South Carolina Nursing Home Blog : South Carolina Nursing Home Lawyer & Attorney : Poliakoff & Associates Law Firm : Elderly Care, Senior Care

A Florida nursing home, Casa Mora Rehabilitation and Extended Care, will pay an $18,500 fine after neglecting a dying resident, and mishandling the resident’s death.  A nurse failed to administer life-saving attempts to a 58 year old woman who was unresponsive. The nurse thought the resident had requested not to be resuscitated, even though the woman wasn’t wearing a bracelet that identified DNR.

The resident's daughter claimed that the facility hadn’t followed the necessary procedures to keep her mother alive.  The Florida Agency for Health Care Administration investigated her claim and agreed that the facility was negligent.  In addition to the fine, the facility will implement new procedures which will hopefully prevent incidents like these in the future.

See article at MySunCoast.

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CBS New York reported that two nursing home aides, David Rover and Thomas Mocera, have been accused of taking graphic photographs of approximately eleven nursing home residents in three Suffolk County nursing homes. New York Attorney General Eric Schneiderman asserts that among the photographs taken by the two were images of bed sores, patients’ private areas covered in feces, and an overflowing colostomy bag. These images were reportedly taken without the patients’ consent, violating both their privacy and dignity.

The incidents reportedly occurred at Woodhaven nursing home in Port Jefferson Station, Long Island State Veterans Home in Stony Brook, and Jefferson’s Ferry in South Setauket. Representatives from Woodhaven declined to comment to CBS New York, and representatives from Jefferson’s Ferry denied that there was any evidence that such an incident occurred. Fred Snanga, the director of Long Island State Veterans Home was “completely outraged” by the actions of the two men.

Rover and Mocera are both pleading not guilty to the charges. Family members of the victims are calling for better screening processes for nursing home employees.

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CTV News reported that four employees from St. Joseph’s at Fleming long- term care facility in Ontario, Canada have been suspended with pay after video footage showed them abusing a patient. The footage was captured by Camille Parent, who installed a camera in the room of his mother, Hellen MacDonald, an 85 year-old patient at St. Joseph’s suffering from dementia. Parent was prompted to install the camera after his mother suffered a suspicious black eye.

The footage shows a staff member blowing his nose in Mrs. MacDonald’s sheets while making her bed, another staff member changing her diaper with the door open, and yet another shoving a rag covered in fecal matter in Mrs. MacDonald’s face. The incidents all occurred within a period of three weeks.

In 2010, the Long- Term Care Homes Act was passed, enacting a zero tolerance for abuse policy in Ontario extended care facilities. When asked whether or not the footage depicted what he would classify as abuse, Alan Cavell, CEO of St. Joseph’s, told CTV news, "I don’t want to give my opinion directly. I would think that most people would say that it was." Investigations are under way by both St. Joseph’s and the Ontario Ministry of Health.

CTV News reported that there were over 10,000 incidents of seniors suffering abuse in nursing homes in Canada last year. In light of these disturbing figures, Parent continues to raise awareness about residents’ safety and the quality of care they receive in long-term care facilities through his new organization, Ontario Cares.

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The NY Times reported on a new report that indicates that lawsuits improve the quality of health care because providers learn from their mistakes. "New evidence, however, contradicts the conventional wisdom that malpractice litigation compromises the patient safety movement's call for transparency. In fact, the opposite appears to be occurring: the openness and transparency promoted by patient safety advocates appear to be influencing hospitals' responses to litigation risk."

Lawsuits can also reveal errors that should have been reported but were not — medical providers notoriously underreport errors (although studies have shown that the threat of litigation is not responsible for this underreporting) and lawsuits may fill these gaps.

Experts agree that the best way to reduce medical error is to gather and analyze information about past errors with an eye toward improving future care.  Full disclosure and transparency is the best way to improve safety and prevent injury.  Several factors appear to have overcome resistance to transparency, including widespread laws requiring disclosure to patients.  Hospitals have also found that disclosing errors to patients and offering early settlements reduces the costs and frequency of litigation.

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  The Arkansas Times reported a jury in Arkansas returned a unanimous verdict finding that the Greenbrier Nursing and Rehabilitation Center had been negligent in the care and treatment of Martha Bull.  Bull was admitted March 28, 2008 for 30 days of short term rehabilitation. During the night of April 6, 2008 she was in severe pain, sweating and unable to have a bowel movement. Nothing was done. The next shift, she continued to complain. A physician was finally called at 2:20 p.m. April 7. He ordered her transferred immediately to an emergency room. The director of nursing received the fax at 3:34 p.m., but was leaving for the day.  The nursing director failed to properly communicate the order.  No one saw the fax or was aware of it til after she was found dead.  Bull wasn't sent to the emergency room. She screamed throughout the afternoon, so loudly that residents on other halls complained. She was found dead at 10:20 p.m. April 7. The faxed physician's order was found the next day.

The jury found the nursing home guilty of negligence, medical malpractice and violation of resident's rights.  The poorly trained and overworked nursing staff failed to follow doctor's orders for emergency services and treatment of severe abdominal pain.  The jury awarded damages for pain, suffering and mental anguish at $5.2 million.

Even a frivolous and unsuccessful defense appeal will only be the beginning of a long road toward collection, if any.  Defense counsel spent all the liability insurance coverage for legal costs and fees — $100,000 in this case.   Defendants hired six different defense lawyers.  The nursing home is controlled by Central Arkansas Nursing Centers, a private company headed by Michael Morton of Fort Smith.  The individual nursing homes were organized as "freestanding limited liability corporations", with licenses separate from physical property and small liability insurance policies through a self-insurance-style program based in Bermuda.

 The nursing home fought the case for four years but as a trial strategy admitted in the early stage of the trial "that a mistake was made."  The admission of a mistake came only after the trial began. If sincere, it should have done so long ago, expressed regret and demonstrated sincerity by trying to make things right.

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The Columbus Dispatch had an interesting report on the excessive cost of nursing home care.

When Teresa Horstman of Madison County in Ohio was concerned about her father who she says “lived his life with dignity” and was then suffering from dementia, she wanted him to have the highest quality of life. This prompted her to upgraded his assisted-living room to the most advanced care option offered at Springfield nursing home. However, Teresa feels that for the high price she was paying, her father was not getting the improved quality of care that he should. “Attention from the staff was lacking, she said. And, she recalls, a physician who made rounds there failed to respond to her repeated requests that Mr. Horstman receive a clinical evaluation of his condition.”

She says that her father worked his entire life, along with raising nine children and now his life savings are almost exhausted paying for a poor level of care. “He had to sell his belongings. Here we were draining his bank account so he could sit around at a home in poopy diapers.”
Nursing homes defend their prices saying since most resident require help with at least four or more daily activities including bathing, feeding, toileting, and transferring they receive a lot of services that are well worth the price. However, many nursing homes claim their prices are justified by the level of care they provide, however it is important to consider if residents are actually receiving the care they pay for.

Nursing homes say that due to a bad economy and a growing number of elderly individuals that are choosing to receive in-home care rather than move to a facility, the market is very competitive and they cannot continue to raise prices.  Rather than increase the price and risk losing customers, nursing homes are finding other ways to cut cost such as cutting staff, often at the expense of their residents.  Nursing homes decease their staff size and cut employee benefits to save money which compromises the level of resident care. This hurts residents who are not receiving the level of care they pay for since employees who are overworked and under compensated cannot preform their duties.
 

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The Legal Examiner reported on the astounding number of medication errors occurring in nursing homes. Researchers from the Journal of the American Medical Informatics Association observed nursing home staff administering medication to 127 residents and found 428 errors, totaling an alarming 21.2 percent of all medication administrations.  Another study reaffirmed these startling findings, showing that the repeated errors in nursing homes were a “common occurrence”and, obviously, were more likely to cause harm to residents than non-repeated errors.

 Medication errors including giving the wrong dose of medication, giving it at the improper time, or incorrectly following doctor’s orders while administering the medication. While the amount of errors in long-term care nursing homes are alarmingly high, the American Journal of Geriatric Pharmacology found that rates are even higher in assisted-living facilities. This can be attributed to the fact that improperly trained, non-nursing staff is given the responsibility of administering medications. In another study the Journal of General Internal Medicine found that these errors “were the rule rather then the exception” and that many errors involved risky drugs such as hypoglycemic agents and anticoagulants.

Paul Woodley of Saratoga Springs, NY experienced the consequences of medication errors when his wife, who was a resident of Maplewood Manor Nursing Home, was mistakenly administered a dose of insulin intended for her roommate. As a result she suffered from dehydration, pneumonia, and an urinary tract infection until she died sixteen days later.

The American Association of Retired Persons reports that on average Americans age 75 and older typically take over 11 medications each day. With this many medications it is very important that nursing home staff are especially vigilant and correctly trained. Sadly, the current number of medication administration errors is very preventable and likely attributed to the under-staffing and lack of training provided to staff.

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The Post and Courier reported that Charleston state senator Paul Thurmond introduced a bill to make it clear that families have electronic surveillance at their disposal in gauging loved ones’ quality of care. The measure would require state-licensed facilities to inform residents and their relatives of the tool. It also devises criminal penalties for anyone who interferes with the equipment, known colloquially as “granny cams.”  The goal and purpose is to deter abuse abd fraud, and catch sexual predators. 

Sen. Thurmond, R-Charleston, drafted the current bill that allows video to be used in criminal and civil courts. Thurmond said he modeled the measure after one that Oklahoma lawmakers unanimously approved.  Texas, New Mexico and Maryland also allow video cameras.  Since the early 2000s, about a dozen states have considered such measures.

The bill would require permission only from the resident featured, or from a legal representative.
Among its provisions, the law would penalize anyone who tampers with the cameras.

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The Arbitration Fairness Act of 2013 was introduced in Congress.  The House bill had 22 cosponsors and the Senate bill had 17 cosponsors to reintroduce the bill in the 113th Congress.

See press release from Take Justice Back.

The Facts

•The AFA would eliminate forced arbitration in employment, consumer, civil rights, and anti-trust cases.
•The AFA would ensure that the decision to arbitrate is truly voluntary.
•The AFA would restore fundamental rights created by state and federal laws that are currently at risk of being wiped out by forced arbitration.

1. Contact your member of Congress today and tell them you support the legislation.

2 Send an email to Congress through Take Justice Back: http://ow.ly/kNOXh

3. Ask your friends and colleagues to act.

4 Share the Take Justice Back action item with them: http://ow.ly/kNOXh

5. Spread the word--Email the press release to your colleagues and media contacts.

6 Share this Facebook post: http://ow.ly/kNPpN

7 Retweet on twitter: http://ow.ly/kNP4F

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