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

News Channel 36 in Concord, North Carolina had a tragic story of a resident  who fell to her death at a nursing home.  State inspectors have launched an investigation at the Concord nursing home.

The 87-year-old woman was found with a massive head injury on the ground beside an outside loading dock.   The article mentions that a fence near the loading dock is brand new, clearly installed after the patient at Concords Five Oaks Manor Nursing Home was found on the ground.  She'd fallen 4 feet to the ground, hit her head and died after being rushed to the emergency room.

The nursing home administrator did not report the woman's fall or death to the state.  A state spokesman says someone else reported it to them. Concord police told News Channel 36 the same thing.

Just last week Medicare ranked Five Oaks among the worst nursing homes in the country with just one out of five stars. Two state inspections from this year showed deficiencies. One cites accident and supervision problems, with one example where a patient "was on the floor" and staff had to be "disciplined."   Another said a patient was "outside the building."

 Channel 36 had a follow up to this story here.  In the follow up article, the family expressed concern that someone else could die there. The family says she had gotten out of the facility before.

Her daughter, Rosemary Ritchie, said she is worried about other patients at Five Oaks Manor. Doctors told her that her 87-year-old mother was brain dead because of a fall that the nursing home could have prevented.

She says her mom somehow got through a kitchen door that didn't have an alarm or lock on it. That door led out to the back of the facility and a loading dock. "I put her there trusting they would keep her safe and then this happened. It's not right," Ritchie said.

News Channel 36 tried repeatedly to get in touch with management at the nursing home and were told they would not comment.

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A Perfect Cause is an advocacy group that pushes for reform of nursing home laws, regulations, and requirements.  Recently, they got the Oklahoma attorney general and the Oklahoma County district attorney's office to support a push to make crimes against nursing home patients immediately reportable to police.

Jack Crow, who says he believes his wife was abused at a nursing home, is pushing to change the statutes.  Crow's wife, who suffers from Alzheimer's disease, was badly bruised in July. An investigation found that she suffered the injuries in a fall.

Crow disputes the findings and is working with A Perfect Cause to change the reporting procedures.

Current Oklahoma statutes call for someone with reasonable cause to believe abuse or neglect is occurring at a care center in the state, it should be reported to the Department of Human Services or the Sheriff's department.  However, reasonable cause is subjective and no guidance is given to nursing homes as to what constitutes neglect and abuse.

The district attorney and attorney general's offices believe police should be called first.

"When you have a crime scene, there is evidence," said Scott Rowland, of the Oklahoma County district attorney's office. "There is witness testimony in these crime scenes."

A Perfect Cause wants to make sure facilities follow that procedure by requiring them to report suspected abuse to police first, before anyone else.

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The Philadelphia Inquirer wrote an article about how many errors in health care settings do not get reported.  These errors or mistakes, whatever you want to call them, need to be disclosed so we can figure out how to prevent them in the future.  These health care businesses are more worried about getting caught then preventing them.

The article describes several incidents where patients were not given proper care but the hospitals failed to report the problems such as two patients at Fox Chase Cancer Center in Philadelphia required additional surgery after objects were negligently left inside their bodies or three patients at Mercy Fitzgerald Hospital had to be sent back to the OR last year to stop excessive postoperative bleeding or  At Abington Memorial Hospital, an elderly woman recovering from surgery for a broken hip in 2005 was left on a bedpan for at least 41/2 hours. She developed two open bedsores as a result.

For several years now, hospitals in Pennsylvania and New Jersey have been required to report medical mistakes and serious complications to state agencies charged with reducing medical errors. But most hospitals aren't complying, undermining efforts to improve patient safety.  In New Jersey, five of the state's 80 hospitals failed to report a single preventable mistake last year. In Pennsylvania, some facilities didn't report any serious events or even the near misses that might have harmed patients.

James Bagian, head of the Department of Veterans Affairs' National Center for Patient Safety, said: "Anybody that is supposed to report close calls and has zero reports is clueless; Management is asleep at the switch and just waiting until they kill someone."  The public can only learn that a hospital isn't reporting mistakes in those rare instances when the health department cites it for failing to comply with the law.

"There is still some underreporting, and we are working directly with the hospitals to understand why," said Eliot Fishman, policy director of the New Jersey Department of Health and Senior Services.  Consumer advocates want more transparency so patients can make better health-care decisions.

The numbers suggest underreporting is more than just a passing problem.   Calvin Johnson, the Pennsylvania secretary of health, said only people with their "head in the sand" would fail to see the problem of uneven reporting by hospitals. But he noted that with about 200 hospitals and millions of patient visits each year, it is impossible for the state to check every chart.

While it's important to study each of those reports, it is at least as crucial to identify hospitals that are not participating at all, said Conway, of the health-care improvement institute.   "We cannot improve care unless we understand the problems," Conway said. "There can't be safety without transparency."
 

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The Philadelphia Inquirer wrote an article about how many errors in health care settings do not get reported.  These errors or mistakes, whatever you want to call them, need to be disclosed so we can figure out how to prevent them in the future.  These health care businesses are more worried about getting caught then preventing them.

The article describes several incidents where patients were not given proper care but the hospitals failed to report the problems such as two patients at Fox Chase Cancer Center in Philadelphia required additional surgery after objects were negligently left inside their bodies or three patients at Mercy Fitzgerald Hospital had to be sent back to the OR last year to stop excessive postoperative bleeding or  At Abington Memorial Hospital, an elderly woman recovering from surgery for a broken hip in 2005 was left on a bedpan for at least 41/2 hours. She developed two open bedsores as a result.

For several years now, hospitals in Pennsylvania and New Jersey have been required to report medical mistakes and serious complications to state agencies charged with reducing medical errors. But most hospitals aren't complying, undermining efforts to improve patient safety.  In New Jersey, five of the state's 80 hospitals failed to report a single preventable mistake last year. In Pennsylvania, some facilities didn't report any serious events or even the near misses that might have harmed patients.

James Bagian, head of the Department of Veterans Affairs' National Center for Patient Safety, said: "Anybody that is supposed to report close calls and has zero reports is clueless; Management is asleep at the switch and just waiting until they kill someone."  The public can only learn that a hospital isn't reporting mistakes in those rare instances when the health department cites it for failing to comply with the law.

"There is still some underreporting, and we are working directly with the hospitals to understand why," said Eliot Fishman, policy director of the New Jersey Department of Health and Senior Services.  Consumer advocates want more transparency so patients can make better health-care decisions.

The numbers suggest underreporting is more than just a passing problem.   Calvin Johnson, the Pennsylvania secretary of health, said only people with their "head in the sand" would fail to see the problem of uneven reporting by hospitals. But he noted that with about 200 hospitals and millions of patient visits each year, it is impossible for the state to check every chart.

While it's important to study each of those reports, it is at least as crucial to identify hospitals that are not participating at all, said Conway, of the health-care improvement institute.   "We cannot improve care unless we understand the problems," Conway said. "There can't be safety without transparency."
 

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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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