Articles Posted in Nursing Home Negligence

Published on:

ThinkstockPhotos-531917486-SmallJune 15 is World Elder Abuse Awareness Day. Over the past year, almost 1 in 6 elderly people experienced some form of abuse, including psychological, financial, neglect, physical, and sexual, according to figures published by the World Health Organization. The organization collected data from 52 studies in 28 countries.

Psychological abuse is the most common form of elder abuse, according to the World Health Organization. Under this form of abuse, a caregiver will call an elderly person names and take other steps to embarrass them, degrade them, or prevent them from seeing friends and family members. Financial abuse involves mishandling an elderly person’s money or assets, such as when a nursing home fraudulently bills the patient for unnecessary medical treatment. Neglect entails failing to meet a resident’s basic needs in order for that person to live properly, including nutrition, cleanliness, and medical care.

Elder abuse is a hot-button issue worldwide, as the number of people aged 60 is expected to double by 2050. Organizations across the world are trying to increase awareness of elder abuse and highlight how prevalent it is, as one study estimated that only 1 in 14 cases of elder abuse actually get reported to authorities. Certain elderly people are embarrassed to report the abuse, while others think that nobody would believe them. For patients with cognitive disorders or dementia, they simply may not remember the abuse even taking place, which makes them physically unable to report it to somebody else.

Published on:

When we place our aging or sick loved ones in nursing homes, we trust that they are treated respectfully and carefully. Though we cannot always physically be there with them, we take extraordinary steps to ensure their safety and well being. However, abuse still occurs, and at shocking rates. What’s worse is that most cases of abused are never actually reported. One way to eliminate this problem is to place cameras in nursing home rooms to hopefully end elder abuse.

Recently, a camera strategically placed in a Massachusetts nursing home caught a violent case of elder abuse on tape. The footage shows a 93-year-old resident of Wingate Healthcare being tossed around her room. Two nursing home employees pulled the resident by her hair across her room and flung her into her wheelchair. The two staff members can also be seen threatening the resident with their fists. The victim weighed under 100 pounds and suffered from dementia.

As soon as the footage was revealed, Wingate fired the staff members. The two are both expecting to face charges of assault and battery on a person over the age of 60. According to reports, Wingate has been extremely cooperative with authorities and has conducted an independent investigation in the matter.

Published on:

A nursing home in Memphis, Tennessee, is losing patients and staff members as it is being cut off from Medicare and Medicaid reimbursement funding for patient services. The nursing home is Signature HealthCARE at St. Francis, which also has been fined over $1.2 million for failing to meet certain minimum standards. This nursing home received poor grades on multiple Medicare surveys, leading to an overall rating of two out of five stars.

Of the areas surveyed, the nursing home performed worst in health and fire safety inspections. In its most recent health inspection in September 2016, 15 health deficiencies were noted. This number was far above the average number of deficiencies for Tennessee facilities, 5.1. It is also more than two times the national average of 7.2.

Signature is a large nursing home chain. It is based in Louisville, Kentucky. Overall, Signature operates more than 120 nursing homes in the United States, including five in the Memphis area. According to reports, nursing home residents began to transfer to other facilities when news broke that Medicare and Medicaid would no longer be reimbursing the nursing home for services performed for the residents. As of March 2017, around half of the facility’s beds were not being used. This has prompted the nursing home to lay off staff members. The nursing home has said it will appeal the reimbursement decision.

Published on:

The transition to living in a nursing home can be overwhelming and stressful. A change from independent life to assisted living often makes our elderly loved ones angry, frustrated, and anxious. It is no surprise that before nursing homes were so heavily regulated, the use of sedatives as a means to calm rowdy patients was a widespread practice. Using sedatives to calm an elderly nursing home resident is referred to as “chemical restraint,” and it involves the use of potent antipsychotic and other psychoactive drugs to involuntarily sedate unruly patients.

Common types of sedatives are benzodiazepines and antipsychotics, which tend to produce a calming effect. Around 300,000 nursing home patients are receiving some kind of antipsychotic drug to combat the anxiety and aggression frequently found with dementia as a byproduct of Alzheimer’s disease. Drugs like Seroquel and Risperdal are effective in the fight against dementia and other psychotic disorders, but should only be used as a last resort. Additionally, Federal and state laws prohibit the use of chemical restraint for the convenience of nursing home staff. Chemical restraint may only be used if patients pose a threat to themselves or others. Federal and state regulations have done wonders to prevent doping of healthy patients, but cases of unwarranted chemical restraint are all too common.

For example, a lawsuit was recently filed in Chesapeake, Virginia, accusing nursing home staff members of practicing chemical restraint. 84-year-old nursing home patient Alice Mackey claims that she was tied down by two nurses and injected with a heavy sedative. Mackey claims that the restraint was purely to “silence” her. After she was sedated, Mackey was left bound to a wheelchair for the remainder of the night, where she ended up urinating on herself and was left to sit in her own filth.

Published on:

Elderly adults in the care of a nursing home or assisted living facility are vulnerable to many different forms of abuse. For example, a caregiver may physically abuse a patient, including kicking, punching, or assaulting them. Sexual assault or molestation is another form of physical abuse. Patients can also suffer physical injuries as a result of malnutrition or dehydration. Further, improperly administering medication could increase an elderly patient’s risk of falling and injuring themselves. Emotional and psychological abuse, along with financial exploitation, are also considered forms of elderly abuse in Tennessee.

Without being able to constantly supervise a loved one, it can be difficult to know if a nursing home resident is being treated appropriately. Further, many elderly adults suffer from a form of mental or physical handicap which makes it difficult for a family member or caregiver to know if abuse is taking place.

To protect our elderly population, Tennessee has enacted the Tennessee Adult Protection Act. Under the Act, all nursing home employees, including physicians, social workers, and nurses, are mandated to report any reasonably suspected instances of abuse. Any person who knowingly fails to report abuse will be charged with a misdemeanor. This strict requirement reflects Tennessee’s commitment to protecting the elderly. Often times, self-reporting is the only way abuse is detected and stopped.

Published on:

Nearly all nursing home residents depend on health insurance coverage to provide essential services including medical care, nutrition, and hygiene. Typical insurers that provide such coverage include Medicare, Medicaid, and Tricare, if the patient is a former member of the military. These entities can end up paying large sums of money to big nursing home companies providing services to residents. With third party entities picking up the tab for their insured’s health and well being, those doing the billing can be tempted to abuse the process, especially if their goal is to place profits over the needs of patients.

Placing profits over patients is precisely what Life Care Centers of America, Inc. (“Life Care”) was recently accused of doing by the United States Department of Justice. Life Care eventually agreed to pay a fine of $145 million, a record for the Department of Justice. Life Care, based in Cleveland, Tennessee, operates over 220 skilled nursing home facilities across 28 states. It is owned by Forrest Preston, who has a net worth of over $1 billion. As part of the Department of Justice settlement, Life Care also agreed to participate in a “corporate integrity agreement” for five years. This program is designed to make sure Life Care’s procedures and actions comply with federal standards.

The Department of Justice accused Life Care of violating the False Claims Act over a seven year period by intentionally submitting false claims to Medicare and Tricare for millions of dollars for patient rehabilitation services that were not reasonable, necessary, or skilled. The company was accused of giving unnecessary treatments that brought in the most money to the company, regardless of whether the patient actually needed the service provided. Patients were also allegedly kept in therapy regimens for long after they needed to be. Instead of releasing patients once recovery goals were met, therapists continued to treat the patients for as long as reasonably possible. Life Care was accused of creating corporate policies designed to maximize profits accordingly. Per the investigation, Life Care set targets for how much to bill certain patients, provided bonuses for employees who met those goals, and discarded medical recommendations made by therapists regarding the necessity of care being given.

Published on:

The Tennessee legislature enacted a statute that transforms a lawsuit alleging that a “health care provider or providers have caused an injury related to the provision of, or failure to provide, health care services to a person, regardless of the theory of liability on which the action is based” is to be considered a healthcare liability action only.  No longer can these cases be referred to as medical malpractice cases under Tennessee law. The statute directs us to call these a “healthcare liability action,” no matter what is the actual theory of the case.

Forcing all causes of action that occur in a healthcare setting into “healthcare liability actions” matters quite a bit because it can transform the conduct of businessmen into “healthcare professionals.”   Thus, the standard of proof for a Plaintiff to prove that a “healthcare professional” acted with neglect requires expert proof.  Thus, a businessman making a decision to maximize profits by understaffing a nursing home must be called a “healthcare professional” because of this Tennessee law.

An example of how Tennessee law would work can be found in a New Mexico lawsuit where allegations of systemic understaffing in nursing homes by Preferred Care Partners Management Group have been alleged.  Understaffing is a serious problem in nursing home and long term care settings because any individual caregiver can only care for a certain amount of people before their work product declines and starts to suffer.  Thus, it is extremely important that nursing homes employ an adequate number of caregivers so a certain minimum amount of care is received by each patient.

Published on:

Brookhaven Manor is the latest Tennessee nursing home to be investigated for abusing, neglecting and mistreating their patients. Brookhaven Manor, located in Kingsport, Tennessee, is the subject of two investigations, one by the Tennessee Department of Health and another by the Sullivan County (Tennessee) District Attorney’s Office. In November 2016, the Tennessee Department of Health began investigating the nursing home after receiving many troubling complaints. The investigation explored the facility’s administration, doctors, infection control, nursing services, and resident rights. The investigation culminated in a detailed 77 page written report that specifically described the widespread abuse and neglect that took place at the facility.

For example, the department found many instances of doctors providing inadequate treatment plans for the patients’ needs, such as bedsores and other wounds. Failing to timely identify and treat a bedsore could allow that sore to progress into a more significant wound that requires more extensive and invasive treatment. Nurses also did not do a good job of identifying and cleaning wounds, causing residents to contract infections. Investigators even found that nurses would not wear appropriate clothing in rooms where patients had been isolated.

Certain patients were found sitting in their urine and feces, as staff let them sit there unchanged for hours at a time. For patients who required dialysis, the nursing home did not properly classify those patients as needing such services. According to the allegations, certain nurses were not monitoring patients’ weight, which prevented patients from receiving proper diets. One patient in particular gained over 75 pounds in just one month. A significant spike in weight could trigger issues with other conditions a patient has, such as high blood pressure or diabetes. On the other end of the spectrum, a sharp decline in a patient’s weight could cause problems with malnutrition.

Published on:

The issue of sexual assault of elders in nursing homes is a serious one. The phrase promulgated on many college campuses to bring awareness to rape and other unwanted sexual encounters, “No Means No,” also applies in nursing homes. That is, elderly patients who do not maintain good cognitive condition may become victims of unwanted sexual advances and assaults. For example, elders who are Alzheimer’s patients or have dementia cannot effectively consent to sex because of their cognitive impairments resulting from those conditions. Moreover, sexual offenders and predators are usually attracted to individuals who are vulnerable. Certainly, elderly residents of nursing homes are vulnerable to sexual manipulation, coercion and assault.  When considering a nursing home or observing one in which a loved one is staying, consideration should be given to the security procedures of the facility. Are outsiders allowed to come and go, or must they check in? How often do aides and others check on individual residents, in order to assure that unwanted individual are not in their rooms? A check of local crime reports may also reveal sexual assaults or rapes near or in the facility.

Unfortunately, many nursing home sexual assaults are committed by third party criminals with no ties to the nursing home itself. For example, a man was arrested in September for walking into a Kentucky nursing home near Knoxville, Tennessee, and sexually assaulting a resident who had dementia. According to the police, he walked into the nursing home, entered the patient’s room, exposed his genitals, and let the patient hold them. A nurse entered the room, caught him in the act, and called the police. Officers charged the man with intoxication of alcohol, indecent exposure and sexual abuse.

Further, some nursing home residents are victims of sexual abuse by nursing home employees. A nursing home may negligently fail to conduct criminal history background checks on employees, or it may recklessly ignore an applicant’s prior history of sexual offenses. In such situations, the nursing home itself places vulnerable elderly residents in direct danger of sexual abuse. When considering a nursing home, ask administrators about their application hiring processes. Ask if they conduct criminal background checks on potential employees. Ask point-blank about whether any of their staff have prior charges or convictions for sexual offenses. Learn about the people who will be taking care of your loved one.

Published on:

hospital bedA common warning sign of nursing home abuse in Tennessee and elsewhere is bedsores, which are also known as pressure ulcers. They arise because somebody stays in the same position in a bed or chair for far too long. The accumulated pressure on one spot of the body causes a sore to develop.

Elderly nursing home residents often can’t move as much as they would like or at all, and pressure sores can be a sign that they have been left too long in the same position without being moved. Bedsores are worsened by malnutrition or dehydration. The lack of nutrients causes the immune system to get overtaxed, resulting sometimes in an infection.

There are numerous Tennessee laws designed to make sure that nursing homes provide a uniform minimum standard of care. The laws are supposed to make sure that residents’ needs met and are kept in good health. These laws require, among other things, that facilities provide food and water to residents and provide at least two showers every week and more upon request.

Continue reading