February 15, 2011

Patient in Pennsylvania Nursing Home Dementia Ward Beats Another Patient to Death

As a Pennsylvania nursing home lawyer, I was shocked and saddened to read about the death of a nursing home patient at the hands of another patient. The Tribune-Democrat of Johnstown, east of Pittsburgh, reported Feb. 14 that 70-year-old Theodore Shaw died at the Cambria Care Center in Ebensburg after another patient repeatedly slammed a door into his head. The second patient has not been named, but has been transferred to a secure dementia ward in another nursing home owned by the same parent company. Both men were residents of the secure 60-bed dementia ward at the Cambria Care Center. Both the state police and the Pennsylvania Department of Health are investigating the incident, including whether the men's dementia played a role.

A spokesperson for the nursing home's parent company, Grane Healthcare, said the perpetrator had never shown any indication of violence in the past. But on the evening of Feb. 12, nursing home staff members reportedly found him repeatedly slamming a door into the head of Shaw as he lay on the ground. They believe it was intentional. Two workers suffered reportedly minor injuries as they tried to stop the attack, but Shaw died in a hospital two days later. In addition to the criminal investigation by Pennsylvania state police, the Department of Health is looking into whether either patient should have had constant supervision. If it finds that Cambria Care Center should have supervised the patients more closely, the nursing home would be required to come up with a plan to correct the problem and could also face fines or other penalties.

As a Philadelphia medical malpractice lawyer, I certainly hope this home is not guilty of lax supervision. Most people think of Pennsylvania nursing home abuse as an act committed by caregivers. This does happen and is inexcusable, but danger can also come from other residents. That's especially true for dementia patients, who are literally not in their right minds. Because dementia patients can hurt themselves or others without realizing it, nursing homes have a special obligation to watch them closely - including separating them into special wards, as this home did. Failure to correctly supervise patients could constitute nursing home neglect. When a patient is hurt as a result of this kind of neglect, families should talk to a Pennsylvania injury lawyer about their legal options for securing justice and fair financial compensation.

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February 9, 2011

Pennsylvania Nursing Home Receives Second Round of Citations From State DPW

As a Pennsylvania nursing home lawyer, I was very interested in a report of trouble at a Pittsburgh-area nursing home. As the Pittsburgh Business Times reported Feb. 9, Katera's Kove in Beaver County has been cited and fined and had its license downgraded by the state for the second time in about six months. The 79-bed facility in Wampum, Penn. received a second provisional license Jan. 31, after receiving a first one last July. It was also cited for problems including inadequate staff training and re-using medical equipment, which raises sanitation issues. Katera's Kove Inc. has until Feb. 17 to correct those problems or face fines of $1,704 a day. Its owner, Lynn Katekovich, said this would not be a problem.

Last year's inspection of Katera's Kove resulted in an admissions ban, fines and citations for problems including improper food storage and failure to document when medication was given. At that inspection, it had four repeat violations, including allowing smoking in unapproved areas, missing equipment from first-aid kits and burned out light bulbs in six rooms. Katekovich said at the time that she felt the DPW's enforcement was selective and planned to appeal. That appeal did not happen, and the admissions ban was lifted. The late January inspection found more problems, including the re-use of a glucometer and its equipment with multiple patients. The devices test diabetics' blood to monitor blood sugar, and use disposable lancets to pierce the skin for sanitary reasons. Katera's Kove was cited for disinfecting this equipment with alcohol and re-using it. Katekovich said this had been approved by the DPW in the past, but "all of a sudden you get an inspector who doesn't think it's sanitary."

As a Philadelphia medical malpractice lawyer, I agree with that inspector. In fact, so does the Pennsylvania Department of Public Welfare, which specifically warns against (PDF) using the same glucometer, lancets and test strips in multiple patients. This is an important part of basic sanitation for any medical facility, but it's especially important at a nursing home, where the elderly and immune-compromised population lives in a close space that encourages the spread of disease. No doubt re-using a glucometer and equipment saves money, but an outbreak of disease spread in this way could harm the patients and eventually cost far more, in medical costs and costs related to a Pennsylvania nursing home abuse lawsuit. If this is typical of the home's attitude toward sanitation, it's no surprise that the DPW is keeping an eye on Katera's Kove. As a Philadelphia injury lawyer, I hope the inspection and publicity improves policies at this home before a patient is harmed

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February 1, 2011

Pennsylvania Legislature Considers Medicaid Cuts That Could Affect Nursing Homes

As a Pennsylvania nursing home lawyer, I was interested to read an article about an ongoing debate in the state legislature on cutting Medicaid costs to balance the budget. The Pocono Record reported Feb. 1 on the proposal and the debate surrounding it in Harrisburg and around our state. New governor Tom Corbett campaigned in part on a promise to cut the budget, and he had enthusiastic support in some areas. But state Sen. Pat Vance, who is a former nurse, told a York County audience recently that there just isn't much left to cut because most of the Medicaid funding goes to the elderly and disabled. The state Department of Public Welfare said the elderly are the fastest-growing group of Medicaid recipients in Pennsylvania.

Medicaid costs are a problem in every state, with an aging population and medical advances that prolong lives. In Pennsylvania, the elderly are 14 percent of all Medicaid recipients but incur 33 percent of costs. About 50,000 of the estimated 2 million Pennsylvania Medicaid enrollees are in nursing homes; another estimated 35,000 are in alternative care such as small group homes or in-home care. Vance promoted in-home care in her speech, noting that it's less than half the cost of nursing homes ($25,000 instead of $60,000 per patient per year). Ironically, however, alternative care may be cut from the state budget because that coverage is not federally required, as nursing home care is. Stuart Shapiro, president of the industry group Pennsylvania Health Care Association, said cutting in-home care would likely mean family and friends would care for the recipients instead, with "a tiny percentage" going to nursing homes.

As a Philadelphia injury lawyer, I find that difficult to believe. Families use in-home caregivers because they don't usually have the skills needed to care for someone with a serious disability, or the money to quit their jobs and become full-time caregivers. Families who lose their safety nets would likely turn to Medicare or even sell an older loved one's home in order to get that person needed, professional care. That would be a shame, because in-home care offers advantages beyond financial savings. Keeping patients in familiar settings is easier on them personally, and in-home care avoids some of the institutional problems with nursing home care. Caregivers are more likely to be consistent and familiar with the patient's needs, and less likely to be overwhelmed by work and forget important things or commit Pennsylvania nursing home abuse. And of course, no community of other patients reduces exposure to communicable diseases. As a Philadelphia medical malpractice lawyer, I hope the state takes a long view on elder care when doing the hard work of cutting the budget.

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January 25, 2011

Study Finds Unnecessary Treatments for Dementia Patients Drive Up Medicare Costs

As a Pennsylvania nursing home lawyer, I was interested to see a study saying unnecessary treatments may be one reason for the growing cost of caring for the elderly. As the New York Times New Old Age blog reported Jan. 21, a study published in the Archives of Internal Medicine found that some of the most expensive treatments for late-stage dementia patients are also the most unnecessary ones. These included hospitalization and related after-care. In fact, author Dr. Susan Mitchell said in addition to being avoidable, these hospitalizations can be traumatic and confusing for dementia patients and may make them uncomfortable when antibiotics are used.

Mitchell and her colleagues at the Hebrew Senior Life Institute for Aging Research studied Medicare spending for 300 patients in greater Boston over 18 months. The largest share of the spending, 30 percent, went to hospitalization; 10 percent more went to skilled nursing administered after the hospital. Many hospitalizations were for pneumonia or related respiratory problems, which are common problems for dementia patients. However, Mitchell said, about 75 percent of the hospitalizations were for ailments that could have been treated just as well in the nursing home. In addition to being less expensive, leaving the patient in the home could also avoid the emotional trauma to patients who don't understand why they're being moved. And in patients near the end of their lives, palliative care may be preferred by some, the post said. Mitchell added that nursing homes may hospitalize patients they can treat on-site to shift costs from Medicaid to Medicare, which pays higher rates.

Any unnecessary medical treatment is a bad sign to me, as a Philadelphia medical malpractice lawyer. In addition to being expensive and traumatic, sending patients to the hospital unnecessarily puts them at risk of infection, medication mistakes and other problems that can arise from a change in caregivers. Even the emotional trauma can have significant effects on a patient with already compromised health, and physical injuries could send that patient into a health decline that could even end in death. If Mitchell is right that nursing homes do this to make a bit of extra money, that's even worse -- because it explicitly puts the nursing home's profits ahead of the best interests of the patients, their families and the taxpayers. Patients who believe their loved ones have been used as pawns in this way should talk to a Philadelphia injury lawyer right away.

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January 19, 2011

Study Finds Health Care Underfunded by Medicaid in Pennsylvania and Other States

As a Philadelphia medical malpractice lawyer, I was interested to see a recent report on the ongoing funding problems for nursing homes that accept Medicaid. The American Health Care Association, a nonprofit long-term care trade group, released a study last week showing that nationally, state Medicaid programs underpaid nursing homes by $5.6 billion. That works out to a national payment of $7.17 per hour per patient, which the AHCA points out is below the current minimum wage. The states with the seven biggest funding shortfalls included Pennsylvania, at number six, and neighbors New York, New Jersey and Ohio.

The study (PDF) was commissioned by AHCA and performed by private company Eljay LLC. It puts Pennsylvania's projected funding deficit for 2010 at $15.13 per hour per patient. The deficits come from the difference between the "allowable costs" for Medicaid services and what Medicaid pays homes. The actual cost of providing nursing home services might exceed Medicaid allowable costs, the report said, which means the shortfall might be even bigger. This is a major issue for nursing homes because Medicaid makes up about 64 percent of their funding, along with Medicare, long-term care insurance and private payment. A separate study published in the Archives of Internal Medicine found that nursing homes eliminated about five percent of their beds between 1998 and 2008 because of budget cuts, with a disproportionately high number of those beds disappearing in communities with high percentages of minorities or poverty.

This issue is interesting to Pennsylvania nursing home lawyers like me because funding has a direct effect on the quality of care patients receive. If, for example, nursing homes choose to let go of staff members, those staff members have less time to spend with each individual patient, and may be tempted to leave more often for higher-paying jobs elsewhere. The results can be disastrous, including patients allowed to wander without supervision, staff members who don't notice bedsores or other problems, distracted aides who mix up drugs and overworked staff members giving inappropriate dementia drugs just to keep patients cooperative. These and other cutbacks can expose patients to unacceptable Pennsylvania nursing home abuse, which means adequate funding for elder care must be a priority.

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January 12, 2011

Wilkes-Barre Police Find No Evidence for Nursing Home Patient's Sexual Assault Claim

As a Philadelphia injury lawyer, I was interested to see a story about an unsubstantiated claim of sexual abuse in a Pennsylvania nursing home. The Times Leader of Wilkes-Barre reported Jan. 12 on an investigation into a claim by a 91-year-old woman that she was sexually assaulted by two other women. According to the article, investigations by the city police department and the home itself could not substantiate the patient's claim. The police said they are still investigating but don't expect charges to be filed.

The accuser, who was not named, lives at Riverstreet Manor in Wilkes-Barre. According to the article, she accused two women of sexually assaulting her several weeks ago. No more details were reported. A spokesperson for the home said the home has a zero tolerance policy for abuse and undertook its own investigation, as well as contacting the local police and the health department. They were unable to turn up any evidence that the assault took place, the spokesperson said. The home has also been in contact with the accuser's family, who the spokesperson said were pleased with the way the home handled its investigation.

As a Pennsylvania nursing home lawyer, I hope these investigations came to the right. Sexual abuse is a grave accusation at a nursing home and has resulted in high-profile criminal prosecutions in other states. It's possible that the woman's accusations couldn't be substantiated because they sprang from a mental problem such as dementia. Unfortunately, people who truly are abusing nursing home patients often rely on patients' physical or mental illnesses to keep them silent, or dispute their claims if they speak up. That's why it's important for nursing homes to take all allegations of Pennsylvania nursing home abuse seriously, even when they come from unreliable people.

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January 4, 2011

Article Reminds Pennsylvania Nursing Homes to Beware of Spreading Viruses in Winter

As a Pennsylvania nursing home lawyer, I know nursing homes can be a breeding ground for disease outbreaks when staff members aren't careful. So I was very interested in a Dec. 29 article in the Allentown Morning Call reminding nursing homes and hospitals that we've entered the worst time of the year for noroviruses. Norovirus is the scientific name for the type of virus that causes gastroenteritis, known more colloquially as stomach bugs. In the first three months of 2010, the Pennsylvania Patient Safety Authority said, nursing homes reported nearly twice as many cases of norovirus as they did for the entire rest of the year. Outbreaks are also a risk at hospitals, the article noted, but the risk is much higher at nursing homes. Hospital outbreaks affected an average of six people, the authority said, whereas nursing home outbreaks affected an average of 25.

Norovirus is spread by fecal contamination of food and water, person-to-person contact or contact with contaminated surfaces. Part of the reason outbreaks are more common in nursing homes, said the article, is that people live in nursing homes, often in close quarters. That means they can't easily be quarantined, the way they could in a hospital. In addition, the article noted, a norovirus tends to affect nursing home patients more dramatically. In healthy adults, infection means 2-3 days of vomiting, diarrhea and general misery. In older people, this can cause life-threatening dehydration and be complicated by any underlying health problem. Not surprisingly, experts say the best way to prevent outbreaks is by washing hands thoroughly and wiping down surfaces often. Many nursing homes also ask workers to stay home until they are completely recovered from illness.

As a Philadelphia medical malpractice lawyer, I know these are the same guidelines that health care facilities -- including nursing homes -- should always implement. The reminder is important, however, because it's very easy for staff members to cut corners when they don't see the danger. Failure to wash hands, wipe down tables, change sheets, etc. often enough isn't just unpleasant to look at or think about -- it can actually cause serious health problems in a population of older and sick nursing home patients. For someone with a compromised immune system, a norovirus that a healthier person might shake off can lead to hospitalization or even death.

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December 21, 2010

Study Finds Disclosing Errors Won't Create More Pennsylvania Nursing Home Lawsuits

As Philadelphia medical malpractice lawyers, we were very interested to see an article about a study saying there's some benefit and no risk when doctors disclose their mistakes to patients. American Medical News, a publication of the American Medical Association, reported Dec. 15 on a study by a team at George Mason University. Led by Lorens A. Helmchen, a professor of health administration and policy, the team polled adult patients in Illinois about whether they'd be more likely to sue, or more likely to recommend the hospital, if the hospital admitted a medical error and provided financial compensation. The results: patients said they'd be no more or less likely to sue, but would be twice as likely to recommend the health care provider. Helmchen said disclosure might improve patients' perception of the institution's quality.

Helmchen's team is working with the federal Agency for Healthcare Research and Quality on a three-year project examining whether a disclosure and compensation model used in Michigan can work elsewhere. The University of Michigan has followed this model for nine years and discovered that it actually reduces litigation costs. This is the opposite of what many nursing homes, doctors and other health care providers tend to think, as Helmchen noted. The poll of 1,018 Illinois adults found that 27 percent would still consider filing a medical malpractice claim, if the institution responsible admitted the error and offered financial compensation. Helmchen said these results showed no evidence that admitting the error increased litigation. However, nearly 40 percent said they would still recommend the provider even after a mistake, if the mistake was disclosed and compensation was offered. And only 10 percent said they believed their doctors were likely to admit a mistake on their own.

Our Philadelphia injury lawyers aren't surprised. It seems clear to us that it's hard to trust people or institutions that you do not believe are willing to tell you the truth. Admitting a mistake goes a long way toward helping the victim of that mistake believe you are dealing with him or her honestly -- and doing the best you can to ensure it won't happen again. We find the same patterns in our work as Pennsylvania nursing home lawyers. Patients' families, and juries, understand that nursing homes are busy places and sometimes mistakes happen. But when homes try to cover up Pennsylvania nursing home abuse, neglect or serious mistakes, juries and families tend to see it as unwillingness to even recognize the problem, never mind make amends and try to protect others.

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December 14, 2010

Senate Committee Hears Testimony on Overuse of Antipsychotics in Nursing Homes

As a Philadelphia medical malpractice lawyer, I'm very concerned about the overuse of powerful antipsychotic medications in nursing homes. So I was pleased to see a MedPage Today article Dec. 9 showing that patient advocates have echoed those concerns in Congressional panel. The Senate Aging Committee invited leaders in the profession of nursing and a nursing home reform advocate to discuss this issue and how it could be affected by the aging of America's population. As baby boomers move into retirement, the panelists said, over-medication of dementia patients is a growing issue. In fact, Dr. Patricia Grady of the National Institute of Nursing Research said people in her field felt "we're headed in a very fast train toward the end of a cliff."

Panelists agreed that dementia patients are at risk of over-medication because they can be verbally or physically difficult. These patients can't express themselves clearly, however, which raises the risk of unnecessary medication. Christine Kovach, a professor of nursing at the University of Wisconsin at Milwaukee, talked about one patient who was given antipsychotics after she started resisting staff members who tried to move her. Almost four weeks later, staff members X-rayed the patient and discovered that her hip was broken. Patricia McGinnis, executive director of California Advocates for Nursing Home Reform, said her own mother had been given the powerful psychiatric medication Risperdal after being placed in a nursing home for the temporary care of a broken hip. Not only did her mother not need it, McGinnis said, but the home didn't contact any her or any of her siblings for informed consent. She suggested several non-medication ways to address dementia patients' behavior problems, including understanding the patient's past and personality and ensuring that they consistently have the same caregivers.

The article quotes outside medical experts who claim the overuse of psychiatric medication is not a serious problem. As a Pennsylvania nursing home abuse lawyer, I suspect neither of the people quoted are familiar with actual practices at nursing homes. While dementia patients can genuinely have psychotic symptoms, many homes start patients on antipsychotics as soon as they enter the home, or as soon as they show any sign of making staff members' jobs more difficult. Because antipsychotics are powerful drugs that change patients' brain chemistry, this is not just a waste. It can actually pose a risk to the patient, from drug interactions or serious side effects like diabetes and tardive dyskinesia. When this is done for the convenience of the staff, it's a form of Pennsylvania nursing home abuse that patients and families should not permit.

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December 7, 2010

Worker Sentenced for Abuse at Nursing Home Owned by Philadelphia Company

An article on abuse at a Massachusetts nursing home recently caught my eye as a Pennsylvania nursing home lawyer. The Berkshire Eagle, a newspaper in western Massachusetts, reported Dec. 3 that a former employee of a Pittsfield nursing home was sentenced to two years of probation and a suspended sentence for physically assaulting an 81-year-old patient with dementia. Sandra E. Yankey, 46, pleaded guilty to assault on Marie Jean Oppermann at Springside Nursing Home on Aug. 12 of this year. Oppermann died a month after the assault, of causes not considered related. The assault was the first of two reported incidents of abuse at Springside, triggering structural changes from the home's parent company in suburban Philadelphia, Genesis Healthcare Corp.

According to witnesses, Yankey punched Oppermann at least twice, pulled her hair, yanked her head from side to side and verbally berated her. Oppermann had dementia and was confined to a wheelchair. Other staff members present stepped between the two women and physically removed Yankey from the room after she refused to leave on her own. Oppermann later seemed bewildered and upset, staff members said, complained of pain in her left arm and had a tuft of hair in her lap. Yankey was immediately fired and later charged with felony assault. It was later discovered that she also had a past criminal conviction. After that incident, a staff member came forward to report another abuse incident in which a different employee stuffed a sock in the mouth of a blind, elderly dementia patient and told her to shut up. That employee was also fired. The man who was director of the home at the time no longer works there.

This article points out several times that Yankey will not go to jail or prison as long as she keeps to the terms of her probation. As a Philadelphia injury lawyer, I understand very well that this outcome could be frustrating to families like the Oppermanns. Pennsylvania nursing home abuse is a crime against Pennsylvanians who can't defend themselves -- and often can't even protest their mistreatment -- and should be taken very seriously. Fortunately, families that aren't satisfied with the criminal justice system have another way to seek justice: filing a lawsuit in the civil courts. A Philadelphia medical malpractice lawyer can help clients hold negligent caregivers and nursing home companies responsible for their actions. That includes all of the physical, emotional and financial effects on the victims and their families.

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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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