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

Associated Press reported that a nursing home was fined $360,000 related to the suspicious deaths of 6 patients at a northern Illinois nursing home.  Investigators have evidence that leads them to believe that the nurses employed by the nursing home was giving unnecessary drugs to the residents so they would not have to care for them.  This kind of behavior is considered a chemical restraint.  Because of patient load and lack of adequate staffing, the nurses give sedatives and other medications to quiet the residents so less care is required.  If the residents are asleep, the staff doesn't have to respond to call bells, change briefs, or feed the residents. 

Penny Whitlock was indicted last spring on criminal charges including neglect and obstruction of justice.   Authorities began investigating the facility in Woodstock after six patients suspiciously died in 2006. Another employee, nurse Marty Himebaugh, also has been charged in the case.

 

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Koco.com,  a news website from Oklahoma City, had an article about a resident being physically abused with video evidencing significant bruises.  The article states that the resident's family is looking for answers after a woman was found covered in bruises while she was staying in a Norman nursing home.

The workers at the Whispering Pines Nursing Home said Carol Crow, 60, was injured when she fell but did not provide any details to support this conclusion.  The family doesn't believe the injuries could come from a fall. The family is offering a reward for information because the Department of Human Service has refused to investigate.

"It was very traumatizing. She just cried the whole time," said Julie Glass, Carol's daughter. "She had bruising all the way around her face, all the way completely down her chest and around her neck."

"Her story is that a man knocked her down, got on top of her and beat her unconscious," said Jack Crow.  The family said they took their story to DHS, which sent them a letter saying that it wouldn't open a case because there was no indication of abuse.

The Crow family offered a $2,500 reward for information. They posted signs around Norman and in front of the nursing center. The sign posting led to a confrontation with Whispering Pines representatives.

"I'm angry at the fact that I don't know what they're covering up," said Glass. "The people that are left there have no one. They have no one to protect them."

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ABC News, the Denver Channel, had an article about a nursing home employee beating a sick and vulnerable resident of a nursing home.  This story disgusts me.  I hope they throw the book at this guy.  I hope he will never be able to work in the health care industry again. This kind of assault happens far too frequently and typically gets covered up by the nursing home or regulatory agencies.

The article mentions thar Kalen Randolph was arrested for nearly beating to death an elderly patient in his care. He physically assaulted a 74-year-old stroke victim at Ashley Manor.   "He struck him repeatedly. Turns out, he had serious bodily injury, according to one doctor. (Randolph) also then fled the scene leaving eight of these elderly patients at the home without supervision," said Aurora Police spokesman Detective Bob Friel.

Because of a 911 hangup call, police responded quickly to the attack at 3:40 a.m., but Randolph was not in the area.   "We know that he ended up meeting with a girlfriend and having sex in her car. And that's what he was doing at the time when these elderly patients were left in the home," said Friel.

Randolph, a certified nurse's assistant, is charged with eight counts of neglect and one count of second-degree assault.  Ashley Manor is a small facility for Alzheimer's and brain injury patients. It has only nine patients.

Where was his supervisor?  Was he the only person working on third shift?  The nursing home should be held accountable for the actions of their employees.

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KAALtv.com had a disturbing article on residents being abused in a Minnesota nursing home.  The conduct of these "professionals" is outrageous and disgusting.  They should be arrested and thrown in jail and never work in the health car eindustry again.  I would be surprised if anything happens to them.  They will probably get rehired easily knowing how the nursing home industry works.

The article mentions that an investigation by the Minnesota Department of Health found that at least 15 nursing home residents were abused mentally and physically.  The abuse actually could have been prevented months earlier.

According to the Minnesota Department of Health 15 residents at the Good Samaritan Society nursing home were verbally and or physically abused by several nursing assistants, some of them are not even 18 years old.  The abuse was discovered back in December of 2007, but could have been earlier than that.

The 5 perpetrators were responsible for caring for the residents.  The Freeborn County Attorney's office says dealing with vulnerable adults makes it difficult to prosecute when they don't have statements from the victims.   It sounds like the prosecutor is making excuses for his own incompetence.  Why doesn't he ask the nurses to take polygraph tests?

The Freeborn County Attorney says the five women face gross misdemeanor charges, which means only one year in jail, a $3-thousand dollar fine or both as a maximum plenty. There is no mention in the article if the nurses licenses have been revoked or if they work at another nursing home now.

 

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Deseret News had an article about the sentencing of a nursing home employee who molested an 85 year old resident where he was employed.  This is a tragic and preventable situation. Why didn't anyone supervise this CNA?  How could they have hired this guy?  Why did they allow him to plea to a lesser crime? How could they give him such a light sentence?

Jacob Mut Bolith was charged in July 2007 with first-degree felony rape, second-degree felony forcible sex abuse and class A misdemeanor lewdness. However, in a plea agreement, he pleaded guilty to forcible sex abuse, a second-degree felony, and the other two charges were dropped.  He was only sentenced to serve a one-to-15-year sentence and ordered him to pay restitution.

"To do this to my mother ... is unconscionable," one daughter said. Her other daughter said a medical exam showed that the defendant did more than "what he admitted."

The article doesn't mention if the facility knew or should have known about their employee's tendencies or if they did a background check or if they recieved prior complaints about his behavior or if the State even investigated the nursing home.

 

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The Fort Worth Star Telegram had an article about a tragic situation where an abused resident died before the grand jury was able to indict his tormentor. 

Elaine Doores, a retired biology professor diagnosed two years earlier with Alzheimer’s, struggled to find the right words to describe the abuse she survived.   "He has hurt me a lot. Every time he bathes me. He puts things in me.  . . . He had sex with me more than once. It’s all the time in the bath."

The 68-year-old woman’s statement led to the arrest of Donald Gene Shelby, a certified nursing assistant at the James L. West Alzheimer’s Center where Doores had been living.

Her daughter says the district attorney’s office stalled in handling the case.  "They sat on it while the victim got worse," Pitt said. "That’s the disservice they did to my mom and my family."

She believes that prosecutors dealing with victims who have dementia or Alzheimer’s should try to present the case to a grand jury without delay.

Elaine Doores was placed in a nursing home Jan. 23, 2007, two years after being diagnosed with Alzheimer’s.  Pitt said Doores had difficulty speaking and performing motor skills but recognized relatives.

Pitt said that on Feb. 18, Shelby told her that her mother was upset the day before because the pajamas that she wanted to wear were dirty. Pitt said she was puzzled because her mother had never seemed to care what she wore.  Later, during the same visit, Pitt said that when she suggested getting "Donald" to help Doores go to the bathroom, her mother became agitated. When questioned, Doores told her daughter that Shelby was "bad" and had done something "wrong."

Pitt said she sought the help of a floor nurse, who asked Doores whether Shelby had touched her. Doores answered, "Yes." When the nurse asked where, Doores replied, "Everywhere," Pitt said.

Pitt went home and told her husband, Deven Pitt, a Fort Worth police detective. At his suggestion, the two contacted Detective S.L. Schloeman, the on-duty investigator with the sex crimes unit, and filed a police report.

Afterward, Doores provided a statement to Schloeman, a copy of which Pitt gave to the Star-Telegram. Doores described Shelby as "scary" and said she was afraid of him. She said he made threats and told her not to tell anyone what he had done.

Schloeman, now a sergeant in patrol, said that to determine Doores’ mental state, she had asked Doores questions, including some about her daughter’s birth date, the current year and where she lived. Doores answered every question correctly, Schloeman said.

"She displayed symptoms of having just a minor case of Alzheimer’s," Schloeman said. "She was able to give me a clear, concise description of what had happened to her. She was able to identify the suspect in a photo spread and identify him by first name."

On March 2, 2007, Schloeman obtained an arrest warrant for Shelby on suspicion of aggravated sexual assault. The next day, Shelby surrendered at the Tarrant County Jail and was released after posting $50,000 bail.

Tarrant County court records show that Shelby was indicted in March 1987 on a charge of indecency/fondling. The state dismissed that case in January 1988 after the accuser, a male minor, committed suicide. 

How could he get a job at a nursing home when he had been arrested for abusing a vulnerable person?  Did the nursing home do a criminal background check?

 

 

 

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A recent Cornell University study reports aggression is commonplace in nursing homes--between residents themselves and between residents and employees of the nursing home.  Verbal and physical abuse is more common than the industry acknowledges. In an online report with McKnight’s Long Term Care News, the study documents many observations made at a city-based nursing home which found at least 35 different types of abuse, with screaming being the most popular. Physical violence included pushing, punching, and fighting.

The report also referenced another two-week study wherein researchers found that 2.4 percent of nursing home residents have been victims of physical aggression; 7.3 percent claimed they were verbally abused. A third report discussed an investigation in which 12 nurse observers found 30 incidents of aggression between residents in one eight-hour shift. Victims were most commonly male and often had “wandering cognitive processing problems.”

A report released earlier this year by the Congressional Government Accountability Office (GAO) revealed a widespread “understatement of deficiencies,” that included malnutrition, severe bedsores, overuse of prescription medications, and nursing home resident abuse in the nation’s nursing home inspection reports. The report stated that nursing home inspectors routinely ignore or minimize problems that pose serious, immediate patient threats.

Facilities are generally only inspected once a year by overworked and underpaid state employees. Federal officials sometimes attempt to validate state inspector work by joining them on visits or conducting follow-ups. It was in a follow-up that the GAO discovered the state missed at least one serious deficiency in 15 percent of all inspections. Worse, in nine states, inspectors missed serious problems in over 25 percent from 2002 to 2007.

There are 16,400 nursing homes with over 1.5 million residents nationwide; approximately one-fifth of the homes were cited for serious deficiencies last year. “Poor quality of care—worsening pressure sores or untreated weight loss—in a small, but unacceptably high number of nursing homes, continues to harm residents or place them in immediate jeopardy, that is, at risk of death or serious injury,” the report said. Taxpayers spend about $72.5 billion annually to subsidize nursing home care and facilities must meet federal standards to participate in Medicaid and Medicare, which covers over two-thirds of its residents, at a cost of over $75 billion annually.

Unfortunately, nursing home abuse tends to be underreported because individual homes do not take elder abuse seriously and residents fear embarrassment, injury, even incapacitation for speaking up.

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The DesMoines Register has an article about a woman who complained about the care her mother ws recieving at a nursing home being arrested after the nursing home stated that she was "abusing" her mother.  This lack of accountability by the nursing home is astounding.  Trying to quiet the family of a neglected resident who had every right to complain about the poor care given to her mother is ridiculous.  Obviously, the nursing home did not want the family to witness other acts of neglect and wanted to protect their mother.  Below are excerpts of the article.

A Cedar Falls woman who claims she was jailed in retaliation for complaints about her mother's care at a Waverly nursing home has sued the home and the city.   Maxine Veatch, 64, and her sister, Christine Price, 57, of Mason City sued Bartels Retirement Community, at whose nursing home their 94-year-old mother, Agnes Bell, has lived since 2004.

Co-defendants include the home's administrator, Debra Schroeder; its director of nursing, Brianna Brunner; and Police Sgt. Jason Leonard.  Veatch and Price allege false imprisonment, negligence, defamation and malicious prosecution. Police and nursing home officials could not be reached for comment. The sisters have asked for at least $75,000.

The federal lawsuit alleges the sisters noticed problems such as medication errors and a lack of cleanliness in 2006 when they visited their mother at Bartels' Woodland Terrace nursing home. When they raised their concerns with managers, administrators compiled "a book of false and/or misleading accusations" against the sisters, the lawsuit claims.

The state has cited the home for 11 violations since 2004. Last year, inspectors alleged a high rate of medicine errors and problems with nursing services.

Bell allegedly collapsed in Veatch's arms on Sept. 27, 2006, while she walked with her daughters to the home's dining room. Veatch swung her 145-pound mother into the nearest wheelchair, and Bell recovered within a few minutes, according to the lawsuit.  A worker at the home reportedly complained to her bosses that she saw Veatch shove her mother into the wheelchair. Veatch was summoned two days later to the police station, where Leonard allegedly issued her a citation for assault and put her in jail for 23 hours. Veatch was then barred from the nursing home for 13 months. Price was denied visits for eight months.

Veatch was acquitted of the criminal charge. After Iowa Department of Human Services officials classified her as an abuser, Veatch appealed the decision, and her mother testified on her behalf. Administrative Law Judge Mark Lambert overturned the department's finding and stated that Veatch had "prevented a potentially much more serious injury to her mother."

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In many of our neglect and abuse cases, the victim is unable to testify regarding the bad care because of dementia or death.  I read an article today about a man who is competent and speaking up for his rights and the rights of others at the facility where he lives.  Mr. Crawley is a competent 48 year old man who resides at Sunrise Rehabilitation & Care in Marion, N.C.   "I am not being treated like, I feel, as a human being," said Crawley. 

Crawley became a paraplegic as a result of a car wreck in 1982. His 81-year-old father, Joe Crawley Sr., can no longer take care of him and he started living at Sunrise Rehab on Oct. 15. For the first two weeks there, the staff didn't give him a bath or shower.  "I don't know what is going on here," he said. "It seems like they make a lot of errors in simple things."

Crawley said his elderly roommate will talk incoherently and constantly yell about having to urinate, and, rather than listening to him, the staff will shut the door. With the heater running, that makes the room get hot for both Crawley and his roommate. He said he has called the nurse's station to have the door opened but is ignored.

His sister said the staff once left a feces-soiled blue pad on his wheelchair for more than two hours. His father, who visits him twice a week, found it and thought his son had had an accident. He bagged up the soiled pad and took it to the nurse's desk.  "That's an unsanitary condition and that's neglect," said Pilgrim.

Crawley said he's confined in his bed 21 hours a day.   This will increase the likelihood of developing pressure ulcers. 

Crawley added he's paying $879 a month to stay at Sunrise Rehab, which leaves him with just $30 out of his monthly disability check. He wishes he could go someplace else.

"I don't know if they think I am incoherent or lost my faculties or don't know what is going on," he said. "But I do know what is going on. I need more than anything to be transferred to a place that deals with wound care."

"They are neglecting the people," said Buckner. "That is why there is a waiting list at Autumn Care."

The official Web site for Medicare contains information about nursing homes across the nation. The site states that Sunrise Rehab had 11 health deficiencies, which are above the state and national averages. One of the deficiencies included failure to "write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property."  Another deficiency found on May 10 by inspectors was failure to "give professional services that meet a professional standard of quality."

In addition, inspectors found on Aug. 30 that Sunrise Rehab failed to "make sure that residents are safe from serious medication errors" and it also failed to "make sure that the nursing home area is free of dangers that cause accidents."

See full article here.

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Washington Post has a great article by Marie-Therese Connolly about demographics and elderly abuse.  Ms. Connolly worked at the DOJ and has years of experience with the nursing home industry.  Below are some excerpts.

As though declining health, impending mortality and other challenges weren't hard enough, too often old age is also plagued by abuse, neglect and exploitation.

Science has extended our lives dramatically: In 1900, Americans' average life expectancy was 47. By 2000, it was 77, and it's still rising.  Estimates of the prevalence of elder abuse vary wildly, but by some reports there could be up to 5 million cases a year, with 84 percent going unreported. All other factors being equal, victims of even relatively minor mistreatment are three times more likely to die prematurely than those who are not victimized.

Furthermore, our nation is in the midst of three seismic demographic shifts that will put seniors at even greater risk for mistreatment. Older people are living longer, until they're frailer and more vulnerable. They are increasingly alone in old age, given that families are smaller and more geographically and emotionally dispersed. And the pool of potential caregivers is aging and shrinking. We need 30,000 geriatricians: We have only 9,000.

Neglect may sound more benign than abuse, but it usually lasts longer, is harder to prove and prosecute, and can be just as lethal.   Thirty percent of seriously ill elders surveyed have told researchers that they would rather die than go to a nursing home.  But while neglect of one person is tragic, systemic neglect by a facility or chain housing numerous residents can be catastrophic.

Facility owners may extract millions in profits, leaving insufficient funds to care for residents. Insulated by corporate structure, casting blame on facility staff, they are rarely held accountable.  But the news about staffing, the most critical factor in the quality of long-term care, is bleak: A government study in 2002 concluded that more than half of the nation's nursing homes are understaffed at levels that harm residents. Nursing homes receive $80 billion from Medicare and Medicaid annually to care for 1.5 million residents.  Yet not a single federal employee works on elder abuse issues full-time.

Marie-Therese Connolly, a fellow at the Woodrow Wilson International Center for Scholars, is former coordinator of the Department of Justice's Elder Justice and Nursing Home Initiative.

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Texas Attorney General Greg Abbott has filed a lawsuit against a Fort Worth assisted living center, claiming its manager threatened residents with a hammer, withheld food and locked some of them out of the building at night.  See full article here.

Abbott says the alleged abuse took place at the Oasis Village assisted living facility, located in Fort Worth's Polytechnic neighborhood. A district judge issued a temporary injunction against the owner of the facility, God's Intercessory Prayer Warriors Ministries, Inc., and its manager, Bertha McCoy.

According to state inspectors from the Department of Aging and Disability Services, at least five residents at the facility have complained that McCoy abused them. Some residents said she took the mattresses from their beds and forced them to sleep on metal bed frames, as punishment for soiling their sheets. They also said she locked them out of the building overnight. State inspectors also found evidence that McCoy hit several residents and threatened some with a hammer.

Inspectors reportedly found a hammer in McCoy's office during a recent visit.

The state has filed suit against Oasis Village with the facility facing a punishment of up to $10,000 per penalty.   All of the residents at the facility have been relocated.

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There is an article in an Ohio newspaper that discusses an alleged rape of a male resident at a nursing home.

After visiting her fiancé Saturday night at Concord Care and Rehabilitation Center, Linda Monegan knew something was wrong.  Unable to talk or see after suffering a stroke, her 55-year-old fiance nodded his head to signify he was in pain. He had been sexually assaulted by a nurse.

Concord Care night-shift nurse John R. Riems, 49, 100 block of W. Cedarwood, was arrested Monday on felony charges of rape and gross sexual imposition. During questioning Riems recalled abusing nearly 100 patients during his more than 20-year career.  Riems, who obtained his registered nursing license in 1985 through Providence Hospital's nursing school, has worked at several nursing homes.

Concord Care director Jessica Short refused to answer any questions. Instead, she handed over a four-sentence typed statement, closed her office door and called police. The statement indicated an employee accused of "inappropriately touching" a resident was fired.

After she told police about the incident, Monegan said she was ordered by a nurse not to return to Concord Care, and now fears for her beloved's life.

Many of Reims' victims were elderly or disabled and unable to report the abuse.

The family is calling for justice to be served not only on Riems, but the entire nursing staff, who they say are responsible for patient neglect.   Besides the sexual abuse, Monegan said her fiancé suffered from burns to his legs, dehydration, bed sores and an unkempt trachea tube while staying at Concord Care since October 2007.

"What if that was your family member?" Monegan said. "What if that was your loved one?"

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I realize that this post might be a bit off topic but it shows the arrogance of insurance companies and their contempt and disdain for the rule of law.  Nursing home attorneys routinely see this when the insurance companies refuse to provide nursing home records or when they state an elderly resident's life is not worth much because "they were already going to die" or when they blame neglect on resident complaince.

Allstate Insurance Co. told a judge that they refuse to produce key records to the Court no matter how much the Court fines them.  Judge Michael Manners has already fined them $25,000 a day since mid September — a total of $2.4 million and growing.

Last month the Missouri Supreme Court ordered the documents produced. At issue are the so-called McKinsey documents which show how Allstate set up a claims scheme in the 1990s that shortchanges clients while earning the insurance company huge profits.

Allstate still refuses to disclose the damaging documents.

The case stems from a car wreck seven years ago on Interstate 70. Allstate client Paul Aldridge of Hawaii ran into the back of a truck and severely injured the driver. He is suing Allstate for bad faith for refusing to pay the claim for years.

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The L.A. Times has an incredible story that is far too common in today's nursing home industry.  

 Rita Kittower buried her husband last month.  She had bade a tearful goodbye to her mate of 49 years, who had passed away in an exclusive assisted living facility in Calabasas. "He just stopped breathing," Kittower said she was told by a staff member.

Then came the anonymous phone call the day after the funeral. A female employee of the nursing home told Rita that her 80-year-old husband's death had been anything but peaceful. She said Elmore Kittower had been beaten to death by someone on the staff. 

Detectives from the Los Angeles County Sheriff's Department asked if they could exhume her husband's body to determine what actually happened.

Mr. Kittower had a stroke which necessitated a stay at a nursing home for rehabilitation. Through a recommendation, Mrs. kittower found a place called Silverado Senior Living in Calabasas. The place specialized in taking care of residents like Mr. Kittower.  The price for such service wasn't cheap. Rita said she paid nearly $75,000 a year for her husband to share a room with another patient.

On Sunday, Oct. 28, the Kittower family gathered at Silverado to celebrate Elmore's 80th birthday. The following Sunday, Rita and Elise came back for another visit.  It was the last time they would see Elmore alive.

Two days later, a sheriff's deputy told her that her husband had died at 8:30 that morning. When Rita called the nursing home she was told that Elmore had "just stopped breathing."

On Nov. 10, the day after her husband was buried, Rita received the mysterious call from a woman who identified herself only as Maria. The woman said she hadn't slept in three days.

The woman said a staff member had punched Elmore in the eye and wrapped a towel around his head in an apparent attempt to suffocate him.

She hung up the phone, but not before getting the woman's number. Rita asked her son to call the woman back. He elicited more details from the caller. When Rita asked about it, he said, "You don't want to know."

Rita asked her nephew, Paul Zwerdling, to call the Sheriff's Department.   As it turned out, sheriff's officials already had their suspicions about Elmore Kittower's death. The woman who called Rita Kittower also made an anonymous call to the Lost Hills sheriff's station and mailed an anonymous letter to a nearby fire station.

Lt. Al Grotefend said detectives gathered sufficient evidence to warrant an exhumation.  After consulting with family members, she agreed to the exhumation in order to "find out the truth" and protect any other potential victims. 

Sources confirm some trauma to Kittower's remains that was consistent with an assault.

Grotefend said detectives developed a prime suspect in the case -- a caregiver who no longer works at the facility.  The suspect was arrested shortly after Kittower's death on suspicion of elder abuse, but the case was rejected by the district attorney's office.

Grotefend said that the arrest was made before the exhumation and that detectives have since gathered additional information and plan to resubmit the case to prosecutors.

Not surprisingly, Mark Mostow, a paid spokesman for Silverado Senior Living, said the company had completed its own "investigation" and "found nothing to substantiate any wrongdoing."   However,  Mostow admitted that the employee accused of assaulting Kittower had been terminated for violating an undisclosed policy.

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A family whose mother passed away two years ago after spending just a month in a nursing home says her death should not have happened then and now they're asking for help. "She walked, talked, could eat on her own," said Arnold Trevino, remembering his mother before she checked in," he said, "when she left out of there, she left out of there an invalid, she couldn't talk," he explained. Full article here.

He says after his mother stayed at the Valley Grande Manor for just 30 days, the damage was done.   Trevino said his problems with Valley Grande Manor began when his sister, a registered nurse, told the staff her mother was suffering a heart attack. He claims the staff refused to take her to the hospital, so he called the state to get her out. "When she was taken to the hospital, doctors told us she had not been fed, given any water and that she had abusive bruising that they don't know how she relieved," said Trevino.

That's when he took pictures he says are even more proof. Natalia Trevino died just weeks later, her death certificate names malnutrition as a contributing factor.

Trevino says he's frustrated, because even though this report shows several violations including LVN staff without a valid license, and others with convictions working there, he can't get anyone to take action.

But Trevino wants someone to take action against the staff that treated his mother. "I want for them to face the same consequences that I would have faced if I would have taken my mother to the hospital in that condition," Trevino said.

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This story really upset me.  I can't imagine the excuses the nursing home will use to explain this neglect away.  Florida police began investigating why an 82-year-old man from the University Center West nursing home was so severely neglected, he ended up in the hospital.

The man was taken to the hospital suffering chest pains and difficulty breathing.  What doctors found was so alarming, they had to call DeLand police.

Doctors told police the hospice patient had bed sores, his breathing tube was infected, and they found maggots in his left eye.

JoAnn Grasso, the administrator of the nursing home, declined to comment specifically on the case.

Former University Center West employee Monique Miller said she was not surprised.

"I haven't seen maggots — but bed sores, yes," Miller said. "That doesn't surprise me at University Center West. No, it does not, because I've seen it several times."

Miller said supervisors at the home are lax and allow unhealthy conditions to continue until its too late.

"You have to be half dead for them to send you out to the hospital, because they're afraid to lose money, or their beds will be empty," Miller said. "That's scary. It's very scary. You have to watch it. You have to be very careful when you put a family member in a nursing home — all nursing homes."

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Kansas City, Missouri Police are investigating the alleged rape of an 80-year-old woman at a Northland nursing home.   While management vehemently denies anything happened, a medical examination shows otherwise. 

The 80-year-old woman was found naked from the waist down Wednesday afternoon.

According to the police report, the victim's daughter noticed bruising in her private area and asked if anyone touched her there. The victim replied, "Yes, it was hell."

Police said they have not had a chance to talk to the victim because the nursing home has given her sedatives.  They hope to speak with her soon.

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I saw an article about resident abuse that is common and difficult to prove without the testimony of an honest employee of the nursing home.  The industry has labeled injuries caused by abuse to be "injuries of unknown origins".  Perhaps, they should polygrapg the employees who provided care and treatment to the resident to determine how it happened.

Peggy LeNoir expected to celebrate her father's birthday, but instead was looking at disturbing pictures taken from his nursing home bed.

"I seen a black eye. He got a bruise on top of his head. He got bruises on his back. His back is bruised up and swollen and I see marks on his leg." says LeNoir.

When he came here he was walking and talking, now he can hardly move. She had already complained about the bed sores he was suffering. Then Peggy got a call Monday to check on her dad. What she saw shocked her.  The nursing home said her father may have fallen. But Peggy says how, since he can't walk, talk and can barely move.   If he fell, who picked him up? Why didn't they do an incident report then or notify the family as required by the regulations!

More frustrating, she says a staff member told her to leave and even called police.
Peggy's brother, Randy, says it's just time for some straight answers.

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This article is shocking and disgusting.  This woman should go to jail for a very long time!

A 79-year-old woman who has lost the use of her arms, legs and speech was humiliated in May when her caregiver at Homeland nursing home in Harrisburg smeared fecal matter over the woman's face during a shower, city police reported.

Roseanne Anderson, 50, of the 2400 block of Market Street, Harrisburg, was arraigned Tuesday night before District Judge William Wenner on charges of simple assault and recklessly endangering another person. She was committed to Dauphin County Prison in lieu of $50,000 bail.
Police said the incident happened May 9 at the nursing home in the 1900 block of North Fifth Street.
Where was the woman's supervisor?  Did she do this before?  How did the police find out?

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I saw this article on another website discussing the recent Cornell University study on physical abuse between residents.  Resident on resident abuse is underreported and mismanaged in the nursing home setting and most likely caused

Physical abuse in a nursing home may include staff or other residents.  According to a Cornell University Study, resident-on-resident violence in long-term-care facilities is far more prevalent than previously thought.  The authors of the study admit nursing home abuse is  woefully understudied.

The new study, funded by the National Institutes of Health (NIH), is only the second published report to look at patient-to-patient violence. Cornell University examined the records of 747 nursing home patients over the course of the study. Of those, 42 where involved in 79 incidents at nursing homes that actually required police intervention. The finding surprised researchers, especially because the study was not even focused on nursing homes. Rather, it looked at overall community crime, and nursing homes where just one area that was examined. 


Many nursing home patients suffer from varying degrees of dementia, and this often plays a factor in the violence.  Common triggers can be unwanted touching or disputes over television.   It is often the byproduct of a neglectful staff. Conflicts are far more likely to escalate to physical violence when patients are unattended. However, attentive staff can take steps to separate feuding patients before the situation deteriorates.

The report also questions the wisdom of housing dementia patients together. This is standard practice in most nursing homes, which generally have a dementia ward. But, because dementia often triggers violence, the report suggests it might be better to incorporate these patients into the general population as much as possible. 

As many as one in 20 nursing home residents are victims of nursing home abuse. Because there is no uniform system for reporting nursing home violence, experts on elder abuse concede that current estimates are probably just the tip of the iceberg.   There is no requirement to report resident-on-resident violence. In fact, the Cornell researchers only looked at cases that involved police calls. There were simply no records available to them detailing physical confrontations between residents that did not escalate to this level of violence.

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There is a great discussion on abuse in nursing homes that I found here.

Nursing Home Abuse is on the rise even though less people are entering nursing homes with debilitating conditions according to recent data. The true number is probably much higher but The National Center on Elder Abuse estimates at least one in 20 nursing home patients has been the victim of abuse. There are nearly 1.4 million Americans that are living in nursing homes right now.

Unfortunately, a nursing home is not always the place of respite and healing it should be. According to the National Center’s study, 57% of nurses’ aides working in long-term care facilities admitted to witness, and even participating in, acts of nursing home abuse. The report sites systemic problems within the nursing home industry, like inadequate pay for workers and chronic understaffing, as contributing to the epidemic of abuse.

Neglect is the most common form of abuse. Residents in soiled beds and clothes, or those suffering from bedsores and frozen joints are most likely victims of neglect. Indications that a patient is over or under medicated can also signal neglect.

About 2500 cases of physical abuse or rape are reported each year.

Neglect is often caused by understaffing at nursing homes. However, this does not mean that neglect is more benign than other forms of abuse. In fact it can be deadly, as it was for an Alzheimer’s patient living at the Atrium I Nursing Home in Pennsylvania. The 88-year-old woman was allowed to wander away from the facility and died from exposure. The nursing home administrator was later charged and convicted of involuntary manslaughter in the patient’s death. 

Because this type of abuse can easily be covered up by staff, the true number is not really known. Elderly people can often be victims of falls, so sometimes, bruises, sprains or factures do not alarm a patient’s loved one. However, if these injuries cannot be fully explained, or if they are occurring frequently, further investigation is probably needed.

One of the most insidious forms of nursing home abuse is sexual abuse. According to a 1996 Medicaid Fraud Report, 10% of all physical abuse cases in nursing homes are of a sexual nature. Sexual predators will usually take advantage of disabled patients who are physically unable to tell anyone about their assaults. Often, this type of abuse is only discovered when a patient shows evidence of sexual contact, perhaps in the form of a sexually transmitted disease. In Illinois the repeated rape of a mentally disabled woman wasn’t discovered until she became pregnant. A nurses’ aid was charged and plead guilty to sexual assault in that case last month.

Because its victims are so helpless, nursing home abuse is one of the most underreported crimes in our nation Families of nursing home patients must become aware of the signs of abuse, and they must be willing to advocate for their loved one. Often, family members are the only people who can prevent a tragic outcome for a long-term care patient.

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 At a hearing this month concerning the state of the nursing home industry 20 years after the landmark Nursing Home Reform Act (better known as OBRA ‘87), Senate Special Committee on Aging Chairman Herb Kohl (D-WI) addressed the deficiencies of a system that has allowed some poorly performing nursing homes to escape penalties.

Testimony by the Government Accountability Office (GAO) presented at the hearing concludes that many nursing homes shown to be providing substandard care are still not being subjected to any sanctions, and are therefore not be motivated to make the lasting improvements necessary to protect the health and safety of residents.

According to the GAO, in 2006 nearly one in five nursing homes nationwide was cited for poor care or, more specifically, care that can cause actual harm to residents.

“Without question, the Nursing Home Reform Act improved nursing home care in this country. Today, many of the nation’s 16,000 nursing homes are providing adequate or excellent care. But shamefully, quite a few nursing homes are getting away with providing a lot less, putting a good number of the seniors living in long-term care facilities at risk. This is unacceptable, and raises questions about how and why our enforcement system is failing,” said Chairman Kohl. “This committee has a long history of closely scrutinizing the quality of nursing home care, and we intend to reaffirm that commitment.”


The GAO report also found that those deficient facilities that do make the effort to attain compliance often slip back into poor performance, and that of the poorly performing nursing homes studied by the government in 1999, nearly half of those had made no progress in their standard of care by 2006. In his opening statement, Chairman Kohl said he would be sending a written request to the Centers for Medicare and Medicaid Services (CMS) for a bimonthly briefing on any progress made in regard to today’s GAO recommendations. Chairman Kohl also expressed interest in improving the availability of public information on the quality of individual nursing homes, so that consumers can easily access information concerning any deficiencies found or sanctions levied against a nursing home in order to make an educated decision about which facility can best serve the long-term care needs of a family member.

Additionally, Chairman Kohl announced his intention to introduce legislation that would create a streamlined, cost-effective system of background checks nationwide for those who apply for jobs in long-term care facilities, much like the pilot program that is being conducted by the state of Michigan. After establishing a comprehensive system that combined several state registries with the state criminal background check and an FBI check, Michigan prevented more than 600 people with criminal and/or abusive histories from working in the long-term care industry in the past year alone. 
Friends and Relatives of Institutionalized Aged (FRIA) has been NYS’s unique consumer resource for free information and assistance on long term care issues, with a special focus on nursing home care. FRIA has played a pivotal role in reforming the industry since its inception. In addition, FRIA provides direct services to seniors and their informal caregivers, working to improve individual problems with long term care as well as positively impact the state system generally. FRIA’s services include:

–Free telephone bilingual Helpline service that assists over 1,500 callers each year on a wide array of long term care concerns,

–Organizing, assistance and support for over 60 NYS Family Councils attendant to nursing homes, representing over 20,000 nursing home residents,

–Caregiver Advocacy Center that provides information and interventions on resident rights, family rights, and care complaints, and,

–Community education and outreach that educates seniors and their families on NYS’s long term care system, reaching over 1,000 community members in 2006 alone, not counting media appearances. http://www.fria.org/index.shtml

Over 1.6 million people are living in nursing homes in the U. S. today; in New York State where FRIA is based there are 657 nursing homes with 120,347 certified beds. Generally, people in these homes suffer from chronic disease, physical disabilities and mental disabilities and/ or dementia and depend on professional assistance for day-to-day care and continued survival. They may or may not have close family or friends nearby to oversee their care. They depend on the compassion and professionalism of the nursing home staff to make their end of life days more dignified, supportive and as pain free as possible.

Demographic projections predict a doubling by 2030 of people over 65 years of age, with expectations of increasing numbers of over 85 year olds and of those with dementia. Addressing the issues presented by the NHRA is critical not only for those older Americans alive today, but also, given the staggering aging baby boomer demographics, so we can resolve the issues before the problems take on unmanageable proportions.

The Nursing Home Reform Act has had notable successes in reducing restraints, in some cases reducing overmedication of residents, and in recognizing family and friend council organizations. Yet, it continues to miss its mark in ensuring the broader mission of the Act- to ensure that residents receive quality care that will result in their maintaining or achieving the highest practicable physical, mental, and psychosocial well being- largely because the following, important elements of our federal legal framework are absent:

–Minimum staffing levels are not established for nursing homes,

–State agency oversight, through surveys, complaint investigations, and sanctions, are weak and agencies are not made appropriately accountable to CMS,

–Financial transparency of federally supported nursing home operations, with enforceable random auditing, is non existent,

–Nursing home closures are not adequately addressed.

Minimum staffing levels are not established for nursing homes

Current federal and NYS laws only call for “sufficient” staffing in each home, a vague standard and one honored more in the breach than in the practice. The absence of an enforceable, federal standard has resulted in inconsistent and low staff levels in homes throughout the country. The GAO, HCFA/CMS, and FRIA’s own Helpline callers, among others, consistently document that low levels of staffing directly result in poor resident outcomes: indignities, miseries, injuries, and deaths.

CMS itself recommends minimum total (not including administrative) staffing levels that range from 2.75 to 3.9 hours per resident per day. Other experts  recommend a higher level of hours per resident per day. It should be remembered that these are minimum standards, below which experts expect harm to residents will result. Evidence exists to indicate that no more than 10% of homes nationwide meet these minimum standards. In NYS, for example, a study was done by NYS Attorney General Elliot Spitzer, to determine the staffing levels in homes. This study found that 2% met this minimum standard. Moreover, in the last few years, the population living in nursing homes has become more frail and less competent. Thus, residents need even more staff time and attention than the population did when the experts developed these minimum standards.

Cases drawn from FRIA’s Helpline can illustrate how low staffing levels translate into real life crises for our nations’ elderly.

–A daughter is concerned because her 75 year-old father, who has both Alzheimer’s disease and depression, is having difficulty swallowing. He needs to be fed slowly but the nursing home is attempting to place him on a feeding tube against his wishes. She requested that the facility take time to feed him, she knows her father enjoys eating his meals and will suffer greatly if he were denied that pleasure. Also, the daughter recently discovered her father developed a pressure sore but the doctor did not notify her of this development and her father is being left in a wheelchair all day, which exacerbates this condition.

–A women’s sister had a fracture and suffered a stroke, she was sent to a nursing home to recuperate and receive rehabilitative therapy. Her sister was not toileted or changed in a timely manner, frequently left to sit in her excrement, and developed a pressure sore and a painful rash.

–A daughter complains that her mother is depressed because she is rarely taken out of her room for activities, even though she is otherwise mentally competent.

–A spouse is afraid because his wife has lost 15% of her body weight since she arrived at the home a month ago, and seems to be missing meals and he is afraid she is wasting away.

Because most homes operate on a profit margin basis, there is no incentive for them to staff up to these higher needs without federal government intervention. For that reason, legislative requirements are the only way to ensure that appropriate staffing will occur.

And, although some states have addressed the issue with lesser state standards, the nursing home program is largely a federally funded program, driven by CMS standards and reporting. It is therefore incumbent upon the federal government to take a strong lead in this area.

For that reason, FRIA supports federal legislation, like that introduced previously by Rep. Henry Waxman, that would require minimum nurse staffing ratios totaling 4.1-4.85 hours per resident per day. In March, FRIA personally delivered to Congress over 500 petitions from New Yorkers calling for this minimum staffing level in homes. Extracts from their heartfelt petitions reflect the urgency and pleas for this simple but meaningful reform:

–“Please remember all of us will be old at some time.”

–“There are those people in facilities who have no one to help out if their care needs aren’t met because of understaffing.”

–“We are not just talking about the elderly. I speak for my 25 year old daughter.”

–“It is an outrage that seniors who spent their lives taking care of us cannot achieve a standard of health care in nursing homes that secures adequate coverage for them!”

FRIA also supports the interim step urged in NCCNHR’s testimony that Congress require CMS to collect accurate staffing data from the nursing homes and make this information available to the public. It is remarkable in this world of high tech data collection, that consumers and the government are forced to rely upon self-reported data about such a crucial element of care and appropriate usage of federal money.

Currently, staffing level data at homes are accepted by CMS with no independent verification of this information. Based on what families and residents tell us, we must seriously question whether the data provided by nursing homes to CMS is reliably accurate, and we fear that even the low levels currently reported are higher than what is provided to residents in actuality.

Establishing appropriate, minimum nursing staff levels in nursing homes is the single most important protective act we can take for the safety and well-being of our nation’s elderly residents. Moreover, establishing staffing minimums will provide preventative protection for residents. It is a far better, more reliable model than continuing to solely rely on enforcement efforts of state agencies ‘after the fact’ of poor care, efforts we recognize are grossly inadequate. Care of the elderly requires personal attention. There is simply no short cut. Setting minimum staffing levels alone would give new meaning to the promise of the NHRA.

Lax government enforcement

It comes as no surprise to those who have loved ones living in nursing homes that the GAO’s new report, “Nursing Home Quality and Safety Initiatives,” found that homes are not sanctioned for non-compliance with federal standards, despite actual harm caused to seniors by their failures. Historically FRIA has witnessed the GAO issue similarly glaring reports with no corresponding action from federal or state officials, evidencing a callous disregard for our frail seniors. In fact, there are numerous regulations governing quality of care that provide a basis for sustaining quality of care deficiencies as violations of law. Yet, according to the GAO, more than 300,000 elderly and disabled residents lived in chronically deficient nursing homes where they were “at risk of harm due to woefully deficient care.” Other GAO reports have found that these figures actually understate the actual number and the seriousness of violations.

Part of the problem is that enforcement must be non negotiable and swiftly pursued when deficiencies are found- but it is not. FRIA believes that the process by which survey findings are disputed by homes may provide an inappropriate opportunity for homes to ‘reduce’ both deficiency findings and fine imposition. We all recognize that, on occasion, a surveyor may make a mistake requiring appropriate supervisory discretion to modify the results. However, we have been led to believe that substantive changes are made to at least the state findings routinely, along with reduction of fines. This process undercuts the viability and credibility of surveyor work and misleads the public about the quality of care in nursing homes. In this regard, it should be remembered that the survey findings are key tools disclosed to consumers representing the government’s professional assessment of the nursing home. By intentionally modifying the original survey results to minimize the findings, states are providing consumers with an erroneously ‘better’ picture of the home on which to rely. As such, consumers are deceived and potentially injured by this approach.

Surveyors in few states routinely speak to families and family councils to determine the consumer perspective about the quality of care and responsiveness of facilities. In New York State, it is a rare occurrence for surveyors to speak to residents or families, unless these individuals are selected for conversation by the nursing home administration. More random conversations with consumers are necessary. And, such conversations must be private with the identity of the parties fully kept confidential. Off-site discussions are the best way to accomplish this result and most families we know would welcome the chance to provide helpful input.

FRIA believes that the government has the requisite knowledge and capacity to perform professional surveys appropriately. FRIA urges new training of surveyors to impress the need for thoroughness, inclusiveness of family, correct categorization of deficiencies, review of extant complaints against the nursing home, and proactive questions.

And, complaint investigations need to be beefed up, by detailing specific legislative process demands, and possibly monetary recourse for consumers who have been retaliated against because they raised complaints against a nursing home.

During the past 10 years, FRIA has answered over 14,000 telephone calls from residents and families raising nursing home complaints. Few substantiated complaints result in a statement of deficiencies. For example, in New York City only 22.9% were substantiated but only 4.7% received deficiencies in 2004. Similarly, in 2005 26.7% of complaints were substantiated but only 3.8% resulted in deficiencies. In some cases, the complainant was never interviewed by the state Department of Health. In others, the complainant was interviewed early on, but never given an opportunity to respond to the facility’s arguments or explanations thereafter. Often, a complainant may have information demonstrating the falsity of a facility’s account but is not given a chance to present it to the investigator. In most cases, DOH investigators seem to simply accept the facility’s version of events and use it as the basis for not sustaining a complaint, not going beyond the four corners of the nursing home’s documentation, even when conflicting documentation is presented by the consumer. And, there is no appeal mechanism for a consumer to challenge a finding, even if it involves allegations of serious, irrevocable harm.

In reconsidering the complaint process, it must be remembered that residents and families harbor tremendous fear of retaliation being directed against their vulnerable loved one or themselves, if they complain about a nursing home or staff member. It is easy for a retaliating nursing home to ‘ignore’ the resident of a complaining family member, or to restrict the family visits, on a wide variety of fabricated grounds. Given the enormous courage it takes to file such a complaint, it is truly disheartening and disempowering for a resident or family when its complaint is not sustained following an inadequate investigation.

Financial transparency
The lack of financial transparency results in significant opportunities for fraud, misinformation and confusion. On average, 67 percent of nursing home residents have their care paid for by the Medicaid program; 9 percent are covered by Medicare. The federal government is paying upwards of $50 billion/year for care. There must be accountability and transparency for how public dollars are being spent, especially given the serious findings of understaffed, inferior and deficient care. Nursing home chains are proliferating, yet in NYS we have so far found it impossible to access ownership and investor interests in nursing homes.

Nor do advocates and consumers – and possibly not even government – have any standard way of knowing how much money is actually being spent on direct care costs for their loved ones. Given the huge amount of state and federal dollars invested in nursing homes, financial transparency is critical to safeguarding the public’s investment in these facilities, and assuming that the NHRA requirements are satisfied.

Nursing home closures

In recent years, governmental long term care policies across the states have focused on a shift from institutional to home and community based care. FRIA supports home and community based options for those who have the full resources to live safely and independently. Yet even if our communities offered a full range of accessible, affordable housing and coordinated health and social services ( which they currently do not) our communities would still need nursing homes that are staffed beyond minimum standards and that support a dignified life to accommodate those with dementia, those without family/friends to oversee care, those who prefer socialized living settings, and more. Further, the shift from institutions is partly in response to overly simplistic and idealistic notions of independence that blind many to the complex caregiving needs of seniors and their families/friends. It is also dollar-driven by the questionable belief that home and community based care costs less than nursing home care. Consequently, instead of implementing policies to protect our nation’s seniors in nursing homes, the nursing home model is being eroded by short-sighted state and federal policies.

For example, in New York, in 2004, Governor Pataki, like many other state officials, called for the closing of thousands of nursing home beds in the state. His statewide Commission to review the nursing home and hospital systems recommended that more than 3,000 nursing home beds statewide be cut. New York City alone will lose over 1,200 nursing home beds by 2008, despite its increasing senior population. Families are already hard-pressed to find nearby sub-acute and long term care beds upon hospital discharge or in response to health crises. Government needs to insist that strong protections be put in place to protect residents dislocated by voluntary and involuntary closures, that family/friends have the ‘say’ over where the resident will be transferred, and that there is oversight over to ensure that unbefriended residents are moved to appropriate facilities.

Although the issues presented by long term care are complicated and far reaching, enacting minimum safe staffing standards is not. Congress can better protect our seniors today by acting on this long overdue issue. It is that simple. If we fail to take the action that we all know is necessary, we are essentially saying that the frail elderly are disposable. We urge this committee to support this long-overdue and critical legislative effort. 5-26-07

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It is horrible how the U.S government treats war veterans.  This article discuss how a Phoenix, Az nursing home for veterans was cited for negligence because of mismanagement and understaffing.

State review blames staffing shortage for nursing home troubles.  A state government-run nursing home for veterans suffered from staffing shortages, poor morale and mismanagement.

The Governor's Arizona State Veteran Home Review Team report said the Phoenix nursing home had problems with nursing shortages, high personnel turnover, poor organization and lack of direction from state administrators.   The vets home has been fined by federal regulators for poor care and some cases of patient negligence.

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Georgetown police could not find any physical evidence to corroborate one of the recent complaints filed against Georgetown Healthcare and Rehab in Maryville. In March, police were called to the facility after a resident said he was choked by a nurse.

The incident happened in December but he waited to report it because he was “in fear of possible retribution.”  The nurse denied the charges but was placed on suspension during the investigation. 

The resident was shown pictures of 12 women who work at that facility and was asked to show the investigators the one who choked him. The photo selected was not the nurse he accused of the abuse. There was a inconsistency in part of his allegations.

“Based on this investigation, there is no physical evidence or witnesses to support this allegation,” Investigator Johnell Sparkman wrote in his report. “At this time this case is unfounded.”

Helluva an investigation.

No polygraph examination of the accused? Prior complaints? Interview other residents?

See story here

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The nursing home industry and insurance lobbyists have fought (and continue to fight) to limit the duties of nursing homes in conducting background checks on employees.  It is ridiculous. Background checks are cheap and quick in the computer age even with the high turnover rate of employees.  Look at this story where a nursing home aide raped 90-year-old resident.. It could have been prevented if they did a background check.

William Morrison, a former aide at the Rome Memorial Hospital Residential Health Care Facility,  was convicted last month of raping and sexually assaulting a 90-year-old resident of the nursing home.

Morrison was an employee at Rome Memorial Hospital for several months before being transferred to the hospital’s affiliated 80-bed nursing home. Rome Memorial Hospital Residential Health Care Facility intended to perform a criminal background check when Morrison was hired, but it was not completed before he raped the elderly resident.

The background check would have revealed that Morrison was previously convicted for one felony and several misdemeanors in the 1990s. His last conviction was for a misdemeanor drug offense in 1999

See story here

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Rat dies in mouth of California nursing home patient

Staffing was so inadequate at a California senior center that a rat crawled into an Alzheimer's patient's mouth and died there before staff noticed, a lawsuit claims.

The lawsuit alleges that Paragon Gardens Assisted Living and Memory Care Community in Mission Viejo overbooked their facility to receive corporate bonuses, but cut back on staff to increase profits.

"The facility so literally ignored the needs of their residents ... as to allow vermin in the form of a rat to become lodged in the mouth of Sigmund Bock and die therein," the lawsuit alleges.

Chatelle said that Bock was found holding a glue trap that had been placed in his room by a pest control company to catch a single field mouse. She said the dead field mouse was inside the trap when Bock picked it up.

Bock's attorney, Stephen Garcia, challenged that account. He said two traps were placed in Bock's room and both were laced with poison, not glue.

He said Paragon records show a staff person noticed Bock "playing with a rat in his room and eating candy ... with the rat" on the morning of March 18. Paramedics called to the scene noted "possible ingestion of rat poison" in their report and an emergency room file says that Bock was "found in room in care facility with dead rat in mouth."

Last year, the state moved to revoke Paragon Gardens' license after a 71-year-old dementia patient wandered from the facility and was never found. The state Department of Social Services also claimed six clients were injured from improper care, according to spokesman Michael Weston. The company has appealed.

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