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

The Daytona Beach News Journal had an article about the findings against Ridgecrest Nursing and Rehabilitation Center for various and significant violations including when a patient was ignored as he had lain for almost 12 hours with broken bones. Hopefully, the authorities will terminate its ability to collect  taxpayer funds from Medicare and Medicaid after a state review found conditions there harmful to residents.

Barbara Fasold, 76, fell out of bed at Ridgecrest while her bedding was changed at 5 a.m. on Feb. 19 -- breaking both legs and her left shoulder. Rescue workers weren't summoned to take her to the hospital until after the next shift came on about 4:45 p.m.. The report states that Fasold's X-rays were completed by 8:40 a.m. the day she fell, but the nursing facility's staff didn't read them until 4 p.m. She was taken to Halifax Health Medical Center and admitted for her injuries. Ultimately, however, she died at a hospice facility, six days after she fell. "There was no evidence of the staff attempting to secure the (X-ray) results before then, even after the resident complained of pain," the report states.

A letter from Robert Dickson, field-office manager for the Agency for Health Care Administration's Quality Control Division, states that his agency is recommending to the federal government the facility be fined $250 a day, retroactive to Feb. 19, until Ridgecrest is in compliance with state nursing-home standards. Also, if the facility is not in "substantial compliance" by Sept. 15, the state agency will recommend that its contract with the Centers for Medicare and Medicaid be terminated.

Dickson's office issued a letter to the facility March 4, based on the inspection report from Feb. 18, that said, "no discernible deficiencies were noted on the day of this survey."

The new findings gave poor marks to the care for two out of 10 residents whose cases were reviewed. The 59-page report and plan of correction stand in stark contrast to a routine inspection report based on a visit to the 160-bed facility the day before the patient was hurt -- when no deficiencies were found.  What a surprise.

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USA Today had an interesting and controversial article on two new studies that show the bones of some post-menopausal women who take bisphosphonates (Actonel, Boniva, Fosamax, Reclast) to ward off osteoporosis can stop rejuvenating and become brittle after prolonged use.   Bisphosphonates are among the top-selling drugs in the USA,with annual sales exceeding $3.5 billion.

Osteoporosis is a health risk for the aging population. An estimated 10 million Americans have the disease and almost 34 million have low bone mass, putting them at risk for spine and hip fractures.   Studying bone biopsies in women who suffered femur fractures, lead researcher Dr. Joseph Lane found the quality of the bone diminished after long-term bisphosphonate use.

Dr. Rosenwasser's research notes that bone densitometry (DXA) scans show a buckling potential in the femur area of the hip in patients being treated for osteoporosis with bisphosphonates. His studies note the decline after four years of use or more. "It can be thought of as a brittleness," Rosenwasser says. "Think of it as not a lack of quantity of bone mineral but of quality of organization."

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Lexington Herald-Leader had an article about Kentucky indicting nursing home employees for neglecting a resident and trying to cover it up.  A nurse and two nursing assistants have been indicted in connection with a case of neglect at Creekwood Place Nursing Home in Logan County.

One of the nursing assistants, Melissa L. Lyon, was trying to transfer a patient into bed on her own, even though the patient's care plan called for two people to lift the person.   As a result, the patient suffered a fractured leg.   After the incident, Lyon and the other nursing assistant, Destiny W. Duncan, "concealed the true facts of the incident," the news release says.

The nurse, Barbara A. Moore of Beechmont, "did not call a physician or family member or check on the victim, all of which caused the victim prolonged suffering and pain," the release states.  Each of the women was indicted on a single count of knowing abuse or neglect of an adult, a Class C felony. 

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The Madison Record had an article about a lawsuit against a nursing home that allowed a disabled elderly woman to fall and fracture both her hips. Hazel Timmons, guardian of River Reed, filed a suit against Stearns Nursing and Rehabilitation Center on May 21 in Madison County Circuit Court.  Reed lived in the Granite City nursing home from May 25, 2007, through July 7.

When Reed was admitted to the nursing home, employees were aware she suffered from Alzheimer's and dementia and was usually disoriented and confused.  Nevertheless, employees allowed Reed to wander unattended in the hallway during the middle of the night on May 29, 2007. During her unsupervised walk, Reed predictably fell and fractured her left hip.  Yet again, on June 6, Reed was left unattended in a wheelchair and without a personal alarm. And, again, she injured herself when she fell out of the wheelchair.

Reed fractured her right hip after she was left unattended in her wheelchair with her tab alarm in the off position on June 15, 2007. During this incident, Reed attempted to walk unassisted when she was known to be non-weight bearing and at high risk for falling.

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The St. Clair Record had an article about a Madison County jury compensating a plaintiff in a negligence trial close to $150,000 in damages.  Jurors deliberated late into the evening before finding for Paul Graves in his suit against Rosewood Care Center of Edwardsville.

The 2003 case was brought by Graves on behalf of his deceased father's estate.   Alfred Graves received inadequate care while at Rosewood Care Center of Edwardsville and that lack of care and violations of the home's own procedures led him to fall and break his hip.

The jury awarded Graves damages for his father's loss of life experienced, pain and suffering and medical expenses. The largest damages were for the loss of life the jury found Alfred Graves, the plaintiff's father, experienced after a fall at the nursing home in January 2003. Those damages totaled $75,000. An additional $30,000 was given for Alfred Graves' pain and suffering and over $44,000 for his medical and nursing expenses.

Rosewood argued that the fall was an accident that had nothing to do with the care Alfred Graves received.

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Chicoer.com reported the filing of a lawsuit against Windsor Chico Creek Care and Rehabilitation Center for negligence and the wrongful death of a Geraldine Pavcik.  Pavcik was admitted to the facility on June 17 for short term rehab after a minor back injury.

Because Pavcik was at risk of falling, her doctor had ordered bed-rail restraints, a lowered bed, an alarm system, and that she be closely attended to.   All are standard preventative measures available in most nursing homes but they depend on proper supervision and a quick response time to call bells and alarms which, of course, depends on adequate staffing.  Most residents fall because the nursing home chose to be understaffed and that leads to falls.

These measure were not in place on "multiple occasions" while Pavcik was in the nursing home.  On July 3, Pavcik was left unattended and without bed rails and a bed alarm.  At 7 a.m. that day, she fell out of bed, severly fracturing her left hip.  Although her hip was X-rayed at the facility at 2:45 p.m., she wasn't transferred to an acute-care hospital until after 9 p.m.

Pavcik had surgery for her fractured hip, but the operation affected her mental condition, and she was no longer able to eat or drink effectively.   As a result, she contracted "aspiration pneumonia," a type of pneumonia that can develop in people who inhale liquid or bits of food. The woman died of respiratory failure as a result of pneumonia.

Among the accusations against the nursing home are that its administrators failed to hire enough staff to keep Pavcik safe, that her doctor's orders were not followed, that she wasn't transferred to an acute-care hospital when she needed to be, and that her doctor was not notified as her condition declined before she died.

 

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Oregon Live.com had an article about a Portland judge who ordered the jailing of the former nursing director of a Northeast Portland nursing home where a 60-year-old woman cried in pain with broken legs for five days before staff called an ambulance.

Suzanne Kay Ruddell was found guilty of felony criminal mistreatment by a jury.  She must serve 19 months of prison time and three years probation for her role in the death of Linda Ober, who was dropped by aides while being moved into her bed.  The nursing home covered up the fal and failed to get x-rays or notify the family as required by law.

Ruddell waited five days before ordering X-rays for Ober despite multiple reports from different staffers that Ober was screaming or crying in pain. Ober died after a surgery to repair two shattered leg bones.

Sara Cunningham, one of Ober's five adult children, said the nursing home failed to notify them.  The family never got a chance to say goodbye.   "It wasn't until she'd endured five days of excruciating pain that my mom was taken to the hospital," she said. "This is inexcusable, especially for a nurse who's supposed to help people."

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Hip Fractures Among Older Adults

More than 95% of hip fractures among adults ages 65 and older are caused by falls (Grisso et al. 1991). These injuries can cause severe health problems and lead to reduced quality of life and premature death (Wolinsky et al. 1997; Hall et al. 2000).

How big is the problem?

In 2003, there were more than 309,500 hospital admissions for hip fractures (NCHS 2006).
From 1993 to 2003, the number of hip fracture hospitalizations increased 19%, from 261,000 to 309,500 (NCHS 2006).
However, after adjusting for the increasing age of the U.S. population (U.S. Census Bureau 2006), the hip fracture rate decreased 14%, from 901 per 100,000 population in 1993 to 776 per 100,000 population in 2003 (NCHS 2006).
In 1990, researchers estimated that the number of hip fractures would exceed 500,000 by the year 2040 (Cummings et al. 1990).

What outcomes are linked to hip fractures?

As many as 20% of hip fracture patients die within a year of their injury (Leibson et al. 2002).
Most patients with hip fractures are hospitalized for about one week (Popovic 2001).
Up to 25% of adults who lived independently before their hip fracture have to stay in a nursing home for at least a year after their injury (Magaziner et al. 2000).
In 1991, Medicare costs for hip fractures were estimated to be $2.9 billion (CDC 1996).

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