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An Oklahoma woman has been charged with 17 different counts of elder abuse. Robyn McKinney owns and operates Branding Brook, an assisted care living facility in Vinita, Oklahoma. The facility specializes in caring for patients with extreme limitations or disabilities. Due to the extreme nature of many of the patients’ disabilities, they are unable to communicate or move effectively, essentially rendering them helpless and completely reliant on McKinney and her staff to take care of them.

This makes it all the more unsettling to hear reports that McKinney had been abusing these residents for years. McKinney, who was responsible for keeping track of residents’ finances and medications, had been psychologically and physically abusing residents by withholding their money and verbally attacking them, according to complaints made by residents. Reports further claim that McKinney had even put a padlock on the facility’s refrigerator. This knowledge comes at the heels of a 911 call placed by someone who reportedly witnessed McKinney attack and bite a resident on the nose.

One of the only ways to stop nursing home abuse from happening is to report it. Reporting can come from a resident, a resident’s family member, or an employee who witnessed the abuse or neglect of a patient. Reporting nursing home negligence is critical because it only becomes more of a problem the longer it is allowed to continue. Unfortunately, facilities that neglect patients continue to operate daily. Elder abuse is all too prevalent, and often under reported. A study found that 30% of nursing homes in the United States were cited for almost 9,000 instances of abuse over a two year period. This same study also found that the percentage of nursing homes cited for abuse has increased every year since 1996.

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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.

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The dreaded phone call comes, and you just cannot believe that it could be true. The call comes from a loved one who resides at a nursing home. The loved one tells you she has been sexually assaulted by one of the nurses or caregivers at the facility. The disturbing trend of nursing home employees sexually assaulting patients is becoming more and more widespread. Even harder to believe is that some nursing homes go to great lengths to cover up sexual abuse or quickly dismiss these allegations instead of conducting a meaningful investigation to find the truth.

It is well known why people are placed in nursing homes in the first place. For starters, they are unable to live independently and adequately care for themselves. Loved ones may not be able to provide them with the necessary care either. Oftentimes, nursing home residents are elderly, sick, and disabled. They have medical conditions preventing them from driving and functioning independently, including Alzheimer’s and dementia. Others have medical conditions requiring them to be monitored 24/7.  Some patients are wheelchair-bound which completely limits their mobility.

Sexual abuse is one form of nursing home abuse. When sexual predators are allowed to work in nursing homes, they are given an opportunity to prey on residents in their most weakened states. For example, a male nursing aid in Minnesota was sentenced to eight years in jail for raping an 83-year-old nursing home patient who had dementia. He was caught molesting the woman in her bed at Walker Methodist Health Center. The eight year sentence was one year more than what prosecutors were seeking. In defense of the sentence, the judge noted how the nursing aide “violated a position of trust” when he abused the patient.

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A recent study shows that delirium can be linked to mortality rates in nursing homes. The report, authored by Dr. Martin M. Forsberg of the Rowan University School of Osteopathic Medicine, found that roughly 18% of the nursing home population suffers from delirium. Delirium is a serious disturbance in mental abilities that results in confusion, abnormal thinking or behavior, and affects perception, attention, and mood. Another characteristic of delirium is restlessness.

At first glance, the signs of delirium may look a lot like dementia, which is a byproduct of Alzheimer’s disease, but the two are different conditions. Dementia as a result of Alzheimer’s primarily affects an individual’s memory and intellectual abilities, while delirium is displayed more in abrupt spurts of confusion. One key difference is inattention, as individuals suffering from delirium have trouble focusing on one idea or task. On their face, the two conditions may appear almost indistinguishable, which is why many nursing home patients who suffer from delirium are misdiagnosed as having Alzheimer’s, which means they do not receive the proper medical care.

The two also differ by how they are brought on. Dementia as a result of Alzheimer’s is not always a normal part of aging. Currently, there is no cure for Alzheimer’s. Delirium, on the other hand, is normally caused by a combination of factors that make the brain vulnerable and trigger a malfunction in neuropathic activity. There may be a single contributing factor or a combination of factors including malnutrition, dehydration, sleep deprivation, emotional distress, chronic illness, and surgery or other medical procedures that involved anesthesia. For instance, a patient may suffer from a serious illness while simultaneously facing neglect from caregivers. Certain environmental factors may play a role in delirium. For example, the absence of a clock, television, or phone in a nursing patient’s room has been found to worsen the symptoms of delirium.

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The family of a nursing home patient is suing Whitehall of Deerfield Healthcare Center, an Illinois nursing home facility, and its employees for the negligent care that lead to the patient’s death. Cheryl Hobart filed a lawsuit in Cook County, Illinois, seeking damages against Whitehall of Deerfield, alleging that Whitehall failed to properly administer patient John Hobart’s medication, which caused him to overdose and ultimately pass away.

Of all the injuries associated with nursing homes, medication errors can be the most preventable. Despite this fact, medication errors are one of these most common causes of action in nursing home litigation. More than half of adverse drug effects are contributed to medication errors.

Medication errors can occur at any one of three stages: prescription, monitoring, and administration. When prescribing patients new medications, physicians may often misdiagnose the illness, prescribe the wrong dose of the medication, or fail to consider how a new medication may interact with medications the patient is already taking. Nursing home patients are particularly susceptible to adverse medication reactions because many elderly patients require a combination of different medications to help sustain a healthy lifestyle. Most nursing home patients have between eight and 10 medications, on average, which can lead to a higher likelihood of an adverse interaction. It is estimated that unforeseen adverse interactions account for 22% of prescribing errors, while prescribing the wrong dose accounts for nearly 63%.

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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.

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There are over 15,500 nursing homes in the United States, housing roughly 1.4 million elderly and disabled adults. Many of our loved ones, including our parents and grandparents, require full time care in these facilities. When we cannot provide the necessary care for these individuals ourselves, we entrust nurses, doctors, and administrators to treat our family with the same care and attention that we would provide.

Many, if not most, nursing homes receive funds from Medicare and Medicaid and must be adequately staffed with a sufficient amount of properly trained employees, or risk the loss of funding in the future. While lawmakers have taken strides to ensure our loved ones are adequately protected, elder abuse and neglect affect the lives of thousands of American families each year.

It is absolutely vital for families considering moving a loved one into an assisted living facility to conduct thorough research into the quality of potential homes. A well-organized nursing home should be adequately staffed with administrators, dieticians, nurses, and nursing assistants, among other professionals. Proper staffing ensures that residents receive adequate care in all aspects of living and do not fall victim to neglect. Unfortunately, many nursing homes are understaffed, or the employees are under-trained.

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As in any business, there is usually a link between operational costs to run the business and the available profits for the owners.  This is a problem when the health and well being of the disabled or elderly residents are being disregarded. A Tennessee-based nursing home recently came under fire for failing to pay its utility bills and neglecting patients. Due to neglect, several patients developed pressure ulcers and genital wounds. Failing to timely indentify and treat the beginning stages of a pressure ulcer could be the difference between a full recovery rather than amputation, infection or even death. While the patients were receiving inadequate care, the co-founders of the nursing home were paying themselves annual salaries of $432,000 and $288,000 respectively. They also each drove a Porsche that was financed by the nursing home.

The stress of helping with aging family members is never easy, even in the best of circumstances.  Family members must cope with their own personal feelings of mortality, as well as the additional stress of providing both physical and emotional support to loved ones in this difficult time.  The attempt to absorb these additional responsibilities can be overwhelming.  Often, these hard working people are forced to reach out for help to assist with the care of their elderly or disabled relatives.  They may turn to places like a nursing facility, where they are told trained and skilled professionals are available around the clock, seven days per week, to monitor and care for their family members.

Unfortunately, the truth may be the facility is inadequately staffed, exposing the residents to dangerous conditions and failing to correct deficiencies from past inspections. Even if the facility is properly staffed, at least according to state minimum standards, that does not necessarily mean the residents are in good hands.  Some facilities fail to properly conduct background checks of the staff or volunteers, which could place residents at risk of assault or sexual abuse.  Moreover, the staff may not have the necessary training and/or education to properly care for and monitor the residents.

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When a loved one can no longer be cared for by their family members alone, many turn to a nursing home to step in and provide the level of care their loved one needs to survive.  Family members expect and trust that the ones caring for their loved ones in that nursing home, including doctors and nurses, are doing so with the utmost care and respect for their family members. Nursing homes are trusted with providing essential services including health and hygiene. However, optimal care does not always end up being provided in these settings.  Sometimes, unfortunately, the people trusted with caring for the patient are the ones who inflict the most harm.

Nursing home abuse by caregivers takes many forms. 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.

Recent headlines highlight stories of of defenseless elderly persons or the disabled being intentionally abused by their caregivers.  For example, a Florence, Alabama nursing assistant was indicted after being accused of physically attacking a dementia patient. After becoming frustrated with the patient, the nursing assistant was accused of antagonizing the victim, causing the 89 year old patient to become even more combative.  According to reports, the nursing assistant struck the patient twice on the stomach and grabbed her arm, causing the patient’s skin to tear and bruise. She also sustained knots on her head. Similarly, in New Jersey, a Certified Nursing Assistant was arrested on charges involving slapping, squeezing the mouth, hair pulling, and pinching a patient.  News stories such as these are hard for anyone to read, especially since elderly and sick nursing home patients are essentially defenseless in those situations.

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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.

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