$1.25 million verdict in Georgia pressure ulcer case

Melvin Raybon died in pain four years ago, and a DeKalb County jury agreed that the cause of his suffering was neglect at the Tucker nursing home where he lived for nine months.  The jury compensated Raybon’s daughter $1.25 million for the pain and suffering her father felt the last year of his life.  

The nursing home provided inadequate care and attention to Raybon. He was admitted in 2002 when he turned 67.  Nine months later, he had to go to a hospital for treatment of a bed sore that infected his left buttock to the bone.  Nursing assistants from the nursing home testified there weren’t enough staff to provide adequate care to Raybon.   The staff neglected him by failing to follow standard protocol of turning and repositioning him every two hours which is necessary to prevent and treat his pressure ulcers.

Raybon also suffered from malnutrition as a result of the infection, which sent his body into a death spiral that led to more bed sores and infections and finally his death in June 2004.

Kindred Healthcare was the company that owned the nursing home at the time. The facility was sold to a new owner last year.

$360,000 fine for chemical restraint

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.

 

Temporary agency nurses supplement staffing

Dan Miller of the Patriot-News wrote an interesting article about Harry Accor who runs a temporary staffing agency that provides nurses, practical nurses and certified nursing assistants to fill employment gaps in nursing homes. Accor's agency, Care Corps LLC, provides temporary staffing to 16 nursing homes from Lancaster and York to Philadelphia.

Care Corps has 89 employees. As part of his expansion in this region, Accor expects to hire 55 to 70 licensed practical nurses, 15 registered nurses and more nursing assistants.  He previously worked as a nurse through various agencies, but the experience was frustrating and the work sporadic.   Agencies sent him to homes he hadn't been to before, where he didn't know the staff or patients.

Accor said the nurses and nursing assistants his agency places in nursing homes are Care Corps employees and not independent contractors. Care Corps offers benefits and tuition assistance.  These measures make his work force more stable providing stability at nursing homes where staffing shortages are always a problem.

The use of temporary staffing agencies by nursing homes is a sensitive subject.  Accor would not identify any nursing homes to which his agency, Care Corps, provides staffing. He said those homes don't want people to get the impression that they are experiencing staffing problems. 

Almost all nursing homes have difficulty keeping adequate staff, especially because of high turnover among nursing aides who might not make much more than minimum wage, said Nicholas Castle, an associate professor at the Graduate School of Public Health at the University of Pittsburgh.  Castle's own research has found a link between lower quality and nursing homes that rely heavily on temporary staffingHigh use of temporary staffing can be an indicator of more significant issues at a home, running the whole way through top management, Castle said.

Nursing homes also typically pay a higher wage to nurses and aides from agencies, in return for agency staff being quickly available at the home's convenience, Castle said. This can lead to a vicious cycle, by making it more difficult for nursing homes to increase wages and benefits and reduce the staff turnover that leads to use of the staffing agencies.

 

Extendicare's neglect and understaffing causes wrongful death

On Seattlepi.com there was an article about the tragic death of Lee Ann Steele caused by the understaffing and neglect of a for profit nursing home.

Lee Ann, who had suffered a stroke,  lived at Aldercrest Health & Rehabilitation Center.  She needed a tracheotomy. The Steele family had felt assured by the facility's promises of skilled, high quality care, but less than 24 hours after their daughter was admitted, her tracheal tube clogged with mucous, causing oxygen loss and brain damage. Lee Ann Steele, once a vibrant church secretary who had volunteered at a food bank, died a few months later, in January 2007. She was 49.

The family wanted answers so they filed a lawsuit against Exyendicare Homes, Inc., the company that owns and manges the facility.   The complaint, filed in King County, accuses Milwaukee-based Extendicare of violating consumer-protection laws by advertising "quality standards above government regulations" and failing to deliver.

The lawsuit highlights problems regarding Extendicare, one of the largest nursing-home chains in America. The company runs 268 facilities for up to 30,000 residents.  In Washington, two of the company's homes are on a federal list of troubled facilities that require extra inspections by the U.S. Department of Health and Human Services.

Four of its homes, including Aldercrest, have been barred in the past from accepting new residents. Five have been hit with fines totaling thousands of dollars.  Many complaints, including those alleging wrongful deaths, stemmed from neglect and poor treatment for such conditions as pressure sores and diabetes.

She said the company appeared to have a high turnover in management. She also said the homes routinely accepted more residents -- and more acutely sick residents -- than staff members could handle. 

On Oct. 5, 2006, the day Steele was admitted, her family found her lying on a sheetless rubber mattress and her tracheal-tube equipment on the floor, unhooked, with no one attending to her for several hours.  Steele  suffered respiratory distress and died soon after.

 

Another lawsuit against Sunrise Senior Living

Sunrise Senior Living faces another neglect and negligence lawsuit (08/20/08 Orange County Register).  Sunrise was ordered to pay $2 million in damages after the death of a resident in May.  The family of Therese Sperry is suing Virginia-based Sunrise Senior Living which owns and operates Villa Valencia Health Care Center.

Sperry spent two weeks in Villa Valencia's skilled nursing unit in January 2007. She developed avoidable pressure ulcers on her feet that were neglected and went untreated.  The lawsuit alleges negligence by Sunrise Senior Living and says the nursing home failed to provide adequate medical staff for ailing residents - despite five health and safety citations in the last decade by state health regulators.   The most recent violations, from last year, include sexual molestation of a patient during a bath and failure to change a patient's catheter often enough to prevent infection.

After a brief hospital stay, she was sent to Villa Valencia for a week to gain strength.  Four days after her admission, she had redness on both heels, which later developed into ulcers that spread to her muscle and bone. Sperry's family immediately transferred to a different nursing home, where she was properly treated for wounds.  She endured debilitating pain until her death.

The suit argues that the facility "carried out a scheme to place 'profits over people' ... (and) intentionally underfunded and understaffed the facility in order to decrease expenses and increase profits."  Proof of understaffing arose in the trial over the death of Mary Kathleen Adams, who also developed pressure ulcers while at the center in February 2005. She died two months later.  In May, a jury ordered Sunrise to pay $2 million to Adams' family for negligence and punitive damages.

"Big corporations like Sunrise cut down on costs and staffing at the expense of patients," said Kim Valentine, one of the lawyers representing the Sperry family, and who also represented Adams.  Valentine also said court testimony showed employees were quitting because of the poor quality of care - a finding reflected in a report by the independent California Nursing Home Search. The agency found that nursing staff turnover at Villa Valencia was 82 percent in 2006, much higher than the state average of 67 percent.

 

Understaffing causes neglect

State and national organizations pushing for nursing home reform say life-threatening problems in facilities for the elderly usually are linked to inadequate staffing.

Nursing home residents have their needs ignored because staffers are overworked, according to top officials with the National Citizens' Coalition for Nursing Home Reform in Washington, D.C., and Kentuckians for Nursing Home Reform, which has its headquarters in Lexington.

Serious problems have also occurred at Baptist Convalescent Center in Newport, where two patients became severely dehydrated, with one dying, and at Villaspring of Erlanger Health Care Center, which is under investigation by the Kenton County Commonwealth Attorney's office. 

"Ninety-two percent of the nursing homes in the country are not staffed at a level that allows them to provide adequate care," said Alice Hedt, executive director of the national coalition, which is pushing federal legislation that would mandate specific staffing levels in nursing homes.

"Our main issue is staffing in nursing homes. It's the basis for most of the abuse and neglect that we see," said Bernie Vonderheide, who heads the advocacy group in Kentucky.

Like the federal government, Kentucky has no specific staffing requirements that establish a ratio between the number of patients and the number of staff members that must be on duty to care for those patients, Vonderheide said.

"Kentucky is one of 13 states without staffing regulations. They follow the federal regulations that only say that you must have sufficient staff to provide adequate care. We say that they interpret these widely and wildly," Vonderheide said.

Thirty-seven other states have much more specific standards on staffing, he said.

Hedt testified before the Senate Special Committee On Aging on May 2 - roughly 20 years after passage of the federal government's Nursing Home Reform Law. In her testimony, Hedt cited two studies that had been completed by the U.S. Department of Health and Human Services.

"These reports and other research show that below 4.1 hours of nursing care a day, residents will almost certainly be harmed - suffer from pressure sores, dehydration, malnutrition, fractures, infections and other conditions that cause pain, decline in functioning, avoidable hospitalization and death," Hedt told the committee.

The Baptist Convalescent Home in Newport received a citation from the state earlier in the week after a resident died two days after he was removed from the home suffering from dehydration.

See full article here

Mismanagement and understaffing lead to poor patient care

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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