Articles Posted in Nursing Home Abuse and Neglect

April 21, 2008

Pressure Ulcers – Quick Discovery, Quick Cure

Studies show that almost 50% of California nursing homes do not meet federal standards in preventing pressure ulcers. The problems are so widespread that the treatment of these ulcers – also called bed sores – will no longer be covered by Medicare if the sore was acquired after admission into a nursing home.

Family members should be aware that a bed sore can develop in only a few hours if an area of the skin is subjected to enough pressure that cuts off blood flow to that area. The skin will initially appear red and will be painful, slowing appearing to have a purple color. This is the best time prevent the sore from advancing to something more serious.

Nursing home and assisted living residents are at high risk for developing pressure ulcers, and those residents that are bedridden, wheelchair bound, or those will limited mobility must be examined frequently for the development of bedsores. A small bedsore can quickly become a large sore if treatment is not promptly provided.

April 9, 2008

Southern California Nursing Home Citation Watch

by Randall Walton

This list contains the issuance of citations to Southern California nursing facilities by the California Department of Public Health over the last six months. All the citations listed are issued for reasons related to patient care. For verification of the citation, please contact the local department office or Walton Law Firm LLP.

<font size='2'Facility	Date	Citation
Los Angeles Nursing Homes
Ayer-Lar Health Care Center	09/21/07	Class B
Bellflower Convalescent	01/29/08	Class B
Brierwood Terrace Convalescent	12/28/07	Class B
Calif. Healthcare and Rehabilitation	11/14/07	Class B
Casitas Care Center	12/19/07	Class B
Chandler Convalescent	10/3/07	Class B
Country Villa Los Feliz	11/29/07	Class B
Country Villa Wilshire	01/4/08	Class A
North Walk Villa Convalescent	12/10/07	Class A

Orange County Nursing Homes
Coastal Community Hospital	10/11/07	Class A

San Bernardino Nursing Homes
Citrus Nursing Center	10/11/07	Class AA
Ontario Health Center	03/19/07	Class A
Sky Harbor Care Center	10/24/07	Class AA

San Diego Nursing Homes
La Mesa Healthcare Center	02/06/08	Class B
Lemon Grove Care and Rehabilitation	01/10/08	Class B
Life Care Center Escondido	01/24/08	Class B
Palomar Continuing Care	11/15/07	Class A
Palomar Heights Care Center	01/31/08	Class AA
Pleasant Care Convalescent	10/19/07	Class B
Villa Las Palmas Healthcare	12/14/07	Class B
Vista Knoll Specialized Care	12/4/07	Class B

Ventura Nursing Homes
Maywood Acres Healthcare	11/5/2007	Class A
Victoria Care Center	11/20/07	Class A

Class AA: The most serious violation, AA citations are issued when a resident death has occurred in such a way that it has been directly and officially attributed to the responsibility of the facility, and carry fines of $25,000 to $100,000.

Class A: Class A citations are issued when violations present imminent danger to patients or the substantial probability of death or serious harm, and carry fines from $2,000 to $20,000.

Class B: Class B citations carry fines from $100 to $1000 and are issued for violations which have a direct or immediate relationship to health, safety, or security, but do not qualify as A or AA citations.

April 8, 2008

Nursing Home Care Fails To Improve Despite Funding Increases

by Randall Walton

The quality of care provided by California nursing homes has declined by almost every measure since the implementation of a new Medi-Cal rate system that increased funding the nursing facilities according to a new study by the University of California, San Francisco (UCSF). Meanwhile, nursing home complaints and the issuance of deficiencies have grown dramatically since the rate hike.

Critics contend that the nursing home industry crafted the rate hike on the basis that it was necessary to improve care. And while staffing levels improved under the new law, nursing home staff turnovers increased. The study reveals that 144 nursing homes in California failed to meet state minimum staffing requirements (.pdf).

According to the California Advocates for Nursing Home Reform:

April 5, 2008

Brain Injury Risk Heightened by Falls

by Randall Walton

The signs and symptoms of a brain injury are not always as clear as you might think. Most patients who suffer a traumatic brain injury can walk, talk, and give the appearance of a normally functioning person. There are, however, symptoms that point to brain trauma.

The month of March is set aside to increase the awareness of traumatic brain injuries, which can be caused by a bump, blow, or jolt to the head. The Centers for Disease Control and Prevention reports that falls – particularly in people over age 75 – are the leading cause of brain injuries in the United States.

Those who care for the elderly should be aware of the symptoms of a brain injury. In a mild injury, a person might have a persistent headache, confused, or have blurred vision. Another symptoms is a lost of smell or taste. A more severe injury may cause vomiting, slurred speech or weakness in arms or legs.

April 4, 2008

Will Nursing Home Employee Union Lobby Against Patient Rights?

by Randall Walton

Those of us who sue nursing homes and assisted living facilities for elder abuse and neglect of residents know how hard it is to uncover the evidence needed to meet our burdens of proof (which are higher than the typical case). Whether it’s proving a systemic problem of understaffing, ignoring resident fall risks, or establishing false charting, the victims of abuse or neglect always face tremendous hurdles in proving they were neglected. In reality, it’s usually the family trying to prove the wrongdoing since the victim is frequently dead because of the abuse or neglect.

What we certainly don’t need is nursing home caregivers, through their union representatives, colluding with industry trade groups to lobby against the rights of nursing home residents all in the name of job security and wages. This disturbing article in the San Francisco Weekly suggests that for the Service Employees International Union this might be a goal.

According to the article, the two-million-member SEIU, the country’s largest union, would offer political support for nursing home industry goals of limiting patients’ or families’ right to sue for abuse and neglect in exchange for the right to organize nursing home employees in a number of California nursing facilities. This collaboration has led to a division within union ranks, and a growing dispute between SEIU’s California healthcare affiliate and the national union office.

April 2, 2008

Bedsore Prevention Takes Group Effort

by Randall Walton

When there is sustained pressure in an area of skin that cuts off circulation to that area, the skin will start to breakdown creating what is common called a bedsore or pressure ulcer. If you’ve never seen one, consider yourself lucky. Not properly cared for, these sores and develop into wounds so deep that muscle and bone can sometimes be exposed.

It has been reported that two million Americans experienced pressure ulcers every year, usually the result of a combination of poor nutrition, dehydration, and immobility. Recent studies, however, suggest that fighting bedsores requires a team approach, enlisting not just the bedside caregivers, but many other nursing home employees.

A study by the Journal of the American Geriatrics Society involving 52 nursing homes around the United States reported a reduction of almost 70% of serious bedsores acquired in the facilities after utilizing a team approach to the prevention and treatment of sores.

December 13, 2007

Many U.S. Nursing Homes Practice “Off-Label Use” of Antipsychotic Drugs

by Randall Walton

Medicaid spends more money on antipsychotic drugs than any other prescription drug. Physicians are prescribing these powerful drugs in record numbers to nursing home residents in order to control their behavior, not for the treatment of psychotic illness.

It is reported that nearly 30% of the total nursing home population is receiving medication in a practice that is known as “off label use” of prescription drugs. It’s no surprise to lawyers who practice this area that studies also reveal that nearly 21% of nursing facility residents being given these drugs do not have a psychosis diagnosis.

“You walk into facilities where you see residents slumped over in their wheelchairs, their heads are hanging, and they’re out of it, and that is unacceptable,” says Christie Teigland, director of informatics research for the New York Association of Homes and Services for the Aging, a not-for-profit industry group. Her research, which she believes reflects national trends, shows that about one-third of dementia patients in New York’s nursing homes are on antipsychotics; some facilities have rates as high as 60% to 70%. “These drugs are being given way too much to this frail elderly population,” Dr. Teigland says.

September 23, 2007

U.S. Nursing Homes: More Profits, Less Nursing Care

by Randall Walton

Nursing home owners have claimed for years that they are barely getting by, and the lawsuits against them for negligent care are going to drive them out of business, leaving no place to put seniors. We reject this argument as a time-honored trick by tortfeasors to become the victims after causing harm to others. A New York Times article substantiated that the nursing home business is plenty profitable.

According to the Times, private takeover of nursing homes leads to poorer care, and increases the likelihood of nursing home abuse or neglect. A survey of complaints against more than 16,000 U.S. nursing homes found that care often deteriorates significantly after homes are acquired by large private investment firms.

The Times compared the number of complaints received against 1,200 nursing homes acquired by these for-profit firms against those of 14,000 other nursing homes.

September 20, 2007

Pressure Ulcer “Stages” Updated

by Randall Walton

The National Pressure Advisory Panel updated its definition of the four “stages” used to diagnose pressure ulcers or decubitus ulcers (often referred to as bed sores). It also added two new stages on deep-tissue injury and ulcers that cannot be staged. The updated stages of pressure ulcers were released at the conclusion of its 2007 annual conference held in San Antonio, Texas.

A pressure ulcer or bed sore is a 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. In elderly or disabled patients, sores can begin on the skin of the tailbone, back, buttocks, heels, back of the head, or elbows. Poor nutrition or dehydration can weaken the skin and make it more vulnerable.

The new staging definitions are as follows:

September 19, 2007

Medicare To Stop Paying For Treatment Of Pressure Ulcers

by Randall Walton

The Centers for Medicare and Medicaid Services announced last month that, it will no longer reimburse hospitals for treating eight “reasonably preventable” conditions as of October 2008 the Wall Street Journal reports. Pressure ulcers are among the most prevalent, costly and dangerous on the list. In addition to interfering with recovery, lengthening hospital stays and causing extreme pain and discomfort, pressure ulcers can increase the risk of infection, with nearly 60,000 deaths annually from hospital-acquired pressure ulcers.

Nursing homes and long-term-care facilities have made strides of their own in prevention, motivated in part by the costs of lawsuits for failure to prevent bed sores. Prevention methods can include using ultrasound to identify skin breakdown before a pressure sore forms, special pressure reducing mattresses and ensuring that residents are turned at least every two hours.

Despite the availability of these, and other, prevention techniques, nursing homes have long failed to do much to prevent pressure ulcers as they had no real incentive to do so (other than the fear of lawsuits). Most commonly, nursing homes save money by not having enough staff on hand to ensure that residents receive the treatments required. They are then “rewarded” for this behavior by Medicare paying them extra money per patient to treat the decubitus ulcers. As of October of 2008, nursing homes will instead have to “pay” to treat pressure ulcers which they cause. Hopefully this disincentive will result in better care for all nursing home residents.

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