Recently in Pennsylvania nursing home news Category

March 12, 2014

Distilling the 2014 Nursing Home Ratings by U.S. News & World Report



When a family makes the decision to transition a loved one into a nursing home it can be an overwhelming and understandably emotional experience. The daily care, safety, and overall wellbeing of your loved one are being placed in the hands of another. It is a duty that many nursing home staffs and facilities pride themselves in excelling in. U.S. News & World Report has released their sixth annual data and ratings results of nearly every nursing home in the United States. The search tools and valuable information within the detailed U.S. News database can help make choosing a nursing home a better, quicker, safer, more informed experience. The user-friendly search tools gives a multi-layer approach in finding a suitable nursing home that meets the needs for you or a loved one. It is estimated that over 3 million Americans live in approximately 16,000 nursing homes throughout the United States. That number is expected to only increase as the nation's older adult population continues to steadily climb. Much of the raw data relied on by U.S. News in rating nursing homes comes from Nursing Home Compare, the federal database detailing every Medicare and Medicaid certified nursing home in the country. You can search by state, region, city, or zip code, or by a numerical star rating of 1 to 5. The 2014, ratings of 1,893 nursing homes in Pennsylvania indicate that 702 nursing homes, about 25 percent, earned a five-star rating, while less than 5 percent of Pennsylvania nursing homes earned a one-star rating.

Distilling the ratings:

There are three key areas that the overall ratings correlate to, the nursing home's individual ratings of their (1) state-conducted health inspections, (2) sufficient nursing staff and, (3) the quality medical care measures. As a nursing home injury specialist with practices in both Pennsylvania and New Jersey, when looking at a nursing home's overall rating, I place particular importance on a nursing home's nursing staff rating. The nurse staff rating relates to the average number of hours per day of care received per resident from nurses and physical therapists. A nursing home with a low rating for nursing staff raises concerns as understaffing is the leading cause of neglect and abuse in nursing homes and long care facilities. When a nursing home is inadequately staffed the required daily care to stave off fatal infections, pressure sores, devastating falls, and to meet the minimal quality of care required by both federal and state regulation, is often found lacking. Sufficient staffing is a critical component in running a safe, clean, well managed nursing home, so much so that all nursing homes participating in Medicare are required to meet specified requirements of the Federal Nursing Home Reform Act, part of the Omnibus Budget Reconciliation Act of 1987. Specifically facilities are legally required to have "sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident." Therefore, when narrowing down the choices of a nursing home facility remember to pay close attention to the nursing home's staff rating, as this singular component can have life-altering effects.

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March 3, 2014

Competency and Arbitration Clauses


I have spoken extensively about nursing home arbitration clauses often placed within nursing home admission papers. An arbitration clause has the power to dictate which causes of action can go before a jury and which must go through arbitration, a more discrete out of public view dispute resolution option. Arbitration agreements are construed according to contract law, requiring a valid offer, acceptance, and consideration. The recent case brought before the Pennsylvania Court of Common Pleas, Tyler v. Kindred Healthcare Operating, the court overturned the defendant's preliminary objections to plaintiff's wrongful death and survival complaint. The court held that the meeting of the minds could not be established when the decedent signed her admission papers for admittance into Kindred Healthcare nursing home. Further finding that the decedent's daughter was also unable to act as the decedent's power of attorney as the decedent had not given away any rights nor did the decedent authorize any family member to make any legal decisions on her behalf.

In Tyler v. Kindred Healthcare Operating, plaintiff Avenia Tyler brought a wrongful death and survival action against two nursing homes, Kindred Healthcare Operating, Inc. ("Kindred"), and St. Francis County House ("St. Francis"). Plaintiff alleged that decedent Ruth McNear, had developed necrosis, advanced pressure sores on her right lower extremity, and a second fracture to her right femur which required surgery. Plaintiff further stated that Ruth McNear had passed away due to complications from the second leg fracture and subsequent surgery. At the time decedent's death, McNear was in complete control and care of defendants. When proper care is taken bedsores should not be present in residents of nursing homes. Part of care plans for residents that have limited mobility is a reposition of the resident approximately every 2 hours. If repositioning continues to be overlooked or ignored, often as a means to save limited time in understaffed facilities, a resident can suffer bedsores, urinary tract infection, and even a wrongful death. As part of the Federal Nursing Home Reform Act of 1987, all nursing homes that receive federal funding are required to have "sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident." Bedsores are the most common form of negligent care given in nursing homes. It takes time and pressure for a bedsore to begin to form and even more time for the pressure wound to become infected.

Ultimately the court held that the arbitration clause could not be enforced as the decedent was not competent at the time of signing and therefore there was no meeting of the minds when the contract was executed. Medical records note at the time of signature decedent was disoriented and her thoughts were cloudy. While a resident at the nursing homes, nurses noted that decedent was both confused and impaired. St. Francis the second nursing home for the deceased Ruth McNear wanted to enforce the arbitration clause despite the late McNear state of confusion. The court held that the decedent's daughter could not act as her mother's agent simply because there is a familial relationship. Instead, the court held that the decedent would have had to given Lynette, her daughter power of attorney or at the very least the authority to make legal decisions on her late mother's behalf. Accordingly, the court held in favor for the plaintiff finding that the survival action could not be severed from the wrongful death action.

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February 19, 2014

Federal Arbitration Act Pre-emption of Pennsylvania's Wrongful Death Act and Survival Act Upheld, Lipshutz v. St. Monica Manor


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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February 10, 2014

Parking Lot Accidents and Older Adult Drivers


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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October 16, 2013

Elder Justice is a Necessity in Pennsylvania


Picture for a moment the life you built, saved, and diligently worked for, being stripped away from you at a time when you are unable to fight for yourself. That is what is occurring to millions of older Americans every year. Statistics vary from one in ten older Americans a year being abused, approximately a little over 4 million, to almost 11 percent or 5.7 million. Elder abuse includes physical, emotional, and sexual abuse, as well as, self neglect, and financial exploitation. Often times these patterns of abuse are at the hand of a relative, loved one, or a trusted caregiver or institution. As was true for the actor Mikey Rooney an outspoken advocate of senior rights. On March 2, 2011, Mikey Rooney appeared before a special U.S. Senate committee considering legislation to curb elder abuse. Before the panel, then 90 year old Mikey Rooney claimed he had suffered elder abuse when he was denied basic necessities such as food and medicine, and was financially, verbally, emotionally, and psychologically, tormented at the hands of a stepson and his wife. As ominous as it may sound, everyone must protect themselves and their loved ones from people who prey on our older Americans.

According to the 2010 U.S. Census, the nation's older population is growing and is only projected to further expand as "baby boomers" begin to reach the age of older adults. Pennsylvania has the fourth largest population of older citizens comprising approximately 21.4 percent of the population, or about 2.7 million individuals over the age of 60, with another 2.4 percent over the age of 85. The Pennsylvania State Plan on Aging ("The Report"), is a report released every four years as dictated by federal and state law in order for the commonwealth to receive federal funding under the Older American Act of 1965. The Report estimates that a rapid growth in Pennsylvania's older adult population is slated to reach an epic high by 2030. At which time, another 22.2 percent of the state's population approximately 2.8 million people, who currently fall into the age bracket of 45 to 59 will become incorporated in the older population increase.

The impact of the recent economic recession has greatly affected the surge in reports of abuse, neglect, abandonment, and financial exploitations of Pennsylvania's older population. Individuals in need of older adult protective services have grown exponentially. In 2011-2012 nearly 18,000 adults in Pennsylvania were in need of older adult protective services, that is a 17 percent increase from the previous year. Much like we check on our elderly neighbors when a heat wave strikes, so to should we speak up if we see any signs of elder abuse. If you believe there was an instance of elder abuse please at your earliest convenience contact the nursing home experts and personal injury attorneys at Rosenbaum and Associates for a free consultation. According to the SeniorLAW Center, victims of elder abuse, neglect, and financial exploitation, have three times the risk of dying prematurely. Typically the signs and symptoms may include, bruises or broken bones, dramatic weight loss, confusion due to malnutrition, medications, or an acute illness. Changes in the older adults behavior such as being withdrawn, signing over their house to a relative, or withdrawing large sums of money from a saving account, are all suspect. The Department of Aging's elder abuse hotline 1 (800) 490-8505, is available 24 hours a day, 7 days a week, for any person who believes that an older adult is being abused, neglected, exploited, or abandoned.


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September 19, 2013

Courts and Not Arbitrators Have Jurisdiction Over Pennsylvania Nursing Home Lawsuit - Pisano v. Extendicare Homes, Inc.


I've written a lot here about the trouble with arbitration agreements in nursing home negligence lawsuits. Arbitration is a form of "private judging" that allows disputes to be resolved out of court. It's often touted as quicker and less expensive than going to court, and thus advantageous to both sides of the dispute. But for nursing home companies, arbitration is often the preferred solution because it allows them to hide allegations of serious abuse or neglect, away from public records. In some cases, arbitration companies have even been known to decide cases in a way that's most favorable to their customers--the nursing home companies, who send them the cases and sometimes pay all of the bill. That's why I was pleased to see Pisano v. Extendicare Homes, Inc., a Pennsylvania Superior Court case denying an attempt to take the dispute to arbitration.

Vincent Pisano was admitted to Belair Health and Rehabilitation Center in April of 2010. His daughter, Jamie Pisano, had his power of attorney at the time and executed an agreement saying any dispute would be resolved by mandatory binding arbitration. Some time later, Vincent Pisano died at the facility. His family alleges negligence by Extendicare (doing business as Belair) in a wrongful death lawsuit filed by son Michael Pisano, individually and as administrator of his father's estate. Jamie Pisano executed a disclaimer and renunciation in October of 2011, giving up all proceeds in a recovery for wrongful death, and is thus not a party to the case. In trial court, Extendicare objected to the court's jurisdiction, citing the arbitration agreement. The trial court refused to compel arbitration, however. The parties agree that the agreement is valid and binding, the court said, but the wrongful death action was outside its scope.

Extendicare appealed, but the Pennsylvania Superior Court affirmed. In Pennsylvania, wrongful death actions by the estate of the deceased are separate from survival actions by the deceased person's immediate family. In this case, the agreement in dispute is broad enough to cover tort claims as well as contract claims. In relevant part, it says the parties agree to arbitration of "all disputes arising out of or relating in any way to this Agreement or to the Resident's stay at the center [including] ...wrongful death." Thus, the case turns on whether a Pennsylvania wrongful death lawsuit is derived from Vincent Pisano's rights. The Superior Court ruled that it is not. Pennsylvania courts have consistently ruled that wrongful death and survival actions are two separate rights of action deriving from a single death, the court said, but not from the decedent's rights. Thus, because Extendicare's agreement is between it and Vincent Pisano, it does not bind his family, the court found.

This is good news for Pennsylvania families that suffered a wrongful death because of nursing home abuse or neglect. The Superior Court is not the highest court in Pennsylvania, but if its reasoning is adopted by higher courts, it will be settled law in our state that arbitration agreements don't bind family members who never signed them. And that's important, because as I mentioned, arbitration is often not friendly to families hurt by nursing home abuse in Pennsylvania. It takes away their right to settle disputes in open court, file appeals and more. If this case is appealed further, I will be interested to watch its progress.

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September 5, 2013

Pennsylvania Counties Increasingly Consider Selling Their Public Nursing Homes


Because I practice nursing home abuse law in Pennsylvania, I was interested to see that publicly owned nursing homes are rapidly dwindling in our state. According to the Pocono Record, Monroe County's government is considering selling its publicly owned Pleasant Valley Manor, in part because it's running at a loss. To the west, Franklin County is already in the process of selling its nursing home, Falling Spring Nursing and Rehabilitation Center. One Monroe County Commissioner, Charlie Garris, noted that the trend in Pennsylvania counties is increasingly toward selling county-owned homes. But residents of both counties expressed concerns about the quality of care in the homes as they transitioned from public, nonprofit ownership to private, for-profit ownership. The news comes on the heels of an announcement from the Catholic Archdiocese of Philadelphia that it will sell several nursing homes in greater Philadelphia.

In Monroe County, the commissioners are considering a sale because the home is losing money. Pleasant Valley Manor lost $940,000 in 2012 and had already lost the same amount in the first six months of 2013. Garris noted that a supplier of food to the home once withheld its deliveries until it got paid, suggesting that the home's administrators were behind on payment. The only commissioner to publicly oppose a sale is Suzanne McCool, who said the county has a moral obligation to take care of elderly and infirm residents. The article said "there's a fear" that a for-profit home might not take indigent residents.

In Franklin County, Commissioner Robert Ziobrowski said county-run homes are no longer needed for indigent Pennsylvanians, because Americans can now rely on Medicare and Medicaid as well as private insurance. They have chosen two finalists from among the 10 private companies that offered to buy Falling Spring. But according to the local newspaper, Franklin County residents are concerned that private ownership will result in a drop in quality of care.

I share that concern. In my experience pursuing nursing home neglect lawsuits in eastern Pennsylvania, there is genuine cause for concern when nonprofit homes are sold to for-profit companies. As I noted in my blog post about the Catholic Church's sale of homes, studies show that nonprofit homes do better on multiple measures of care, including staffing ratios, number of bedsores, citations from government regulators and more. Indeed, one study concluded that statistically, for-profit ownership leads to an additional 7,000 pressure sores a year. The difference may be attributed to things like attempting to get along with fewer employees or employees who are not well trained, both of which can lead to overwhelmed employees who cut corners or forget important tasks. Nursing home abuse is devastating and sometimes fatal; Pennsylvanians should think very carefully before doing anything that could lead to more of it.

Based in Philadelphia, Rosenbaum & Associates represents clients across eastern Pennsylvania who have suffered serious injuries from abuse or neglect at a nursing home.

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August 22, 2013

Residents of Catholic Philadelphia Nursing Homes Face Uncertain Future Due to Sale


As a Pennsylvania nursing home lawyer, I was interested to see reports that the Catholic Archdiocese of Philadelphia plans to sell six nursing homes in greater Philadelphia. According to the Philadelphia Daily News, the archdiocese is selling six nursing homes and one assisted-living facility in order to address financial problems. Three of the homes are in Philadelphia: Immaculate Mary Home, St. John Neumann Home and St. Monica Manor. St. Martha Manor and Villa St. Martha are in Chester County, St. Francis Country House is in Delaware County, and St. Mary Manor is in Montgomery County. The announcement comes after several years of financial problems for the archdiocese. The National Catholic Reporter said the homes ran a deficit of $1.4 million at the end of fiscal year 2012.

In all, 1,400 residents will be affected by the proposed sales, as well as more than 2,000 employees. The archbishop for Philadelphia, Charles Chaput, said it will be a condition of the sale that no residents will be evicted, and "every effort will be made" to retain employees. As a Philadelphia injury lawyer, I am concerned for these residents and employees, because a sale is likely to mean a change to for-profit status. Studies show that nonprofit nursing homes generally deliver higher-quality care than for-profit homes, as measured by factors like citations by government regulators, use of restraints, number of bedsores the residents sustain, and staffing ratios. A 2009 meta-study published in the British Medical Journal drew that conclusion, echoing 2002 and 1991 studies. Among other things, it said, there are 7,000 pressure sores per year that can be attributed to for-profit care, statistically speaking.

It's not a given that for-profit status inevitably leads to Pennsylvania nursing home abuse, but if I had a loved one in one of these Catholic facilities, I would watch the sales closely. In my experience as a Philadelphia medical malpractice lawyer, for-profit status can lead to neglect when profit-motivated owners choose to understaff their homes or hire cheaper, unskilled workers. Overworked employees may skip or simply forget needed care, leading to problems like bedsores, missed medications or lack of attention to basic nutrition and hydration. In more serious cases, nursing home employees have been known to steal residents' drugs, physically abuse them or overuse psychiatric drugs as "chemical restraints" against unruly dementia patients. All of these are forms of abuse and neglect in nursing homes, which no Philadelphia family should have to experience.

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May 22, 2013

Carbon County Nursing Home Patient Charged With Homicide in Another Patient's Death


In an unusual situation, an eastern Pennsylvania nursing home patient is being charged with a homicide in the death of another patient. As a Pennsylvania nursing home lawyer, I was interested to see that Carl Smith was arraigned on charges of involuntary manslaughter for pushing Margaret Lechleitner, 85. Both were residents of the dementia ward at Weatherwood Nursing Home in Weatherly, a Carbon County community between Allentown and Scranton. Lechleitner died after she fell to the floor, hit her head and suffered a subdural hematoma, a kind of blood blister. The death was ruled a homicide by the Luzerne County coroner--but the ruling only means that it was caused by another person, not that it was a criminal act. According to WNEP, medical experts and a judge will decide whether the case should go to trial.

The incident leading to Lechleitner's death took place April 20. Smith told authorities that Lechleitner pushed him first and he pushed back, though police say there's no evidence that she pushed him. After Lechleitner hit her head, she was taken to the Hazleton General Hospital just over the county line, where she died the next day. Police said they had to balance competing interests in the case, because Smith has dementia as well. An officer said the police wanted to make sure justice was served for Lechleitner's family, but also that everyone around Smith is safe and that Smith continues to get treatment. An Alzheimer's Association of Pennsylvania spokeswoman told WNEP that she has never seen an arrest, or indeed any situation where one dementia patient caused the death of another.

Interestingly, no one in the articles commented on the oversight responsibilities of the nursing home. Of course, there may have been nothing that nursing home attendants could do, if the incident happened quickly. But if Smith and Lechleitner were left together without supervision, the home may be vulnerable to a Pennsylvania nursing home abuse lawsuit alleging that it was negligent. Dementia patients end up in nursing homes because they need the kind of 24-hour supervision that families often can't provide. In fact, in nursing homes, they are known for having difficult behavior. Nursing home staffs are supposed to keep them out of trouble, but as a Philadelphia medical malpractice lawyer, I know understaffed, stretched-thin homes let things slide sometimes--and patients can die or suffer injuries as a result.

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May 6, 2013

Task Force Formed to Study Senior Abuse and Neglect


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.

March 27, 2013

Judge Dismisses Nursing Home Neglect Lawsuit Against Bucks County


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.

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February 20, 2013

Western Pennsylvania Nursing Home Settles Lawsuit Alleging Worker Attacked Patient


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.

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January 24, 2013

Eastern Pennsylvania Nursing Home Resident Sexually Assaulted by Fellow Resident


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.

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December 18, 2012

Nursing Home Workers Caught on Camera Manhandling and Taunting Disabled Patient


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.

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December 4, 2012

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


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.

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