Stolen Pressure Relieving Mattress

Many residents assessed as a high risk for bed sores, also known as pressure ulcers, are given special pressure reducing cushions or mattresses which help to reduce the chances of their skin breaking down. That’s what was recommended and given to Margaret Patterson, a 78-year-old woman with Alzheimer’s. She received the special mattress while in a hospital, and it was transferred with her to her new nursing home. After that, it disappeared. Her daughter noticed it was gone and asked the administrator about it and was told they would “look into it.” During the subsequent month before the mattress was tracked down and returned, Patterson developed a pressure sore.

Patterson is one of four residents alleged to have been neglected or abused while at the facility in a trial that is currently ongoing. See article at The Examiner.
 

Video Surveillance

Last fall, the New York Times posted an informative blog article discussing the pros and cons of families placing hidden cameras to protect loved ones from being abused or neglected in nursing homes. Certainly, many of the most shocking cases of abuse which have been discovered have come to light due to exactly this scenario: The family starts to suspect something is wrong. The clues are not always obvious, but they raise concern. Maybe their mother has a few new unexplained bruises, or grandpa is suddenly fearful of strangers. Trinkets might go missing, or baths or meals might seem to be skipped. Worried, the family reports their concerns, but receives only verbal assurances and no change in care. They can’t prove what happens at night, but they just feel that something is wrong, so they place a camera to verify that their loved one is safe, only to discover that they are being neglected or abused.

Video evidence is certainly powerful when it comes to light. Allegations of abuse can be glossed over as unreliable, a paranoid family, a delusional resident. Physical wounds can be blamed on an innocent fall instead of a physical attack. Psychological trauma can be blamed on medication, mental deterioration, and other diagnoses. Video footage of a resident being abused or neglected by staff however cannot be disputed.

Oklahoma, New Mexico and Texas have explicitly given state residents the right to place hidden cameras in facilities. Others are debating privacy issues, and some are concerned that the workers should be given notice that they may be recorded. The issue remains contested, but hopefully state governments will put in place standards which equally protect both the safety and the rights of nursing home residents. See NY Times Blog.
 

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The Dementia Village

Often this blog focuses on things going wrong in the nursing home and elder care industries. Today though, the focus is on a groundbreaking facility in Holland that seems to be getting a lot of things right. De Hogewayk is a special home built for residents with severe dementia. Dementia patients are known for their tendency to become confused and wander off, looking for something, someone, or just because they don’t understand why they need to stay close to care givers. Due to this, many dementia wards employ lock downs, medications, and alarms to help keep the residents safe.

De Hogewayk, or The Dementia Village, takes a different approach. The facility is set up like a small burg, with streets free from cars and buses, shops like a grocery store and hair salon, and houses, where several residents stay together with a few live in care givers who wear street clothes, not scrubs. It has been compared to a miniature version of “The Truman Show,” a movie where Jim Carrey discovers that he lives in an artificially constructed town. The village is completely self-contained, so the residents may wander as they please and participate in the little tasks, like picking up milk at the store, joining a club or hobby group, or visiting a friend down the street, that make them feel useful and happy. The staff is instructed not to correct the residents as they describe their delusions, but does not lie to them if they ask questions about where they are or how the village runs.

The idea came from a conversation between two workers in a traditional dementia ward, who both agreed that they were glad that their recently deceased mothers had passed on quickly, instead of having to be in a place like the ward where they worked. Once they realized what they had said, the conversation turned to what a dementia facility could be like, should be like, and how to make it happen.

Giving residents freedom and a sense of normalcy has been a big hit within the community and the waiting list for the facility is very long. The project was completed with funds from both the government and the community, and does not cost much more than traditional dementia care options in Holland. Similar facilities are being planned and built in Switzerland and the US. It is encouraging to see a facility striving so hard to treat the residents as normal people who have different needs, instead of as patients who need to be medicated and locked up for their own good. The model won’t work for every community, but forward-thinking innovation like the idea that brought about The Dementia Village is key to changing the landscape of how elder-care facilities are planned and run.

 

For more information, see The Guardian and Gizmodo.

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Repeat Offenders

Government officials in Texas are squabbling over whether to terminate state contracts with nursing homes which repeatedly are found to abuse and neglect residents. The Department of Aging and Disability Services (aka DADS) in Texas has figures that show that severe violations, which put residents in immediate danger, have gone up 35%. Anecdotal evidence of such incidents is unfortunately not hard to come by.

For instance, there is the case of Minnie Graham, a 97 year old who’s family caught three different employees slapping and shoving her by installing a surveillance camera. A review of the DADS records shows that Ms. Minnie Graham’s home had 79 deficiencies from 2010-2013. Meanwhile, the facility received more than $8 million from Medicaid. The Department for Aging and Disability Services did recommend that the facility be cut off from government funds. Twice. However, the termination never happened. Federal law requires the department to reconsider terminations if the facilities come back into compliance within six months, even when the facilities are repeat offenders.

State Representative Elliot Naishtat is on the Human Services Committee, which oversees DADS and he is very concerned with this reality. He worries that there are not enough inspectors (something the DADS spokesperson denies) and has stated that he will push legislation that increases fines and sanctions against substandard nursing homes.

See full article at KHOU.

One Day of Neglect

ValleyCentral.com reported the tragic story of Isidora Martinez. After only one day of being neglected in a nursing home, under deplorable conditions, Martinez had to be rushed off to the hospital in an ambulance.  Upon admission to Valley Grande Manor, Isidora was stable, after undergoing two major surgeries to remove a cancerous mass in her pancreas.

The family went to visit her the next day and found that she had not been changed or bathed. Isidora said that the facility was not taking care of her.  Isidora’s son, Desi, found that his mother was soiled, with her wounds open and unclean, and her incisions from her surgery were infected. To make matters worse, the nurses call button in her room was not working.  Desi stated that the facilities were outdated and the restrooms were filthy. When alerted of Isidora’s condition, the nurses refused to call for help.

When Isidora arrived at the hospital, she was diagnosed with sepsis. Sepsis is a potentially fatal whole-body inflamation, caused by severe infection. It is caused by the presence of microorganisms, such as bacteria, fungi, viruses, and parasites in the blood.  Since her hospitalization, a representative from Valley Grande Manor visited Isidora to apologize.

Luckily Isidora’s family was able to take an active role in her care. Many times, when a loved one is placed in the care of a nursing home, family members are not able to make daily visits. With how quickly Isidora’s health declined, it is scary to think what would have happened if she was left in such a state of neglect for an extended period of time.  When placed into facilites that are in states of disrepair with incompetent, uncaring staff, the life expectancy of a resident decreases significantly. Facilities attempt to defend themselves when untimely deaths of their residents occur by claiming that such persons were dilapidated and were in declining health. In reality, these facilities are responsible for causing the deaths and injuries of residents because of their negligent care practices.

Tort Reform = Corporate Bailout

Mr. Jernigan is a Florence attorney and president of the S.C. Association for Justice, formerly the S.C. Trial Lawyers Association.  He wrote the below article in The State newspaper about additional efforts to "reform" the civil judicial system.

"In a recent guest column (“Lawsuit reforms will promote job growth,” March 9), business leaders Cathy Novinger and Otis Rawl urged lawmakers to pass a pair of “tort reform” bills they claim will “improve the civil lawsuit climate.” They won’t.

I have great respect for Ms. Novinger and Mr. Rawl, but the only legal “climate” those two bills improve is one that serves giant corporations. The ability of ordinary citizens to seek justice would be seriously undercut.

One bill would limit punitive damages that juries could award when people are injured. The other would place an arbitrary cap on compensation for pain and suffering and shield trucking companies from being held accountable for the actions of their drivers.

These bills would, in essence, limit the legal rights of ordinary S.C. citizens. This is nothing more than an effort to protect corporations from the consequences of their reckless actions.

The arguments to support this legislation are the same old claims we always hear: If big companies can’t be sued, then they’ll have so much more money to hire people and grow the economy. But here are the facts.

First, tort cases make up less than 6 percent of the entire civil caseload. Few of these cases ever go to trial, and when they do, the plaintiff only wins about half the time. According to the U.S. Department of Justice, the average jury award is only $24,000. It’s hard to see how limits are needed.

Second, giving trucking companies free reign to put drivers with a history of speeding and wrecks on our state’s roads without consequences endangers us all.  No one should be protected by law from being held responsible for reckless behavior that injures people and endangers lives — especially not big companies.

Third, the state’s business climate is doing just fine without these unnecessary changes. Last year, export growth in our state was 85 percent higher than the national average.  Nearly every week, a new employer locates in South Carolina.  Building permits are on the rise, and recent surveys found S.C. manufacturers and business leaders are their most optimistic in years.

In fact, Site Selection magazine, Development Counsellors International and the Small Business & Entrepreneurship Council all consistently rank our business climate in the top five nationally. That’s good news.

Countless independent studies conducted by consumer groups and nonprofits have shown that economic growth is not enhanced at all by the type of “tort reforms” these bills would create. The opposite is true. There is more evidence to show that hamstringing our civil justice system is likely to slow employment growth.

Ms. Novinger and Mr. Rawl argue that these bills come “at no expense to the taxpayer,” but that claim couldn’t be further from the truth: This legislation is little more than a government bailout for corporate wrongdoers, with taxpayers picking up the tab.

By granting corporations immunity from responsibility, more individuals will be forced to seek financial help for medical bills and lost work from taxpayer-funded programs such as Medicaid and Social Security Disability.

Additionally, these so-called “tort reform” bills infringe upon our Seventh Amendment right to a jury trial in civil cases. And that comes at a tremendous cost to all S.C. citizens, including taxpayers.

The civil justice system exists so that those who are harmed by the actions of others can be compensated fairly for their loss. That right exists so wrongdoers can be punished for their actions. In a free and just society, nothing is more important.

The facts are clear: These “tort reforms” would benefit the few at the expense of the many.

If we continue to allow special interests and corporate lobbyists to use phony arguments to rig our civil justice system, the price we’ll all pay is one no free society can long survive: the loss of our constitutional rights.

Sex Offender Taking Care of Vulnerable Residents

Recently, authorities discovered that a man convicted of third-degree sexual assault was employed at a nursing home facility. This man was able to obtain employment because of the facilities failure to conduct any sort of background check. This facility is now no longer able to legally accept new patients. The man was working there as an environmental services coordinator. He was fired when the facility finally discovered he had such a violent criminal history.

It remains unclear, in this facility, as to how many other current and/or former employees were hired without background checks. Such negligent hiring procedures calls into question the integrity of the entire staff in the facility. No statement has been made on behalf of the facility as to how they plan on correcting their huge error. A fine was issued to the facility in the amount of $31,000. The facility has had 30 previous violations. In this respect, the fine seems like a mere slap on the wrist for a place that repetitively fails to maintain proper standards of care for residents. See article here.

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Aide Accused of Theft

A home health aide at All Heart Home Care of Manasquan, NJ was charged with stealing approximately $19,000 from an elderly resident’s bank account. The accused is Sheila McFadden. McFadden was arrested while attempting to cash one of the checks that she had stolen. She was charged with Forgery, and Receiving Stolen Property. A total of twelve checks were stolen and cashed. During this time the investigation remains open. See article at Ocean County Signal.

Many times, crimes such as theft from residents in elder care facilities can be prevented. Nursing homes need to take a more proactive approach in screening employees and implementing quality control procedures. The majority of facilities choose to not pay their employees much above minimum wage. This leads to the workforce seeking to find any other way possible to supplement their income and not care about fulfilling their job requirements. Overall, this leads to staff providing negligent care and abusing residents.
 

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Another Sexual Assault

Back in February police received credible reports that an elderly, mentally incapacitated woman was being sexually assaulted at the Autumn Leaves Memory Care Center.  Eventually Stephen Reed, a caregiver at the facility was named as a suspect.  He was finally arrested by The Northern Oklahoma Violent Crimes Task Force on March 25, 2014.  Reed is charged with first degree rape, and is due in court tomorrow.

Unfortunately disgusting and tragic things like this happen all the time nationwide. Even worse, most victims of sexual assault in nursing homes are not able to report the crime that is being committed against them because of mental or physical incapability. Many nursing homes and care centers are negligent in supervising their employees.  Even the most trained and experienced caretakers need to be checked up on how they are doing their job, or otherwise situations like these will occur and the crimes will continue to happen. The Autumn Leaves Care Center should have paid more attention to their employees and how their residents are being treated. The entire care facility needs to be thoroughly investigated to make sure there are no more victims of sexual assault.  See article at KRMG.
 

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Florida Bill Protects Corporate Profits

Tom Schroeppel wrote the below letter to Tampa Bay Times on the Florida bill that will give corporate owners immunity for negligence that affects resident's safety. My favorite line was "It's like exempting an airline from lawsuits after a plane crash because the corporate leaders weren't flying the plane."

"As the son of a nursing home resident and as a longtime advocate for nursing home residents' rights, I'm surprised and disappointed by Florida Senate Bill 670/House Bill 569. This bill effectively shields investors in nursing homes from civil lawsuits on behalf of injured or dead nursing home residents. As your article indicates, this bill appears specially designed to punish one law firm that has successfully tracked down and extracted legitimate damages from the real and often hidden owners of neglectful nursing homes.

The bill says that if you or a loved one is injured or dies due to nursing home negligence, you can sue everyone from the nursing home license holder — which can be a shell company with no assets — down to the overworked and low-paid nursing assistant actually providing care. Just don't think about suing the parent company, because "passive investors" are exempted from all lawsuits.

A passive investor is defined as "an individual or entity that does not participate in the decisionmaking or operations of a facility." This definition would encompass both the corporate owners of large nursing home chains and the private-equity companies that are increasingly seeing nursing homes as easy targets for acquisition, looting and disposal. It's like exempting an airline from lawsuits after a plane crash because the corporate leaders weren't flying the plane.

I also can't understand how the many good nursing homes that belong to the Florida Health Care Association — the primary mover behind this bill — can back a bill that will benefit only their most venal and neglectful competitors, companies that put profits ahead of care and want to get off cheaply when they injure or kill their residents.

For the sake of all our vulnerable nursing home residents, I urge anyone who has a loved one in a nursing home or who may someday end up in a nursing home to contact his or her state legislator and urge them to kill this terrible bill. It does nothing but help bad nursing home operators avoid the legal consequences of injuring or killing their residents."

 

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