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

Chicago Tribune had an article about the Joint Commission's new campaign to help prevent falls in health care settings and in nursing homes. Millions of Americans are injured in falls each year, and many of them are preventable with proper supervision and safety devices.  The Joint Commission's new campaign includes brochures on prevention tips. These are things like exercise to improve balance; turning on lights when entering dark rooms; and getting help before trying to get out of a bed.

The commission's president, Dr. Mark Chassin, points out that falls can cause life-threatening injuries and can even be fatal. And he says following these simple precautions can really help.

Restraints are not typically used in nursing homes.  However, in some situations restraints are necessary to prevent a fall incident.  The percentage of nursing home patients with restraints fell to 5% in 2007, down more than half from 1999, according to a recent report from the Agency for Healthcare Research and Quality.

Roughly 11% of all nursing home patients had restraints at the end of the last decade, according to the 2009 National Healthcare Disparities Report from AHRQ. Restraint use was at 6% in 2006.

Nursing home residents who are physically restrained for long periods are prone to pressure sores and other problems, such as chronic constipation or incontinence as well as emotional problems, according to AHRQ.

• Email This
• Print
• Comments
• Trackbacks
• Share Link

The News & Observer had an article about the civil lawsuits that have been filed against Britthaven after a Britthaven nurse heads to court on murder charges in the morphine-related death of a patient, and serious injuries to two other patients.  Registered nurse Angela Almore ihas been charged with second-degree murder and patient-abuse charges related to the death of 84-year-old Rachel Holliday and morphine-induced injuries to six other patients.   A medical examiner reported that Holliday died of pneumonia and that the levels of morphine in her system likely contributed to her death. None of the patients had been prescribed morphine.

The case of Jadwiga Orlowski v. Britthaven Inc. is one of the cases pending.  The suit accuses Britthaven of negligence, including failure to monitor Orlowski, who suffered from dementia according to the complaint, and not providing a bed with side rails.

Her husband, Marian Orlowski, died of pneumonia on July 16 at age 86.  Orlowski was a former distinguished professor in pharmacology at The Mount Sinai School of Medicine in New York, was nominated for a Nobel prize in 2004 for his pioneering drug treatment for blood-plasma cancer.

"Later on that same day, Dr. Marian Orlowski was found on the floor of his room," states a legal complaint filed by the Orlowskis' attorney, Carmaletta Henson. "He had fallen and sustained serious personal injuries, including a fracture to his left hip."

Britthaven of Chapel Hill is one of four "special focus facilities" in the state. This designation by the federal Centers for Medicare and Medicaid Services notes a pattern of substandard care. Chapel Hill Health and Rehabilitation, along with the Brian Centers in Goldsboro and Gastonia (owned by SavaSeniorCare), are also on the list.

Last year, CMS ordered Britthaven of Chapel Hill to pay $216,400 in fines because it was out of compliance with Medicare requirements. Those penalties stem from the case of Mary Lou Barthazon, a 95-year-old woman who likely broke both thigh bones near her knees on Sept. 30, 2007, when a nursing assistant dropped her while trying to lift her from a chair to her bed, according to a federal judge.  The nursing assistant ignored Barthazon's care plan, which required a mechanical lift.  Her fractures went untreated for two weeks because the nursing assistant did not report the incident. Barthazon's daughter, Anne Blanchard, insisted Barthazon go to the emergency room on Oct. 14. She died four days later.

Blanchard has sued Britthaven, alleging negligence and wrongful death. In her motion to dismiss the lawsuit, Britthaven lawyer Pamela Robertson denies "that defendants had a duty to supervise or control the clinical care, treatment or judgment of any healthcare provider."

Robertson's motion also denies "that either state or federal nursing home standards, policies, regulations, rules or standards of participation establish the standards of health care applicable to Britthaven of Chapel Hill."

Britthaven tried to avoid a trial by forcing the case to arbitration. Superior Court Judge Abraham Penn Jones concluded that the contract was signed under duress as both she and her mother were suffering serious health problems and her 23-year-old daughter had only months earlier suffered partial paralysis in a rollerblading accident. Wrote Jones, "The contract is ... procedurally and substantively unconscionable."

• Email This
• Print
• Comments
• Trackbacks
• Share Link

Amarillo Globe News had an interesting article about new technologies at Texas long term care facilities to help care for Alzheimer's patients and give them more freedom.  The article mentions The Garden at Childers Place and its "plush accommodations".  The 20-bed "neighborhood," preferred over the term "unit," was built in 2007 and recently became a state-certified facility for Alzheimer's patients.

Childers Place is now one of four Amarillo facilities that are state-approved for Alzheimer's patients. The other three are: Ussery-Roan Texas State Veterans Home, Ware Memorial Care Center and Windflower Nursing, a part of Craig Methodist Retirement Community. All four combined have capacity for 155 patients.

Alzheimer's disease is a progressive and fatal brain disorder affecting 5.3 million Americans, the majority of which are 65 or older. The disease also is the most common cause of dementia, a mental disorder characterized by loss of memory and other intellectual abilities, according to the Alzheimer's Association. More than 80 percent of dementia cases are attributed to Alzheimer's.

Childers Place is operated by the Bivins Foundation. Residents living in one of the neighborhoods can move into The Garden if their condition deteriorates or they need more assistance. The layouts of the three communities are the same, allowing for as smooth a transition as possible.

The facility can only be entered by key-card access, required by the state. The wing is divided into two sections, with 10 rooms down each hallway. Each room has its own bathroom and shower, and residents are encouraged to outfit it with their own furniture.  Each section has its own communal living room, immaculately set with furniture and a fireplace. A communal kitchen also is available and equipped with staff-operated safety features to avoid any harm to residents.

The use of technology is likely the facility's greatest asset. Motion sensors in the room alert the nurses' station and pagers can notify staff members if a resident leaves a room. A resident who needs to use the restroom at night need only get out of bed, and a weight sensor placed in the bed gradually turns on lights in the room and bathroom. The lights turn off whenever the patient returns to bed. Residents who need help getting to the restroom are a fall risk, and staff members are quickly alerted so they can come to help.

"The smart-room technology keeps staff from hovering over a patient, and it gives them more freedom," Hendley said. "It really cuts down on (patient) anxiety."

• Email This
• Print
• Comments
• Trackbacks
• Share Link

The Madison-St. Clair Record had an article about a lawsuit filed on behalf of Wealthie Lee Lockett against The Lincoln Home and Weiss Management Group for acts of negligence resulting in a broken thigh bone.  The lawsuit contends that employees continuously violated Lockett's rights from Jan. 18, 2008, through her death on Dec. 18, 2008.

During her stay at the nursing home, Lockett sustained a comminuted left femur fracture, among other injuries, causing her to suffer severe and repeated pain, mental anguish and emotional distress and to become further debilitated and disabled. Employees at The Lincoln Home failed to evaluate Lockett to ensure she received adequate supervision, failed to provide her with adequate care, failed to provide her with immediate treatment by trained personnel, failed to notify her physician of significant changes in her physical condition, failed to ensure that they established a nursing care plan based on her needs, failed to provide necessary services to maintain Lockett's highest state of well-being and failed to appropriately update her plan following her fracture.

Weiss Management, which owned The Lincoln Home, also allegedly performed a number of negligent acts, including its failure to operate the home in such a way that provided Lockett with adequate supervision, its failure to operate the home in such a way as to protect Lockett from neglect, its failure to properly monitor its employees and staff, its failure to screen and evaluate the references of nursing staff, its failure to terminate employees at the home who were known to be careless and incompetent, its failure to provide nursing personnel duties consistent with their education, its failure to prevent and correct problems at the nursing home and its failure to discharge its legal obligations, the suit states.

• Email This
• Print
• Comments
• Trackbacks
• Share Link

The Star Tribune had another great article about State health investigators' conclusion that Providence Place is to blame for the death of a resident who rolled down a stairwell in her wheelchair last May and died.  The Minnesota Health Department said the woman died because the facility failed to change the resident's care plan after she had twice previously tried to open the door to the same stairwell. The second attempt came 30 minutes before the woman died.  Nursing homes have a duty to keep residents safe and prevent foreseeable injuries. 

According to the report:

The woman, who suffered from anxiety, depression and other behavioral problems, had a history of wandering around the facility and trying to open doors. A few weeks before the fatal fall, an employee saw the resident inside the stairwell and pulled her out. The employee reported the incident to a registered nurse on staff. On the day of the fall, the woman was found on the concrete stairwell landing, face-down and strapped into her wheelchair. Efforts to resuscitate her by staff members and paramedics failed.

• Email This
• Print
• Comments
• Trackbacks
• Share Link

The Boston Globe had a great article on technologically advanced wheelchairs that operate by voice command. The robotic wheelchair is being developed at the Massachusetts Institute of Technology.  The prototype can cruise the halls of MIT’s computer science lab, often without a passenger. When one of the students working on the device tells it to “Go to the kitchen,’’ a computer-generated voice responds: “Do you want to go to the kitchen?’’ If the answer is yes, the wheelchair, using a map of the route that it has previously “learned,’’ will drive to the kitchen.

MS sufferer and nursing home resident Richard Hatch is excited about the wheelchair because he’s helping to design it, along with fellow residents of the Boston Home in Dorchester, a residential and outpatient facility for people with neurological disorders such as MS and Lou Gehrig’s disease.  Hatch and 19 other residents carry laser scanners on their conventional wheelchairs, to give the MIT team a sense of their daily patterns and needs.

The voice-based information system will be tested at the home in three to six months. More technologically difficult aspects of the chair, such as navigation by voice command, will be added in a year or two. Over the long term, he’d like the chair to be able to monitor each user’s vital signs, including heart rate, temperature, and blood pressure.

“Assistive technology tends to have a relatively high rate of abandonment,’’ MIT associate professor Nicholas Roy said. “It’s either not nice to use, uncomfortable, or not obvious [how to use it]. It doesn’t fit the problem.’’

The wheelchair is designed to be tracked so the staff will know the location of each of the home’s 96 residents. But the residents also want to use the tracking ability to help them find their friends, which can be difficult when everyone’s in a wheelchair.

“We had not appreciated the extent to which being in a wheelchair impedes social engagement,’’ Roy said. At Hatch’s request, a monitor on the chair will include the Boston Home’s daily schedule, so residents will know the time of their next social event, outing, or relaxation session.

The prototype, which is a modified power wheelchair, cost about $10,000, roughly double the price of a wheelchair without such specialized equipment. Teller said he expects costs will fall quickly as more are made, and as laser scanners — the most expensive piece of equipment, at $4,000 — come down in price.

• Email This
• Print
• Comments
• Trackbacks
• Share Link

The Orange County Register had an article about the lawsuit filed on behalf of Oliver J. Shrock who was neglected at Kindred Healthcare Center of Orange.  The nursing home was fined $85,000 for their neglect and maltreatment.

Oliver J. Shrock's death on July 18, 2009 – four days after he suffered a fall and fatal head injuries  was labeled by the state as an "AA" citation – the worst violation that the state can issue against a skilled nursing facility.  The state concluded that the center disregarded Shrock's safety by not listening to the family's warnings, and not implementing safety measures, such as the use of a bed alarm.

Shrock's daughters, Kathleen S. Sakoguchi and Deborah Anne Whitman, sued the center and its former owner, Kentucky-based Kindred Healthcare Operating Inc.. Shrock's family told the center that Shrock – who was dependent on staff for most needs – was at high risk for falls, according to the lawsuit.

He fell soon after arriving at the center, but wasn't injured significantly. The center installed a bed alarm to help prevent future falls and placed mats on the floor to limit possible injuries.  But these measures weren't always in place when Sakoguchi visited her father, and she repeatedly had to tell staff to attach the bed alarm. The fall that caused his death happened on July 14, when Shrock was preparing to go home.

"A nurse assistant discovered Shrock on the floor bleeding from his head and she did not know how long he had been lying on the floor,'' according to the suit.  Shrock was taken to a hospital, and died four days later.

• Email This
• Print
• Comments
• Trackbacks
• Share Link

The Daytona Beach News-Journal had a tragic story about a 76-year-old resident at a DeLand nursing home who went for 12 hours without treatment after she broke her shoulder and both her legs in a preventable fall.  The incident under investigation started when a patient fell out of bed at 5 a.m. Friday as her bedding was being changed.  The patient, whose identity was withheld by police, was put back into bed after the fall. But it wasn't until after the next shift came on -- at 4:42 p.m. -- that emergency workers were summoned to attend to her injuries. She was taken to Halifax Health Medical Center in Daytona Beach where she was admitted.

The incident is under review by the Agency for Health Care Administration, which is charged with overseeing 31 nursing homes. Records with the state agency show that at its last inspection in October, nine deficiencies were cited at the facility that is owned by Graystone Healthcare Management, which operates 28 nursing homes in Florida, Indiana and Ohio. Among the citations: accident hazards and food storage.

• Email This
• Print
• Comments
• Trackbacks
• Share Link

Kentucky.com had an article about Lynwood C. Bauer, a nursing assistant charged with one count of reckless abuse of an adult in connection with the abuse of a patient at Britthaven Nursing Home in Pineville, according to Kentucky Attorney General Jack Conway's office.

The criminal complaint alleges that Bauer recklessly inflicted physical pain and injury on a Britthaven resident while working as a certified nursing assistant at the facility.  The victim was a male resident paralyzed on the left side of his body from a stroke.  His treatment plan called for him to be moved with a mechanical lift by two staff people.

The nursing assistant, presumed to be Bauer, told investigators he moved the male resident from a chair to the bed without the lift or help from staff. The nursing assistant then left the resident sitting on the edge of the bed while he walked across the room. The assistant said he did not check the man's treatment plan and did not know he was paralyzed.

When the resident fell from his bed, the nursing assistant told investigators, he put the man back to bed with no assistance from other staff. In addition to the man's treatment plan, nursing home policy requires that after falls, residents be assessed by a RN for injuries before they are moved.

When other members of the nursing staff came into the room after the injury, they discovered that the resident had "raised" and "red painful areas" on the back of the head, and his left shoulder, rib cage, hip and knee, according to documents.

The resident was taken to a local hospital and then transferred to a Tennessee hospital where he later died.

• Email This
• Print
• Comments
• Trackbacks
• Share Link

Minnestoa Public Radio reported a story about a resident in a St. Anthony nursing home rwho fell, hit her head, and died four days later, after an employee failed to follow basic safety precautions, according to state health investigators.   An investigation by the Department of Health cited the employee for neglect.  The incident occurred after a nursing assistant at St. Anthony Health Center left the resident's room without setting a sensor alarm, lowering the bed, or placing a mat by the bed.

Her doctor ordered these precautions in the resident's care plan, after determining that the resident was at risk of injury from falls.  The resident suffered a fatal hematoma on her forehead from the fall. She appeared drowsy and weak after the incident.  Within two days, her condition had worsened, and included "periods of unresponsiveness and apnea," the report said.

The resident was admitted to hospice where she died.

Incredibly, the death certificate lists the cause of death as heart disease.

• Email This
• Print
• Comments
• Trackbacks
• Share Link