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

WNBC.com had a story about how a nursing home lied to a resident's family regarding her death at the facility.  This typeof cover up oftens happens in nursing homes. The staff is typically the only ones who really know what happened to a resident.   The staff are worried about their job or are instructed by their corporate masters to mislead or cover up the neglect and abuse.

Olive Chase was 94 when she died at Sunrise at Fleetwood, an expensive assisted-living home in Mount Vernon, in February 2007.  The nursing home told Chase's son that she had died in her sleep. The nursing home created an elaborate story that his mother had breakfast, was left alone at one point, and the aide returned to find she had died peacefully in her sleep.  The staff said Chase was sleeping at 7:30 a.m., but was "unresponsive" four hours later. Days after Chase was cremated, however, her family got a tip from someone with second hand knowledge of her death that the woman did not die peacefully.

Bob Chase, son of the woman who died, spoke with some of the staff and to the source who was the first nurse on the scene after his mother's death.   The nurse saw Olive's head caught between the bars of her hospital bed with her feet hanging off the side. The nurse said it appeared as if she struggled and then died of strangulation.

"Her tongue was protruding. It was purple," the nurse said.

The nurse said one of the maintenance workers then lifted Olive's legs while she held onto one of her shoulders.

"We brought her up, laid her flat on her bed," said the nurse. "I brushed her hair. This nursing coordinator told us, 'Don't say anything.'"

The nurse said the last person to treat Olive for a bedsore raised the bed for the treatment but did not lower it after, despite instructions to do so. Olive was known to wander, the nurse said.

"We had a sign on the top of the bed, readily visible, stating to lower the bed at its lowest level when finishing care," the nurse said.

An anonymous call to the state Department of Health days after Olive's death reported that the woman appeared to have died of asphyxiation after her head was caught in the bars, which triggered an investigation. The department concluded the caller's complaint was valid. The department found that Olive's body had been rearranged after her death, but it was not reported that way in Sunrise's records.

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Newport News Dailypress.com had an article about a suspicious death of a resident of a nursing home.  There appears to be a link between his death and medicine he got the day before.

A nurse who gave unauthorized medicine last week to a nursing home resident who later died has been fired.  Police are considering whether the medication caused or contributed to the death of John P. Stratton, 76, of Newport News, who was staying at the James River Convalescent and Rehabilitation Center.  Stratton was given the medicine on May 5, and died about 4 a.m. on May 6.

The nurse's decision to give Stratton the medicine was not an accident.   "She intentionally gave him the medication," police said. "Her intent in giving it to him will have to come out later."

Police are trying to find out whether Stratton was given an increased dose of a medicine he was prescribed, or medicine he wasn't supposed to get at all.

Joseph Law, James River Convalescent's administrator, said the nurse — whom he declined to identify — was fired after an internal investigation. The actual reason for her firing, Law said, was separate from the issue surrounding Stratton's death. "The nurse was terminated because of facility protocol," Law said. "During our investigation some other information was discovered." He did not elaborate. What a bunch of nonsense. Clearly the facility does not want to admit what happened or what they found out in their "internal investigation". 

It could take a month or longer for the toxicology results.  The examination will include any possible interaction between the medicine the nurse gave him and other drugs Stratton was taking.

One of Stratton's daughters, Denise Barnes of Newport News, said the family doesn't know what drug or drugs the nurse gave her father.   A staffer at the home brought to his attention the possible link between the medication and Stratton's death. He then called police and state agencies.

I'm surprised they didn't fire the staffer who refused to cover it up.

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This is not a post about a nursing home case.  But it is interesting.  I was emailed a blurb about an article on how the VA is directing their staff (presumably doctors) to avoid diagnosing patients with Post Traumatic Stress disorder. 

The email was titled "suggestion" - and it "suggested" diagnosing patients with a diagnosis which would provide lower disability payments.  Now, of course, the email doesn't come out and say that - it does, however, come out and say that they should consider a diagnosis of "Adjustment disorder R/O PTSD" - Adjustment disorder certainly sounds less expensive. 

I think all of us have had or will have adjustment disorder ~ adjusting to a new job, adjusting to a new marriage, adjusting to a new divorce, adjusting to a new baby, adjusting to a new house . . . . This is a far cry different from what some of our Soldiers returning home from war experience.  Adjustment disorder doesn't seem to accurately cover it.

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Jay Cameron whose mother died in a California nursing home filed a lawsuit against the facility saying it caused his mother’s death by reducing staff to save money. 

Cameron alleges the home committed elder abuse, fraud, wrongful death, negligence and violated patient rights. He is asking for an undetermined amount of money and reimbursement for attorneys’ fees. 

Cameron’s mother, Margaret Williams, was a resident at Mission View before being transferred to French Hospital Medical Center where she died.  Williams fell three times at the facility, suffered a hip fracture and developed pneumoniacausing her death.

Compass Health and administrators at Mission View are trying to increase profits by reducing staff and employing people who were not properly trained or qualified, leading to Williams’ death.

Attorneys for Cameron, Greg Coates and Michael Thamer, argue that the nursing facility took short cuts in care that resulted in unsanitary and hazardous living conditions and left residents unsuper vised. They also said there was an increase in accidents and injuries suffered by residents and nursing staff and other signs of inadequate care.

State records for 2006-07 show the state Department of Public Health issued three citations against the home in 2006 for patient care and fined the facility $2,800, spokeswoman Lea Brooks said.   In April 2007, during a recertification survey, state investigators found deficiencies at the home, Brooks said.

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The children of 94-year-old Alice Limbrick claim their mother's legs had to be amputated  because of negligent care during her stay at the Green Acres Parkdale nursing home.

The trial of Roy Limbrick vs. Mariner Health Care Inc. (Green Acres) began Jan. 23.  The defense will attempt to convince the jury that the amputating Alice Limbrick's legs had to be taken because of Alice's medical conditions and old age.

Alice Limbrick was admitted to Green Acres for long-term care with multiple health problems.  During her residency, Alice fell fracturing her left hip.

The plaintiffs say Limbrick was admitted to the hospital as a result of the preventable fall where she developed pressure ulcers (bed sores) and eight blisters on both heels and left leg. She was in stable condition and was discharged back to Green Acres.

A week later, she was readmitted to the hospital with gangrene on both heels.   The decubitus ulcers to her heels and left leg continued to deteriorate.  Limbrick's legs were amputated below her knees. 

In the suit, the plaintiffs allege that Green Acres' nurses were negligent in the following ways:

Failing to properly monitor, treat and care for the decubitus ulcers, which progressed and worsened while Alice was a resident;

Failing to properly assess Alice's risk level in the progression of pressure ulcers;

Failing to prevent the progression of Alice's decubitus ulcers;

And by failing to prevent infection in Alice's decubitus ulcers.

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The family of a Pennsylvania man who died shortly after falling and fracturing his hip at an Oakmont nursing home has filed a lawsuit asking for reasonable compensation from the facility for neglect and causing his death.

The family of Charles Grice filed suit Thursday against Presbyterian SeniorCare over negligent operation of its nursing home, The Willows.  Mr. Grice injured his hip when he fell unassisted out of his wheelchair. He died after surgery to fix his fractured hip. 

The staff of The Willows failed to take necessary precautions with Mr. Grice's care even though he was assessed as being at high risk for falls. He had entered the nursing home for rehabilitation, and was to return to home.

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Family of man who disappeared sues Gooding nursing home.  The family of a man who allegedly wandered away from the Idaho nursing home five years ago has sued thecorporation that operates the facility.

In the lawsuit filed on behalf of Magic Valley Manor resident John Henry Davis allege the home and Northwest Bec-Corp didn't supervise him or keep him safe and free from harm.

Wendell, who suffered from Alzheimer's disease, disappeared in July 2002.

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Dothan, Alabama police have arrested a 68-year-old man and charged him with molesting a woman at the nursing home where he lived last month. See full article here.

Aaron Howell is a convicted sex offender.  Howell violated the state community notification act when he moved into Westside Terrace Health and Rehabilitation Center on Nov. 30.  During the month of December he sexually abused an adult female employee there.

The violation to the state community notification act was discovered after an employee at the rehabilitation center viewed the sex offender Web site.  Thursday, Dothan police investigators charged Howell with felony first-degree sex abuse, and two felony violations of the community notification act.

Howell faces the new sexual assault charges nearly 15 years after he was convicted of molesting a 6-year-old girl in February 1993. Howell pleaded guilty in 1993 to first-degree sex abuse after Houston County investigators charged him when he lived in Cottonwood. 

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A Rockport, Arkansas nursing home chose to evict an elderly resident who was chronically ill. The home dropped her off at a motel in Aransas Pass and never notified the family. 

The home claims it wasn't getting paid for her to stay there.  Ladewig suffers from chronic bronchitis and a muscle disease. Ladewig said she was brought to this motel room after getting evicted. Her family were never told about the move.

When nursing home personnel dropped her off, the family said they left her with food for the weekend and these two portable oxygen tanks that would last about eight hours.

"I would have run out of oxygen and died," said Ladewig. "That's what would have happened to me if she wouldn't have come out looking for me. That's what would have happened."

"There is no phone in this facility, even if in the middle of night she went in respiratory failure or a situation where she couldn't get up, she has no way to contact anybody, whatsoever," Biggs said.

The family said the nursing home was paid through early December.

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Here's an interesting little article about the former director of operations for Beverly LIving Centers in one of the midwestern states.  "Ken Williston," as he's called in the article, says he was the representative of the national office, and assisted nursing home administrators in meeting the company's clinical and financial goals.  Seems he realized that Beverly was attempting to eliminate family choice of hospice care in favor of SeraCare, which is owned by Beverly.  Mr. Williston reported this finding to his immediate supervisor and to the company compliance officer, and was unemployed within 30 days.

Williston, himself a nursing home administrator, states "Its all about family choice, patient choice.  That's what its all about.  By law, the family has the right to choose their hospice care and home care.  I raised that point with management, and that's why I'm sitting here right now."

Beverly is one of the chains that was recently (2005) acquired by a private equity firm (Fillmore Capital).  Williston says that they know nothing about nursing homes, and they've cut the overhead by ten to fifteen percent to increase their income.

Also sounds like Beverly was increasing their income by encouraging families to "choose" additional health care from their own companies - more money in, less money out.

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The headquarters of The Carlyle Group, a Wall Street Investment corporation that made our blog a few weeks ago when we wrote about its involvement with Habana Health Care Center (see Wall Street and Nursing Homes? and Nursing Home Profits), was the site of a demonstration Monday, October 22nd by nursing home advocates.  The Carlyle Group is in the process of taking over Manor Care Inc., a Toledo, Ohio-based nursing home chain with facilities across the country.  Manor Care has several facilities in South Carolina.  

The Washington Business Journal reports that the demonstration was organized by SEIU Healthcare, a health care workers union, and it's purpose was to express worries caregivers and advocates have about the quality of care residents will receive after the the takeover as well as the status of jobs within the facilities.  As we blogged in previous articles mentioning The Carlyle Group, there is much data to support the fact that staffing numbers are cut and care quality goes down when Carlyle is involved.

On Monday, Carlyle made a pledge to quality care at Manor Care facilities saying that education, training, and staffing levels would ensue proper clinical care and all federal and state regulations would be met.  A Carlyle higher-up stated that "Manor Care is poised to become an even stronger health care provider under Carlyle's ownership." 

A statement released by Carlyle said the acquisition of Manor Care is expected to be completed by the end of November.  I suppose only time will tell if Carlyle will uphold their promise to provide quality care to the residents of the former Manor Care facilities.  A statement released by the executive vice-president of the union that organized Monday's event says advocates will continue to hold Carlyle Group "accountable for improving care and staffing at Manor Care." 

The Washington Business Journal also reported that the demonstration was planned to continue on Tuesday at Capitol Hill to lobby Congress to "hold hearings on private equity ownership of nursing homes."  

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I recently read an article about Charles Grassley, Republican Senator from Iowa who is on the Senate Finance Committee asking long term care insurance companies to explain how they are handling policy holders' claims.  This is the quote I love the most:  "Many long-term care insurers have recently announced that they are raising premiums because they underestimated how many policy holders would eventually make claims."  Hmm, that's interesting.  You're selling insurance for long-term care to the elderly - can't you just assume that most of these people will eventually make a claim?  Or are the insurance companies betting that people will die before they need nursing home care? 

Its sad that people pay into the insurance companies for coverage, and then get the run-around to collect on their claims.  And worse than that, my guess is that many of these "insured" are not in the position to stay on the phone arguing with the insurance company in an effort to get the claims paid - and the insurance company probably bets on this too.

Additionally, Senator Grassley has asked the Government Accountability Office to look at the effect of private equity ownership on quality of care in nursing homes.  According to a recent NY Times article, the number of serious health deficiencies is 19% higher in homes owned by investment firms than in average nursing homes, indicating most likely that these firms are putting profits over people.  One of the things that Senator Grassley points out is that the public is in the dark about nursing home deficiencies, and about the extensiveness of deficiencies industry wide. 

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USA Today recently reported that the numbers of elderly (defined in the article as the population of people 85 and older) living in nursing homes is declining.  The article points out that these numbers don't include those living in Assisted Living Facilities, which may in fact reflect a good portion of the 85 and older population. 

This is a good thing, as it may mean that people are living better instead of just longer.  I say that for a couple of reasons:  1) you have to be functioning at a certain level to be in assisted living, 2) it is my opinion that it is always better not to be in a nursing home.

The article also points out the sad fact that the decline is most likely in the "upper-income white population" who has the financial ability to take advantage of options other than nursing home placement.  Everyone else will likely have nursing homes as their only option.  The other sad fact is that "the average nursing home patient runs out of money within six months and must go on Medicaid" - so while these individuals will go broke, and eventually the Medicaid system may go broke, the nursing home industry continues to make money.

To read the entire article, click here.

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Federal and State regulations mandate that a nursing home hire and retain a medical director for nursing homes.  In a recent case, after a lengthy investigation, a nursing home was found guilty of fraud for failing to have a medical director.   It took the jury about two hours to decide.

The state took Billie Anderson to court because investigators say from March 2002 to January 2003 Anderson operated Anderson Health Care in Gray without a medical director.

During that time she still collected about $100,000 dollars a month for her Medicaid patients—that is a violation of Medicaid laws because she didn't have a medical director.

The guilty verdict means the jury believes Anderson knew there was no medical director and that she concealed or failed to disclose that information to the state.

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Here is an interesting article about an investigation at a nursing home involving a resident who died from suffocation. 

It was Friday, September 7 when authorities say Stephanie Galletti who lived at the Taylor Nursing Home and Rehabilitation Center got tangled in some bed rails and suffocated.   According to a search warrant, it is part of a neglect investigation into Galletti's death. She was an Alzheimer's patient with a history of falling out of bed.

Court papers reveal a housekeeper "found Ms. Galletti's head wedged between her bed rail and her mattress."   Included in the evidence seized from the nursing home Wednesday were medical records and an air mattress from Galletti's bed.

According to court papers, the elderly woman died at 7:40 a.m., but her death was not reported to police until 9:48 a.m.   No one can explain the two hour delay.

In the affidavit investigators said, "No explanation was given as to the two hour delay in reporting the incident."  Authorities are also investigating a bed alarm that is supposed to sound if a patient falls out of bed. Detectives said Galletti's bed alarm was turned off.

The bed alarm should not have been off according to the physician's orders.  Clearly, the home did not have the bed alarm on and did not properly supervise the resdient.

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New England Journal of Medicine has an article about Oscar, a hospice cat at the Steere House Nursing and Rehabilitation Center in Providence, R.I., who seems to have an uncanny knack for predicting when nursing home patients are going to die, by curling up next to them during their final hours.

His accuracy in 25 cases has led the staff to call family members once he has chosen someone. It usually means they have less than four hours to live.

The 2-year-old feline was adopted as a kitten and grew up in a third-floor dementia unit at the Steere House Nursing and Rehabilitation Center. The facility treats people with Alzheimer’s, Parkinson’s disease and other illnesses.

After about six months, the staff noticed Oscar would make his own rounds, just like the doctors and nurses. He’d sniff and observe patients, then sit beside people who would wind up dying in a few hours.

Oscar is better at predicting death than the people who work there, said Dr. Joan Teno of Brown University, who treats patients at the nursing home and is an expert on care for the terminally ill.

No one’s certain if Oscar’s behavior is scientifically significant or points to a cause. Teno wonders if the cat notices telltale scents or reads something into the behavior of the nurses who raised him.
Oscar recently received a wall plaque publicly commending his “compassionate hospice care.”

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The U.S. Attorney's Office and the Pennsylvania Department of Public Welfare filed a complaint Thursday against the Holland-Glen Nursing Facility in Hatboro, Pa..  See article here.

The complaint alleges the facility has been operating without a nursing facility license and its services "substantially depart from generally accepted professional standards of care, thereby exposing patients to significant risk and, in some cases, to actual harm."

Among the specific allegations in the complaint are that Holland-Glen fails to properly administer medications, provide proper general resident care, check the backgrounds of its employees, and has falsified both resident medical records and records of billings to governmental and other payors.

The complaint seeks an injunction to prevent Holland-Glen from continuing to provide unlicensed care.

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 A lawsuit against a Fort Smith-based nursing home company can proceed as a class-action suit, the Arkansas Supreme Court ruled this week.

The court affirmed a decision to grant class-action certification to a suit alleging Batesville Nursing and Rehabilitation Center failed to live up to contractual and statutory obligations to take care of the basic daily needs of hundreds of residents.

The suit, filed in 2005 by Annette Thomas, names the nursing home and its parent company, which was known in 2005 as Beverly Enterprises, as defendants. Beverly changed its name to Golden Horizons last year following its purchase by Golden Gate National Senior Care.

The suit alleges between Sept. 13, 2000, and June 30, 2004, the nursing home failed to care properly for 489 residents by, among other things, failing to provide adequate staffing and failing to provide a clean, safe living environment.

Attorney Philip Bohrer of Baton Rouge, La., argued the case did not include personal injury claims, but rather claims involving issues such as understaffing which would have affected all residents of the facility. Granting class-action status was preferable to "having 400 individual trials on the same issue and the same evidence," he said.

Bohrer also said many of the plaintiffs are elderly and unaware of their rights and would not be able to file individual claims against the company.

In its decision Thursday, the Supreme Court said the plaintiffs showed the case met the criteria for class-action certification. The justices agreed with Harkey the defendants would benefit from class-action status.

"A class action is clearly a more efficient way of handling a case where there is a predominating, common issue to be resolved for all 489 class members. A class action is also fair to both sides in this case, as it is a vehicle for all class members to have their claims heard, and Beverly will not have to defend against the same assertion of liability in a multitude of different lawsuits," Justice Robert Brown wrote.

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Here is an article about a nursing home company indicted in 2004 for the death of a resident.
Life Care Centers of America Inc. was finally indicted in the preventable death of an elderly woman whose body was found in her overturned wheelchair at the bottom of the front stairway of an Acton facility.

Life Care Centers of America Inc., which owns and operates the Life Care Center of Acton, was charged with manslaughter, abuse and neglect of a long-term care facility resident, and making a false Medicaid claim in connection with the death of 74-year-old Julia McCauley on April 17, 2004.

Attorney General Martha Coakley said that beginning in 1999, a physician had ordered McCauley to wear a device called a WanderGuard, which would set off an alarm and lock the doors of the facility if she approached them. The order also required nursing home staff to check the device daily to ensure it was functioning properly.

On the day she died, McCauley went through the front entryway of the Life Care Center and fell down the stairs. She was not wearing the WanderGuard device. 

The corporation will face a maximum fine of just $1,000 on the manslaughter charge, and no corporate official faces prison time.

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Nursing homes change with the time
Industry keeps up with residents’ expectations
Originally published April 01, 2007 
By Katie E. Leslie
News-Post Staff

FREDERICK -- For many people, the words "nursing home" bring to mind images of cold tile hallways, greenish room lighting, unattended seniors in distress and a sterile environment that speaks more of an outdated hospital than a home.
Some parts of the industry may have earned that reputation, but Cheryl Wright, marketing director for Homewood at Crumland Farms in Frederick, said today's nursing homes are a far cry from the disturbing visions of yesteryear.

"There's still a lot of education (in the community) that needs to happen," Wright said. "The reality is, things have changed for the better."

Homewood, one of Frederick County's 13 nursing homes, is in the new generation of long-term care centers ----multi-staged retirement communities. In such establishments, people 55 and older can live independently in a house or apartment, and as their needs increase, move into an assisted living unit and ultimately into an advanced care unit.

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