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

The Star-Tribune had an interesting and scary article on a nurse who stopped giving CPR to a resident.  A registered nurse wrongly ordered a halt to CPR on a resident at Woodbury Health Care Center.  The resident was dead before emergency responders could take over. On arriving at the home they questioned why CPR was stopped.

The nurse, who was not identified in the report, had a history of disciplinary actions. "She is dead," the nurse told a fellow staff member soon after he began applying chest compressions on the resident according to a state Health Department report. The staffer kept up resuscitation efforts until the nurse repeated her command to stop by yelling at the staffer.

Clearly, this is a serious violation of a resident's rights.  Residents have a right to any and all treatment that will prolong their life.

The nurse's personnel file, included in the report, shows that she had been cited for needing to improve her job knowledge, professionalism and relationships with subordinates, residents and families. A doctor filed a formal complaint against her in 2007 for "improper conduct" and in 2009 she was disciplined for failing to follow wound-management protocol.

Until late last year, Woodbury Health Care Center was on the federal government's list of about 200 nursing homes that get closer scrutiny, including semiannual inspections, because of a history of regulatory problems. Inspectors found 23 rule infractions in the home's annual inspection in April 2008; that was down to the state average of nine a year later.
 

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This guest post is contributed by Jennifer Johnson, who writes on the topics of Nurse Practitioner Schools. She welcomes your comments at her email Id: j.johnson19june@gmail.com.

It's always good for both the nursing home patient and their family members to understand what the patient's rights are while he or she is under the care of a nursing home. Knowing how a patient should be treated—medically, physically and emotionally—starts by having a clear understanding of the foundational rights provided to patients through the Federal Nursing Home Reform Act, part of the Omnibus Budget Reconciliation Act of 1987 (aka OBRA '87).

The Act, which was rolled up into OBRA '87 as part of one big package, sets up minimum standards of care and establishes rights for people living in certified nursing facilities in the U.S. The Act spearheaded a continual move away from nursing homes having almost an old-school prison or insane asylum mentality and includes measures that help protect a resident's quality of life as well as quality of care.

Some of the key provisions in the Act include:

• A resident will maintain and, if possible, improve their ability to walk, bathe and perform other daily living activities unless medical reasons prevent them. Alongside this is the resident's right to be free from unneeded physical (or chemical) restraints;
• Residents' medical conditions will be assessed and an individualized care plan must be developed for them;
• All paraprofessional staff must receive the appropriate amount of hours of training and testing;
• A resident must be allowed to stay in the nursing home even if the facility does not receive payment, or if the resident's medical condition changes drastically;
• The right of a resident to maintain personal funds with the nursing home (or designate a trusted person to do it for them), to return after an overnight stay with family or friends, to choose their own physician, and to access their own medical records;
• The nursing facility is prohibited from breathing down the neck of family members to pay for Medicare and Medicaid services.
• Ramifications for facilities that fail to meet minimum standards.

Medicare also informs patients of their rights in a nursing home to be treated with dignity and respect, to be informed in writing of all services and fees, to manage your own money, to have a certain amount of privacy, to maintain certain unharmful personal belongings, and to refuse medications and treatments.

If a patient or his or her family have reason to believe these rights have been violated, the family may wish to take legal action, for the sake of the resident and all other residents in the facility.

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Chico enterprise Record had a tragic story about a nursing home preventing a mother from seeing her disabled daughter.  This is clearly in violation of the Resident's rights and should not be tolerated.  Gladys McManaman says she's miserable because a nursing home has limited the time she can visit her disabled daughter.  Gladys said the nursing home's administration will only let her visit Patricia between 9 a.m. and noon and only on weekdays.

There are no exceptions, she said. She couldn't visit on Mother's Day, Easter or her daughter's birthday.  And if she stays a bit longer than the three hours she's allowed, a staff member will tell her sharply, "It's four minutes past noon — you have to go!" she said. "It's hateful."

The facility's administration is retaliating against McManaman for filing complaints about the place.  McManaman said she's lodged complaints with the state Department of Public Health about Patricia's care.  She said Patricia has had many falls and has often been neglected by the staff.   Also, the facility has not responded when her daughter has needed urgent medical care, she said.   McManaman said Patricia was born with severe disabilities.

She admits she's gotten mad at times when Patricia was neglected or given improper care at the nursing home but what mother wouldn't get mad when the facility is neglecting your child.

 "She knows me, she responds to me," McManaman said. "I would think more than anyone, they would welcome my being there so I could alert them to what her needs are."  The nursing home  prohibits her from doing just about anything for her daughter. She can't even comb Patricia's hair without worrying a staff member might come in and reprimand her.

The only thing she's allowed to do is her daughter's laundry — something the facility is happy to have her do.  McManaman recently filed a lawsuit against Riverside, hoping to win more visiting time, but she said she is frustrated at how long that is taking.

What Riverside is doing is clearly illegal, but it's done by nursing homes quite often, said Pat McGinnis, director of the San Francisco-based California Advocates for Nursing Home Reform.

McGinnis said patients' families have the right to visit whenever they want, although they don't always realize this.

McManaman said she's not in good health and, at her age, wonders how long she'll live and what will become of her daughter if she should die.

"In the last years of my life, I sure didn't expect this," she said.

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Dave Johnson wrote on the Huffington Post on June 17, 2008 the following article about how arbitration screws consumers and victims of corporate malfeasance.

Does your credit card or bank loan agreement have an "arbitration clause?" More and more consumer-oriented contracts and "agreements" have clauses specifying that disputes must go to arbitration rather than our civil justice system. The justification for this is that arbitration saves the time and expense of working within our legal system. But here's the thing: the corporations choose the arbitrators and every arbitrator knows they will never, ever, ever, ever (ever) get another job if they rule against the corporations. Never.  And guess what: 98.8% of arbitrations end up in favor of the corporations. This is not a surprise.

The Progressive States Network's newsletter has a story about this today, Arbitration:"Set up to squeeze small sums of money out of desperately poor people".

The headline above is a quote from former West Virginia Supreme Court Justice Richard Neely, describing what his role was as an arbitrator at the National Arbitration Forum (NAF), a for-profit company hired to enforce mandatory arbitration clauses for credit card consumer loans. "NAF is nothing more than an arm of the collection industry hiding behind a veneer of impartiality," says Richard Neely.

In a devastating expose by BusinessWeek, Neely and other former arbitrators describe an arbitration system stacked completely against consumers -- a system where creditors win 99.8% of all disputes involving companies ranging from Bank of America to Sears to Citgroup. Arbitration clauses buried in the fine print of credit card offers means consumers lose the right to have disputes decided in an independent court and instead are forced into corporation-selected arbitration firms.

The BusinessWeek story mentioned in the Progressive States Network story is titled, Banks vs. Consumers (Guess Who Wins).

This story about credit card companies taking unfair advantage of consumers is one more attack on citizen rights to access our own legal system (one more of so many attacks). Think about what is happening here. First the big corporations fought against "regulations" which are the rules that We, the People set up requiring safe workplaces or environmental standards, or products that do not injure people, etc. Then when fewer regulations of course resulted in worker or consumer injuries or toxic spills or other harms the inured parties filed more lawsuits asking the companies to make good. So in response to these lawsuits the corporate-financed "tort reform" movement came along, working to limit the ability of citizens to be compensated for the results of corporate bad behavior. The result has been fewer regulations preventing harms and more restrictions on citizen access to courts where we can seek damages after we are harmed.

I didn't even bring up the corporate-conservative movement efforts to install their own business-friendly judges in the courts.

But even those erosions of our access to justice has not been enough for the greedy corporations. Now there is arbitration: clauses that show up in contracts and agreements that remove your ability to take a dispute to the courts at all! And the judges in these courts are dependent on the corporations for their livelihood!

Deregulation, tort reform and now arbitration that is rigged against the consumer. Drip, drip, drip. One after another the big corporations are eroding the rights of citizens.

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When two residents at a nursing home in Santa Cruz got eviction notices last March, they decided to fight them. They called Linda Robinson of Advocacy Inc., a Santa Cruz nonprofit, to help them file appeals with the state Department of Health Services. A little more than a year later, the issue is being resolved according to an April 11 memo signed by Kathleen Billingsley, deputy director of the state health department.

The April 11 memo affects nearly 900 nursing home patients in Santa Cruz County as well as 1,400 nursing homes statewide with more than 133,000 beds.

"In a year, dozens, maybe hundreds, of [eviction] notices are sent," Connors said. "They get issued way too often in my experience. Patients have the right to be protected from arbitrary transfers"

Billingsley's April 11 memo to district managers covered policy and procedures for appealing eviction notices. It also said staff must receive training to make sure policy and procedures are followed.

Last year, a lawsuit was filed, complaining about a backlog of nursing-home complaints. This month, a state auditor, reporting on 17,000 complaints filed over two years, said the department had not completed about 60 percent of its investigations in a timely fashion.

See article here.

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