Articles Posted in nursing home news

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Nursing home negligence and abuse in Philadelphia and elsewhere is a national epidemic – and a national disgrace.

But nursing facilities themselves are not the only parties who commit egregious, illegal actions. Witness the case of a Bensalem woman, who was arrested in June for allegedly stealing more than $300,000 from a 67-year-old woman living in an area nursing facility. Investigators say that 65-year-old Virginia Marquardt had obtained Power of Attorney for her neighbor, after the woman’s husband passed away back in July 2007.

This power allowed Marquardt to control the woman’s assets, money, and bank accounts. Marquardt then allegedly embarked on a series of abuses of her power and trust. First, she made herself a 50% beneficiary of the estate. Then, in the spring of 2008, she drew up a new will for the victim, naming herself as beneficiary of her assets to the tune of 50%.
If that wasn’t insult enough, Marquardt then allegedly slowly stopped paying for woman’s nursing home care. The outstanding balance for the care climbed over $20,000 in 2009.

By the end of that year, Marquardt had stopped paying the home entirely. She told the facility that the resident had run out of money. Meanwhile, the victim still possessed investments that had not been liquidated.

In 2010 and 2011, Marquardt did pay for some of the nursing home care, but the outstanding balance continued to grow. Investigators later found that Marquardt had siphoned off more than $300,000 of assets and used that money to pay for trips to Las Vegas, to buy luxury watches, and to pay off credit cards. Finally, in June, police arrested Marquardt and set her bail at $300,000. After posting 10% of that money, she was released, and the court system will now determine what will happen to her.

This case sounds very sad for a number of reasons. Assuming the allegations are true, who knows what motivated Ms. Marquardt to engage in this behavior? Furthermore, who knows how the 67-year-old’s care might be affected by the financial double cross?
This situation illustrates how Philadelphia nursing home financial abuse cases can take years to surface.
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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.
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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.

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As a Philadelphia medical malpractice lawyer, I know medication errors are a major source of medical mistakes for patients of all ages. But I was disappointed to see an April 20 article about federal data showing that the majority of all medication error victims who wind up in the hospital are seniors. The data comes from the federal Agency for Healthcare Research and Quality, part of the Department of Health and Human Services. That agency found that medication errors have grown by 52 percent between 2004 and 2008, the last year it studied. That’s 1.9 million people injured badly enough to need hospitalization, up from 1.2 people injured in 2004. Another 838,000 patients were treated in emergency rooms and released, 18 percent of whom were 65 or older.

The medication errors included errors patients made themselves and mistakes by caregivers providing the medicines. Reasons included overdoses, mistakes by pharmacists, bad reactions, mixing incompatible medications and more. The kind of drug that most often sent people to the hospital was corticosteroids, a class of drugs used to treat arthritis, asthma, inflammatory bowel disease and several other conditions. That class of drugs was responsible for 283,700 hospitalizations. Next most common were painkillers (269,400 cases), blood thinners (218,800), cancer and immune-system drugs (234,300) and heart and blood pressure medications (191,300). In emergency rooms, visitors most often didn’t specify a drug, but also cited painkillers, antibiotics, tranquilizers and antidepressants, and corticosteroids.

This news concerns me as a Pennsylvania nursing home lawyer because people in nursing homes are likely to have complicated medical needs. Families generally put their loved ones in nursing homes when their needs are too constant or complicated for the families to handle themselves. For the same reasons, nursing home patients are less likely to be able to notice a mistake with medicine or speak up when they do. At the same time, nursing home employees can make mistakes or even intentionally make an unauthorized change in medication. Even the best intentions can fall flat when nursing homes are understaffed, robbing employees of the time they need to make sure details are right. And in some cases, employees have perpetrated Pennsylvania nursing home abuse by stealing painkillers from patients for their own use, intentionally giving inappropriate sedatives or withholding medication to save money. In either case, it’s unacceptable for an institution we trust with the care of vulnerable older loved ones. Families who find themselves in this position should talk to a Philadelphia injury lawyer right away.
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The family of 54-year-old Rodney L. Volkening of South Elgin, Illinois, has filed a lawsuit against Tower Hill Healthcare Center, a South Elgin nursing home, for negligence in Volkening’s care, reports the Elgin, Illinois Courier-News. Volkening had spina bifida, a permanently disabling birth defect that, combined with his other medical conditions, left him in need of constant medical care.

Yet when Volkening was admitted to a hospital after his time at Tower Hill, hospital staff observed that he had not been receiving proper medical care at all. His colostomy bag had exploded and there was “a large amount of stool around” him, according to Volkening’s family’s attorney, Craig Brown. According to the lawsuit, Volkening had severe bedsores “that were covered by an old dressing covered by stool. He had a fever of 107 degrees with apparently no anti-fever medication being given to him at the nursing home prior to his arrival.” “Because he presented to the emergency room with poor oral hygiene and poor skin care,” Brown said, hospital staff suspected abuse and negligence at the nursing home and filed a report with the Illinois Department of Human Services.

Volkening’s death certificate lists a staph infection and pneumonia as the causes of his death. While the family’s lawsuit does not allege that the neglect caused Volkening’s death, Brown said that they are investigating whether the nursing home’s poor hygiene led to the infection that caused his death. Regardless of the outcome of that investigation, Brown and Volkening’s family still intend to hold the nursing home responsible for failing to live up to its “statutory obligation not to violate the rights of any resident, including the obligation not to abuse or neglect any resident,” as laid out in the state Nursing Home Care Act. As a Philadelphia injury lawyer it is important to make sure a nursing home is living up to its obligations under both state and federal regulations.

It is sad that nursing home patients and their families are unable to depend on the professional integrity of nursing home staff to ensure patients’ health and safety. As a Pennsylvania nursing home abuse lawyer, I have seen many cases involving neglect that led to serious illness or wrongful death.
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The Gary, Indiana Post-Tribune ran several articles recently about the demise of Northlake Nursing and Rehabilitation Center, a nursing home that was so consistently negligent in its patient care that the Indiana State Department of Health first suspended its license and ultimately issued an emergency closure order. As a Pennsylvania nursing home negligence lawyer, I was glad to read that authorities took action to save patients from being abused further, and I hope that the patients who were harmed are able to recover.

The Post-Tribune recounts a number of horrible instances of abuse at the nursing home. Mary Ann Jackson, 51, was at Northlake because she had suffered a stroke. She came to the nursing home with one bedsore, but during her stay, it spread to become a massive sore across her legs and buttocks. Jackson’s sister said that when family came to visit her, staff members would bandage Jackson’s sores to make it appear as if she was recovering, when in fact she was getting worse. “Nearly her whole behind was gone,” said Shelli Jackson, Mary Ann’s sister. “You could see the muscles and ligaments down to the bone. Her bedsores were so bad she was stuck in a fetal position with her legs glued together.” A state inspection of Northlake found that the nursing home had failed to alert Jackson’s doctor to problems such as her high blood pressure, heart failure, vomiting and significant weight loss.

After just one month in the nursing home, Mary Ann was transferred to a hospital and the family was advised that both of her legs needed to be amputated. The family refused and moved her to another hospital, where staff recommended that Mary Ann go into hospice care. The family chose not to follow this advice either. Miraculously, Mary Ann is recovering. “She’s much better now,” said Shelli. “Her minor bedsores are healing and she’ll need skin grafts. She talks. She doesn’t have renal or heart problems, but she’s still struggling with the changes and she’ll need wound care for the rest of her life. The good news is they said she’d be dead in a month and it’s been four months.”

Mary Ann finally transferred to Lawrence Manor Healthcare Center in Indianapolis. Rick Lipscomb, director of social services and admissions there, was horrified by Mary Ann’s condition and said that he had never seen a case like hers in his 21 years in the field. “She had one foot in the grave,” he said. “I don’t know how she didn’t die. I’ve seen animal carcasses on the side of the road that looked better than when she arrived here from another nursing home. … People should go to jail for what happened to her.” Sadly, Mary Ann’s case was just one of many stories of abuse and neglect in the Post-Tribune’s articles about Northlake.
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A legal case out of Chicago caught the eyes of our Pennsylvania nursing home abuse lawyers. The Chicago Daily Herald reported Feb. 25 that the former director of a nursing home is being tried for neglect and obstructing justice for her role in a scandal involving a nurse who allegedly euthanized patients. Penny Whitlock, 60, directed the Woodstock Residence Nursing Home during a series of suspicious deaths in 2006. Nurse Marty Himebaugh is accused in the case of “playing Angel of Death” by giving dangerously high doses of drugs to selected patients.

Himebaugh is accused of causing at least four deaths at Woodstock. At first, investigators thought these were “mercy killings,” but state investigators later found evidence that she chose patients who she thought were difficult or annoying. Other nurses reported to Whitlock that Himebaugh was acting strange and once said she’d given a patient a cocktail so she wouldn’t bother her during her shift. Himebaugh faces felony charges of neglect and possession of a controlled substance. Whitlock herself is accused of failing to follow up on those and other complaints, even allegedly saying Himebaugh could “continue to play Angel of Death.” Both women face a maximum of three years in prison, and are also targeted by civil nursing home abuse lawsuits from victims’ families.

Our Philadelphia nursing home negligence attorneys wish those families the best of luck pursuing justice from Himebaugh, Whitlock and Woodstock. From an earlier story, we learned that prosecutors have chosen not to charge either woman with murder because they’re not sure they can prove that charge beyond a reasonable doubt. In cases like this, families may have no chance to hold wrongdoers responsible in the criminal courts. Instead, they can turn to the civil courts, where the standard of proof is slightly lower — a preponderance of the evidence. This allows them a day in court as well as a chance to recover damages for the pain, suffering and expense of a severe nursing home abuse case.
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An article about trouble at a nursing home in North Carolina caught the eye of our Pennsylvania nursing home negligence attorneys. The Times-News of Burlington, N.C. reported Feb. 18 that opiates were found in the blood of several residents of The Britthaven of Chapel Hill nursing home, even though none had been prescribed an opiate drug. State officials planned to investigate. The home’s parent company is also running its own investigation, and Chapel Hill police have already investigated and determined that no crime was committed.

The case started when a blood test for one resident in the Alzheimer’s unit found opiates, despite no prescription for such a drug. (Several kinds of prescription painkillers contain opiates.) The news concerned the nursing home’s staff, some of whom thought other patients in the Alzheimer’s unit seemed sluggish. Testing turned up opiates in at least two other patients, who were admitted to a hospital. The first resident died of a case of pneumonia that the home’s spokesperson said was unrelated. The head of the state’s Division of Health Service Regulation said the incident was confusing, especially because no drugs were missing or misplaced at the home. However, he said, some antibiotics can create a false positive for opiates.

The nursing home was already getting extra inspections because of its poor record of care. Inspections in 2008 and 2009 found that certified nursing assistants didn’t have enough time per patient to meet state standards. In November, the home also paid a fine for a water-temperature violation that investigators said could have led to an accident for a resident.

As Philadelphia nursing home abuse lawyers, we are surprised the police finished their investigation before the state started its own. If antibiotics are the culprit, it should be fairly easy to determine whether any of the residents who tested positive were taking such a drug. If that’s not the case, state investigators — and residents’ families — should look carefully for evidence of wrongdoing at the home. Alzheimer’s patients can be difficult, and at some homes, this has led to misuse of sedative and antipsychotic drugs to control behavior. Opiates can have sedative effects, but they can also cause patients’ breathing to slow and stop, putting their lives in danger. It also causes withdrawal when patients quit abruptly. Any evidence that opiates were misused at the home should cause swift and permanent changes to protect residents.
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As Philadelphia nursing home negligence attorneys, we were disappointed to see that nursing homes across the state are experiencing and expecting financial trouble because of the recession. The Lebanon Daily News reported Jan. 22 that nursing homes in the region are laying off staff members, cutting patient services or even closing. The problem is driven by the bad economy, which has resulted in cuts to Medicare and cuts or lack of growth on the state level. The issue is particularly important because 90% of Pennsylvania’s nursing home patients are part of the Medicaid system.

According to one advocate for the elderly and disabled, Medicaid and Medicare are chronically underfunded in Pennsylvania to begin with. The funding cuts will make this worse, he said, as would the Medicare cuts included in the federal health care bill, if they pass. Homes shouldn’t have trouble providing basic services, but he said they might end up cutting recreation and other quality-of-life services. Local homes told the newspaper that they were renegotiating contracts and looking for ways to cut costs without letting go of staff.

Our Pennsylvania nursing home abuse lawyers hope that’s true. Adequate staffing levels, and low staff turnover, are an essential part of making sure nursing homes are safe and healthy places. When staff members are overworked, skilled nurses are absent or employee churn is high, details and even basic care are more likely to be overlooked. This can lead to serious cases of neglect or abuse at nursing homes, sometimes with tragic results.
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Our Pennsylvania nursing home negligence lawyers were disturbed to see a recent report suggesting some nursing homes have intentionally over-medicated their patients. The New York Times reported Jan. 15 that federal regulators have sued Johnson & Johnson for paying illegal kickbacks to a nursing home pharmaceutical distributor named Omnicare. The complaint in Boston federal court said Johnson & Johnson paid Omnicare to buy its products. Those products included prescription drugs like the powerful antipsychotic Risperdal, which is frequently used off-label to control behavior in patients with dementia. The Justice Department accused Johnson & Johnson of committing Medicaid fraud by inflating the number of prescriptions it paid.

Omnicare is a “middleman” that manages insurance issues, processes payments and distributes medications. The government alleges that it took illegal payments from Johnson & Johnson from 1999 to 2004. Among other things, the lawsuit says the drug maker paid for information previously distributed for free, and paid rebates every quarter based on Omnicare’s success at switching patients to its drugs from competitors’ drugs. These rebates are legal, but only if Medicaid gets the same discount as other large purchasers. The lawsuit says Johnson & Johnson tried to disguise its rebates to Omnicare in quarterly reports to the government.

As Philadelphia nursing home abuse attorneys, we wonder how many other companies may be guilty of similar behavior. Kickbacks are particularly dangerous in nursing homes because they encourage nursing homes to over-prescribe medicines. Some of these medicines may be appropriate, but they can also carry serious side effects. In fact, we wrote here last week about problems with the atypical antipsychotic Risperdal, which carries an FDA warning that it may increase the risk of death in elderly patients with dementia.
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