Facility only fined 13,300 for neglect resulting in choking death

 The Syracuse Post Standard had an article recently discussing the (small) fine that a nursing home received for neglecting a resident who died as a result of choking.  How could they levy such a small fine for a preventable death? 

The government fined a Minoa nursing home $13,300 for failing to provide prompt emergency care to a choking resident who died.  The Centers for Medicare & Medicaid Services said The Crossings put residents in immediate jeopardy and provided substandard quality of care, the most serious deficiencies.

The Crossings was one of four nursing homes in the region fined for poor care between June 1 and Sept. 19, according to the Long Term Care Community Coalition.   The fine against The Crossings stems from an Oct. 15, 2007, incident involving a resident:  The report said:

The woman was served a dinner of blueberry pancakes and sausage that a nurse aide cut into bite-sized pieces. A short time later, the aide noticed the women's mouth was open, she was not breathing and her lips were blue.  The aide failed to call a "code blue," an announcement that alerts all staff to an emergency situation and summons them to provide assistance. It also activates the 911 system. The aide also failed to start the Heimlich maneuver.  A licensed practical nurse who came to help did not take these steps, either.  The registered nurse supervisor who arrived on the scene did not immediately call a "code blue" or 911.

I wonder what "a short time later" means?  I am surprised the nursing home did not claim that the resident had a DNR so they did not need to intervene!!

Wrongful death lawsuit filed for fatal fall

Family sues nursing home after senior falls, dies (09/26/08 Orange County Register) By Rachanee Srisavasdi and Courtney Perkes

Luveda Fern Kessler fell and cut her leg as she got out of bed at her Laguna Hills assisted living apartment.   It was 1:33 a.m. The 83-year-old woman did as she had been told to do: Press a personal emergency response call button.  She waited, bleeding from the two-inch gash. Twenty-four minutes later, at 1:57 a.m., an unidentified staffer at Villa Valencia Health Care Center called 911.  Valencia is owned and operated by Sunrise Senior Living that owns hundreds of for profit nursing homes.

Paramedics arrived at 2:10 a.m. Kessler lay on her stomach, nonresponsive. She was soon pronounced dead at a local hospital. Villa Valencia did not report the incident to the state.  

The Virginia-based company - which runs 445 senior centers internationally - has garnered criticism in two other lawsuits this year over care of residents at Villa Valencia's adjacent nursing home unit.

In one of the cases, a jury in May awarded $2 million to the family of Mary Adams, who died in March 2005 after a brief stay at the center. Lawyers representing the Adams family argued that Villa Valencia was understaffed to give Adams adequate treatment for her pressure ulcers - which lead to her death.

A nurse identified Kessler as being at risk for falls, but she was not given assistance getting out of bed or going to the bathroom.

"My preference would be to have her at my house,'' said Joanne Kessler, who lives in Aliso Viejo. "But I have a condo with a tri-level. There's no way she could handle stairs. I thought, 'It was better than her being alone, back in Seal Beach.' "

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