February 21, 2010

Pennsylvania Nursing Home Aide Charged With Stealing Patients Drugs

Nursing home employees have a lot of access to prescription drugs. As Philadelphia nursing home negligence attorneys, we know that this can lead to serious wrongdoing in some cases -- such as the case of 26-year-old Andrea Markland. The Allentown Morning Call reported Feb. 9 that Markland, a former aide at a Telford nursing home, will stand trial for stealing time-released painkiller patches from the bodies of residents. She is charged with neglect of a care-dependent person as well as theft and receiving stolen property.

Markland's victims were two women in their eighties who had been prescribed time-release patches containing fentanyl, a powerful synthetic opiate. One of the victims has died since the thefts. In written statements to police, Markland admitted that she stole the patches five to seven times, cut them open and ate the medicated gel inside to feed an addiction to painkillers. By stealing the patches, the home's nursing supervisor said, Markland left the women in "debilitating pain." She also stole from the people who were paying for the women's treatment, a police officer said. Markland was caught after another employee saw her leaving an area where she wasn't supposed to be working.

As Philadelphia nursing home abuse lawyers, we suspect that this problem happens more often in nursing homes than it's reported. Opiates and other painkillers are widely abused and are heavily restriction because of their high potential for abuse. It's easy to predicts that nursing home workers might be tempted to abuse their positions, or even intentionally take a job to get access to narcotics. Nursing homes have a legal and ethical obligation to protect their residents from employees and potential employees willing to feed their addictions at residents' expense.

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February 19, 2010

One Fifth of Nursing Homes in Pennsylvania and Nation Get Low Medicare Ratings

Our Philadelphia nursing home neglect lawyers believe independent rankings are one of the best ways for families to begin their searches for a safe and caring nursing home. So we were dismayed by a Jan. 27 USA Today article showing that about a fifth of nursing homes have consistently received poor ratings from the Centers for Medicare and Medicaid Services. The poorly rated homes are in every state and the District of Columbia, the newspaper said, and a quarter of a million people live in them. Perhaps most significantly, the report said almost all of the poorly rated homes were owned by for-profit companies.

The Medicare ratings began in 2008, so there are only two years of data to compare, the article said. But in those two years, about a fifth have consistently scored one or two stars on a five-star scale. The ratings are calculated from inspection reports, complaints from patients and families, health and safety violations and more. The lowest-rated homes had an average of 14 problems per home. Medicare spokespeople said the overall ratings have already improved in the past year and may continue to improve in future years, as homes continue trying to improve.

As Pennsylvania nursing home abuse attorneys, we agree that two years isn't much time to improve a rating. But this ignores the question of how those homes came to be poorly rated in the first place. No doubt many homes existed for years or decades before the Medicare ratings started in 2008 -- and so did their problems. Trying to improve now is still a good thing, but it also implies that long-term, difficult-to-solve problems may continue to plague them. We would advise clients to research this very carefully before placing a loved one in such a home.

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February 17, 2010

How to Spot Theft From Patients in Pennsylvania Nursing Homes

Nursing home abuse makes headlines, and it's a serious problem that homes and residents' families should be watching for. But as Philadelphia nursing home neglect attorneys, we find that theft and financial exploitation may be even more common in nursing homes. Theft in nursing homes can be straightforward -- an employee, another resident or a visitor may simply take money and valuables out of the patient's room, or sometimes even from his or her person. It can also be subtle and sneaky, with the thief using threats, intimidation, medication, medical conditions or deception to get valuables.

In some ways, nursing home residents make good targets for theft. Older people tend to have more savings and if they own a home, it's probably paid off. People in nursing homes are also there because they have problems living independently, making them dependent on others. Unscrupulous people can take advantage of incapacitating health conditions to steal things outright, and depend on the resident's inability to communicate clearly to keep them out of trouble. In other cases, thieves may coerce, threaten or deceive patients into giving things away or signing away rights to valuable property. Sometimes, the victim even knows about it, but believes the financial move benefited him or her, or that it's a reasonably sized gift.

To catch financial exploitation in nursing homes, residents' families should keep an eye on the resident's finances and valuables. Watch bank accounts for unexpected activity, and be sure you have the right to ask questions if necessary. During visits, make sure your loved one has all of the money and items he or she used to have, particularly items that wouldn't be casually lost or given away, like heirloom jewelry and wedding rings. And if you suspect particular people, watch those people to see they're spending more than you believe they could make at their jobs. If you catch a thief in time, you may be able to get the money back, through a criminal prosecution or a Pennsylvania nursing home negligence lawsuit.

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February 15, 2010

Life-Threatening Bedsores Can Be Caused by Nursing Home Neglect in Pennsylvania

Bedsores -- also known as pressure sores and decubitus ulcers, are one of the most common neglect-related health problems that arise in nursing homes. Our Philadelphia nursing home negligence attorneys frequently hear stories about them from victims of abuse and neglect at nursing homes, or victims' families. However, we find that many people who have never cared for someone with mobility problems don't realize bedsores exist and don't know how to detect them. This can be a problem, because it can delay the family's realization that their loved one is not being properly cared for, allowing the problem to worsen.

Bedsores develop when someone who is bed-bound or wheelchair-bound spends too long in the same position, especially on a bony part of the body. Fully mobile people don't develop them because they can simply shift position when they're uncomfortable. The pressure of the patient's own body weight, gravity and friction eventually cut off blood flow to the area, damaging and eventually killing the tissues. Excess moisture, lack of sanitation, poor nutrition and some underlying medical conditions can worsen the problem. At first, bedsores may look like a reddish (in light-skinned people) or darkened, blue or purple (in dark-skinned people) patch of skin. But as time goes on, they start to look like increasingly serious ulcers. If left untreated for too long, bedsores can create holes in the skin reaching down to muscle or bone. At their most serious, bedsores can cause potentially fatal infections, gangrene, anemia or kidney failure.

Despite the seriousness of the problem, preventing bedsores is simple. The accepted standard of care is to simply turn the patient every two hours (or sometimes more frequently). Some patients also use special pressure-relieving seating and mattresses. Nursing homes are easily able to do this -- but frequently, turning patients falls by the wayside due to poor training, lack of caring or understaffing and overwork. Patients who can't leave their rooms or tell someone about the problem may suffer for weeks without relief, until the problem is so serious that they need hospitalization. This is one reason pir Pennsylvania nursing home neglect lawyers believe it's essential for families, especially families of patients with communication problems, to understand how to spot and fix bedsores.

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February 13, 2010

Nursing Homes in and Outside Pennsylvania May Fail to Protect Residents From Sexual Violence

A recent Chicago Tribune article called attention to a little-recognized but important problem among nursing home patients: physical and sexual violence between patients. As our Pennsylvania nursing home abuse attorneys know, mentally ill or diminished patients in particular pose a risk to other patients if not properly medicated and supervised. The Chicago Tribune took a look at this problem and published some disturbing results Jan. 26. According to the article, authorities have investigated 86 cases of sexual violence in Chicago nursing homes since 2007, in a quarter of the city's homes. Despite all of those investigations, authorities made an arrest in only one case.

In the majority of the cases, elderly or disabled female residents were attacked by male residents. Only a few cases involved attacks by staff, although the one prosecution the newspaper found was of an orderly. The Tribune said attacks were more likely in homes that housed a high percentage of younger mentally ill people who had been convicted of crimes, some of them violent crimes. Of the 30 homes where sexual assaults happened, 21 were federally rated as below average or well below average on staffing levels. In one case, a 61-year-old woman yelled "No, no, please" as she was assaulted by a 47-year-old man with a history of "inappropriate sexual behavior," but said she was too scared to fight back. The home's police report, filed months later, said she described the sex as consensual.

These stories are deeply disturbing to Philadelphia nursing home negligence lawyers like us. Most stories of nursing home abuse focus on abuses of power by staff, but as this article shows, abuses by other residents can and do happen. Every nursing home resident has a basic right to be safe in his or her home. Homes that fail to provide adequate protection not only fail in their basic duties, but leave themselves vulnerable to administrative or criminal penalties and nursing home negligence lawsuits.

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February 10, 2010

Family Sues Philadelphia Nursing Home Over Father's Death from Exposure

Our Pennsylvania nursing home negligence attorneys wrote recently about a Pittsburgh Tribune-Review investigation of state-run veterans' nursing homes. As part of that investigation, the newspaper profiled a nursing home neglect lawsuit filed by a family here in the Philadelphia area. The daughters of Harold Chapman sued the Delaware Valley Nursing Home after the 75-year-old dementia patient died of exposure in December of 2007. Surveillance tapes showed that Chapman, a former Philadelphia police officers, simply rode an elevator downstairs with an off-duty staff member and walked out the door, two hours before any staff members noticed he was missing.

It was New Year's Eve when Chapman left the building; his widow, Barbara Chapman, said everyone in the building was busy getting ready for a party. Records show no one was monitoring Chapman at the time, nor did anyone stop him from leaving the building even though he was only wearing pajamas. Two hours later, a nurse noticed he was missing, but it took more than another hour to notify the home's commander and call the police. A search of the grounds on foot and by police helicopter turned up nothing, but the next day, Chapman was found dead of hypothermia, only a short distance from the building. A staff member who was with Chapman before he left quit his job when he discovered he would be questioned.

State officials would not comment on the incident. However, the Delaware Valley home was later cited for breaking several laws in the incident, and staff members were reprimanded or suspended for their roles. It was just one of several homes with serious problems found in the Tribune-Review's investigation. Unfortunately, as Philadelphia nursing home abuse lawyers, we know that patients like Chapman are particularly vulnerable to neglectful and poorly-run homes, because they don't have the ability to speak out or protect themselves. We represent clients who, like Chapman's daughters, are pursuing justice from homes whose negligence has harmed or even killed patients.

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February 8, 2010

The Importance of Staffing Levels at Pennsylvania Nursing Homes

As Philadelphia nursing home negligence lawyers, we cannot overestimate the importance of proper nursing home staffing levels as a way to prevent abuse and neglect. A 2004 study from the National Institutes of Health said the nursing homes with the lowest ratios of patients to staff performed significantly better on metrics measuring quality of care. Like all workers, nurses and aides work best when they aren't so overloaded that they neglect duties or lose their tempers. But unlike most workers, overworked nursing home staffers can have a dramatic negative effect on vulnerable people's quality of life.

Staffing levels determine how much time each patient gets with a nursing home staff member. When staff members don't have the time to give patients the attention they deserve, even the well-meaning ones may forget things. This can lead to serious health consequences right away, as with missed medication, or over time, as with bedsores or dehydration. The stress of overwork can also lead to overt abuse by staff members who feel resentful against the home or impatient with difficult residents. And nursing homes that chronically understaff may fill holes in their rosters with temporary workers, who aren't always subjected to the same rigorous background checks. A recent Los Angeles Times article found that temporary nurses were hired despite criminal backgrounds, having been fired or having had their licenses pulled in other states.

Federal law requires nursing homes to maintain adequate staff levels and ensure that an RN is on duty at least eight hours a day, although it does not specify a patient/staff ratio. Unfortunately, nursing home staffing levels are still a problem because it's expensive to hire and retain a high-quality workforce. Faced with these costs, some homes' owners choose to skimp -- putting their residents at serious risk. Our Pennsylvania nursing home abuse attorneys handle numerous cases that stem from a lack of adequate attention and care for residents' needs.

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February 6, 2010

Newspaper Exposes Serious Negligence at Pennsylvania Veterans' Nursing Homes

Our Pennsylvania nursing home neglect attorneys were shocked and disturbed to read a recent article exposing serious problems with two state-run nursing homes. The Pittsburgh Tribune-Review reported Jan. 25 that the state health department's inspectors found negligence and misuse of psychiatric drugs at the Hollidaysburg Veterans Home between Pittsburgh and Harrisburg. Another home, the Gino J. Merli Veterans' Home in Scranton, was cited for allowing two outbreaks of scabies, failure to prevent or treat bedsores and failing to maintain sanitary conditions. The state runs four other veterans' homes, but only these two garnered the lowest possible rating because of serious repeat violations.

In Hollidaysburg, health inspectors found that patients were improperly receiving psychiatric medicines to control their behavior. Attendants routinely physically restrained patients for bathing or medical treatment. Abuse concerns reported by a psychiatrist went uninvestigated by a director who said he didn't believe he had to investigate statements about staffers' personal feelings. In another case, home staff didn't contact police about suspected abuse, despite a state law compelling them to, so the victim's wife did it.

At the Scranton home, residents endured two rounds of scabies because home officials failed to ensure that an employee had recovered fully before coming back to work. It was also cited for failure to prevent bedsores. In one case, a doctor ordered treatment for bedsores, but the home failed to take action for nine days. At least two other patients were cited for dehydrated residents. And over three years, the state found 38 reports of possible patient abuse by staff or other patients.

As Philadelphia nursing home abuse lawyers, we hope this article leads to immediate corrective action by state regulators. Nursing home patients are in homes because they can no longer care for themselves, and that often means they're at the mercy of their caregivers. As the report shows, bad caregivers can have a profound effect on their health and their quality of life.

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February 4, 2010

Pennsylvania Nursing Homes Bracing for Medicaid and Medicare Funding Cuts

As Philadelphia nursing home negligence attorneys, we were disappointed to see that nursing homes across the state are experiencing and expecting financial trouble because of the recession. The Lebanon Daily News reported Jan. 22 that nursing homes in the region are laying off staff members, cutting patient services or even closing. The problem is driven by the bad economy, which has resulted in cuts to Medicare and cuts or lack of growth on the state level. The issue is particularly important because 90% of Pennsylvania's nursing home patients are part of the Medicaid system.

According to one advocate for the elderly and disabled, Medicaid and Medicare are chronically underfunded in Pennsylvania to begin with. The funding cuts will make this worse, he said, as would the Medicare cuts included in the federal health care bill, if they pass. Homes shouldn't have trouble providing basic services, but he said they might end up cutting recreation and other quality-of-life services. Local homes told the newspaper that they were renegotiating contracts and looking for ways to cut costs without letting go of staff.

Our Pennsylvania nursing home abuse lawyers hope that's true. Adequate staffing levels, and low staff turnover, are an essential part of making sure nursing homes are safe and healthy places. When staff members are overworked, skilled nurses are absent or employee churn is high, details and even basic care are more likely to be overlooked. This can lead to serious cases of neglect or abuse at nursing homes, sometimes with tragic results.

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February 1, 2010

Investigating Nursing Home Negligence in Philadelphia

As Pennsylvania nursing home abuse attorneys, we see many clients who discovered abuse and neglect of their loved ones after it led to severe health consequences. Unfortunately, this is probably the most common way families discover problems, because victims don't always have the ability to directly tell their loved ones something is wrong. And of course, corrupt nursing home staff take steps to hide abuse and neglect. But if your family suspects abuse or neglect, there are steps you can take to prevent serious physical and emotional harm to your loved one.

Experts say the best offense against nursing home abuse is to stay aware. Studies show patients receive better treatment when their families visit often, so if possible, make sure you visit regularly. To reduce the chance that nursing home staff will anticipate your visits, you should try to schedule the visits at different times of the day and week. During your visit, check the patient for physical and mental problems not related to any underlying health condition. Examples might include unexplained weight loss, signs of dehydration, confusion in a mentally competent person or medications a doctor didn't order. Also, examine the cleanliness of the facility itself and the way staff interacts with the patients. If patients seem dominated by staff, anxious or overly sedated, there may be a problem.

If you discover evidence of neglect or abuse at a nursing home, you can and should report the home to state health authorities. Families have also set up hidden cameras in homes to capture clear and convincing evidence of abuse. But even a swift investigation that shuts down a bad home for good can't help families deal with the physical and emotional damage abuse can cause. To penalize negligent nursing homes and recover the financial costs of dealing with the abuse, families should contact a Philadelphia nursing home neglect lawyer to discuss the possibility of a civil lawsuit.

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January 29, 2010

Drug Company Sued for Paying Kickbacks to Nursing Home Company Operating in Pennsylvania

Our Pennsylvania nursing home negligence lawyers were disturbed to see a recent report suggesting some nursing homes have intentionally over-medicated their patients. The New York Times reported Jan. 15 that federal regulators have sued Johnson & Johnson for paying illegal kickbacks to a nursing home pharmaceutical distributor named Omnicare. The complaint in Boston federal court said Johnson & Johnson paid Omnicare to buy its products. Those products included prescription drugs like the powerful antipsychotic Risperdal, which is frequently used off-label to control behavior in patients with dementia. The Justice Department accused Johnson & Johnson of committing Medicaid fraud by inflating the number of prescriptions it paid.

Omnicare is a "middleman" that manages insurance issues, processes payments and distributes medications. The government alleges that it took illegal payments from Johnson & Johnson from 1999 to 2004. Among other things, the lawsuit says the drug maker paid for information previously distributed for free, and paid rebates every quarter based on Omnicare's success at switching patients to its drugs from competitors' drugs. These rebates are legal, but only if Medicaid gets the same discount as other large purchasers. The lawsuit says Johnson & Johnson tried to disguise its rebates to Omnicare in quarterly reports to the government.

As Philadelphia nursing home abuse attorneys, we wonder how many other companies may be guilty of similar behavior. Kickbacks are particularly dangerous in nursing homes because they encourage nursing homes to over-prescribe medicines. Some of these medicines may be appropriate, but they can also carry serious side effects. In fact, we wrote here last week about problems with the atypical antipsychotic Risperdal, which carries an FDA warning that it may increase the risk of death in elderly patients with dementia.

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January 27, 2010

Philadelphia Nursing Home Incorrectly Tells Family Resident Died

Our Philadelphia nursing home neglect attorneys were very interested in a news report about an unusual form of negligence by a nursing home. According to a Jan. 19 article in the Philadelphia Daily News, a Northeast Philadelphia nursing home mistakenly told the wife and son of 81-year-old Leonard Cantz that he had died. Dolores Cantz and her son Michael began making funeral arrangements and gathering their family, only to receive another call, five hours later, saying there'd been a mistake. The nursing home staff had mixed up Cantz's name with that of another patient, and he was very much still alive.

Leonard Cantz lives in the home because he has Alzheimer's disease, which means he didn't realize the home's mistake. But the first call was very upsetting for Dolores and Michael Cantz, who first heard that an ambulance was on its way to the home. Michael Cantz took the day off work and rushed to the home, but called en route and was told that his father was already dead. Upset and grieving, they called a funeral home to make arrangements. When the funeral home's representative arrived, he found Leonard Cantz still alive. It was only after he arrived at the nursing home that the home's staff realized their mistake and called the family back to explain. The family was delighted to find him still alive, but upset to be launched into the grieving process by mistake.

As Pennsylvania nursing home abuse lawyers, we normally handle cases involving abuse or neglect of the patient. But this type of negligence by nursing home staff may also be actionable, especially if it causes severe loss of income, medical or funeral bills and extreme emotional distress.

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January 20, 2010

Magazine Nursing Home Rankings Provide Resource for Pennsylvania Families

Families looking for a safe, loving and dignified home for their loved ones should turn to a recent issue of U.S. News & World Report magazine. As Philadelphia nursing home negligence attorneys, we're glad to say that the magazine has created a resource for families similar to its yearly college rankings. The magazine offers starred rankings of several aspects of each home, along with indicators of homes with problems and information on their ownership, size and whether they take Medicare or Medicaid. It has also published a four-step guide to choosing a nursing home.

The "how to choose" guide is actually four separate guides, each focusing on a separate part of the process. The first guide asks readers to decide whether a home is truly necessary, the second shows how to build a short list, and the third explains what to look for at the all-important on-site visit. The fourth and final article explains how to follow up to ensure that your choice is working out. The rankings themselves rely on a Medicare tool called Nursing Home Compare, but expand that tool's search capability to include multiple criteria, such as ranking, location and religious affiliation. Information is updated every quarter.

As Pennsylvania nursing home neglect lawyers, we think this is a great tool for families making this important choice. Nursing home choice matters greatly, because the nursing home is your loved one's permanent, long-term home. A bad nursing home can lead to unhappiness, but also serious health problems from neglect or abuse, or even death.

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January 18, 2010

Study Finds Philadelphia Nursing Homes May Overuse Dangerous Antipsychotics

As Philadelphia nursing home neglect lawyers, we were very interested in a new study published in the Jan. 11 issue of the Archives of Internal Medicine. Researchers from the University of Massachusetts at Worcester found that in 2007, a disproportionately large proportion of nursing home patients received a drug from a class of drugs known as atypical antipsychotics. These drugs are indicated for mental illnesses like schizophrenia, but have several side effects serious enough that their use is now heavily restricted by the FDA. In particular, a 2005 safety labeling change warned that atypical antipsychotics may raise the risk of death in older people with dementia.

No drug is currently approved for controlling difficult behavior in patients with dementia, but atypical antipsychotics are widely used off-label for this purpose. This is despite the 2005 safety warning and the increased risk of stroke, diabetes, hyperglycemia and other side effects. Nonetheless, the study found that about a third of all nursing home patients in 2007 received the drugs. And one third of those patients had no diagnosis of mental illness or dementia. The scientists also found that patients were more likely to receive atypical antipsychotics after entering a nursing home that already had high prescribing rates. This may indicate a problem with "organizational culture," the authors wrote, and more studies should examine whether the practice has negative health consequences.

This is disturbing news, because it suggests that some nursing homes may be using dangerous, powerful drugs unnecessarily. The risks of atypical antipsychotics are so serious that another recent study found a 19% drop in prescriptions after the 2005 safety warning. Nursing homes who put their patients at risk of death or disability for no good medical reason are committing a form of nursing home abuse.

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January 15, 2010

Outbreak of Water-Borne Disease Near Pennsylvania Threatens Nursing Home Residents

Our Philadelphia nursing home negligence attorneys were interested to see a news story about an outbreak of a rare disease at a nursing home. United Press International reported Jan. 14 that one resident has died and another fell ill at the Golden Hill Nursing Home in Kingston, N.Y. The two residents had Legionnaires' disease, a bacterial infection affecting the victim's respiratory tract. (Unfortunately, it gets its name from an outbreak at an American Legion convention here in Philadelphia.) The disease often leads to pneumonia and is considered a particularly serious threat to older people, people with weakened immune systems and smokers -- all common characteristics for residents of nursing homes in Pennsylvania.

The woman who died from Legionnaires' disease was 88 and had a compromised immune system, the article said. Another woman, 91, was hospitalized but has now been released. Legionnaires' disease takes up to two weeks to incubate, the article said, so staff members are watching other residents for signs of illness. The bacteria that cause the disease are not passed from person to person like the flu, but enter the body when the victim inhales infected water vapor. Health inspectors are examining the water system at the county-run home and will disinfect it when they find the source.

This incident raises serious concerns for Pennsylvania nursing home abuse lawyers like us. Legionnaires' disease is generally prevented by modern water treatment methods. An outbreak suggests that someone responsible for the water supply at this home -- the home itself, a government agency or an individual -- failed to follow established practices intended to prevent contamination and disease. If this is the case, residents who fall victim to Legionnaire's disease, and their families, would have a strong nursing home negligence claim.

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