Articles Posted in Nursing Home Abuse and Neglect

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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.

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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:

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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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The federal Older Americans Act provides funding to states to fulfill the goals of the Act, namely the protection of the vulnerable elderly population. To receive federal funds, states must comply with a variety of statutory requirements, including the formation of an office of the State Long-Term Care Ombudsman.

Under federal law, the designated state ombudsman may designate a local ombudsman office to provide services to protect the health, safety, and welfare of long-term care residents. It is the job of the local ombudsman to “identify, investigate, and resolve complaints made by or on behalf of residents that relate to action, inaction, or decisions, that may adversely affect the health, safety, welfare, or rights of the residents.” (42 U.S.C. §3058g(a)(5)(B)(iii).)

Generally, any concerns about resident rights issues, physical abuse or neglect, transfer and discharge issues, or any other unexpected injury, illness, infection or death should be reported to your local ombudsman office. Reports of elder abuse or neglect are confidential, and will not be revealed in any legal actions that might arise from the complaints.

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The Nursing Home Complaint Investigation Improvement Act (AB 399), authored was approved last week in the Assembly Health Committee by a vote of 10-0. The legislation would fight abuse and neglect by improving the quality and timeliness of nursing home complaint investigations. AB 399 has over 30 registered supporters including the AARP, Congress of California Seniors, Gray Panthers, and Bet Tzedek Legal Services. There is no registered opposition.

According to the California Chronicle, AB 399 would require the Department of Health Services (DHS) to complete investigations within 40 working days; send complainants a written summary of findings about their complaint; investigate facility-reported complaints of abuse and neglect within the same time frames as public complaints; and extend the number of days a complainant has to seek an informal conference from five business days to 15 days after receipt of the determination.

“Today’s vote is an important step toward restoring public confidence in California’s nursing home oversight system,” said Michael Connors of California Advocates for Nursing Home Reform (CANHR). “Timely DHS investigations will help ensure that nursing home residents are protected from further neglect and abuse once it’s been reported.”

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The California Advocates for Nursing Home Reform (CANHR) in San Francisco has been fighting for the rights of long-term nursing home residents for more than 20 years. Through community education, legislation and litigation, it has been CANHR’s goal to remind decision makers of what needs to be done about long-term care; that this “forgotten population” consists of our mothers and fathers, our husbands and wives, our brothers and sisters, and that their suffering is our shame. CANHR has received numerous awards for its work.

Walton Law Firm is proud to support the work of CANHR, and is now participating in its 2007 Campaign for Justice, an effort to continue the great work of this valuable organization. If you are interested in providing your support to the cause, and helping to give a voice to the voiceless, please visit our contribution site and contribute. Any contribution you can make will be appreciated.

Thank you.

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A couple who operated a New Orleans area nursing home was acquitted of 35 negligent homicide charges and 24 counts of cruelty. Jurors believed the couple’s mistake of staying in the nursing home during Hurricane Katrina should not be singled out and defense attorneys argued it was the government that did not do their job.

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Providing nutritional support through feeding tubes to patients who are unable to eat enough orally to sustain themselves is an important component of supportive nursing care. Feeding tubes that enter the stomach through the abdominal wall, or percutaneous gastrostomy tubes (PEG tubes), can cause serious injury or death if misplaced or become dislodged. Nursing standards require that caregivers check the proper placement before using the tube for any purpose, whether it is for nutritional support, medication administration, or hydration. Failure to do so can expose the nurse and the nursing facility to legal liability.

Walton Law Firm currently represents two nursing home residents who were provided tube feedings after the tube was misplaced or became dislodged, causing tube feeding material to spill into the peritoneal space. Both patients became immediately septic, and one, a 73-year-old man, died.

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Peer abuse in nursing homes is becoming more prevalent as the number of residents suffering from dementia or Alzheimer’s disease increases. Nursing facilities that accept individuals with dementia or Alzheimer’s or any other psychological disorders have a duty to properly evaluate each resident and plan for the care of that resident in a manner that protects the resident, the staff, and all other residents of the facility. Failure to do so may expose the nursing home to legal liability. Walton Law Firm currently represents the family of a San Bernardino man who died shortly after being attacked in a nursing facility by a fellow resident.

Several recent news stories, including an article in Newsweek, highlight the growing problem of peer abuse in nursing homes. (Click link to see MSNBC’s article: Nursing-Home Residents at risk For Peer Abuse)

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An Alzheimer’s patient was strangled by her bedrail while residing at an assisted living facility. She slid off her bed, became trapped between the mattress and the bed rail, and died from positional asphyxia. Bed rails, often used to prevent injuries, can be deadly if not used properly and under the right circumstances. Currently there are many defective bedrails on the market whose dimensions do not meet the current FDA recommendations. Walton Law Firm represents the family of the 90-year-old woman who is pursuing a claim against the residential care facility for the improper use of bed rails, and against the manufacturer and distributor for producing and supplying defective bedrails.

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