Nursing Homes Abuse Blog

A Prime Example Of How Not To Treat An Injured Nursing Home Patient.... Ignoring Them

Jonathan Rosenfeld — Wed, 16 May 2012 12:34:53 -0600

I've got a confession to make. Sometimes when I'm in my office I make personal calls. Sometimes I even take time away from my day to forward email chains of perverted jokes to friends. Other times, I'll talk with my colleagues about my weekend plans--- sometimes even on a Monday. I'd imagine my style of intermixing personal plans during the course of my workday is fairly normal as many of us spend a good chunk of our waking hours plugging away at our jobs.

Since its my blog, I generously chose to call these daily diversions 'personal plans', but surely these could be aptly categorized simply as 'distractions'. While for all these mini-distractions I encounter--- or create for myself in the course of the day, I would at least like to think that these distractions aren't really that problematic because I still make doing what needs to be done at my job priority number one.

I began to consider the daily distractions almost all of of face during the course of the day-- both at work and at home--- when I read about an almost unbelievable episode of extreme nursing home neglect involving staff at a Iowa nursing home. An internal video shot at All American Restorative Care in Washington, IA depicts what I'd consider to be a situation involving far more than a healthy dose of distraction during a Christmas party at the facility.

The video from the facilities video-monitoring system confirms that over the course of 48 minutes, at least four nursing home employees walked past a patient who had fallen to the floor and struck her head. While two of the employees did have the courtesy to ask the woman if she was 'ok', no one actually initiated any follow-up to confirm that her claims were indeed accurate.

An investigation by officials from the state confirmed the rampant distraction--- or more accurately-- complete neglect of the the patient. Equally alarming, the state's investigation revealed that even though the patient appeared to be "pretty out of it" (indicative of a possible head injury), several nursing home staffers elected to bring her back to her room without any neurological assessment.

Approximately 90 minutes after the woman was taken back to her room, staff finally chose to send her to an emergency room where the patient was treated for a laceration to her head.

Whatever the underlying reasons are for staff literally ignoring an obviously injured patient, their behavior is without excuse and is simply emblematic of an environment where patient needs are ignored. Particularly with an injury to her head, this patient is truly lucky that her injury wasn't exacerbated by the distracted--- err--- grossly neglectful staff members. Clearly, these people need to be reminded about focusing on their jobs.

Related Nursing Homes Abuse Blog Entries:

Why Do So Many Nursing Home Patients Suffer Fall-Related Injuries When Preventative Techniques Are So Easy To Implement?

Nursing Homes Post-Fall Care Of Injured Patient Criticized By State Investigators

Rapid Decline For Elderly Nursing Home Patients Following Fall-Related Injuries

Falls In Nursing Homes Are A Serious Threat To The Safety Of Many Patients

http://www.nursinghomeinjurylaws.com/common-nursing-home-injuries/falls/

http://www.rosenfeldinjurylawyers.com/practice/nursing-home-injuries/nursing-home-falls/

Assisted Living Facility Blamed For Death Of Resident Who Was Struck By Car

Jonathan Rosenfeld — Tue, 15 May 2012 07:18:40 -0600

At the heart of many allegations of negligence involving assisted living facilities is an underlying presumption that the facilities failure to properly supervise a resident resulted in an injury to a patient. Supervisory issues take center stage in many cases because the need for additional supervision is a primary reason why many people seek out the services of an assisted living facility in the first place-- because they can not care for themselves at home.

While we frequently discuss the internal threats to patients at nursing homes or assisted living facilities-- such as through falls or food poisoning, more attention needs to be put upon the inherent safety threats posed to residents when they 'wander' or 'elope' from the safety of the facility as these threats may not always be deemed valid.

When discussing situations involving patient elopement, the circumstance commonly involves a patient who lacks the capacity to truly comprehend the ramifications of their actions. Unlike a patient who may be unhappy with their situation or living arrangements at a nursing home or assisted living facility and seeks to 'escape' back to the life they once knew, the most concerning cases of patient elopement / wandering involve patients who lack the cognitive ability to make decisions for themselves.

Individuals plagued with Alzheimer's and other types of memory loss are perhaps the biggest risks when it comes to categories of patients who are "elopement risks". Identifying patients who pose a risk of eloping from the facility is indeed one of the most important factors in preventing these situations from occurring in the first place. Once the risk has been identified, facilities can then implement both physical safeguards and behavior modifications to help prevent incidents of elopement from occurring.

I was again reminded about the dangers related to patient elopement when I read about an incident involving a patient who eloped from an assisted living facility in New Jersey and was struck by a car and killed as she was crossing the highway adjacent to the facility. According to news reports of the incident, the woman suffered from schizophrenia, psychosis, both short-term and long-term memory loss and was known to was identified as being an 'elopement risk' by the facility.

Believing that this incident should have been avoidable with proper care, the family of the deceased resident has initiated a lawsuit against both the ALF, Brandywine Assisted Living, and the company's CEO.

From a legal perspective, if the circumstances prove to be correct, this facility obviously breached its duty of care in looking after this vulnerable patient. Particularly with the advancements in technology being made with both GPS locating technology and other devises to notify staff when a patient is attempting to leave a facility, incidents such as this really need not occur.

Related Nursing Homes Abuse Blog Entries:

Man Wanders From Illinois Nursing Home With Dangerous Track Record Of Patient Care

State Fines Nursing Home Where Patients Drowns In Puddle In Front Of Facility

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

"They've Got to Be of the Devil" - Woman Describes Mother's Assault in Nursing Home

Jonathan Rosenfeld — Mon, 14 May 2012 07:10:01 -0600

On Friday, April 13, Louise Jones received the call that every daughter dreads.

“They told me that my mom had taken a blow to the head,” said Jones, whose mother, Elizabeth Kennedy, is a resident at the Maple Grove Health and Rehabilitation Center in Greensboro, NC. “She’s 86 and defenseless, and I wasn’t there to protect her.”

According to Greensboro’s local FOX affiliate, staff at Maple Grove called police after noticing a large bruise on Kennedy’s head. It was unclear from the report who noticed the bruise, or why the facility decided to reach out to authorities when it did. A photo used in the FOX report shows a 2- 3-inch purplish mark above Kennedy’s right eyebrow.

“I felt all kinds of emotions when I saw [the bruise] - hurt, anger, revenge,” said Jones. “She’s like my child. She can’t get up. She can’t walk. This is the coldest anybody could be. They’ve got to be of the devil. They have to be.”

Jones said that Maple Grove offered to move her mother to another facility, but that she declined, seeing that her mother’s doctor can only visit her in Maple Grove.

Medicare’s “Nursing Home Compare” Web site gives Maple Grove three out of five possible stars. According to Nursing Home Compare, Maple Grove only earned two out of five stars in the area of Health Inspections. During the time period between December 1, 2010 and February 29, 2012, the facility racked up a a total of 10 violations - more than double the state average of 4.

“If [Maple Grove] has anything Godly in them, maybe they can come forth on their own, and maybe it can make things a little bit easier,” Jones said. “But I don’t think it will ever justify how I feel, what it’s put me through, or what my mother has endured.”

Maple Grove ignored a FOX reporter’s request for comment.

Related Nursing Homes Abuse Blog Posts:

Primer on North Carolina Nursing Home Laws
Elder Abuse: Why Bruises Can Be Tell-Tale Signs of Poor Care
When Bruises Can’t Speak For Themselves: The Difficulty Proving Abuse of Disabled Nursing Home Residents

Nursing Home Injury Laws: New Mexico

Jonathan Rosenfeld — Sun, 13 May 2012 06:00:25 -0600

Number of nursing homes in New Mexico: 71

Patients living in New Mexico nursing homes: 5,570

Occupancy rates of New Mexico nursing homes: 81.6%

Average number of deficiencies at each New Mexico nursing home: 6.1

Percent of New Mexico nursing homes with serious deficiencies for actual harm to patient: 29.6%

Most common deficiencies at New Mexico nursing homes: Comprehensive Care Plans, Unnecessary Drugs, Clinical Records

Distribution of ownership of New Mexico nursing homes: 69 % for profit, 23% non profit, 7% government

Most populated cities in New Mexico: Albuquerque, Las Cruces, Rio Rancho, Santa Fe, Roswell

Staffing levels at New Mexico nursing homes (daily hours):Above average, 3.8 total staff, 1.4 licensed nurse

Visit Nursing Home Injury Laws to learn more about New Mexico nursing homes and your legal right

**Data based upon 2009 CMS data, U.S. Department of Health and Human Service

Ban Lifted on Nursing Home: Despite Numerous Violations, State Says Issues are "Corrected"

Jonathan Rosenfeld — Fri, 11 May 2012 08:00:57 -0600

Five days after it banned new patients from entering the Bristol Nursing Home in Bristol, TN, the state Health Department decided the facility was “in compliance” and could accept residents again.

“[Conditions leading to] ‘immediate jeopardy’ citations have been corrected,” said the Health Department’s announcement, in late April.

“Immediate Jeopardy” situations are “crisis” situations in which there’s either a potential for harm or actual harm done to one person. Once they’ve identified an “Immediate Jeopardy” situation, regulators are required by federal law to make sure the situation doesn’t continue.

“The principles of Immediate Jeopardy apply to all certified Medicare/Medicaid entities, and need to be followed for all individuals receiving care and services in those entities,” said the Centers for Medicare & Medicaid Services Web site.

An examination of four Tennessee Health Department surveys revealed that Bristol Nursing Home failed to:

Administer proper medications
Keep residents’ toenails at proper lengths
Contain violence among residents

According to Tennessee Health Department documents, 30 percent of all nursing homes - about 30 total - had substantiated complaints in 2010.

To read more about immediate jeopardy and other important nursing home terms, visit:

Nursing Homes Abuse Blog: Terms to Better Understand Your Nursing Home
Nursing Home Injury Laws: Glossary

Nurses Canned After Faking Insulin Test Results For Elderly Nursing Home Patients

Jonathan Rosenfeld — Thu, 10 May 2012 06:06:32 -0600

In a bold display of laziness, two nurses at a Minnesota Nursing Home have been terminated from their positions after an investigation at Cook Nursing Home revealed that the nurses were lying about administering blood sugar tests to seven residents at the facility.

The imaginary blood sugar levels were then used to arbitrarily administer insulin to patients at the facility. As reported by the Devils Lake Journal, the situation was doscovered when a resident told staff at the facility that she couldn't remember having her blood sugar tested the evening before.

While this disturbing situation apparently resulted in no injury to any of the patients involved, failing to monitor and control a patient's blood sugar level certainly poses a significantly opportunity for serious injury or even death to vulnerable patients..

Patients with inadequate insulin levels are at risk for developing a complication known as diabetic ketoacidosis. Without the insulin needed for the body to optimally function, the body then looks to tissue and fat deposits in the body for energy. However, unlike a normal "fat burning" process induced by exercise, situations involving diabetic acidosis commonly involve the development of acids known as ketones which can result in toxicity.

Similarly, patiens who are given unnecessary insulin may be at risk for developing a condition known as hypoglycemia. Hypoglycemic patients can faint, fall or even go into a coma when insulin is not administered in its proper dose or is given at an inappropiate time.

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

Nursing Homes Must Be Prepared To Handle Diabetic Patients

Never Event #3: Poorly Controlled Blood Sugar, Hyperglycemia & Hypoglycemia

New Technology May Help In The Prevention Of Pressure Sores In Nursing Home & Hospital Patients

Jonathan Rosenfeld — Wed, 09 May 2012 06:40:08 -0600

When it comes to medical complications that realistically pose a serious threat of disabling--- or even killing-- patients in nursing homes and hospitals across the country, few conditions can compare to pressure sores.

As innocent as the term may sound, when "pressure sores" progress, they should perhaps be more accurately referred to as "large open wounds" when they progress to their more advanced stages. An advanced pressure sore remains one of the indelible emblems of poor care--- when the skin and tissue in the area of the wound gives way to a large opening in the body where the underlying organs and bone may be visible.

What makes pressure sores uniquely disturbing compared with other medical complications is that patients at many medical facilities are no less at risk for developing this complication than they may have been 10, 20... or even 100 years ago! Unlike other medical complications that have been drastically reduced or eradicated with the implementation of medication and technological advancements, pressure sore prevention relies primarily on the backs of the staff members whom are responsible for caring for immobile patients.

By moving a patient from their bed or wheelchair at regular intervals, the bodies natural circulatory process of bringing is allowed to operate as nature intended. Life-sustaining blood flow to brings nutrients to tissues in the body which may not have been receiving it due to unrelieved pressure on the person's body.

Unfortunately, the anatomical differences in people combined with the unique positioning of the individual in a bed or wheelchair commonly results in situations where the first indication of the build-up of unrelieved pressure on the body--- is a pressure sore in its primary stages. While, pressure sores in their early stages may be healed with timely care-- too often early stage pressure sores simply progress to more advanced wounds when staff fail to make necessary interventions or in circumstances where patients are quite ill.

Without a tool to determine who needs to be moved--- and when, medical facilities typcially use a one size fits all approach and (theorretically) move patients at regular intervals . While the regular "turning" may serve its purpose in terms of preventing pressure sores in a substantial number of patients, the frequency may be insufficient or impracticible for others.

Perhaps the identification of the early stages of pressure sores is about to gets a much needed gift in the form of new medical technology?

I recently read about a new product to help in the assessment of mobility (and circulation) in bed-ridden patients. The Mobility Monitor is a patient monitoring system used beneath the mattresses of physically compromosed patients, to alert staff when a patient needs to be moved-- or when they can rest.

Beginning in June, the system will be commercially available to nursing homes and hospitals as a much needed tool in the arsenal of pressure sore prevention.

I look forward to seeing this promising device in nursing homes and hospitals. While the device promises to improve patient care, I would think that such a device would be welcomed by many facilities as the device appears to take much of the subjectivity associated with nursing care out of the patient-care equation and staff can focus more of their energy on actively listening to what the patient needs as opposed to worrying about adhering to a strict schedule.

Read more about the Mobility Monitor here.

Related Nursing Homes Abuse Blog Entries:

Bed Sore Prevention: Staff Must Turn & Reposition Bed-Ridden Patients At Regular Intervals

What devices or products can be used to prevent or relieve bed sores?

Medical Malpractice Lawsuits & Hospital Acquired Pressure Sores

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

Dangerous Joliet, IL Nursing Home Loses License Following Pattern Of Poor Care

Jonathan Rosenfeld — Tue, 08 May 2012 07:25:06 -0600

A pattern of disturbing events involving patient care has proved to be enough for officials at the Illinois Department of Health (IDPH) to revoke the license of Hillcrest Nursing and Rehabilitation Center in Joliet, IL.

The Chicago Tribune reported that on April 11th authorities from IDPH sent notice to the corporate offices of Hillcrest that the facilities licence was to be revoked effective May 11th.

Hillcrest Nursing Home has been the focus of a series of disturbing events involving patient care during the past several years. However, inspections conducted at the facility over the past year clearly depict a facility that has little regard for patient safety and well being.

Two episodes involving suspicious deaths at the Joliet nursing home have proved to be simply too concerning for Illinois officials to overlook. In particular, a patient died in a January 23rd incident in which the patient apparently strangled herself with a coaxial cable. An investigation into the incident revealed that staff who were to be supervising did not detect the situation because they did not enter patient rooms. Equally disturbing were the multiple pieces of drug paraphrenia found in the patient's room.

Another patient death in the past year caught the attention of authorities when a 37-year-old patient at Hillcrest died as a result of "anti-depressant intoxication" from several medications that she was prescribed. Like the incident above, an investigation into the incident was made essentially impossible as authorities discovered a lack of paperwork documenting the how or when the patient's medication was administered. Further, authorities learned that staff at the facility destroyed unused narcotic medication in a very unconventional manner-- by dousing the medication with Coca-Cola and pouring it down the toilet.

As a nursing home lawyer who commonly sees patterns of patient injury and death involving certain facilities, I applaud the decisive action taken by IDPH authorities. While the license revocation will no doubt pose a source of stress and inconvenience for patients, actions such as this are indeed in the best interest of both current patients as well as others whom may have been considering this facility for their skilled nursing needs.

Take a look at recent Hillcrest nursing home surveys via the IPDH site here.

Related Nursing Homes Abuse Blog Entries:

Enough Is Enough. Recently Filed Illinois Nursing Home Lawsuit Highlights The Problems That Accompany 'Difficult' Residents

Morphine Overdose Of Patient Initiates A Lawsuit Against Doctor & Nursing Home

Terms To Better Understand Your Nursing Home

Inadequate Nursing Home Fines: Officials Need A Lesson From The NBA

Jonathan Rosenfeld — Mon, 07 May 2012 07:10:52 -0600

At their most basic level, fines imposed against nursing homes for negligent care of patients serve to both punish facilities for situations that may have developed in the past and to serve as a way of prodding facilities to improve the care they dispense--- or else they will face similar sanctions again if the problems persist.

If all goes according to plan, facilities that receive a fine will stop, pause-- and think about the type of care that they provide to patients because the fine imposed against them remains enough of a sting for the facility to improve its patient care.

The trouble that I continually see with the overwhelming number of monetary fines imposed against nursing homes is that the fines are rarely commensurate with the degree of inadequate care provided. Moreover, when the fines imposed against offending nursing homes are evaluated in the context of a facilities business operations, they amount to little more than the cost of doing business.

Poor care, meager fines

Perhaps a recent string of fines imposed the Connecticut Department of Health against several nursing homes in the state is about as good an example of these simply inadequate fines as one can find?

***According to a recent article in The Middletown Press, the DPH handed over the following fines.

$650 to a Aurora Senior Living of Cromwell after a patient patient choked to death on marshmellows. The patient was known to have dysphagia and the treating physician ordered that the patient was not to receive solid foods.
$600 fine imposed The Apple Rehabilitation West Haven following a state investigation where 15 patients with various ailments were not given their prescribed medications for approximately one year.
$510 to New London Rehabilitation and Care of Waterford after a patient was injured during a transfer with a Hoyer lift.
$815 following a situation at Masonic Health Center of Wallingford involving two residents who were injured while being transported improperly in wheelchairs and for the drastic weight loss in two other patients.
$510 when staff at Apple Rehabilitation Laurel Woods of East Haven transferred a patient in the bathroom with one staff member when their care plan indicated that they were to be transferred with two employees

From the perspective of acting as a deterrent, regulatory agencies and legislatures need begin flexing far more regulatory muscle--- or episodes of poor care such as this will always plague the industry.

Maybe some of these state agencies need to confer with officials at the NBA, who seem quite capable of using fines to get players behavior in line with the leagues values? Incidentally, no elderly people were neglected, abused or injured in relation to these incidents.

$25,000 fine imposed a against a player who posted the photo of a scatily clad woman on Twitter.
$35,000 fine to a player who was either licking blood off an injured finger or gesturing to the crowd
$500,000 fine to the owner of an NBA team who issued a one sentence response to a fan during the NBA lockout
$40,000 fine to Kobe Bryant for missing to appearences during and All-Star Game weekend

Related Nursing Homes Abuse Blog Entries:

Illinois Lawmaker Seeks To Tighten Reigns On Nursing Homes

What good are nursing home fines when they're not enforced?

Shouldn't Nursing Home Fines Be Reflective Of The Type Of Violation Committed?

How Much Do Nursing Home Need To Be Fined In Order To Clean Up Their Acts?

Nursing Home Injury Laws: New Jersey

Jonathan Rosenfeld — Sun, 06 May 2012 06:00:25 -0600

Number of nursing homes in New Jersey: 358

Patients living in New Jersey nursing homes: 45,610

Occupancy rates of New Jersey nursing homes: 89.8%

Average number of deficiencies at each New Jersey nursing home: 8.5

Percent of New Jersey nursing homes with serious deficiencies for actual harm to patient: 27.4%

Most common deficiencies at New Jersey nursing homes: Accident Environment, Professional Standards, Quality of Care

Distribution of ownership of New Jersey nursing homes: 68% for profit, 27% non profit, 6% government

Most populated cities in New Jersey: Newark, Jersey City, Paterson, Elizabeth, Edison, Trenton

Staffing levels at New Jersey nursing homes (daily hours):Above average, 3.8 total staff, 1.6 licensed nurse

Visit Nursing Home Injury Laws to learn more about New Jersey nursing homes and your legal right

**Data based upon 2009 CMS data, U.S. Department of Health and Human Service