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Preventing hip fractures and increasing the rate of recovery must be a top priority in all nursing homes across the United States. A recent study published in the medical journal JAMA Internal Medicine discusses the survival rates of nursing home residents after having a hip fracture surgery. The study used data from nursing homes and Medicare claims totally roughly 60,000 nursing homes residents who had been hospitalized for a hip fracture during the years of 2005 to 2009. The study’s objective was to get hard evidence on both the mortality rate and the decline in activities of daily living for residents of nursing homes who had received surgery for a hip fracture. The lead author of the study, Dr. Mark D. Neuman, from the Perelman School of Medicine at the University of Pennsylvania reported that six months after surgery one in three patients had died with 28 percent of those who had survived became newly dependent on others for basic care. As a Pennsylvania and New Jersey nursing home injury specialist I am well aware of the dangers of neglect in a nursing home setting. Falls in particular pose a real threat to individuals’ ability to live mobile self-sufficient lives.

The Centers for Disease Control and Prevention estimates that the number of hip fractures will online likely rise as the population continues to age. Approximately 95 percent of all hip fractures occur because of a serious fall normally onto one’s side. At the centennial annual meeting for the Clinical Orthopaedic Society Dr. Erika J. Mitchell addressed the mortality rate and severity of hip fractures in the geriatric population. Dr. Mitchell bringing to light the scope of the problem stated that, “Statistically speaking, up to half of all women will have fragility fractures in their lifetime, and up to a third of all men.” Further stating, “Far more people will have a fragility fracture than will have a heart attack, cancer, or stroke.” Once one fracture occurs the chance of a second fracture within 3 to 5 years is nearly 50 percent.

Preventative Measures:

According to the CDC one in five patients will die within a year of having hip fracture surgery with a large portion of those deaths attributable to complications from the surgery. Pneumonia after a hip fracture can increase the patient’s mortality rate by as much as 43 percent. Osteoporosis is a disease that causes bones to become porous and thus more susceptible to factures after sustaining a fall effects over 10 million people in the United States with another 34 million at risk of the disease. Helping to strengthen your bones into old age can reduce the chance of suffering a hip fracture, but there are other steps as well that both nursing homes and health advocates should take into consideration when working with aging patients.

If you or your loved one takes both prescribed and over the counter medication including supplements inform your doctor of all of your medicines to ensure that no drug interactions are causing dizziness or balance issues. Make nursing home residents eyesight is checked every year as loss of eyesight steady increases with age. Throw rugs and other trip inducing items should be cleared to ensure a path that is free from obstructions. Added guardrails around a tub and toilet can also help reduce instances of falls. Sometimes in nursing homes falls occur because a resident is tired of waiting for assistance often verging on neglect and instead independently tries to go about their daily activities without assistance leading to a severe fall or other injury. Nursing home staff levels play a vital role in the safety and wellbeing of the nursing home residents. When choosing a nursing home facility make sure to look to the staff levels and frequency in staff overturn.
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The death of 94-year-old nursing home resident Irene Sansone has left her loved ones with may questions, primarily was it an avoidable tragedy? In August 2013, Irene Sansone was admitted to the Golden Living Center in Waynesburg, a small borough in Greene County, Pennsylvania, about 60 miles outside of Pittsburgh. For over 7 months Ms. Sansone was a resident at the nursing home until her death on the evening of February 22, 2014. It has been reported by the Pittsburgh Post-Gazette that during the night in question Ms. Sansone may have attempted to get out of bed and in the process her head became lodged between the mattress and the bed rail. Ms. Sansone’s torso fell to the ground trapping her body in the bedrail and mattress, ultimately making it so that Ms. Sansone was unable to free herself. According to the Greene County coroner’s office, Irene Sansone died as a result of “accidental asphyxiation.” While accidental asphyxiation was the official cause of death, Ms. Sansone’s niece and caretaker, Stephanie Jupina, strongly believes that the tragic accident could have been avoided with proper supervision. Ms. Jupina stated, “I think this is a serious case of neglect.” In such instances when you have a loved one seriously injured or killed while in a nursing home, and there are lingering doubts, it may be advisable to speak with an experienced Pennsylvania and New Jersey nursing home injury specialist.

Golden Living Center in their past yearly inspection had fewer minimal harm deficiencies than the state average. With the nagging feeling lingering Ms. Jupina scheduled a meeting with administrators from Golden Living Center the following day. The executive director of the Golden Living Center, Jackie Hainer, stated that the nursing home has 24-hour staff on site, with 106 employees, some full-time, many part-time, including what they call, “casual employees.” With ample staff coverage, Ms. Jupina questions who was the last staff member to check on her Aunt, and what was the nursing home’s policy for checking on nursing home residents throughout the night? Golden Living Center declined to comment citing privacy restrictions of the Health Insurance Portability and Accountability Act. If you are considering admission to a nursing home, especially if the resident is advanced in age or disabled, knowing the nursing home’s night policy and use of bed alarms can be the difference between life and death.
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On Thursday March 7, 2014 the members of the newly formed Pennsylvania Long-Term Care Commission, along with the Secretary of Public Welfare and the Secretary of Aging, met for the first time to begin developing long-term fiscally responsible recommendations for the current Pennsylvania long-term care health care system. By executive order Governor Tom Corbett on January 31, 2014 established a 25 person commission with the goal to “ensure the system and its services are person-centered, efficient, effective, and fiscally accountable.” According to Secretary of Public Welfare Beverly Mackereth, Pennsylvania spends an estimated $4.7 billion each year on Medicaid long-term care services. As the demands of the aging Pennsylvanian population is expected to grow so to will the cost of the long-term care services. As a nursing home injury specialist I am hesitantly hopeful that true change will be initiated on a state level.

The need for long-term care is inevitable with one of four citizens expected to be over the age of 60 by 2015. Governor Tom Corbett established the commission as part of the Healthy Pennsylvania plan that helps to ensure affordable quality health care. One of the more serious and common injuries sustained by nursing home residents are falls. In 2000, the cost of all fall injuries in the United States for people 65 and older exceeded $19 billion. It seems that if Pennsylvania wants to lower the cost of Medicaid long-term care services then we must invest in proper staffing in all long-term care facilities as well as training to reduce preventable injuries such as falls. While a fall to a young health individual may only require time to heal and a little rest, a fall sustained by an older American can be severe and costly.

The cost of a fall increases rapidly with age. According to a 2005 study entitled “The acute medical care costs of fall-related injuries among U.S. older adults,” the average cost for hospitalization for a fall injury was about $17,500. In nursing home setting falls are often caused by lack of supervision, unrevised fall risk plans, medications that causes dizziness or lack of coordination, and understaffing. Traumatic head injuries, hip fractures, and broken bones caused by a fall can require extensive care and hospitalization and can even be fatal. A long-term care patient may have to undergo surgery, take pain medication, and have physical therapy when released, all of which can lead to a loss in their quality of life. As mobility and independence tend to go hand in hand it is common to see residents who after suffering a severe fall suffer bouts of depression as their daily routines become interrupted. By the end of the year the Long-Term Care Commission will submit their recommendations to the Governor, hopefully plans to lower the rate of preventable injuries will be among the suggestions.
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A disturbing trend has surfaced recently, according to Dr. Joan Teno from Brown University. It seems that 20 percent of nursing home patients on Medicare who have advanced Alzheimer’s dementia were dispatched to hospitals and nursing homes during their last few months, which effectively ran up their bill to the taxpayers. Not only are their charges increased, their demise is prolonged via expensive intensive care and tube feeding.

When an elderly patient comes down with pneumonia, infections or problems swallowing, assisted living centers and nursing homes might believe hospital care is necessary. However, money may be the chief motivator for the transfer since Medicare pays 300 percent more than the standard rate per day to treat patients who have recently been hospitalized.

Teno said she wonders if the care is necessary and if the system is doing the best for the patient. She said, “A lot of this care just feels like in and out, in and out.” Teno was one of several researchers from Harvard and Dartmouth who co-authored a study that was published in the New England Journal of Medicine.

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As a Philadelphia medical malpractice lawyer, I wrote disapprovingly last month about the push among nursing home companies for an exemption from the Affordable Care Act. The Act is the official name of the health care reform law that has become the focus of several political fights, and one of its many provisions requires companies with 50 employees or more to provide health care to their employees. Companies that failed to do this would be fined. At least one industry group has told the media that the homes cannot afford to provide it because they have only a limited ability to raise their prices. Now, according to a June 20 article from Healthcare Finance News, nursing home patient advocates are actively opposing this with a letter of protest to the federal Department of Health and Human Services.

The group of 24 patient advocacy organizations was headed by Families for Better Care, a Florida-based group run by a former Florida nursing home ombudsman, Brian Lee. The letter called the industry’s request an “outrage” that could have “disastrous consequences for residents.” By exempting health care workers from the requirement to provide health insurance, the letter argued, the government would allow nursing home employees to continue coming to work sick, exposing their vulnerable patients to illnesses their compromised immune systems find hard to fight off. The letter also pointed out the very high rate of workplace injuries suffered by direct-care workers and the low wages that make it difficult for them to take time off or buy insurance in the open market. In an accompanying press release, Lee pointed out that nursing homes are largely government-funded and profitable. A McKnight’s Long-Term Care News article suggested that the industry may be moderating its request.

I hope so. As a Pennsylvania nursing home lawyer, I do not believe it is in the best interests of anybody but nursing home owners to give them an exemption. People in the lowest-paid jobs frequently work when they’re sick because they can’t afford a doctor or a day off. Giving these workers access to basic health care would allow them to call in sick less often and get better faster. Not only would this limit residents’ exposure to illness — a goal in any facility where contagion is likely — but it ensures that care is not interrupted by frequent turnover or substitutes. And that, as research has repeatedly demonstrated, reduces the chance of Pennsylvania nursing home abuse, neglect and other negative outcomes for patients. When the federal government considers this requests, as a Philadelphia injury lawyer, I hope it does so with patients’ best interests in mind.
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A popular Jamaican resort has settled a fatal personal injury accident case, agreeing to pay the family of Jarred Smith $6.5 million. Smith of Erie, Pennsylvania was killed in July 2006 while playing on an Aqua Jump water trampoline at the Beaches Sandy Bay hotel in Negril, Jamaica. Smith and his family were at the hotel to attend a wedding.

According to Ceola Smith, the young man’s mother, Jarred was jumping on the water trampoline when he dove headfirst into the surrounding water. Although Aqua Jump instructions require 10 feet of water for safe use, the resort had situated the water trampoline in water that was only four to five feet deep. Jarred struck his head on the bottom of the seafloor which rendered him quadriplegic. Unable to move, the young man drowned.

Personal injury attorneys arguing wrongful death on behalf of Jarred’s family argued that the resort had been negligent in failing to locate the water trampoline in accordance with safety instructions, failing to provide written instructions to guests concerning safe use of the water trampoline and failing to provide an appropriate flotation device which Jarred’s mother believed would have saved her son’s life. Attorneys for Sandals Resorts International countered by questioning whether the young man had actually struck his head on the seafloor and arguing that the trampoline was designed defectively.

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