August 12, 2013

Nursing Homes As Dangerous Workspaces

by Levin & Perconti

Allsup recently shared the results of a workplace injury study that it conducted this month. Analyzing data from the U.S. Bureau of Labor Statistics, the firm compiled information on the scope of serious workplace injuries, the type of work that is most dangerous, and tracked how those details varied from state to state.

But what does this have to do with nursing homes?

It turns out that nursing homes are actually some of the most dangerous workspaces in the country.

The study results and a helpful map can be found on the Allsup website.

Nursing Home Injuries
As discussed in a McKnights story on the study, the researchers defined workplace injuries for purposes of the effort as any time an employee needed a “job transfer or restriction” as a result of an accident on the job.

Overall, working in a nursing home is the fifth most dangerous job in America--when calculated based on suffering some form of injury. The only job sites ahead of nursing homes are ones you might expect to come with occasional injuries: amusement parks, animal slaughtering facilities, beverage manufacturing, and foundries.

Altogether the state of Maine had the most injuries at nursing homes, averaging five employee injuries per one hundred workers. When divided between private run homes and public homes, a few other neighboring states top the list. Iowa has the most worker injuries at state-run sites while Indiana had the most at private homes.

The study itself did not delve into many specifics regarding how the injuries came about in any workplace setting. However. McKnight’s coverage of the data notes that one of the likely causes in the nursing home context is the injuries sustained by caregivers when trying to transfer residents. In fact, OSHA (the Occupational Safety and Health Administration) has created an awareness campaign to education employees and employers about the risks of skeletal and muscular injuries that commonly strike these workers.

Nursing Home Safety for Everyone
This news may come a surprise for those who are used to discussing injuries to residents--not their caregivers. But it is a stark reminder of the significant dangers that exist at these homes. Perhaps most importantly, it is a testament to the all around lack of commitment to safety that permeates at different facilities, for both residents and front-line care workers alike. Owners and operators simply have to do better.

The comments section on the McKnights story actually offers a few helpful ideas about the underlying problems. For one thing, improper staffing may be to blame. Not having enough caregivers to provide the full support that each resident needs often results in both inadequate care to the ailing senior as well as injury to the workers. That is because caregivers are more likely to rush, cut corners, and make hasty actions in order to keep up with an unrealistic caregiving agenda. There is simply only so much that one worker can do in any given time, if administrators do not hire enough workers to accommodate the need, problems will arise.

See Other Blog Posts:

Illinois Nursing Home Cited for String of Nutrition Violations

95-Year Old Park Forest Man Dies After Confrontation with Police

July 22, 2013

Settlement Reached In Nursing Home Case

by Levin & Perconti

A lawsuit was recently settled in a nursing home neglect case again HCR Manor Care. As mentioned in a new WV Records story, the underlying suit was filed in early February 2012 by the administrator of the estate of a former resident at a HCR Manor Care facility. The suit claimed that the four-year resident of the facility suffered neglect which resulted in serious injuries, pain, suffering, and ultimately, her death. The 85-year old allegedly had pressure sores develop, infections, and various other physical and mental problems resulting from lackluster care. Allegations were also made about a nursing home fall, with premises liability claims included in the lawsuit. The suit was eventually settled by the family for a confidential amount.

$90 Million Case Still Going
One of the most high-profile nursing home neglect cases in recent memory also involved the nursing home chain HCR Manor Care. What made the case so unique and headline-grabbing was the size of the verdict against the company after a jury heard evidence about systematic problems in care against the chain--$90 million.

In another case against HCR Manor Care, a female resident was allegedly mistreated to the point that she was not even fed properly. As a result, the senior died of dehydration following her nursing home stay. That case ultimately went to trial and a jury wa asked to settle the dispute. The jury returned a verdict in favor of the plaintiff. The family was awarded $11.5 million in compensatory damages for the losses sustained by their loved one as a result of poor care. On top of that, in a somewhat unique move, the jury also awarded $80 million in punitive damage.

As readers know, punitive damage are quite rare in all civil lawsuits. Unlike compensatory damages--which are tied to actual losses--punitive damages are meant to punish the defendant. In this case, the purpose was to actually make an impact on the large nursing home chain, hopefully spurring them to change practices and prevent more residents from being hurt unnecessarily.

Even though the jury reached its verdict, the family has yet to receive a dime, because the defendants in the case are appealing the ruling. Specifically, they are arguing to the state’s Supreme Court that the lawsuit implicated a damage cap law , which arbitrarily limits the awards a plaintiff can receive, regardless of what a jury decides. The nursing home chain claims the maximum non-economic damage award (let alone punitive damage award) is only $500,000.

These two cases are reminders of a few principles that underlie nursing home neglect lawsuits. First, many nursing home chains exhibit substandard care over and over again. With profits so large, many of these facilities simply assume that lawsuit payouts are part of doing business. Residents are hurt over and over with little changing. Second, even then, facilities often do everything in their power to prevent paying for the consequences of their negligence, even if it involves appeals that drag out the process for years. Unfortunately, fairness for residents is often low on the totem pole for owners and operators of the largest nursing home systems.

See Other Blog Posts:

Supreme Court DOMA Ruling May Soon Affect Rights of Couples in Illinois

Ex-Chicago Cub Kerry Wood Discovers Body of Nursing Home Resident

July 8, 2013

Dozens of Criminals Charges Filed Against Group of Alzheimers Care Workers

by Levin & Perconti

Nursing home culture is critically important to resident care. News stories and blog posts discussing specific instances of elder neglect always follow a predictable pattern: a resident was hurt, a specific caregiver is cited for problematic actions which caused the injury, and some discipline or punishment was doled out to that caregiver. The downside to this repeated narrative is that it may create the impression that all instances of mistreatment is nursing homes are caused by specific workers who make mistakes.

That masks larger problems about general lack of attention to resident safety by entire nursing home teams. The culture at a facility among employees sets the stage or future care. If cut corners or focus on profit maximization becomes the norm, then it is just a matter of time before a senior resident is harmed as a result. When the harm occurs, one specific employee may have made a mistake, but the problem is far larger than a single errant person.

This is why the same low quality nursing homes often have multiple neglect lawsuits and allegations of mistreatment---it is a cultural problem. In fact, in an “exception that proves the rule’ situation, there are times when mass mistreatment is uncovered implicating many different employees at a single facility.

Dozens of Caregivers Cited
For example, Mcknight’s Long-Term Care News published a story last week on a rash of criminal charges filed against over twenty different individuals at a single long-term care home. All told at least seventy specific criminal charges were filed implicating many in the home, including the owner. The mass mistreatment and subsequent criminal charges were filed after an extensive three-month investigation.

There was not one specific action which led to the charges, but an apparent culture of poor care which skirted state law and exploited residents. The facility in question caters specifically to residents with Alzheimer’s. As we have frequently noted, seniors with cognitive conditions like Alzheimer’s and dementia are the most likely group to be hurt by poor care.

In this case the allegations range from administering medication improperly to employing convicted felons (which is unlawful in the state). More specific details uncovered in the investigation shock the conscience. For example, residents were allegedly restrained with bed sheets. At other times, multiple diapers were placed on residents so that caregivers could go longer without changing the resident. The disregard for basic dignity and dehumanization of these vulnerable community members is shocking.

Don’t Stay Silent
Understandably there has been significant community outrage following these mass criminal charges. Those working on elder care issues know, however, that these stories are not flukes--similar mistreatment occurs daily throughout the country. It is only stopped when someone stands up and demands accountability. Talking to the local ombudsman, state regulatory bodies, neglect attorneys, and others is the best way to put an end to the abuse and neglect.

For help throughout Illinois, please feel free to contact our legal team today. We have decades of experience on this very issue, working to protect seniors and hold negligent facilities accountable for the harm they cause.

See Other Blog Posts:

Illinois Nursing Home Wrongful Death Lawsuit Tied to Poor Communication

Illinois Nursing Home Residents Lose $100,000 From Administrator’s Theft

June 19, 2013

Hidden Cameras in Nursing Homes Raise Privacy Concerns in Illinois

by Levin & Perconti

Hidden video cameras are an effective tool in exposing instances of nursing home abuse or neglect and in monitoring the treatment of loved ones in these facilities. There have been many instances where recording devices have helped family members discover that the staff was providing negligent care or committing elder abuse. One recent case involved a nursing home employee hitting and taunting a resident who lay in bed. When such mistreatment occurs, video recordings provide powerful evidence of poor treatment that can lead to staff members’ being fired and can be used in a nursing home lawsuit or criminal prosecution.

However, the use of hidden cameras or other recording devices in a nursing home raises privacy concerns. Is it legal for a nursing home resident or family member to use these surveillance techniques? The short answer is yes, it is legal to use a hidden camera to catch neglectful or abusive nursing home employees. Still, it is important not to violate privacy laws while using these recording devices to prevent or expose elder abuse.

There are legal limits on how hidden cameras can be used to monitor the behavior of staff members in nursing homes. In Illinois, it is illegal to listen to or record a conversation unless everyone in that conversation has consented to the recording. Because of this law, it is important to make sure that your camera records video but does not record sound. You should also make sure that either your loved one or his or her legal guardian has consented to the use of a recording device. Otherwise, your Illinois nursing home attorney may not be able to use that video recording in your lawsuit as proof of abuse or neglect. You could also be at risk for criminal penalties for violating Illinois law.

In response to the growing use of hidden cameras to catch employees who commit nursing home abuse or neglect, some states have enacted or have introduced laws specifically addressing video monitoring of nursing homes. These laws explicitly allow residents or their family members to install recording devices. Any video acquired from these devices may be used in a criminal prosecution or in a lawsuit for nursing home neglect or nursing home abuse. The laws also prohibit nursing home staff from tampering with or removing these recording devices. In addition, nursing homes are not allowed to reject prospective residents or remove current residents who wish to use a recording device.

Illinois has not yet passed a law that addresses video surveillance in nursing homes, but there are still ways to legally use recording devices to deter or catch neglectful or abusive nursing home staff. Our experienced nursing home lawyers know that elder abuse happens in facilities in our area every day and that in many cases, these practices go unnoticed and unpunished. Used lawfully, video cameras can be a powerful instrument to help prevent the mistreatment of residents and to hold accountable businesses and employees who commit nursing home abuse or neglect.

See Our Related Blog Posts:

Criminal Charges in Elder Abuse Case
Ten Year Sentence for Nursing Home Abuse Caught on Tape

June 5, 2013

Whistleblower Case Against Nursing Home Provider Goes Forward

by Levin & Perconti

Misconduct at nursing home takes many forms. Of course the most well-known way that these facilities act inappropriately is when the individual care they provide to residents is substandard, resulting in falls, pressure sores, wandering, over-medication, and other neglect outcomes. One of the main ways that facilities are held accountable for those lapses are when individual families seek legal recourse by filing a civil lawsuit.

However, a lawsuit is also sometimes appropriate to hold certain home accountable for most systematic problems, usually related to overbilling and misuse of taxpayers funds. Many homes rely on Medicaid (and some Medicare) enrollees. That means that most bills are actually paid by taxpayers. There are very specific rules about what services taxpayers will and will not pay for. Yet, in a rush to increase their bottom line as much as possible, far too many homes cut corners with those rules and sometime intentionally disregard them in order to increase profits. When they occurs, the law allows private individuals with knowledge of the situation to file suit. Those individuals are usually current or former employees of the home who eventually decide that they no long can be a part of an organization that acts in such a way.

Kickback Lawsuit
McKnight’s Long-Term Care News, for example, recently shared information on a lawsuit by a whistleblower against a nursing home chain and other outside care providers. The suit, filed pursuant to the federal False Claims Act (common in these cases) alleges that the nursing home providers received millions in kickbacks all in order to bilk Medicare and Medicaid.

It is easy to see how these arrangements can be crafted to increase the profits of both the nursing home and therapy organizations as the expense of the taxpayers. The outside therapy groups can bill the public for all of the services they provide to nursing home residents--even if they are not necessary--and if the nursing home can receive a portion of those payments (via kickbacks) for ordering the unnecessary therapy. It is a win-win for those companies. But it is obviously illegal, unethical, and damaging to the rest of us.

In this case, the nursing home company is accused of received more than $10 million in kickbacks for using therapy services in 62 different nursing homes that it operates. The two companies are claimed to have entered into an illegal subcontract where therapy services were provided by a new provider. The provider paid an up-front fee to do so and then paid 10% of its billings to the long-term care facility company. This netted millions for the nursing home.

All those with knowledge of any unethical or illegal billing practices at nursing homes in Illinois should be aware that they have legal options to bring the matter to light. In fact, laws are written to incentivize coming forward, with the whistleblower often receiving a percentage of any funds recovered in a subsequent suit. Our nursing home attorneys work on many different cases involving misconduct by these long-term care facilities, both on individual resident problems and system-wide problems.

See Other Blog Posts:

Looming Problems with Alzheimer’s Care in Nursing Homes

Bipartisan Federal Law Proposed to Prevent Elder Neglect and Financial Exploitation

March 27, 2013

Nursing Home Resident Forcibly Returned to Negligent Facility

by Levin & Perconti

Nursing homes and hospitals often have close relationships. That is because individuals may go to and from one facility to another on different occasions. This relationship works both ways. On one hand, many seniors move into a nursing home only after a serious medical event which places them in a hospital. For example, after a heart attack, stroke, fall at home, or similar event, a senior may require hospitalization. Often, when the immediate injury is healed, the individual is still not in a condition to go back to prior living situation. That is why many seniors move into a nursing home directly into a nursing home.

Alternatively, while nursing homes do provide skilled medical care, they are not capable of providing every medical need for residents. When a nursing home resident suffers a serious medical emergency or an advanced ailment, then the resident must often go back into a hospital. This back and forth may happen several times, and there is therefore a clear relationship between many nursing homes and hospitals.

This is a natural relationship that is necessary to ensure that ailing seniors receive the exact care they need at the right time. However, this also sets up a tangential financial relationship between these entities. Hospitals often want to have the residents admitted for care when finances incentivize it. On the other hand, depending on insurance and payment structures, they often have the incentive to release patients--particularly those who have taken up a room for an extended length of time--into a nursing home. The nursing home obviously likes this as it is another bed filled and money coming in.

Money Over Care
Sadly, these money matters sometimes take priority of the best interest of seniors. For example, My Elder Advocate recently explained how a senior was forcibly ejected from a hospital and brought into a nursing home that he did not want to be at. The senior, an 85-year old man, was in the hospital recovering from an MRSA infection. Interestingly, the infection itself was developed while the man was in the hospital--a common problem plaguing many facilities. Antibiotic treatment are needed to recover from these ailments. Yet, before those treatments were even finished, administrators wanted the man removed from the hospital and brought back to a nursing home.

Bizarrely, several hospital staff members entered the man’s room and forcibly removed him from the hospital. In the rough-handling of the frail 95 pound elderly man, his phone was taken so that he could not call his wife. All of this led to his readmission to the nursing home he lived in previously. There are allegations of nursing home neglect at that facility, where he apparently lost over 2 pounds, suffered seizures, and otherwise did not receive the care he should have been entitled to. Yet, regardless of those allegations and irrespective of his desire not to go back to that facility before his antibiotic treatment was finished, he was forcible required to go back.

This represents a sad example of how resident interests can be ignored for the the interests of the facility itself. This should be fought against every step of the way.

See Other Blog Posts:

Elder Abuse Caregiver Had History of Problems

Levin & Perconti Secure Successful Verdict in Illinois Nursing Home Neglect Case

March 20, 2013

Elder Abuse Caregiver Had History of Problems

by Levin & Perconti

All those working on elder care issues understand that the vast majority of neglect goes unreported. This is a tragedy for two reasons. First, it means that individual seniors are forced to endure pain and suffering without help. Second, the under reporting means that more seniors in the future may be affected by neglect. That is because those who get away with mistreating seniors once are far more likely to do it again. Some caregivers who have a history of skirting requirements are often the ones found responsible for the most egregious cases of abuse and neglect.

For example, take a case out of California. We have already discussed the allegations against a woman who cared for ailing seniors in her own home. Headlines were made when the woman was charged with a felony following the death of one an 88-year old woman who was in her care. The senior had dementia and was under the woman’s care for five years. However, the quality of that care was suspect. That is because the woman developed incredibly serious (Stage IV) bedsores which ultimately led to her death.

Our neglect attorneys have worked on many cases where bedsores are at issue. Bed sores are almost always preventable, and when they arise, caregivers can be held responsible. Most of the time that responsibility comes in the form of civil lawsuits, which, for example, can provide financial compensation to those harmed. However, in more unique circumstances, those involved may also be punished criminally.

That is what happened in this case, as the caregiver who ran this facility is facing a felony. In one of the first such cases of its kind, the woman is now facing “involuntary manslaughter” charges. All told she may face up to twelve years in prison.

History of Problems
Since the initial filing, more and more information has been uncovered about the care provided at the home and the history of the woman now facing serious criminal charges. Perhaps not surprisingly, the woman was on the radar of the state’s department of social services for more than a decade and a half.

Amazingly, the woman was cited over forty times since 1996 for various care deficiencies and violations of state and federal caregiving rules. A Sacramento Bee story on the matter explains how more than half of those violations were “Type A” violations. These are the most serious mistakes which place the health and safety of seniors at risk. Yet, despite all of those problems, the state did not move to take away the woman’s license until after she was criminally charged with the death of her former client.

The case is a sad reminder that by the time a caregiver is actually held responsible for harmful conduct, on many occasions they have likely already harmed others without recourse. It is also a testament to the fact that state regulatory agencies cannot always be assumed to shut down poor facilities or care settings. The reality is that many negligent caregivers continue to provide services to vulnerable seniors.

See Other Blog Posts:

Hospital Fails to Report Elder Abuse

Family Files Wrongful Death Lawsuit Against Nursing Home

February 25, 2013

Controversial Feeding Tube Use for Elderly

by Levin & Perconti

Most adequate elder care focuses on “quality of life.” But the phrase itself is somewhat elusive. In a few situations it is not necessary easy to determine if a certain course of conduct will improve one’s quality of life or make it worse. There are general principles that can be applied to better make choices on behalf of a senior loved one, but every decision is ultimately a personal one. What might be a welcome act or service for one person may be shunned by another. All of this is why we continue urge resident-centered care that is based upon specific understanding of an individual’s strengths, weakness, likes, and dislikes.

Feeding Tubes
One area where these questions are often asks relates to use of feeding tubes. An editorial from My Elder Advocate recently touched on the concerns, providing an interesting perspective on the use of these measures among those caring for seniors. In short, the article explains how at first blush it may seem like use of feeding tubes is a critical life-saving step. However, the truth is that there are serious questions about whether these tubes serve any function. In fact, in some cases seniors may ultimately suffer serious injury or death as a result of their use.

According to some sources, in the worst performing homes as many at 35% of all residents with cognitive impairments (dementia, Alzheimer’s) are on feeding tubes. Those familiar with basic elder abuse facts understand that residents with these mental impairments are always far more likely to fall victim to elder neglect.

Of course in certain limited settings the use of feeding tubes may be essential. This includes situations where the senior has swallowing issues or to prevent aspiration pneumonia. However, as with many other treatments that are important in limited situations (i.e. antipsychotic medications), feeding tubes are often drastically over-used. The over-use is usually caused by the convenience factors--caregivers may decide to continue use because it makes their job easier, not because it is absolutely necessary for the resident.

Real Risks
The potential overuse of feeding tubes is not just a theoretical issue--the use of the devices comes with real risk of harm. For example, one study found that elderly individuals who are on a feeding tube at a hospital and then discharged into a skilled nursing facility are at a higher risk of developing pressure sores than those not on the feeding tube. In addition, there are many examples of caregivers who made mistakes with the insertion of the tube, errors which often prove fatal for the vulnerable elderly resident.

For these reasons, it is often more appropriate to engage in careful hand feeding of residents where at all possible. Besides minimizing a few risks, it is often far more comfortable to the senior to be fed that way as opposed to the obtrusive tube inserted into their body. However, as with so many caregiving issues, many facilities decide not to put in the time and staffing to actually allow hand feeding. There is a temptation to overuse the tubes simply for their convenience and cost-saving for the facility regardless of the resident’s best interest.

See Other Blog Posts:

Fireworks in a Nursing Home Abuse Trial

Elder Abuse Manslaughter Charges

December 28, 2012

Report on Disparities in Nursing Home Sanctions

by Levin & Perconti

ProPublica recently issued a report which explores an important topic related to holding nursing homes accountable for mistakes and ensuring changes are made to prevent future harm. The story takes a look at federal oversight of nursing homes, particularly the scattered penalties for care lapses. Obviously, accountability and enforcement of rules is a crucial way quality standards are upheld at these homes. If there are no consequences for providing inadequate care, many facility owners and operators will provide sub-par services to maximize their own bottom line. In fact, many already do. But when it is well-known that errors will be costly, the incentive to prevent those errors increases dramatically.

Unfortunately, punishments are often not doled out consistently or evenly, perhaps limiting the deterrent function of public oversight.

Different Punishments
The report explores the disparity in outcomes following the accidents that led to resident deaths at nursing homes in two different states. In the first case a resident was eating a cookie when he began choking. The resident went to the nurse’s station, but efforts to dislodge the airway blockage failed. In the second case, a resident pulled out her own breathing tube. Caregivers were not able to catch the problem in time.

Following both of the incidents leading to death government investigations were conducted. In each, the investigators found problems with the care provided during the incident. In the first case the employees did not immediately call 911. In addition, they had not been properly trained to respond to emergencies of that nature--a lapse which may have cost the resident his life. In the second incident, the resident in question had removed her tube twice in the prior month. Investigators determined that the caregivers should have done more to prevent the accident, knowing about the risks. The final reports in each case resulted in essentially the same violations representing “immediate jeopardy” of leading to resident harm.

So what were the punishments for the care lapses?

In the case involving the choking death the nursing home was fined $9,500. In the second case, the facility was hit with over a $350,000 fine. Each fine was based largely on the recommendations of state officials who were also involved in the matter.

The report refers to this reality as the “balkanized” system of nursing home punishments following care lapses and citations. Even though federal money is involved, each state essentially determines its own punishments, resulting in significant disparities. Some locations demand more sizeable sanctions for the most serious problems, while other states are far less demanding. It turns out that while CMS officials have to approve final sanction amounts, they almost always rubber-stamp the state suggestion.

Many argue that the failure to standardize these violations allows the poorest facilities to go by without improvement. A nursing academic interviewed for the story explains, “If you don’t go after these really bad violations and try to force these nursing homes to improve quality, they’re going to continue to cause harm and jeopardy.”

This is just one of many reasons why it is always important for individual family members to come forward after their loved ones have been harmed and perhaps file a lawsuit to ensure full accountability is had to prevent future problems.

See Our Related Blog Posts:

Chicago Nursing Home Lawsuit Alleges Maggots in Resident Ear

Federal Officials Join Nursing Home Lawsuit

December 6, 2012

More Problems at Winchester House Nursing Home in Libertyville

by Levin & Perconti

Those who follow issues related to elder care and nursing home neglect in Illinois are probably aware of the fact that poor care is not evenly dispersed across all long-term care facilities. Instead, there are often chronic problems at a smaller subset of facilities where preventable injuries occur time and again. That is not to say that nursing home neglect can’t occur everywhere--it certainly can--but overall there are certain home that are far more likely to cause harm.

This is exactly why it is incredibly important to be as diligent as possible when deciding where to have your loved one move if they need long-term care. If there is a choice between a few facilities, be sure to research the track record of those homes to determine if any of them have a series of problems related to poor care.

Yet, the reality is that there is often very little time to properly and fully vet a facility before having a loved one move in. They may be discharged from the hospital, and the need a new living location immediately. In that way, many families have no choice but to trust that the facility will abide by their legal requirement to provide appropriate care at all times to keep their relatives safe. Unfortunately, many homes fall far short of those requirements.

Several Citations at Winchester House
For example, last month the Sun-Times discussed the fourteen separate citations issued to a single Illinois nursing home, the Winchester House in Libertyville. The citations came after two different surveys of the facility conducted by members of the Illinois Department of Health and Human Services.

In addition to the fourteen citations for chronic “deficiencies” at the home, the facility also faced scrutiny for its failure to properly handle issues with one particularly troubled resident. The resident had severe mental retardation, Downs Syndrome, and dementia. He was also known to have severe agitation issues and was prone to wandering. Considering his vulnerabilities and risk-factors, it was important for the facility to have specific plans in place to ensure he was not a harm to himself to other residents.

However, for the report, it does not seem that the caregivers at the facility were able to control the man. In mid October the man was found unclothed from the waist down while standing next to another female resident in a bed. The female resident was partially unclothed as well. The female resident had to be taken to the hospital, but fortunately not evidence of assault was found.

If you or anyone you know might have suffer harm as a result of poor care at Winchester House or any other long-term care facility in Illinois, please contact the attorneys at our firm to see how we can help. The legal professionals on our team have decades of experience fighting on behalf of those affected by nursing home negligence, including for things like pressure sores, falls, wandering, and resident-on-resident attacks. We understand that often the only way to ensure real changes are made at these facilities for the long-term is when they are held fully accountable for the consequences of their actions.

See Our Related Blog Posts:

Woman Pleads Guilty to Illinois Elder Abuse

Government-Run Illinois Nursing Home to be Privatized

November 13, 2012

Questions Raised About Post-Hurricane Nursing Home Care

by Levin & Perconti

We recently touched on some concerns that were raised about several nursing homes that were not evacuated in the wake of Hurricane Sandy--even though they were in the "must evacuate" area as a result of their proximity to the ocean. Those in the facility during the storm explain that the rising waters flooded the first floor, took out the back-up generators, and presented a very real safety risk. Employees stated at the time that the decision not to evacuate was made by city officials, who told the caregivers to keep the vulnerable seniors residents in place.

Along the same lines, the New York Times reported recently on serious concerns raised by advocates about the care provided to some nursing home residents at one facility during and after the weather emergency. For example, one facility in Queens, New York saw its first floor underwater after winds knocked out the windows and rising water surged into the area. Many residents were on the upper floors of the facility at the time. When their power went out, they assumed that things would be fine, because the generators would soon kick back on. They didn't. That is because those generators were engulfed by the water.

All of this led to serious, but predictable problems. As time dragged on without power, the residents became increasingly cold--there was no way to get heat. On top of that, they soon grew hungry. But there was a problem, the kitchen was on the flooded first floor, and there was not enough food stocked away by the owners before the storm hit. Residents also did not have adequate water. That means that they were stuck on the upper floors of the facility in the cold, thirsty and hungry. It was not until hours laters that emergency crews arrived and were able to evacuate the resident to emergency shelters.

But it gets worse.

In the aftermath of the quick evacuation, there was a sense of chaos Residents were transported to different locations, often without their medical records. Most were taken to different locations without a staff member present. All of this has created a nightmare, with many family members of residents having no idea where their loved ones were taken. Even now, nearly two weeks after the hurricane hit, some relatives are still looking for their family members. They are scattered in hospitals, emergency shelters, and other locations without much documentation.

How did this situation arise?

Poor planning. But fingers have been pointed all over the place regarding who is at fault for the planning errors. Public officials and several employees of the facility explain that the home's owners and operators are at fault for failing to act prudently for a storm that they knew was coming. The nursing home director and administrator allegedly left the area before the storm and did not return until afterward. An investigation by city, state, and federal investigators has already been launched.

At very least, the facility should have taken basic steps to account for the obvious danger presented by the storm. That includes beefing up staff members so that all tasks could be handled properly, ensuring proper food and water, securing adequate medicine, and guaranteeing supplies like flashlights. In addition, medical records should have been prepared so that if an evacuation was required, those records would travel with patient.

See Our Related Blog Posts:
Nursing Homes in Hurricane Sandy Aftermath

Fact Sheet on Dangers of Antipsychotic Medicine

October 13, 2012

New White Paper of the Importance of Staffing

by Levin & Perconti

Few nursing home administration details are talked about more in relation to ensuring proper care and avoiding neglect and abuse than staffing levels. The research effort was published by OnShift, and is available at the LTL Magazine online here. The main idea of the paper is to stress the importance of “staffing acuity.” It lists five reasons to make a focus on these staffing issues a top priority for long term care management.

The first of those reasons relates to quality of care. The paper pointed to research showing that “acuity drives better outcomes.” The paper notes that this care is a more “clinically driven and individualized approach.”

Important in identifying proper staffing levels is appropriate technologies and monitoring systems. The report note that changes in resident conditions, assessment, or intake rates affect what is an appropriate staffing level. In that way, every day (and every shift) can include the right number of staff members with the right skill set. Our lawyers who work on cases of abuse and neglect in Illinois are very familiar with the problems that come with mismatched staffing levels and skills. The sad truth is that most facilities have a long-way to go before their staffing is appropriate at all times. It is perhaps unsurprising that the problems usually stem to facilities having too few staff members who are not properly trained to ensure all residents receive the care they need. This is unacceptable, and those families affecting are well served by protecting their legal rights when it causes harm.

The white paper notes that this focus on proper staffing comes with better nursing home rating and reimbursements. It notes how the Centers for Medicare and Medicaid Services based it five star rating system, in part on staffing. But total staffing is not all that matters. The paper notes that for the rating purposes “staffing rating encompasses not only the hours of care provided each day, but also adjustments based on the level of acuity of a home’s residents.”

This focus is also on reducing hospital readmission rates from the nursing homes. When a resident’s health deteriorates, he or she may be forced to go back to the hospital. On some occasions that health deterioration is connected to neglect by staff members at the nursing home. It is for this reason that many reform efforts at the state and federal level is focused on reducing hospital readmission rates. Facilities with superior rates may see reimbursement benefits while those with the worst rates could face penalties. Improving staffing levels and training is perhaps the most critical way to limit those costly and harmful hospital readmission rates.

Finally, beyond improving care and providing financial incentive to the facility via CMS ratings and reimbursements, the focus on staffing also leads directly to improved employee, resident, and family satisfaction rates. In our work on these cases, our attorneys have worked with many staff members who note that one of the biggest challenges of their jobs is not having enough time to perform all of their caregiving duties. Those unsatisfied caregivers are more likely to leave their jobs and therefore increase turnover rates. Those turnover rates affect the quality of patient care as well as the financial costs to the facility.

See Our Related Blog Posts:

Nursing Home Fall Sparks Civil Lawsuit

Levin & Perconti Settle Nursing Home Neglect Case Against Clark manor Convalescent Center

September 28, 2012

Nursing Home Suspension Lifted After New Care Plan Created

by Levin & Perconti

Knox News reported earlier this month on a follow-up to a tragic case of nursing home neglect and abuse on which we’ve previously posted. The underlying case involved the rape of an 89-year old woman with severe dementia. Late last month the senior resident told her family that earlier in the summer a man entered her room and raped her. She did not know the man. Eventually the police were called in and a rape test was performed. The test revealed DNA samples of the attacker--though the criminal has yet to be identified.

Of course this opened up a big question: how on earth did the man enter the room and have access to the vulnerable senior? Perhaps the most obvious answer is that the attacker may have been a male employee of the facility. Lawyers and other advocates working on these cases appreciate that sexual assault by caregivers is not unheard of.

The state Department of Health investigated the matter, issuing a suspension on new admissions into the facility after determining that the home’s current policies and procedures placed residents at risk of harm. This particular home is run by a large nursing home conglomerate which operates at least 225 facilities in 28 different states. In other words, if this company was cutting corners or not abiding by proper safety protocols, then tens of thousands of residents may be at risk.

The story explains that the suspended facility in this case allegedly sought to act quickly to correct the problem. Staff members received better training on identifying, reporting, investigating, and documenting abuse allegations. In addition, updated background checks were ordered on all male employees. Twenty-four security was hired, door locks were changed, windows were made more secure, and surveillance cameras were installed. In addition, another employee was hired--a state-licensed administrator--to ensure the home followed rules and regulations in the future.

After all of these changes were made the state lifted the suspension, allowing new admissions to the home.

Ensure Actual Improvement
Our team of lawyers is familiar with this course of conduct, as one of the most common demands by state and federal regulators involve changes in policies and procedures. In this case, the story suggests that a wide-range of actual physical changes and resource additions that will make residents at the facility safer. It is a clear testament to the importance of coming forward with misconduct allegations and ensuring full accountability. Fellow residents may be spared significant pain, injury, or even death.

However, it is important to keep a close eye on all facilities where misconduct has occurred into the foreseeable future. It is natural for a home to make concessions in the immediate aftermath of an incident, with regulators keeping a close eye. It is another thing for those changes to translate into cultural modifications that improve care indefinitely. For that reason, all those with friends or loved ones are encouraged to remain vigilant about quality of care issues at all long-term care homes--particularly if the home has had problems with these issues in the past.

See Our Related Blog Posts:

Developments in Nursing Home Medication Kickback Lawsuit

Drug Companies in Lawsuit for Illegally Receiving Nursing Home Residents

July 9, 2011

Nursing Home Attorneys File Suit Against Understaffed Facilities

by Levin & Perconti

All across the country, nursing homes are being run with less than the optimum number of staff. They are being understaffed in a hope to cut costs and increase profits. When nursing homes fail to properly staff their facilities, the chance of accidents and mistakes greatly increases. State and Federal laws set a minimum standard that nursing homes must comply with. The problems arise when facilities choose to ignore these government regulations.

People choose to go to nursing homes not because they want to, but because they are at a point in their lives where they need more care and attention than can otherwise be provdided to them. Many nursing home residents have been finding out that the nursing homes promise to provide them the care and treatment they need is often a fabrication. The nursing homes that choose to understaff their facilities have been rewarded with large profits by failing to provide the required number of nursing hours and as a result, patients of these homes have not received adequate care.

Some problems that can occur when a facility is understaffed are falls, pressure sores, dehydration and malnutrition, all of which stem from an overall lack of quality care and attention. It is easy to blame the staff of the nursing home when problems arise, but in reality the staff is often doing the best it can with the resources it is provided. If there are not enough staff members to provide supervision for the residents who are at risk for falls then it is likely a resident will fall, and it is no stretch of the imagination to assume that if there are not enough staff members to turn and reposition residents who are at risk for the development of pressure sores, that a resident will eventually develop pressure sores.

It is not the nurse’s fault that these injuries are occurring; a nurse can only care for so many residents at once. The facilities are setting their staff up for failure. Without adequate staffing, it is impossible for any resident to truly get the care and treatment they need. Owners of the nursing homes need to stop choosing profits over people and people need to start demanding better nursing home care.

The nursing home attorneys at Levin and Perconti have been fighting against facilities that understaff their Illinois nursing homes. Many residents of nursing homes have come to Levin and Perconti after suffering an injury, only to find out that one of the main reasons that the injury occurred was because the facility they were at was understaffed. Hopefully, the civil liability that these homes are opening themselves up to by understaffing will be enough of a deterrent to stop them from doing so in the future.

April 14, 2011

Nursing Home Wandering Death Explained By Inside Source

by Levin & Perconti

A tragic example of nursing home negligence was reported earlier this year by KCBD News. The nursing home death occurred at a facility known as Tumbleweed and involved a 71 year old resident who froze to death after being outside for several hours in frigid conditions.

The victim was a known wanderer, had dementia and Alzheimer’s. Surveillance video indicates that the man wandered out of the facility, slipped, and hit his head on an object outside. Nursing home employees did not find the man until 8 a.m. the next morning by which point he had died of exposure to the elements.

Amazingly, the man had only been transferred to Tumbleweed that very day. He previously lived in a separate nursing home that was shut down by state officials. An anonymous nurse at the negligent nursing home explained that according to facility protocol, residents were supposed to be checked on every two hours. But that was never followed. On top of that, a new resident who is known to wander and has dementia should have been monitored even closer.

The nurse explained the risks of the facility revealing that residents “can be outside for hours” without notice by employees. She continued that regular checks of residents and alarms on the doors were only installed the very day after the death because the facility management expected there to be a fuss made about the safety of the nursing home. On a separate occasion that very weekend, the nurse explained that a resident left the facility and hitchhiked to another town.

The family has indicated that they will seek legal action against the negligent facility.

Continue reading "Nursing Home Wandering Death Explained By Inside Source" »

January 19, 2011

For-Profit Nursing Homes May Be Overcharging Medicare

by Levin & Perconti

The care provided to residents by nursing homes driven by profit has often been questioned. Many observers wonder about their belief in committing as many resources as possible to ensuring that nursing home residents receive the care they deserve. There remains an inherent tension between spending money on quality care and cutting corners to increase the bottom line to owners and shareholders. We provide close oversight of these for-profit institutions when allegations arise of residents victimized by their inadequate care.

Along the same lines, new reports last week from the New York Times blog share another way in which these for-profit facilities may do anything in their power to maximize their payout. A Department of Health and Human Services report examined the rates at which different types of nursing homes classified the level of care each resident needed. The classification is important, because it determines the amount of funding provided to the facility by Medicare. The “higher” the classification, the more care needing to be provided to the resident and the more money to be sent.

Amazingly, in the years 2006 to 2008, the number of residents classified in the most severe group (demanding the most funding) jumped from 17% of all residents to 28%. Those changes cost Medicare a staggering $5 billion.

When examined further, researchers discovered that the leap had little to do with the changing dynamic of nursing home resident—their average health level remained unchanged. That means that facilities themselves were likely changing the classification to raise more money. In particular, for-profit nursing homes were much more likely to claim the highest classifications. 33% of for-profit resident are in that category, while only 18% of non-profit residents. Even within the group of profit-making facilities, the largest chains had the largest percentage of high classification residents.

Continue reading "For-Profit Nursing Homes May Be Overcharging Medicare" »

December 30, 2010

Several Nursing Homes Cited For Problems, One to Close

by Levin & Perconti

We have often explained how it is imperative for state regulatory bodies to take proactive steps to ensure that area nursing homes are abiding by all necessary regulations. It is simply unacceptable to allow vulnerable nursing home residents to be repeatedly subjected to sub-par care. One way to prevent the abuse is to take action before specific acts of negligence are reported.

Lo Hud News reported earlier this week on one regulatory body that is working to take proactive measure. The paper reported on steps taken by that areas health department to cite deficient facilities (and close one egregious home) for care violations.

Specifically three nursing homes were fined for not following advance directives for terminally ill patients in the facilities and the all-too-common problem of allowing pressure sores to develop. Three facilities will pay $28,000, $22,000, and $20,000 respectively for elder care negligence. One other facility will be closed completely after receiving 21 violations in the last three years.

Continue reading "Several Nursing Homes Cited For Problems, One to Close" »

September 13, 2010

Nursing Home Administrator Filed Suits Against La Salle County

by Levin & Perconti

An Illinois nursing home is facing a new lawsuit this week as the former head of the La Salle County Nursing Home is challenged the events that led to her termination last year.

According to My Web Times, Adrienne Erickson was fired as administrator of the nursing home in September of 2009 after only three and a half months in the post. She claims that her termination was without merit—that she was actually given no reason for her firing. The LaSalle County Board which is in charge of operating the facility claims that Erickson was an “at will” employee, meaning that no reason was needed to terminate the employment.

While the termination letter sent to Erickson did not specifically mention a reason for the firing, a review of the events leading up to the termination point to a likely cause of the problem. Shortly before the firing, the La Salle County Nursing Home had received a significant amount of negative criticism following an Illinois Department of Public Health report that challenged safety protocols at the facility.

A female resident at the facility was repeated molested by a male resident and the Illinois state agency claimed that hospital staff should have done more to monitor and prevent the abuse.

Our Chicago nursing home attorneys at Levin & Perconti have experienced the culture of negligence that can develop at these facilities when there is not competent oversight and leadership. The vulnerability of many residents at these nursing homes is extreme—meaning that even slight mistakes by staff members can have deadly consequences. The precarious situation is well-known to all those who are charged with ensuring that these facilities run smoothly. Therefore, there is no excuse for failing to ensure that the nursing home is free of preventable mistakes and abuse. If you or someone you know may have suffered because of mismanagement at one of these Illinois facilities, please contact a nursing home lawyer today.

August 11, 2010

Chicago Nursing Home Faces Forced Closure

by Levin & Perconti

A negligent Chicago nursing home will be closed by the state, reports CBS 2 Chicago. Columbus Manor Residential Care Home faces over $100,000 in fines and closure after Illinois nursing home inspectors uncovered repeated examples of inappropriate care at the facility.

Reports confirm that residents were attacking each other physically, and one elderly female resident was forced to fight off another male resident's attempt to sexual assault her. In another case, the nursing home staff failed to inform the doctor of one resident about his serious illness. The 61 year old resident died as a result.

A basic component of any nursing home care is honest reporting about medical conditions and ensuring a safe living environment for all residents at the facility. However, Columbus Manor was unable to meet even these fundamental requirements of adequate nursing home care.

Our Chicago nursing home attorneys at Levin & Perconti have experience uncovering the negligent, abusive conduct at our city's nursing homes. We have fought countless legal battles on behalf of victimized seniors and their families who have endured these shameful care practices for years. Our commitment is to vindicating the abused and helping to ensure that future acts of nursing home negligence never occur.

That is why we support all efforts by Illinois regulators to shut down the worst nursing homes in our city. Unfortunately, many administrators of these facilities refuse to make the necessary changes to ensure that their residents are treated to the quality of care that they deserve and that the law demands. The only recourse is to close them down so that no future resident is put in peril.

Please contact our office if you know of any similar nursing home abuses.

August 2, 2010

Nursing Home Investigated for Negligent Care

by Levin & Perconti

Wisconsin’s largest nursing home remains under investigation this week after continued reports of substandard nursing home care. The Milwaukee-Wisconsin Journal Sentinel has been following the developments at Mount Carmel Health & Rehabilitation Center.

The investigation by the state’s public health department is in its second week. The review was prompted by a viral outbreak at the facility which affected at least 21 residents. It was unclear exactly what caused the medical problem which was classified as leading to “generalized respiratory symptoms.”

This is only the latest is a long line of examples of extreme misconduct by the facility. Seven other lawsuits are still pending against the nursing home. On top of that, the state noted 35 specific care violations at the facility this year alone. In one case, staff members were caught lying about the location of a resident. The staff members reported seeing one resident repeatedly over a ten hour period, even though in reality the resident had left the facility and was arrested for prowling in a nearby neighborhood.

The seven remaining lawsuits at the facility involve residents who died as a result of pressure sores, physical falls, failure to provide assistance devices and elopement. It seems that everything that could go wrong at a nursing home has gone wrong at this facility.

Unfortunately the outrageous conduct at Mount Carmel is not an isolated example of chronic nursing home negligence, as our Chicago nursing home attorneys at Levin & Perconti know all to well. For decades we have witness the same nursing homes committing the same acts of negligence leading to deadly consequences to the residents at their facilities. Unfortunately too many facilities fail to learn from their previous mistakes.

Often the only thing that gets the attention of negligent nursing homes and their corporate backers are lawsuits that affect their bottom line. Our attorneys are committed to protecting the rights of injured nursing home residents and their families. If you or someone you know has been similarly victimized, please contact our office.