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In early June, the CDC published a report that showed 80% of cases of Legionnaires’ disease were associated with a long term care center. 18% were acquired from hospitals. The CDC has always collected data from states on legionella infections, but has never required the source of the infection to be included. For the report, the CDC asked 21 jurisdictions to identify the likely source.

According to the CDC, Legionnaires’ disease develops from legionella bacteria and causes a pneumonia-like infection that causes severe respiratory issues and can be fatal. One in 10 people will die from acquiring Legionnaires’ disease under normal circumstances, but if the disease is contracted from a health care facility, the odds off death jump to one in 4. The thought is that Legionnaire’s disease in health care environments is more severe and that hospitalized patients, being ill or in some form of bad health, have less positive outcomes when facing the infection.

Becoming infected by legionella is dependent on several factors. If younger, healthy adults come in contact with the bacteria, the disease will likely not develop. However, risk factors for the bacteria developing into Legionnaires’ disease include being over the age of 50, being immunocompromised or otherwise unhealthy, and having been a smoker or a current smoker. Legionella bacteria is spread through contaminated water and very rarely can be self-induced by aspirating any sort of water.

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The Canadian killer nurse nicknamed the Shadow of Death by a judge has been sentenced to life in prison for the murder of 8 patients and the attempted murder of 4 others, all between 75 and 96 years of age. The nurse, Elizabeth Wettlaufer, committed the crimes between 2007 and 2014 by using injected insulin to slowly torture and kill her helpless victims. The murders occurred at 3 different long term care facilities, as well as at one victim’s personal home and no motive has ever been given. Court proceedings revealed that Wettlaufer was formerly addicted to opioids, as well as an alcoholic. Her marriage had fallen apart and she had recently gotten a divorce before she murdered her first victim in 2007.

While she is eligible for parole in 25 years, legal experts believe it’s unlikely she will ever see freedom.

Civil Cases Likely Won’t End in Victory

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57 families have won a 5 year fight against Mary Health of the Sick Convalescent and Nursing Hospital in Newbury Park, CA. The non-profit facility is run by a group of nuns and has a relatively good reputation in light of the accusations from the families. The nursing home is rated 5 out of 5 stars by Nursing Home Compare, the nursing home rating system managed by the Centers for Medicare and Medicaid Services (CMS). The families contend that physicians at the facility were giving ‘black box’ antipsychotic drugs to their loved ones without obtaining the legally required consent. Black box antipsychotics carry a strong warning of the increased risks of use, including stroke and death, by elderly patients with dementia and dementia-related conditions such as Alzheimer’s.

More Than a Financial Victory

In the lawsuit, the families accused the facility of falsifying consent forms saying they had received approval for use of the drugs, as well as calling family members after the drugs were given to ask them to come in a sign forms approving their use. The attorney for the nuns tells the press that the decision to settle was more about returning their full attention to caring for the residents and less about admitting guilt.

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In a House vote yesterday, H.R. 1215, also known as the Protecting Access to Care Act, passed by an extremely close margin of 218 – 210. With such questionable support, patient advocates and all of us who fight to uphold the 7th amendment (the right to a trial by jury) feel hopeful that Senate Democrats and Republicans will vote against the bill. While the date of a Senate vote is yet to be announced, we cannot stress enough how important it is to continue contacting your Senators to voice your opposition to the bill. To make your voice heard, you can call your members of Congress by visiting www.takejusticeback.com/protectpatients.  Please act now.

Statement from the American Association of Justice on the passage of H.R. 1215 in the House of Representatives:

For Immediate Release 

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A New York Post exclusive article reveals that ManorCare CEO Paul Ormond is demanding to be paid the large bonus he was promised when he agreed to a restructuring of the company in 2007. Ormond is demanding $100 million from the Carlyle Group, the private equity firm that recently ceded ownership of HCR ManorCare amid a Department of Justice investigation for Medicare fraud and rumors of loan default and impending bankruptcy.

In 2007, the Carlyle Group sold the real estate associated with all ManorCare properties to Quality Care Properties for nearly $7 billion. To agree to the sale and restructuring, CEO Paul Ormond was promised $100 million in compensation. While it’s unclear when the package was set to be paid out, Ormond is now demanding the full amount, which ManorCare is in no position to afford. The company, the second largest nursing home chain in the country, has defaulted on its loans and is believed to be heading towards a bankruptcy filing. Regardless of his demands, Ormond will likely receive close to $60 million from a bankruptcy filing.

A bankruptcy filing will mean the closing of some, if not many, of ManorCare’s 500 nursing homes. The chain currently has over 34,000 beds and has been plagued over the years by allegations of poor care. Since 2015, it has been facing an investigation for Medicare fraud, specifically for pushing unnecessary rehab services and then billing Medicare for them, including services that were not performed.

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The Center for Justice and Democracy at New York Law School shared a strongly worded letter to House Speaker Paul Ryan and House Minority Leader Nancy Pelosi speaking out against H.R. 1215. The letter, written on behalf of 80 major public interest organizations, highlights the damages that could result from passing H.R. 1215, the so-called Protecting Access to Care Act. Among the most notable passages is this:

“Even if H.R. 1215 applied only to doctors and hospitals, recent studies clearly establish that its provisions would lead to more deaths and injuries, and increased health care costs due to a “broad relaxation of care.” Add to this nursing home and pharmaceutical industry liability limitations, significantly weakening incentives for these industries to act safely, and untold numbers of additional death, injuries and costs are inevitable, and unacceptable.

The latest statistics show that medical errors, most of which are preventable, are the third leading cause of death in America. This intolerable situation is perhaps all the more shocking because we already know about how to fix much of this problem. Congress should focus on improving patient safety and reducing deaths and injuries, not insulating negligent providers from accountability, harming patients and saddling taxpayers with the cost, as H.R. 1215 would do.”

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After a couple of false starts, H.R. 1215, the Protecting Access to Care Act is going to the House floor this week.  This massive medical malpractice bill also applies to nursing home and drug and device cases.  The bill caps non-economic damages at $250,000, eliminates joint liability for economic and non-economic loss, caps attorney fees, has a restrictive statute of limitations and says that a doctor and a pharmaceutical company cannot be named in the same lawsuit.

This means, among many other things, that finding an attorney to handle a case of nursing home abuse or neglect will be more challenging and that financial compensation for injuries such as pain and suffering cannot surpass $250,000. 

The bill will not get better during floor debate.  The only amendments that will be allowed are amendments that make the bill worse for patients.  The debate on this bill will begin on Tuesday with vote on final passage scheduled for Wednesday. 

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The Des Moines Register recently co-published a report with ProPublica, a public interest group, about the uptick in reports of nursing home employees using social media as a way to share demeaning photos and videos of residents.

After several stories made headlines last year, the Centers for Medicare and Medicaid Services (CMS) called on nursing homes to develop training and policies regarding resident abuse. Specifically, CMS encouraged facilities to educate staff about improper use of cell phones and social media as a means of sharing ‘demeaning or humiliating’ photos and videos. Regardless of the push for facilities to prevent and correct staff members from using Facebook, Instagram, Snapchat and other platforms to share offensive content, the report discovered at least 18 cases of such abuse in the last year alone, with 6 of those in Iowa. The authors note that the number of incidents has increased since 2015 and that the 18 recent cases of which they’re aware are likely just the tip of the iceberg. In all, ProPublica states that they are aware of 65 cases of social media posts of nursing home residents since 2012.

An Increasing Problem

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It looks like trouble for HCR ManorCare. The nursing home giant, the country’s second largest chain, was recently abandoned by the private equity firm that has owned the company for the last 10 years. The firm, Washington, D.C.-based Carlyle Group, had already sold off nearly all of the real estate associated with ManorCare in 2011.

Rumors of problems at ManorCare began over 2 years ago when the U.S. Justice Department filed a lawsuit against the chain for billing Medicare for ‘medically unreasonable and unnecessary services.’ While the chain has attempted to blame the fraudulent charges on a greedy few rather than on a corporate moneymaking scheme, that hasn’t prevented many high level ManorCare executives from leaving the company. Unnamed sources within ManorCare have recently revealed that the company owes close to $400 million to investors for senior loans. Senior loans are particularly important because borrowers are legally obligated to repay this type of debt to a lender before paying any other creditors. In light of these revelations, several vendors have recently abandoned relationships with ManorCare, a sign that the chain’s financial issues are leading to a bankruptcy filing and potential closure of facilities.

ManorCare Well Known but for Many of the Wrong Reasons

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The widow of a Charleston, West Virginia man is suing the nursing home that allowed her husband to allegedly leave the facility without pants in 42 degree weather in March 2015. The widow, Patsy Rowe, alleges that Princeton Center LLC was negligent in its training of staff on how to properly supervise and care for residents suffering from mental disabilities. Due to his elopement from the facility, Mr. Rowe suffered injuries that ultimately led to his death in October 2015.

The case is a sad reminder of the frequency of wandering and elopement from nursing homes. Elopement specifically refers to a resident leaving the facility unnoticed, while wandering refers to the ability of a resident to move freely throughout a facility without adequate supervision. Both instances can be tragic for a resident who suffers from limited physical or mental capabilities. Nursing homes and care facilities are directly responsible for the supervision of its residents and are required to meet the specific needs and care requirements of each person. Oftentimes, lack of staff and improper training on safety measures are to blame for a resident being able to wander through or altogether leave a facility.

The Chicago, Illinois nursing home abuse and neglect attorneys of Levin and Perconti have successfully handled numerous cases of wandering and elopement from facilities, including a $1 million verdict for the family of a woman who wandered unnoticed from her room and died from a 5th story fall from a window in her nursing home.