Pennsylvania Nursing Home Abuse Attorney Blog

The Administrative Office of Pennsylvania Courts (AOPC ) announced the establishment of the Elder Law Task Force formed by the Pennsylvania Supreme Court to investigate the increasing troubles regarding abuse, neglect, guardianship and the access senior citizens have to justice. Justice Debra Todd is chairing the task force, which will recommend possible legislation, amended laws, training and best practices. The task force has one year to finalize their study.

Supreme Court Chief Justice Ronald Castille said that Pennsylvania's older population has significantly increased and as it grows, it is straining the ability of courts to provide services to protect elderly Pennsylvanians. He further stated that the requirements of the elderly will last for years, especially with regard to elder abuse, guardianships and their access to legal recourse. He said that it is time to guarantee that older Pennsylvania citizens will not suffer abuse or the loss of their savings.

Justice Todd has said that our society focuses on child abuse, but rarely addresses the abuse of the elderly. The force is hoping to put new laws into effect before the elderly population swells even more because with more elderly citizens comes more elderly abuse. Nowadays the number of people in the United States who are over 65 years old is greater numerically and proportionately than it has ever been, according to the U.S. Census Bureau. Pennsylvania is only exceeded by three other states in terms of elderly population density.

The AOPC gave three instances of elder abuse that would be addressed by the task force. One example was a 64-year-old man from Lancaster who relied on his personal care aide to fix his meals, bathe and dress him because he only had one leg. The police said that the aide neglected the man so severely that the amputee developed skin ulcers that reached the entire way to the man's bone. Due to the extensive wounds, he lost his other leg.

Another example dealt with a Bucks County woman enlisted a neighbor to handle her personal finances since she was entering a nursing home. The neighbor squandered her savings on casino trips, jewelry, posh vacations and golf outings rather than paying her bills. The man has been charged with five felony theft charges.

The National Institute of Justice recently funded a study that reported that in 2009 eleven percent of folks over the age of 60 were the victims of senior abuse. Justice Todd said that at least the two previous cases had been reported. Todd said the U.S. Administration of Aging's National Center on Elder Abuse reported recently that for every one reported case, it's estimated that there are five unreported cases. Justice Todd called that statistic shameful and insisted that Pennsylvania can do a better job protecting seniors from abuse and neglect.

As a Philadelphia medical malpractice lawyer, I was interested to read about a recent court ruling involving a suburban Philly nursing home. According to McKnights Long-Term Care News, a federal judge has dismissed a case against Neshaminy Manor, a home run by Bucks County. The lawsuit alleged that negligent practices at the nursing home led to injuries and eventually the death of Almira Will. Will depended on an oxygen tank, but her daughter, Lauretta Notwick, alleged that she frequently found the tank empty or turned off when she visited. The federal judge in the case granted a dismissal to Bucks County, ruling that the county is not legally responsible for injuries that do not stem from county policy, and that no policy appears to have led to Will's injuries.

Will had end-stage chronic obstructive pulmonary disease, a condition that required her to have constant oxygen from a tank. She was admitted to Neshaminy Manor in August of 2008 after breaking her hip. Notwick's lawsuit alleged that during visits, she frequently found her mother's oxygen tank turned off or empty. She claimed that this was a result of a Bucks County policy saying staff "may" replace oxygen cylinders with needles halfway into the red zone that signals a need for a refill. The federal judge, Lynne Sitarski, ruled that the nursing staff may have provided poor care, but the Bucks County policy was not to blame because it left the replacement time up to staff discretion. Notwick also argued that staff negligence led to Will falling numerous times while at Neshaminy Manor, once breaking her hip again. But the judge ruled that Bucks County is not liable for this because there's no evidence that allowing Will to fall was a result of county policy.

As a Pennsylvania nursing home lawyer, I hope this family continues to pursue the lawsuit. The article doesn't make clear who exactly was sued, but typically, the nursing home is legally responsible for its employees' behavior. With private homes, that's true regardless of whether the employees were carrying out policy or simply making bad choices. The rules may change because this home is part of the Bucks County government, but in general, government employees are not immune to lawsuits. Of course, Notwick can also sue the employees who provided negligent care as individuals, but suing them as individuals does nothing to induce their superiors to make (or enforce) policies that avoid Pennsylvania nursing home abuse. Individuals also have far less money, which may be an issue for this family if they suffered significant financial losses from the bad care, such as high medical bills and funeral expenses. As a Philadelphia injury lawyer, I would be interested to see whether this ruling is revisited.

Continue reading "Judge Dismisses Nursing Home Neglect Lawsuit Against Bucks County " »

As a Pennsylvania nursing home lawyer, I was pleased to see that a Western Pennsylvania family has settled its Pennsylvania nursing home abuse lawsuit with a nursing home. According to the Altoona Mirror, Affinity Health Services Inc. settled claims that a worker there assaulted a 77-year-old woman two weeks before her death. Christine Welshans was left with bruises and blood on her face after the alleged assault on Aug. 16 or 17 of 2009. The aide accused of hurting Welshans was also accused of assaulting another patient, but the case involving Welshans was closed after her death two weeks later was ruled heart-related. The family's lawsuit noted that the aide, not named in the article, had a history of abusing patients at another home.

Welshans had physical problems, but was pleasant and able to interact with staff until the night of Aug. 16 or the early morning of Aug. 17. That's when the lawsuit alleges she was battered around the face by the aide. A city police report the next day said Welshans had bruising around her eye, her cheek and her chin, and dried blood on her cheek. After the incident, she was agitated and claimed someone had hit her. There was no witness to the attack, but a witness did see the other attack that night, in which the aide pinned a woman's arms to her body using the belt on a robe. Though that incident led to charges, they were dismissed at a preliminary hearing. The lawsuit claimed Affinity was negligent in hiring the aide with the history of violence.

As a Philadelphia injury lawyer, I'd like to know what happened to the aide--who, let us remember, assaulted the other patient in front of witnesses. The article didn't mention whether the aide was disciplined by the state or the company for the assault on the other patient, or for the allegations involving Welshans. It does mention that the law enforcement officer who gave the aide a voice stress test after the incident thought he or she was lying, which was probably important in court. If the aide was not fired after these incidents, Affinity will have a lot of questions to answer--especially if he or she assaults more patients. For-profit nursing homes don't like to lose staff because replacing them costs money, but keeping this kind of employee puts patients in danger. As a Philadelphia medical malpractice lawyer, I hope Affinity did the right thing with this aide.

Continue reading "Western Pennsylvania Nursing Home Settles Lawsuit Alleging Worker Attacked Patient" »

As a Pennsylvania nursing home attorney, I was surprised and disappointed to see an article about sexual assault at a Lancaster County nursing home. According to Lancaster Online, a man at Maple Farm Nursing Center in Akron, Penn., is in county jail after admitting to sexually assaulting a female Alzheimer's patient at the facility. Glenn Hershey of Akron is charged with involuntary deviate sexual intercourse, aggravated indecent assault, indecent assault and sexual assault in connection with the incident that took place early on Jan. 20. He has been discharged from the nursing home and will not be permitted to return, the home's executive director said.

Nursing home staff checked on the victim, an 86-year-old Alzheimer's and dementia patient, around 4:50 a.m. Sunday and found her nude from the waist down and complaining of pain in her abdomen and genitals. Earlier that night, staff had seen Hershey leaving the victim's room and asked if she'd had a visitor, but she said she had not. Court records show that the nursing home staff was aware that Hershey is a sex offender convicted in 1993 for sexual assault of a professional escort. He had called the escort and offered her money for sex, but when she discovered that he didn't have the money, he assaulted her anyway. After Sunday's assault, Hershey admitted to sexual contact with another female resident at Maple Farm. The home declined to provide further details, citing privacy concerns.

Because Maple Farms staff knew about Hershey's past history, many residents' families are probably questioning whether staff did an adequate job of protecting other residents from him. In fact, some may be wondering whether it was appropriate to admit Hershey to the home at all. Dementia patients like the victim need extra protection because their disease robs them of the ability to fully take care of themselves. If staff members knew about the potential for a rape and didn't take adequate steps to protect residents, they may be guilty of neglect, which is a form of Pennsylvania nursing home abuse. As a Philadelphia injury lawyer, I wouldn't be at all surprised to see a lawsuit from the victim's family, and possibly action from other families as well.

Continue reading "Eastern Pennsylvania Nursing Home Resident Sexually Assaulted by Fellow Resident" »

As a Pennsylvania nursing home lawyer, I was disappointed to see another case of a hidden camera turning up serious Pennsylvania nursing home abuse. NBC10 Philadelphia reported on an abuse case that was uncovered at a nursing home in Bucks County. Two former employees at the Arbors at Buck Run were caught on camera dumping a wheelchair-bound woman onto a bed, singing and yelling directly into her face. Regina Battles, 20, and Irene Rodriguez, 22, have since been fired and are in county jail on charges of neglect of a care-dependent person, reckless endangerment, harassment and assault. The home has been issued a shutdown order by the Pennsylvania Department of Public Welfare, but it's appealing that order and will remain open for 30 days.

The Philadelphia Inquirer reported that the victim's daughter planted a hidden camera in the room because she suspected mistreatment of her 83-year-old mother, an Alzheimer's patient. On three consecutive days in October, the camera caught Battles and Rodriguez handling the victim roughly as they helped her into and out of bed. For example, the videos show Battles grabbing and pulling or pushing the woman's legs roughly; and both workers placing her on the floor before shoving her into bed. Another video shows the victim falling out of bed with no help coming and no preventive measures. The woman can clearly be seen crying in some videos and was caught another time covering her face in fear. The victim was taken to the hospital in November with minor wounds to her legs and feet, and is now living at another home.

The Arbors at Bucks Run, a private for-profit home, immediately fired both employees after the family complained to the state. However, the complaints triggered a state inspection Dec. 3 and revoked the home's operating license Dec. 7. The Inquirer said the action was a penalty for hiring Rodriguez and Battles before finishing background checks; PhillyBurbs.com cited gross incompetence, negligence and misconduct. The home may continue operating while it appeals.

As a Philadelphia medical malpractice lawyer, I look forward to hearing more about this case. It has several similarities with the 2011 case involving the Quadrangle nursing home, in which a dementia patient's daughter confirmed suspicions of abuse with a hidden camera. That family went on to file a lawsuit against the home, and the employees caught on camera were criminally charged for their part. The employees in this case have a defense attorney who believes their actions were misinterpreted, but as a Philadelphia injury lawyer, I suspect the videos will speak for themselves when it's time to go before a jury. But more importantly, I hope the regulatory action taken against this home results in long-term improvements in patient safety.

Continue reading "Nursing Home Workers Caught on Camera Manhandling and Taunting Disabled Patient" »

A major issue for Pennsylvania nursing home lawyers like me is the ability to sue the nursing home's parent company as well as the home itself and individual employees. Many Pennsylvania nursing home abuse cases involve issues of understaffing or under-training, or negligent hiring, all of which can stem from poor decisions by the nursing home company. In Scampone v. Highland Park Care Center LLC, the estate of Madeline Scampone made these kinds of allegations against Highland Park Care Center and Grane Healthcare, alleging they had been directly negligent as well as indirectly negligent through the actions of their employees. Highland Park was the Pittsburgh-area nursing home where Scampone died; Grane was the management services company for Highland Park. The trial court granted a nonsuit for Grane, finding insufficient evidence of its liability, but the appeals court reversed and the Supreme Court upheld that.

Scampone lived at Highland Park from 1998 until her death in 2004, undergoing treatment for dementia, high blood pressure, lung disease and osteoporosis. Between June 2002 and January 2004, she was admitted to the hospital five times for urinary tract infections. During the final hospitalization, she was also admitted for malnutrition, dehydration, bedsores and an acute myocardial infarction. She died in early February. Her son, acting on behalf of her estate, later alleged in the lawsuit that Highland Park and Grane themselves were negligent, as well as responsible for the negligence of their employees. The trial included testimony from former employees that they lacked the time to follow care orders for Scampone or ensure that she had adequate food, water, medicine and activity; witnesses said staff members failed to follow doctors' orders.

At the end of this testimony, Grane moved for a nonsuit and received it; Highland Park also received a nonsuit on punitive damages. However, the Superior Court reversed, finding sufficient evidence to support direct and vicarious liability for Grane and punitives for Highland Park. Both corporate entities appealed to the Pennsylvania Supreme Court.

That court upheld the lower court, but with different reasoning, finding that a resident like Scampone may have a valid claim for corporate negligence against the nursing home and related entities. It rejected arguments that nursing home companies cannot be liable for direct negligence because they work through their employees and officers, saying it had recognized a direct duty in the past and that vicarious liability is an insufficient substitute. Nor did the high court believe the nursing home's argument that its own caselaw limited corporate direct liability to hospitals. The proper question in this case, the court said, was whether evidence showed the kind of relationship between Scampone and the defendants to give rise to a duty of care. Because the trial court did not make its decision on that basis, the Supreme Court said, the case must be remanded to make that determination and conduct any resulting trial.

As a Philadelphia injury lawyer, I am very pleased to see the state's highest court reject arguments that would have exempted nursing homes from liability in Pennsylvania. Though the court made its decision according to its caselaw rather than what it perceived as good public policy, I believe it's good public policy to retain nursing home companies' accountability for wrongdoing. Nursing home companies don't like to be sued, so if they know a suit is a strong possibility, they're more likely to prevent any unsafe behavior. This may be the wrong reason to do the right thing, but the end result will be better protection for the elderly and disabled people in Pennsylvania nursing homes. As a Philadelphia medical malpractice lawyer, I believe these vulnerable patients are owed the strongest regulatory scheme we can devise.

Continue reading "Pennsylvania Supreme Court Permits Suits Against Nursing Home Parent Company and Affiliates - Scampone v. Highland Park Care Center" »

As a Pennsylvania nursing home lawyer, I know that outbreaks of disease are distressingly common in nursing homes. Any situation where people live in close quarters increases the risk of a communicable disease, but in nursing homes, the situation is worse because the residents are usually elderly and not in peak health. As a result, the staff's failure to take basic precautions like washing hands can cause a deadly outbreak. Now, a new study from the University of Chicago School of Medicine shows that outbreaks of norovirus--a virus that commonly causes the stomach flu--in nursing homes is associated with a risk of death or hospitalization from any cause. While it's not surprising to find that norovirus causes norovirus-related hospitalizations, the study suggests that the virus may increase all risks to patients.

The study, reported in the online version of the Journal of the American Medical Association, was a retrospective analysis of two years' worth of Medicare and CDC records from nursing homes in Oregon, Wisconsin and Pennsylvania. (These were the states with the greatest number of outbreaks, which is bad news here in Pennsylvania.) During the duration of the outbreaks, the study found, hospital admission rates were 124 per nursing home per year, higher than the 109.5 per home per year rate when there was no outbreak. Death rates during outbreaks were 53.7 per home per year and 41.9 per home per year when there was no outbreak. Significantly, the study found that the risk of death disappeared when the home had a high number of registered nurse hours per resident, but increased when the RN time dropped to 0.75 hour per resident per day.

Researchers suggested that the risks may stem less from norovirus itself than from the disruptions caused by the outbreaks. As a Philadelphia medical malpractice lawyer, I agree that this seems likely. Many nursing homes--especially private, for-profit homes--are perpetually understaffed because staff is very expensive. This is unfortunate for patients, because studies consistently show that care is better and risks are lower with a higher staffing ratio, especially when skilled staff has more hours. A viral outbreak undoubtedly strains those stretched resources, causing a higher risk of things going undone or unnoticed. As a Philadelphia injury lawyer, I'm familiar with the results: missed or wrong medications, inattention to basic food and water and bedsore needs, dementia patients permitted to wander and more kinds of Pennsylvania nursing home abuse.

Continue reading "Study: Norovirus Outbreaks in Nursing Homes Increase Risk of Death From Any Cause" »

I was disappointed to see a recent report of Pennsylvania nursing home abuse so serious that it led to criminal charges. The Altoona Mirror, a community newspaper in western Pennsylvania, reported Sept. 26 that the former owner of Warner's Home for the Aged and two ex-employees of the home were charged with neglect by a grand jury in the case of Kenneth McGuire. McGuire was 80 when he died from complications of serious neglect by the home's employees. His hospitalization and death led to the revocation of the home's license in December of 2011. Now facing charges of neglect of a care-dependent person are ex-owner Sherry Jo Warner, 64, and ex-employees Diana Frye, 62, and Marjory Koch, 44.

McGuire had lived in the home five years before he was admitted to the hospital on Nov. 5, 2011. A doctor's visit in July of that year had turned up nothing worse than a small sore on his leg. However, McGuire's condition deteriorated in the months after, requiring him to move from using a cane to walk to using a wheelchair. As a result, he needed more intense care, including regular turning to prevent pressure sores as well as basic care like bathing and feeding. After his hospital admission, it became clear that he had not received that care in some time. His toes and shins were covered in pressure sores, and one foot was gangrenous. He was also covered in dried urine and feces when he was admitted to the hospital, and he was dehydrated, malnourished and suffering from sepsis. His doctor and the staff at the medical center testified that he was in worse shape than any other nursing home patient they had seen.

As a Pennsylvania nursing home lawyer, I'm sorry to say that this story sounds familiar to me. Pressure sores (also known as bedsores and decubitus ulcers) are a very common condition in nursing homes because the homes deal with so many people who have limited mobility. They are simple to prevent--caregivers must turn the patient regularly--but this is time-consuming. As a Philadelphia injury lawyer, I know many of the for-profit nursing homes cut their staffs, or the quality of their staffs, in an attempt to save money, and keeping up with important duties like this gets more difficult as a result. I believe the safety of patients should be prioritized above profit for the home's corporate parent, and I'm glad we have laws enforcing that even when the caregivers fail in this most basic duty.

Continue reading "Authorities Charge Eastern Pennsylvania Nursing Home Employees With Criminal Neglect" »

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.

Continue reading "Pennsylvania Nursing Home Abuse: Out-of-State Case Highlights the Horrific Extent of the Problem" »

As a firm that's very active in Pennsylvania nursing home abuse and neglect law, Rosenbaum & Associates pays close attention to the relevant machinations going on in Harrisburg.

As readers of this blog might remember, last fall, the Pennsylvania House passed a bill supported by associations like Pennsylvania Health Care Association/Center for Assisted Living Management. The bill aimed to limit punitive damages that liable nursing homes would have to pay in certain cases. Damages would be limited to double compensatory damages (at best), with an exception for situations in which intentional misconduct occurred.

The bill would also compel plaintiffs to file in the county in which the abuse/negligence happened -- as opposed to in counties that have a reputation for being more favorable to plaintiffs.

The Nursing Home Associations' push may have stalled out for now, but analysts believe that the effort could be kick started again in the fall.

Advocates of the legislation cite the fact that Pennsylvania's malpractice insurers paid out nearly $320 million in 2011, according to National Practitioner Data Bank research. That would make Pennsylvania the second biggest medical malpractice payout state - ahead of New Jersey and Illinois, but significantly short of New York's numbers (a $680 million payout!)

The Nursing Home Association has also complained that nursing facilities often operate on small margins; and these fragile businesses could lose everything in a single massive lawsuit. Advocates of the bill also point to massive, almost cartoon-like judgments in places like Florida, where two state facilities last year got hit with judgments of $200 million and $900 million, respectively.

What advocates of this Pennsylvania Nursing Home legislation are not paying attention to...

It's true that abuse/neglect lawsuits and settlements can place a burden on facilities. But isn't that burden a good thing? If you or someone you love got hurt in a PA nursing home due to a prescription medication foul-up, bedsore metastasizing into life threatening sepsis, or other horrific scenario, wouldn't you want to be able to leverage a full suite of legal tools to get compensated and to take care of your loved one?

Is our current system always totally fair? No.

But it's more unfair to victims of abuse or neglect than it is to owners of negligent facilities - by a long shot.

Perhaps if advocacy groups like the Pennsylvania Health Care Association/Center for Assisted Living Management spent more time identifying best practices for senior care -- and punishing facilities for straying from a high standard -- there would be less need for law firms and less need for the kind of legal actions that these groups rail against.

The horror stories that we've personally heard - and have helped to abate - along with compelling statistics at both the national and state levels suggest that the onus is on delinquent nursing facilities. These facilities need to do a better job of taking care of people: of fulfilling their fiduciary responsibilities not only to their patients but also to our communities.

Continue reading "Pennsylvania Nursing Home Abuse Law, Designed to Limit Punitive Damages, Stalls in the PA Legislature" »

Pennsylvania nursing home negligence and abuse is obviously a huge problem. But a similar - and linked - issue is the cost of senior care.

Who should pay for a nursing home stay: the resident and his/her family... or the government? This question is at the core of a lot of nursing home legal disputes in Pennsylvania and elsewhere.

An Appellate Court ruling in the case of Health Care and Retirement Corporation of America v. John Pittas may have significant bearing on this debate, insofar as it may serve as a harbinger for a changing "balance of burden."
Here are the key details...

Pittas's mother had entered a Pennsylvania nursing home while recovering from a car accident. Although she had a pension and collected Social Security, her income amounted to just $1000 a month. This was obviously significantly less than the cost of her stay at the home. Over six months, she racked up unpaid bills of approximately $93,000.

To get paid, the nursing home leveraged Pennsylvania's filial responsibility statutes to try to get her son, John Pittas, to pay the $93,000 owed. Three-fifths of all U.S. states have filial responsibility statutes, which compel adult children to help pay for their parents' nursing home care, when the parents are indigent.

Interestingly, nursing homes can sue family members arbitrarily. Pittas argued that he was just one of many children who could have shared his mom's burden -- and that he was unfairly singled out. But the Appellate Court ruled that the nursing facility could go after him and not his siblings or his mom's other relatives.

Situations like the Pittas case are nuanced and trick. Medicaid cannot take into account the income and assets of adult children of elderly parents who need care, when the program determines eligibility. Likewise, once a person is already enrolled in Medicaid -- and becomes eligible for long-term benefits -- lawsuits like the one that hit Mr. Pittas become untenable.

In this particular case, the women had applied for Medicaid, but her application was pending. It hadn't gone through. So when she racked up her bills, the facility was allowed to sue her son.

The practice of compelling adult children to take care of aging parents has a long legacy - dating at least back to England's Poor Relief Laws from the 1600s.

Cases like this one have been relatively rare in recent years, but inside analysts are sensing a shift. They believe that these "let's make adult children pay for their parents' care" cases will become more and more common, given the escalating costs of senior care, forces urging the government to "turn down the flow" of funds for senior benefits, etcetera.

Continue reading "Landmark Pennsylvania Nursing Home Case Could Change Balance of Burden: All About Health Care and Retirement Corp of America v. John Pittas" »

Did you recent lose a loved due to suspected Philadelphia nursing home abuse or negligence?

If so, you might find it instructive to read about a consolidated opinion handed down last week by the West Virginia Supreme Court of Appeals. The decision nicely demonstrates how higher level courts can powerfully influence lower level courts.

The case has many layers, so we'll walk through the details in a straightforward fashion.

The decision concerned three separate lawsuits -- each one pertained to a nursing home abuse/negligence tragedy. In each case, a family member had lost a parent or other loved one in an area nursing home due to negligence.

The nursing homes in question forced the plaintiffs to participate in arbitration, thanks to specific clauses in the homes' admissions contracts. These agreements compelled the plaintiffs to arbitrate disputes - not to sue over them.

Based on these agreements, the defendant nursing homes asked the courts to dismiss the plaintiffs' cases and send them to arbitration, instead. A County Circuit Court in Kanawha, West Virginia dismissed two of the suits on these grounds. A County Circuit Court in Harrison, West Virginia refused to weigh in and instead asked the West Virginia Supreme Court to step in.

In light of the confusion, last June, the WV Supreme Court took up the cases. The Court agreed that arbitration could be a useful way of managing disputes... but found that West Virginia's Nursing Home Act, which disallowed nursing home arbitration clauses in certain contracts, was pre-emptive under the Federal Arbitration Act.

The defendants obviously did not like this ruling! They appealed to the U.S. Supreme Court, which ruled in February and reversed the WV Court's opinion. Last week, based on the SCOTUS ruling, the West Virginia Supreme Court sent the suits back down to the Circuit Courts.

Chief Justice Menis Ketchum nevertheless voiced frustration: "many contracts... for admission [in nursing homes] are signed by a patient or family member in a tense and bewildering setting...it may be disingenuous for a nursing home to later assert that the patient or family member consciously...accepted an arbitration clause [and understood that it was] intended to eliminate their access to the courts, if the nursing home negligently injured or killed the patient."

This complicated and nuanced case demonstrates that even family members and patients who have been aggrieved may be limited in terms of options for justice and compensation.

To that end, if you or someone you love needs help with a potential Pennsylvania nursing home abuse or negligence case, look to the team here at Rosenbaum & Associates for experienced, compassionate legal guidance.

Get a free consultation today by connecting with us online or via phone.

As a Pennsylvania nursing home abuse attorney, I was shocked and saddened to read about the tragedy of Rachel Holliday, an 84 year old patient at a Chapel Hill nursing home, who passed away after being horribly abused. She allegedly got sick after being doped with morphine by a nurse who apparently didn't want to be bothered to care for her patients.

Nurse Angela Almore was sentenced last Monday to five months behind bars and two and a half years of probation as part of a plea deal she made with prosecutors. The allegations against Almore were all too familiar to anyone who has studied the nursing home abuse case literature. Nurse Almore had been on duty at Britthaven Nursing Home in Chapel Hill, North Carolina, on February 13 and February 14, 2010. On Valentine's Day evening, Holliday started suffering respiratory distress; and she had to be rushed to UNC Hospitals for treatment.

Doctors at first couldn't figure out what was wrong with her. They eventually realized that there were opiates in her system. This was confusing, since she had not been prescribed opiates.

As her medical crisis deepened, other patients in the Alzheimer's unit began to exhibit lethargy and signs of health problems. Many of them needed to be rushed to hospital as well. All told, 14 patients in the unit tested positive for opiates - and only one had been prescribed opiates.

Sadly, Rachel Holliday passed away from morphine toxicity. The other affected patients fortunately survived their overdoses. Investigators with the North Carolina State Bureau of Investigation found circumstantial evidence pegging Almore as the responsible party. The local district attorney, Lamar Proctor Jr., told the judge in the case that "[Almore] made some statements that she didn't want to see patients that night...[so] she knocked all their a**es out."

After reflecting on the gravity and sadness of the situation, we'd be in remiss if we did not try to extract useful lessons. Here's one key takeaway: when caregivers shirk their duties - even innocuously -- the effects on patients can be profound, damaging, and perhaps even fatal.

At her trial, Almore openly sobbed and expressed contrition. But what she did cannot be undone. Unfortunately, the slight errors of omission - or acts of disrespect - that often constitute Pennsylvania nursing home abuse/neglect can easily create havoc and pain for elderly residents and their families.

That said, building a compelling case against a nursing home or a nursing home employee can be surprisingly difficult. At Rosenbaum & Associates, we have nearly two and a half decades of experience helping hurt elderly patients and their relatives obtain compensation and justice.

If you're confused or frustrated about what's happened to your loved one, our Pennsylvania personal injury team can empower you and help you develop a complete, aggressive strategy to get you results.

As a Pennsylvania nursing home lawyer, I was extremely interested to see an announcement of arrests in a major alleged Medicare fraud ring involving nursing home care. According to the Philadelphia Business Journal, the FBI announced in late March that it had arrested five nurses at Home Care Hospice Inc. of Philadelphia, a for-profit hospice. Those arrested, all of greater Philadelphia, include Patricia McGill, the hospice's director of professional services; and nurses Natalya Schvets, Giorgi Oqroshidze, Yevgeniya Goltman and Alexsandr Koptyakov. Those arrests followed the October arrest of HCH's co-owner, Matthew Kolodesh, In all, the defendants are accused of submitting $9.32 million in fraudulent Medicare claims, for patients who weren't eligible for hospice care or who received less care than was billed for them.

According to the Business Journal, the now-defunct HCH provided hospice care for patients from nursing homes, private homes and hospitals. However, the FBI believes employees conspired to admit ineligible or inappropriate patients between 2005 and 2008. The four nurses McGill supervised are accused of creating fraudulent nursing notes for about 150 patients, in support of Medicare bills for services never provided; other notes reflected a higher level of care than actually provided. Those notes were submitted by McGill and an unindicted hospice director called A.P., for a total of $9.328 million in false Medicare claims. When HCH was notified of a claims review audit, McGill and A.P. reviewed and altered charts where necessary to support the false documents. After the audit required HCH to refund $2.625 million to the federal government, McGill and A.P. asked the staff to discharge hospice patients; 128 were discharged over four to five months, but often moved to another hospice owned by Kolodesh. Within six months, about 20 percent of those discharged were returned to HCH.

Unfortunately, this kind of news about a for-profit nursing business does not surprise me as a Philadelphia medical malpractice lawyer. I recently wrote about an article exposing exactly this kind of fraud in for-profit hospice care, and it's easy to see the parallels with for-profit nursing home care. With hospice care, the goal is to make patients comfortable at the end of life, but fraudulently included patients often aren't at the end of life. That means they may be inappropriately given powerful painkillers or other drugs, and that they and their families may suffer emotionally from believing they are near death. That belief may also lead patients to abandon future plans and squander the time they do have in expensive full-time care they don't need -- another form of Pennsylvania nursing home abuse. As a Philadelphia injury lawyer, I believe all of these injuries can and should be penalized when appropriate, including through a lawsuit.

Continue reading "FBI Arrests Five Nurses at Philadelphia For-Profit Hospice, Alleging $9 Million Medicare Fraud" »

As a Philadelphia injury lawyer, I know financial exploitation of seniors is a serious problem, but one that gets discussed less than some of the horrifying Pennsylvania nursing home abuse or neglect cases that have made it into the media. So I was interested to see a report in the Philadelphia Inquirer on Feb. 20 that a nursing home staff member was caught with property belonging to her patients when she was pulled over for another reason. Shakeana Sims of Newark, Del., works at the Kendal Crossroads Nursing Home in Kennett Square, Penn. Sims, 25, was pulled over at 12:45 a.m. after an officer noticed that her car had a false registration. Computer records then showed several outstanding warrants for Sims, leading to her arrest and the discovery of the stolen objects.

Sims is a nurse's aide at the home, in Chester County. News sources did not report on the reasons for her outstanding warrants. However, they were enough to lead to her arrest. After she was taken to the police station in New Castle County, Del., for processing, officers found the stolen items among her personal belongings. They included a watch, a bank card and a blank check, all belonging to two of the residents Sims cares for at the Kendal Crossroads nursing home. She was arrested for stealing property from those residents, as well as for several traffic offenses, and held in lieu of bail.

As a Pennsylvania nursing home lawyer, I suspect this arrest is raising some alarms among residents of Kendal Crossroads and their family members. Theft from nursing home residents is not necessarily reported by the state and federal agencies that track nursing homes' safety and hygiene, but it's a serious problem. As with physical abuse and neglect, nursing home patients may not be able to raise an alarm about theft because of their health conditions and because nursing home staff is not predisposed to believe them. As a result, discovery of the theft is often delayed until family members notice missing money or valuables. By this time, of course, a thief may have gotten access to the patient's accounts, potentially destroying his or her financial security. Patients and their families at this nursing home may be wondering how this happened under the watch of supposedly careful administrators -- and whether any other employees have sticky fingers or a criminal record that should concern them. As a Philadelphia medical malpractice lawyer, I hope these families are effectively advocating for themselves.

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