Wednesday, December 28, 2011

Investigation uncovers nursing home abuse in...

A Toronto newspaper investigation into nursing home inspections uncovered numerous incidents of poor nursing home care in Waterloo Region and cited four facilities in cases of abuse.
The Toronto Star discovered hundreds of cases of neglect and abuse of seniors while examining more than 1,500 inspection reports for long-term care homes across Ontario since the Ministry of Health and Long-Term Care introduced a new inspection system about a year ago.
Inspections are done in response to complaints of poor care or the home’s reporting of an incident such as an alleged assault. The story was carried in Thursday’s Waterloo Region Record.
The newspaper report sparked action at Queen’s Park, with Health Minister Deb Matthews convening an emergency meeting Friday to find out why long-term care facilities are still not following rules on the reporting of abuse and neglect. At the meeting will be the Ontario Long Term Care Association representing two-thirds of Ontario’s 627 homes and several groups representing family and resident councils in homes.
The focus of the Thursday story was a 71-year-old woman with dementia, who is allged to have been sexually assaulted in her room by a facility staff member, who is now facing charges. Premier Dalton McGuinty responded to story saying there is “clearly more work to do” on the issue of protecting seniors. “I heard about this horrific incident and my heart goes out to the woman involved, her family and friends,” McGuinty said.
Locally, the investigation revealed 46 inspection reports of worrisome incidents in long-term care facilities in Waterloo Region and Wellington County. Six nursing homes were cited regarding reports of abuse, either by staff on resident or resident on resident.
TheRecord - Provincial investigation uncovers reported abuse in...

Saturday, December 24, 2011

man charged in neglect-related death

Authorites on Wednesday charged an Independence man with criminal involuntary manslaughter in the Nov. 1 death of his disabled mother, who died from complications of neglect. Prosecutors allege that James E. Owens failed to provide adequate “nourishment, hygiene and medical care” to his 74-year-old mother. An autopsy determined that Carol F. Brown died from complications of “infected decubitus ulcers and sepsis” due to neglect. Owens, 52, told detectives that he did not feed his mother or summon medical help after he thought she had suffered a stroke because she had said she wanted to die at home, according to a police affidavit filed in Jackson County Circuit Court. At the hospital, a maggot was removed from an open wound on one of Brown’s legs, according to court documents.
Read more here:
Independence man charged in mother’s neglect-related death -

New Mat may prevent Pressure Sores

People permanently confined to bed can develop bed sores. New smart cushioning is intended to eliminate the discomforts of lying and sitting. An integrated sensor system equalizes pressure selectively.

Anyone confined to a wheelchair or a bed has to deal with numerous complications. Frequently, they suffer from bedsores or decubitus ulcers as physicians call them. Bony prominences, such as the sacrum, coccyx and ischium, are especially endangered spots. Unrelieved pressure can lead to tissue necrosis. Damage can extend into the periosteum and, at the worst, into bones themselves. The ulcers are entryways for germs, which can trigger sepsis.

While hitherto available passive aids such as air, gel or vacuum cushions relieve pressure, they do not relieve the affected area optimally. Some patients are also unable to actively control the distribution of pressure and alleviate their own suffering. They are dependent on others for help. Personal care assistants or family caregivers must constantly keep an eye out for the formation of pressure ulcers.

A newly developed sensor mat will take over this job in the future and thus prevent tissue damage: researchers at the Fraunhofer Institute for Factory Operation and Automation IFF in Magdeburg are endowing textile cushions with the capability to “feel” by outfitting them with smart sensor systems.

Friday, December 23, 2011

Nurse Aide CNA - guilty in Cleveland nursing home abuse

A Cleveland nursing assistant CNA has pleaded guilty in the nursing home abuse of an Alzheimer's patient whose son recorded the mistreatment on a video camera hidden in an air purifier in the woman's room.
Maria Karban, 26, of Cleveland pleaded guilty to misdemeanor criminal assault on an elder Thursday in Cuyahoga County and faces up to six months in jail. Her attorney declined comment until the sentencing next month.
Karban and another nursing aide are accused of abusing Esther Piskor, 78, between April 8 and May 15 at a at MetroHealth Medical Center facility.
Virgen Caraballo, 45, of Cleveland pleaded guilty last month to seven felony counts of patient abuse or neglect and also is to be sentenced in January.
MetroHealth has fired the women and two other employees.
Woman pleads guilty in Cleveland nursing home abuse

Wednesday, December 21, 2011

Nursing Home Resident killed in California

Authorities say an 81-year-old man has been arrested on suspicion of murder for allegedly beating to death his 94-year-old nursing home roommate at an Orange County nursing home. According to police, William McDougall allegedly took a bar used to hang clothes from a closet, and used it to repeatedly strike his roommate, Manh Ban Nguyen, about the head.

Detectives are still investigating a possible motive for the nursing home assault, which occurred at Palm Terrace Healthcare Center, a 99-bed residential facility in Laguna Hills. Nguyen, who was found beaten around the head, was pronounced dead at Saddleback Memorial Medical Center.
The report does not say whether either man suffered from alzheimers or had a past record of mental illness or felony.

Saturday, December 17, 2011

Nursing Home Abuse caught on Tape

Three wnrkers at a nursing home in Pennsylvania have been arrested after being caught on tape hitting and mocking an elderly woman who suffers from dementia. Relatives of the 78-year-old woman installed a hidden camera after officials at the home rejected their suspicions that she was being abused, ABC News reported. The woman had told her daughter she was being punched and slapped by staff, asking: "Why do they keep picking on me?"

The video shows the employees "engaging in acts which I can only describe as humiliating, taunting and abusive of the victim in this case, including forcing the victim to stand topless for several minutes while the defendant and the other employees mocked her," the district attorney said. "The way the defendants allegedly abused this victim is inexcusable. Patients suffering from dementia and Alzheimer’s are among our most vulnerable citizens." The three employees have been charged with offenses including aggravated assault.

Thursday, December 15, 2011

Insurance Industry Manufactures Crises and Harms America

Great article today from Center for Justice and Democracy on the planned phony insurance 'crisis' planned by insurance companies to manufacture falsehoods to the American public in order to deny Americans access to the Courts and to advance tort reform.

The first definitive expose of 35 years of manufactured insurance crises. So far there have been three. They document how this industry is now creating a fourth.

Imagine an industry that sold a product which every person and business in America needed. This product was so important that the industry could literally threaten the economy of a state by pulling its product out. The seller of this product was accountable to no federal agency and regulated only by very weak state agencies. It was also exempt from anti-trust laws so the entire industry, including so-called “competitors,” could use the same collusive pricing agencies to help determine the product’s price – price fixing that would land others in jail. Other laws permitted it to keep its financial data secret, enabling it to routinely mislead lawmakers, regulators and members of the media about its financial condition. This secrecy allowed it to create phony “crises” to help promote its own legislative agenda, padding its bottom line at the expense of everyday Americans.

The industry’s economic cycles lead to what are known as “hard” and “soft” insurance markets; there have been three full cycles in the past 35 years, with soft markets characterized by stable or low rates (good for policyholders but disliked by the insurance industry) and hard markets, characterized by sudden and astronomical rate hikes for policyholders. These hard markets lead to sometimes devastating “liability insurance crises.”
While the existence of this self-made cycle is clear to insurance industry insiders, insurers often
publicly deny the cycle’s existence while their lobbyists try to take advantage of skyrocketing
rates to push for so-called “tort reform.”
A bill has recently been introduced to eliminate the anti trust exemption irrationaly enjoyed by insurers over the years at the expense of policy holders:

Study: Repeat Offenders: How the Insurance Industry Manufactures Crises and Harms America

Wednesday, December 14, 2011

Former nursing home employees claim firing for reporting fired for reporting maggots

Three former employees of a Pittsfield Township nursing home where maggots were found on a patient have sued the nursing home and its parent company alleging they were fired for reporting patient abuse and neglect at the facility.
The three all worked as certified nursing aides at Whitehall Healthcare Center of Ann Arbor and were involved in the state’s investigation into the discovery of maggots in a patient’s genital area last summer, the lawsuit states.
One was fired after filing a complaint that brought the state to the facility to investigate a patient’s fall, the lawsuit states. Two others were fired after they and the employee who filed the original complaint told state investigators about the discovery of the maggots, the lawsuit claims.

Ex-nursing home employees: We were fired for reporting maggots at Whitehall

New York Scores a dismal rating on Nursing Home Care

New York has a surprisingly poor record in providing long-term care for its residents, according to a new score card comparing all 50 states and the District of Columbia on the availability and quality of services. New York ranked 41st.

The rankings, published by AARP, the Commonwealth Fund and the Scan Foundation, incorporated data on 25 measures of long-term carefor the elderly and the physically disabled, and on the support services given to family members who provide care like bathing and feeding in the home. The report focused primarily on services for people who need assistance with routine activities of daily life but may also need medical care.
New York’s poor marks on the quality of care delivered and quality of life provided are especially disturbing. The state ranked 44th in the percentage of high-risk nursing home patients who develop bed sores, which is often a measure of neglectful care. It ranked 50th in the percentage of home health patients and 28th in the percentage of nursing home patients who were sent to the hospital, which is often considered an indicator of inadequate care in the system.
It also ranked 50th in the percentage of disabled adults living in the community who always or usually get the support they need. This is an ominous statistic given the drive to move larger numbers of people out of institutions and into community-based care.

Sunday, December 11, 2011

Drug tampering by nurses in Kansas nursing regulations

A nurse with a prior felony conviction for forging prescriptions dilutes morphine solutions for five Halstead nursing home patients. Another nurse convicted of stealing drugs from patients at an nursing home gets another job in Topeka, where she adds tap water to a painkiller prescribed for a 105-year-old patient.
Still another nurse fired from her last job at a Wichita hospital over drug discrepancies gets a new job in Salina, where she's later accused of taking home syringes full of morphine and replacing the medicine with a dangerous sodium chloride solution.
Drug tampering cases by 3 Kansas nurses highlight gaps in state nursing regulations | The Republic

Saturday, December 10, 2011

Video Treating Pressure Ulcer

Nursing home safety: Troubled Chicago nursing home may lose funding

Nursing home news: Federal authorities are moving this week to terminate Medicaid funding to the troubled Wincrest Nursing Center on the city's North Side after state and federal inspections documented nursing home residents engaged in bloody fights and drug abuse that spilled from the facility out into the surrounding community. An 80-bed home that primarily houses adults with mental illnesses, including dozens with felony records, Wincrest has for years been the subject of complaints by local officials and neighbors, as well as students and staff from nearby Loyola University Chicago. Seven Loyola residence halls housing about 600 students stand within a block of the home at 6326 N. Winthrop Ave. Authorities have documented knife attacks, drug abuse at Wincrest Nursing Center. We earlier pointed out the problems facing residents when past felons are admitted into nursing homes and discussed the danger to elders when this happens.
See blog post
See Release:
Nursing home safety: Troubled Chicago nursing home may lose Medicaid funding -

Wednesday, December 7, 2011

Nursing home workers arrested for 'waterboarding' a dementia care resident

Two nursing home workers in Georgia were arrested after a coworker reported them to the police for performing a waterboarding-like attack against a resident with severe dementia.
A grand jury indicted the two women, on charges of false imprisonment and battering a nursing home patient, for the 2008 incident, The Huffington Post reported. According to a local report, the workers confined the 89-year-old nursing home resident to a shower room, and held back her arms and wrists while using a shower nozzle to simulate the sensation of drowning. The alleged attack was reportedly sparked by an argument about ice cream. The employees are both awaiting a trial date.
Intentional assaults, such as the type involving Kindred CNA Bernadette Stackpole can and should be criminally prosecuted. In most states not assaults on nursing home residents is a crime.
Nursing home workers arrested for 'waterboarding' a dementia care resident - McKnight's Long Term Care News

Sunday, December 4, 2011

Were Nursing Home Regulations too Burdensome for Lifecare?

In a recent sucessful litigation against Lifecare Nursing Home of Lynn Massachusetts, Lifecare's attorneys filed several motions to exclude evidence or to get advance rulings on the use of arguements they did not want made at trial. The case alleged nursing home negligence involving the wrongful death of a disabled resident.
On such motion "in limine"by Lifecare sought to prevent Plaintiff from arguing that the various state and federal regulations regulating nursing homes constituted the "standard of care" applicable to nursing home care. Actually I never intended to argue that the regulations were the per se standard of care.  In fact the Judge denied their pre trial motion. I was allowed to argue that the regulations were relevant for consideration.

What was eye opening was the language Lifecare put forth in support of their motion:
"When a practical nursing home is compared to these standards, it would be virtually impossible for the nursing home to avoid a finding of negligence."

The Hamill Firm of Quincy, Massachusetts concentrates their practice on advocating for elderly nursing home residents and has a successful track record of verdicts and settlements including some of the highest emotional distress verdicts ever awarded in Massachusetts for nursing home abuse. The Hamill group encourages all residents injured by neglect in Massachusetts nursing homes to call for a free evaluation of their claim. 

Thursday, December 1, 2011

Flexible Nutrition Aproach recommended for Nursing Home Residents

When planning nursing home residents' meals and dining experiences, Food has to look good, taste good, and be offered courteously and in a comfortable setting... Long-term care facility providers should avoid overcomplicating the operation of food services and follow common sense principles. Multiple factors can complicate fulfillment of nursing home residents' nutritional needs. Altered metabolism, medication, or illness can bring on loss of appetite; shortage of staff to assist dependent residents at mealtimes are also obstacles facing long-term care facilities.
Strategies for enhancing the nutritional status of residents, include:
- Careful assessment of altered nutritional status;
- Flexibility in accommodating residents' food and eating preferences;
- training of staff;
- Improved staff communication

Residents families should always be polled as to their loved ones eating preferences and habits. Following these rules can avoid malnutrition, dehydration and rapid weight loss.

Massachusetts Regulations 105 CMR 150 .. state:
(G) Preparation and Serving of Food
(1) All foods shall be prepared by methods that conserve the nutritive value, flavor and appearance.

Federal Regulations 42CFR 483.35 "Dietary Services" states that:
(d) Food. Each resident receives and the facility provides--

(1) Food prepared by methods that conserve nutritive value, flavor, and appearance;
(2) Food that is palatable, attractive, and at the proper temperature;

Significant weight loss can often be avoided. If not stemmed however it can lead to a downward spiral of a residents health. Adherence to the existing regulations added to a specifically tailored diet for the resident can go a long way toward health maintenance.

The Hamill Firm of Quincy, Massachusetts concentrates their practice on advocating for elderly nursing home residents and has a successful track record of verdicts and settlements including some of the highest emotional distress verdicts  ever awarded in Massachusetts for nursing home abuse. The Hamill group encourages all residents injured by neglect in Massachusetts nursing homes to call for a free evaluation of their claim. 

Monday, November 28, 2011

Massachusetts Finishes in Bottom Third of States for Nursing Home Care

"Lowered Expectations" in Massachusetts Nursing Homes

Massachusetts Long Term care report cards including Nursing Home care marks graded Massachusetts at the third out of fourth quadrants for nursing care quality.
For these importatnt indicators see the state rank (out of 50)
- Quality of Life & Quality of Care: 34th
- Support for Family Caregivers: 39th
- Percent of home health episodes of care in which interventions
to prevent pressure sores were included in care plan for at-risk patients: 40th
- Percent of adults age 18 with disabilities living in the community
who are satisfied or very satisfied with life: 38th
- Percent of home health patients with hospital admission: 38th

- Cost: 17th most expensive

The disparity between the quality of services delivered and the cost of nursing home care is telling and unacceptible in a state with so many top level health care resources. In this case "you don't get what you pay for".
Massachusetts State Scorecard - The Commonwealth Fund

Friday, November 25, 2011

Quality of Care Ftag 309 Nursing Home Regulations

§483.25 Quality of Care (Ftag 309) regulating Nursing Home care:
States that “Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care.”

The stated Intent of section: §483.25  is that the “facility must ensure that the resident obtains optimal improvement or does not deteriorate within the limits of a resident’s right to refuse treatment, and within the limits of recognized pathology and the normal aging process.”

Definitions: §483.25
“Highest practicable physical, mental, and psychosocial well-being” is defined as the highest possible level of functioning and well-being, limited by the individual’s recognized pathology and normal aging process. Highest practicable is determined through the comprehensive resident assessment and by recognizing and competently and thoroughly addressing the physical, mental or psychosocial needs of the individual.

Interpretive Guidelines §483.25 - Unavoidable harms to nursing home elders:
In any instance in which there has been a lack of improvement or a decline, one must determine if the occurrence was “unavoidable or avoidable”. A determination of unavoidable decline or failure to reach highest practicable well-being may be made only if all of the following are present:
• An accurate and complete assessment (see §483.20);
• A care plan that is implemented consistently and based on information from the assessment; and
• Evaluation of the results of the interventions and revising the interventions as necessary.

Compliance with F309, Quality of Care - The nursing home facility is in compliance with this requirement if staff:
• Recognized and assessed factors placing the resident at risk for specific conditions, causes, and/or problems;
• Defined and implemented interventions in accordance with resident needs, goals, and recognized standards of practice;
• Monitored and evaluated the resident’s response to preventive efforts and treatment; and
• Revised the approaches as appropriate.

Full Text of
42CFR483.25 Quality of care
    Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care.
    (a) Activities of daily living. Based on the comprehensive assessment of a resident, the facility must ensure that—
    (1) A resident’s abilities in activities of daily living do not diminish unless circumstances of the individual’s clinical condition demonstrate that diminution was unavoidable. This includes the resident’s ability to—
    (i) Bathe, dress, and groom;
    (ii) Transfer and ambulate;
    (iii) Toilet;
    (iv) Eat; and
    (v) Use speech, language, or other functional communication systems.
    (2) A resident is given the appropriate treatment and services to
maintain or improve his or her abilities specified in paragraph (a)(1) of this section; and
    (3) A resident who is unable to carry out activities of daily living receives the necessary services to maintain good nutrition, grooming, and personal and oral hygiene.
    (b) Vision and hearing. To ensure that residents receive proper treatment and assistive devices to maintain vision and hearing abilities, the facility must, if necessary, assist the resident—
    (1) In making appointments, and
    (2) By arranging for transportation to and from the office of a practitioner specializing in the treatment of vision or hearing impairment or the office of a professional specializing in the provision of vision or hearing assistive devices.
    © Pressure sores. Based on the comprehensive assessment of a
resident, the facility must ensure that—
    (1) A resident who enters the facility without pressure sores does
not develop pressure sores unless the individual’s clinical condition
demonstrates that they were unavoidable; and
    (2) A resident having pressure sores receives necessary treatment
and services to promote healing, prevent infection and prevent new sores
from developing.
    (d) Urinary Incontinence. Based on the resident’s comprehensive
assessment, the facility must ensure that—
    (1) A resident who enters the facility without an indwelling
catheter is not catheterized unless the resident’s clinical condition demonstrates that
catheterization was necessary; and
    (2) A resident who is incontinent of bladder receives appropriate
treatment and services to prevent urinary tract infections and to
restore as much normal bladder function as possible.
    (e) Range of motion. Based on the comprehensive assessment of a resident, the facility must ensure that—
    (1) A resident who enters the facility without a limited range of motion does not experience reduction in range of motion unless the resident’s clinical condition demonstrates that a reduction in range of motion is unavoidable; and
    (2) A resident with a limited range of motion receives appropriate treatment and services to increase range of motion and/or to prevent further decrease in range of motion.
    (f) Mental and Psychosocial functioning. Based on the comprehensive assessment of a resident, the facility must ensure that—
    (1) A resident who displays mental or psychosocial adjustment difficulty, receives appropriate treatment and services to correct the assessed problem, and
    (2) A resident whose assessment did not reveal a mental or psychosocial adjustment difficulty does not display a pattern of decreased social interaction and/or increased withdrawn, angry, or depressive behaviors, unless the resident’s clinical condition demonstrates that such a pattern was unavoidable.
    (g) Naso-gastric tubes. Based on the comprehensive assessment of a resident, the facility must ensure that—
    (1) A resident who has been able to eat enough alone or with  assistance is not fed by naso-gastric tube unless the resident’s clinical condition demonstrates that use of a naso-gastric tube was unavoidable; and
    (2) A resident who is fed by a naso-gastric or gastrostomy tube  receives the appropriate treatment and services to prevent aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, and  nasal-pharyngeal ulcers and to restore, if possible, normal eating skills.
    (h) Accidents. The facility must ensure that—
    (1) The resident environment remains as free of accident hazards as is possible; and
    (2) Each resident receives adequate supervision and assistance devices to prevent accidents.
    (i) Nutrition. Based on a resident’s comprehensive assessment, the facility must ensure that a resident—
    (1) Maintains acceptable parameters of nutritional status, such as body weight and protein levels, unless the resident’s clinical condition demonstrates that this is not possible; and
    (2) Receives a therapeutic diet when there is a nutritional problem.
    (j) Hydration. The facility must provide each resident with sufficient fluid intake to maintain proper hydration and health.
    (k) Special needs. The facility must ensure that residents receive proper treatment and care for the following special services:
    (1) Injections;
    (2) Parenteral and enteral fluids;
    (3) Colostomy, ureterostomy, or ileostomy care;
    (4) Tracheostomy care;
    (5) Tracheal suctioning;
    (6) Respiratory care;
    (7) Foot care; and
    (8) Prostheses.
    (l) Unnecessary drugs--(1) General. Each resident’s drug regimen must be free from unnecessary drugs. An unnecessary drug is any drug when used:
    (i) In excessive dose (including duplicate drug therapy); or
    (ii) For excessive duration; or
    (iii) Without adequate monitoring; or
    (iv) Without adequate indications for its use; or
    (v) In the presence of adverse consequences which indicate the dose should be reduced or discontinued; or
    (vi) Any combinations of the reasons above.
    (2) Antipsychotic Drugs. Based on a comprehensive assessment of a resident, the facility must ensure that—
    (i) Residents who have not used antipsychotic drugs are not given these drugs unless antipsychotic drug therapy is necessary to treat a specific condition as diagnosed and documented in the clinical record; and
    (ii) Residents who use antipsychotic drugs receive gradual dose reductions, and behavioral interventions, unless clinically contraindicated, in an effort to discontinue these drugs.
    (m) Medication Errors. The facility must ensure that—
    (1) It is free of medication error rates of five percent or greater; and
    (2) Residents are free of any significant medication errors.

Associated Regulations:
Some examples include, but are not limited to, the following:
• 42 CFR 483.10(b)(11), F157, Notification of Changes
Determine whether staff notified the resident and consulted the physician regarding significant changes in the resident’s condition or a need to alter treatment significantly or notified the representative of a significant condition change.
• 42 CFR 483.(20)(b), F272, Comprehensive Assessments
Determine whether the facility assessed the resident’s condition, including existing status, and resident-specific risk factors (including potential causative factors) in relation to the identified concern under review.
• 42 CFR 483.20(k), F279, Comprehensive Care Plan
Determine whether the facility established a care plan with timetables and resident specific goals and interventions to address the care needs and treatment related to the clinical diagnosis and/or the identified concern.
• 42 CFR 483.20(k)(2)(iii), 483.10(d)(3), F280, Care Plan Revision
Determine whether the staff reviewed and revised the care plan as indicated based upon the resident’s response to the care plan interventions, and obtained input from the resident or representative to the extent possible.
• 42 CFR 483.20(k)3)(i), F281, Services Provided Meets Professional Standards of Quality
Determine whether the facility, beginning from the time of admission, provided care and services related to the identified concern that meet professional standards of quality.
• 42 CFR 483.20(k)(3)(ii), F282,Care Provided by Qualified Persons in Accordance with Plan of Care
Determine whether care was provided by qualified staff and whether staff implemented the care plan correctly and adequately.
• 42 CFR 483.30(a), F353, Sufficient Staff
Determine whether the facility had qualified nursing staff in sufficient numbers to assure the resident was provided necessary care and services 24 hours a day, based upon the comprehensive assessment and care plan.
• 42 CFR 483.40(a)(1)&(2), F385, Physician Supervision
Determine whether the physician has assessed and developed a relevant treatment regimen and responded appropriately to the notice of changes in condition.
• 42 CFR 483.75(f), F498, Proficiency of Nurse Aides
Determine whether nurse aides demonstrate competency in the delivery of care and services related to the concern being investigated.
• 42 CFR 483.75(i)(2), F501, Medical Director
Determine whether the medical director:
- Assisted the facility in the development and implementation of policies and procedures and that these are based on current standards of practice; and
- Interacts with the physician supervising the care of the resident if requested by the facility to intervene on behalf of the residents.
• 42 CFR 483.75(l), F514, Clinical Records
Determine whether the clinical records:
- Accurately and completely document the resident’s status, the care and services provided in accordance with current professional standards and practices; and
- Provide a basis for determining and managing the resident’s progress including response to treatment, change in condition, and changes in treatment. 

The Hamill Firm of Quincy, Massachusetts concentrates their practice on advocating for elderly nursing home residents and has a successful track record of verdicts and settlements including some of the highest emotional distress verdicts ever awarded in Massachusetts for nursing home abuse. The Hamill group encourages all residents injured by neglect in Massachusetts nursing homes to call for a free evaluation of their claim. 

Consumers are also invited to use the many free nursing home consumer resources available at the Hamill law firm website and blog including our free guide to avoiding abuse and our guide on selecting the safest nursing home.

Hamill Law

Understanding Certified Nursing Assistants in Nursing Homes

Direct care workers -- certified nurse aides, home health aides, and personal and home care aides -- are the primary providers of paid hands-on care for more than 13 million elderly Americans. They assist individuals with a broad range of support including preparing meals, helping with medications, bathing, dressing, getting about (mobility), and getting to planned activities on a daily basis. Although direct care workers constitute one of the largest and fastest-growing sectors of the workforce, there is a documented critical and growing shortage of these workers in every community throughout the United States. There is significant need to attract many more direct care workers in the near future.
The U.S. Department of Health and Human Services is working to improve the quality of direct care jobs and stabilize this workforce on a number of fronts. For over a decade, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) has made the direct care workforce a major focal point of its policy research agenda. ASPE has convened expert meetings and conferences; produced seminal reports and reports to Congress on the long-term care workforce; reviewed state-based policies and provider practice initiatives; examined the utility and efficacy of worker registries, background checks, and wage pass-throughs; explored potential new sources of new workers; and sponsored a number of program evaluations and demonstrations. The Patient Protection and Affordable Care Act (P.L. 111-148) strengthens the investment in direct care work by authorizing several new initiatives aimed at improving the quality of direct care jobs, workforce development, and long-term care.
This chart book highlights findings from two new ASPE-sponsored national surveys: The 2004 National Nursing Assistant Survey and the 2007 National Home Health Aide Survey. Both surveys represent a major advance in the data available about two of America’s most important jobs -- certified nursing assistants working in nursing homes and home health aides working in home and hospice care settings. The chart book is intended to help multiple audiences understand these jobs, issues, and challenges; and to establish useful benchmarks as goals toward which improvement efforts might aspire.
Understanding Direct Care Workers: A Snapshot of Two of America’s Most Important Jobs -- Certified Nursing Assistants and Home Health Aides

Nation’s Largest Nursing Home Pharmacy and Drug Manufacturer to Pay $112 Million to Settle False Claims Act Cases

The nation’s largest nursing home pharmacy, Omnicare Inc. of Covington, Kentucky, will pay $98 million, and drug manufacturer, IVAX Pharmaceuticals of Weston, Florida, will pay $14 million to resolve allegations that Omnicare engaged in kickback schemes with several parties, including IVAX, the Justice Department announced today. Approximately $68.5 million of the settlement proceeds will go to the United States, while $43.5 million has been allocated to cover Medicaid program claims by participating states.

Nation’s Largest Nursing Home Pharmacy and Drug Manufacturer to Pay $112 Million to Settle False Claims Act Cases

Sunday, November 20, 2011

Resident "behaviour issues" in Nursing Homes

I attended a criminal sentencing in a Massachusetts Superior Court for an aide who had been found guilty of 4 counts of assaults on and mistreatment of nursing home elder residents. The sentencing Judge did not sentence the aide to jail because,  astonishingly, he apparently felt sympathy for the aide. Th CNA (Certified Nurse Aide) had been "forced " to work too many hours. And the residents she cared for were sometimes difficult if not "violent" because they had suffered from Alzheimer's disease. As if "resistance" by an ill resident justifies criminal retaliation! Educating the judiciary has become a constant theme in bringing civil cases. Most are unaware or pay lip service to very strict federal regulations prohibiting abuse. state regulations also prohibit abuse:
42CFR§483.13 Resident Behavior and Facility Practices
§483.13(b) Abuse (Ftag 223)
"The resident has the right to be free from verbal, sexual, physical, and mental abuse, corporal punishment, and involuntary seclusion."
Each resident has the right to be free from abuse, corporal punishment, and involuntary seclusion. Residents must not be subjected to abuse by anyone, including, but not limited to, facility staff, other residents, consultants or volunteers, staff of other agencies serving the resident, family members or legal guardians, friends, or other individuals.

“Abuse” means the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish.” (42 CFR §488.301)
This also includes the deprivation by an individual, including a caretaker, of goods or services that are necessary to attain or maintain physical, mental, and psychosocial well-being. This presumes that instances of abuse of all residents, even those in a coma, cause physical harm, or pain or mental anguish.
“Verbal abuse” is defined as the use of oral, written or gestured language that willfully includes disparaging and derogatory terms to residents or their families, or within their hearing distance, regardless of their age, ability to comprehend, or disability. Examples of verbal abuse include, but are not limited to: threats of harm; saying things to frighten a resident, such as telling a resident that he/she will never be able to see his/her family again.
“Sexual abuse” includes, but is not limited to, sexual harassment, sexual coercion, or sexual assault.
“Physical abuse” includes hitting, slapping, pinching and kicking. It also includes controlling behavior through corporal punishment
“Mental abuse” includes, but is not limited to, humiliation, harassment, threats of punishment or deprivation.
§483.13(c) Staff Treatment of Residents ( F224 and F226)
The facility must develop and implement written policies and procedures that prohibit mistreatment, neglect, and abuse of residents and misappropriation of resident property.

§483.13(c)(1)(i) Staff Treatment of Residents
(1) The facility must (i) Not use verbal, mental, sexual, or physical abuse, corporal punishment, or involuntary seclusion;
Our office represented 3 of the victims of this criminal conduct. We were much more successful than the attorney general in bringing justice to the families. At trial, victims who were assaulted and or mistreated received judgements of $300,000, $450,000 and an a third case resulted in a trial settlement.

Friday, November 18, 2011

Residents Rights in Nursing Homes

Federal Regulations (42CFR§483.10) require that in a nursing home setting: "The resident has a right to a dignified existence (see also §483.15(a) Dignity) self-determination, and communication with and access to persons and services inside and outside the facility. A facility must protect and promote the rights of each resident, including each of the following rights" 42CFR§483.10
Residents Rights are not only good medicine, they are mandated by Federal; and state laws and make up the Standard of Care in nursing homes.
These rights include the resident’s right to
• Exercise his or her rights (§483.10(a));
• Be informed about what rights and responsibilities he or she has (§483.10(b));
• If he or she wishes, have the facility manage his personal funds (§483.10(c));
• Choose a physician and treatment and participate in decisions and care planning (§483.10(d))
Other rights include:
§483.10(e) Privacy and Confidentiality
§483.10(f) Grievances
§483.10(g) Examination of Survey Results
§483.10(h) Work
§483.10(i) Mail
§483.10(j) Access and Visitation Rights
§483.10(k) Telephone
§483.10(l) Personal Property
§483.10(m) Married Couples
§483.10(n) Self-Administration of Drugs
§483.10(o) Refusal of Certain Transfers

Attorney Hamill has 34 years experience advocating for injured people including those who have suffered from nursing home neglect, abuse or wrongful death. The Hamill firm represents elders victimized by criminal assaults , bed sores, falls from Hoyer lifts, sepsis and malnutrition. For more information contact the Hamill group at (617) 479-4300 or use the firm's website contact form.

Wednesday, November 16, 2011

Admitting Past Felons into Nursing Homes

The Desmoine Register had this article the same day I wrote about placement of past felons in nursing homes and how they increase risk of crimes upon nursing home residents.
State officials say doctors did not view convicted sex offender William Cubbage as a sexual predator when they recommended moving him to an Iowa nursing home where he’s now suspected of sexually assaulting an elderly woman. At one time, a psychologist hired by the state believed Cubbage had victimized “a large number of female children” without being charged or prosecuted for those offenses, according to court records.
Two decades of sex crimes in nursing home abuse suspect’s past The Des Moines Register

With violent attacks by felons living in some nursing homes, some facilities are scrambling to comply with disclosure laws required in some states to notify state public health officials when they admit offenders. The number of felons reported to be living in the facilities increased last month in some states. Past reported felonious acts have included rape, theft, assaults, illegal drug use and violence. Some former felons also have serious psychiatric conditions.

Monday, November 14, 2011

Elder Pain Study Shows Disparity in Races

According to a study conducted to measure pain in elderly nursing home residents showed a marked disparity between racial groups:
- About one-quarter of all nursing home residents reported or showed signs of pain.
- Forty-four percent of nursing home residents with pain received neither standing orders for pain medication nor special services for pain management (i.e., appropriate pain management).
- Among residents with dementia and pain, nonwhite residents were more likely than white residents to lack appropriate pain management.
- a significantly greater proportion of residents without dementia reported pain compared with residents with dementia.

Over 40% of all nursing home residents with pain received neither standing orders for pain medication nor special services for pain management. Among residents with dementia and pain, there were differences in appropriate pain management between nonwhite and white residents, with nonwhite residents being more likely than white residents to lack appropriate pain management. Questions exist as to the disparity of adequate pain relief for non white residents. Is it because the facilities they are in are inferior and lack adequate resources?

Products - Data Briefs - Number 30 - March 2010

Sunday, November 13, 2011

Pressure Ulcers v Deep Tissue Injury vs Blisters ll

Afte publishing the post about Pressure Ulcers v Deep Tissue Injury vs Blisters I received an excellent email from Sue Hull, MSN, RN, CWOCN, who operates
"The reason DTI is discussed along with pressure ulcers in the NPUAP document is because it is caused by pressure. If it occurs while a person is a resident of a nursing home, it would indicate negligence in that the measures had not been taken to prevent pressure. I believe it is standard care that a pressure ulcer risk assessment is done on admission and at predetermined intervals thereafter in nursing homes (as in home health, where I work). Based upon the findings of the risk assessment, interventions are to be implemented to prevent skin breakdown. If DTI develops, something was missed in the process, or something is wrong with that particular nursing home's process.

If there were factors that truly did make the DTI unpreventable, those factors should be copiously documented. It should never be a surprise when a pressure ulcer develops. Eg. if a resident MUST have the head of the bed in a high Fowler's position to breathe, it should be heavily documented along with the skin assessment, and a sacral DTI should be watched for. It should not be a surprise.
Also, when there is DTI, it is not undectible, even in persons of color. There are changes, such as warmth, bogginess, blood filled blisters, and color changes. If boney prominence are routinely checked for these things, the DTI will be detected."
Thanks for your input Sue.

Saturday, November 12, 2011

Nursing homes report more felons

What happens when an elder applies to a nursing home who is a convicted felon or a dangerous criminal? What safety meassures are taken by the nursing home to protect the elder residents from predatory actions such as sexual assaults and criminal assaults? Shouldn't they be screened for the protection of all residents? Shouldn't residents families be warned about these types of admissions?
Nursing homes report more felons -

Pressure Ulcers vs Deep Tissue Injury vs Blisters

Our law office has handled several Pressure Sore, Pressure Ulcer cases where the defense tries to categorize a pressure ulcer as a "deep tissue injury" which was hidden and not visible to caregivers thereby excusing the caregivers from observing and treating the wound. They usually contend  that the wound popped up out of nowhere suddenly and in an advanced stage. In other words this wound was unpreventable and untreatable in its earlier stages because it was hidden under the surface of the skin. This defense distorts the definitions and progression of each type of wound.  Usually the actual progression of most skin disorders I have handled were in fact pressure ulcers and not hidden "deep tissue Inujury". Mischaracterizing a pressure ulcer as a deep tissue injury is usually an attempt to skirt the mandate of federal regulations regarding the prevention of bed sores. They are seperate and distinct skin wounds.

483.25(c) Quality of Care - Pressure Sores (also called Tag F314):
"Based on the Comprehensive Assessment of a resident, the facility must ensure that-
(1) A resident who enters the facility without pressure sores does not develop
pressure sores unless the individual’s clinical condition demonstrates that they were
unavoidable; and (2) A resident having pressure sores receives necessary treatment and services
to promote healing, prevent infection and prevent new sores from developing."

The National Pressure Ulcer Advisory Panel in 2007 redefined the definition of a pressure ulcer and
the stages of pressure ulcers, including the original 4 stages and adding 2 stages on deep tissue
injury and 1 on unstageable pressure ulcers.
A Pressure sore is defined in 2007 by the National Pressure Ulcer Advisory Panel (NPUA) as a
"A pressure ulcer is localized injury to the skin and/or underlying tissue usually over a bony
prominence, as a result of pressure, or pressure in combination with shear and/or friction."
Pressure ulcers develop when capillaries supplying the skin are compressed enough to impede perfusion, leading ultimately to tissue necrosis. Without pressure over a bony prominence you don't have a pressure sore.

NPUA stated in 1998 that a Stage I pressure ulcer is an observable pressure related alteration of intact skin with indicators, as compared to an adjacent or opposite area on the body, which may include changes in one or more of the following: skin temperature (warmth or coolness), tissue consistency (firm or boggy feel), and/or sensation (pain, itching). The ulcer appears as a defined area of persistent redness in lightly pigmented skin, whereas in darker skin tones, the ulcer may appear with persistent red, blue, or purple hues.  A pressure sore is visible or it is not a pressure ulcer by the 1998  definition.

A "Deep Tissue Injury", by contrast is defined in 2007 by NPUA as "Purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear." The area may be preceded by tissue that is painful, firm, mushy, boggy, warmer or cooler as compared to adjacent tissue. Deep tissue injury may be difficult to detect in individuals with dark skin tones. Evolution may include a thin blister over a dark wound bed. The wound may further evolve and become covered by thin eschar. Evolution may be rapid exposing additional layers of tissue even with optimal treatment.

Note the distinction created by these definitions when examining a stage 2 pressure ulcer versus a "deep tissue injury":  A stage 2 pressure ulcer: "Stage II: Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled blister. Presents as a shiny or dry shallow ulcer without slough or bruising.* This stage should not be used to describe skin tears, tape burns, perineal dermatitis, maceration or excoriation." Note that NPUA indicates that *Bruising indicates suspected deep tissue injury.
Note also that Stage 2 pressure ulcers can appear as "blisters" but they are indeed stage 2 pressure ulcers not common or benign blisters.
The Hamill Law Group has 34 years experience advocating for injured people including those who have suffered from nursing home neglect, abuse or wrongful death. The Hamill firm represents elders victimized by criminal assaults,  pressure sores , falls , sepsis and malnutrition.  For more information contact the Hamill group at (617) 479-4300 or use the law firm contact form.

See update to Pressure Ulcers vs Deep Tissue Injury vs Blisters

Friday, November 11, 2011

Elder Abuse: Late-in-Life Surgery Excessive?

Surgery is ridiculousy common in older people during the last year, month and even week of life, researchers reported Wednesday. Are these types of surgery just another form of Elder Abuse?
The most comprehensive examination of operations performed on Medicare recipients in the final year of life found that nationally in 2008, nearly one recipient in three had surgery in the last year of life. Nearly one in five had surgery in the last month of life. Nearly one in 10 had surgery in the last week of life!
Do doctors too often operate on an elder who is a dying patient? And if so what pain and anguish does surgery entail? Who profits? The health care industry? At whose expense? The frail elderly patient who is dying? What dignity is lost by end of life unnecessary surgery? Will the the surgery improve or destroy the quality of their life at the end?
Lancet Report Cites Rate of Late-in-Life Surgery -

Thursday, November 10, 2011

Sweet Book of Williamstown Rehab (CareOne LLC) faces possible civil claim

Family of fallen resident recently hired the Hamill Firm to represent them to investigate a possible civil action against Sweet Book of Williamstown Rehab (CareOne LLC) .  John S., a 72 year old  resident died from fall related injuries in 2011 according to an autopsy.
Sweet Brooks latest nursing home performance surveys are discussed here. Sweet Brook scored in the lowest 5% percentile according to state performance survey results for 2011.The Hamill firm has successfully suited nursing homes for wrongful death and fall related cases.

Federal safety regulation 42 CFR §483.25(h) (Ftag 323)  "Accidents" requires that
The facility must ensure that -
(1) The resident environment remains as free from accident hazards as is
possible; and
(2) Each resident receives adequate supervision and assistance devices to
prevent accidents.

Sweet Book of Williamstown Rehab (CareOne LLC)

Saturday, November 5, 2011

Hospital Delerium a Hazard for the Elderly

20 percent of the 11.8 million elderly patients in hospitals develop delirium.
Distinguishing between delirium and dementia, which even medical professionals often mix up, is critical. Delirium signals that something in the body is seriously wrong and needs attention, fast. Dementia, not so; it’s chronic confusion and memory loss that comes on gradually and gets worse. Delirium is confusion that comes on suddenly, often within hours, brought on by such triggers as infection, the stress of a disease or operation, not getting enough food or water or sleep, or medications often administered in the hospital.
How to know if your family member is suffering delirium? Caregivers who know the patient in normal times are the best judges of when things are not right. Look for any of these four signs:
Acute change of mental status: Not making sense when he or she talks? Disoriented, illogical, unable to focus? Trust your instincts. Let the staff know this is not normal behavior.
Inattention: As you hold the patient’s hand, ask him or her squeeze every time you say the letter A, as you clearly spell out “save a heart.” “If they miss two, or squeeze on the wrong letter, that is a sign of delirium,” said Dr. Michele Balas, assistant professor in the College of Nursing at the University of Nebraska Medical Center.
Altered level of consciousness: You’re looking for two possible extremes. In hyperactive delirium, patients are anxious, agitated, aggressive, picking at clothes or IVs. In hypoactive delirium, they’re lethargic, sleepy and not making eye contact.
Confusion and disorganized thinking: Can the patient track a conversation? “Ask simple questions, like, ‘Does one pound weigh more than two pounds?,’ or ‘Will a stone float on water?’” .
Another Hospital Hazard for the Elderly -

Friday, November 4, 2011

NY State Elder Abuse Study Finds Abuse

A recent New York Study on Elder Abuse found that:

■ The findings of the study point to a dramatic gap between the rate of elder abuse events reported by older New Yorkers and the number of cases referred to and served in the formal elder abuse service system.
■ Overall the study found an elder abuse incidence rate in New York State that was nearly 24 times
greater than the number of cases referred to social service, law enforcement or legal authorities who
have the capacity as well as the responsibility to assist older adult victims.
Psychological abuse was the most common form of mistreatment reported by agencies providing data on elder abuse victims in the Documented Case Study. This finding stands in contrast to the results of the Self-Reported Study in which financial exploitation was the most prevalent form of mistreatment reported by respondents as having taken place in the year preceding the survey
■ Applying the incidence rate estimated by the study to the general population of older New Yorkers,
 an estimated 260,000 older adults in the state had been victims of at least one form of elder abuse in
 the preceding year (a span of 12 months between 2008-2009).

The Elder Justice Act lacking Effectiveness

One Year after passage of the landmark Elder Justice Act, reforms and enforements have not been instituted due to lack of funding!

The Act would have addressed Elder care in Nursing Homes and promoted "coordinated planning among all levels of government; generating and sharing knowledge relevant to protecting elders; providing leadership to combat the abuse, neglect, and exploitation of the Nation’s elders; and providing resources to States and com munities to promote elder justice. The problem of elder abuse, neglect, and exploitation requires a comprehensive approach that integrates the work of health, legal, and social service agencies and organizations;"

Elder Justice Act - full text

The Elder Justice Coalition - Home Page

Elder Justice Act

The historic health care reform bill that President Obama signed into law includes the Elder Justice Act, the Nursing Home Transparency and Improvement Act, the Patient Safety and Abuse Prevention Act, the CLASS Act and provisions designed to improve the ability of people to get needed long-term care services at home.
It took three years to enact Nursing Home Transparency and Improvement, seven to pass the Elder Justice Act, and a dozen to create a national program of criminal background checks on long-term care workers. They all became law when President Obama signed the Patient Protection and Affordable Care Act.
Following are some important long-term care highlights of the new legislation:
Nursing Home Transparency and Improvement
- Establishment of a consumer rights information page on Nursing Home Compare, including services available from the long-term care ombudsman.
- A requirement for nursing homes to make surveys and complaint investigations for three years available on request and to post a notice that they are available.
- A requirement that states maintain a website with information on all nursing homes in the state, including survey reports complaint investigation reports, plans of correction, and other information that the state or CMS considers useful.
Elder Justice Act
See summary of Elder Justice Act from ABA. See full text of act here: Elder Justice Act
Patient Safety and Abuse Prevention Act
this legislation creates a national program of criminal background checks on employees of long-term care providers who have access to residents of facilities or people receiving care in their own homes.
Home and Community-Based Services

Obama Signs Elder Justice Act

Wednesday, November 2, 2011

Massachusetts Elder Abuse Lawyer Advises on Nursing Home Safety Culture Factors

Boston Massachusetts nursing home abuse attorney Bernard J. Hamill says a 2011 federal study of safety “culture” in nursing homes highlights the need to consider certain factors in choosing the right facility for a loved one.

Hamill, founder of the Massachusetts personal injury lawyers of Hamill Law Group, says the multiple factors were looked at in the study to evaluate the atmosphere regarding elder safety in nursing homes. The safety culture factors measured included:
perceptions of resident safety
communication about incidents
supervisor actions promoting resident safety
organizational learning
management support for resident safety
training & skills
compliance with safety procedures
communication openness between staff
nonpunitive response to error
adequate staffing

Two overriding factors in the study eclipsed all other variables: first, whether the nursing facility was a private for-profit corporation or whether it was governmental or non-profit; the second variable was the size of the nursing home. For-profits fared significantly worse in promoting a culture of safety. Larger nursing homes were worse than smaller facilities in promoting a safe culture for elder residents.
The report found nonprofit/government nursing homes:
had a higher average percent positive response than for profit nursing homes on all 12 patient safety culture composites.
had a higher percentage of respondents who indicated they would tell their friends that this is a safe nursing home for their family
had a higher percentage of respondents who gave their nursing home an overall rating on resident safety of “Excellent” or “Very Good”
The study on resident safety revealed that 3 times more residents of large nursing homes (over 200 beds) described the safety culture as “poor” as compared with smaller nursing homes (under 49 beds).

Massachusetts Elder Abuse Lawyer Advises on Nursing Home Safety Culture Factors

Tuesday, November 1, 2011

Michigan authorities deny "Disgusting" neglect occuring in MI nursing homes

An advocacy group says many patients in MI have experienced severe nursing home neglect and abuse.
The Michigan Protection and Advocacy Service says one of the worst cases involves a resident who had to have maggots suctioned out of her throat, after she was taken to an emergency room because she was having trouble breathing.
Another resident had maggots infesting her body near her catheter.
But state officials say these are isolated cases, and most nursing homes do a good job caring for residents.
Mike Pemble is with the Department of Licensing and Regulatory Affairs.
"Certainly these are two disgusting cases, and these kind of thing should not happen -- and I would not make excuses why they happened," says Pemble. "But I don't think it's fair to hold it up and say this is happening in all nursing homes."
Pemble says he does not think the state’s oversight of nursing homes needs major changes.
The advocacy group says the state needs to increase penalties against nursing homes where abuses occur.
State: "Disgusting" neglect cases not typical in MI nursing homes Michigan Radio

Thursday, October 27, 2011

Nursing Home Survey on Patient Safety Culture: 2011 User Comparative Database Report

Based on data from 226 nursing homes in the United States, the Nursing Home Survey on Patient Safety Culture: 2011 User Comparative Database Report provides initial results that nursing homes can use to compare their elder patient safety culture to other U.S. nursing homes. The report consists of a narrative description of the findings and four appendixes, presenting data by nursing home characteristics and respondent characteristics for the database nursing homes.

Patient Culture Survey Part 1 2011

Patient Culture Survey Part 2

Nursing Home Survey on Patient Safety Culture: 2011 User Comparative Database Report

Wednesday, October 26, 2011

Fayette jury awards more than $1 million in nursing home injury case | Voiceless & Vulnerable: Nursing Home Abuse

A Kentucky jury ruled Monday that Lexington's Cambridge Place Nursing Home should pay more than $1 million in damages to a resident who fell and was found severely injured in an equipment storage room.
Irene Hendrix was found in January 2009 after she went missing while moving up and down the hall in a Merry Walker, a type of walker that includes a seat. She had broken bones in her face, there was bleeding in her brain, and she had a 4-centimeter cut on her forehead, a cut on her lip and a swollen eye, according to state documents.
Hendrix, who was in her late 80s at the time and who had been diagnosed with Alzheimer's disease, had to be hospitalized. She has since moved to another nursing home.
In 2009, Hendrix's daughter and guardian Mary Gullette filed a lawsuit against N&R of Cambridge Place LLC, identified in state records as the owner of the nursing home, and Health Systems of Kentucky LLC, identified in state records as the management company for the nursing home. The lawsuit alleged negligence, which nursing home officials denied.
The jury deliberated about two hours Monday before awarding $1 million for Hendrix's physical pain, suffering and mental anguish and $27,473.48 for her medical costs.
"A jury spoke today regarding the level of care they expect for their loved ones in nursing homes in Fayette County," one of Gullette's attorneys, Scott Owens, said after the verdict was returned.
Fayette jury awards more than $1 million in nursing home injurx case Voiceless & Vulnerable: Nursing Home Abuse

Saturday, October 22, 2011

CDC Pressure Sore Data Briefs - NCHS Number 14 - February 2009

Data from the National Nursing Home Survey, 2004
In 2004, about 159,000 current U.S. nursing home residents (11%) had pressure ulcers. Stage 2 pressure ulcers were the most common.
Residents aged 64 years and under were more likely than older residents to have pressure ulcers.
Residents of nursing homes for a year or less were more likely to have pressure ulcers than those with longer stays.
One in five nursing home residents with a recent weight loss had pressure ulcers.
Thirty-five percent of nursing home residents with stage 2 or higher (more severe) pressure ulcers received special wound care services in 2004.
Pressure ulcers, also known as bed sores, pressure sores, or decubitus ulcers, are wounds caused by unrelieved pressure on the skin (1). They usually develop over bony prominences, such as the elbow, heel, hip, shoulder, back, and back of the head (1-3). Pressure ulcers are serious medical conditions and one of the important measures of the quality of clinical care in nursing homes (1,4). From about 2% to 28% of nursing home residents have pressure ulcers (2,3). The most common system for staging pressure ulcers classifies them based on the depth of soft tissue damage, ranging from the least severe (stage 1) to the most severe (stage 4). There is persistent redness of skin in stage 1; a loss of partial thickness of skin appearing as an abrasion, blister, or shallow crater in stage 2; a loss of full thickness of skin, presented as a deep crater in stage 3; and a loss of full thickness of skin exposing muscle or bone in stage 4. Clinical practice guidelines for pressure ulcers have been developed and provide specific treatment recommendations for stage 2 or higher pressure ulcers, including proper wound care (5). This Data Brief presents the most recent national estimates of pressure ulcer prevalence, resident characteristics associated with pressure ulcers, and the use of wound care services in U.S. nursing homes.
Products - Data Briefs - Number 14 - February 2009

94-Year-Old Beaten to Death in Nursing Home

Authorities say an 81-year-old man has been arrested on suspicion of murder for allegedly beating to death his 94-year-old roommate at an Orange County nursing home. According to police, William McDougall allegedly took a bar used to hang clothes from a closet, and used it to repeatedly strike his roommate, Manh Ban Nguyen, about the head.
94-Year-Old Beaten to Death in Nursing Home - By his 81-year-old roommate