Articles Posted in Incidents

The nursing home industry in many areas has been challenged by complaints of abuse and neglect by aides, state and federal surveys and investigations with the possibility of sanctions that go so far as denying licensure, as well as the uncertainty as to sources of funding to pay for care at these facilities. These issues and accompanying discussions are often framed in terms of the lasting and consequential effects on facility residents, and the disciplinary actions taken against a nursing home and/or specific nurses or aides. In Connecticut, however, there is news of specific action that nursing home workers are taking to protect themselves from their employers and a threatening state budget proposal.

In the state of Connecticut, in earlier April, a significant 3,500 employees from 27 different nursing homes agreed to go on a workers’ strike starting the last week of the month. Local reporting details the primary motive as protesting the state government for its budget that may threaten reimbursements to nursing homes through federal insurance programs like Medicaid, which is typically a tremendous source of income for nursing homes. Connecticut’s governor has proposed a budget that would eliminate a previously planned cost-of-living increase that is factored into reimbursements to medical providers for care given to Medicaid insurance recipients. As indicated in an article, approximately 70% of nursing home residents in Connecticut are covered by Medicaid insurance, and cuts to that would obviously take away from money going to the facilities, which in turn are used to in part pay employees’ salaries.
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When it comes to vulnerable individuals, particularly the elderly or infirmed, pneumonia presents not just an illness, but a condition that could lead to death if left unattended by doctors. In western Minnesota, an elderly nursing home resident was hospitalized after he was found to have numerous open sores on his body, very dry skin, and exhibited symptoms of malnourishment and dehydration. Prior to being rushed to the hospital, the nursing home staff gave him extra oxygen as well as cough syrup to help with his breathing problems as well as his changing body temperature. They added Tylenol to the mix as well, and used a cold cloth to try to control his temperature. When he got to the hospital, he was not responsive. Hospital staff diagnosed the pneumonia there, and noticed that he had very little food or liquid, in addition to the clear sores and dryness on his skin. Sadly, within three days he had succumbed to the pneumonia.

Staff Never Notified the Doctor

There is a particularly disturbing aspect of this case that will undoubtedly put this nursing home in a bigger spotlight, and should be of tremendous concern to nursing home consumers and their families. While clearly there must have been questions as to the chosen methods to treat the patient – Tylenol, cough syrup, and oxygen – for pneumonia symptoms, the astounding discovery was that nursing home staff allegedly failed to even once consult a doctor about the patient’s symptoms that affected his body temperature and breathing abilities.

As we have discussed in multiple posts, and as has been followed in the news in recent weeks, a 98-year old resident of a nursing home in South Holland, Illinois, died in a mysterious incident in early February 2015. At first it was unclear what had happened, and initially news outlets reported that the victim was one of six residents who experienced abnormal blood pressures and respiratory issues.

However, the other five residents initially survived those ailments, while the 98-year old resident passed away (the causes of their problems were as yet deemed unknown; by early March, two of the other victims – aged 88 and 98, had passed away, though any connection to this initial incident is unclear). Fire officials ruled out any gas or carbon monoxide poisoning. Authorities opened investigations into the matter, including conducting a toxicology test. A nurse at the facility was suspended after these latter deaths.
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We have written before about how the elderly population will continue to grow in the years to come, as the members of the enormous baby boomer population enter their golden years. As they grow older, the need for various levels of third-party care will be necessary or at least preferred to keep them as healthy as possible and in some cases allow them to lead relatively independent lives. As this segment of the population grows, the costs of caring for so many will increase, possibly putting a strain on finances and the abilities of insurance companies to adequately cover care for their policyholders.

Life Spans & Insurance

In recent decades, in addition to health insurance, other long-term insurance policies such as life insurance were considered essential parts of planning ahead for the eventual need for care in later years. In recent news, however, this fact-of-life type of insurance is on the cusp of becoming much less affordable, and thus much less available to the growing crop of elderly Americans. The expectations about life spans of policyholders and how much it would cost to care for them influenced policy provisions and premium rates, yet this sector has apparently hit a breaking point because those past assumptions have not matched the current reality as costs increase for an aging but still living part of the population.
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We previously posted about a fascinating situation in the West Virginia judicial system involving an apparent conflict of interest by a judge on the state’s highest bench, and a nursing home case. The Chief Justice of the West Virginia Supreme Court, the state’s highest court, was called upon to recuse herself from a case before the court that found against a nursing home at the trial level and resulted in a $90 million award to the family of an elderly nursing home resident that passed away after nearly three weeks at the facility.

There was conflict over whether the resident’s dementia led to her ultimate death, or if it was dehydration from a possible neglect by nursing home staffers that led to her death. The high court upheld the ruling against the Heartland Nursing Home, also refusing to throw out punitive damages, and modifying the damages award to reduce it to about $48 million. The Chief Justice wrote the majority opinion rendering the decision in the plaintiff’s favor. The case went up on appeal in part on the argument that state law capped certain medical malpractice damages. The controversy over the Chief Justice’s involvement in that case centered on over $30,000 in campaign contributions she received for her re-election campaign and that was coincidentally arranged for by the attorney of the plaintiff in the Heartland case, who himself reportedly made a contribution of $1,000. This attorney also bought a Learjet plane for $1 million from the Chief Justice’s husband.
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In Scranton, Lackawanna County, Pennsylvania, a former nursing home aide will go to trial over accusations that several months ago the staffer, who was a certified nursing assistant, assaulted one of the Gardens of Green Ridge nursing home residents. The allegations include that the young nursing assistant physically restrained the 76-year old female resident by holding the resident’s room door closed to keep her trapped inside the room. In addition to this particular restraint, the nursing home aide has also been accused of physically assaulting the patient by dragging her around by her wrists and arms, which resulted in bruising in those areas as well as on her shoulders.

It has been stated that the nursing home has cameras that have captured the alleged abuse and physical restraint, and that witnesses testified that they heard the resident hit the aide, and that the resident yelled at the aide to not touch her. However, the accused’s defense attorney indicated that the aide was simply following orders from a superior to keep the patient in line because she was agitated. Notably, the patient suffered from dementia. As the trial approaches, the one good piece of news is that the patient has been moved to a different nursing home, and is reportedly doing all right.
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Background

A few months ago, an Illinois psychiatrist was suspended indefinitely from practicing because of his alleged abuse of an antipsychotic drug called clozapine. Dr. Michael J. Reinstein prescribed clozapine to more than half of his patients at nursing homes as well as mental health facilities. Clozapine is used to keep patients sedated when they become irritable or violent – many of them suffer from dementia or other ailments, and antipsychotic drugs such as clozapine are used to hold them down. Such drugs can be considered an unacceptable form of chemical restraint that advocates have fought against in recent years in favor of more humane methods that avoid drug dependency.
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Many across the country, but especially in the northeast and in Western New York, recall the pre-Thanksgiving deluge of snow that completely buried the greater Buffalo area, and left businesses closed and residents shut in their homes. The snow fall was so deep and the roads so buried and treacherous that it was nearly impossible to get around. Some facilities even had to be evacuated. Even the Buffalo Bills had to escape to Detroit, Michigan, to play its game that weekend that was supposed to be played in Buffalo.

Amidst the madness, a nursing home in the Buffalo area was forced to evacuate its more than 170 residents as well as staff personnel because the snowfall was so heavy that local building and fire officials thought it might actually collapse the building’s roof, which is what already had happened to an adjacent building. This of course could lead to injuries and burying the residents in mounds of snow, so it was a seemingly prudent and responsible decision by the facility’s management to protect its residents.
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In the course of examining the numerous unfortunate cases of abuse and neglect of patients at nursing homes and long-term care facilities, sometimes other issues, even basic ones, get lost in the shuffle but are very significant when it comes to caring for patients. In addition to meeting adequate standards of care in accordance with government regulations and the ever-evolving patient bills of rights, nursing homes also have a duty to ensure even the most basic safety for its residents irrespective of medical treatment.

This includes making sure that the building that houses the patients is itself safe and up to the proper safety and fire codes; that all fire alarms and sprinkler systems function properly; and that evacuation protocols are designed to ensure residents are removed from the building in the event of fire or other imminent danger. In recent coverage about the deficiencies at Sauk Valley nursing homes, it was reported that in addition to negligence and a lack of care, some of the nursing homes even failed to properly follow building and fire codes.
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Various news outlets reported recently on a case of financial predatory behavior which required the involvement of law enforcement. At a Utah assisted living facility, a Certified Nurses Assistant was accused of significant financial fraud against an 88 year old resident patient. The woman was accused of stealing two credit cards from the resident, one of which was used 15 times in mid-May 2014. On that one card the nursing assistant racked up charges of $2,963.14. She also used the second stolen credit card about 9 times just prior to use of the first, racking up $576.29 in charges. Police arrested and charged the nursing assistant on a third degree felony count of exploitation of a vulnerable adult, as well as three (3) third degree felony counts for unlawful use of a finance card, as well as a class-A misdemeanor charge of theft.

Police arrested the nursing assistant on evidence from security camera footage that captured her making purchases at local businesses where the two credit cards were used. Police showed this footage to a manager at the nursing home, who positively identified the nursing assistant. When police were able to adequately connect the dots, the jig was up for the allegedly abusive (financially) nursing aide. Her bail was set at $21,943.

Elder Financial Exploitation