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.
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.
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.
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.
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
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.
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.
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.
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
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.
Illinois Nursing Home Abuse Blog