The Injury Board Commentary - Nursing Home & Elder Abuse - Most Popular

For-Profit Nursing Homes Care is Lower Quality

Dottie Perry — Tue, 31 Jan 2012 16:24:35 GMT

For Profit Nursing Homes Care is Lower

The nation’s largest for-profit nursing homes deliver significantly lower quality of care because they typically have fewer staff nurses than non-profit and government-owned nursing homes according to an article published online in advance of print publication in Health Services Research.

The University of California- san Francisco analyzed the quality of care at nursing homes around the country. It is the first-ever study focusing solely on staffing and quality at the 10 largest for-profit chains. Those chains in 2008 were: HCR Manor Care, Golden Living, Life Care Centers of America, Kindred Healthcare, Genesis HealthCare Corporation, Sun Health Care Group, Inc., SavaSeniorCare LLC, Extendicare Health Services, Inc., National Health Care Corporation, and Skilled HealthCare, LLC.

According to the article from 2003 to 2008, these chains had fewer nurse “staffing hours” than non-profit and government nursing homes. Their total nursing hours were 30 percent lower and they were below the national average for RN and total nurse staffing. The article also indicated they had the sickest residents- those that need more aggressive care.

These chains were cited for 36 percent more deficiencies and 41 percent more serious deficiencies than the best facilities in the country. Deficiencies include failure to prevent pressure sores, resident weight loss, falls, infections, resident mistreatment, poor sanitary conditions, and other problems that could seriously harm residents.

The authors indicated that more study is needed. They also suggested that greater accountability and quality oversight mechanisms would help improve nursing home care, along with effective funding incentives and sanctions for low staffing and poor quality.

The important message from this study to consumers considering putting a loved one in a nursing home is to look closely at the nursing homes before putting a loved one there. An excellent organization to obtain information about nursing homes is The National Consumer Voice for Quality Long-Term care (formerly NCCNHR; http://www.theconsumervoice.org/ )

Originally posted at InjuryBoard by Dottie Perry

Faced With More Claims, Long-term Care Insurers Deny Benefits

Nick DiCello — Wed, 02 Sep 2009 09:26:19 GMT

As Baby Boomers aged, there was a boom in the sale of long-term care insurance during the 1990’s. Now, however, an ever increasing portion of our population, which is living longer and longer, is seeking protection under their long-term care policies. One insurance company executive described the situation as follows: “The long-term care party of the 1990s gave us one hell of a hangover in the 2000’s.”

Long-term care insurance is a contract or policy of insurance which promises, in exchange for the timely payment of premiums, coverage for expenses of long-term care, such as the costs of a nursing home or assisted living facility. As more and more Americans with long-term care insurance enter these facilities, the insurance industry is faced with making good on their promises. Some insurers, however, have miscalculated the profitability of certain long-term care insurance products. For example, many insurers fighting to get into the “long-term care party of the 1990s” overestimated policy lapse rates and miscalculated the mortality rates for the target population. Now, during the “hangover,” insurers too commonly attempt to refuse payment of legitimate claims, sometimes on a global scale.

On March 15, 2006, Penn Treaty President and CEO issued a news release indicating that a “review is showing us that our policyholders remaining on claim beyond three years (particularly on policies issued prior to 2002) appear to be living longer than we had previously anticipated, which will likely cause us to pay higher future benefits due to the expanded duration of these claims.”

Denial of a long-term care claim or the loss of one’s long-term care coverage can be devastating. Imagine becoming accustom to life in a long-term care facility only to one day receive a letter from your long-term care insurer stating that it is “no longer medically necessary” that you or a loved one continue to receive nursing home care, and that benefits will end. This is a common exclusion cited by long-term care insurers to deny benefits. Without benefits, the elderly individual must tap into his or her assets to continue to pay for care, or must burden their family for assistance. Ultimately, once one’s assets are exhausted, he or she is forced to seek government assistance.

If you or a loved one has had their claims for long-term care benefits denied or their policy rescinded, contact the trial attorneys at Spangenberg, Shibley & Liber, LLP for a consultation, and protect your legal rights.

Originally posted at InjuryBoard by Nick DiCello

Stage 4 Bed Sore (Decubitus Ulcer)

M. Brandon Smith — Fri, 30 Mar 2007 00:09:55 GMT

The final stage in the bed sore classification system is stage 4. In a stage 4 bed sore, the most serious and advanced stage, almost all skin has been lost in the affected area and a very deep wound has occurred. The would itself has extended through the muscles, tendons, organs, and/or bones. Stage 4 bed sores, also termed decubitus ulcers, almost always require surgical intervention to remove the decayed and necrotic tissue. The infection status in a stage 4 bed sore is very serious and can lead to extremity amputation and/or death if not treated properly. A stage 4 bed sore is only seen in the most egregious circumstances of neglect and improper care. In the hospital or nursing home setting, a stage 4 bed sore should NEVER occur. Sadly for thousands of residents and patients each year, however it does time and time again.

Originally posted at InjuryBoard by M. Brandon Smith

Pennsylvania Proposal Seeks Cap On Punitive Damages In Nursing Home Claims

Scott Cooper — Wed, 25 Jan 2012 07:45:29 GMT

What do you think about a Governor and legislator supporting a law which places an arbitrary cap on punitive damages if you, or a loved one, are the victim of negligence in a nursing, long-term care, assisted living, and personal care facility? This even includes unlawful conduct! This is precisely what the Governor and many legislators in Pennsylvania are proposing and supporting.

The Pennsylvania House of Representatives passed a measure, last week, which will cap the punitive damages awarded in nursing home abuse lawsuits. House Bill 1907 (HB 1907) now goes to the Pennsylvania Senate where the Senate should be urged not to even consider this unconstitutional, unnecessary, and hurtful measure.

Specifically, the legislation caps punitive damages at 200 percent of compensatory damages awarded in medical negligence lawsuits that name nursing, long-term care, assisted living, and personal care facilities as defendants, even for unlawful conduct. The only exceptions are when a defendant intentionally or knowingly acted negligently.

The sole reason for passing the law is to bolster a nursing home’s profits at the expense of safety. Even more insulting to the elderly and victims is the fact that Pennsylvania’s Governor Corbett is endorsing this measure.

Don’t you agree that this Bill should not see the light of day?

Scott B. Cooper
Schmidt Kramer PC
209 State Street
Harrisburg, PA 17101
(717) 232-6300 – Telephone
(717) 232-6467 – Facsimile
scooper@schmidtkramer.com
Facebook.com/SchmidtKramer
Twitter.com/TalkToALawyer

Originally posted at InjuryBoard by Scott Cooper

New Jersey Passes Safe Patient Handling Practices Act

Dan Frith — Wed, 09 Jan 2008 06:31:15 GMT

I cannot tell you how many times we have been involved in medical malpractice cases against hospitals and nursing homes where a patient has been seriously injured as a result of being dropped. Typically, the patient is being transferred from bed to wheel chair or wheel chair to shower chair and, as a result of improper technique and training, is dropped to the floor suffering fractured hips, legs, and arms. Well, it looks like the state of New Jersey is doing something about it as a result of a newly enacted law!

The "Safe Patient Handling Practices Act" requires licensed health care facilities to establish comprehensive patient handling safety procedures to minimize risks when moving patients or restricting their movements. The new law requires all health care facilities to implement a program that will include:

* An assessment of the assistive devices necessary to carry out the safe patient handling policy;
* Recommendations for a three-year capital plan to purchase patient handling equipment and aids;
* A plan for ensuring availability of and prompt access to mechanical patient handling equipment and aids on all units for all shifts;
* Training for health care workers;
* Protocols and procedures for assessing and updating appropriate patient handling requirements; and
* Informational materials to educate patients and their families.

The law requires a training program for health care workers, as well as educational materials for patients and their families to help familiarize them with safe patient handling policies and practices at the facility. A facility's policy also will be posted in a location easily visible for staff, patients, and visitors. The posted policy will be mandated to include a statement concerning the right of a patient to refuse the use of assisted patient handling.

Kudos to New Jersey!

For more information on this subject, please refer to our section on Nursing Home Abuse and Elder Neglect.

Originally posted at InjuryBoard by Dan Frith

Nursing Home Abuse Report Leads to Closure

David Rowell — Sat, 15 Nov 2008 13:19:16 GMT

Following recent reports of an increase in nursing home abuse and neglect, state and Federal agencies may be increasing their surveilance and inspection efforts. A round of such surveys by the Florida Agency for Health Care Administration and the federal Department of Health and Human Services found widespread abuse at the Key West Convalescent Center, and led to an order for closure of the facility.

Reports called the survey results "damning," and the responsible agency stated that a "system failure jepoardized all the residents in the facility."

Nursing home abuse or neglect is a serious problem, one that is likely to grow worse as the American population ages. According to the U.S. Census Bureau, the number of Americans 65 and older is expected to reach almost 90 million people by the year 2050.

Nursing home abuse or neglect can occur in various ways: physical abuse, emotional abuse, sexual abuse and others. Signs of abuse or neglect can be obvious or subtle, including bed sores, bruises, welts and other skin damages, anxiety, agitation or emotional withdrawal, weight loss and other signs of poor nutrition or poor hydration, and many others.

Like other victims of abuse, abused nursing home residents may be reluctant to speak out, and this problem can be worsened by the potential for retaliation by the abusive staff member.

If you suspect that your loved one has been the victim of nursing home abuse or neglect, you should first ensure that your loved one receives prompt medical attention. You should consider contacting the State agency charged with nursing home oversight; you may want to contact a lawyer who is familiar with this area of law.

For more information about nursing home abuse and neglect, check the InjuryBoard Help Center on this topic.

Originally posted at InjuryBoard by David Rowell

Mentally Ill Patients Pose Danger to Elderly Nursing Home Residents

Kristina Labanauskas — Tue, 24 Mar 2009 17:40:05 GMT

There has been a significant increase in the number of mentally ill patients residing in nursing homes. And, mixing frail elderly with younger and stronger mentally ill patients in nursing homes has resulted in violence throughout the country.

Nearly 125,000 young and middle-aged adults with serious mental illness lived in U.S. nursing homes last year. That was a 41 percent increase from 2002, when nursing homes housed nearly 89,000 mentally ill people ages 22 to 64. Younger mentally ill people now make up more than 9 percent of the nation's nearly 1.4 million nursing home residents, up from 6 percent in 2002.

This increase is in large part a result of the closing of state mental institutions, the shortage of hospital psychiatric beds, and the surplus in nursing home beds, as today’s elderly are more likely to stay in their homes as they are healthier than previous generations.

States are responsible for screening mentally ill patients, as federal law prohibits nursing homes from admitting a mentally ill individual unless the state has found that person needs the nursing home’s high level of care.

Although federal law guarantees residents the right to be free from physical abuse, a number of tragic cases have occurred in nursing homes.

If you or someone you know has been the victim of abuse, contact a professional to discuss whether legal action should be pursued.

Originally posted at InjuryBoard by Kristina Labanauskas

94 Percent of Nursing Homes Violated Federal Standards in 2007

Chrissie Cole — Tue, 30 Sep 2008 07:12:00 GMT

Nine out of 10 nursing homes in the U.S. last year were cited for violating federal health and safety standards, says a recently released report by the Department of Health and Human Services’ Office of Inspector General.

The study found 94% of for-profit homes had received citations relating to problems including medication errors, poor nutrition, abuse and neglect of patients and more.

Overall, 88% of non-profit nursing homes and 91% of government-run homes received citations.

About 20 percent of the more than 37,000 complaints inspectors received last year concerned abuse or neglect of patients.

Deficiency rates varied in each state, for instance: some 76% of Rhode Island nursing homes received a deficiency citation, while 100% of the nursing homes in states such as Alaska and Idaho were cited, the report said.

More than 1.5 million Americans live in nursing homes and as a condition of housing Medicaid and Medicare patients, the nation’s nursing homes must meet federal standards. The federal program costs taxpayers more than $75 billion a year.

Originally posted at InjuryBoard by Chrissie Cole

Tennessee's' "Kill Old People Cheap Act" Defeated For This Year

George Fusner — Wed, 22 Apr 2009 12:04:59 GMT

This morning the Tennessean reported that the bill pending in the legislature to cap damages for nursing home negligence failed in subcommittee last might. Amen. Why should a particular industry get special treatment when it injuries old and frail people? It should not.

Being held responsible for ones own actions is called personal responsibility. This is specially true when you are dealing with people who are so vunerable. I am responsible for my 88 year old Mother. Although her mind is still with her, she is very frail. She lives in an assisted living facility in Brentwood. Her care is excellent. I did a lot of research on various facilities before selecting Southland Place. There was a vast difference in staffing, cleanliness, attitude among other items. Cost did not seem to be a factor.

No industry or class of tortfeasors should be treated differently or given special privileges. One of the founding principals of this country was that all persons would be treated equal and bear responsibility for their own actions. The Fourteenth Amendment to the US Constitution provides for equal protection for all people. It states:

All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the state wherein they reside. No state shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any state deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.

How clear can it be? Juries do a wonderful job of making decisions. Trial by jury is guaranteed by the 7th Amendment to the US Constitution. Our Judges to a great job of overseeing the system. There are adequate laws in place if an error is committed. As they say "if it ain't broke, don't fix it." Don't allow special interests to "Kill our old people cheap."

Originally posted at InjuryBoard by George Fusner

Fairness in Nursing Home Arbitration Act Does Not Become Law

Billy Cunningham — Sat, 30 May 2009 09:05:53 GMT

In January I wrote a blog on S. Bill 2838, Fairness in Nursing Home Arbitration Act. This bill never became law. The last action taken by the Senate on the bill was in September when it was reported favorably out of committee and then on October 1, 2008, it was placed on the Senate Legislative Calendar under General Orders. Calendar No. 1109. This bill has now been proposed in previous Sessions of Congress last two years. At the end of each session all proposed bills and resolutions that haven't passed are cleared from the books. The bill was never debated by the Senate. This means the bill will have to be reintroduced under a new number in the next session.

The bill was sponsored by Sen. Mel Martinez [R-FL] and co-sponsored by Sen. Patrick Leahy [D-VT], Sen. Russell Feingold [D-WI], Sen. Richard Durbin [D-IL] and Sen. Herbert Kohl [D-WI]. I would urge all you to contact your Senators and Congressmen before the next session and urge them to get this bill reintroduced and passed.

Nursing home abuse continues and arbitration is not the way to handle these cases. When loved ones are put in nursing home today the facility often presents a series of documents to be signed in order for the family member to be admitted. Often stuck in the middle of all those is an arbitration agreement. I have never seen one drafted that is designed to favor or even equally treat the resident. Those agreements are signed by residents with dementia who do not have the capacity to enter into any other kind of contract. Or they may be signed by a family member who does not have a power of attorney or court appointment authorizing them to enter into contracts on their behalf. The nursing home does not care who signs them- it is just part of a process. That process is not in the best interest of the resident. I have seen forged signatures on nursing home arbitration agreements and had one facility admit it forged the signature.

One way to protect against this happening is for everyone to have a power of attorney that prohibits the attorney in fact from entering into any contract that has an arbitration clause or agreement in it. Here is an example of the clause that should be in every power of attorney:

“NO POWER TO AGREE TO BINDING ARBITRATION. Although I have given my attorney-in-fact this general and durable power of attorney, I specifically withhold from my attorney-in-fact the power to agree or consent to binding arbitration, or to agree to any other process that would preclude the right to have a jury decide any issue in controversy concerning my person or my property; this does not, however, preclude non-binding alternative dispute resolution processes such as mediation. “

There are things we can all do to protect our loved ones in nursing home. Let’s start a letter writing campaign now to get the Fairness in Nursing Home Arbitration Act reintroduced and passed.

Originally posted at InjuryBoard by Billy Cunningham