Nursing Home Nightmare

"Kill me or let me die," were Alan's dying words, one month after the trauma of his forced eviction from a nursing home that didn't want him anymore. Those words still haunt my sister and I, knowing in our hearts the nursing home trauma killed him prematurely.
Alan (not his real name) was going to die anyway, terminally ill with Alzheimer's and Lewey Body dementias.
But dying in terror wasn't part of the plan. We never expected as prophetic, his WWII-generated fears as an orphan being "taken away by police."
We believe the living nightmare of his being"Baker-Acted" was the result of having to go on Medicaid.
Medicaid reimbursement to health care facilities is less than Medicare or private insurance. Nevertheless, we'd been assured a Medicaid-paid room would be available, as a current resident of the nursing home, once his Long Term Care insurance ran out.
We were wrong to believe them.
My sister and I shared a grim bond that Christmas day. Her husband Alan just died the day before. My husband died exactly ten years before, the day after.
We spent the day in stunned awareness of the painful irony.
This article isn't about us, however.
It's about advocacy.
My sister spent almost every day in the nursing home with Alan for two years. Caregivers relied upon her for help. I was there when she couldn't be. We did that and more. Still, this happened.
After the shock of Alan's death, anger set in.
The cruel acts perpetrated on him would not go unanswered. Many, fearing retribution if challenging caregivers, don't speak up and nothing changes.
Nursing Home Nightmare: Alan's Story Part II - Life in the Slow Lane

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Attorney Hamill files Wrongful Death Suit against Massachusetts Nursing Home

Hamill Law Office recently filed a civil wrongful death lawsuit in the Berkshire County, Massachusetts superior court on behalf of the Estate of John B. Satiro against Sweet Brook nursing home. Satiro was fatally injured by a fall at the Williamstown facility. Plaintiff Satiro was a resident of Sweet Brook transitional care and living center located at 1561 Cold Spring Road in Williamstown, Massachusetts. Sweet Brook Transitional Care and Living Center is owned by Des Senior Care Holdings, LLC, of Fort Lee, NJ.
According to the complaint (Berkshire county docket # 2012-1248) filed by attorney Hamill, Satiro was injured when staff members dropped him from a hoyer lift while attempting to transport him.
Elder Advocate Attorney files Wrongful Death Suit against Massachusetts Nursing Home

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Bridgewater nursing home sued by family of ill woman killed

The family of a Bound Brook woman killed trying to cross Route 22 in 2010 is suing the nursing care facility where she was living at the time.Anastasia Zavitsanos was a 74-year-old resident of Brandywine Assisted Living at Middlebrook Crossing when she “eloped” through a side door of the facility about 1:15 a.m. May 12, 2010, according to the lawsuit filed late last month in Superior Court in Somerville.
The lawsuit claims Zavitsanos, who was admitted to the facility in 2004, was known by the staff to suffer from schizophrenia, psychosis, short-term and long-term memory loss and to be “an elopement risk” who “wanders with exit-seeking behaviors.”
The lawsuit accuses the facility and its officers of negligence, deviation of standard care and gross neglect, improper management, resident rights violations and consumer fraud and seeks unspecified damages for Zavitsanos’ death.
Bridgewater nursing home sued by family of ill woman killed crossing Route 22 | MyCentralJersey.com | MyCentralJersey.com

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No procedure for flu detection at Nursing Home

A report into the nursing home where seven residents died following a flu outbreak has found there was no procedure for an early detection of influenza.
The Health Information and Quality Authority (HIQA) published a report into the Nazareth House nursing home, Fahan after nine elderly residents died between March 22 and April 8. Seven of the deaths have been classified as possibly caused by an influenza related illness.
Two inspections by HIQA found deficits in the standard of nursing home cleanliness and hygiene and the maintenance arrangements for equipment. A number of shower chairs and commodes were not in a satisfactorily clean condition and were rusty. The report was also critical of communication procedures at the home, which can accommodate 48 residents. It found that senior management was not communicated with in a timely manner and there was a lack of clarity and accountability about how information on the outbreak had been reported.
No procedure for early flu detection at Nazareth House - HIQA - Local - Donegal Democrat

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Holding VT. nursing home owners accountable

Glori Law and Susan Petrie's father was living in a nursing home just 10 days when they learned he was being attacked by another resident who was mentally unstable.

"My dad had bruises on his face when he was in the funeral home," Law said. They later discovered it wasn't a first time offense. "This person was quite violent and had been doing this. There were a lot of people that had been attacked," Petrie said. A medical examiner ruled the attacks were the cause of their father's death.

But on Tuesday there was change in the nursing home law. "Today is closure," Petrie said. "I felt very guilty because I was the one who made the decision for him to go into the nursing home."

Holding nursing home owners accountable - WCAX.COM Local Vermont News, Weather and Sports-

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Nursing Home Owner Cheats Government, Neglects Residents

Not enough food for nursing home residents. Little air conditioning or heat. Roofs leaking to the point that barrels and plastic sheets were used to catch rain water. Trash that piled up in dumpsters. Flies and rodents everywhere, along with rampant mold and mildew.
These were just some of the abusive conditions that elderly residents of three Georgia nursing homes lived under for several years.
The primary culprit: the owner of these nursing homes who, despite having received more than $32.9 million in payments from Medicare and Medicaid for residents’ care, elected to pocket much of the money instead.
FBI — Nursing Home Abuse: Owner Cheats Government, Neglects Residents

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Camera Catches Abuse in Nursing Home

A woman used a high-resolution video surveillance camera to record a nurse beating her mother in a nursing care home. She placed the camera in her mother's room after she noticed she had bruises on her arms and hands only six weeks after moving into the home.

The camera disguised as a table clock, caught Jonathan Aquino, 30, hitting the old woman six times on the face, arms and abdomen. Another footage showed the old woman, who had severe arthritis, being man-handled by caregivers. The Daily Mail reports Aquino was jailed for 18 months for assault, and four other staff at the care home were sacked after Jane Worroll showed the nursing home manager footage of nursing staff abusing her 81-year-old mother, Mary Worroll, at the care home.

Read more: http://www.digitaljournal.com/article/323488#ixzz1stYOhABP

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Nursing home residents with dementia improperly given antipsychotics

From April 29th Boston Globe: an article about excessive medication of our nursing home elders who should not be on anti-pyschotic med:
"Ledgewood Nursing home is one of many nursing homes that have commonly used antipsychotic drugs to control agitation and combative behavior in residents who should not be receiving the powerful sedatives. Nineteen percent of such Ledgewood residents - those without a diagnosis for which the drugs are recommended - received the medications, anyway, exposing them to the risk of dangerous side effects.
“There is a lot of guilt about putting your mom in a nursing home, and I felt I made a competent choice,’’ Weingartner said. “I wish that what I know now, I would have known then.’’
The situation she encountered at Ledgewood is alarmingly common in Massachusetts and across the nation, a Globe investigation has found. Federal data show that roughly 185,000 nursing home residents in the United States received antipsychotics in 2010 contrary to federal nursing home regulators’ recommendations - often elderly people like Murphy who have Alzheimer’s or other dementias.
The drugs, which are intended to treat severe mental illness such as schizophrenia, can leave people in a stupor. The US Food and Drug Administration has issued black-box warnings - the agency’s most serious medication alert - about potentially fatal side effects when antipsychotics are taken by patients with dementia.
Nursing home regulators have for years collected data about individual homes’ use of antipsychotics but have not publicly released facility-specific information, citing patient privacy concerns. The government finally provided the data to the Globe, 19 months after the newspaper submitted a Freedom of Information Act request.
The data show that in more than one in five nursing homes in the United States, antipsychotics are administered to a significant percentage of residents despite the fact that they do not have a psychosis or related condition that nursing home regulators say warrants their use. The proportion of homes using antipsychotic drugs in this fashion is even higher in Massachusetts


Nursing home residents with dementia often given antipsychotics despite health warnings - The Boston Globe

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Nursing home violence

Two years into the state's fight to close a troubled South Side nursing home, the facility remains open and even has successfully booted out two state-appointed monitors who were installed to ensure patient safety.
Police reports and state health department inspections allege a pattern of patient-on-patient violence at the Rainbow Beach Care Center, a 200-bed facility that houses and treats indigent adults with mental illness.
In the most serious episode in July, two male residents were accused of pinning down a 45-year-old female patient and raping her. When police arrived at Rainbow Beach to investigate that allegation, they learned that the two men had allegedly attempted to sexually assault a second seriously disabled female resident just weeks before.
The state, which had moved to revoke the facility's license in April 2010, placed monitors at Rainbow Beach in the wake of those attacks. But earlier this year, an attorney for the facility persuaded a Cook County judge to issue a temporary restraining order barring them from the premises.
State authorities say the push-back from Rainbow Beach underscores how vigorously some nursing home operators are using the courts to contest enforcement efforts, even as the industry presses for legislation that patient advocates say could water down nascent state reforms.
Nursing home violence: Troubled Chicago facility expelled two state monitors - chicagotribune.com

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Consumer Group Bashes SNF Industry for Inferior Care Despite “Astonishing” Profits

Nursing homes remained “highly profitable” despite Medicare reimbursement cuts, but they’re still providing inferior elder care, says citizen advocacy organization Families for Better Care—a claim that the American Health Care Association (AHCA) was quick to counter.
Despite “astonishing” recent nursing home earnings reports for publicly traded nursing homes, resident care remains “mediocre at best” with too many residents troubled by untreated pressure sores, falls, abuse, or other negligent medical practices, contends Brian Lee, executive director of Families for Better Care.
“The industry’s analysts framed the Medicare adjustment as an eventual doomsday for the nation’s nursing home market. But the industry’s own reports show quite the opposite, revealing surging revenues, strong profits, and expansion through acquisitions,” said Lee in a statement. “The industry is wallowing in strong profits while failing to consistently provide quality care.”
Even after the average 11.1% Medicare cuts to skilled nursing facility payments that went into effect last October, the industry remained a “thriving enterprise” with many companies reporting better than expected operating results, according to Lee. The resident advocacy organization cited one company’s annual revenues spiking nearly 200%, while another called 2011 an “exceptional year.”
“The reason care declines in nursing homes is that executives unnecessarily target labor costs to offset any reimbursement adjustments,” Lee said. “While this obviously maintains a robust bottom line for investors and cushy CEO salaries, the decline in frontline staff puts residents in jeopardy for harm while simultaneously creating dangerous working conditions for employees.”
A study released last November shows a steady decline in nursing hours for Medicare-licensed facilities and what Families for Better Care calls an unacceptably high level of deficiencies.
Consumer Group Bashes SNF Industry for Inferior Care Despite “Astonishing” Profits : Senior Housing News

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“If you didn’t chart it you didn’t do it.” Part 1 | Pat Iyer.com

Incomplete documentation can dramatically affect a malpractice case. In the ideal world all pertinent observations and interventions are recorded. But is “If you didn’t chart it you didn’t do it” true? For a variety of reasons, medical records may be incomplete. Emergency situations, such as cardiac arrests, often result in gaps in documentation as patient needs take priority. Ideally the nurse tries to record detailed notes after the emergency is over, but this does not always happen because the nurse must direct attention to the other patients who took a back seat to the crisis. Sketchy documentation complicates the defense of a case and provides the plaintiff’s attorney with an opportunity to advance theories of liability.
Plaintiff’s attorneys may use the phrase, “If you didn’t chart it, you didn’t do it” to convince the jury that essential care was not given. Defense attorneys sometimes attempt to preempt the anticipated attack on the nurse’s credibility or documentation. This is brought up on direct examination of the nurse during trial by having the nurse testify about the impossibility of recording every detail or observation of the patient. Another defense technique is to have the nurse testify about the nurse’s usual practice which may or may not be recorded in the medical record.
Missing documentation coupled with a poor outcome complicates the defense of cases no matter what strategy is employed, and it provides the plaintiff with an opportunity to successfully argue that care was not rendered. In the case below, the nurses could not prove they contacted the physician, if they did.
The plaintiff, age sixty-three, suffered a back injury and could not to return to work as a nurse. She decided to have an anterior approach lumbar fusion of the spine. This was to include surgery to the spine from the front of the body and then a day or two later, surgery from the back. For the anterior approach the plaintiff’s abdomen was opened and her internal organs were moved in order to get to the spine. After surgery the plaintiff had fluctuating blood pressure and no pulse in the left leg. The nurses noted the lack of pulse in the leg but did nothing about it.
The next morning, when Dr. Brown arrived to perform the second part of the surgery, he discovered her problems and had her rushed for a CT scan which showed internal bleeding in her abdomen and a blockage of the artery which supplies blood to the left leg. The plaintiff was transferred to another hospital by helicopter, but the surgeons there were unsuccessful in salvaging the leg and an above-knee amputation was performed. The plaintiff had been unaware of the problem with the leg overnight due to being heavily medicated. The plaintiff’s abdomen took four years to heal because the surgical incision wouldn’t fully close due to the swelling of her organs and the internal bleeding. The plaintiff also had infections and required repeated surgeries to repair the damage to her abdomen. The matter settled for $5.25 million. (1)
Good documentation is consistent, concise, chronological, continuing, and reasonably complete. (2)
“If you didn’t chart it you didn’t do it.” Part 1 | Pat Iyer.com

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Long-term care facilities seniors at higher risk for assaults

It's always a tough decision to put a loved one in a nursing home. For Sandra Croteau it was made even more difficult by the fact that her mother had recently died and her 58-year old developmentally disabled brother, Keith, had taken a turn for the worst.
"Him and my mom were very close and he just went downhill (after she died). He wouldn't eat, he wouldn't wash, his life skills were gone" she said.
After much thought, Sandra placed her brother in a long-term care facility in Sudbury, Ont. She found a room at Extendicare York, a home normally reserved for the frail and elderly, but she didn't have any other options.
"We didn't know what else to do" she said.
On January 24, 2007 Keith was brutally assaulted and killed by his roommate, Bryan Belliveau. Croteau discovered too late that her brother's roommate was a 55-year old man diagnosed with chronic schizophrenia, psychopathic personality disorder, who had a history of not complying with his medication. Years after the murder, Sandra Croteau also learned that Belliveau was on a suicide watch.
"He's on suicide watch and they were arguing and nobody comes? Who was watching him?" she said.
Sandra believes the long-term care system needs an overhaul so that this type of tragedy doesn't happen again: "The system failed my brother and also failed Bryan. He should not have been there either. " she said.
W5 asked Extendicare what changes have been made to make their homes safer since Croteau's murder. Rebecca Scott, Director, Communications and Government Relations at Extendicare Inc. responded by email.  "We are all deeply saddened by the tragic incident that occurred at Extendicare York in 2007," said Scott.
W5 asked Extendicare if they had increased staffing in their homes to prevent future tragedies. They wouldn't comment directly on staffing numbers but said they have taken steps to increase safety in the home.  "Since 2007, we have undertaken a number of initiatives to assist in preventing something like this from happening again," wrote Scott.
Common problem
Resident-to-resident abuse in long-term care is far more common than you might think. Through access to information, W5 obtained the number of resident-to-resident assaults in Ontario nursing homes. There were 1,788 incidents in 2010.
The statistics include everything from shoving and pushing to, choking, punching and even sexual assaults. With the help of a statistician, W5 analyzed the data and discovered that the rate of assault in long-term care is four times higher than in the population at large.

Pat Masters has first-hand knowledge of those statistics. Her father was assaulted by a fellow resident at The Perley and Rideau Veterans' Health Centre in Ottawa.
The person who attacked Pat's father wasn't a typical frail and elderly nursing home resident. Pat describes him as a man in his 70s who was diagnosed with aggressive dementia.
"He was a very physically fit individual. He had no weakness in how he walked. (He was) a very vigorous man," she said.
Experts argue that residents with aggressive behaviours should not be placed in care facilities alongside the frail elderly. However, with the closure of psychiatric hospitals and group homes, there really is nowhere else for these patients to go.
The CEO of the Perly and Rideau Veteran's Health Centre, Greg Fougere, acknowledges that resident-to-resident altercations can occur but, in an interview with W5, insisted that they are not a common event at his facility. However he does admit that nursing homes in general need more staff to deal with these new and challenging patients.   "We don't have enough staff to provide as much care as we would like to. And really our seniors deserve it," said Fougere.
In order to ensure her father's safety at the Veteran's Health Centre Pat is now paying an extra $63,000 a year for a personal support worker to take care of him. She's one of the lucky few that can afford it.
"I'm happy and able to do it. What about those people who aren't able to do it? What do they do?"
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