residents particularly susceptible to injuries?  The facilities unfamiliarity of resident probably is a primary reason, however there are some steps that can be taken to minimize the difficulty of the transition during 'respite care' admissions:

• Write out lists of each residents: medical conditions, schedule, dietary needs and physicians
• Provide the faciltiy with an ample supply of necessary medications
• Provide the facility the names and telephone numbers of treating physicians
• Try to use the same facility for respite-care stays so they may develop a level of familiarity with the person
• Avoid admitting residents on weekends when staffing tends to be lower and more senior staff tends to be away from the facility
• Meet with facility administrators before the planned stay and get confirmation that the facility is capable of caring for your loved one

If your loved one suffered an injury during a short-term admission to a nursing home, you may have a cause of action against the facility.  The nursing home litigation team at Strellis & Field has handled many casing involving injury or death within 24-hours of admission to a new facility.  Put our history of success to work for you. (888) 424-5757

Respite Care Resources:

Respite Care: Understanding, Finding And Understanding Caregiver Relief, Helpguide.org

Respite Care, Healthopedia.com

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Occasionally I receive emails and comments from blog readers asking what 'really' constitutes neglect.  Its easy to point to definitions, but the best explanations usually come by way of example.

Yesterday, I was reviewing the chart of a 70-year-old lady who resident who died in a Chicago nursing home.  The lady who died from complications following a severe burn on her leg due to contact with a wall-mounted radiator. 

An investigation by state nursing home investigators verified that the woman's bed was jammed so close to the radiator that it had repeatedly come in contact with the bed, mattress and the woman's body (there were several burns noted on her right side). Despite the facilities own documentation of problems due to keeping the bed too close to the radiator, the bed was kept in place for months before the woman sustained a severe burn.

Four months after the 'radiator problems' had been initially noted, this woman sustained a third-degree burn to a large portion of her lower leg. Conservative burn treatment was unsuccessful in healing the large leg burn and ultimately the woman required a skin graft. 

The woman underwent several weeks of successful burn treatment in a hospital.  However, the woman was ultimately moved back to the original nursing home where she was injured and quickly contracted an infection. Within two weeks of moving back to the nursing home, the woman died.

In this case, the nursing home resident was a victim of neglect on so many occasions, it is literally difficult to keep track.  Nonetheless, the point is not how many times the facility failed to properly care and assess the patient, but rather how easily preventable the injury and subsequent death were.

Related Nursing Homes Abuse Blog Posts On Nursing Home Burns

Resident Who Smoked & Used Oxygen Suspected Of Causing Fire At Assisted Living Facility

Unsupervised Nursing Home Resident Dies From Burns

Burns In Nursing Homes

Web Resources For Burn Victims

American Burn Association

Alisa Ann Ruch Burn Foundation

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Ricky Hamilton, the husband of Kimberly Hamilton, has filed a nursing home negligence lawsuit against Kenwood Nursing Home and the facilities parent company, Extendicare in Madison Circuit Court.  The lawsuit alleges the nursing home deviated from acceptable standards of care and failed to maintain a safe environment.  The lawsuit made a 'jury demand' and seeks an award of medical expenses, attorney fees and punitive damages.

Kenwood Nursing Home is part of the Richmond Health and Rehabilitation Complex in Richmond, Kentucky.  The facility has has several smalling nursing homes on the property including Kenwood and Madison Manor.

Madison Manor has a well-documented history of problems.  In 2008, the facility received a Type-A citation from the Cabinet for Health and Family Services after officials obtained a copy of a video documenting abuse of a resident.  Following disclosure of the video, 9 staff members were fired and a new training program was implemented for the staff.

Nursing home ombudsman Kathy Gannoe, said her agency received 26 complaints regarding 14 Madison Manor residents in 2008.  After investigating each claim, Gannoe determined 80% of the charges were verified. 

Amazingly, the Kentucky nursing home had even more complaints in 2007.  In 2007, nursing home ombudsmen investigated 56 complaints relating to 26 residents. According to Gannoe, 96.5% of the complaints were verified and one-quarter of the complaints were referred to law enforcement. Read more about this nursing home negligence lawsuit here.

About Extendicare

Extendicare Homes Inc. is headquartered in Milwaukee, WI.  The company was recently named in a class action lawsuit for violating consumer-protection laws by advertising "quality standards above government regulations" that they failed to deliver. Extendicare is one of the largest nursing-home chains in North America. The company runs 268 facilities for up to 30,000 residents.  Nearly all of Extendicare's nursing facilities have higher-than-average scores for health deficiencies and safety violations.

Nursing Home Abuse Blog Entries On Extendicare

Videotape Reveals Abuse In Kentucky Nursing Home

Poor Nursing Home Care Subject Of Class Action Lawsuit Against National Nursing Home Chain, Extendicare

Failure To Clean Trach Tube Leads To Lawsuit

Web Resource

Department Of Health & Human Services, Civil Remedies Division, decision involving Richmond Health & Rehabilitation Complex

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Yes.  In nursing home negligence cases, if Medicare and/or Medicaid paid any medical expenses on your behalf, the agencies are entitled to be reimbursed. Federal laws impose a Medicare and/or Medicaid lien on all injury-related cases involving a recovery from a third-party.

Because many nursing home residents are recipients of Medicare and/or Medicaid, it is important to understand that these agencies have an automatic right to get reimbursed from a recovery from a third-party (any party that may have caused the injury).  Lawyers who handle nursing home negligence cases should be able to help determine what benefits Medicare / Medicaid paid on your behalf.  Moreover, lawyers handling nursing home negligence cases should give you an exact figure as to how much money Medicare and/or Medicaid is receiving from a recovery.

Resource

Third Party Liability in the Medicaid Program

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Following an appeal by a nursing home operator based on an excessive verdict, an Appellate Court has ordered a re-trial of the punitive damage aspect of a nursing home negligence case.  The case was originally tried in Warren County Circuit court and a jury awarded $4.1 M in compensatory damages and $29.8 M in punitive damages.  

The nursing home negligence lawsuit was brought by the daughters of Cheatum Myers, an 88-year-old man who allegedly died prematurely while he was a resident at a nursing home owned by National Healthcare Corporation, a Murfreesboro-based nursing home operator.  The family's lawsuit involved separate counts for negligence, medical malpractice and wrongful death.  

National Healthcare Corporation has 60 days from the entry of the Appellate Court's decision to file a motion to reconsider with the Tennessee Supreme Court.  National Healthcare Corporation is the 11th largest nursing home operator in the United States and currently houses over 9,000 elderly residents.  Read more about this nursing home negligence lawsuit here.

Punitive Damages

Punitive damages are damages not awarded in order to compensate the plaintiff, but in order to punish or deter the defendant and similar persons from similar behavior that harmed the plaintiff (injured party).  In most jurisdictions, plaintiffs must get permission from the court to pursue a claim for punitive damages.  There is no set limit or absolutely impermissible ratio of punitive damages to compensatory damages, though punitive damages with outrageously high ratios have been reversed by appellate courts.

Related Nursing Homes Abuse Blog Posts

Juries Sending A Message To Nursing Homes

Big Verdicts Against Nursing Homes

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A truly horrific report of elder abuse has surfaced from East Moline, IL where police have arrested a nursing home worker after he allegedly raped an 82-year-old resident at the facility where he worked. Paul Hubbard was arrested by East Moline Police after a co-worker saw him raping the nursing home resident.  

Court records reveals that Hubbard was employed by Parkview Terrace Nursing Home and has sexual intercourse with an elderly resident who was unable to give consent.  The resident was taken to Illini Hospital for examination and has been released.

The Illinois Department of Public Health conducted an investigation into the incident and based on its preliminary findings, the nursing home did not violate any rules or regulations. The Department's investigation continues to make sure the facility conducted a background check on all employees before hiring them.  

Paul Hubbard's record from Rock Island County contains only a parking ticket.  Hubbard's first court hearing is Tuesday morning. 

About Parkview Terrace

Parkview Terrace is a 72-bed facility in East Moline, Illinois that cares for resident with various physical and psychiatric conditions.  Parkview Terrace received a measly 1 out of 5 stars by Medicare's centralized nursing home rating system.  Further, Parkview Terrace made headlines recently when a widow brought a nursing home negligence lawsuit against the facility for the death of her husband relating to dehydration and malnutrition.

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The North Carolina Department of Health and Human Services has issued a report very critical of the nursing care provided to an Alzheimer's patient who recently died from injuries she sustained from a fall.  The report follows an extensive investigation of the nursing practices at Five Oaks Manor Nursing Home.  The resident at issue is 87-year-old Annie Bell Scarboro who died from head injuries related to a fall from a loading dock off the kitchen.

The state's report indicates that on December 18th, Scarboro managed to wheel herself in her 'merry walker' through three sets of unlocked doors to the outside area without the staff's knowledge.  The report also indicates there were no door alarms on any doors-- including the one leading to the outside area where Scarboro died.

This incident follows similar wandering episodes Scarboro had while a resident at the facility.  On May 22, 2008, managed to escape through the exact same doors she managed to navigate through prior to her death.

The state's report into this nursing home death, concluded the facility failed to comply with 483.25(h) Accidents and Supervision, the facility failed to "ensure that the resident environment remains free from accident hazards as is possible; and each resident receives adequate supervision and assistance devices to prevent accidents."

Among the 'assistance devices' ordered to be implemented at the nursing home, by state authorities is the installation of a Mag-Lock and Accutech alarm system.  The Mag-Lock / Accutech system automatically locks doors as an Alzheimer's resident approaches the area with a special bracelet that activates the system. 

While a sophisticated alarm system would have prevented this nursing home death.  The sad reality is that this incident should have been prevented. Had the facility followed basic safety measures for Alzheimer's patients-- staff supervision and locks on doors-- there is little doubt this death could have been prevented.

Read more about this report of nursing home negligence here.

View a complete copy of the investigative report of this incident here.

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Winchester House, a Lake County, Illinois nursing home, has chosen to settle a pending nursing home negligence lawsuit involving a resident who fell multiple times in the facility and ultimately died.  Under the terms reached during mediation, the family of Helen Menneke will receive $1 million for the loss of their 83-year-old relative.

Helen Menneke was admitted to Winchester House in 2004 for treatment and care of dementia. Ms. Menneke fell several times over the course of her admission, suffering a traumatic brain injury and fractured bones.  

Although nurses implemented an alarm system for Ms. Menneke's bed and wheelchair, they were unsuccessful in preventing additional falls.  The nursing home has reportedly made changes in the manner nursing home employees check on nursing home residents following this lawsuit.

How many falls must occur before a nursing home can be held responsible for a resident's fall-related injuries?  The answer is dependent upon the needs of the resident.  If the individual required full assistance for transfers and care needs, the nursing home owes a duty to provide staffing assistance at all times.  If however, the resident is more independent the duty of a facility becomes somewhat clouded.

Regardless of the resident's fall-risk potential, the nursing home must take notice after a resident falls.  After the nursing home has notice of a resident fall, the facility must re-evaluate their preventative measures to prevent additional falls from occurring.  The use a restraints, alarms and most importantly staff supervision are key to assuring nursing home residents remain safe.  If your loved one has sustained a injury from a fall, do not assume the fall was not preventable.  An experienced nursing home attorney will be able to evaluate the matter and determine if the nursing home may be responsible for the injury.

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A wrongful death lawsuit filed was recently filed on behalf of the Estate of Stanley Dancy against Washington Heights Nursing Home.  The lawsuit alleges Mr. Dancy was admitted to the Chicago nursing home for rehabilitation for a recent illness.  Within a month of his admission, Mr. Dancy developed four advanced-stage pressure sores, a urinary tract infection and malnourishment.  

The elderly man was sent to Mount Sinai Hospital for treatment of his medical conditions.  After receiving inpatient hospital treatment, Mr. Dancy was discharged to a different nursing home in the Chicago area.  "Unfortunately, by that time, it was too late to reverse the deterioration of his condition," said his daughter, Charlotte Parnell.

The Illinois Department of Public Health investigated Washington Heights for two weeks following Mr. Dancy's death and no violations were found according to a spokeswoman for IDPH.

Read more more about this Cook County lawsuit against Washington Heights Nursing Home here.

I do not know what the cause of death was in this matter, but this situation demonstrates the devastating spiral of medical complications that is likely to develop when an elderly person is afflicted with severe pressure sores.  Once advanced stage pressure sores develop, it becomes increasingly difficult for a elderly person's body to battle the wounds.  Literally, all of the person's energy is used to battle the wound.  

When the pressure sores are accompanied by other medical complications like a urinary tract infection and malnourishment, the body is practically defenseless to battle one--let alone all of the medical conditions.  

Although the Illinois Department of Public Health investigated this matter and found no violations, the finding itself does not mean the nursing home may escape liability.  Given the fact that this man contracted three serious medical conditions during the first month of his stay, the nursing home obviously did not identify or properly address the man's needs.  

Washington Heights Nursing Home has been the subject of multiple investigations by IDPH regarding nursing home abuse and neglect.  Take a look at the multiple citations here.

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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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A 90-year-old nun who was a resident at Summit Park Hospital and Nursing Care Center in New York died following a head injury when a stand alone closet fell and hit her on the head.  The woman sustained injuries to her head and face.  She was transferred to a local hospital where she succumbed to her injures.

This was the third incident within a year at Summit Park Nursing Home involving similar closets falling and injuring a resident.  Incidents involving injury to nursing home residents must be reported to authorities. However neither of the similar incidents involving falling armoires were reported by the nursing home.

Centers for Medicare and Medicaid fined the facility $17,300 following the incident and the facility faces additional fines imposed by state authorities. New York Health Department spokeswoman, Claire Pospisil, comments, 'They have to take appropriate steps to ensure that this never happens again."

Not only has this nursing home been jeopardizing the safety of its residents, but perhaps even more alarming is the fact that it has chosen to play by its own rules.  If this facility failed to report the two other incidents in which patients were injured with the same armoir type closets, rest assured they are not properly attending to the needs of their residents.  What else is this dangerous nursing home hiding?

Read more about this dangerous nursing home here.

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On the heels of the recent Department of Health and Human Services report which demonstrated safety problems at virtually every nursing every nursing home across the country, recent article reports that Central Illinois is no different.  In 2008, four nursing homes in Peoria County, Illinois, were cited for negligent treatment of their residents. The Illinois Department of Public Health has cited Bel-Wood Nursing Home, Sharon Health Care Willows,  Manor Court of Peoria and Rosewood Care Center  for negligent patient care.  

Below is a summary of the incidents from the above Peoria County, Illinois nursing homes:

• Bel-Wood Nursing Home: received citation for not reporting one resident's mysterious leg bruise.
• Sharon Health Care Willows: was cited for not reporting several incidents , Including one staff member's aggressive intervention, and one resident's fall.
• Rosewood Care Center: cited for failing to report one woman's fall from a toilet.  A report states was related to her death.
• Manor Court of Peoria: was cited for failing to take a key preventative measure relating to patient safety, failing to conduct background checks on two nursing aides they hired earlier this year.

While nursing home administrators may feel like they are wrongfully targeted by state authorities, the investigations hopefully catch potentially dangerous situations before actual harm to the residents occurs.  Nursing home inspectors are the last line of defense for vulnerable nursing home residents. As IDPH Marketing Director, Melaney Arnold, says “We are very stringent and want to make sure that we are protecting the public, the resident's health and safety."

In Illinois, any complaint of nursing home abuse or neglect may be reported to the Illinois Department of Public Health (800) 252-4343.

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Even the best facilities occasionally provide bad treatment to their residents.  A wrongful death lawsuit has been recently filed against Schwab Rehabilitation Hospital, a nationally recognized rehab center in Chicago on behalf of the family of a deceased resident.  The family carefully selected Schwab as a rehabilitation center for their loved one's physical therapy and rehab training following the amputation of a leg. 

Unfortunately, even this well respected facility, failed to provide basic care for an elderly man's needs.  When the man was admitted to Schwab, the physicians ordered that the man be transferred in and out of his wheelchair with the use of a mechanical lift and two staff members.  The day after his admission a CNA ignored the physicians' orders and attempted to transfer the man into his wheelchair herself.  In the process the man fell and fractured his hip and femur. 

Like many physically fragile elderly, the injury lead to a spiral of deteriorating medical problems.  Following surgery at nearby Mt. Sinai Hospital, on his hip and femur fractures, the man became immobilized and developed a pressure ulcer on his sacrum.  Additionally, the man was diagnosed with sepsis, pneumonia, and respiratory failure.  Within three months of the fall, the man died.

The man's family filed a lawsuit against Schwab for negligent rehabilitation treatment.  The lawsuit was filed in Cook county Circuit Court.  Read more about this poor treatment at this well known Chicago rehabilitation hospital here.

This case demonstrates that a facilities reputation does not guarantee quality medical treatment.  Incidents at well-regarded medical facilities may occur with less frequency, but are just as devastating as incidents occurring at facilities with lesser reputations.  This case also highlights the importance of staff following physician orders.  If the CNA had simply followed the instructions set forth by the treating physicians this sad incident could have been avoided.

In this case, an investigation conducted by the Illinois Department of Public Health confirmed the care this elderly man received was improper.

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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 Chicago Tribune reported that the Woodstock Residence received nearly $360,000 in fines related to five suspicious deaths at the facility.  The facility has been in the headlines in the past for the for intentionally giving high does of medication to elderly patients. Originally labelled an 'angel of death' for the staff's sympathy towards suffering patients, new information has been released related to the intentional medication over-dosing at the facility in an Illinois Department of Public Health investigative report.

The report demonstrates that the staff at the Woodstock Residence intentionally drugged residents to turn them into unresponsive zombies and make the nurses jobs caring for them easier.  The report also shows a more malicious side to the nursing staff's care. 

"She won't make it through the day," Marty Himebaugh, 57, allegedly told a co-worker in reference to a restless patient, according to a 130-page IDPH report. "I made sure of that."  Himebaugh, a licensed practical nurse at the Woodstock Residence, was fired Oct. 31, 2006, at the suggestion of Illinois State Police, who were investigating the suspicious deaths, the report stated.

The state report also refers to a man in his mid-50s with Down syndrome who died in April 2006, and it quotes Himebaugh as telling a co-worker: "Those people aren't meant to live that long. They are meant to die in their teens and I'm going to help him along."

In April Himebaugh and Penny Whitlock, the former director of nursing at the facility were charged criminally for the their behavior.  The two face a variety of charges including: endangering the lives of their residents, criminal neglect of a long-term care residents, obtaining morphine by fraud, unlawful distribution of a controlled substance and obstruction of justice.  State prosecutors did not believe there was enough evidence to prove the nurses intended to kill the patients.  The duo await trial after pleading not guilty to the charges.

The Woodstock Residence was fined a record $300,000 by the state of Illinois and $57,350 by the federal Centers for Medicare and Medicaid Services.  According to The Department of Public Health the most serious violations involved the use of "chemical restraints"—drugs used to sedate patients. State law prohibits using drugs to discipline nursing home residents or as a staff convenience.

Renamed the Crossroads Care Center of Woodstock in December and owned by a limited liability company of the same name, the nursing home is appealing the fines according to its attorney.  The nursing home also faces wrongful death lawsuits filed by the families of the deceased residents.

Medication overdoses are a common problem in nursing homes.  Generally thought to be a tragic mistake, this case should cause people to step back and evaluate is the overdosing is really an intentional act with a deadly intent.  Am I so skeptical to think that this is not an isolated incident.

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Nursing home visits are great for both residents and their friends and families.  Everyone is usually happy to see each other and discuss current world topics, the weather, baseball or food.  However, don't let the smiles distract you from what should be a secondary reason for visiting friends and family members in nursing home--doing a mini inspection. 

I'm not talking about getting up on the roof of the nursing home and looking at the quality of the shingles or heading down to the basement to look at the hot water heater.  Rather, when visiting don't be shy about prodding around both the facility itself and on your loved one.  Look at the: cleanliness of the facility, look at the food, pay attention to the temperature of the room, look for familiar faces, look at the schedule of activities, chat with the staff--keeping track of all the small parts of your loved one's environment is the best it can be.

If your family member is bed-bound, pull the sheets back and peek under the robe.  Is everything clean?  Are their any dry or cracked areas of skin?  Is there any unpleasant smell?  Does everything look ok?  Even the sharpest elderly may lack sensation in areas of their bodies to detect skin irregularities.  If something looks wrong-- it probably is.  Early detection of potentially deadly conditions, such as pressure sores, may save your loved one from pain and embarrassment down the road.  You're not being a pest, you're being a caring friend or family member looking out for your loved one's best interest.

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Bad nursing homes generally have a pattern of poor care.  There will always be isolated incidents at even the most well staffed facilities.  However, when repeated incidents occur within a brief period of time there are usually deeper problem with the facility. 

Case in point, two recent lawsuits were filed against the Devon Gables Health Care Center.  The first lawsuit involves, Elfriedel Sitzman, a female resident who was not give adequate care following a stroke.  The lawsuit claims that Sitzman fell and broke her arm in a fall during her stay at the facility from November through December, 2007.

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Dehydration is a common problem amongst nursing home residents.  Dehydration occurs when you do not drink adequate fluids or you lose fluids due to: sweating, vomiting or diarrhea.  If an elderly person becomes dehydrated they are susceptible to cramps, organ malfunction, pressure sores and even death.

Older people are particularly susceptible to dehydration because many elderly have the following conditions:

• Decreased thirst
• Kidneys that do not work well
• Choose to avoid liquids because of incontinence
• Have difficulty holding a glass
• Pain urinating
• Take medications decreasing urine output
• Inability to regulate body temperature
• Diabetes
• Inability to communicate

Signs of dehydration include:

• Dark yellow urine
• Sunken eyes
• Ashen skin
• Dry skin
• Bleeding gums
• Urinary tract infection
• Weight loss

It is the nursing home's responsibility to properly hydrate all residents.  Nursing home staff should monitor the amount of fluids consumed by each resident on a daily basis.  If a nursing home allows a resident to become dehydrated they are guilty of nursing home neglect.

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