Articles Posted in nursing home news

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Often with aging comes the necessary need of daily medications to help control pain, cholesterol, blood pressure, and other ailments. In nursing homes across Pennsylvania and New Jersey strict maintenance and dispensing procedures of patient medication is key to both the patient’s ailments and survival. In some cases the pain medication has attracted unscrupulous characters that take advantage of elder patients often robbing them for their pain medication. Withholding medication from a nursing home resident can amount to nursing home abuse. Chronic pain is both under treated and a common ailment according to a recent study published by the Archives of Gerontology and Geriatrics. The study made up of 105 nursing home patients with the mean age of 82, living in two separate nursing homes in Torino, Italy, found that chronic pain was wide spread. The study suggests that chronic pain was present in 82.9 percent of the sample of patients studied, and that persistent pain lasting more than 24 months was present in half of the residents. Chronic pain can affect every part of a resident’s daily life. From their mood, nutrition consumption, sleep pattern, and overall quality of life, chronic pain can play a direct role in making a resident’s life enjoyable. That is why instances of prescription theft are particularly disheartening in the nursing home setting.

Many of those who work in nursing homes who steal prescription medication from residents are caught and prosecuted, as was the case for a former nurse at North Muskegon senior care facility in Missouri. Former registered nurse Ruth Ellen Everett unknowingly was under investigation by local police as she worked at Hillcrest Nursing Center in North Muskegon. As reported by MLive News affiliate, Everett was arrested on charges of elder abuse and larceny in connection with stolen morphine from a patient at the senior care facility on Monday, April 28. Unfortunately many residents are unaware that their medication has been tampered with and therefore are unable to press charges. Prescription theft in a nursing home or extended care setting can be slow and steady process leaving the victim often helpless and disoriented or writhing in pain. If you or a loved one is in a nursing home or being cared by another it is important to note what medications the resident has been prescribed. In some instances when a medication is stolen by a care provider the doctor may assume that the medication is not working and change the dosage. In some instances lethargy, weight loss, and anti-social behavior may result. If you are advocating on behalf of a loved one feel free to ask more information regarding medication tracking and rules over who and how medications are doled out in your specific nursing home or special care facility.
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Earlier this month the Social Security Administration adopted new representative payee policies originating from a Philadelphia based pilot program with new screening requirements for all potential representative payees. Representative payees are individuals who collect on the behalf of a disabled individual who is deemed unable to competently manage their own finances and therefore require a legal proxy. The new backgrounds checks disqualifies individuals who have been convicted of one of twelve listed crimes from being able to serve as a payee. The crimes include human trafficking, false imprisonment, rape or sexual assault, first-degree homicide, kidnapping, robbery, multiple forms of fraud, abuse, neglect, forgery, and identify theft. According to the Huffington Post “Bob Casey: Social Security Screening Program Should Be Expanded” January 27, 2013 article, U.S. Senator Bob Casey has been a strong advocate of tougher screening policies for individuals granted representative payees for years. In Pennsylvania and other states such as California and Massachusetts with a significant older adult population, financial elder abuse is a rising area of concern as it impacts an older adult’s overall quality of life. As a Pennsylvania and New Jersey nursing home injury specialist some typical signs of financial abuse may include drastic changes in behavior, weight loss, medical decline due to shortage in medication, and even unusual financial behaviors such as large cash withdrawals, or signing over a piece of property. If you suspect that you or a loved one has suffered financial elder abuse feel free to talk to a Pennsylvania and New Jersey elder abuse specialist today.

The initial pilot representative screening program began this past June in Delaware, Maryland, Virginia, West Virginia, and Pennsylvania. As of this March program has become standard practice for the Social Security Administration. While Senator Bob Casey has been advocating for tougher policies to combat finical abuse of elders and those who are disabled for many years, it was not until a recent horror was discovered of extreme abuse and neglect in Philadelphia that made the topic ripe for action. What has been referred to as the “Philadelphia Dungeon Case” only describes a fraction of the alleged horror that at least six victims were subjected to by those who they thought they could trust. The Philadelphia Police Department discovered the victims in the Tacony section of Philadelphia on October 15, 2011. The accused ringleader Linda Ann Weston and five others were charged with a laundry list of offenses including a federal hate crime involving acts against the disabled. For over a decade the Philadelphia resident allegedly lured children and the disabled into her care, and then imprisoned and drugged her victims for their Social Security checks.
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The Department of Health and Human Services’ Office of the Inspector General (“OIG”) released the March 2014 edition of Compendium of Priority Recommendations, (“Compendium“) which for the first time addressed the need for reform in nursing home care. The Office of the Inspector General is required under the Inspector General Act of 1978, to report to Congress problems, abuses, and deficiencies, which still need to be addressed, as well as the duties listed in the Consolidated Appropriations Act of 2014 which requires the reporting of the top 25 unimplemented recommendations that best protect the integrity of the Health and Human Services programs. It is common for OIG recommendations to require legislative, regulatory, or administrative action to become policy. Even Congressional appeal can be required, especially if financial backing is necessary to implement the new ideals. As I have reported before when it comes to elder abuse tracking the problem can be one of the biggest challenges. That is why as a nursing home injury specialist I was pleased to see the latest Compendium specifically addressing “Medicare Quality of Care and Safety Issues.” Three areas of concern were included in the Compendium regarding nursing home reform, (1) improving quality of care plans and discharge procedures in nursing homes, (2) decreasing preventable harm and hospitalization of nursing home residents, and (3) improve emergency response and preparedness in nursing homes. While these recommendations may be incorporated in future elder abuse studies and possibly help to reform elder abuse rights, for many the help can come too late. If you or a loved one were seriously injured, neglected, or abused as a resident in a nursing home in Pennsylvania or New Jersey, our dedicated team of nursing home injury specialists may be able to help you get the compensation you deserve.

Improve Care Plans Improve Nursing Home Safety

Of the three proposed areas of nursing home reform, I found the quality of care plans and oversight to be of particular importance as it spells out the individualized plan of care that the resident is to receive. A care plan can assist in tracking any significant changes of the resident, including their mental, physical, and emotional health. The individualized care plan is also important as it details what kind of medication and what level of supervision the resident needs. For instance, a person who has dementia will need different care from someone who is bedridden, yet without proper supervision both resident’s health could greatly suffer. Insufficient care plans are also costly to both the government and private nursing homes. The Compendium report found that Medicare paid approximately $5.1 billion in 2009 for stays in which the nursing home did not meet quality-of-care requirements. Oversight for care plans and implementation is also an area that needs to be focused and addressed on a state and federal level according to the report. Nearly 37 percent of nursing home care plans do not meet federal requirements and the report also found that services were not provided as specified by the care plans. Increased oversight alone has a tremendous opportunity to help decrease instances of low quality of care in nursing homes. To read more about the areas for improvement and suggestions in long term care by the Office of the Inspector General read the latest issue of the March 2014 edition of Compendium of Priority Recommendations.
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Earlier last week, nursing home advocates took to the Oklahoma governor’s office in hopes of initiating desperately needed nursing home reform talks. Of particular importance a meaty Oklahoma nursing home reform Bill, which sought to address many elder abuse and neglect concerns, was defeated last month. As a Pennsylvania and New Jersey nursing home abuse attorney I was interesting in a proposed Oklahoma House Bill 2901 much of which was geared towards supplementing elder care resources as a means of preventing nursing home abuse and neglect. House Bill 2901 was tailored to increase nursing home staff, create medical director oversight, and other measures. The House Bill did not make it to committee, but it did help shed light on staggering cases of elder abuse that on average is greatly underreported. The Oklahoma based grassroots long-term care reform organization, A Perfect Cause, estimates that more than 3,500 nursing home residents in Oklahoma die each year from nursing home abuse and neglect. The House Bill 2901 would have address preventable deaths and injuries in two separate areas of interest, mandated increased nursing staff, and the state required investigation of family members and the accused, while investigating elder abuse claims. As reported by Oklahoma’s Own News 9, there were disagreements in the language and content of the bill, but lawmakers look optimistically to the next session in which to work out their disagreements. Wes Bledsoe, an advocate for nursing home reform, and President and Co-Founder of A Perfect Cause, estimates that about 62,000 cases of nursing abuse goes unreported nationwide. Underreporting is one of the many hurdles in addressing nursing home abuse and elder abuse on both a state and federal level.

Nursing home abuse reform has remained in Oklahoma’s legislature since the December 2012, disturbing nursing home abuse that was caught on tape. A hidden camera in 96-year-old Eryetha Mayberry’s nursing home room exposed the devastating abuse she was being subjected to on a daily basis by members of the nursing staff. Mayberry suffered from dementia, which requires greater care and more supervision as the patient’s capacities diminish. Dementia patients are particularly vulnerable to unscrupulous residents and staff members in nursing homes that take advantage of a patient, knowing full well that their victim will not be able to fully recall the transgressions. Mayberry’s daughter, Earlene Adkisson, installed the camera after she believed items were disappearing from her mother’s room. The extreme instances of abuse caught on camera including rough handling, choking, blocking the resident’s airways and more, totally shocked and horrified Mayberry’s family. The reported images left many questioning whether “granny cams” or monitoring devices were needed to keep themselves and their loved one’s safe. Oklahoma lawmakers say they have seen a rise in proposed legislation for the installation and monitoring of cameras in common areas of nursing homes. However, informed consent for monitoring in nursing homes is a complicated legal terrain, as you have to balance the general welfare of the residents and the individual resident’s right to privacy. Many opponents strongly believe that the safer alternative is to add more quality staff to help ease the burden of daily care.
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A recent ruling by the Court of Common Pleas in Philadelphia, upheld the federal and state public policy that favors promoting arbitration agreements. There are definite plus and minus to arbitration. Especially true with nursing home arbitration agreements, where the publics’ knowledge of a nursing homes’ safety record is greatly limited. Before placing a loved one into a facility checking their safety record of known allegation of serious abuse and neglect is of great importance. However, when a party is bound by contractual principles, which upholds arbitration agreements, instead of being able to file a lawsuit that is public record, these legal disputes are processed in a more private manner. It has long been touted as an efficient, and less costly alternative to trial litigation, enabling the courts to free up limited resources and time. Often, nursing home companies’ favor, and accordingly place an arbitration agreement clause into their contracts, a contract which is required to be signed prior to admission into their facility. As was the case in Lipshutz v. St. Monica Manor, the Philadelphia Court of Common Pleas found that the survivorship action related to a wrongful-death case was bound by the arbitration agreement and further upheld by federal law.

In Lipshutz v. St. Monica Manor, the plaintiffs brought a wrongful death and survival claims on behalf of their deceased mother and her estate under Pennsylvania’s Wrongful Death Act and Survival Act. Decedent suffered a stroke on November 4, 2011 at which time she was taken to Jefferson University Hospital. The decedent was discharged with an “impaired mental status” unable to care for herself. On November 11, 2011, decedent’s daughter, plaintiff Elizabeth Lipshutz, acting as her mother’s power of attorney, signed an admission agreement which contained within a mandatory arbitration clause. On May 16, 2013, plaintiffs alleged that the substandard care at St. Monica Manor was the direct cause of the decedent’s untimely death.

Because the decedent’s daughter acted with the authority and in a representative capacity, the court held that the survival claims had to be remanded to arbitration. At the time of the signing there was a valid contract supported by fundamental contract principles, such as a valid offer, acceptance, and consideration and that no traditional defenses to formation were available. The court held that the Federal Arbitration Act (“FAA”) pre-empts Pennsylvania civil procedure rules, Pa.R.Civ.P. 213(e), which requires wrongful-death claims and survival claims to be litigated together.

In determining who was bound by the arbitration clause, the court looked to Pisanco v. Extendicare Homes, Inc., which determined that “one who is not a party to a contract cannot be bound by it, and that arbitration agreements are not binding on non-signatory beneficiaries.” Here, her four children, three of whom did not sign an arbitration agreement with St. Monica Manor, survived the late Mrs. Lipshutz. Therefore, Elizabeth Lipshutz signing of the agreement in her capacity of power of attorney bound her late mother’s decedent’s survival claims to arbitration, but did not affect her own right or the rights of other surviving beneficiaries to bring wrongful death claims. While the Court of Common Pleas is not the highest court in Pennsylvania, if higher courts uphold the ruling, it can soon become precedent in the state.
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Earlier this month, in a devastating and gruesome parking lot accident, a group of pedestrians were run over after leaving church in Bradenton, Florida. At approximately 11:20 a.m. Sunday, February 2nd, 2014, 79-year-old Doreen Landstra, of Palmetto FL., was seen backing out from a handicapped space at the Sugar Creek Country Club. 1 pedestrian was declared dead at the scene, while 2 more were pronounced shortly after arriving at local area hospitals. Another 4 pedestrians were transported in critical condition; no word has been released at this time on their current condition. According to the Bradenton Herald, Florida Highway Patrol sighted Doreen Landstra the driver of the white Chevrolet SUV with “improper backing.” If found guilt of this non-criminal moving violation, Florida’s mandatory punishment imposed where there is a fatality involved, is a fine of $1,000 and suspension of one’s license for six months. This week’s earlier church parking lot accident was not the first for Landstra. Only two and a half years earlier, on July 28, 2011, Landstra accidentally drove her 2009 Chevrolet Tahoe into a McDonald’s restaurant as she tried to pull into a parking lot space. The Centers for Disease Control and Prevention (“CDC”) finds that as drivers age, their risk of being severely injured or killed in a motor vehicle crash increases. The most recent CDC statistics finds that nearly 500 older adults are injured daily due to motor vehicle accidents.

As a personal injury lawyer, practicing in both Pennsylvania and New Jersey, I understand the complexities and life-altering events a parking lot accident can have especially on our older population. Many older Americans can quickly have their freedom and quality of life greatly impacted if they are involved in a motor vehicle accident, both as a driver and as a pedestrian. In this case, 8 such lives were greatly affected by Sunday’s parking lot accident. A tragedy such as being struck and run over by a car can require expensive medical bills, a long stay in a hospital, extensive physical therapy, and in some rare cases it may require that the injured party check into a long-term care facility, while they heal from the injuries sustained.

Nationwide, according to the June 2008 National Highway Traffic Safety Administration (“NHTSA”) study, pedestrians are more likely to be fatally injured between the hours of 3 a.m. and 6 a.m. and especially during the weekend days of Saturday and Sunday. Parking lots in particular can seem like a mind field for drivers and pedestrians alike. As one ages their eyesight also degrades making it more difficult to see at dusk, and at night. On average, a vehicle fatally injures 13 pedestrians every day. While many do not consider parking lots a place to drive with added caution, such as in a school zone, in parking lots pedestrians and other vehicles can act unpredictability. Unpredictability when driving can increase the likelihood of being involved in a parking lot accident.

In Pennsylvania, if you are a driver over the age of 55, you are eligible to receive a 5 percent discount on your vehicle insurance, if you complete a Pennsylvania Department of Transportation approved Basic Mature Driver Improvement Course. In order to maintain the discount the driver would have to take a supplemental Refresher Mature Driver Improvement Course, every three years. The courses are offered through AAA, AARP, or Seniors for Safe Driving.
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While the most frequent type of abuse and neglect reported in older patients tends to be physical abuse, the majority of mistreatment involves neglect or quality-of-life issues. When a caregiver fails to properly tend to a patient an infectious disease can set in. Infectious diseases account for one third of all deaths in people 65 years and older. Despite advances in antibiotic therapies, infectious diseases continue to be a major cause of death in older adults. Further frustrating the matter is that infections do not present themselves the same way in older patients. Nonspecific complaints and subtle changes in their cognitive impairments, as well as weight loss, are some of the signs indicating that an infection has set in older adults. The role of a caregiver is all that more important in tracking any physical and mental changes in their patients. It is not uncommon for a patient to form an infection especially when a catheter is being used, as was the case in Schoemaker v. Ganon, et al.

In October 2008, the plaintiff Shannon Schoemaker was receiving at home care serviced by defendants Concordia Hospital, Inc., and their agents. On October 13, 2008, Ms. Schoemaker was being fed through an indwelling catheter, the nurse attending to her, nurse Yapp, indicated that there were signs of redness at the site of the catheter. Despite the increase in infectious caused by a catheter and that Ms. Schoemaker exhibited early signs of a possible infection, nurse Yapp failed to take any further steps. There were no plans in place for a follow up even though Ms. Schoemaker displayed signs of a catheter-related line infection. In fact the nurse had no intention of checking on Ms. Schoemaker until eight days later. Two days after nurse Yapp indicated redness at the site of the catheter, Ms. Schoemaker called Concordia Hospital, Inc. Hospital Home Care as Ms. Schoemaker had developed an infection that progressed and rapidly worsened. When Nurse Yapp returned Ms. Schoemaker was in acute respiratory distress with mottled lower legs, purple nail beds, lips, and nose. Ms. Schoemaker was hospitalized for forty-two days and had multiple surgeries where both of her legs were amputated, as well as the tip of her nose, and her left pinky finger.

Before the Court of Common Pleas in Lehigh County the jury rendered a verdict in favor of Ms. Schoemaker where they found the defendants liable. The jury awarded a $23 million in damages to Ms. Schoemaker. While defense argued that the harm Ms. Schoemaker suffered was not causally connected to the infection at her catheter site, the jury concluded that the plaintiff was not contributorily negligent. This verdict is among the highest ever for a medical malpractice case in Lehigh County and among the highest in all of Pennsylvania. It goes to prove the importance of a quality caretaker, and how their decisions and the quality of care rendered can have life or death consequences for elder patients in their care.
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When Pennsylvania nursing home abuse takes place, it often takes place behind closed doors. If the victim is a patient with disabilities that prevent clear communication, it may be some time before the abuse is uncovered. That’s why I was interested, as a Philadelphia injury lawyer, to see news out of Ohio that a long-term hidden camera investigation of one nursing home has led to revocation of the home’s license and possible criminal charges. The Columbus Dispatch reported that state officials recorded “shocking and disturbing” instances of abuse and neglect with hidden cameras at Autumn Health Care Nursing in Zanesville, Ohio. The local NBC affiliate added that the cameras revealed multiple kinds of neglect and falsified documents. The home has 60 days to shut down; the state is helping patients move to new facilities.

NBC reported that patients’ families’ complaints originally motivated the investigation. The state attorney general wouldn’t say how long the cameras were in place, but state regulators have been monitoring the nursing home for at least four years, in response to complaints. The cameras, installed with permission from patients and families, recorded neglect of at least one patient’s medical, nutritional and personal needs. Employees were accused of falsifying documents to make it look as if those needs had been met, the article said. Once the state health department had these results, it performed an inspection and found violations in patient treatment and care; infection control; food and nutrition; and resident rights. Families were upset that their loved ones were not given adequate care and that they had to move.

The state attorney general said criminal charges could be filed in the case, including possible charges of Medicare fraud, patient abuse, theft and falsification. The articles don’t say what exactly happened to these patients, and perhaps it’s for the best that the patients themselves and their families will have a chance to decide whether to go public. But as a Philadelphia medical malpractice lawyer, I suspect we’ll receive more details if any of the families involve decide to file lawsuits. Lawsuits are a real possibility because patients and their families often end up with steep medical bills from this kind of neglect. Malnutrition, dehydration and pressure sores can be serious threats to an immune-compromised elderly person, requiring hospitalization. The obligation to change facilities is also unlikely to be cheap. All of these costs are recoverable in Pennsylvania with a Pennsylvania nursing home abuse lawyer‘s help.
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When you hop onto a Pennsylvania nursing home abuse blog, like this one, you’re bound to find stories that may at first blush seem to create a confirmation bias. In other words, this blog is maintained by a high profile and widely respected Philadelphia nursing home neglect and abuse law firm. So it obviously contains information and stories that elevate the salience of nursing home abuse and neglect.

Thus, you might be led to believe that this blog is biased and that it “over reports” the extent of the problem.

But both objective statistics and good science reporting should refute this skeptical mindset.

Consider, for instance, a terrifying story from last week’s news alone – which highlights the horrific and diverse extent of the problem.

Arlington Texas police are investigating claims that a woman’s elderly mother had been abused at the Heritage Oaks Nursing Home on Gibbins Road. 83-year-old Mynez Carter is afflicted with Alzheimer’s disease. She needs round the clock care. Her family became angry and suspicious, after they saw unexplainable bruises on the matriarch’s body.

What was causing those disturbing bruises?

The woman’s daughter, Freddie Johnson, suspected abuse at the nursing home.

To test her theory, Ms. Johnson surreptitiously installed a hidden camera in her mom’s room to try to catch suspected abusers in the act. She later told news sources that, once she saw the hidden camera footage, “my heart started racing and I was horrified. And I was more mad than anything just to know this was going on with my mother…”

Ms. Johnson said the video clearly demonstrated that staff workers had been abusing her mom.

In one case, one of the workers pinched Carter’s leg. In other case – a scarier example – one worker pulled her mom’s hair and pushed on her head. Johnson and her siblings met with the administrator of Heritage Oaks, Jerry Warren. They also filed a police report, and Texas police are investigating.

One of the most disturbing – and also captivating – aspects of the story is the hidden camera.

We all want to know “what goes on” when we’re not around. That’s fundamental human curiosity at work. Many people who are even slightly dubious about a nursing home would likely be intrigued by what a “hidden camera” might have to say.

Hidden cameras are interesting devices, in that they reveal unfortunate truths about the limits of our trust. What does it say about our society that the children of an elderly woman in desperate need of care must spy on their mother, just to make sure that she is not getting abused?

This is a deep question with potentially worrisome answers.
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The Pennsylvania nursing home neglect and abuse attorneys here at Rosenbaum & Associates often hear about some awful and depraved acts. These horror stories strengthen our resolve to ensure justice and maximize safety for our clients. Unfortunately, many nursing home abuse victims lack perspective about just how pernicious and disgusting these crimes can be; as a result, they may fail to take swift and effective action to stop them.

Consider, for instance, recent accusations against employees at a nursing home called Envoy of Staunton. The situation at this nursing home is, to put it mildly, disgraceful.

Consider these points:

• One employee, 47-year-old Anthony Johnson, faces both criminal and civil charges in connection with accusations that he groped a 53-year-old patient and compelled a 43-year-old patient to have oral sex with him. One of the family members of the victims finally reported Johnson’s actions to the police. Envoy finally fired the nurse’s aide, but that punitive action obviously cannot undo the damage done to the assaulted patients.
• Meanwhile, Diane Renee Kline, a 41-year-old administrator and RN, stands accused of failing to report exploitation/abuse to Adult Protective Services. This may not seem to be as “serious” as the crimes that Johnson allegedly committed, but when nursing home watch dogs fail, the system basically collapses;
• 69-year-old Charles Williams, another Envoy employee, stands accused of penetrating a 71-year-old woman with an animate object. In that case, the nursing home immediately contacted police, but still… it does not speak well of a facility when multiple disgusting events occur.

An inspection of this nursing home exposed ten different deficiencies in areas as diverse as food safety, medication management, care and services, and infection control.

The crime of nursing home sexual assault in Philadelphia or elsewhere is grim and terrifying. Some victims may be too terrified to come forward to authorities or even to family members. Others may be too sick or cognitively impaired to report the abuse or even understand what’s happening.

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