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August 31, 2010

Pennsylvania Families Can Use Nursing Home Compare to Avoid Unsafe Homes

As a Philadelphia nursing home negligence attorney, I was interested in a recent article in the New York Times that discussed a rating system now available to families seeking information about nursing homes. This is an important tool to help families assess these facilities as they make decisions about where they or their loved ones will be cared for. As a Pennsylvania nursing home abuse lawyer, I've seen many cases of abuse, neglect and other negligence in nursing homes where profits come before patients, and I know that families need all the help they can get to avoid substandard facilities.

The Nursing Home Compare tool on Medicare.gov allows families to find and compare information about every Medicare and Medicaid-certified nursing home in the country, using a rating system of one to five stars. One star means that the nursing home is far below average, and five stars indicates that it's far above average, on measures of health inspections, staffing, and quality. It also provides an overall rating based on annual inspections and data reported by nursing home administrators.

Experts advise families seeking nursing homes to use the rating system, in addition to visiting the nursing homes they're considering at varying times of the day and asking the nursing aides how long they've been in their jobs. They also suggest talking to nursing home administrators, other families and the local aging agency's ombudsman. By putting all these sources of information together, families may be able to avoid some of the worst problems that nursing home patients can experience, like bedsores and other injuries that result from understaffing, inexperienced or poorly screened staff, and financial abuse by poorly supervised staff members.

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August 18, 2010

Jury Awards $400,000 to Victim of Negligence by Nursing Home Company Operating in Pennsylvania

Several months ago, I wrote about the sad case of John J. Donahue, a nursing home resident who died in 2005 after his eye was gouged by a metal hook in an accident caused by negligent nursing home staff. A jury in Plymouth Superior Court in Brockton, Mass., has found in favor of Donahue's family and ordered the Embassy House nursing home, where Donahue was hurt, to pay $400,000 plus interest for pain, suffering and disfigurement. As a Philadelphia nursing home negligence attorney, I am pleased to see patients and their families successfully hold negligent nursing home caregivers accountable when they hurt the people they're supposed to protect.

Marlene Owens, 76, of Easton, Mass., has been fighting for years to force Kindred Healthcare to own up to its culpability for harming Donahue, her stepfather. Kindred owned Embassy House at the time of the injury and operates nursing homes all over the United States, with several facilities in Pennsylvania. Donahue was 93 when nursing home staff failed to use a Hoyer lift properly when trying to move him, and his left eye was gouged by a metal hook. His eye had to be removed, and Donahue died of sepsis soon after. Donahue had signed an arbitration agreement that would have prevented him or his estate from suing the nursing home if he were killed or injured there, but at the time he signed it, he was 91 and suffering from delusions. A judge invalidated that agreement in 2009, allowing the lawsuit to go forward. The jury in Plymouth Superior Court agreed with Owens that negligence was a substantial contributing factor to Donahue's injury, although they did not find Kindred Healthcare responsible for his death.

Kindred Healthcare's lawyer said that the chain does still ask patients to sign arbitration agreements like the one Donahue signed, but noted that it is voluntary. Still, in my view as a Pennsylvania nursing home abuse lawyer, families should avoid signing these agreements whenever possible. They do not protect the patient's or family's interests; they protect the nursing home from being held responsible for its actions in an open court. Under an arbitration agreement, if a patient is injured or killed because of negligence or abuse by nursing home staff, families cannot turn to the legal system -- they have to go to an arbitrator, a private legal expert whom the company pays to settle the dispute. This is done outside the public eye and generally by someone who is being paid by the nursing home company, casting his or her neutrality into question. Because the court system is much less expensive, I do not believe nursing home companies would steer families into arbitration if they did not believe they would benefit. When a family member's life, health, and dignity are at stake, you should not limit your options by signing an arbitration agreement.

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July 20, 2010

Budget Cuts Mean Pennsylvania Families Must Watch for Nursing Home Negligence

As Pennsylvania nursing home neglect attorneys, we pay attention to news about investigations of nursing homes that neglect or abuse patients. In Kentucky, there has been an uproar over how long it takes for the state to investigate reports of abuse and neglect. Families of nursing home patients in Pennsylvania should take note of this conflict in Kentucky, because state budget cuts in Pennsylvania could lead to similar problems here. With state agencies increasingly trying to do more with less, nursing home patients' families should not depend entirely on the state to make sure nursing homes live up to their responsibilities to care for patients properly.

Because of the current recession, it's especially important for families to watch carefully to make sure that their loved ones are receiving proper care in nursing homes. State agencies are severely underfunded and have a limited ability to enforce their own rules. Pennsylvania's 2010-2011 budget will require layoffs from every state agency. More state employees will be laid off if the state does not receive $850 million for Medicaid, which helps to pay for many nursing home patients' care, from the federal government. Even though there are laws and regulations governing how nursing homes should treat their patients, state regulators will be trying to do their jobs with less money and fewer people. Inspections may not happen as often as they should, and follow-up after those inspections to make sure violations are corrected may take longer, or not happen at all. In addition, politicians, possibly looking for donations from nursing home companies, sometimes pressure state regulatory agencies to overlook nursing homes' negligence. Then, poorly run homes can get away with hurting people longer, sometimes until someone dies.

As Philadelphia nursing home abuse lawyers, we have seen many cases of neglectful and abusive treatment of nursing home patients, including theft and financial exploitation; life-threatening bedsores caused by staff members' poor training, lack of caring, or understaffing; and infections caused by poor hygiene. Unfortunately, government regulators are unlikely to catch and correct all of these violations given their own underfunded circumstances. Sadly, families simply can't afford to trust regulators to make sure that their loved ones are being treated properly in nursing homes.

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July 9, 2010

Pennsylvania Families Should Look Carefully at Nursing Home Staffing Levels

A judgment of more than $670 million against nursing home company Skilled Healthcare Group Inc. in California underscores a message I hope that all nursing home operators will hear: Staffing levels matter. Patients and family members had brought a class-action lawsuit against the company, and the Los Angeles Times recently reported that a Humboldt County, CA, jury ordered Skilled Healthcare to pay damages for having understaffed 22 assisted living facilities. The jury imposed the maximum damages for violating California health and safety codes requiring 3.2 nursing hours per patient per day, along with $58 million in restitution. The jury has not yet decided whether to require Skilled Healthcare to pay punitive damages as well. The company, which also operates nursing homes in seven other states, vowed to appeal the jury's decision. As a Philadelphia nursing home negligence attorney, I'm glad that the patients and family members stood up for themselves and that the jury found in their favor.

As I wrote several months ago, staffing levels are extremely important to the quality of care a nursing home patient receives, and ultimately to their quality of life. Low staffing levels can result in serious, negative consequences for patients. Staff members can forget to administer medication or read a patient's treatment plan. They can be delayed in responding to call buttons because they're busy with other patients. Over time, bedsores or dehydration could develop without busy staff members noticing. Some staff members feel so stressed and overworked that they take out their anger and resentment on patients. Others might see opportunities to steal from nursing home residents -- opportunities that they wouldn't act on if there were other staffers around.

We have written about many situations like these from our perspective as Pennsylvania nursing home abuse lawyers. Studies show that understaffing at nursing homes is a real problem, depriving staff members of the time they need to provide the best care. As Philadelphia nursing home neglect attorneys, we hope that nursing homes will live up to their obligation to provide appropriate staffing levels.

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June 24, 2010

Pennsylvania Nursing Home Uses Baby Seal Robot to Comfort Dementia Patients

The Wall Street Journal reported recently on a development in nursing home care that could be good for nursing home patients if it's used well: a socially interactive robotic baby seal. A robotic stuffed animal may seem like a strange substitute for real human interaction. But from my perspective as a Philadelphia nursing home negligence attorney, if the baby seal robot is used as a supplement to, rather than a substitute for, edifying interaction with staff and visitors, it could be a welcome source of enjoyment for nursing home patients.

The six-pound baby seal robot, called Paro, was invented five years ago by a Japanese robot manufacturer. Its electronic innards allow it to recognize and respond to voices, track people's movements with its head and eyes, bat its eyelashes and repeat behaviors that get a positive response. Danish nursing homes have invested in Paro robots since a 2008 study found that they soothed dementia patients and improved their communication. Here in Pennsylvania, a Pittsburgh nursing home has found that some of its residents interact with the robot as if it's a pet, and some staff find that the robot facilitates social interaction among residents. Marleen Dean, activities manager at Vincentian Home in Pittsburgh, said that Paro comforts dementia patients. "Some of our residents need more than we as human beings can provide... We've tried soft teddy bears that talk and move. But they don't have the same effect."

This robot sounds like a good alternative for centers that want the positive interactions of a pet but have practical concerns holding them back. But as a Pennsylvania nursing home abuse lawyer, I hope they it does not take the place of social interaction that's led and supervised by human staff members. Paro can be used as a substitute for pet therapy, but it seems cruel to deprive nursing home patients of interactions with real, live beings in favor of a more convenient robot. I would especially discourage nursing homes from relying on robots or pet therapy in place of adequate staffing with well-trained, qualified human beings to meet patients' needs. Everyone needs meaningful social interaction to stay mentally healthy. A robotic baby seal gives patients something to love, which is valuable, but it can't provide mentally stimulating conversation or a real relationship. Nor can it turn the eagle eye on patients' conditions that a human family member or friend might. And it is certainly no substitute for adequate care from a professional staff.

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June 8, 2010

Article Highlights Dangers of Poor Hygiene to Pennsylvania Nursing Home Residents

McKnight's Long-Term Care News ran a feature article recently on a topic of great importance to Philadelphia nursing home negligence lawyers like us: increased scrutiny on whether proper hygiene practices are used in nursing homes. Infections from drug-resistant bacteria have received increasing media attention in recent years, yet less than 50 percent of healthcare workers wash their hands as they should. This potentially deadly lapse in hygiene is also a serious violation of nursing home patients' trust in the people and institutions that are supposed to be caring for them.

A 2007 study published in Clinics in Geriatric Medicine showed that 1.5 to 2 million healthcare-associated infections occur in long-term care residents annually. That works out to one infection per resident per year, and studies show that 80% of infections are a result of bacteria transmitted by touching. Nursing homes need to make certain that all their employees take the time to wash up properly, but employees are often rushed in their interactions with patients because the institutions try to save money by understaffing. As Pennsylvania nursing home abuse attorneys, we know that that can lead to skin problems, infectious pneumonia, worsening of bedsores, and the continual passing of infectious diseases from one patient to another, or between patients and staff members. Given nursing home patients' dependence on the staff to care for them, it is only right that patients should be afforded the dignity that comes with proper hygiene.

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April 4, 2010

Technology for Incontinence Management Could Help Pennsylvania Nursing Home Patients

McKnight's Long Term Care News recently reported that Australian nursing homes have begun using a new tool that promises to significantly reduce staff time devoted to managing patient incontinence: electronic underpants. This technology, called the Smart Incontinence Management System, or SIMsystem, uses an electronic moisture sensor that detects when a patient has had an accident. Then, SIMsystem sends a text message or page to staff to let them know that the patient needs their assistance. SIMsystem can be used with disposable diapers, and the article suggests that it can cut staff time spent on incontinence significantly.

As a Philadelphia nursing home neglect lawyer, I was interested in this news because more attentive care for incontinent patients could also help prevent bedsores, a common problem for nursing home patients. Bedsores form when patients are left in the same position for too long, but excess moisture from incontinence is one typical way they are aggravated. However, an electronic system can't prevent bed sores all by itself, obviously. Nursing home staff members still need to tend to patients regularly and appropriately. And even with the aid of innovative technology in patient care, adequate staffing is necessary to make sure that patients' treatment plans are followed and that there are enough staff members to go around. As a Pennsylvania nursing home abuse attorney, I hope that nursing homes that outfit incontinent patients with the SIMsystem will not assume that this new technology means that they can get away with fewer staff members. Understaffing in nursing homes can lead to serious failures in patient care, including but certainly not limited to pressure sores.

Patients in nursing homes have the right to expect that they will be well cared for, regardless of what kind of technology the nursing home employs. Paralyzed or otherwise immobile patients develop bedsores because they are unable to shift positions on their own. The Mayo Clinic's Web site points out that elderly patients have thinner skin than young people do, so they are more susceptible to bedsores. The Center for Disease Control and Prevention's data show that 1 in 10 nursing home patients suffered from bedsores in 2004, showing just how common this injury is in nursing homes. The presence of severe bedsores can be evidence of nursing home negligence.

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April 2, 2010

Pennsylvania Families Should Beware of 'Worthless Services' in Nursing Homes

According to a recent Washington Post article, the U.S. Department of Health and Human Services is investigating rampant fraud and abuse in Medicare billing for "high-end services" at nursing homes. The Justice Department said nursing homes have been categorizing patients inappropriately in billing forms in order to receive higher payments from Medicare for "services not rendered, and ... worthless services." This article caught my eye because it's yet another example of the wrongdoing that nursing homes and their staffs can get up to right in front of patients who are unable to clearly object or tell an outsider. As a Pennsylvania nursing home abuse attorney, I wonder whether nursing homes that try to make higher profits by overbilling Medicare are also more likely to try to generate profits by overmedicating or financially abusing patients.

The article alleges that nursing homes have been categorizing many more of their patients in "ultra-high" Medicare billing categories than can be justified by those patients' medical records. Medicare has annually paid out up to $542 million more than it should have for services for these patients. The recently enacted health care reform legislation changed the rules to combat this problem, which is considered part of the "waste, fraud and abuse" that both parties oppose. Certain nursing home chains have been singled out as especially egregious offenders, including HCR ManorCare, which operates in cities throughout Pennsylvania.

The article does not specify the kinds of unperformed services for which nursing homes charged Medicare. But with the recent settlements for pharmaceutical company kickbacks to nursing homes for overmedicating patients for profit, as a Philadelphia nursing home negligence lawyer, it seems fair to wonder whether a nursing home that cheats in one way isn't dishonest in other ways too. I am glad that the Department of Health and Human Services is thoroughly investigating these patterns of fraud and putting nursing homes on notice that increasing profits through fraudulent claims is unacceptable. Hopefully, the increased scrutiny will encourage nursing homes to be more conscientious in all aspects of their work.

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March 29, 2010

Pennsylvania Families Should Be Alert to Sexual Abuse of Nursing Home Patients

The Troy (New York) Record recently reported on the sentencing of a former nursing home aide for sexually abusing a nursing home patient. As a Pennsylvania nursing home abuse lawyer, I was glad to see the court make clear that abuse of helpless nursing home patients will not be tolerated. Robert Gunderson, 52, of Schoharie County, NY, pled guilty to attempted first-degree sexual abuse. Gunderson admitted to touching the breast of a 78-year-old woman who was a patient at the Northwoods Rehabilitation Center and Extended Care Facility in Schaghticoke, NY, where he worked as a nurse's aide. The patient was "physically helpless," according to the Record, and the abuse occurred in late 2007 and early 2008. Gunderson was sentenced to ten years' probation, although he could have faced up to seven years of jail time on the charges that were brought against him.

Surprisingly, these are not the first allegations of sexual abuse concerning Gunderson. He is also facing a charge of third-degree sexual abuse for an alleged incident that took place during his employment at the Eddy Ford Nursing Home in Cohoes, NY. In August and September of 2008, Gunderson is alleged to have French kissed a patient with multiple sclerosis who was confined to a wheelchair. It is disturbing that Gunderson was able to behave this way toward patients in two different nursing homes over the course of a year. Nursing homes have a legal responsibility to ensure that they hire qualified staff with no history of abuse or other dangerous criminal violations. Nevertheless, some homes may cut corners to save money. For example, they may not conduct sufficient background checks. Or they may be so understaffed that personnel do not see patients frequently enough to notice signs of abuse from another staff member.

Nursing home patients' family members should be alert to signs of abuse when they visit. According to an article in Nursing Homes, signs that a patient may have been sexually abused include: "difficulty in walking or sitting, pain or itching in genital areas, the occurrence of sexually transmitted diseases, unexplained bruising, welts, lacerations, fractures, or other injuries, decreased socialization, self-injurious behavior and/or attempts to hurt others, fear of specific people or places, [and] habit disorders such as pulling hair or ears."

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March 25, 2010

Pennsylvania Families Should Take Note of Financial Abuse Schemes in Nursing Homes

A former nursing home business office manager in California has been charged with kidnapping an 85-year-old Alzheimer's disease patient from her Berkeley nursing home. According to the San Francisco Gate, Concepcion "Connie" Pinco Giron, 51, stole more than $50,000 from six elderly patients of the Elmwood Nursing and Rehabilitation Center, including the one she kidnapped. California state Attorney General Jerry Brown said, "This is a shocking case of nursing-home abuse and a gross violation of trust." As a Pennsylvania nursing home abuse lawyer, I urge nursing home patients and their families to watch their finances as carefully as they can.

Giron's schemes involved opening bank accounts at Citibank in the patients' names, according to the Department of Justice. Then she transferred their money into her own account, wrote herself checks from their accounts, and used their ATM cards. She also allegedly stole money from their trust accounts at the nursing home. Giron also told one patient's son that he had to pay an extra $600 per month for his mother's care, and then kept the money for herself, over the course of 18 months. And in August 2008, Giron claimed that one of the patients would be transferring to another facility, but in fact kidnapped the patient and moved her into Giron's own home. Then Giron cashed the patient's pension and Social Security checks.

In August 2009, the state attorney general's Bureau of Medi-Cal Fraud and Elder Abuse began investigating Giron in response to a complaint about her. That month, investigators found the kidnapping victim, 85-year-old Carnell Williams, in Giron's home, physically unharmed. Giron has been charged in Alameda County with kidnapping to commit another crime, false imprisonment, elder abuse and six counts of theft from elder or dependent adults by a caretaker. She is being held at the Santa Rita Jail in Dublin in lieu of $365,000 bail.

A dependent, elderly nursing home resident should not have to fear that his or her lifetime's worth of savings will be stolen by his or her caretakers, and thankfully many nursing home employees are honest. Nevertheless, financial exploitation of the elderly is all too common. Patients and their families should track their bank accounts and be alert to any unusual activity.

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March 23, 2010

Dangerous Negligence Attributed to Pennsylvania Long-Term Care Hospital Company

Spurred by reports of negligence in patient care, McKnight's Long Term Care News reports that the Senate Finance Committee has demanded that Select Medical Corporation answer questions about its staffing levels and quality that were raised in a recent New York Times article. Select, a Pennsylvania-based corporation, runs 89 long-term care hospitals and is one of the largest such companies in the United States. Among the troubling cases that concern the Senate Finance Committee are a patient's heart attack and death after a nurse turned off his heart monitor because she was tired of hearing its beep.

Long-term care hospitals treat seriously ill patients who are too sick for nursing homes and who are not improving quickly at regular hospitals. The New York Times reports allegations that Select structures its patients' stays so that it can maximize payments from Medicare, regardless of the patients' medical needs, and it inadequately staffs its hospitals for financial reasons. Patient care is compromised as a result of these profit-driven concerns. Select denies all of these allegations. Nevertheless, Select's hospitals received four times the number of citations for serious violations of Medicare rules that regular hospitals received in 2007 and 2008.

The only penalty that Medicare can use to punish hospitals for such violations is to bar them from Medicare entirely. That penalty is rarely used, and in one case when it was applied, the hospital successfully sued to bar Medicare from imposing it. However, the families of some victims of long-term care hospital negligence have filed lawsuits against the companies. Even if Medicare does not stop abusive long-term care hospitals from continuing to harm patients, negligent institutions and the companies that run them can still be held accountable through lawsuits.

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March 17, 2010

Pennsylvania Families Should Take Note of Serious Problems in Nursing Homes

An investigative report that found 38% of Massachusetts nursing homes had been rated "below average" got the attention of our Pennsylvania nursing home neglect attorneys. The Boston Herald's March 7 report found dozens of problems with neglect, lack of cleanliness, and poor staff training over two years. These lapses led to patients' deaths and nursing home staff members' attempts to cover up their negligence. In a 2008 incident in Danvers, Massachusetts, nurses failed to do CPR on an unresponsive patient, whom a doctor pronounced dead 15 minutes later. A nurse admitted to falsifying the patient's medical records.

In other reports, nursing home staff ignored treatment plans to keep patients from losing too much weight -- a common problem in nursing homes -- neglected to provide appropriate pain medication, and failed to protect patients from themselves and each other. Industry experts pinned part of the blame on low staff-to-patient ratios, leading to staffs that are too overworked to give patients the attention they need. "Most nursing homes are too understaffed to avoid harming residents," said Janet Wells, director of public policy at the National Citizens' Coalition for Nursing Home Reform. Even W. Scott Plumb of the Massachusetts Senior Care Association, which represents nursing homes, said that high staff turnover and worker shortages are continuing problems for nursing homes. These problems will only worsen as baby boomers age and nursing homes are flooded with even more patients.

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March 15, 2010

Treatment Plans are of Vital Importance for Pennsylvania Nursing Home Patients

As Philadelphia nursing home abuse lawyers, we took note of the Lexington (Kentucky) Herald-Leader's March 3 report about a mistake by a nursing assistant that cost a nursing home resident his life. Lynwood C. Bauer, 27, was charged with reckless abuse of an adult in connection with his work as a former certified nursing assistant at the Pineville, KY, Britthaven Nursing Home. The nursing home was also cited for actual harm and for failing to report the incident immediately. Bauer was being held in lieu of $500,000 bail.

Bauer failed to read the patient's treatment plan before working with him. Because of this, Bauer was unaware of appropriate and safe procedures for moving the patient from his bed. The patient was paralyzed on his left side from a stroke, so two people and a mechanical lift were required to move him, according to his treatment plan. But Bauer moved the patient alone and left him sitting on the edge of his bed. The patient fell, and Bauer put him back in bed, again without assistance. In another violation of the nursing home's policy, Bauer failed to assess the patient for injuries after the fall. Other staff members later found that the patient was injured and required hospitalization. Bauer was fired, and the patient died at the hospital.

We see cases like this often in our work as Pennsylvania nursing home negligence attorneys. Nursing home patients are often unable to speak up for themselves to remind staff members of their treatment plans. It takes only one negligent staff member to harm a nursing home patient, leaving him or her with further damaged health and quality of life, not to mention the costly medical bills from hospitalization that should never have been needed in the first place. Lynwood Bauer will face up to a year in jail if convicted, but family members of patients who have been injured or killed because of nursing home negligence can sue to recover damages for their pain, suffering and expense.

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March 13, 2010

Nursing Home Company Operating in Pennsylvania Allowed Delusional Patient to Sign Binding Arbitration Agreement

Recently, we wrote about the dangers of agreeing to binding arbitration in nursing home contracts. As Pennsylvania nursing home negligence attorneys, we strongly advise nursing home patients and their families to avoid binding arbitration agreements, and a March 8 story in the Boston Herald starkly illustrates the reasons why. The family of John J. Donahue is suing a Brockton, Mass., nursing home over his death from serious injuries sustained because of a staff member's negligence. Donahue, 93, was paralyzed and needed staff members' help moving. Because a staff member tried to move Donahue alone, using a lift that was supposed to be operated by two people, Donahue's left eye was gouged by a metal safety hook on the machine. For reasons not made clear in the article, the home waited 15 hours before taking him to the hospital. Donahue's eye had to be removed, but he still developed an infection that caused sepsis, a dangerous immune system overreaction. This led to his death six weeks later.

Donahue's stepdaughter and the executor of his affairs, Marlene Owens, tried to sue Embassy House Skilled Nursing and Rehabilitation Center. However Donahue had signed an arbitration agreement when he entered the home at the age of 91, barring him from requesting a jury trial if he was killed or injured by Embassy House's negligence. At that time, Embassy House's own records showed that he was suffering from confusion, delusions and depression. Owens and her nursing home abuse attorney fought this agreement in court, winning a declaration last year that the agreement was invalid because Donahue was "unable to act in a reasonable manner." Further, the judge said, Embassy House should have known that Donahue was not competent to sign away his right to a trial. This decision opened the way for Owens to sue Embassy House and Kindred Healthcare, Embassy House's parent company at the time. Kindred Healthcare operates in Pennsylvania as well. Owens alleges that both companies' negligence led to her stepfather's terrible accident, deformity and death.

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March 11, 2010

Dementia Predicted to Rise Among Very Elderly in Pennsylvania Nursing Homes

As Philadelphia nursing home neglect lawyers, we took note of a recent study reporting that the rate of dementia is likely to rise significantly as people live longer. McKnight's Long-Term Care News reported Feb. 25 that the University of California study predicted "epidemic" levels of dementia in people over the age of 90. For people over 100 years of age, the likelihood of having dementia is over 40%. Over the next four decades, the number of seniors over age 90 will more than quadruple.

Often, the families of patients with dementia are unable to care for them at home, so it is likely that many of these people will need care in a nursing home setting. This makes it particularly important to be vigilant for signs of abuse -- for example, overmedication of patients to make them easier for the nursing home staff to manage. As we discussed recently, a nursing home company operating in Pennsylvania was accused of participating in a kickbacks scheme with pharmaceutical companies. As part of this scheme, the nursing homes had incentives to overprescribe Risperdal, an anti-psychotic drug that is used to "chemically restrain" patients with dementia. Unfortunately, patients who are unnecessarily prescribed these chemical restraints may die from them.

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