Articles Posted in Nursing Home Attorneys

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national health disparity month

April Is National Health Disparities Month

The National Institutes of Health (NIH) estimates nearly two-thirds of individuals who rely on federal and state funding to support their healthcare and long-term care services have multiple chronic conditions. Most of these conditions impact specific racial and ethnic minority communities who have disproportionately been supported with the appropriate diagnosis and treatment needed to thrive. As April marks an opportunity to call attention to these issues under National Health Disparities Month, it’s an important time to start discussion about the significant problems we have in the United States and right here in Illinois, in relation to at-risk populations who receive Medicare or Medical Assistance to treat chronic diseases. These groups are currently battling greater morbidity, mortality, and disability rates as a result of their long-term care coverage.

According to Centers for Medicare & Medicaid Services (CMS), Medicare and Medical Assistance (Illinois’ name for Medicaid) populations that experience disproportionately high burdens of disease are provided worse quality of care, and barriers to accessing long-term care than others. CMS officials say, “these populations include racial and ethnic minorities, sexual and gender minorities, persons with disabilities, as well as individuals living in rural areas.”

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MedPage Today reports that a new study shows that many strokes may be missed in hospital emergency departments in the days before the problems of the stroke become obvious. Misdiagnosis or failure to diagnose strokes can have devastating consequences.

The study was retrospective, meaning that it looked back in time at what had happened to stroke victims in the time leading up to their strokes. The study shows that of 187,188 admissions for stroke, 12.7% of the stroke patients studied visited an emergency department and received a non-stroke-related diagnosis within the thirty days leading up to the ultimately diagnosed stroke. Doctors from Johns Hopkins University say this indicates a possibly missed stroke. One in every ten of those non-stroke related discharges were for headache or dizziness. Those were likely strokes, according to the researchers. Women, members of minority groups, and people under age 45 were most at risk for experiencing one of these undiagnosed strokes.

Effects of Failure to Diagnose Strokes:

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As with any profession, experience in certain legal cases ultimately breeds the best results. That is why all those who may work on nursing home neglect cases in the future should take advantage of the opportunity to learn the ins and out of these matter from those who have worked on these cases for decades. Fortunately, attorneys have just that opportunity thanks to a new seminar being organized by the American Association for Justice (AAJ). The meeting is entitled “Litigating Nursing Home Cases Seminar: From Case Selection to Trial,” and is being presented in conjunction with the AAJ’s Nursing Home Litigation Group. It is open to AAJ Plaintiff Members and AAJ Paralegal Affiliates.

As the name implies, the seminar will cover everything from the intake process to identify the cases with the best chance of success all the way to the ultimate trial. Considering its wide-ranging scope and the critical importance (and prevalence) of these cases, this seminar is something that many local attorneys and firms should consider.

Promotional materials for the event explain that “Program highlights include sessions on building a corporate case by following the money trail, proving understaffing at the nursing home, and selection and use of experts.”

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No legal case is ever identical to any other. No matter what, the law is very fact-specific, requiring a close examination of individual details. However, that does not mean that there are not trends. When it comes to Illinois nursing home neglect and abuse issues, those trends are quickly picked up on by those who work on these matters day in and day out. For example, time and again residents develop pressure sores as a result of inadequate care. Those sores are often not treated properly, develop infection, and may contribute to a senior’s death. Every year there are literally dozens of examples of this form of neglect.

Another trend in nursing home neglect cases are falls. Every resident must be analyzed for their fall risk, as physical vulnerabilities often mean that a single nursing home fall can prove fatal. By analyzing risks ahead of time, facilities are able to develop proper care plans to minimize risk. Sadly, those plans are often not done correctly or not followed, resulting in falls that can take the life of a resident.

Illinois Nursing Home Fall Lawsuit

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The Times Argus reported this week on a new lawsuit filed by the son of a former nursing home resident. The suit makes claims of negligence against the long-term care facility which resulted in the death of the 84-year old woman. The report provides few details of the incident, but it does indicate that some of the most common problems with dementia care might have present in the case.

According to the story, the elderly woman suffered from dementia and was known to wander. The suit claims that at some point in 2010, the resident entered the room of another resident–a 58-year old man. When she entered, the other resident apparently told her to “get out” before the man somehow knocked the woman to the ground. As often happens when a vulnerable nursing home resident suffers a fall, serious injuries were involved. The senior resident was struggling fight the injuries, but she ultimately passed away two days after the accident.

The senior resident’s son eventually sought out a legal professional to learn about his rights. He likely made the decision to help his mother enter the facility specifically because he knew of her wandering risk and other vulnerabilities. It is unacceptable, therefore, for the home to allow these sorts of preventable accidents to cause harm–or even death.

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Many seniors in Chicago and throughout Illinois face mobility problems. To help, full knee and hip replacements are often recommend by medical professionals to ease various ailments that affect those joints. When successful, the replacements can offer welcome relief to seniors who have spent years faced with pain and movement issues.

However, like all medical procedures, it is absolutely critical for community members to understand the risks of each operation. All medical treatment has some risk, and that is why it is critical for patients to be informed about their options before going forward. Of course, at the end of the day it is up to the patients to decide if they want to go ahead or not. But just because the patient has the ultimate say does not mean that doctors and medical professionals are not without some obligation to provide accurate information about those risks, taking them into account when making recommendations to the patient.

Failure to Identify Risks

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As discussed earlier this week, the federal Centers for Medicare and Medicaid Services (CMS) is in a position to exert significant influence over quality of care at nursing homes. That is because most facilities depend on receiving payment from the CMS programs covering seniors without the means to pay for nursing home care on their own. For this reason, CMS has requirements, incentives, and programs aimed and getting facilities to provide better care to both improve senior lives and lower overall long-term care costs.

Minimizing Nursing Home Neglect

For example, last week CMS officials announced the start of a new program aimed at lowering avoidable hospitalizations of nursing home residents. When senior residents are abused or neglected, they often require hospitalization to treat the consequences of the mistreatment. It is not uncommon for those hospitalizations to drag on, as senior bodies are often frail–complications are common. Those hospitalizations are quite expensive. Minimizing readmissions to hospitals is therefore a key cost-containment effort.

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One of the first questions those considering taking legal action ask involve their recovery. What damages does the law allow? In most cases the answer is pretty straightforward–medical expenses, pain and suffering, emotional loss, and more. In some cases of senior abuse or neglect there may also be lost wages, though most seniors in these cases do not work.

On top of these damages, some may have heard about “punitive damages.” These are unique awards which do not seek to connect damage to a specific harm suffered by a plaintiff. Instead, punitive damages are rooted in punishment–seeking to deter others from engaging in similar conduct as the defendants. Much confusion remains around these damages. They remain quite rare, and, in most cases, they will not be awarded. To help explain the situation the Center for Justice and Democracy has a “White Paper” that provides a helpful overview. Click Here to view the entire document.

Punitive Liability

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The new Russell Sage e-book on long-term care (viewed here), includes a chapter on the payment systems for these crucial services. It is impossible to separate programs to tackle the elimination of neglect and abuse without taking finances into account. Who pays for this care, how they pay for it, and how the funds are used is at the center of all discussions about quality of care.

In general, long-term care services–including stays in a nursing home or via at-home support–are paid for by insurance. Some individuals have private long-term care insurance while others (a majority) rely on public insurance programs (Medicaid) to pay for the care. It is undeniable that public coffers are stretched to the bone. No one is quite sure how the Medicaid system will be able to continue paying for the current level of services indefinitely, especially considering the growing number of seniors who will likely need long-term care paid for via Medicaid in the future. However, there has yet to be a strong push for increased use of private insurance to ease the burden on the public. Some hope this changes.

Private Long-Term Care Insurance

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CBS News reported today on the details surrounding new data which shows that more and more people under 65 years old are living in our nation’s nursing homes.

About in on in seven nursing home residents in the U.S. is now under the age of 65 according to data from the Centers for Medicare and Medicaid Services. The younger residents often face unique health challenges and quality of life concerns.

For example, one 26 year old resident interviewed for the story has been living in a nursing home since last year after a gun accident left him paralyzed. The young resident explained that it was very lonely at the facility where the vast majority of residents are elderly retirees. The nursing home presents the lone option for the young man to get care. His father is on the road as a truck driver and his mother is sick with lupus. Medicare payments are the only way he is currently able to survive.

Some facilities that have a larger population of younger residents are able to make improvements that help raise their quality of life. Replacing bingo night with poker games, allowing younger residents to share rooms, and similar changes often have a big impact of resident happiness.
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