Yourlawyer.com (Nursing Homes Abuse / Negligence In Nursing Home News)

Nursing Home Resident Develops Bed Sore, Facility Facing Neglect Lawsuit

Wed, 06 Mar 2013 00:00:00 -0500

An Illinois nursing home has been accused of providing negligent care to one of its residents to the point that he was forced to undergo a partial amputation of his leg.

According to a local Patch.com report, the Hillcrest Nursing and Rehabilitation Center in Joliet, Ill., has been named in a lawsuit claiming the male resident received negligent care at the nursing home that’s currently fighting to keep its doors open.

The lawsuit was filed in late-February in Cook County Circuit Court in Illinois, according to the report.

The Plaintiff was moved to the Hillcrest Nursing and Rehabilitation Center in July 2010 after suffering a series of strokes that left him paralyzed on one side of his body and unable to speak. The complaint against the nursing home states that during his stay there, Rush developed serious bed sores and was dehydrated.

The resident’s condition worsened as his stay was extended at the nursing home. The Plaintiff developed a pressure sore on his left heel that became infected and forced him to have part of his leg amputated. He moved from Hillcrest Nursing and Rehabilitation Center after that surgery.

The Plaintiff’s sister-in-law told the news source that when her relative entered the nursing home back in 2010, he was still able to move about with the help of a walker and some supervision. At the time he was removed from the nursing home, he had part of his leg gone and was “deathly ill.” She added that the amputation was performed on his left leg but that he was paralyzed on his right side, an indication that the substandard care at the nursing home was to blame for his current state.

The Hillcrest facility has been in the crosshairs of state health and oversight officials in Illinois for the past several years and that after the filing of this recent lawsuit against in, the state’s Dept. of Public Health fined the nursing home more than $30,000 and that an investigation had uncovered at least 23 reported incidents of verbal, sexual, physical, and mental abuse against the residents there during a five-month period in 2011. There are also two reports of suspicious deaths linked to the nursing home. The nursing home has also lost its Medicare and Medicaid funding eligibility because it failed to meet minimum standards of care for residents.

Hypnotic Sleep Aids Up Risk of Hip Fractures Among Nursing Home Residents

Tue, 05 Mar 2013 00:00:00 -0500

The use of sleep medicines among nursing home residents increases their risk of suffering hip fractures.

New research that’s been published in the journal JAMA Internal Medicine shows that nursing home residents with mild or moderate cognitive impairment face a greater risk of suffering a hip fracture if they’re taking a non-benzodiazepine hypnotic sleep aid than if they’re not. Some of the more popular brand names of these drugs are Ambien and Lunesta.

The study was conducted in the U.S. The study examined reports from more than 15,000 long-term residents of nursing homes across the country. Each of the records examined were of nursing home residents who had suffered a hip fracture. All study participants were over the age of 50 and were Medicare recipients between July 2007 and December 2008.

Based on a review of the medications each resident had been taking at the time of their fracture, the study determined that 11 percent of them had been taking a non-benzodiazepine hypnotic sleep drug in the month prior to breaking their hip. The study concludes that people taking these drugs like Ambien and Lunesta face a 66 percent higher risk of suffering a hip fracture than those not taking the drugs.

Several other factors related to these drugs affect the risk of suffering a hip fracture, including the severity of their cognitive and functional impairment. Residents who are more mobile and require less assistance were more likely to suffer a hip fracture while taking a non-benzodiazepine sleep drug. Those with a lesser severity of cognitive impairment also face a greater risk of suffering a fracture while taking these drugs.

Also, the study found, patients who were recently prescribed the drugs like Ambien and Lunesta were more likely to suffer hip fractures. The report cites the study in its conclusion, “New users and residents having mild to moderate cognitive impairment or requiring limited assistance with transfers may be most vulnerable to the use of these drugs. Caution should be exercised when prescribing sleep medications to nursing home residents.”

Medicare Waste on Substandard Nursing Home Care Tops $5B in 2009

Mon, 04 Mar 2013 00:00:00 -0500

The federal government spent more than $5 billion in neglectful, abusive, and substandard care at nursing homes across the country several years ago. Considering the cost of care is on the rise and conditions on average have declined, that cost is probably more in the years since.

According to an Associated Press report, an investigation from the Dept. of Health and Human Services found that Medicare reimbursements totaling $5.1 billion in 2009 went to nursing homes across the country that failed to meet the minimum standards of care for skilled nursing facilities. This included the cost of prescription drugs residents took that may not have been necessary or those that had dangerous interaction risks.

For a nursing home to be eligible to accept residents who are insured by the federal Medicare program, they must establish a baseline standard for the care of those residents. The increasing cost of health insurance and health care have taken its toll on nursing homes in the last decade and the standard of care across the board has declined considerably. Budget cuts have led to poor management and population increases at nursing homes have stretched skilled staff thin, forcing facilities to hire unqualified help who have proven more likely neglect or abuse residents.

Some states like Florida that were once considered havens for retirees or people that required full or assisted nursing care on a daily basis have become known for the converse now.

And while the quality of care has dropped, so has the federal government’s ability to keep its proverbial eye on many of the nursing homes it reimburses for the care they are or aren’t providing their residents.

The federal study found that one in three nursing home residents getting Medicare funding is staying at a facility that failed to meet minimum standards of care. Further detailed in the federal government’s report is the fact that one in five patients admitted to a nursing home that received Medicare funding did not have their specific medical problems addressed by the facility or its staff. In some cases, patients received care they didn’t need because the nursing home was more interested in receiving the money from Medicare funds than providing quality care to its residents.

All told, this equated to about $5.1 billion in waste in 2009, alone. Plainly speaking, the HHS report warns, “These findings raise concerns about what Medicare is paying for.” The agency issued several warnings in its report, including one to the federal government to increase oversight into the nation’s network of Medicare-eligible nursing homes. One way to do this is to tie the rate of Medicare reimbursements to the quality of care a nursing home or other skilled nursing facility provides.

Hidden Camera Footage Captures Abuse of Elderly Dementia Patient at Bronx Nursing Home

Wed, 20 Feb 2013 00:00:00 -0500

A New York woman has discovered proof that her grandmother was being subjected to physical abuse at the Bronx nursing home where she lived.

According to a WABC-TV report this week, Diana Valentin had noticed unusual bruising and other markings on her 89-year-old grandmother when she visited her at Gold Crest Care Center, a nursing home in the Bronx. The elderly woman had been forced into a nursing home facility when the symptoms of her Alzheimer’s disease and dementia required full-time care.

Instead of that care, the woman was often left helpless and defenseless and subjected to physical abuse by at least one nurse’s aide at Gold Crest Care Center.

With only an inkling that her grandmother was being abused, based on the visible bruises on her body, Valentin set up a hidden camera in her room to capture the suspected abuse in progress. The woman had complained to administration officials at Gold Crest Care Center but those accusations were largely ignored, leaving the granddaughter frustrated and willing to seek her own justice. It did not take long for her to get her evidence. Valentin hid a camera inside a plastic plant pot, where it was able to capture views of her grandmother in her bed.

In the first video of more than 600 hours captured, a nurse’s aide can be seen grabbing the elderly woman’s arm and twisting it. The aide did this to lift the woman off her bed only to slam the helpless victim back to her bed. After watching the first video, Valentin acted to remove her grandmother from the Bronx nursing home, transferring her from there to a local emergency room. The elderly woman now lives at a nursing home in New Rochelle, N.Y.

Valentin presented the video evidence she had collected to local authorities and it has led to the arrest of one aide employed at Gold Crest Care Center, 55-year-old Sandra Kerr. Kerr faces charges of endangering the welfare of a physically disabled person, according to the WABC-TV report.

Though the news source would not comment for the report, Valentin said that three other workers in addition to Kerr have been terminated from their jobs at the Bronx facility.

Reports like these are increasing at a faster rate as more Americans are placed in nursing homes. Populations at nursing homes is increasing and there are many more facilities than there were in the last decade but due to budget constraints and the rising cost of care, nursing homes have taken to making questionable decisions regarding staffing their facilities, often failing to perform background checks on employees and improperly supervising that staff to avoid incidents like these and other shocking cases of abuse and neglect.

Nursing Home Employee Gets 7 years after Hidden Camera finds her Stuffing Latex Gloves in Patient's Mouth

Wed, 23 Jan 2013 00:00:00 -0500

A nursing home employee in Oklahoma City is facing criminal abuse charges this week after she was discovered stuffing latex gloves in the mouth of an elderly dementia patient under her care.

According to a report, the family of the 96-year-old woman had suspected that someone was stealing from her room at the nursing home. They installed a hidden camera and instead of theft, what they saw instead were shocking displays of elder abuse.

On separate occasions, the hidden camera recorded evidence of abuse against the dementia patient. It is unclear whether other employees at the nursing home were also abusing this specific patient but in one series of shots, another caretaker is seen in the room watching idly as the other commits the abuse.

As stated, one of the incidents involves the nursing home employee forcibly stuffing latex gloves into the patient’s mouth and holding her mouth closed. In other incidents, the employee can be seen in the footage holding down the patient by placing pressure on her chest. She also forced her head down in order to get her to lay down.

Since the patient was suffering from Alzheimer’s disease, dementia, and severe arthritis, these acts of abuse would have been extremely painful. The woman died a few months after the video evidence was brought to light and while the abuse is not currently considered a cause of the woman’s death, it likely made life more difficult for the woman in her final weeks.

A 23-year-old nurse’s aide from Nigeria who had been working at the home and was identified as the person who stuffed the latex gloves in the woman’s mouth was sentenced to seven years in prison, two of the years being suspended.

As the nation’s economy weakens, it has directly impacted the quality of health care available in the U.S., especially at the thousands of nursing homes operating across the country. As more people choose to enter a nursing home facility, the demand for rooms increases and so does the need for competent aide in tending to these patients’ many needs.

Budget cuts have forced many nursing homes into making questionable decisions with hiring staff, often opting to pay lower-wage employees over more skilled practitioners. Safety inspections that aim to ensure patients are receiving competent and skilled care have declined and that has put thousands more nursing home residents of risk for abuse and negligence.

Pennsylvania nursing home employees arrested after video footage shows their abuse

Mon, 17 Dec 2012 00:00:00 -0500

Two former employees of a Pennsylvania nursing home have been arrested, accused of abusing at least one elderly patient at their place of employment.

According to an NBC News report from Philadelphia, the abuse happened at Arbors at Buck Run, a nursing home facility in Bucks County, Pa., outside the city. The two employees of that facility accused of abuse were caught on hidden camera footage physically abusing one resident at the facility.

The video footage allegedly shows one of the aides arrested this week dancing in front of the wheelchair-bound patient. Another clip shows another "dumping" the patient from her wheelchair onto her bed. There was also evidence of the nursing home resident being "mishandled" and physically abused. The footage was courtesy of a hidden camera installed by the resident's daughter who had suspected, based on evidence she found during previous visits, that her mother was being abused.

That inkling led to the cameras being hidden in her residence at Arbors at Buck Run, which were able to capture hard evidence of the suspected abuse.

Local and state police authorities are investigating the incidents depicted in the video footage. Investigators with the state's Dept. of Public Welfare have also joined the effort this week. Those investigations will likely include questioning other staff employed and formerly employed at Arbors at Buck Run, as well as residents of the nursing home in suburban Philadelphia.

It may be that this one resident was not the only one subjected to abusive treatment.

Nursing home abuse is one statistic that continues to disturbingly rise. More Americans are retiring to what they think are the comforts of nursing homes or other assisted-living facilities. Many more are being constructed but many more are operating on shoestring budgets and that often forces them to hire unqualified staff to care for the growing number of residents.

Not properly investigating backgrounds of nursing home employees has led to needless abuse at the hands of care workers. In some cases, employees of nursing homes will float from facility to facility, often avoiding being caught in any abusive behavior by leaving before it becomes too late. In other cases, employees of nursing homes are forced to work long hours, care for too many patients, or perform tasks they're not capable of doing, a situation that often leads to neglect.

FDA urged to act on bed rails safety

Mon, 26 Nov 2012 00:00:00 -0500

Hundreds of deaths and thousands of injuries still aren't enough to prompt stronger warnings on the use of and dangers posed by bed rails.

Bed rails are designed to keep patients safe in their beds, namely older patients in assisted-living, nursing home, and hospital settings. These rails extend along a bed. For many patients who are prone to roll out of bed for various reasons, these beds could be a life-saver but for many more people each year, they’ve become a serious health hazard. Patients suffering from Alzheimer's disease or other conditions that could cause them to fall out of bed may benefit from bed rails but some older models could cause more injury than benefit.

If a patient were to fall from bed and slip between the spaced-apart rails on common bed rails, they could become trapped, putting them at risk of suffocation or strangulation. These injuries are more common when people are using beds with older model rails. Most newer models of bed rails are not designed to allow a patient to slip through them.

According to the New York Times, there are about 4,000 injuries each year that require emergency room care that are blamed on bed rails. In the last decade, about 150 people have died as a result of being trapped in a bed rail. The Consumer Product Safety Commission has received at least 36,000 reports of injuries blamed on bed rails between 2003 and May of this year.

Most of the injuries are among the elderly, often in hospitals or nursing homes. Despite the rising rate of injuries blamed on bed rails, federal health officials have continually allowed manufacturers to talk them out of requiring safety warning labels to be placed on all bed rails detailing their injury risks.

The source found that the Food and Drug Administration and CPSC have repeatedly balked at issuing warnings or requiring that safety labels be placed on all bed rails that would at least make most consumers aware of the potential dangers. Experts told The Times they believe that many of the injuries and deaths caused by these bed rails could have been avoided with more awareness among both health care professionals and patients.

The FDA did issue a warning about the potential hazards of bed rails in 1995 but only issued voluntary guidelines for their use instead of requiring a warning label in 2006. Again, as the injury and death reports continue to accumulate, both federal agencies are being bucked to require that safety labels be placed on these ubiquitous devices.

Newer model bed rails aimed to prevent many of these injuries and some health care facilities have made their employees aware of these potential dangers have reduced the rate of injuries blamed on bed rails since 1995, but many facilities and home health patients still rely on older model rails.

National Nursing Home Abuse Lawyers File Wrongful Death Lawsuit Against Margaret Tietz Center for Nursing Care

Tue, 14 Aug 2012 00:00:00 -0400

Parker Waichman LLP, a national law firm dedicated to protecting the rights of nursing home abuse and negligence victims, has filed a lawsuit on behalf of the estate of a Queens, New York woman who died, allegedly due to the negligence of Margaret Tietz Center for Nursing Care. The suit was filed on July 26th in the Supreme Court of the State of New York, Queens County (Index No. 16031/12). Margaret Tietz Center for Nursing Care, Inc., Margaret Tietz Nursing and Rehabilitation Center, Margaret Tietz Center for Nursing Care, Inc. and Margaret Tietz Center for Nursing and Rehabilitation Center have been named as Defendants.

According to the Complaint, the Plaintiff’s decedent was a resident at Margaret Tietz Center for Nursing Care from December 2010 through March 2011. During this time, she was under the exclusive care, custody, control and management of the nursing home staff. The lawsuit alleges that the negligent actions of the nursing home staff caused the Plaintiff’s decedent to suffer a number of injuries leading up to her death in September 2011. Allegedly, the deceased had suffered bed sores (decubitus ulcers), skin breakdown, infections, malnutrition and dehydration as a direct result of nursing home negligence. The suit alleges that the Plaintiff’s decedent was forced to undergo medical treatment, incurred medical expenses, suffered disfigurement, disability, pain and suffering, mental anguish, loss of enjoyment of life, loss of dignity and death.

The lawsuit alleges that the Plaintiff’s Decedent rights given were violated under Public Health Law and holds the Defendants responsible for these violations. The Defendants are being charged with negligence, gross negligence and wrongful death. The lawsuit also seeks compensation for punitive damages and attorney’s fees.

Parker Waichman offers free legal evaluations to the victims of nursing home abuse and neglect, as well as their families. If someone you love was victimized by a negligent nursing home, please visit our nursing home abuse and negligence website. Free lawsuit evaluations are also available by calling 1-800-LAW-INFO (1-800-529-4636).

About Parker Waichman LLP

Parker Waichman LLP is a leading personal injury law firm that represents plaintiffs nationwide. The firm has offices in New York, New Jersey, Florida and Washington, D.C. For more than two decades, Parker Waichman LLP has assisted thousands of clients in receiving fair compensation due to the negligence of others and injuries resulting from defective drugs, medical devices and other products.

For more information on Parker Waichman LLP, please visit yourlawyer.com or call 1-800-LAW-INFO (1-800-529-4636).

Contact:

Parker Waichman LLP
Gary Falkowitz, Managing Attorney
(800) LAW-INFO
(800) 529-4636

Parker Waichman LLP Files Wrongful Death Lawsuit on Behalf of West Islip Nursing Home Resident

Thu, 28 Jun 2012 00:00:00 -0400

A New York woman’s death is being blamed on the negligent care given to her at a nursing home run in the state.

The estate of the woman is being represented in a lawsuit filed recently in Supreme Court of the State of New York by the national law firm of Parker Waichman LLP. Our Lady of Consolation Geriatric Care Center, located in West Islip, N.Y., is named as the Defendant. It is there that the woman allegedly received negligent care during her two-and-a-half year stay at the facility.

She was admitted to Our Lady of Consolation Geriatric Care Center in December 2008 and suffered a fall in May of last year. The impact of the fall broke her left tibia and fibula bones. The complications from those injuries eventually led to her death just six days later in a nearby hospital.

Falls are one of the leading causes of death among the elderly and nursing homes are required to keep their facilities free of hazards that could cause a resident to trip or fall. It is also required to provide certain safety features in a resident’s room that could present hazards, such as railings around the tub and in the bathroom

The lawsuit claims the deceased woman’s rights were violated during her time at Our Lady of Consolation Geriatric Care Center and is seeking damages on charges the nursing home is guilty of negligence, gross negligence, and wrongful death. It states the negligent care delivered at the West Islip nursing home caused the Plaintiff-Decedent to “undergo medical treatment, incurred medical expenses, suffered disfigurement, disability, pain and suffering, mental anguish, loss of enjoyment of life, and death,” according to the firm’s announcement of the lawsuit.

“One of the largest causes of potentially preventable hospital emergency room visits made by nursing home residents is injury due to a fall,” Brett Leitner, Nursing Home Abuse & Neglect attorney at Parker Waichman LLP, said. “This is all the more reason that nursing homes must be vigilant about keeping the facility free of dangerous conditions that might cause an elderly patient to slip or trip and fall, and must provide proper safety devices, supervision, and interventions to prevent falls from occurring.”

More and more Americans are living in nursing homes and this, along with a general economic downturn, has resulted in a strain on many facilities. Tightened budgets often result in under-staffed nursing homes and assisted-living facilities which are often forced to hire poorly trained staff to keep operations in some form of order.

These conditions and an overall lack of adherence to safety standards puts this growing population at greater risk of serious injuries and wrongful death. Many residents do not receive the care they’re supposed to receive or even the care necessary to keep them healthy, like proper exercise, or alive, such as regular feedings and proper hygiene.

Parker Waichman Files Nursing Home Negligence Against Nassau County Facility

Sun, 01 Jan 2012 00:00:00 -0500

A New York nursing home is facing allegations that its negligence led to the untimely death of a Nassau County woman under its care for less than two months.

The deceased woman, on behalf of her estate, is being represented in a lawsuit against that nursing home by the national law firm of Parker Waichman LLP, which has represented numerous other victims of nursing home abuse or negligence. In the lawsuit filed against UPR Care Corp. (doing business as Cold Spring Hills Center for Nursing and Rehabilitation) in Woodbury, N.Y., the unnamed victim was admitted to the nursing home in late-January 2011 and stayed there until early-March.

During her short stay, the victim developed numerous serious health complications, all of which are being blamed on the negligent care provided to her at Cold Spring Hills Center for Nursing and Rehabilitation. The claim against the nursing home lists some of the complications as “numerous decubitus ulcers, skin breakdown, infections, malnutrition, dehydration, and other injuries.”

Throughout and after her short stay at the nursing home, the plaintiff was admitted to Winthrop-University Hospital in Mineola, N.Y., for the treatment of these conditions, namely the breakdown of her skin. The hospital, the lawsuit claims, was unable “to render her proper and adequate care and treatment to prevent the worsening” of her skin problems. She was admitted to the hospital for stays ranging from one week to two, including a final visit on May 3, 2011. The victim died on May 4, just more than four months after first being admitted to the nursing home.

The lawsuit, filed this week before the Supreme Court of the State of New York, charges Cold Spring Hills Center for Nursing and Rehabilitation with negligence, gross negligence, and wrongful death. It seeks unspecified compensatory and punitive damages, plus fees, on behalf of the woman’s estate.

This case is an example of something becoming far too commonplace in U.S. nursing homes, as many have been forced to make drastic budget restrictions in the face of an economic downturn. With less money, nursing homes have been forced to hire poorly-trained staff and care workers, have taken their eyes off screening potential employees as those who may be more likely to abuse patients or have a history of abuse against patients, and have drastically reduced the actual number of staff members.

These conditions can often result in negligent or abusive care. Fewer employees does not allow a nursing home to offer adequate care to its residents. Medications are often missed, confused, or abused. Common medical complications, like ordinary infections, can quickly worsen in no attention is given to it. Residents who require round-the-clock care are less likely to receive that.

Further, important medical records are not kept and family members who suspect their relative under a nursing home’s care is being abused or neglected may not get proper response or are ignored if they raise their concerns to nursing home administrators.

Baltimore Nursing Home Evacuated After 3 Days Without Air Conditioning

Wed, 07 Jul 2010 00:00:00 -0400

A Baltimore nursing home went without air conditioning for three days before anything was done about it. It wasn’t until a resident of Ravenwood Nursing and Rehabilitation Center called 911 Tuesday that the problem was addressed. Temperatures in the Baltimore area hit 105 degrees yesterday.

It is believed the facility’s air conditioning went out sometime Saturday, though some Baltimore media outlets are reporting that the system went down as early as Friday. At any rate, authorities said the temperature inside the 190-bed nursing home was 91 degrees by Tuesday morning.

All 150 residents currently at Ravenswood are being moved to other facilities today, the Associated Press is reporting.

The Maryland Department of Health and Mental Hygiene is investigating to see if Ravenwood personnel followed proper procedures. Nursing home facilities are required to report malfunctions of such a nature.

“The equipment failure could easily have put clients at risk,” said David Paulson, communications director for the department. He described conditions inside the facility as “unsuitable” and “irresponsible.”

Baltimore City Emergency Management spokesman Scott Brillman told WBALTV that the office got in touch with Ravenwood’s corporate office in Louisiana, and arranged to bring 12 portable air conditioners. Two were deployed on each floor, and about 40 of Ravenswood’s most vulnerable patients have been moved to lower floors. Mechanics have been called in to fix the air conditioning in the meantime.

Unfortunately, the air conditioners and window fans deployed so far haven’t been enough to cool the building adequately, so Ravenswood is being evacuated at this time.

Ravenswood houses a number of vulnerable patients, WBALTV said. Some are under 65, but with serious medical conditions. A number are gunshot victims.

Miraculously, no residents have suffered health complications related to the heat, the Associated Press said.

Nursing Homes Administer Psych Drugs For No Reason

Tue, 27 Oct 2009 00:00:00 -0400

The Chicago Tribune broke with an expose on how some powerful psychotropic medications are being administered to nursing home residents in Illinois without consent and without valid psychiatric diagnoses. Some of these elderly have suffered from a variety of adverse responses that include, said the Tribune, “tremors, dangerous lethargy, and a higher risk of harmful falls or even death.”

Psychotropic medications include antipsychotics, antidepressants, and anti-anxiety medications, explained the Tribune.

According to the Tribune, it found 1,200 violations affecting 2,900 patients since 2001, all involving pychotropics; however, it is believed that the figures are higher given the dearth of regular investigations. According to the Tribune, some sites only inspect once every 15 months, and generally only conduct spot checks.

Psychotropic drugs have been administered for a wide array of seemingly pointless reasons, for instance one woman because she would not wear a bra, a man for being “easily annoyed," a blind woman for "yelling out" and being "easily annoyed," another woman due to "her inability to perform her personal hygiene," and another woman for being "nasty." The Tribune looked through tens of thousands of state and federal inspection reports involving everything from "five-star" to run-down facilities.

Some nursing home residents do suffer from the types of “major mental illness” that warrant antipsychotic medications; however, many of the patients administered these medications did not have a diagnoses of psychosis and some were so delicate and frail that they required an oxygen tank to breathe, said the Tribune.

Researcher Christie Teigland, is looking at the data on some 275,000 nursing home residents who have been diagnosed with dementia, said the Tribune. Teigland has found that those patients taking psychotropic drugs were likelier to fall or deteriorate versus other patients and, when taken off the medications, tended to improve.

Dr. David Graham, a U.S. Food and Drug Administration (FDA) scientist, speaking before congress two years ago, said that he estimated that there are thousands of nursing home resident fatalities annually over antipsychotics being administered unnecessarily and to patients who are not diagnosed with any mental illness. Of note, said the Tribune, these types of medicines can be very dangerous and many carry the FDA’s strongest warnings—the black-box warnings. Side effects from antipsychotic medications include significant “lethargy, permanent involuntary muscle movements, seizures and sudden death,” said the Tribune.

Until 1987, there were little regulations regarding sedating nursing home residents; however, although a law was enacted then to protect residents from unneeded medications, the dosing still occurs, said the Tribune. And, while such facilities are prohibited from administering pychotropics without a prescription, patient’s consent, and “justification,” the Tribune inspection found that this is not always the case.

In its review of 742 Illinois nursing homes, most—at least two-thirds—were cited for incidents involving psychotropic medications at least once in an eight-year period, said the Tribune. Of these, said the Tribune, dozens were cited yearly and some had added a bogus mental illness diagnosis to patient files. Sadly, the Tribune found, some patients were prescribed the medications to ameliorate some symptoms while underlying issues—the Tribune noted pain or infection as just two—went untreated.

Housing Mentally Ill in Nursing Homes Sometimes Leads to Violence

Tue, 24 Mar 2009 00:00:00 -0400

Sadly, it seems that nursing homes are increasingly housing the elderly alongside patients with mental illness. The problem is that, in some cases—said U.S. News & World Report, citing the Associated Press (AP)—violence, sometimes with deadly consequences, has been reported.

U.S. News noted that there is insufficient housing in psychiatric units, mental institutions are closing, and nursing homes have more room now that the emerging elder population is healthier or remaining in their own homes longer. Because of these logistical and health changes, younger, seriously mentally ill residents—some suffering from depression, schizophrenia, or bipolar disorder, said the AP—can be found in nursing homes along with the frail and defenseless elderly.

According to AP reports and based on exclusive information it obtained via the Freedom of Information Act, nearly 125,000 mentally ill young and middle-aged adults were living in U.S. nursing homes last year, versus 89,000 in 2002, an increase of 41 percent, noted MedPageToday, which reported that some states showed increases of 75 percent or greater. The current population of mentally ill patients in nursing homes accounts for nine percent of the total nursing home population, said MedPageToday, citing Center for Medicare and Medicaid Services (CMS) data.

MedPage pointed out that Medicaid pays housing for those with so-called chronic psychiatric disorders assuming the mentally ill population in a facility does not exceed 50 percent; age is not a factor in this case. According to the AP, families have sued to try to change these practices and consumer advocates argue that, with proper care, the mentally ill can live in their own housing.

The AP noted that there is no tracking of killings or serious assaults by mentally ill nursing home residents against the elderly and that nursing home training does not always include what it necessary to treat seriously mentally ill patients, leaving the mentally ill angry and the elderly frightened and reclusive.

The AP pointed to a variety of violent, sometimes-fatal crimes committed against elderly residents by mentally ill patients in nursing homes. These incidents and the CMS data point to the fact that nursing homes have become "dumping grounds" for the mentally ill, the report said, quoted MedPage:

A 77-year-old Alzheimer’s patient died after being hit in the face with a clock radio. The man’s roommate was a mentally ill 50-year-old man with a history of aggression and “altered mental status,” who—after being found covered in blood—was arrested and charged, but found unfit to stand trial. He was committed to a mental institution.
A 23-year-old woman was charged with starting a fire that resulted in the deaths of 16 patients at the nursing home where she resided. The woman suffered from multiple sclerosis, dementia, and depression; was found not competent to stand trial; and was moved to a mental institution.
A 77-year-old patient died 10 days after his 62-year-old roommate beat him with a bathroom towel bar; the roommate was found incompetent to stand trial.
A 69-year-old patient was raped by a 21-year-old man diagnosed with bipolar disorder with aggression; had a history of violence; and was left unsupervised, despite telling staff he was sexually frustrated.

Nursing Home Abuse Arrests in Rochester NY

Fri, 30 Jan 2009 00:00:00 -0500

Two nursing homes in the Rochester, NY area are embroiled in an abuse scandal. Yesterday, one certified nurse aide at the Kirkhaven Nursing Home in Rochester, and another who worked at the Edna Tina Wilson Living Center in Greece, NY, were arrested as part of a state-wide probe into nursing abuse and healthcare fraud.

According to the New York State Attorney Generals office, the aides arrested were 32-year-old Monique Jones, who worked at Kirkhaven, and 47-year-old Nellie Weller, an aide at the Greece facility. Jones is accused of kicking an 88-year-old resident in his ribs. Weller allegedly tied a 76-year-old resident's nightgown around his neck and legs, leaving him unable to move or use his urinal. Both aides have been fired from their jobs at the facilities.

Jones and Weller have each been charged with endangering the welfare of an incompetent or physically disabled person and willful violation of the health laws. The maximum penalty for each charge is one year in prison. They were each arraigned yesterday, and were released on their own recognizance. Jones will return to court on February 9 and Weller is due back in court on March 19.

The arrest were part of a wide-ranging probe into nursing home abuse and healthcare fraud in the state. Prior to the arrest of Jones and Weller, there had been 30 arrests statewide of nursing home employees from hidden-camera investigations.

"Thousands of New Yorkers and their families depend on nursing home aides and healthcare professionals to provide vital services to their loved ones," said Attorney General Cuomo said in a statement announcing the arrests. "For any of these caregivers to abuse the trust we place in them is reprehensible, and my office will continue to intervene on behalf of vulnerable New Yorkers to ensure safe and quality care."

Unfortunately nursing home abuse is a common crime. The National Center on Elder Abuse estimates at least one in 20 nursing home patients has been the victim of negligence and or abuse, though it concedes that the number is probably higher. According to the National Center’s study, 57% of nurses’ aides in long-term care facilities admitted to having witnessed, and even participating in, acts of negligence and abuse. Data from the U.S. Centers for Disease Control and Prevention show that nursing home neglect played role in the deaths of nearly 14,000 nursing home patients between 1999 and 2002.

Study: Standards Needed for Nursing Home Social Workers

Thu, 08 Jan 2009 00:00:00 -0500

Low federal standards and inconsistent state laws have caused lapses in nursing home social workers’ qualifications. Although social workers are integral to nursing home residents’ quality of care, there are vast differences among workers backgrounds based on the first national study on nursing home social workers, said The Press Citizen. This, according to the findings of a University of Iowa study that surveyed 1,071 nursing home social service directors.

The study found only half of all nursing home social workers actually have a social work degree; unbelievably, 20 percent do not have a four-year degree of any kind; two-thirds do not belong to any professional organizations; and the vast majority—62 percent—are not licensed in social work said The Press Citizen according to the study.

UI also noted that for-profit nursing homes are 31 percent less likely to hire a degreed social worker. Mercedes Bern-Klug, study lead and assistant professor of social work at UI’s College of Liberal Arts and Sciences expressed concern over the findings noting that nursing home social workers are responsible for a variety of critical areas of care. "Nursing home social workers handle very serious emotional issues affecting residents, family members, and other staff members, and they deserve to be educated on how to handle these issues," Bern-Klug said. "Everyone benefits when nursing homes hire qualified social workers," she added.

UI noted that nursing home residents struggle with serious disorders such as dementia, and pointed out that the highest suicide rates are among the elderly; worse, older patients are often victimized, "Still, many people in charge of social work in nursing homes aren't social workers, and the federal government doesn't require that they be social workers," Bern-Klug said. Bern-Klug said 10 states do not address nursing home social worker qualifications, seven state codes seem to be out of compliance with federal standards, only 21 states require a social work degree, and there are loopholes in some state laws. For instance, in Colorado, if a rurally-located for-profit nursing homes advertises for one week in its local paper for, but is not able to find, a qualified social worker, it is not required to hired such a worker, while in Indiana, a clergy member who completes a 48-hour course and consults with a social worker can deliver social services.

Also, UI said nursing homes with over 120 beds must meet federal regulations requiring one full-time social worker be employed; however, a bachelor degree in any human service area—not specifically in social work—and a year of supervised field experience is considered sufficient. Because most nursing homes—70 percent—do not meet the 120-bed standard, they are not required to employ a social worker and despite that most do employ one such worker, there are insufficient social workers to provide the individualized care patients need and, often, said, Bern-Klug, social workers are consumed with marketing and activity planning. "I asked 1,000 social workers, 'How many residents can you handle? Federal guidelines say you can do 120.’ An overwhelming majority said fewer than 60,” she said. "We need legislation to demand well-prepared social workers and to set reasonable social worker-to-resident ratios…. Decades of research has documented the negative consequences of having too few nurses in a nursing home, and still we don't have strong laws demanding a realistic nursing ratio," Bern-Klug said.

Nursing Homes Rated on New Government Website

Mon, 22 Dec 2008 00:00:00 -0500

The Centers for Medicare and Medicaid Services (CMS) has launched a Website ranking nearly 16,000 nursing homes. Reuters Health reports that this is the first-ever federally-managed Website that >ranks nursing home facilities for quality.

"Around three million Americans depend on nursing homes at some point during each year to provide life-saving care," CMS administrator Kerry Weems said in a statement announcing the website launch. "Most of those individuals are enrolled in Medicaid or Medicare and we all bear a special responsibility to protect their health and welfare."

The CMS oversees the Medicare and Medicaid insurance programs, explained Reuters Health. The 15,800 nursing homes rated by CMS participate in the public insurance system. According to CMS, in the first round of ratings, about 12 percent of the nation's nursing homes received a full five-star rating while 22 percent scored at the low end with one star. The remaining 66 percent of facilities were distributed fairly evenly among the two, three, and four star rankings, Reuters said.

Looked at were the incidence of bed sores, resident mobility, and if recommended medical care was received, said Reuters Health, which said the site—www.medicare.gov—will receive monthly updates and will include staffing levels and if the facility is for- or not-for-profit. "The new Website improvements also include links to information for community-based alternatives to nursing homes that may be of great interest to families," Thomas Hamilton, who helped develop the new system, told Reuters Health.

Nursing homes must meet federal residents' rights requirements to participate in Medicare or Medicaid. Some states have residents' rights in state law or regulation for nursing homes, licensed assisted living, adult care homes, and other board and care facilities. A person living in a long-term care facility maintains the same rights as an individual in the larger community.

In spite of the law, nursing home abuse continues to be a serious problem. The National Center on Elder Abuse estimates at least one in 20 nursing home patients has been the victim of negligence and or abuse, noting the number is likely higher. According to the National Center’s study, 57% of nurses’ aides in long-term care facilities admitted to having witnessed, and even participating in, acts of negligence and abuse.

Earlier this month, Business First of Buffalo reported that New York State Attorney General Andrew Cuomo announced the arrests of nursing home employees over charges of resident neglect and abuse. According to Business First, three employees were arrested and charged and a fourth was convicted for “abusing elderly and ill patients.”

The arrests followed a New York state-wide investigation into institutional care abuse and neglect said Buffalo First. A prepared release stated that the acts involved “physically attacking and using racial slurs against an 86-year-old Alzheimer’s patient, slapping a 100-year-old patient in the face, and tying an elderly patient with dementia to a chair for two consecutive nights.”

NY Nursing Home Abuse Investigation Yields Arrests

Tue, 09 Dec 2008 00:00:00 -0500

New York State Attorney General Andrew Cuomo has announced the arrests of nursing home employees over charges of resident neglect and abuse, Business First of Buffalo is reporting. According to Business First, three employees were arrested and charged and a fourth has been convicted for “abusing elderly and ill patients.”

Cuomo announced the arrests yesterday, following a New York state-wide investigation into institutional care abuse and neglect said Buffalo First. A prepared release stated that the acts involved “physically attacking and using racial slurs against an 86-year-old Alzheimer’s patient, slapping a 100-year-old patient in the face, and tying an elderly patient with dementia to a chair for two consecutive nights.” In the release, Cuomo said his “office remains committed to protecting the vulnerable and defenseless by uncovering and prosecuting alleged abuses at nursing homes across the state,” noting that elderly New Yorkers deserve better “than to endure suffering at the hands of those entrusted with their care.”

The four involved are Corey Austin, 28; Jeffrey Perry, 23; Patricia Penman, 57; and Jeanette Sovereign, 45. Austin, a certified nurse aide, was terminated last February from the Gowanda Nursing Home after what Buffalo First described as a violent encounter with a patient. WIVB.com reported that, according to court papers, Austin used racial slurs and attacked the patient, repeatedly pushing him to the floor and pinning him to his bed with his knee in the patient’s back. Austin was convicted of two misdemeanors—one a Class A—for endangering the welfare of an incompetent or physically disabled person and for willful violation of health laws, said Buffalo First; Austin faces a maximum two-year jail term when he is sentenced next month.

Perry, another certified nurse aide is accused of tying an elderly resident to a chair with a belt for two nights at the Gowanda Nursing Home; the patient suffers from dementia, reported Buffalo First. WIVB reported that, according to court records, the resident was found alone, tied to a chair, and in the dark. Perry was charged with endangering the welfare of an incompetent or physically disabled person and willful violation of health laws, reported WIVB.

Sovereign, a licensed practical nurse, said Buffalo First, was at the facility at the time of the crime and is accused of knowing that the incident occurred but not reporting it. WIVB reported that Sovereign was charged with willful violation of health laws.

The investigation led to the arrest of a certified nurse aide who stomped on an 84-year-old female resident of Kaleida Health Deaconess Skilled Nursing Facility said Buffalo First. The resident was lying in a fetal position noted WIVB. Also, a certified nurse aide was sentenced for stealing $8,000 from a 97-year-old resident at The Waters of Orchard Park nursing home in Orchard Park, said Buffalo First. In that case, notes WIVB, the money was stolen to pay a cocaine debt. The investigations continue, utilizing hidden camera technology and have, to date, led to the arrests or convictions of over 47 nursing home employees, reported Buffalo First.

Penman, a certified nurse aide, is accused of physically abusing a 100-year-old female resident from the Rosa Coplon Jewish Home and Infirmary. The woman suffers from dementia, physical disabilities, and is unable to self-care, said WIVB.com, which added that Penman slapped the woman in the face. WIVB reported that Penman is charged with endangering the welfare of an incompetent or physically disabled person and willful violation of health laws.

Nursing Home Workers Charged by Attorney General

Wed, 08 Oct 2008 00:00:00 -0400

Four nursing home workers caught on tape mistreating a patient were charged yesterday with falsifying records and endangering a resident at a Suffolk County facility familiar with such problems, according to Attorney General Andrew Cuomo. This case represents the fourth recent nursing home abuse case in the state, it is the first to originate out of the New York City area in which hidden camera technology was used to obtain evidence against nursing home employees, Cuomo says.

Cuomo said the hidden camera technology has been used upstate, producing 26 convictions and forcing one nursing home into receivership. Cuomo also said that small cameras are installed at facilities across Long Island. "We're going to be using this technology aggressively," he said. "It gives us a whole new avenue for making these cases," Cuomo added. In the recent case, the tiny camera was placed in the room of an 84-year-old man at Long Island’s Medford Multicare Center for Living. Investigators monitored the camera feed from January to March in 2007, officials said.

The charging documents state that the camera revealed that Betty Cheslak, 52, of Rocky Point, a certified nursing aide, was talking on a cell phone while using a machine to transfer the patient from a wheelchair to the bed. Cheslak roughly bumped the patient’s head against the railing and did not turn him to prevent pressure sores nor help him with exercises. Also, Jacqueline Francis, 45, of Jamaica, Queens, a certified nursing aide, changed the man's underwear only once during an eight-hour shift, despite that she was required to change him once every two hours; Francis neglected to shower him and did not turn him in bed.   Rima Chaudhry, 46, of Smithtown, and Toni Miller, 37, of Middle Island, who are both licensed practical nurses, failed to take the man's heart rate before giving him heart medication and failed to give him water through his gastronomy tube. Apparently, Chaudhry did not give the patient his medication at times because the facility had run out; however, she later marked records indicating
that the medications had been withheld by doctors.

All four healthcare workers were arraigned in First District Court in Central Islip and were charged with endangering the welfare of a physically disabled person, a misdemeanor. They were also charged with falsifying records for changing documents to show they provided treatment when they actually did not, a felony. All four workers pleaded not guilty and were released without bail. Cuomo declined to release video evidence, but at a Mineola news conference yesterday, he showed another hidden camera video that led to criminal charges at a Rochester facility.

Meanwhile, the 320-bed Medford facility has faced accusations of patient mistreatment previously and was fined $6,000 by the state Department of Health in 2003 for care lapses that included not hydrating patients. In 2004, it was fined $2,000 for pressure sores, and had 47 violations in its latest inspections, which is nearly double the state average. Mordechai Klein, of Brooklyn, the facility’s majority owner according to Health Department records, was in Israel Tuesday and could not be reached.   Cuomo said the investigation was ongoing. The facility could face civil charges, officials said.

Majority of Nursing Homes Cited For Safety and Health Violations

Tue, 30 Sep 2008 00:00:00 -0400

Nursing home abuse and neglect continues to be a serious problem in the U.S. According to a new report conducted by the inspector general of the Department of Health and Human Services, a whopping 94 percent of all for-profit nursing homes were cited last year for violations of federal health and safety standards. In total, 90 percent of all nursing homes – including those owned by non-profit groups and government agencies - were cited last year for violations of health and safety standards.

The violations cited by the inspector general’s report included infected bedsores, medication mix-ups, poor nutrition, and abuse and neglect of patients. The inspector general also said on Monday that some nursing homes “have systematically failed to provide staff in sufficient numbers and with appropriate clinical expertise to serve their residents.” In other cases, nursing homes billed Medicare and Medicaid for services that “were not provided, or were so wholly deficient that they amounted to no care at all,” the inspector general said.

According to The New York Times, more than 1.5 million people live in the nation’s 15,000 nursing homes. To participate in Medicare and Medicaid, facilities must meet federal health and safety standards. These programs cover more than two-thirds of nursing home residents, and cost taxpayers more than $75 billion per year.

About two-thirds of the nation’s nursing homes are owned and operated by for-profit companies. Non- profit organizations own 27 percent, while government entities own and operate 6 percent.

According to the inspector general’s report, in the past year, poor nursing home conditions were the subject of 37,150 complaints. Of those, 39 percent were later substantiated by inspectors, and at least 20 percent involved the abuse and neglect of patients. What’s more, 17 percent of nursing homes had deficiencies that caused “actual harm or immediate jeopardy” to patients, the report said.

While the report said privately-owned nursing homes were the most likely to have safety and health violations, others did not fare much better. Of the facilities owned by non-profits, 88 percent were cited for violations, while 91 percent of government-run institutions received citations. According to the report for-profit nursing homes averaged 7.6 deficiencies per facility, while not-for-profit and government homes averaged 5.7 and 6.3, respectively.

It is not surprising that privately-run nursing homes have some of the highest rates of deficiencies. Over the past several years, private equity firms have been actively working to acquire nursing homes, and have taken over large chains like of HCR Manor Car, Genesis Healthcare Corp. and Beverly Enterprises. These firms buy facilities and then drastically reduce their costs – usually by cutting staff – with the goal of eventually selling the facilities at huge profits.

According to a New York Times investigation published last year, facilities owned by private investment firms score worse than national rates in 12 of 14 indicators regulators used to track ailments of nursing home residents. And the Centers for Medicare and Medicaid Services says that residents of such nursing homes suffer more from depression, loss of mobility and the loss of the ability to dress and bath themselves. And both federal and state regulators told the New York Times that citations for quality-of-care deficiencies, like moldy food and restraining residents for long periods of time, rose at every large nursing home chain that was acquired by a private investment group,

Study: Over 10 Percent Of Older Americans Suffer Abuse

Wed, 20 Aug 2008 00:00:00 -0400

A new University of Chicago study—the first such comprehensive review of elder mistreatment in the United States—has found that approximately 13 percent of elderly Americans are subject to abuse. Worse, such elders are most commonly abused by a person who either verbally or financially abuses them. "The population of the country is aging, and people now live with chronic diseases longer. So it's important to understand, from a health perspective, how people are being treated as they age," said lead author Edward Laumann, the George Herbert Mead Distinguished Service Professor in Sociology at the University of Chicago. While other studies have been conducted, they were based on small, non-representative samples of the population or on data gathered from the criminal justice system or welfare agencies. As such, those studies were not considered as comprehensive as this new study, which was conducted in response to a National Research Council report calling for scientific study of elder mistreatment.

Laumann and his research team found nine percent of adults reported verbal, 3.5 percent reported financial, and 0.2 percent reported physical mistreatment. The study also found physical impairment plays a role in mistreatment. "Older people with any physical vulnerability are about 13 percent more likely than those without one to report verbal mistreatment but are not more likely to report financial mistreatment," said co-author Linda Waite, the Lucy Flower Professor in Sociology at the University. The study revealed adults in their late 50s-60s are more likely to report verbal or financial mistreatment than older patients. "Perhaps the respondents are including fairly routine arguments, perhaps about money, with their spouse, sibling or child in their reports or perhaps older adults are more reticent to report negative behavior," Laumann said. The findings found wide variations in mistreatment depending on age and ethnicity and were reported in "Elder Mistreatment in the U.S.: Prevalence Estimates from a
Nationally-Representative Study," published in the current issue of the Journal of Gerontology: Social Sciences.

In addition to other findings, the study found that females were about twice as likely to report verbal mistreatment, but no higher level of financial mistreatment, than men; Latinos were about half as likely as nonLatinos to report verbal mistreatment and 78 percent less likely to report financial mistreatment; and blacks were 77 percent more likely to report financial mistreatment than whites. Respondents were questioned about the past 12 months, as follows: "Is there anyone who insults you or puts you down?" (verbal); "Is there anyone who has taken your money or belongings without your okay or prevented you from getting them, even when you ask?" (financial); and "Is there anyone who hits, kicks, slaps, or throws things at you?" (physical). Twenty-six percent reported verbal mistreatment, 26 percent identified a spouse or romantic partner as responsible, 15 percent said their children mistreated them verbally, while the remainder said a friend, neighbor, co-worker, or boss was responsible.

Among people who reported financial mistreatment, 57 percent reported someone other than a spouse, parent or child, usually another relative, was taking advantage of them.

Shameful Conditions Continue in Adult Homes

Tue, 19 Aug 2008 00:00:00 -0400

We have long been reporting on the horrendous conditions in some of this country’s nursing homes as well as some of the abuses suffered by nursing home residents. In one such case, 54-year-old resident Karen Preston left the Roscoe Manor Adult Home in uptate New York; stumbled into the woods about a mile away; fell repeatedly; wandered in circles; curled up under a tree; and was found by police, two days later, frozen. Her socks were nearby and she was not wearing shoes. The medical examiner ruled that she died of hypothermia. Preston suffered from severe schizophrenia and lived in Roscoe Manor because she needed help with daily activities and self-care.

In many of this country’s worst adult homes, residents are routinely subjected to neglect, filth, and indifference according to a Times Herald-Record investigation found. A year after the Preston disappearance, another Roscoe Manor resident—Ella Maye—left the home. Maye, 78, suffered from dementia and heart disease and state police believe she suffered a fatal heart arrhythmia as she was trying to crawl back to Roscoe Manor when she collapsed on a neighbor's front lawn and died. Roscoe Manor is supposed to conduct hourly bed checks; however, owner Charles Benson said an employee had failed to do so. No one noticed Ella Maye was missing.

Adult home inspection reports and history documented by state agencies reveal that residents of some New York's Hudson Valley adult homes are at a significant risk of illness, injury, or even death due to carelessness or negligence on the part of the homes' operators and staff. Inspections at 22 licensed adult homes in Ulster, Sullivan, and Orange counties from 2001-2007 revealed 846 violations were found to directly affect the safety or well being of its residents. State documents indicate that in some cases, residents are left to sit in soiled clothing, are subject to physically or verbally abusive staffers, and suffer repeated cases of mismanaged medications.

Further, state oversight has been ineffective in regulating these homes. For instance, in 2005, a Narrowsburg Adult Home resident with a long history of substance abuse and mental illness set three fires in the home in one day. In the first two events, staff told the alarm company there was no fire; emergency services were not notified. The third fire so badly damaged a wing of the building that 20 residents required relocation. Inspectors found the building’s sprinkler system had not been properly maintained or repaired and was rendered inoperable. Also, staff was not supervising residents’ medication doses. In 2006, inspectors reported that a 16-year-old was routinely assigned to work a shift on Fridays and Saturdays. Another inspection found no staffers present and residents were roaming about. Residents complained that workers routinely locked themselves in the kitchen at night.

In 2006, the Jeffersonville Adult Home neglected to seek help for a resident who waded into a creek after threatening to jump in, and who slashed her wrists soon after in a suicide attempt; a resident who repeatedly injured herself and threatened suicide; and a resident who assaulted staff and punched an elderly resident in the face. A 2002 inspection of Monticello Manor found a staffer in a room shouting at a naked resident with the door open and the resident's roommate present. A state inspector noted that an employee put new bed sheets on top of a wet, urine-stained mattress.

Fairness in Nursing Home Arbitration Act Approved

Thu, 17 Jul 2008 00:00:00 -0400

The House Judiciary Subcommittee on Commercial Law and Administrative Law just approved the Fairness in Nursing Home Arbitration Act of 2008, moving the Act one step closer to becoming law. The Act prohibits the signing of an arbitration agreement as a prerequisite to nursing home admission. Critics of such agreements say they only help shield the owners of long-term care facilities from the consequences of allowing nursing home abuse and neglect to occur on their premises.

This means that a pre-dispute arbitration agreement between a long-term care facility and a resident—or those acting on a resident’s behalf—are not valid nor are these pre-dispute agreements specifically enforceable. Republicans on the subcommittee voted against the measure and some members tried to add amendments to make the Act easier on nursing homes, for example, Representative Chris Cannon (Republican-Utah) tried to add language to exclude nursing home physicians and providers and ensure the bill would not be retroactive, to name a couple. These amendments were shouted down in voice votes.

U.S. Senators Mel Martinez—Republican-Florida—and Herb Kohl—Democrat-Wisconsin—introduced the legislation to protect dispute resolution options for nursing home residents in response to the growing number of facilities that required patients to agree to arbitration as the only method for dispute resolution prior to admittance. "When a family makes the difficult decision to help a loved one enter a nursing home, among the primary considerations is quality care. Forcing a family to choose between quality care and forgoing their rights within the judicial system is unfair and beyond the scope of the intent of arbitration laws," said Senator Martinez. "This effort restores the original intent and tells families that they don't have to sign away their rights in order to access quality care."

"Nursing home residents, one of our nation's most vulnerable populations, must not lose their right to hold nursing homes accountable in the event of abuse or neglect," Senator Kohl said. "This bipartisan legislation protects senior long-term care residents who unwittingly sign away their constitutional right to have their case heard by an impartial judge or jury. I am proud to work with Senator Martinez in introducing this bill, and urge my colleagues in the Senate to pass it without delay."

In 1925, the Federal Arbitration Act (FAA) was enacted by Congress with the intention of “allowing parties an alternative forum to efficiently resolve business disputes.” Since the FAA was enacted, arbitration has expanded to now include non-business disputes. Also, nursing homes often require patients to sign mandatory pre-dispute arbitration clauses upon admittance. Many have long felt this requirement is an “unwarranted intrusion into a vulnerable population's right to access the civil justice system” to resolve potential claims.

The Fairness in Nursing Home Arbitration Act reflects the FAA's original intent and requires that agreements to arbitrate nursing home disputes be made after the dispute has arisen and not at the time of admittance into the home. While the new Act does not prohibit arbitration in nursing home disputes, it does prevent a nursing home corporation—which typically has greater bargaining power--from forcing residents and their families into arbitration via a non-negotiable contract that was forced on the resident prior to the dispute. The Act also ensures arbitration occurs on a voluntary basis and is not forced.

Aggression Among Nursing Home Residents Not That Uncommon

Wed, 09 Jul 2008 00:00:00 -0400

A recent Cornell University study reports aggression among nursing home residents—verbal and physical abuse--is more common than once believed. In an online report with McKnight's Long Term Care News, the study claims that many observations made at a city-based nursing home found at least 35 different types of abuse, with screaming being the most popular. Physical violence included pushing, punching, and fighting.

The report also discussed another two-week study wherein researchers found that 2.4 percent of nursing home residents claimed to have been victims of physical aggression; 7.3 percent claimed they were verbally abused. A third report discussed an investigation in which 12 nurse observers found 30 incidents of aggression between residents in one eight-hour shift. Victims were most commonly male and often had “wandering cognitive processing problems.”

A report released earlier this year by the Congressional Government Accountability Office (GAO) revealed a widespread “understatement of deficiencies,” that included malnutrition, severe bedsores, overuse of prescription medications, and nursing home resident abuse in the nation’s nursing home inspection reports. The report stated that nursing home inspectors routinely ignore or minimize problems that pose serious, immediate patient threats. "Because of the nature of nursing home life, it is impossible to eliminate these abusive behaviors entirely, but we need better scientific evidence about what works to prevent this problem," said Karl Pillemer, director of the Cornell Institute for Translational Research on Aging at the College of Human Ecology.

Facilities are generally inspected once yearly by state employees who work under contract with the federal government. Federal officials attempt to validate state inspector work by joining them on visits or conducting follow-ups. It was in a follow-up that the GAO discovered the state missed at least one serious deficiency in 15 percent of all inspections. Worse, in nine states, inspectors missed serious problems in over 25 percent from 2002 to 2007.

There are 16,400 nursing homes with over 1.5 million residents nationwide; approximately one-fifth of the homes were cited for serious deficiencies last year. “Poor quality of care—worsening pressure sores or untreated weight loss—in a small, but unacceptably high number of nursing homes, continues to harm residents or place them in immediate jeopardy, that is, at risk of death or serious injury,” the report said. Taxpayers spend about $72.5 billion annually to subsidize nursing home care and facilities must meet federal standards to participate in Medicaid and Medicare, which covers over two-thirds of its residents, at a cost of over $75 billion annually.

Although laws vary by state, most states do have laws—which include criminal penalties—in place to protect senior citizens from elder abuse; nursing homes are not exempt from these laws. Unfortunately, nursing home abuse tends to be underreported because individual homes do not take elder abuse seriously and residents fear embarrassment, injury, even incapacitation for speaking up.

In February, the Bush administration finally published the names of 131 of the nation’s worst nursing homes.

Nursing Home Ratings System to be Online By Year's End

Thu, 19 Jun 2008 00:00:00 -0400

A new nursing home rating system should be up and running on the Medicare Website by the end of this year. The new site will employ a 5-star system to rate nursing homes based on government inspection results, staffing data and quality measures. It is hoped that the new ratings systems will act as an incentive to encourage nursing homes to improve quality, and to stem the high rate of nursing home abuse and neglect that endangers so many residents.

There are 16,400 nursing homes with over 1.5 million residents nationwide. Unfortunately, the quality of many nursing homes is questionable - according to a recent report by the General Accounting Office, approximately one-fifth of all nursing homes were cited for serious deficiencies last year. The National Center on Elder Abuse estimates at least one in 20 nursing home patients has been the victim of negligence and or abuse, though it concedes that the number is probably higher. According to the National Center’s study, 57% of nurses’ aides in long-term care facilities admitted to having witnessed, and even participating in, acts of negligence and abuse. Data from the U.S. Centers for Disease Control and Prevention show that nursing home neglect played role in the deaths of nearly 14,000 nursing home patients between 1999 and 2002. Even when the consequences are not fatal, nursing home negligence robs victims of a sense of security and their dignity.

Information on nursing home quality can be tough to come by for families in the process of selecting a facility for a loved one. The new ratings use information on a facility's staffing level, the number of patients with bed sores, violations and other data that shed light on the quality of care. It may also include information such as whether a nursing home provides care to patients with dementia or those on ventilators.

Earlier this year, the Centers for Medicaid and Medicare Services added the identities of so-called Special Focus Facilities — nursing homes that rank in the worst 5% to 10% for inspection results in a given state - to the Nursing Home Compare database on its website. These homes were selected for stepped-up scrutiny by regulators. The list includes about 130 facilities.

Consumer advocates are pleased that Medicare has committed to providing families with a tool they can use to find a quality nursing home, but stress that the site will only be useful if it is easy to use. Ease of use is one of Medicare's major goals for the site, and the agency will be accepting public comments in July and August on the site and its contents.

One patient advocate also told The Wall Street Journal that the new nursing home ratings will rely too much on information furnished by the facilities themselves, which may make them inaccurate. " Too often, nursing facilities report that residents are doing much better than they really are and that they have more staff than they really have," Toby S. Edelman, senior policy attorney with the Center for Medicare Advocacy said. "Relying on nursing homes to describe accurately how well they are doing -- and reporting that information as fact -- just doesn't make sense."

Nursing Home Arbitration Agreements Unfair to Residents

Wed, 18 Jun 2008 00:00:00 -0400

Nursing home abuse and neglect has reached epidemic levels. Unfortunately, many nursing home patients and their family are signing away one of the most important tools in the fight against abuse and neglect - their right to sue.

The National Center on Elder Abuse estimates at least one in 20 nursing home patients has been the victim of negligence and or abuse, though it concedes that the number is probably higher. According to the National Center’s study, 57% of nurses’ aides in long-term care facilities admitted to having witnessed, and even participating in, acts of negligence and abuse. Data from the U.S. Centers for Disease Control and Prevention show that nursing home neglect played role in the deaths of nearly 14,000 nursing home patients between 1999 and 2002. Even when the consequences are not fatal, nursing home negligence robs victims of a sense of security and their dignity.

When abuse or negligence occurs, a lawsuit can be one of the most effective ways to force a nursing home to change its ways. Often, the conditions that lead to nursing home abuse and negligence - such as understaffing, inadequate meals, etc. - are the result of management's attempts to cut costs. Sometimes, it is only after the nursing home is forced to pay a hefty lawsuit settlement or judgment that conditions at a facility will change for the better.

Unfortunately, rather than maintain safe facilities for their residents, many nursing homes would rather find other ways to avoid lawsuits. To that end, some nursing homes have started requiring new residents and their families to sign documents that take away their rights to file a lawsuit, and must agree to submit any complaints to binding arbitration. These arbitration agreement are becoming more common, as more and more nursing homes are acquired by giant corporations.

The arbitrators in these nursing home abuse cases are usually corporations themselves, and they are generally paid by the company that owns the nursing home named in the complaint. While the arbitrator is supposed to be an independent party, critics of these agreements say they serve as a shield to for nursing home companies to avoid the consequences of budget and staffing cutbacks.

The nursing home industry defends itself by pointing out that arbitration is voluntarily agreed to and not a condition for admission. But the process of admitting a loved one to a nursing home is often stressful, and accompanied by a slew of paperwork. Many families who have complained about the arbitration process claim they were not really aware of the ramifications of signing an such an agreement.

The confusion over nursing home arbitration agreements has led to the filing of more than 100 lawsuits challenging them. And the controversy has gotten the attention of Congress, where a Senate committee is holding hearings on the issue this week. Both the House and Senate are also considering bills that would make nursing home arbitration agreements unenforceable.

Sen. Herb Kohl, D-Wis., who heads up the Senate Committee on Aging, told the Associated Press that the proposed legislation is not seeking to ban arbitration agreements entirely. Rather, it would require that the decision to go to arbitration would need to be made by both parties after a dispute occurs, not at the time a resident is first admitted to a facility.

Nursing Home Problems Missed in Inspections, GAO Says

Thu, 15 May 2008 00:00:00 -0400

In a report scheduled for release today, the Congressional Government Accountability Office (GAO) reveals a widespread “understatement of deficiencies,” that include malnutrition, severe bedsores, overuse of prescription medications, and nursing home resident abuse in the nation’s nursing home inspection reports. The report states that nursing home inspectors routinely ignore or minimize problems that pose serious, immediate patient threats.

Facilities are generally inspected once yearly by state employees who work under contract with the federal government. Federal officials attempt to validate state inspector work by joining them on visits or conducting follow-ups. It was in a follow-up that the GAO discovered the state missed at least one serious deficiency in 15 percent of all inspections. Worse, in nine states—Alabama, Arizona, Missouri, New Mexico, Oklahoma, South Carolina, South Dakota, Tennessee, and Wyoming—inspectors missed serious problems in over 25 percent from 2002 to 2007.

There are 16,400 nursing homes with over 1.5 million residents nationwide; approximately one-fifth of the homes were cited for serious deficiencies last year. “Poor quality of care—worsening pressure sores or untreated weight loss—in a small, but unacceptably high number of nursing homes, continues to harm residents or place them in immediate jeopardy, that is, at risk of death or serious injury,” the report said. Taxpayers spend about $72.5 billion annually to subsidize nursing home care and facilities must meet federal standards to participate in Medicaid and Medicare, which cover over two-thirds of their residents, at a cost of more than $75 billion a year.

Senators Charles E. Grassley (Republican—Iowa) and Herb Kohl (Democrat—Wisconsin and Senate Special Committee on Aging Chairman), requested the study and introduced a bill to upgrade nursing home care and increase penalties for federal standards violations. The maximum fine, now about $10,000, would be increased to $25,000 for a serious deficiency and $100,000 for deficiency resulting in patient death. The senators are pushing their bill for inclusion in a package of Medicare changes Congress is expected to pass in June.

The American Health Care Association, a nursing home trade group, opposes the bill. “We should not be increasing fines, adding auditors, and encouraging a ‘gotcha’ mentality. We should be testing new, less punitive ways to measure and improve the quality of care,” said Bruce A. Yarwood, association’s president. But, David P. Sloane, senior vice president of AARP, the lobby for older Americans, said it was “one of the most significant nursing home reform initiatives” in two decades. Under the bill, nursing homes must provide consumers and the government with more information about their owners and “affiliated or related parties,” including any individual or company with a role in managing operations. Lewis Morris, chief counsel to the inspector general of the Department of Health and Human Services, said he has been frustrated in identifying nursing home owners for facilities providing substandard care. “We have found nursing home residents who were grossly dehydrated or malnourished. We’ve found patients with maggot infestations in wounds and dead flesh. We’ve found residents with broken bones that went unmended,” he said. After discovering such problems, the federal government now requires some companies to sign compliance agreements, which are monitored by outside experts.

Elderly in Nursing Homes More Likely to be Depressed Than Those Living at Home

Fri, 09 May 2008 00:00:00 -0400

A recent study has shed new light on the frequency of depression among nursing home patients. The study - which involved 272 elderly patients with an average age of 81— looked at how often those patients reported feeling depressed and were prescribed antidepressants at both a long-term care facility and through a home-care agency. The research revealed that patients in a nursing home setting are more likely to be prescribed antidepressants and to self-report depression as compared to those patients being treated in a home-health care setting. Jodi Shapuras and Lindsay Egan, undergraduate students in the social work program at ISU, conducted the research at their internships as part of a senior-level field practicum class. Shapuras and Egan said they weren’t surprised by their findings.

“We are both interested in working with the elderly population in our careers, so we conducted this research to get a better feel for the prevalence of depression in those who need some level of outside care,” said Shapuras of Mitchell, Indiana. “As social workers, it is important to understand the mental health issues, such as depression, within the different care settings. We actually hypothesized that the long-term care patients would utilize antidepressants more and would self-report depression more,” said Egan of Terre Haute, Indiana. “When an individual moves to a long-term care facility, they undergo a tremendous amount of changes. They are no longer able to live independently and are relying on others for care and this greatly affects how they feel about themselves and the world around them.”

At the long-term care facility, 30 percent of the elders in the study reported feeling depressed, versus 11 percent who received care in their homes through medical and social services. The study also found that the long-term care facility prescribed antidepressants to over half of the elders in the study—62 percent—at some point following admission, compared to only a quarter of the home-cared elders.

Shapuras added that in the home-care setting, elders are still residing within a familiar environment. “They are still at home and independently able to complete some activities of daily living, such as bathing, cooking, or feeding themselves, whereas a long-term care patient may not be able to do all of these tasks,” Shapuras said.

Shapuras and Egan presented the findings of their study entitled, “Comparison of Depression in Elders Who Receive Home-Health Care to Elders Residing in a Long-Term Care Facility,” at ISU’s 12th annual Undergraduate and Graduate Research Showcase. The women received first place in the undergraduate oral presentation division.

Shapuras and Egan are hoping their findings will bring attention to the issue of depression in elderly patients who require care to the extent to which antidepressants are prescribed in long-term care settings. “I would like to see more effective alternative treatments researched, as opposed to what seems in many cases to be the automatic prescribing an antidepressants,” Egan said.

Shapuras said she would also like to see more research conducted in this area. “It seems as though medications are sometimes viewed as the ‘fix-all’ when depression becomes apparent,” she said. “I hope to work in the field of gerontology as a social worker and to make some positive changes somewhere along the line.”

Reporting Suspected Nursing Home Abuse

Wed, 07 May 2008 00:00:00 -0400

Nursing home abuse, though despicable, is hardly uncommon. Although laws vary by state, most states do have laws—which include criminal penalties—in place to protect senior citizens from elder abuse; nursing homes are not exempt from these laws.

Unfortunately, nursing home abuse tends to be underreported because individual homes do not take elder abuse seriously and residents fear embarrassment, injury, even incapacitation for speaking up. As with any abuse, the only way to prevent more instances is to stop it immediately as soon as abuse is suspected.

Thoroughly investigate any nursing home being considered. Undervalued, underpaid, and untrained employees tend to render more abuse. Ask about and watch for high employee turnover rates. Employees who are not properly trained or paid may not be concerned with the residents in their charge and even less concerned about challenging authority if they suspect abuse. In many cases, employees who have been charged with multiple incidents of abuse do not receive punishment and remain employed at the nursing home.

If someone is in life-threatening danger, call 911 immediately. If danger is not immediate, but abuse is suspected, tell someone trustworthy. Contact local adult protective services by speaking with the Eldercare Locator at 1-800-677-1116 between 9:00 am and 8:00 pm Monday-Friday Eastern Time. When making a call to report abuse, be able to provide the elder victim’s address and contact information; known medical problems, including confusion or memory loss; family or other social support system; types of abuse and if any incidents of hitting, yelling, or other abusive behavior have been witnessed; and the caller’s name, address, phone number, and contact method to discuss the abuse. When reporting abuse and not related to the victim, a nursing home abuse hotline is the best option and each state has organizations that monitor these hotlines and can offer assistance. If making a formal complaint against a specific nursing home or staff member, find a sitter to monitor the victim or remove the victim from the facility. Abuse sometimes increases following complaint initiation.

In a harrowing example of widespread elder abuse and negligence, in February, the family of a deceased Norwich, Connecticut man filed what is believed to be the first wrongful death lawsuit against officials at Connecticut’s largest nursing home chain: Haven Healthcare. The suit claimed that misappropriation of Haven funds by Chief Executive Officer Raymond Termini contributed to "deplorable conditions.” The family also sought permission to sue the state departments of public health and social services and Nancy Shaffer, the state's long-term care ombudsman, for failing to investigate and act on complaints lodged by the family. The deceased family member was a patient at Haven homes for over two years when he was rushed to a hospital after his wife found him in excruciating pain and his legs gangrenous and in early rigor mortis, allegedly due to an untreated and infected pressure sore on his hip and physical restraints that immobilized him. The man died two days later.

Also in February, the Bush administration finally published the names of 131 of the nation’s worst nursing homes. There are about 16,400 nursing homes nationwide and taxpayers spend about $72.5 billion annually to subsidize nursing home care. The document containing the nursing homes cited can be accessed at: http://www.cms.hhs.gov/CertificationandComplianc/Downloads/SFFList.pdf

Worst Nursing Homes Named on Federal Website

Thu, 24 Apr 2008 00:00:00 -0400

Families in need of nursing care for a loved one will now have easier access to a list of the most troubled nursing homes in the country, thanks new information being added to a nursing home website developed by the Centers for Medicare and Medicaid Services. Consumer groups are cheering the move, and say that the site - Nursing Home Compare - is now the most complete national site available for finding specifics on nursing homes and long-term care facilities.

Nursing home abuse is one of the most serious problems facing this country’s elderly. Though it concedes that the true number is probably much higher, The National Center on Elder Abuse estimates at least one in 20 nursing home patients has been the victim of abuse. According to the National Center’s study, 57% of nurses’ aides working in long-term care facilities admitted to having witnessed, and even participating in, acts of abuse. The report sites systemic problems within the nursing home industry, like inadequate pay for workers and chronic understaffing, as contributing to the epidemic of abuse. There are nearly 1.4 million Americans living in nursing homes right now, and that number is expected to more than double in the next decade. As it does, advocates for the elderly and disabled fear that incidences of abuse will continue to climb as well.

Finding out whether or not a nursing home has been cited for violations can be a daunting task for consumers. But the Centers for Medicaid and Medicare Services has been working to make the task easier. According to The Wall Street Journal, Nursing Home Compare primarily offers summarized information from inspections performed by state agencies, as well as data the nursing homes must compile and submit to regulators about residents. The site, which is updated monthly, has made additions in the past few years, including information about facilities' sprinkler systems and whether the homes provide certain vaccinations. Some of the most helpful information on the site involves pain management, pressure sores and the use of physical restraints.

Now, the Centers for Medicaid and Medicare Services is adding the identities of so-called Special Focus Facilities -- nursing homes that rank in the worst 5% to 10% for inspection results in a given state - to the Nursing Home Compare database. These homes are selected for stepped-up scrutiny by regulators. The list, which was made public earlier but not integrated in the searchable database, typically includes around 130 facilities, out of approximately 16,000 nursing homes in the U.S

According to The Journal, The Centers for Medicare and Medicaid Services began making some of the information about troubled nursing homes public last fall, amid a push by Sens. Herb Kohl, a Wisconsin Democrat, and Charles Grassley, an Iowa Republican. The senators are sponsoring a bill that would reveal additional data about nursing homes.

While Nursing Home Compare is an excellent tool for consumer looking for nursing homes, experts are quick to remind that nothing can replace an actual visit for evaluating a facility. In-person observations are the best way to determine if a nursing home is at risk of becoming a neglectful or abusive environment.

"Worst Nursing Home List" Now Online

Wed, 13 Feb 2008 00:00:00 -0500

Nursing home abuse and nursing home negligence is a growing problem in the US, but now there is a new tool available to help families avoid the worst nursing homes. The Bush administration finally published the names of 131 of the nation’s worst nursing homes. The administration initially tried to protect the deficient nursing homes, claiming some of the facilities were already showing signs of improvement. But that decision drew the ire of congress, elderly advocates and others who said consumers needed the list to protect loved ones from nursing home abuse and negligence. the list was ultimately released by the Centers for Medicare and Medicaid Services (CMS) and represents those troubled facilities that are cited as being a "special focus facility," a designation used to identify facilities needing increased oversight. For these nursing homes, states conduct inspections at six-month intervals rather than annually.

Last November, the government released only a partial list of 54 nursing homes that ranked among the worst in their states, however, a group of Democratic lawmakers pushed for full disclosure. CMS said Tuesday it was publishing the names after cross checking information to ensure they released the most accurate data. CMS will update its list of negligent nursing homes on a quarterly basis, with its next release scheduled for April.

"This is the latest in a series of steps we will be taking to improve quality and oversight in nursing homes," said Kerry Weems, CMS acting administrator. "We are issuing more information on special focus facilities to better equip beneficiaries, their families, and caregivers to make informed decisions and stimulate robust improvements in nursing homes having not improved their quality of care. This should just be one of the tools," Weems added. "There is no substitute for visiting the nursing home in person."

The list released Tuesday shows 52 nursing homes as not showing improvement after they were cited as being a higher-risk nursing home, while another 52 indicated some improvement. Twenty-seven nursing homes were added to the list in the last six months. Of the original 54 nursing homes disclosed as poor performers last November, 21 have shown some improvement, CMS said, adding that publicity about the problems might have played a factor in the changes.

There are about 16,400 nursing homes nationwide and taxpayers spend about $72.5 billion annually to subsidize nursing home care.

While most nursing homes have some deficiencies, with the average being six to seven deficiencies per survey, the “special focus facilities” exhibited about double that amount and continue to have problems over a long period of time. Each state determines which nursing homes should receive the designation; inspection standards vary among the states.

The offenses that land a facility in the “special focus” category typically involve unnecessary use of medication for elderly residents or inadequate safeguards to protect residents, such as those with Alzheimer's disease, from day-to-day hazards in the nursing home.

Senator Herb Kohl (Democrat-Wisconsin), who chairs the Senate Special Committee on Aging, praised CMS' move saying, "We believe that Americans should have access to as much information about a nursing home as possible," he said. "We also agree that giving consumers more information about our nation's nursing homes is a good idea, but that doing so in a manner that causes a panic is not."

The document containing the nursing homes cited can be accessed at: http://www.cms.hhs.gov/CertificationandComplianc/Downloads/SFFList.pdf

Nursing Home Abuse Concerns Rise in Florida Amid Manor Care Purchase, Publication of Nursing Home "Watch List"

Wed, 02 Jan 2008 00:00:00 -0500

The issue of nursing home abuse is making news in Florida, where the Service Employees International Union (SEIU) and some state lawmakers are urging regulators to examine the issues of nursing home abuse and neglect as they consider granting a nursing home license to a private equity firm that recently purchased facilities in Florida and around the country. The Carlyle Group purchased HCR Manor Care for $4.9 million, and now owns 29 nursing throughout Florida. The SEIU and other nursing home advocates fear that the Carlyle Group will move to cut costs at the nursing homes it owns, something that could put nursing home residents at risk for abuse and neglect. Those concerns have only been heightened by the Florida nursing home “watch list” which already cites some Manor Care properties for providing inadequate care to nursing home patients.

Recently, private investment firms have looked to nursing homes as a possible route to easy money. These firms buy facilities, drastically reduce their costs, then turn around and sell them at huge profits. Private investment groups have been targeting some of the biggest nursing home concerns, in turn affecting the care of millions of patients. In addition to Carlyle’s purchases of HCR Manor Car, Genesis Healthcare Corp. agreed to be bought by private equity in January, and Beverly Enterprises went private in 2005.

But these acquisitions could be coming at a great cost to nursing home patients. According to a New York Times investigation, facilities owned by private investment firms score worse than national rates in 12 of 14 indicators regulators used to track ailments of nursing home residents. And the Centers for Medicare and Medicaid Services says that residents of such nursing homes suffer more from depression, loss of mobility and the loss of the ability to dress and bath themselves. And both federal and state regulators told the New York Times that citations for quality-of-care deficiencies, like moldy food and restraining residents for long periods of time, rose at every large nursing home chain that was acquired by a private investment group. While the Manor Care sale has been approved by shareholders, Florida is one of several states still deciding whether to give Carlyle a license to run the nursing homes.

Meanwhile, a Florida nursing home “watch list” indicates that many nursing homes in the state are problematic, and two of Manor Care’s nursing homes are already on that list. According to inspection records, staff at Manor Care Health Services in Boca Raton served residents cold food, failed to wash their hands before administering medicines and did not follow doctors' orders to remove catheters and treat patients' wounds. In all, 139 of the state's 650 nursing homes are on the watch list. The watch list is part of the state Agency for Health Care Administration's nursing home guide, which grades facilities based on inspection results and is updated every three months. The nursing homes are ranked relative to each other with the best homes getting five stars and the worst getting one star. In addition to Manor Care, some of the homes on the list were also owned by major chains including Classic Residence by Hyatt, which owns 76 nursing homes in the United States.

Nursing Home Abuse Law Could Stiffen Penalties, Change Rules Regarding Private Equity Firms

Fri, 16 Nov 2007 00:00:00 -0500

Nursing home abuse is finally getting some attention from Congress, where two separate hearings were held yesterday to discuss the problem. Committees from both the House of Representatives and the Senate took up the nursing home abuse issue, and now Congress will consider legislation to deal with this serious problem.

Nursing home abuse is one of the most serious problems facing this country’s elderly. Though it concedes that the true number is probably much higher, The National Center on Elder Abuse estimates at least one in 20 nursing home patients has been the victim of abuse. According to the National Center’s study, 57% of nurses’ aides working in long-term care facilities admitted to having witnessed, and even participating in, acts of abuse. The report sites systemic problems within the nursing home industry, like inadequate pay for workers and chronic understaffing, as contributing to the epidemic of abuse. There are nearly 1.4 million Americans living in nursing homes right now, and that number is expected to more than double in the next decade. As it does, advocates for the elderly and disabled fear that incidences of abuse will continue to climb as well.

As a result of yesterday’s hearings, two Senators, Charles Grassley (R-Iowa) and Herb Kohl (D-Wisconsin), are working on legislation that would stiffen penalties for nursing home abuse. The bipartisan legislation would give more enforcement power to the U.S. Centers for Medicare and Medicaid Services, which oversees state inspections of the nation's 16,400 nursing homes and also pays for the care of many poor and elderly residents.

The bill would also address growing concern about increased ownership of nursing homes by private equity firms, amid media reports that such ownership leads to poor quality care. Private equity firms generally buy nursing facilities, cut costs and resell them for a profit. But these acquisitions could be coming at a great cost to nursing home patients. According to a New York Times investigation, facilities owned by private investment firms score worse than national rates in 12 of 14 indicators regulators used to track ailments of nursing home residents. And the Centers for Medicare and Medicaid Services says that residents of such nursing homes suffer more from depression, loss of mobility and the loss of the ability to dress and bath themselves. Unfortunately, private investment firms have created complex corporate structures that obscure nursing home ownership, making it difficult to hold them accountable for nursing home abuse. The complex ownership structure also means that sometimes managers can even legally bypass Medicare and Medicaid reporting requirements. The proposed nursing home abuse legislation would require public reporting of ownership information, including affiliates, and deny payments for new residents until problems are fixed.

Advocates for nursing home residents can only hope that the legislation proposed by Grassley and Kohl will soon become law, although similar legislation has languished in Congress before.

Nursing Home Neglect of Eye Care Erodes Quality of Life, Leave Residents at Risk of Depression

Tue, 13 Nov 2007 00:00:00 -0500

Nursing home neglect often includes a lack of vision care for nursing home residents, a recent study has found. Unfortunately, this problem can have serious implications, as the same study has also discovered that nursing home patients who lack basic eye care have a lower quality of life and are at a higher risk for depression.

Researchers at the University of Alabama, Birmingham have been looking at the lack of eye care services for nursing home patients for some time.   Earlier this summer, they published the first phase of their nursing home vision care survey. The investigation covered a total of 380 patients age 55 and older. In addition to examining medical records, each nursing home patient was interviewed about their use of eyeglasses and vision care. What the study found was startling. Even though 90 percent of the nursing home residents had health insurance, two thirds had no reference to an eye exam in their medical chart. When interviewed, 28 percent of residents said that their last exam occurred the previous year, while 20 percent said that it had been more than two years since their last exam. A third of patients couldn’t recall the last time they had an eye examination.

While the lack of vision care services is considered a form of nursing home neglect, the Alabama study found that often such care is withheld out of ignorance rather than malevolence.   Many nursing home staff – and even the residents’ own families – do not believe that providing eyeglasses to nursing home residents with physical or mental disabilities will offer them any benefits. But the second phase of the University of Alabama study suggests that such assumptions are off the mark.

For this portion of their research, the study authors followed two groups of nursing home patients to see if access to eyeglasses improved quality of life. According to an article published in the "Archive of Ophthalmology", the first group of 78 nursing home residents were given eyeglasses just a week after having received an eye exam.   The second group of 64 people received their glasses two months after the eye exam.   Of the two groups, those who received eyeglasses soonest had higher scores for vision, reading, activity and hobby participation, and social interaction compared with the second group. The first group of nursing home residents also exhibited fewer depressive symptoms than those who had to wait for eyeglasses.

While nursing home residents are 15 times more likely to have vision problems than people with other living arrangements, only 12 percent of US nursing homes have eye doctors on staff.   The authors of the nursing home eye care study wrote in the “Archives of Ophthalmology” that their findings illustrate a need for an examination into the factors that contribute to a lack of eye care availability for nursing home residents.

Nursing Home Abuse Bill Sits in Congress, as Elder Abuse Reaches Epidemic Proportions

Thu, 01 Nov 2007 00:00:00 -0400

A nursing home abuse bill, the Elder Justice Act, has been under consideration in Congress for the past five years but has received scant attention and has yet to be passed. Although nursing home and elder abuse are serious and growing problems in this country, the nursing home abuse bill has never even been voted on. While no one in Congress opposes the nursing home abuse legislation, few are trying to push it through the legislative process.

Congressional critics say that the Elder Justice Act has not been passed for a number of reasons that have little to nothing to do with the bill itself. For one thing, Congress has been distracted by the war in Iraq and partisan bickering. But for the most part, they say the Elder Justice Act has been allowed to collect dust because the issue of nursing home abuse has not garnered the kind of media attention it deserves. This past summer, while much of the media was focused on the problems of Paris Hilton and Brittany Spears, Congress held hearings on nursing home abuse. Those hearings were not covered by one major TV news network.

But the issue of nursing home abuse should be getting more attention, just based on the shear numbers of elderly affected by this crime. Though it concedes that the true number is probably much higher, The National Center on Elder Abuse estimates at least one in 20 nursing home patients has been the victim of abuse. According to the National Center’s study, 57% of nurses’ aides working in long-term care facilities admitted to having witnessed, and even participating in, acts of abuse. The report sites systemic problems within the nursing home industry, like inadequate pay for workers and chronic understaffing, as contributing to the epidemic of abuse. There are nearly 1.4 million Americans living in nursing homes right now, and that number is expected to more than double in the next decade. As it does, advocates for the elderly and disabled fear that incidences of abuse will continue to climb as well.

The Elder Justice Act, while not a cure for nursing home abuse, would bolster efforts to combat this crime. The Elder Justice Act would set up separate elderly justice offices in the U.S. Departments of Justice and Health and Human Services, provide $400 million for state adult protective services over four years and create a federal coordinating committee among agencies to monitor and direct the government's efforts. The bill would also establish forensic centers around the country to probe elderly abuse cases and give local prosecutors more support in bringing cases. And it would penalize nursing homes if they did not report crimes swiftly.

Last year, the Elder Justice Act was finally passed by the Senate Finance Committee, but it was never voted on by the full Senate. Now byzantine Senate rules mean that the nursing home abuse bill will have to go through several more committees before it is up for a vote. And some Senate watchers fear that, with a public more focused on the escapades of Brittany than the problems of the elderly, the Elder Justice Act will never be voted on.

Nursing Home Abuse at Privately-Held Facilities Should be Investigated, Say Senators Clinton and Grassley

Wed, 03 Oct 2007 00:00:00 -0400

To US Senators want to know if nursing home abuse and neglect are more prevalent in facilities owned by private Wall Street equity firms, and they are asking the Government Accountability Office (GAO) to find out.   Their requests come on the heels of a New York Times investigation that found that the quality of care at nursing homes dropped sharply after they were acquired by private investment concerns.

Senators Hilary Clinton (D-NY) and Charles Grassley (R-Iowa) based their requests on the report in the New York Times that said drastic cost cutting measures imposed on nursing homes once they were purchased by private equity firms made nursing home neglect and abuse far more likely.   Recently, private investment firms have looked to nursing homes as a possible route to easy money.   These firms buy facilities, drastically reduce their costs, then turn around and sell them at huge profits.

Private investment groups have been targeting some of the biggest nursing home concerns, in turn affecting the care of millions of patients. Just this August, the private equity firm Carlyle Group won antitrust clearance to buy Manor Care Inc, the largest U.S. nursing home owner for $4.9 billion. Another chain, Genesis Healthcare Corp. agreed to be bought by private equity in January, and Beverly Enterprises went private in 2005.

But these acquisitions could be coming at a great cost to nursing home patients. According to the New York Times investigation, facilities owned by private investment firms score worse than national rates in 12 of 14 indicators regulators used to track ailments of nursing home residents.   And the Centers for Medicare and Medicaid Services says that residents of such nursing homes suffer more from depression, loss of mobility and the loss of the ability to dress and bath themselves.   And both federal and state regulators told the New York Times that citations for quality-of-care deficiencies, like moldy food and restraining residents for long periods of time, rose at every large nursing home chain that was acquired by a private investment group.

Unfortunately, these privately-owned nursing homes are not always subject to the same legal consequences that other facilities would face for providing inadequate care to nursing home patients. Normally, the family of a resident suffering from nursing home abuse or neglect might sue the home’s owners, and regulators could impose stiff fines if conditions weren’t up to standard.   But private investment firms have created complex corporate structures that obscure exactly who owns a nursing home, making lawsuits more difficult. And the complex ownership structure also means that sometimes managers can even legally bypass Medicare and Medicaid reporting requirements.

In making his request to the GAO, Grassley asked that the agency analyze the number of private equity deals involving nursing homes, and quality and safety issues before and after changes in ownership. Clinton asked for an assessment of 63 firms in particular that the GAO cited in March as having a troubled history.

Advocates for nursing home residents can only hope that the Senators’ requests will eventually lead Congress to take action that will make private equity firms responsible for the nursing home abuse and neglect that occurs at the facilities they own.

Nursing Home Abuse, Neglect More Common in Facilities Owned by Private Investment Firms

Mon, 24 Sep 2007 00:00:00 -0400

Nursing homes are big business, and some private Wall Street investment firms have taken notice. In recent years, large groups have been gobbling up nursing homes, which they use to rake in millions of dollars in profits.   But often, those profits come at a devastating price to nursing home residents, who must bear the brunt of an investment firm’s cost-cutting efforts.

According to a report published in Monday’s New York Times, private equity firms like the Carlyle Group and Warburg Pincus, have been buying nursing homes by the hundreds. Once they have acquired a home, these private companies often employ aggressive cost cutting measures to increase profits.   Often, this means reducing nursing staff, and cutting budgets for supplies, activities and even meals.   As a result, an environment is created that is ripe for nursing home neglect.

Take the case of Habana Health Care, a 150-bed facility in Tampa, Florida.   According to the New York Times, Habana was struggling to make ends meet when it was purchased by a group of private investment firms.   Immediately after taking it over, the new management cut costs, including reducing Habana’s staff of registered nurses by half.   Soon, the new investors were reaping large financial rewards.

But Habana’s residents weren’t doing nearly as well.   The New York Times reports that over three years, 15 Habana nursing home residents died from what their families termed negligent care.   During inspections, regulators found staffing below minimum levels, as well as malfunctioning fire doors, unhygienic kitchens and one resident forced to use a broken leg brace.

Unfortunately, Habana is not an isolated incident.   According to the New York Times, facilities owned by private investment firms score worse than national rates in 12 of 14 indicators regulators used to track ailments of nursing home residents.   And the Centers for Medicare and Medicaid Services says that residents of such nursing homes suffer more from depression, loss of mobility and the loss of the ability to dress and bath themselves.   And both federal and state regulators told the New York Times that citations for quality-of-care deficiencies, like moldy food and restraining residents for long periods of time, rose at every large nursing home chain that was acquired by a private investment group.

Normally, the family of a nursing home resident suffering from substandard care might sue the home’s owners, and regulators could impose stiff fines if conditions weren’t up to standard.   But private investment firms have created complex corporate structures that obscure exactly who own a nursing home, making lawsuits more difficult. And the complex ownership structure also means that sometimes managers can legally bypass Medicare and Medicaid reporting requirements.

Several groups are pushing to make such complex corporate structures illegal, but private equity firms are lobbying hard against such laws.   Meanwhile, these companies continue to see huge profits from their nursing home acquisitions, even as the nursing home residents suffer from neglect. According to the New York Times, the investment group that purchased the Habana Health Care Center recently sold it, along with 185 other facilities, for a whopping $1.4 billion.

Nursing Home Abuse and Elder Abuse Screening Programs Should be Routine In Hospitals

Wed, 05 Sep 2007 00:00:00 -0400

Nursing home abuse and elder abuse are among some of the most-under reported crimes, but a new study offers hope that more cases could be uncovered.   While most victims of elder abuse won’t answer direct questions about this crime, health care professionals and social workers who have received training in this area can become adept at screening older patients for the signs of abuse whenever they are admitted to the hospital. But for such a screening system to work, those who work with the elderly must become familiar with both the signs of elder abuse, and the risk factors that make it likely.

In the United States, about 2500 cases of physical abuse by nursing home staff are being reported each year. The National Center on Elder Abuse estimates at least one in 20 nursing home patients has been the victim of abuse. And sadly, an elderly person’s home is not much safer, with three out of five cases of elder abuse occurring in the senior’s own home at the hands of family members. Because this type of abuse can easily be covered up, the true number is not really known. For this reason, an effective method of screening for nursing home abuse and elder abuse is urgently needed.

Israeli researchers studied 730 men and women age 70 and over who had been admitted to two major Israeli medical centers. They found that only 6-percent would report abuse if asked about the crime directly. However, far more had signs that indicated they were victims of this abuse.   The researchers found that when nurses and social workers assessed patients who were admitted to the hospital, they found that 21-percent exhibited signs of abuse, including unexplained bruises and burns, angry behavior, and poor hygiene or dehydration. An assessment of patients’ risk for abuse found that 21-percent exhibited the risk factors most often associated with elder abuse. Those risk factors include emotional instability and poor family relationships.

The authors of the study, which appeared in the Journal of the American Geriatrics Society, wrote that their findings indicate that routine screening of elderly patients should be standard practice whenever they are admitted to the hospital. Though the Israeli study looked at elderly patients who were being cared for by family members, such screening could be particularly useful with nursing home residents, who are also subject to high rates of abuse. Unfortunately, these residents can’t always count on other healthcare workers in their nursing home to help.   According to the National Center’s study, 57-percent of nurses’ aides working in long-term care facilities admitted to having witnessed, and even participating in, acts of abuse.

Because many elderly are often too frightened or confused to report elder or nursing home abuse, hospital personnel are often the only ones in a position to discover this hideous crime. The institution of routine elder and nursing home abuse screening programs at hospitals could potentially improve the lives of thousands of senior citizens.

Nursing Home Neglect Takes on Many Forms: Patients Not Always Getting the Eye Care They Need

Mon, 16 Jul 2007 00:00:00 -0400

The widespread yet heavily underreported problem of Nursing Home Neglect takes on many unexpected forms, one of which being simple eye care. Nursing homes often neglect to provide residents with even the most basic vision care. A study conducted by the University of Alabama at Birmingham found that nearly a third of the nursing home patients it followed had never received an eye exam after being admitted to a long-term-care facility. This occurred despite the fact that more than half of the patients in the study had some form of visual impairment.

Researchers from the university analyzed medical records from 17 Birmingham-area nursing homes. The investigation covered a total of 380 patients age 55 and older. In addition to examining medical records, each nursing home patient was interviewed about their use of eyeglasses and vision care. What the study found was startling. Even though 90 percent of the nursing home residents had health insurance, two thirds had no reference to an eye exam in their medical chart. When interviewed, 28-percent of residents said that their last exam occurred the previous year, while 20-percent said that it had been more than two years since their last exam. A third of patients couldn’t recall the last time they had an eye examination.

The withholding of medical care like eye exams is considered a form of nursing home neglect. Eye care can be difficult for long-term-care patients to access because they often must rely on the nursing home to provide transportation to an eye doctor. There is also a shortage of eye care professionals who serve the geriatric community. But the Birmingham study is especially surprising because each of the nursing homes in the study had access to optometrists who visited frequently. The study said that some nursing home staff might believe that eye care would be of little benefit to patients with cognitive problems like dementia, and that could account for the lack of available eye care services in the facilities.

Fifty seven-percent of the nursing home patients in the study suffered from visual impairment. The researches defined visual impairment as having worse than 20/40 vision in the best eye. This is 15 times higher than rates for adults the same age who do not live in long-term-care facilities. While the study could not pinpoint a reason for this disparity, the researches did say that people who are visually impaired could be more likely to enter a nursing home. Three quarters of the residents had abnormal binocular contrast sensitivity, a condition that makes it difficult for people to see the boundaries of objects. A condition like this makes mobility difficult, and could factor into the decision to move an elderly person to a nursing home.

The data used in the study did not indicate if these visually impaired patients could be helped with treatment. However, 37-percent of visual problems, and even 20-percent of blindness can be corrected with glasses, contacts or surgery. It seems obvious that some of the nursing home patients followed in this study would have benefited from proper eye care.

Nursing Home Abuse & Violence Among Residents Common, Yet Severely Understudied

Thu, 12 Jul 2007 00:00:00 -0400

Physical abuse in a nursing home is not always perpetrated by staff. According to a Cornell University Study, resident-on-resident violence in long-term-care facilities is far more prevalent than previously thought. But the authors of the study concede that they really don’t know how widespread this problem is because nursing home abuse is still woefully understudied.

The new study, funded by the National Institutes of Health (NIH), is only the second published report to look at patient-to-patient violence. Cornell University examined the records of 747 nursing home patients over the course of the study. Of those, 42 where involved in 79 incidents at nursing homes that actually required police intervention. The finding surprised researchers, especially because the study was not even focused on nursing homes. Rather, it looked at overall community crime, and nursing homes where just one area that was examined.

The report states that “abuse” might not be the correct term for these types of patient-related incidents. Many nursing home patients suffer from varying degrees of dementia, and this often plays a factor in the violence. The violence is not usually malicious, but often is the result of confusion on the part of residents. More often than not, these incidents involve a fight between two patients. Common triggers can be unwanted touching or disputes over television.

Even though this type of violence does not fit the classic definition of nursing home abuse, it is often the byproduct of a neglectful staff. Conflicts are far more likely to escalate to physical violence when patients are unattended. However, attentive staff can take steps to separate feuding patients before the situation deteriorates.

The report also questions the wisdom of housing dementia patients together. This is standard practice in most nursing homes, which generally have a dementia ward. But, because dementia often triggers violence, the report suggests it might be better to incorporate these patients into the general population as much as possible.

The Cornell study highlights the need for more research into nursing home abuse. Some estimates suggest that as many as one in 20 nursing home residents are victims of nursing home abuse, but it is not known how often the perpetrators are residents. Because there is no uniform system for reporting nursing home violence, experts on elder abuse concede that current estimates are probably just the tip of the iceberg. Compounding the problem is the fact that many nursing homes are loath to report incidences of abuse for fear of losing their licenses. And there is no requirement to report resident-on-resident violence. In fact, the Cornell researchers only looked at cases that involved police calls. There were simply no records available to them detailing physical confrontations between residents that did not escalate to this level of violence.

Nursing Home Abuse: Neglect, Physical and Even Sexual Abuse are the Harsh Realities Facing Today's Elderly

Thu, 21 Jun 2007 00:00:00 -0400

The revolting reality of Nursing Home Abuse is on the rise. Though it concedes that the true number is probably much higher, The National Center on Elder Abuse estimates at least one in 20 nursing home patients has been the victim of abuse. There are nearly 1.4 million Americans that are living in nursing homes right now, and that number expected to more than double in the next decade. As it does, advocates for the elderly and disabled fear that incidences of abuse will continue to climb as well.

Unfortunately, a nursing home is not always the place of respite and healing it should be. According to the National Center’s study, 57% of nurses’ aides working in long-term care facilities admitted to witness, and even participating in, acts of nursing home abuse. The report sites systemic problems within the nursing home industry, like inadequate pay for workers and chronic understaffing, as contributing to the epidemic of abuse.

Anyone with a loved one in a nursing home needs to be aware of the signs of abuse. Neglect is the most common form, and is easily recognizable if family members know what to look for. Patients in soiled beds and clothes, or those suffering from bedsores and frozen joints could be victims of neglect. Indications that a patient is over or under medicated can also signal neglect.

Neglect is most often caused by understaffing at nursing homes. However, this does not mean that neglect is more benign than other forms of abuse. In fact it can be deadly, as it was for an Alzheimer’s patient living at the Atrium I Nursing Home in Pennsylvania. The 88-year-old woman was allowed to wander away from the facility and died from exposure. The nursing home administrator was later charged and convicted of involuntary manslaughter in the patient’s death.

About 2500 cases of physical abuse by nursing home staff are being reported each year. Because this type of abuse can easily be covered up by staff, the true number is not really known. Elderly people can often be victims of falls, so sometimes, bruises, sprains or factures do not alarm a patient’s loved one. However, if these injuries cannot be fully explained, or if they are occurring frequently, further investigation is probably needed.

One of the most insidious forms of nursing home abuse is sexual abuse. According to a 1996 Medicaid Fraud Report, 10% of all physical abuse cases in nursing homes are of a sexual nature. Sexual predators will usually take advantage of disabled patients who are physically unable to tell anyone about their assaults. Often, this type of abuse is only discovered when a patient shows evidence of sexual contact, perhaps in the form of a sexually transmitted disease. In Illinois the repeated rape of a mentally disabled woman wasn’t discovered until she became pregnant. A nurses’ aid was charged and plead guilty to sexual assault in that case last month.

Because its victims are so helpless, nursing home abuse is one of the most underreported crimes in our nation Families of nursing home patients must become aware of the signs of abuse, and they must be willing to advocate for their loved one. Often, family members are the only people who can prevent a tragic outcome for a long-term care patient.

Many Nursing Home Residents Fail to Receive Adequate Pain Control Due to Deficiencies in Medication Prescribing Practices – Study

Sun, 05 Mar 2006 00:00:00 -0500

A new study conducted by an interdisciplinary team of researchers, and published in the Journal of the American Geriatrics Society, has found that the medication prescribing practices in place at many nursing homes results in poor pain management in residents.

As reported in Medical News Today (3/4/06), the researchers “designed and tested a Nursing Home Pain Medication Appropriateness Scale (PMAS) to screen the overall suitability of prescribing practices for pain in a nursing home setting.”

The team then compared pain assessments performed by trained assistants to the actual medications being prescribed to the residents being evaluated.

The results of the analysis were disappointing in that the “mean” total PMAS was only 64% of optimal and less than 50% of the residents who had “predictably recurrent pain” were actually receiving pain medication. Prescribing of pain medication on the PMAS was found to be better in situations where residents were not in recurrent pain.

Pain is a significant problem in older people and nursing home residents are certainly no exception. The American Geriatrics Society estimates that between 45% and 80% of nursing home residents experience significant pain (Panel on Persistent Pain in Older Persons).

Living in pain, as a result of inadequate pain management, tends to lower a persons overall quality of life and leads to other consequences such as sleep deprivation, poor nutrition, depression, anxiety, agitation, decreased activity, and delayed healing.

According to the researchers: "The inclusion of pain as a quality measure for both short-term and long-term residents is intended to provide an incentive for nursing homes to improve their practices in this area. The use of evidence-based process measures will permit an organization to begin addressing persistent problems in pain management."

Texas Jury Returns $160 Million Verdict for Vicious Beating of 81-Year-Old Nursing Home Resident by Violent Roommate

Thu, 23 Feb 2006 00:00:00 -0500

Although the award will likely be substantially reduced by the trial judge or a Texas appellate court, a San Antonio jury has returned a verdict $160 million in favor of the family of Tranquilino Mendoza, an 81-year-old man who was viciously beaten by a mentally disturbed roommate at the Comanche Trail Nursing Center in 1997.

The jury found that Summit Care Corp., its Texas affiliate, and two of its employees shared responsibility for this particularly brutal beating and its aftermath. Mr. Mendoza survived the attack but died less than three years later from unrelated causes.

"I wish my daddy was here. "I'm glad I had the opportunity to finish what he started.” said an emotional Rosamarie Paradez, who brought the action on behalf of Mr. Mendoza’s estate as his administratrix.

The attorney for the defendants said members Mendoza's family had testified that he had received excellent care the Mr. Mendoza received at the Comanche Trail Nursing Center before the attack. Moreover, defendants argued that, despite the severity of the beating he received, Mendoza made a full and speedy recovery from his injuries.

Defense counsel claimed that, while defendants always wanted “to reasonably compensate Mr. Mendoza and his family for the injuries he sustained," the “enormity of the jury's verdict” makes it necessary for defendants “to pursue available legal remedies."

The evidence at trial showed that Mendoza's roommate had been involved in some 30 assaults prior to his being moved in with the elderly Mendoza on September 26, 1997.

Only two days later, the violent roommate brutally attacked Mendoza with a water pitcher, a glass, and his fists. Although he lived for almost three years after the attack, the jury was convinced that Mendoza never recovered from the severe trauma he suffered as a result of the beating.

(Source: Express-News [San Antonio] 2/23/06)

Jury awards $160 million in nursing home suit

Thu, 23 Feb 2006 00:00:00 -0500

After hearing claims that a nursing home knowingly paired a frail 81-year-old man with a violent, mentally ill roommate who viciously pummeled him, a jury responded Wednesday with one of the largest civil judgments ever awarded in San Antonio.

Finding that Summit Care Corp., its Texas affiliate and two nursing home employees shared the blame for the beating and its after effects, the jury awarded a total of $160 million to the estate of Tranquilino Mendoza, who died less than three years after the attack, from unrelated causes.

Mendoza's daughter was overcome with emotion upon hearing the verdict.

"I wish my daddy was here," said a sobbing Rosamarie Paradez, who as administrator of Mendoza's estate pursued the case after his death.

"I'm glad I had the opportunity to finish what he started."

An attorney for the defendants, said members of Mendoza's family agreed during trial that he received excellent care at the Comanche Trail Nursing Center until the attack. She said medical records demon-strated that Mendoza recovered quickly and fully from his injuries.

"It has been our desire to fairly and reasonably compensate Mr. Mendoza and his family for the injuries he sustained," the defendants attorney said. "Because of the enormity of the jury's verdict, we intend to pursue available legal remedies."

During a trial that ran nearly two weeks before 73rd District Judge Andy Mireles, attorneys for the plaintiffs offered evidence that Mendoza's roommate was involved in 30 assaults before he was paired with Mendoza.

On Sept. 28, 1997, two days after they were assigned to live together, the roommate beat Mendoza with a water pitcher, a glass and his fists. Attorneys said Mendoza was seriously injured and never recovered from the trauma.

There is no definitive list of the largest civil judgments awarded in Bexar County, but the nursing-home case easily ranks among them. In recent memory, three juries in San Antonio's county and federal courts awarded larger sums.

In 1992, a jury awarded $1.3 billion to two men and an Australian firm in a breach of contract lawsuit in a purported con involving 1.75 million ounces of gold.

Mexican-based grocery wholesaler Valores Corp. won a 1999 breach-of-contract lawsuit against Wal-Mart Stores. The jury awarded $624 million in actual damages; the case was settled before punitive damages were awarded.

In 2002, a jury ordered Hillenbrand Industries to pay nearly $174 million to San Antonio-based Kinetic Concepts in a federal antitrust lawsuit.

Class-Action Lawsuit Seeks $600 Million in Connection with Outbreak of Legionnaires' Disease in Toronto Nursing Home that Has Already Killed 21

Thu, 27 Oct 2005 00:00:00 -0400

In the aftermath of one of the deadliest outbreaks of legionnaires’ disease ever, a 58-year-old Toronto resident, who contracted the illness, has commenced a $600 million class-action lawsuit according to a report by CTV News.

That report states in part: “Gerald Glover, 58, was infected with legionnaires' disease earlier this month during the outbreak at the Seven Oaks Home for the Aged in Scarborough. His family is baffled because Glover lives in a building across the parking lot from the home, and they say he hasn't even been in Seven Oaks.

Glover collapsed on Oct. 5 and was admitted to hospital with kidney failure, pneumonia, and temporary loss of memory and hearing. Glover’s daughter Cheryl Glover told CTV News that the suit is aimed at addressing her family's suffering.

‘It's never been about the money,’ she said. ‘We've been to the hospital and seen what they go through my dad has been hooked up to IVs in his arms and a huge one in his neck because of kidney failure, his stomach is all bruised up from being a pin cushion, and we still have no answers.’

The Glover family's lawyer, Glyn Hotz, said he has received phone calls from others interested in joining the class action suit. He said residents should have been better protected.”

According to Hotz: “Toronto Public Health should have taken measures to protect people in the home. They should have had preventative antibiotics and maybe even have moved people. They certainly should have shut the ventilation off, and instead they warned nobody."

After autopsy results confirmed at least three of the deaths at the Seven Oaks Home for the Aged in Toronto were directly linked to legionnaires’ the disease, the search intensified to find the source of the outbreak.

Although health officials had been stressing the fact that all of the dead have been elderly and infirm and that there is no danger to the general public, 30 employees, 26 visitors to the home, one hospital worker, and four people who live or work in the area (including Glover) had also been affected. Including residents of the facility, 127 cases of the disease have been diagnosed.

The search for the source of the disease was conducted by the Public Health Agency of Canada. Plumbing and air conditionaing systems at Seven Oakes were checked and a scan of a one-mile radius around the facility was conducted.

Three scientists and two technicians from the agency’s National Microbiology Laboratory were also sent to Toronto to conduct numerous tests aimed at locating the point of origin of the bacterium known as legionella pneumophilus bacterium. Environmental specialists were also called in to help identify possible sources of the bacteria.

Finally, last Friday, it was announced that the source of the outbreak was traced to the cooling tower on the roof of the nursing home. The bacteria samples from the cooling unit were found to be the same as those taken from the infected residents.

The cooling tower had been shut down on October 6, the day that legionnaires’ disease was identified as the probably cause of the outbreak.

Health officials concluded that an air intake for the home's ventilation system located next to the cooling tower allowed droplets of water containing the bacteria to be spread through the home by the ventilation system. There was no immediate evidence that the cooling tower had been improperly maintained.

Airborne droplets from the tower were blamed for spreading the illness to the four people in the vicinity of the nursing home who were also infected.

Shortly before Friday’s press conference, the 20th death among the home’s residents was announced. That number has since risen to 21 with the death of an 89-year-old resident of the home. Presently, eight victims of the disease remain hospitalized.

Indiana Nursing Home Investigated in Series of Abuse Incidents

Sat, 22 Oct 2005 00:00:00 -0400

State officials in Indiana (U.S.) have banned the Hanover Nursing Center from admitting any new residents as the result of an investigation into a series of incidents involving the abuse of several elderly inhabitants.

One such incident involved a 79-year-old woman who was severely beaten and left with a bloody face.

The Indiana Department of Health has released a report indicating that four Hanover residents were physically or verbally abused since August of 2005. The agency issued an emergency order banning the admission of new residents to the facility. A daily fine of $4,050, which began at the end of August, was also recommended.

Two former Hanover aides are facing charges in relation to the abuse allegations. One is facing a felony battery charge for an attack on a female Alzheimer’s patient and the other is facing a misdemeanor charge for failing to report the event. Both aides pleaded not guilty but are now facing trial on January 12, 2006.

The former aide charged with felony battery is Amy Johnson, who is accused of attacking a female resident in the center’s Alzheimer's unit on August 30.

According to the state's report, Johnson, 28, wrapped her left arm around the resident's neck, punched her in the face, and then asked her "how she liked it." Following the assault, the elderly woman had blackened eyes and blood gushing from her mouth and nose.

Seven other employees were fired because of claims of abuse, including an incident where a male resident was choked "so hard he was turning blue." He also had his thumbs bent back by two aides when he refused to go to bed.

Hanover is managed by Medical Rehabilitation Centers Inc., of Lexington, Kentucky. Executives of the company have called these abuse claims isolated incidents and said that they are enforcing a zero-tolerance policy on abuse like many other nursing homes. The Hanover nursing home is one of 15 such facilities in Indiana, Illinois, and Wisconsin managed by Medical Rehabilitation Centers.

Medical Rehabilitation Centers claims that the rest of the employees at Hanover are angered and outraged about the alleged abuse. The company has also established an anonymous abuse hotline.

A state monitor and two consultants are currently working at the nursing home to effect changes designed to prevent such incidents in the future. The Department of Health plans to conduct a follow-up inspection within the next 45 days to determine if remedial measures have been implemented at the center.

Nursing Home Abuse Lawyer, Negligence Attorney | Nursing Home Injury Attorneys, Elder Care Abuse Lawsuits | Long-Term Assisted-Care Living Facility Lawyer

Sat, 22 Oct 2005 00:00:00 -0400

Nursing Homes Must be Free from Abuse and Negligence, and as Safe as One's Home

Even though Americans are living longer, healthier lives, in the end we all have to watch our parents and other elderly loved ones enter the final chapter of life. The difficult questions about the cost of quality care have grown common enough to be part of the national debate.

Most would prefer to care for their elderly parents, or parent, in the safety of the family home, but sometimes this is simply not feasible. Adult children today tend to put in longer hours at work for lesser pay, and simply can’t find or afford someone to watch over their elderly family member. And if this family member is suffering from a medical condition, it makes home care even more difficult on the family. Therefore, when elderly loved ones can no longer take care of themselves, and when keeping them in your home simply isn’t feasible, a difficult decision must be made: that of putting mom and/or dad into a nursing or other long-term care facility to provide the attention they require. The types of residences available for elderly loved ones range from assisted-living facilities to full-care nursing homes.

At the same time, you shouldn’t have to lay awake at night worrying about how your loved one is faring in a nursing home. They deserve to be safe and properly cared for; furthermore, it’s the law.

If you suspect a love one is being abused by nursing home staff members, you have the legal right to take action based on your suspicions. Unfortunately, many nursing home residents tend not to mention instances of abuse; they may fear that the mistreatment will get worse. Possibly it is because of a medical condition that affects their ability to communicate or to even recall recent events.

Being Able to Decode the Signs of Nursing Home Abuse or Neglect

Nursing home abuse and neglect can often be a hidden problem due to the inability of victims to express pain and neglect. As for the physical signs, caregivers can easily overlook them, often because many nursing homes are understaffed, with overworked nurses and care providers. Sometimes it is up to you to notice if there is anything wrong with your loved one – especially if they can’t communicate and there is no one else to watch out for them.

Some common “hidden” problems at nursing homes:

Bedsores: These are created by unrelieved pressure, friction, humidity and poor nutrition, coupled with an inattentive caregiver who leaves a patient alone in bed for long periods without repositioning.
Weight Loss: Negligent nursing homes often do not have the staff or dedication needed to ensure residents get the necessary nutrition and hydration.
Injuries from Falling: Nursing home management is legally responsible for developing a care plan for each resident to prevent falls.

Number of Nursing Home Victims Reaches Epidemic Proportions

Nursing home negligence is an ongoing, serious problem. The National Center on Elder Abuse estimates that one nursing home patient out of 20 has been the victim of negligence and/or injury, and notes the number may be much higher. Additionally, the National Center reported that 57% of nurse’s aides working in long-term care facilities have admitted to witnessing – and some, even participating in – acts of negligence and abuse against elderly residents.

Due to limited staff and overpopulated facilities, elderly or disabled patients living in long-term care facilities often lack the attention they require. Moreover, elderly residents who require assistance to get through daily life – such as eating, bathing, walking, etc. – do not receive it. The results of this can be disastrous: debilitating falls, painful and immobilizing bedsores, malnutrition, and sometimes death.

If you feel that a loved one has been a victim of elder care abuse or neglect, you both may have valuable legal rights. Parker Waichman LLP is prepared to investigate and pursue all available civil damage remedies. Please complete our online form or call us at 1-800-LAW-INFO (1-800-529-4636) today.