Nursing home whistleblowers fired

More than a month ago two nurse assistants at Bandera Road's Princeton Place nursing home started noticing problems. Sandra Lujan, a four-year veteran of the facility, claimed she saw elderly patients with abnormal and excessive bruising, including bruises in the shapes of fingers and torn skin on faces. Sonia Roman, a nurse assistant at Princeton Place for two years, also saw similar bruising. She also questioned whether there was enough staff to care for all 134 patients, saying many were routinely left unattended. She even confronted one nurse she saw verbally abusing and threatening an elderly patient.Last month both brought reports of abuse and neglect to the nursing home's administration. Within hours both were suspended for insubordination and eventually fired.
Firing employees who come forward with abuse or neglect allegations is not new. It is a pattern I have seen in Nursing Home litigation. Although the term "whistleblower" may not apply to all employees who complain about adequacy of care, the reaction by some nursing homes is the same. In litigation against a Kindred facility involving complaints of abuse by a CNA (certified nurse aide), the complaining persons eventually left because they felt ostracized by their co workers after reporting deficiencies. Some feel threatened. Nursing homes sometimes in-service the reporting individuyal rather than the alleged offender! This is a clear sign of a culture that does not put the care of residents first.

The QueQue: Nursing home whistleblowers fired, Lamar Smith's 'Holiday on ICE', TCEQ tracking emissions in the Eagle Ford - News and Politics - San Antonio Current

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Things Hospitalists Should Know about Infectious Diseases

Never swab a decubitus ulcer unless that ulcer is clearly infected.

Dr. Allen says it’s important to know that it doesn’t make sense to culture a pressure ulcer that doesn’t have any signs of infection, such as pus or redness—although he sees it happen routinely.
“Just because a patient has a bedsore doesn’t mean it’s infected,” Dr. Allen says. “Usually, they’re not infected. But they’re going to have a dozen different germs growing in them.”
Culturing and treatment without signs of infection, he says, often leads to “inappropriate antibiotic use and probably increased length of stay."10 Things Hospitalists Should Know about Infectious Diseases :: Article - The Hospitalist

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Victim critical in nursing home assault

A 42-year-old man has been charged with aggravated malicious wounding after police say he attacked an elderly resident at a nursing home Thursday evening.
Debbie George with the City of Suffolk said William K. Ruffin, a resident at Oakwood Assisted Living Facility on East Washington Street, attacked a 92-year-old woman sometime before 6:30 p.m. She sustained severe facial injuries and was transported to Sentara Norfolk General Hospital by Nightingale.
 Friday morning, George said the victim was in critical condition at the hospital.
 Police arrested Ruffin and have charged him with aggravated malicious wounding of a nursing home resident. He is being held at Western Tidewater Regional Jail without bond at this time.
Victim critical in nursing home assault | WAVY.com | Suffolk

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Wrongful death claim cannot be arbitrated

I waas quoted in this weeks Lawyers Weekly article on Arbitrations in the nursing home context. In an article by Eric T. Berkman, an attorney and freelance writer for Massachusetts Lawyers Weekly, Publishdd Wed, April 25, 2012

A mandatory arbitration agreement that a man signed on his mother’s behalf when she was admitted to a nursing home did not bar his wrongful death suit against the facility, a Superior Court judge has ruled. Judge Troy's ruling essentially voided an arbitration agreement that had been signed by a health care proxy. The judge found that a health care proxy exceeded his permissable authority by signing away the residents right to a jury trial.
The defendant nursing home had argued that the plaintiff was authorized to sign the arbitration agreement under a health care proxy executed by his mother before she was transferred to the facility and thus the agreement was enforceable.

“Under [Chapter 201D, the Massachusetts Health Care Proxy Act], an agent has authority to make ‘any and all health care decisions on the principal’s behalf that the principal could make,’” Troy said in denying the defendant’s motion to compel arbitration. “However, in the view of this court, a waiver of the principal’s legal right to seek redress in court for improper medical treatment does not fall within the statutory definition of a health care decision.”

The 17-page decision is Licata v. GGNSC Malden Dexter LLC, Lawyers Weekly No. 12-066-12. The full text of the ruling can be ordered by clicking here.

Bernard Hamill, an attorney in Quincy who represents plaintiffs in nursing home negligence and abuse cases, welcomed Troy’s ruling.
“Think of it in terms of common sense,” said Hamill, who was not involved in the case. “A health care proxy could never bring a lawsuit [on behalf of a nursing home resident], so why on earth would one be deemed valid enough to waive the ability to bring a lawsuit? That would make no sense.”
Hamill was also gratified that the judge seemed to recognize the reality facing people in the plaintiff’s situation.
“You have a nervous family member sitting down in an admissions office with a huge stack of documents, trying to get their loved one admitted for their own safety. And frequently it’s the only nursing home to accept the candidate,” he said. “Someone in that situation is not going to be reading every document, questioning them and refusing to sign things.”
If nursing homes do not want arbitration agreements challenged, they should not make them part of the admissions process, Hamill added.
“Why not make it truly separate and send it out several days later when the [person acting on the patient’s behalf] isn’t in an emotional state, trying to get their loved one admitted?” he said.

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South Florida Abuse

Southwest Florida can be a retiree’s paradise — but that also makes it an ideal place to prey on the elderly.
At a public forum Tuesday, the Lee Elder Abuse Prevention Partnership shared stories of elder abuse and discussed ways to prevent it.
“Our own parents and grandparents are being taken advantage of,” said co-chairwoman Dotty St. Amand. Part of the problem is Florida does not require private home caregivers to be licensed, according to John Morano, CEO of JT Private Duty Home Care. The state oversees companies such as Morano’s, which require their employees go through background checks. Independent caregivers can be licensed as Certified Nursing Assistants by the Florida Department of Health. But it’s not required.
http://www.news-press.com/article/20120425/CRIME/304250020/Advocates-try-find-ways-prevent-elder-abuse?odyssey=tab

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Social media policy considerations for long term care providers

A single photo of a resident’s decubitus ulcer on Facebook and/or YouTube is perhaps one of a long term care facility’s worst nightmares.Social media policy considerations for long term care providers – a sword or a shield? - Lexology

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Verdict against Rosewood Care Center upheld

The Fifth District Appellate Court has upheld a Madison County plaintiff's verdict in a case that was tried twice against Rosewood Care Center nursing home of Edwardsville.
Jurors awarded $149,115.13 to Paul Graves, administrator of his father's estate in April 2009. Paul Graves contended that Rosewood was negligent in caring for his father, Alfred Graves, during a January 2003 stay at the facility. On the first day of his stay, Alfred Graves fell and broke his hip. Paul Graves claimed that the nursing home violated its own procedures and did not give his father adequate care.
On appeal, Rosewood raised five issues: (1) whether the verdict was against the manifest weight of the evidence, (2) whether the court erred in its issuance of an instruction on the definition of neglect, (3) whether the trial court erred in its issuance of instructions on regulations promulgated pursuant to the Act, (4) whether the trial court abused its discretion by giving an instruction based on IPI 5.01 (Illinois Pattern Jury Instructions, Civil, No. 5.01 (2000)), and (5) whether the trial court erred by admitting into evidence a bill from another nursing home.
Verdict against Rosewood Care Center upheld at Fifth District | Madison/St. Clair Record

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Suit alleges woman's hip fractured at Baptist Hospital

A woman has filed suit against Memorial Hermann Baptist Beaumont Hospital, alleging she sustained a hip fracture while staying in the intensive care unit.
Sheila Antoine claims an ambulance transported her to Baptist Hospital on Feb. 10, 2010, after she began complaining of severe shortness of breath, cough and fever.
Medical personnel decided to take an X-ray of Antoine's chest. While the hospital staff was positioning Antoine on the table, she began to feel discomfort in her legs, according to the complaint filed March 15 in Jefferson County District Court.
Antoine's pain continued for the next few days and was so severe that she could not rotate her hip, the suit states. When medical staff was eventually able to take an X-ray of Antoine's left leg and hip on Feb. 17, 2010, they discovered that she had suffered from a fractured left hip, the complaint says.
"No indication is made in the plaintiff's records of how or when she sustained this fracture from the time she arrived at the facility and through her admission," the suit states.
In addition to the fracture, Antoine claims she suffered from decubitus ulcers while hospitalized.
Suit alleges woman's hip fractured at Baptist Hospital | Southeast Texas Record

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Senior Living: How to watch for and avoid pressure sores

Pressure sores are easier to prevent than to treat. Pay attention to senshtive areas of the skin. Reposition to remove pressure. Keep skin clean and moisturized. Note that too much moisture however, can contribute to bed sores. Skin areas can be kept dry with body powder. Good nutrition and adequate hydration are key to skin integrity
Senior Living: How to watch for and avoid pressure sores » Redding Record Searchlight

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nursing home worker accused of taking nude picture of resident

A case of elder abuse is surfacing in southwest Iowa. An Atlantic woman is accused of taking a picture of a nude nursing home resident earlier this month. Thirty-five-year-old Amanda Sedina, who works at the Salem Lutheran Nursing Home in Elk Horn, faces a serious misdemeanor charge of invasion of privacy-nudity.
Shelby County Chief Deputy Sheriff Rod McMurphy says Sedina allegedly took an inappropriate picture of the bathing 78-year-old female resident. McMurphy says another employee of the nursing home received a text message from Sedina with a picture of the woman attached to it.
The employee notified Salem administrators, who called the sheriff’s office. McMurphy could not comment on Sedina’s motive for allegedly taking the picture. He says the case is extremely unusual for Shelby County.
Elk Horn nursing home worker accused of taking nude picture of resident

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Nursing Home Layoffs Can affect Care

Boston Massachusetts nursing home abuse attorney Bernard J. Hamill says families need know that there is a correlation between staffing levels and the adequacy of elder care in nursing homes. It is common sense and it is backed by state and federal regulations. The challenge is in interpreting data provided by nursing homes to the government regarding staffing adequacy to insure nursing home residents receive the high quality of care mandated by federal and state regulations. Federal regulations state that staffing must be sufficient to provide the “highest” level of care. 42 CFR Sec.483.30 states: “The facility must have sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident, as
determined by resident assessments and individual plans of care.”
Each nursing home reports its staffing hours to its state survey agency. These staffing hours are from a two-week period just before the state inspection. The Centers for Medicare and Medicaid Services (CMS) gets nursing home staffing data from the states. Staffing hours per resident per day is the average amount of hours worked divided by the total number of residents. It doesn't necessarily show the number of nursing staff present at any given time, or reflect the amount of care given to any one resident. Attorney Hamill notes an important warning about staffing levels given by Medicare: “These staffing numbers are based on information reported by the nursing home. Currently there is no system to fully verify the accuracy of the staffing data that nursing homes report. Because of this limitation and because staffing levels may have changes since the last inspection, you should be cautious when interpreting the data.”
Attorney Hamill says that to determine staffing sufficiency, you should always look at the state inspection results, particularly any quality of life or quality of care deficiencies. The best way to interpret the staffing levels is use a results driven analysis. Go see for yourself what the quality of care is. No matter what the staffing statistics say, if a loved one is sitting in unclean clothing or poorly hydrated or neglected, then the care is inadequate. If the care is inadequate, then according to federal definitions the cause could easily be understaffing of sufficient well trained aides.
New Study Shows Nursing Homes Increasing Layoffs

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Mandatory Binding Arbitration Article From CJ&D

According to the Center for Justice in Democracy Factsheet on Arbitration, "Mandatory binding arbitration is a process by which parties “agree” (although consumers rarely know they have “agreed”) to have a third party arbitrator (single arbitrator or a panel), instead of a jury or judge, resolve a dispute. Arbitrators are not required to have any legal training and they need not follow the law. Court rules of evidence and procedure, which tend to neutralize imbalances between the parties in court, do not apply. There is limited discovery, making it is much more difficult for individuals to have access to important documents that may help their claim. Arbitration proceedings are secretive. There is no right to public access. Arbitrators do not write or publish detailed written opinions, so no legal precedent or rules for future conduct can be established. Their decisions are still enforceable with the full weight of the law even though they may be legally incorrect. This is especially disturbing since these decisions are binding so victims have virtually no right to appeal an arbitrator’s ruling."
Fact Sheet: Mandatory Binding Arbitration -- A Corporate End Run Around the Civil Justice System centerjd.org

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Drug Deaths Rising in Nursing Homes

In a nursing home on the southern end of California's Central Valley, three elderly dementia patients died during 2007. Normally, that would not make the headlines. But these patients died after being given powerful antipsychotic drugs to control elders behavior--despite warnings the drugs increase the risk of death in elders with dementia.
Mae Brinkley, 91, Joseph Shepter, 76, and Alexander Zaiko, 85, died at the Kern Valley Hospital, a 74-bed skilled nursing facility in rural Lake Isabella, about 30 miles northeast of Bakersfield. Their cases came to light after a long-term care ombudsman reported to the state Department of Public Health that a patient had been held down and forcibly injected with an antipsychotic medication.
Investigators later found the nursing facility had given 22 patients, some with Alzheimer's disease--the most common form of dementia--high doses of antipsychotic medications to control them for the convenience of staff, according to court papers and the Center for Medicare Advocacy.
Now facing criminal charges are Hoshan Pormir, MD, the patients’ physician, Gwen Hughes, director of nursing, and Debbi C. Hayes, a pharmacist. The charges include three counts of elder abuse resulting in death, five counts of nonfatal elder abuse and two counts of assault with deadly weapons--the psychotropic medications Zyprexa and Risperdal, according to the state's criminal complaint.

Abuse of Mind-Altering Drugs Rising in Eldercare Facilities - New America Media

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Nurse at Southern Cross home did not call doctor and Joyce Wordingham died, court hears

SYSTEMATIC failures at a Tyneside nursing home saw a pensioner in desperate need of medical attention left to die. Dementia sufferer Joyce Wordingham had become so ill it should have been obvious to staff at her nursing home that she needed to see a doctor. However, Daphne Joseph was the only nurse looking after 29 residents at St Michael’s View, in South Shields, and she had not been trained properly amid a “culture of neglect”. So, instead of calling an ambulance, Joseph simply sponged Mrs Wordingham and made a note she looked frail and ill. The next morning, just two weeks after moving into the home, she was found dead in her bed after Joseph handed over to the day shift. Joseph pleaded guilty to neglecting a person who lacked mental capacity but a judge suspended her prison sentence after being told of the conditions she was working in at the Southern Cross-owned home. Mr Justice Coulson, at Newcastle Crown Court, said: “Your neglect was part of an endemic culture of neglect. You had not been trained properly and that failure, which was not your responsibility, was directly relevant to the tragedy that happened.” The judge said the failings included management and leadership
http://www.chroniclelive.co.uk/north-east-news/evening-chronicle-news/2012/03/03/nurse-at-southern-cross-home-did-not-call-doctor-and-joyce-wordingham-died-court-hears-72703-30452504/#.T1Ifo3ZoGqY.blogger

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Pennsylvania's nursing homes are in crisis

Pennsylvania's nursing homes can no longer sustain themselves with the latest cuts to Medicaid, according to a health advocate for the elderly. Families who are likely to pick up the slack also are seeing their support threatened.

"Two-thirds of Pennsylvania's nursing home residents are on Medicaid, and for each one of them, a nursing home loses an average of $19.23 a day," said Dr. Stuart H. Shapiro, president and CEO of the Pennsylvania Health Care Association. "These shortfalls are unsustainable."
The proposed $102 million statewide cut in Medicaid funding would be felt at local nursing homes. The PHCA estimates the cuts will amount to more than $700,000 for nursing homes in Franklin County, $2 million in Cumberland, $800,000 in Adams, $100,000 in Fulton and $2.8 million in York.
Few nursing home administrators want to talk about it.
They have little room to cut expenditures, according to PHCA:
-- Staffing a nursing home around the clock makes up 70 percent of nursing home expenditures. At the same time, nursing homes are highly regulated and must meet minimum staffing requirements.
-- Nursing homes, whether nonprofit or for-profit, operate on the lowest margins of all health care sectors - less than 1 percent versus 5 percent for hospitals and home-health and managed-care companies.
"All health care providers lose money caring for those on Medicaid, but nursing homes suffer the most because they serve a much higher percentage of individuals on Medicaid," Shapiro said.
Nursing homes already have cut staff, reduced benefits, canceled renovations and delayed purchases, he said. Many are turning away people on Medicaid because the homes cannot afford to care for them.
Families will feel the emotional, physical and financial stress.

Pennsylvania's nursing homes are in crisis - Chambersburg Public Opinion

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nursing home blamed for resident’s death

A Cy-Fair nursing home is being sued over claims its nursing home neglect caused the death of one of its residents.
Susan Evangelista, individually and on behalf of the deceased Joanne Gilmore, filed a wrongful death lawsuit on March 2 in Harris County District Court against Grace Care Center of Cypress.
Evangelista says on May 10, 2011, Joanne, a Grace Care Center resident, died as a result of continued and ongoing neglect. Grace Care subjected Gilmore to serious physical and mental injuries, according to the brief.Cy-Fair nursing home blamed for resident’s death Ultimate Cy-Fair:

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Nursing home failed to protect patient from resident with ‘violent criminal record’ — Oak Park & River Forest news, photos and events — TribLocal.com

The family of an Alzheimer’s patient who died after a physical altercation with another patient at Oak Park Healthcare is suing the west suburban nursing home for wrongful death, according to a press release issued Thursday by the family’s lawyers.
The lawsuit, filed Wednesday alleges the facility violated federal and state nursing home regulations in failing to protect patient from physical abuse and failing to provide appropriate supervision, according to the press release.
Anibal Calderon, an 80-year-old resident of the Oak Park Healthcare Center, “was assaulted by a 66-year-old resident with a violent criminal record and felony background,” according to the press release.
Calderon died Feb. 14 after head injuries suffered during the fight at the nursing home two days earlier.
A receptionist at Oak Park Healthcare who declined to give her name said the facility had no comment Thursday.
His death was ruled a homicide, according to the Cook County Medical Examiner’s office.
Police have not charged anyone with a crime and have not released the name of the suspect. Oak Park police also have not released any information on the suspect’s record.
The lawsuit also alleges Oak Park Healthcare failed to promptly report and investigate all suspected physical assault and abuse at the facility, according to the release
Lawsuit: Nursing home failed to protect patient from resident with ‘violent criminal record’ — Oak Park & River Forest news, photos and events — TribLocal.com

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Oak Park nursing home Sued after 80-year-old fatally beaten

The family of an elderly nursing home resident who was beaten to death by a fellow resident of Oak Park nursing home last month has filed a lawsuit claiming the nursing facility failed to protect the 80-year-old from abuse and neglect.

The wrongful death lawsuit against Oak Park Healthcare Center, 625 N. Harlem Ave., was filed in Cook County on behalf of the family of Anibal Calderon.
On Feb. 12, Calderon, who suffered from dementia, was assaulted by a 66-year-old resident with a violent criminal background, the suit claims. A nurse found Calderon unconscious in the Alzheimer’s/dementia ward, Oak Park police said.
Paramedics took Calderon from the extended care facility to Rush Oak Park Hospital, police said. He was later transferred to Rush University Medical Center, where he died two days later.
Family sues Oak Park nursing home after 80-year-old fatally beaten - Chicago Sun-Times

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