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

More than 60 patients at the Good Shepherd Nursing Home in Ohio have become ill after contracting norovirus.  According to the Ohio Department of Health the norovirus outbreak occurred sometime around January 15th.

It is unclear what triggered this norovirus outbreak, but norovirus is highly contagious and can be spread through feces, vomit or food poisoning.  In order to reduce episodes of norovirus, it is important to regularly wash hand and follow common sense sanitation guidelines.

Most people with norovirus initially have a bad stomach ache followed by nausea, vomiting or diarrhea.  Norovirus in the elderly can be particularly problematic because many of the symptoms result in dehydration.  By some accounts, norovirus claims the lives of more than 500 people each year.

Read more about this norovirus outbreak in an Ohio Nursing Home here.

Related Nursing Homes Abuse Blog Entries:

MRSA In Nursing Homes On The Rise Amongst Residents & Staff

Food Safety

Elderly Nursing Home Patients Are Particularly Susceptible To Illness Related To Contaminated Food

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Thanks to Sarah Cole at the ADR Blog for addressing the Ohio Supreme Court's decision in Hayes v. Oakridge Home, (slip opinion No. 2009-Ohio-2054).  I believe this decision represents a major setback for the rights of nursing home residents who sustained injuries due to the negligence of the facility. 

In Hayes, a 95-year-old woman signed an arbitration agreement at the the time she was admitted to Oakridge Home, a Cleveland nursing home.  The arbitration agreement stated that disputes (injuries) between the parties were to be resolved via binding arbitration as opposed to jury trail.  Further, the arbitration clause stated that Hayes could not claim punitive damages or attorneys fees.

Shortly after her admission, the Hayes suffered serious injuries due to a fall from a wheelchair due to the alleged negligence of the facility. Subsequently, the woman died and the executor of her estate filed a nursing home negligence lawsuit against the nursing home in state court. 

The facility claimed that the the lawsuit was inappropriate and the exclusive means of resolving the negligence claim was via arbitration as stated by the admission document.  Although the lower courts ruled the arbitration agreement to be unconscionable due to Hayes' age and the unequal bargaining power of the nursing home vs. elderly, the Ohio Supreme Court ruled the agreement to be enforceable.

As Cole succinctly points out, the primary issues presented before the court were Hayes' age and the 'procedural and substantive unconscionably' of the arbitration clause. In my practice, I see firsthand how skilled nursing facilities take advantage of elderly nursing home patients and their families by burying arbitration agreements in stack of other types of admission paperwork. 

Unfortunately, this decision stresses the need for families to become aware of the legal pitfalls that accompany nursing home life.  Therefore, I suggest, striking any arbitration agreements on all admission paperwork to protect the rights of your loved one.

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

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

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

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

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

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

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

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

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

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

Related Nursing Homes Abuse Blog Entries:

Golden Living Sells All Its Arkansas Nursing Homes

Investors To Gain From Increase In Elderly Population

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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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Sometimes I'm amazed by the number of preventable situations that develop in nursing homes due to a facilities failure to provide basic care.  I mean, doesn't it seem obvious that facilities must provide food, water and a decent environment for their residents?  Am I oversimplifying nursing home care?  Perhaps, but the reality is that an overwhelming majority of nursing home injuries and deaths could be avoided if the facility were to provide this basic level of care.

The Columbus Dispatch reported on this type of preventable situation when it reported on the dehydration death of 61-year-old Peter Southard.  In 2005 Southard was admitted to Whetstone Gardens & Care Center in Columbus, Ohio for short-term nursing care to give his wife a break from her care-giving responsibilities.  Mrs. Southard was the primary caregiver for her husband since he suffered a stroke more than 20 years ago.  The stroke made it physically difficult for Southard to care for himself and realize when he was thirsty.  Unfortunately, the staff at Whetstone Gardens was unable to pick up on his special needs and he died shortly after his 15 day admission to the facility.  The cause of death was dehydration and kidney failure.

Southard's wife brought a wrongful death lawsuit against Whestone due to their failure to provide sufficient liquids to her husband.  Despite claims from the nursing home that the care they provided was sufficient and that Southard died due to dehydration from diarrhea, a jury recognized the facilities failure to provide basic care to this disabled man.  The Franklin County, Ohio jury awarded $500,000 for pain and suffering and $6 million to the wife and family for loss of society.

Dehydration Of Nursing Home Residents

Two out of five nursing home residents suffer from some form of dehydration.  Dehydration in nursing home residents can occur for a variety of reasons, including: diarrhea, the effects of medication, inability to perceive thirst, physical inability to drink or swallow and embarrassment related to incontinence.  Most of the the time, a resident's dehydration is due to inadequate care.  Common situations involving dehydration include:

• Failure of the nursing home to employ adequate staff, which results in the staff's inability to properly feed the residents
• Failure of the staff members to pay adequate attention to those residents needing assistance with eating
• Failure to properly educate the staff on nutrition and feeding methods
• Failure to provide proper supervision over those who provide nutritional services 

In addition to monitoring resident's intake of fluid, staff should be on the lookout for the following signs of dehydration:

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

Is it really too much to ask that nursing homes provide necessities such as water to their residents.  I guess that is what the Whetstone Gardens and Care Center is asking themselves now.

Related Nursing Homes Abuse Blog Posts

Medical Examiner Rules Tennessee Nursing Home Death A Homicide

Grim Details Emerge Regarding Malnutrition In Kentucky Nursing Home

We All Need Water

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An 87-year-old nursing home resident recently died from injuries sustained in a hit and run auto accident that occurred Friday night.  Several people in the area made 911 calls to the local police department that a car versus pedestrian crash occurred in front of the the Good Samaritan Skilled Nursing & Rehabilitation Center where the woman was a resident.  

The woman's family claimed they recently convinced her to check into the nursing home due to declining health.  Nonetheless, her family believes her unhappiness at the facility lead her escape attempt.  "She was unhappy being in the nursing home.  I think she planned her escape well and anticipated going home," said her daughter Linda Meldrum.

While the circumstances leading to the woman's escape and death are under investigation, the woman's daughter points to under staffing as the predominate cause.  "There was a security  door in her room that she was able to disable at 87-years-old  They appear to be very short staffed at night. We were told there was a loud alarm going off but no one went looking to see what was going on"

The Good Samaritan Nursing facility released the following statement regarding the incident:

An unfortunate incident has taken place in which one of our residents was struck by an unidentified vehicle on Detroit Road during the evening of March 13, 2009. This was a "hit and run" incident where the driver left the scene. Good Samaritan urges anyone with any information regarding this incident to immediately report it to the Avon Police Department at 440-934-1234. Out of respect for the privacy of the resident and their family, we cannot share any further information, other than to note that all of the other residents of our health care center are safe. Good Samaritan appreciates the well-wishes and condolences of the community and hopes that the driver involved in this incident will be found quickly.

Read more about this case of elopement in an Ohio nursing home here.

Nursing Home Residents Who Elope

Nursing homes have a duty to protect their residents not just from harm from outside sources, but also from themselves.  In order to minimize the risk of residents eloping, facilities should take the following precautions:

• Install technology updates (such as automatic locks and alarms) to their facilities that to help contain residents with a propensity to wander.
• Train staff to identify residents who are likely to wander from the facility and how to search for missing residents.
• Provide adequate staffing levels to look after residents.  Many of the wandering incidents occur during 'off' hours when the facility is minimally staffed.
• Establish plans to help look for missing residents

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An 87-year-old woman froze to death after walking out of the secured Alzheimer's unit at an Ohio nursing home.  Dortha Gifford was a resident at the Heartland of Woodridge assisted living facility for the last five years.  Gifford lived in the locked unit of the facility because of her propensity to wander. According to Gifford's family, she had gotten out of the assisted living facility on other occasions. 

Why do these tragic themes of missing nursing home residents continue to emerge across the country?  Unfortunately, the answer is not singular.  Nursing homes consistently break the trust families place in them when they fail to:

• Install technology updates (such as automatic locks and alarms) to their facilities that to help contain residents with a propensity to wander.
• Train staff to identify residents who are likely to wander from the facility and how to search for missing residents.
• Provide adequate staffing levels to look after residents.  Many of the wandering incidents occur during 'off' hours when the facility is minimally staffed.

If your loved one has escaped from a nursing home or assisted living facility, the facility is likely responsible.  We have helped many families recover civil damages for the death or injury of their loved one.  More importantly, many of the nursing home cases Strellis & Field prosecute have led to safety improvements at many facilities and help ensure the safety of new residents.

Related Nursing Homes Abuse Blog Posts On Resident Wandering:

Fall Leaves Dementia Patient With Broken Neck At Assisted Living Facility

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

Family Sues Florida Nursing Home For Death Of Resident Who Wandered From Facilityy

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

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John Riems, a former night-shift nurse at various Ohio nursing homes has entered a guilty plea to multiple counts of sexual battery and sexual imposition.   Judge Tygh Tone handed down the sentence that was agreed to by both the prosecutor and the attorney for Riems.  In January, authorities obtained a videotaped confession of Riems where he admitted to sexually abusing about 100 residents at multiple nursing homes since the 1980's.  Most of Riem's victims suffered from dementia or Alzheimer's disease.  Joe Bilgen, whose father was a victim, said Riems' crimes were similar to child abuse because most of the patients had similar states of mind.

Read more about the sentencing of this Ohio nursing home worker here.

Read the Nursing Homes Abuse Blog's earlier entry on this nursing home abuse here.

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Toledo's Liberty Nursing Center has the dubious honor of being cited for situations posing 'immediate jeopardy' to its residents.  The 'immediate jeopardy' violations are were cited in a state report to pose an immediate harm to residents safety.  The report contains various situations involving nursing home abuse including: staff stealing medicine, unlicensed nurses, physical abuse among residents and failing to report injuries occurring at the facility to state authorities.

Read more about this dangerous Ohio nursing home here.

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By now, we have all heard the pleas from Republicans, Democrats and Independents to go out and vote.  Most people put a great deal of thought into how their vote gets cast.  What if votes were cast by people who were unable to comprehend the significance of their vote and had no idea who Barack Obama or John McCain is?

Welcome to nursing home voting for dementia patients.  Here is a report from a nursing home where resident's with dementia are allowed to cast votes for the candidate of their choice...or...whomever has the name closest to their hand.

Of course it is important to give nursing home residents as much access as possible to their constitutional rights, but does this go too far?

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You never know who may turn up at your local nursing home...unfortunately.  68-year old, David 'Daddy Dave' Green was recently discovered as a resident at Florida nursing home. Mr. Green had been on the run for 8years following his escape from an Ohio jail.  Mr. Green is not your ordinary nursing home resident, as he is currently listed as one of America's top 15 most wanted fugtives. Read more about this nototius nursing home resident here.

Nursing home residents have a right to a safe and violence free environment.  If a facility knew or should have known of a residents violent tendancies and they commit a violent act against other residents, the nursing home should be held accountable.

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Despite conditions that would make most fraternity houses seem like the Ritz, Westside Health Care Center and The Terrace at Westside in Ohio continues to receive government payment for providing substandard services in a physically dangerous setting. 

Authorities have long been aware of problems at Westside, yet the facility continues to operate with government funds.  Ohio health inspectors have more than 200 pages of violations at the facilities from 2003 through 2008 and extensive monetary fines slapped on the owners, yet the dangerous conditions  remain. 

A police raid on the facility on March 13th revealed conditions that made the City Council take notice and suggest residents find new places to live.  The police raid found the following physical problems  with the facility and nursing home staff:

Facility Problems

• Fire doors tied shut
• Mold on walls
• Cigarette butts in walkways
• Soiled mattresses
• Roach infestation
• Uncleaned vomit

Staff Violations

• Allowing residents to smoke near oxygen tanks
• Storing medication improperly
• No psychological training for staff caring for residents with psychological problems
• No first aid training
• No fire drill training
• 20% medication error rate

Nursing homes and long-term care facilities that receive Medicare and Medicaid funding must be in compliance with federal regulations.  I guess the government is giving Westside a freebie?  Read more about the nursing home violations at Westside here.

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John Riems, a former nursing home supervisor at Conrad Care and Rehabilitation Center in Ohio. During questioning by prosecutors, Reims admitted to abusing nearly 100 patients during his 22-year career at nursing homes.  Reims is under investigation from an original charges involving the allegations of abuse involving a 55-year-old blind man and a partially paralyzed man in his 80's.  Fourteen more felony counts have been filed against Mr. Reims since the investigation began-- 12 counts of rape and two counts of felonious sexual penetration.  Read more about this Ohio nursing home story here.

I certainly believe in 'innocent until proven guilty,' but with this type of evidence against him, it certainly looks like Mr. Riems at the very least neglecting his nursing responsibilities and at worst perpetrating disgusting crimes against innocent elderly.  In Illinois, nursing home's must screen all employees to prevent any person with a criminal record from interacting with the nursing home residents.

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The report of a fire at Jaycee Village Retirement Community, an Ohio Nursing Home, demonstrates the importance of fire safety in all nursing homes.  Although, no residents were injured, the episode demonstrates how a fire in a nursing home could severely harm residents who are unable to move quickly because they are bed-bound or in wheelchairs.

In June, 2008 CMS, the governmental agency regulating Medicare and Medicaid funded nursing homes, gave all nursing homes receiving federal funding five years to phase in the installation of sprinkler systems at their facilities.  According to a report from the Government Accountability Office, fire sprinklers can decrease the chances for fire related death by 82%. 

Currently, all nursing home must have battery operated smoke alarms in all patient rooms and public areas.  Further, all nursing home receiving public payments are subject to random fire safety inspections. 

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An Ohio woman is bringing a lawsuit against Mansfield Memorial Homes for improper care resulting in bedsores.  Dorothy Modcap, 64, sought skilled rehabilitation for a fractured hip following an auto accident.  What she got instead was a bedsore and infection.  According to her attorney, no preventative measures were put in place to prevent the development of the bedsores.  Bill Campell, Modcap's attorney states:

When you have somebody at that age who is in a wheelchair already, you really have to put interventions in place to make sure the person is turned frequently, or a skin breakdown can develop that turns into a very nasty bedsore.  It is clear that she had absolutely no skin breakdown until she went into the nursing home.

According to public records, Mansfield Memorial Home was recently cited for nine health care violations and five fire safety deficiencies.  Read more about this lawsuit here.

The facts surrounding the above incident are familiar to most nursing home residents who suffer from pressure sores.  Nursing homes must identify people who are susceptible to bedsores and implement care plan for their prevention.  Even the most active and healthy nursing home residents should have preventative care plans in effect.  Failure to implement such a plan represents nursing home neglect.

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