Articles Posted in Nursing Home Abuse and Neglect

Nursing Home malpractice comes in many forms, and has many names. Some call it nursing home abuse or neglect, others elder abuse, but whatever the name, it’s increasingly becoming a problem in the United States. And it’s not just nursing homes. Residential facilities and home health care providers can commit malpractice as well.

Walton Law Firm LLP has represented victims of nursing home malpractice for more than a decade, and has learned that nursing home malpractice can come in many forms. The most common being simple neglect – the failure to notice a change in the resident’s condition, whether it be the occurrence of bed sores, the development of dehydration or malnutrition, or an obvious injury that is not promptly addressed. The law defines neglect simply as the failure to provide care for a person’s physical and mental needs, and to keep them free from health and safety hazards.

More serious cases are those of intentional conduct such as physical abuse, or the intentional mistreatment of a resident, often in retaliation for some prior act. Or the failure to provide basic care because of issues related to under staffing, such as cases involving multiple falls because staff would not respond to call lights. These cases can fairly be described not as just malpractice, but a conscious decision on the part of the nursing facility to expose residents to the risk of harm.

Yesterday the Bush Administration announced that it will create a nursing home rating system by the end of the year. The criteria for ratings has not yet been established, but will likely be a combination of state and federal inspection reports, staffing reports, and resident and family satisfaction surveys. The ratings would be placed on a government website.

“The fact a home has a lower rating will likely put them on the path to improvement,” said Kerry Weems, acting administrator for the Centers for Medicare and Medicaid Services. “I don’t think we’re going to see many people who are very anxious to put a loved one in a one-star home.”

Those looking for information about California nursing homes already have a few options when looking at prospective homes. The California Advocates for Nursing Home Reform have a nursing home guide resource, and the California Healthcare Foundation has its own rating system. Both use the government surveys and staffing reports as a basis for the rankings, so the accuracy of the ratings is based primarily on the government’s information, which can be notoriously unreliable.

A nursing home in Anaheim has received a $50,000 fine in the choking death of a resident. The resident, a brain injured man in his forties who had swallowing difficulty, choked on a piece of burrito.

According to reports, a caregiver was preparing the man’s meal at Parkview Healthcare Center when he reached for the burrito and put it in his mouth. When he began choking, the Heimlich maneuver was attempted but failed. Caregivers were then instructed to begin CPR, but before doing so, looked in the resident’s file to determine to see of there was a DNR (do not resuscitate) order. There was.

A doubtful nursing then called the man’s sister, telling her “your bother is turning black, do you want him revived?” When the sister responded “yes.” The DNR order was wrong. CPR was started. The man was pronounced dead approximately 30 minutes later. The fine was issued due to the nursing facility’s failure to provide “prompt emergency medical care” as requested by the resident.

The U.S. Department of Justice is stepping up efforts to reduce nursing home mistreatment of elders through its Nursing Home Iniative. The iniative focuses on improving enforcement of existing laws, training, attention to medical forensic issues, and increasing the use of reliable criminal background checks.

Through its Elder Justice program, the DOJ is also increasing the enforcement of civil and criminal penalties against nursing facilities and others whose mistreatment results in the serious injury or death of elderly residents. It has also created State Working Groups to improve the coordination of federal, state, and local law enforcement in cases of health care fraud.

For more information, visit the DOJ’s website here.

The son of Maria Cobian, the elderly woman who was hit by a car and killed when she wandered away from her nursing home, has filed a wrongful death lawsuit in Vista Superior Court.

The lawsuit alleges that Palomar Heights Continuing Care Center in Escondido negligently failed to supervise Ms. Cobian, and to ensure the safety of 94-year-old resident, who also suffered from dementia. Ms. Cobian was only a few hundred yards away from the nursing facility when she walked into traffic and was struck by a car. The company of the car that hit Cobian was also named in the lawsuit.

Despite her alleged documented history of trying to leave the facility, and the nursing home’s failure to prevent it, it doesn’t appear that there are allegations of elder neglect under the Elder Abuse and Dependent Adult Civil Protection Act against the facility, which allows for enhanced damages against nursing homes, including pre-death pain and suffering, when certain burdens of proof are met.

Nursing home abuse and neglect is not always perpetrated by staff members. New research from Cornell University suggests that aggression and violence between residents may be more prevalent than abuse or mistreatment from nursing home employees.

According to the study, peer-on-peer abuse is nursing home is a problem that has received little attention.

“Given that nursing homes are environments where people live close together, and many residents have lowered inhibitions because of dementia, such incidents are not surprising,” said Karl Pillemer of Cornell. “Because of the nature of nursing home life, it is impossible to eliminate these abusive behaviors entirely, but we need better scientific evidence about what works to prevent this problem.”

Washington D.C.’s most powerful lobbyists are being hired by the nursing home industry to fight congressional efforts to reform the industry. The industry is closely watching bipartisan legislation that would significantly increase oversight and enforcement of nursing homes around the country.

The new legislation, recently introduced by Sens. Grassley (R) and Kohl (D), would require nursing homes to fully disclose their ownership structures, and would increase penalties if a patient is injured or dies due to negligent or neglectful care. The industry is expected to pay millions to fight this legislation.

Why would nursing home owners disapprove so strongly of a law that requires them to disclose who actually owns and runs the facilities that provide them such a great profit? Liability. Many owners have created maze-like ownership structures that makes it nearly impossible to find out who actually owns the facility when something goes wrong. It’s not uncommon to have a one corporate entity own the building, who then leases it to a second company (the nursing home), who then contracts with a third company to operate it.

The California Advocates for Nursing Home Reform has issued its 2007 Nursing Home Citation Report. CANHR has prepared a citation summary, including the name of the nursing facility, the date, the level of citation, and a brief summary of the facts that led up to the citation. There is also an instructional key to help readers understand how the individual nursing home citations summaries are displayed. The report, which is broken down by California counties, can be found here. (.pdf)

In summary, a total of 651 citations were issued against nursing homes in California by the Department of Public Health in the year 2007, 22 of which were Class AA citations (violations caused a death), and 122 were Class A (violations present imminent danger and a substantial probability of death).

Every skilled nursing facility (nursing home) in California is licensed by the California Department of Public Health (DPH). DPH, in turn, is charged with the responsibility of monitoring nursing homes in the state, which includes conducting annual inspections and investigating complaints of abuse or neglect.

Most complaints involve allegations of abuse or neglect of the nursing home resident, but any topic can be the subject of a complaint, including, but not limited to, poor staffing, unsafe conditions, mistreatment, transfer and discharge concerns, generally poor care, or a violation of patient rights. Once a complaint is made – and any person may make a complaint – the DPH will create a file and assign an investigator to the case. In most cases, the investigation is concluded within 90 days. For a list of local DPH offices click here.

If you have a complaint, it is usually a good idea to first address those concerns to the nursing facility itself, whether it is the administrator or the family council. If dissatisfied with the response, it is suggested to call the local ombudsman in your county for further advice. If a complaint involves serious allegations of abuse or neglect that has resulted in some injury, it probably a good idea to get the advice of an attorney with experience in nursing home abuse or neglect cases, such as the attorneys at Walton Law Firm LLP.

A report from the Government Accountability Office states that widespread deficiencies addressing malnutrition, bedsores, medication errors, and abuse of nursing home residents are often understated.

Congressional investigators have confirmed in the report something advocates for the elderly have known for sometime. That is, nursing home inspectors routinely miss, overlook, or minimize problems in nursing facilities that can pose a serious risk to patient health.

In California, nursing homes are inspected once a year by the Department of Public Health, which sets the licensing standards. The GAO report found that state employees missed at least one serious deficiency in 15% of the inspections audited by the federal government.

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