November 2010 Archives

November 30, 2010

Family Settles With Philadelphia Home That Allowed Patient to Wander in Icy Weather

As a Pennsylvania nursing home lawyer, I have followed a case here in Philadelphia of a man who died of exposure after wandering away from his nursing home. The Philadelphia Daily News reported Nov. 29 that the family of Harold C. Chapman, Jr. has settled a negligence and wrongful death claim with the Delaware Valley Veterans Home. Chapman's daughters sued the home after his death on the last day of 2007, when the home's staff allegedly allowed him to wander unattended into freezing temperatures outdoors. The state-owned northeast Philadelphia home settled the claim for $250,000, the maximum allowed by law to any individual suing a state agency. Part of the money will go to Chapman's estate, and another part to his two adult daughters.

Chapman was 75 and suffered from both Alzheimer's and dementia. On the night of his death, it was New Year's Eve and the home was reportedly getting ready for a party. That was why, his daughters alleged, Chapman was able to walk out the door of the home wearing only his pajamas. Two hours later, staff members noticed that he was missing. He wasn't found until the next morning, even though he reportedly was only a few yards from the home's front door. An autopsy listed the cause of death as hypothermia. In the aftermath of the incident, the state Health Department cited the home for failure to take action leading to death. One employee quit rather than face questioning; the home later discovered that he had a past conviction for stalking. Several others were reprimanded or suspended for their roles in the incident.

As I have written recently, dementia and Alzheimer's patients tend to be institutionalized precisely because they need to be watched. Their diseases keep them from understanding the consequences of simple actions, such as walking into a freezing Philadelphia night without enough protection. Failure to supervise such a person is absolutely a form of Pennsylvania nursing home negligence, just as surely as physical abuse or over-medication. Our Philadelphia injury lawyers help families affected by this type of negligence hold the homes legally and financially responsible for the results. As this case shows, those results can be terrible -- a death or a very serious injury to someone whose loved ones thought he was getting better care than they could provide themselves.

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November 23, 2010

Pennsylvania Facility Narrowly Avoids Losing Medicare and Medicaid Eligibility

As a Philadelphia injury lawyer, I was interested to see that a nursing home in Luzerne County has kept its Medicare and Medicaid eligibility after an inspection showed improvements. The Standard Speaker of Hazelton reported Nov. 17 that Mountain City Nursing and Rehabilitation Center in Hazle Township will not lose its Medicare and Medicaid payments, thanks to a Nov. 15 inspection that showed improvements over an Oct. 13 inspection and survey. The inspections were undertaken by the Pennsylvania Department of Health, which collects information on behalf of the federal Medicare program as well as state-administered Medicaid. Losing eligibility for the two programs would likely have been a serious financial blow for Mountain City, as well as a vote of no confidence by federal regulators.

According to the article, Department of Health inspectors found four deficiencies at the home during the Oct. 13 inspection and survey. Unfortunately, the article did not specify what those deficiencies were. However, they were apparently enough to violate Medicare and Medicaid guidelines. If allowed to continue, those violations could have eliminated Mountain City's eligibility to receive Medicare and Medicaid funding. The Nov. 15 reinspection found the deficiencies had been fixed. A spokesperson for the home's parent company declined to comment on the deficiencies, but Department of Health records for Mountain City show problems with overuse of psychiatric medication to control unpleasant behavior. Drugs alleged to be used incorrectly include the powerful benzodiazepine drug Ativan and the antipsychotics Abilify, Haldol and Risperdal. State inspectors said the maximum dosage of the Haldol had been exceeded without any documented reason why that was necessary.

Overuse and misuse of medication is an ongoing issue in nursing homes, and one that I take seriously as a Philadelphia medical malpractice lawyer. Psychiatric drugs are powerful, and they have been known to injure or even kill people when overused. There are also potential addiction issues with certain drugs, including the family of drugs to which Ativan belongs. And particularly with newer drugs that are less well tested, there can be safety issues even with normal use, never mind overdoses. Risperdal, for example, is connected with an increased risk of diabetes, and most of the drugs named above can trigger a rare but serious neurological disorder. Given these risks, they should only be used when necessary -- and they should never be overprescribed or used off-label in situations where they are not well tested. Using psychiatric drugs to sedate difficult patients for staff members' convenience is absolutely a form of Pennsylvania nursing home abuse that families should not tolerate.

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November 16, 2010

Pennsylvania Legislature Passes Law Intended to Help Locate Missing Elderly People

As a Pennsylvania nursing home abuse lawyer, I keep track of news about missing nursing home and assisted living residents who may have been victims of inadequate supervision. So I was pleased to see that our state has passed a law intended to help locate missing, vulnerable older people more quickly. The Reading Eagle reported Nov. 16 that a bill with that goal has passed the state House and is ready for the signature of Gov. Ed Rendell. It would create Missing Endangered Persons Advisories, similar to the Amber Alerts that currently go out when authorities believe children were abducted. The bill was authored by state Sen. Michael O'Pake, a Democrat from Reading who also authored the Pennsylvania Amber Alert bill.

According to the article, O'Pake was inspired by two relatively recent deaths of older people who died after going missing, including an 82-year-old woman who wandered away from her nursing home and was later found dead. We wrote about a similar case earlier this year, involving a man in his 70s who lived at a Philadelphia nursing home. Harold Chapman, a 75-year-old retired police officer with dementia, was wearing only his pajamas when he rode an elevator downstairs with a staff member. Nonetheless, no one stopped him from simply walking out the front door, and it took two hours for staff members to notice he was missing. He was found dead from hypothermia, just a short distance from the building. The Delaware Valley Nursing Home and several staff members were ultimately cited and fined for the incident, and Chapman's daughters are suing the home.

Dementia patients often end up in nursing homes because they need full-time supervision. Their disease simply robs them of their ability to avoid danger. That's why, as a Philadelphia medical malpractice lawyer, I strongly support this law to establish Amber Alert-style alarms when any vulnerable adult goes missing. However, it's even more important for nursing homes and other caregivers to stop this kind of danger before it starts, by adequately supervising their patients. Unfortunately, this is a chronic problem in some homes, where staff members are simply not paying enough attention or are spread too thin by understaffing to give patients the attention they deserve. Make no mistake: failure to supervise patients who can't care for themselves is a form of nursing home negligence. This can have serious consequences, as Chapman's family and others can attest.

The state of Pennsylvania can charge fines or criminal penalties against homes that allow deaths, injuries or preventable illnesses due to carelessness. But none of these remedies can help families deal with the emotional and financial effects of Pennsylvania nursing home abuse. Abuse, neglect and exploitation can permanently harm patients' health or finances, devastate families or even kill the patients. Dealing with it can also be very expensive, as families drop everything to hospitalize their loved ones or move them to a safer home. That's why victims and their families should consider speaking to a Philadelphia injury lawyer about seeking justice and financial compensation directly from a careless nursing home.

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November 11, 2010

Nursing Home Criminal Background Checks Help Pennsylvania Families Stay Safe

As a Pennsylvania nursing home negligence attorney, I write here a lot about the physical abuse and medical neglect of nursing home patients. But in addition to these threats, nursing home patients and their families are also vulnerable to financial exploitation, particularly when the caregivers have a history of past crimes. Unfortunately, a recent lawsuit settlement in California brought to light the fact that even when state laws require criminal background checks, shoddy work can still allow them to take advantage of the elderly in nursing homes and home care settings.

In the California case, a 92-year-old woman was the victim of financial abuse by her home care provider. Wessa Tanubo pleaded guilty in 2009 to felony financial abuse, after stealing at least $30,000 from Rose Michael by using Michael's credit cards and signing checks to herself. After Michael's family began to suspect that Tanubo was stealing from Michael, they found out that Tanubo had been convicted on drug charges in 1994, and was in and out of prison from 2000 to 2004 on various parole violations. In 2008, San Mateo Superior Court issued a restraining order forbidding Tanubo to have contact with her own child.

All of this should have turned up in a criminal background check performed by Home Care Assistance, the company that placed Tanubo in Michael's home, but HCA didn't discover it. HCA claimed to do national and local criminal background checks, but claims it turned up nothing unusual about Tanubo. To make matters worse, the state of California does not mandate criminal background checks for any caregivers. A 2008 law gave counties the authority to conduct checks in the case of low-income people receiving public assistance, but not a requirement. Because the Michael family was able to pay for Rose Michael's care out of pocket, the law didn't apply to their caregiver. And according to the article, the law is frequently ignored even when it does apply.

Pennsylvania law does require that criminal background checks be performed on all employees and administrators of nursing homes. Prospective employees whose background checks reveal what are known as "prohibitive offenses" can't work in nursing homes. These crimes range from murder to library theft. As a Philadelphia medical malpractice lawyer, I know nursing home patients are at the mercy of the nursing home staff. Criminal background checks are meant to help them and their families feel safe, but they can't guarantee that all staff members will always provide adequate care. That's why it's important for nursing home patients and families to know their rights and keep an eye on staff members they suspect of wrongdoing.

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November 5, 2010

Study Finds Link Between Profits and Pennsylvania Nursing Home Quality Ratings

A recent study in the journal Health Economics reported that nursing homes stand to gain profits if they increase their quality-of-care rating on the Nursing Home Compare report card from the Centers for Medicare & Medicaid Services. As a Philadelphia injury lawyer, I'm always glad to hear of ways to encourage nursing homes to improve the care they give to their patients. However, it's important for families to be aware of their rights to high-quality care, even if the nursing homes don't stand to increase their profits.

In the Health Economics study, researchers compared financial performance of nursing homes before the Nursing Home Compare report card was instituted in 2002 with their performance after the report card went public. The report card rates facilities on how well they control patients' pain, prevent bedsores, keep their residents active and other criteria. Their conclusion: Raising their quality ratings tended to result in financial gains for nursing homes. Nursing homes that rated poorer on quality could increase their scores in subsequent years, but it took significant improvements for this to result in higher profits.

Nursing homes that scored poorly tended to be cautious about making expensive investments in quality of care without evidence that it would yield higher profits. The study's lead author, Dr. Jeongyoung Park of the American Board of Internal Medicine, said that there could be a widening gap between higher- and lower-quality nursing homes because Medicare and private-payer patients tend to choose higher-quality nursing homes, and those patients are the ones who spur nursing homes to make the investments in raising their quality. Thus, the lower-quality nursing homes continue to have poorer patients and fail to make improvements.

Regardless of the quality rating, all nursing homes must provide adequate care for their patients, free of neglect or abuse of any kind. As a Philadelphia medical malpractice lawyer, I have seen many cases in which nursing home patients have been seriously injured and killed because of neglect and negligence. Low staffing levels and poor training of staff in nursing homes more focused on profits than patient care can lead to life-threatening problems. These include severe bedsores; injuries from moving patients without the right precautions; and even patients harming one another when they are left unsupervised. Patients and their families must educate themselves about their rights, choose very carefully and stand up for themselves when they feel that they're not getting the kind of care they should.

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