Nursing Home Abuse Lawyer Blog

Judith C. Dexter, a Tennessee nursing home administrator, has been found unfit or incompetent as a nursing home administrator due to negligence or other reasons. Ms. Dexter was fined $500 and ordered to submit proof of her eighteen continuing education hours for 2007 and an additional nine hours. She allegedly failed to comply with the state Board of Nursing Home Administrators continuing education requirements.

Asta Care Center of Rockford is a 130 bed nursing home facility located in Rockford, Illinois. This facility is rated as a one-star nursing home according to the new system instituted by The Centers for Medicare & Medicaid. A one-star rating is the lowest rating possible and represents a below average facility. While the average number of health deficiencies for the State of Illinois is eight, this nursing home has consistently attained a higher deficiency rate. For the complaint reporting period of July 1, 2007 through September 30, 2008, this facility had forty-five deficiencies. For the complaint reporting period of July 1, 2006 through June 30, 2007, there were sixteen deficiencies and for the complaint reporting period of July 1, 2005 through June 30, 2006, there were fourteen deficiencies.

All nursing home residents have the right to be treated with dignity and respect by the facility staff and other residents. The facility staff is obligated to develop and implement written policies and procedures that prohibit abuse, mistreatment, and neglect of the residents. At Asta Care Center, a CNA was heard yelling and screaming at a resident and told the resident if she wet her pants that she could just sit in it. The CNA was moved to a different area in the facility and allowed to finish her shift. She was terminated the next day. Facility staff were in-serviced on the Facility Abuse Prevention policy and Abuse Prevention Procedures.

Each resident at a nursing home facility must receive the necessary care and services to attain the highest well-being possible. The facility failed residents in this regard. One resident underwent bilateral amputations above his knees. The resident suffered severe pain and developed an infection, yet the facility failed to respond to his needs. The resident first complained of pain in his right stump. Three days later, it was noted that the stump was red and purple with purulent bloody drainage that had a very foul odor. There was no nursing assessment of the surgical site for the first fourteen days. By the time Asta Care Center's staff fully assessed the resident, his surgical wounds were gangrenous and septic. He subsequently required hospitalization and intervenous antibiotic treatment. The nurses caring for this resident were in-serviced one-on-one on the need to assess and document surgical sites on each shift and respond to concerns raised by family members. Nursing staff was in-serviced on proper wound care techniques and the need to document and assess the wounds. In another instance, five residents either did not receive the appropriate dose of insulin or did not receive insulin at all and did not receive the appropriate testing. Facility staff were in-serviced on accucheck testing and sliding scale insulin administration and to check blood sugar levels as required. They were instructed to document the blood sugar levels and document the administration of medication.

Nursing home facilities are required to provide medically-related social services to attain or maintain the highest well-being of each resident. This need was not met for at least one resident of Asta Care Center. The resident vocalized a desire to leave the facility and was told by a facility staff member that he could not. No post-discharge plan had been completed and no assessment had been performed to determine if the resident was capable of signing himself in or out of the facility and no pass privileges had been extended to the resident. The facility in-serviced its staff on facility post-discharge plan of care policy and reviewed each resident’s file to ensure that a post-discharge plan of care is on file. The facility met with the resident and the resident’s legal representative to discuss pass privileges and the appropriateness of pass privileges.

All nursing home residents have the right to choose a personal attending physician. Asta Care Center failed to allow a new resident to choose her own physician. In at least one instance, a resident’s Physician Order sheet indicated that the resident’s physician was to be the Medical Director of the facility. However, the resident had never been provided a list of physicians nor had she chosen the Medical Director as her physician. As a result of this failure, the facility was required to provide a list of physicians for the resident to choose from and she chose a physician. Further, a letter was sent to the residents and their families advising that they had the right to choose a physician or be seen by the facility Medical Director.

It is important that Physician Orders be present in a resident’s file upon admission to the facility for immediate care. Because there were no Physician Orders present when a resident was admitted, a registered nurse took medications off of an office encounter document that was approximately two months old and used it as admission orders. The Registered Nurse was given a written warning for using improper information. Nursing staff was in-serviced for the facility policy that requires nursing staff to provide and use the transfer sheet from the hospital as a basis for determining the transferring physician’s orders. Staff was advised that it was improper to provide medication information from an earlier doctor’s visit to the resident physician.

All nursing home residents should have an accurate Care Plan in place and the Care Plan should be reviewed and revised on a regular basis. Without an accurate Care Plan, the facility is unable to meet the medical, nursing, and mental needs of its residents. Reportedly, Asta Care Center failed its residents in this respect when it failed to develop a hydration care plan for a resident and develop an interim care plan for a resident on dialysis. Nursing staff was in-serviced on new care plans and the need to follow the approaches and interventions mentioned in the care plans. Nursing staff has further been in-serviced to review each resident’s hydration risk.

Nursing homes are required to timely report any changes in a resident’s condition to the appropriate parties. Asta Care Center failed to inform a resident’s representative of the resident’s fall for seven and a half hours. In another instance, a resident’s legal representative was not notified of a resident's fall until an hour after the fall and only after a facility staff member took her break. Facility staff members were given written warnings for their tardiness in reporting two falls suffered by a resident to the resident’s legal representative. Nursing staff were also in-serviced on proper reporting procedures.

Nursing home facilitiesr must not employ individuals who have been found guilty of abusing, neglecting, or mistreating residents. A CNA at the Asta Care Center facility failed to report allegations of verbal and/or mental abuse towards a resident to a supervisor and the facility failed to notify the Illinois Department of Public Health of the alleged abuse within 24 hours. A resident wanted to leave the facility. An activity aide held the door shut with his foot and held on to the resident. The resident vocalized a partial threat against the resident. The resident had bruising on his arms. The employee received a written warning and one-on-one in-servicing on verbal abuse and the requirement that the abuse MUST be immediately reported per facility policy. Nursing staff was in-serviced on the facility abuse policy and the need to promptly report abuse to a supervisor.

All residents should be kept free from unnecessary drugs. Unnecessary drugs would include excessive dosages, excessive durations, inadequate monitoring, and adverse consequences. At Asta Care Center, a resident was given medications that were not to be continued after he transferred to the facility and the facility failed to clarify why the resident was receiving those medications. The facility also incorrectly transcribed a medication dose. While on these medications, the resident exhibited anxiety, verbal and physical abuse, and strange behavior. The facility reviewed the medical orders for the resident with his physician to ensure medications and dosage amounts were correct. In-servicing was performed for facility staff to ensure that corrected medical orders to ensure that residents receive medications as ordered and to ensure that staff obtains informed consent for use of psychotropic drugs, to ensure the diagnosis is documented to support the use of the drugs, and to ensure the Care Plan reflects the need to use psychotropic drugs. Additionally, this facility failed to ensure its residents were free of any significant medication errors and the facility’s failure resulted in an immediate jeopardy situation for a resident. The resident had become lethargic and unresponsive. The resident was transferred to the emergency room, where emergency room personnel found two Fentanyl patches on her body and she had been administered morphine. The Fentanyl had been discontinued by the resident’s doctor. Facility staff were in-serviced on how to reduce medication errors and on the requirement that old medical patches must be removed before new patches are applied. Each resident using body patches must undergo a body check before new patches are applied.

The Terry Law Firm is experienced in handling cases of nursing home abuse and neglect. For more information, call us directly at 1 (888) 317-2525 or visit our website at www.nursinghomejustice.com.

Cumberland Manor Nursing Center is a 124 bed nursing home facility located in Nashville, Tennessee. This facility is rated as a one-star nursing home according to the new system instituted by The Centers for Medicare & Medicaid. A one-star rating is the lowest rating possible and represents a below average facility. The average number of health deficiencies for the State of Tennessee is seven. In 2005, Cumberland Manor was right at the Tennessee average with seven deficiencies. In 2006, Cumberland Manor received nine deficiencies. However, in 2007, the most recent year available, Cumberland Manor ballooned to twenty-six deficiencies.

All nursing home residents have the right to be treated with dignity and respect by the facility staff and other residents. The facility is obligated to hire only people with no legal history of abusing, neglecting, or mistreating residents and to report any acts of abuse or neglect immediately. Cumberland Manor residents were placed in immediate jeopardy when the facility failed to adhere to these policies. The facility also failed to protect each resident from abuse, physical punishment, and caused actual harm to the residents.

Each resident at a nursing home facility must receive the necessary care and services to that meet a professional standard of quality and the highest possible quality of life. According to these survey reports, the facility failed residents in this regard. Several examples include, the facility failing to provide professional services that adhere to each resident’s Care Plan, have enough nurses to care for the residents, make sure each resident entering the facility does not receive a catheter unless absolutely necessary, and provide proper treatment to residents with feeding tubes to prevent problems. The facility also failed to develop a complete Care Plan for each resident that meets all of the resident’s needs and check and update that Care Plan every three months. The facility caused residents actual harm when staff did not do an assessment of each resident each year and did not perform a new assessment after a major change in a resident’s physical or mental health.

The rights of Cumberland Manor’s residents were violated when the facility failed to keep each resident’s personal and medical records confidential, listen to the resident or the resident’s family or act on their complaints or suggestions, and provide care in such a way that keeps or builds the resident’s dignity and self-respect.

All food served to nursing home residents should be appetizing, nutritional, tasty, and attractive and served at the proper temperature. Cumberland Manor failed to provide food according to those guidelines and failed to store, cook, and give out food in a safe and clean way. The facility also failed to provide needed housekeeping and maintenance and make sure that the nursing home area is free of dangers causing accidents.

All residents should be kept free from serious medication errors. Serious medication errors can result in sickness and even death. Cumberland Manor did not achieve that goal for its residents. The facility also failed to have a licensed pharmacist check the drugs that each resident takes at least once a month and to have drugs and other similar products available which are needed daily and during emergencies and to give them out properly.

The Terry Law Firm is experienced in handling cases of nursing home abuse and neglect. For more information, call us directly at 1 (888) 317-2525 or visit our website at www.nursinghomejustice.com.

We discussed the tragic abuse of Thelma Bryant at Kane Regional Center's Glen Hazel facility in our previous blog. Mary Ann Bower has been charged with harassment for throwing objects at Ms. Bryant and pouring water on her head. Her four nursing assistants, Danielle Taylor, Shelly Keene, Karen Perry, and Shalaya Hatten, are accused of assaulting Ms. Bryant by elbowing her in the chest, punching her in the eye, stomping on her feet, and throwing whole oranges at her face.

Allegedly, one of the accused abusers, Shalaya Hatten, previously pled guilty to two harassment charges stemming from two separate incidents when she worked for Allegheny County. Hatten was charged with misdemeanor simple assault in 2003 and felony aggravated assault in 2005. She pled guilty to lesser harassment charges in both incidents. More information concerning the incidents was not readily available at this time.

Hatten is accused of elbowing and swearing at the Alzheimer's patient. According to one witness, she cursed at Ms. Bryant and then put her elbow into Ms. Bryant's chest and pushed hard for up to a minute. The witness alleges that this happened at least twice.

The Summerville at Potomac nursing home in Potomac, Maryland was slapped with a $10,000 fine and has been banned until further notice from accepting new patients after a survey revealed very serious violations in state and federal regulations. In fact, the violations were so serious, the Director of the Department of Health and Mental Hygiene's Office of Health Care Quality said, "These are very serious violations. We do not see them routinely." She went on to say, "We do not direct a plan of correction routinely."

The facility must complete a six-point "directed plan of correction" issued by the Department of Health and Mental Hygiene after a November survey uncovered improperly cared for pressure sores, mismanaged medications, no intervention for patients at risk for falls, and failure to report excessive weight gain and loss. Many of the problems were attributed to the lack of a delegating nurse. A delegating nurse is a registered nurse who monitors patient care and issues patient care directives to the staff. A delegating nurse is to visit the facility every 45 days, but at Summerville, no delegating nurse had been at the facility since August.

The residents' conditions were poor. One woman was suffering from an infected pressure sore that emitted a foul odor and greenish-yellow discharge. Another resident gained 49 pounds in four months and the weight gain was not reported to a physician. Another resident fell nearly ten times and no fall prevention plan was put into place. Another resident did not receive any pain medication during wound treatment. Residents on pureed diets were fed food in which all items were mixed together, rather than separately.

The six-point "directed plan of correction" orders Summerville to appoint a full-time registered nurse, examine the skin of each patient and report findings, enlist a wound-care specialist to address ulcer concerns, operate under a monitor that will report to officials, and to advise residents and their families of the poor survey result.

Dean Cole walked into Golden Living Center Greeley in Stillwater, Minnesota. Twenty-one days later, he was carried out - severely dehydrated. He died a few weeks later. He was only 71.

Allegedly, facility staff did not properly care for Mr. Cole and he lost twenty pounds in twenty days while a resident of Golden Living Center Greeley. He literally ran out of fluid, his kidneys shut down, and his brain ceased functioning. Nursing notes reflected that staff knew he wasn't eating stating:

- Resident picks at food
- Needed to be fed for supper
- Not eating well
- Resident refusing to eat

Sadly, one note did prove that he would eat. When engaged in conversation with a nurse, he ate 75% of his meal.

Golden Living Center Greeley is rated with three out of five stars according to the new rating system instituted by The Centers for Medicare and Medicaid.

Thelma Bryant, 94, did not deserve the abuse she suffered at the hands of a nursing home supervisor and four nursing home employees. Ms. Bryant suffers from Alzheimer's disease. She is wheelchair-bound and unable to care for herself. Reportedly, Ms. Bryant was abused for at least six months until it was reported by another employee in October 2008. There was no explanation for why only Ms. Bryant was singled out for abuse at Kane Regional Center's Glen Hazel 210 bed facility.

Mary Ann Bower was the licensed practical nurse in charge of the second-floor unit at the Glen Hazel facility, which specializes in care for Alzheimer's and dementia patients. She has been charged with harassment for throwing objects at Ms. Bryant and pouring water on her head. Her four nursing assistants, Danielle Taylor, Shelly Keene, Karen Perry, and Shalaya Hatten, are accused of assaulting Ms. Bryant by elbowing her in the chest, punching her in the eye, stomping on her feet, and throwing whole oranges at her face. Their preliminary hearings are scheduled for January 5, 2009.

A worker from another unit witnessed the abuse and reported it to hospital administrators on October 30, 2008. Yet, the abuse continued until at least a day after the abuse report when Shelly Keene allegedly stomped on Ms. Bryant's foot while passing by and then struck her on the forehead when she returned. Another witness heard Ms. Bryant cry out, "Ouch, you're hurting me." The women were suspended without pay pending an investigation and all were eventually fired.

The Glen Hazel facilty received three out of five stars in the nursing home rankings released recently from The Centers for Medicare and Medicaid.

The Terry Law Firm is experienced in handling cases of nursing home abuse and neglect. For more information, call us directly at 1 (888) 317-2525 or visit our website at www.nursinghomejustice.com.

Crestview Nursing Home, Inc. is a 111 bed nursing home facility located in Nashville, Tennessee. Crestview Nursing Home is rated as a two-star nursing home according to the new system instituted by the The Centers for Medicare and Medicaid.

Nursing homes are required to provide professional services that meet a professional standard of quality and meet the needs of the residents and follow each resident's Care Plan. According to the latest government surveys available, Crestview Nursing Home failed its residents when it did not provide such services. The facility also did not provide social services related to medical problems to help each resident achieve the highest possible quality of life. This facility also failed to provide the proper care for residents needing special services, such as injections, colostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses. Residents were placed in actual harm when facility staff failed to provide the right treatment and services to residents who have mental or social problems adjusting. Other quality care deficiencies that were discovered at Crestview Nursing Home were failing to ensure that each resident entering the nursing home without a catheter was not given one and failing to ensure that each resident's nutritional and social activity needs were met.

Ensuring that there are current assessments on file for each resident is crucial for the proper care of the resident. Without current assessments, residents will not receive the care that is presently needed. Crestview Nursing Home failed to make sure that all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them. The facility also failed to check and update the assessment every three months.

Medication errors can lead to a multitude of medical issues and even death. Medication erors occur when a resident is given too much or too little medication. Medication errors also occur when a resident is given the wrong medication or no medication at all. Crestview Nursing Home failed to keep the rate of medication errors below 5% for the last two years.

Nursing home residents are entitled to make decisions for their care as long as they are able to do so. This facility failed its residents in that respect. The facility failed to allow each resident to choose whether or not the resident wanted to manage his or her own money or deposit it with the nursing home. Facility staff also failed to advise the residents about what Medicaid benefits are available to them, what Medicaid will pay for and what the resident will have to pay for, and how to apply for Medicaid. Facility staff also failed to keep each resident's medical and personal records confidential and to listen to the resident or family groups and to act on their complaints or suggestions.

A nursing home resident's safety is paramount. For the past two years, this facility has failed to make sure that the nursing home area is free of dangers that cause accidents. The facility did not provide needed housekeeping and maintenance.

The Terry Law Firm is experienced in handling cases of nursing home abuse and neglect. For more information, call us directly at 1 (888) 317-2525 or visit our website at www.nursinghome justice.com.

Healthcare at Foster Creek, a nursing home located in Portland, Oregon, faces a $2 million lawsuit for a sexual assault that allegedly occurred between its residents. Marko Chandler, 68, was charged with sexual abuse and unlawful sexual penetration for his role in the alleged abuse of a female resident in April 2008. He has been found unfit to stand trial and has been committed to a hospital's mental health unit. Both residents suffered from dementia, although Chandler's dementia was of a lesser degree than his victim's.

This situation is one that could have been prevented. Staff members had seen the female resident standing in a room half-naked with Chandler approximately five days before a worker caught him molesting the woman. Facility staff failed to take any action other than to put her pants back on.

The lawsuit alleges that the facility was the recipient of 38 substantiated complaints of abuse or neglect during the course of the victim's residency at Healthcare at Foster Creek. Healthcare at Foster Creek is rated at two out of five stars, or well below average, in the new rating system instituted by The Centers for Medicare and Medicaid.

The Terry Law Firm is experienced in handling cases of nursing home abuse and neglect. For more information, call us directly at 1 (888) 317-2525 or visit our website at www.nursinghomejustice.com.

Muncie Grimes

No one knows what prompted the fight. All anyone knows is that 69 year-old Levi Montgomery is dead. The fight occurred at Countryside Villa, an 80 bed facility located in Stokesdale, North Carolina. Muncie Grimes, 60, has been charged with second-degree murder in Mr. Montgomery's death. No details about the incident are being released at this time. Inspectors from the state's Division of Health Service Regulation are investigating.

Reportedly, records from the Division of Health Service Regulation show that the facility has not received any fines for operating violations. The records show that there have been medication errors. The last facility inspection was performed in April 2008.

Bordeaux Long Term Care is a 419 bed nursing home facility located in Nashville, Tennessee. For the past two years, Bordeaux Long Term Care's inspection deficiency record has consistently remained poor. Bordeaux Long Term Care received eighteen deficiencies in 2008 and twenty deficiencies in 2007. The average number of nursing home deficiencies in Tennessee is seven and nationwide, the average number of deficiencies is nine. Currently, Bordeaux Long Term Care is rated as a one-star nursing home according to the new system instituted by The Centers for Medicare and Medicaid.

Federal regulations require nursing home facilities to report all alleged violations of abuse, neglect, or mistreatment, whether it be from staff or from another source. According to state surveys, Bordeaux Long Term Care repeatedly failed its residents in this area. On more than one occasion, the facility failed to write and use policies that forbid mistreatment, neglect, and abuse of residents and theft of residents' property.

Bordeaux Long Term Care has received multiple Quality of Care deficiencies over the past two years. The facility failed its residents when it did not provide professional services that meet a professional standard of quality and/or that met the resident's written Care Plan. The services provided did not get or keep the highest quality of life possible for the resident. Residents were not provided proper treatment to prevent bed sores or heal existing pressure sores and the facility failed to make sure that residents entering the facility without a catheter were not given a catheter unless necessary. The facility was also cited for failing to have enough nurses to care for the residents in a way that maximized their well-being. Insufficient staffing is a common method nursing home residents use to save money. Unfortunately, it has a direct correlation to increased poor care.

Bordeaux Long Term Care failed its residents when it did not develop a complete Care Plan within seven days of admission and prepare a Care Plan with a care team. The facility also failed multiple times to perform a new assessment after a major change in a resident's physical or mental health. Following a designated Care plan is a critical element in a resident's care. Failing to update the Care Plan means the residents latest needs are not being met.

All nursing home residents deserve to be treated with respect and in a way that builds their dignity and self-respect. Bordeaux Long Term Care repeatedly failed its residents in the area of resident rights. Bordeaux Long Term Care did not immediately inform appropriate individuals of a major change in a resident's condition, did not provide its residents with a private telephone to use, and did not keep each resident's personal and medical records private and confidential. The facility also did not watch closely that residents who take drugs were not given to many doses or stop or change the drugs if undesired effects were caused. The facility also failed to keep its rate of medication errors to less than 5%.

A nursing home facility needs to be a safe and clean environment for its residents. Bordeaux failed its residents when it did not keep the nursing home area free of accidents, provide necessary housekeeping, and ensure a program is in place to deal with and prevent mice, insects, or other pests.

The Terry Law Firm is experienced in handling cases of nursing home abuse and neglect. For more information, call us directly at 1 (8880 317-2525 or visit our website at www.nursinghomejustice.com.

Ninety-five year old Fannie Mae Rooks was found dead in her wheelchair in an outside smoking area early Wednesday morning in cold, rainy 40 degree weather. Ms. Rooks, a resident of Northgate Park Nursing Home in Florissant, Missouri, was last seen around 9:00 p.m. on Tuesday, December 23, 2008 after being given her medications. Staff alleges that Ms. Rooks must have wheeled herself outside, but her son, Eugene Rooks, said she was too frail to do that and she would not have been able to pull open a heavy door - and she was a nonsmoker.

Preliminary reports from Ms. Rooks' autopsy showed that the death was weather-related. Ms. Rooks did not have Alzheimer's disease or dementia and was alert. She had lived in a nursing home for approximately six years in the assisted living portion of the campus. About two weeks ago, she needed more care and her family moved her to Northgate.

Northgate recently received a one-star rating from The Centers for Medicare and Medicaid Services. The score was based upon inspections of the facility, staff-to-patient ratio, and quality of care issues, such as percentage of residents developing bedsores. The facility, owned by CommuniCare Health Services, has said it is cooperating with investigating authorities. Florissant Police Chief Bill Karabas said "It's a sad case, maybe neglect."

Amberwood Care Center is a 155 bed nursing home facility located in Rockford, Illinois. For the past three years, Amberwood Care Center’s inspection deficiency record has consistently remained poor. Amberwood Care Center received twenty-three deficiencies in 2007, twenty-eight deficiencies in 2006, and fifty-one deficiencies in 2005. The average number of nursing home deficiencies in Illinois is eight. Currently, Amberwood Care Center is rated as a one-star nursing home according to the new system instituted by the Centers for Medicare and Medicaid.

Pressure sores are a well-known risk for bed-bound nursing home residents. Improper treatment of pressure sores, also known as bed sores, can result in severe infection and possibly death. According to the government surveys, Amberwood Care Center placed its residents at risk in this area. A resident exhibited signs of a possible coccyx pressure sore beginning in February 2008. By July 2, 2008, the resident had developed a coccyx pressure sore, which had reached a Stage II status with drainage. On July 10, 2008, a wound care nurse noted that the coccyx pressure ulcer was “unstageable” with a large amount of drainage and 70% thick yellow tissue. On July 16, 2008, the physician notes indicated that a Staph A infection was present in the resident’s wound. Another resident, dependent upon staff for all activities of daily living, had a Stage II pressure sore on her coccyx and Stage IV pressure ulcer. One morning, she was found sitting in her wheelchair, even though she wanted to go back to bed, and was asked if she had a cushion in her wheelchair. She responded, “I don’t have a cushion. It would be nice. I wish I had one.” Later in the day, the resident was seen still sitting in her wheelchair and said, “My butt hurts a little. I have a sore on my butt because they (the facility Certified Nurse Assistants) fool around so much.” The resident was taken to bed and found to have a wet diaper, which can worsen an existing pressure sore and also cause potentially lethal infections. The resident’s Care Plan required repositioning every two hours, incontinent care every two hours, and a pressure relieving cushion when needed. The facility’s own Skin Ulcer Management Protocol policy indicated that residents with Stage II pressure sores on their buttocks, sacrum, or hip were to receive a wheelchair cushion and provide good incontinence care checks every two hours. The nursing staff was in-serviced on pressure ulcer prevention, including using an appropriate wheelchair cushion and reducing pressure off the affected area through repositioning. Staff was in-serviced on proper interventions to control or eliminate friction and shearing forces to a coccyx as well as interventions to prevent infection. The facility’s Director of Nursing was ordered to monitor compliance through random walking rounds to ensure high risk residents were using appropriate wheelchair cushions and being repositioned as needed. To see pictures of the four stages of pressure sores, to go Terry Law Firm, L.L.C.

Nursing home facilities are required to report all alleged violations of abuse, neglect, or mistreatment, whether it be from staff or from another source. During this time period, Amberwood Care Center failed to protect its residents from abuse from other residents. In one instance, a seventy year-old resident became involved in a physical fight with another resident. The resident suffered injuries to his left jaw and had bruising and swelling down his neck. The facility staff had to be in-serviced on the investigation procedure for allegations of abuse, including resident-to-resident altercations and on proper assessment, notification, and documentation of injuries. The facility Safety Committee was instructed to review resident-to-resident altercations at least monthly to ensure procedures were being followed. Staff was in-serviced on completing Behavior Tracking Sheets on residents exhibiting undesirable behaviors. Care Plans are to be reviewed quarterly by the Social Service Director for residents with history of aggressive behaviors to ensure appropriate precautions are in place. Handouts about recognizing warning signs of aggressive behaviors were placed in employee areas for review.

For the safety of all facility residents, certain types of medications, such as Morphine Sulfate, Fentanyl, and Oxycodone, are stored in a double lock container with a key that cannot access any other medications. The facility placed multiple residents in jeopardy when it failed to follow the necessary storage procedures for Schedule II medications. The key locking the Schedule II medication container could also open the discontinued medications storage container.

Care Plans must be in place for each facility resident to meet the resident’s medical, nursing, mental, and social needs and to maintain the highest possible well-being. The facility failed its residents when two residents were involved in a physical altercation at the facility. One resident had not been assessed as being at risk for abuse or for being abusive others and the resident’s Care Plan had not been updated to compensate for the resident’s behavior. Staff was in-serviced on completion of Behavior Tracking Sheets for residents when exhibiting undesirable behaviors. Care Plans were to be reviewed quarterly for residents with history of aggressive behavior to ensure appropriate interventions are in place.

Many nursing home residents rely on facility staff for many, if not all, activities of daily living. Facility staff members are required to provide necessary services to maintain good nutrition, grooming, and personal and oral hygiene. Sadly, residents at Amberwood Care Center did not receiving the treatment they needed or deserved during this time period. One resident’s toenails were yellow, very thick, and long – so long that they actually curled under the edges of his toes. His feet were also dry and cracked. The resident was noted to be noncompliant at times for his personal care, but no one at the facility adjusted the resident’s Care Plan with individualized approaches to address his behavior and needs as required by law. Facility CNAs had to be in-serviced on resident behavior interventions and a facility audit conducted to ensure resident foot care needs were being met.

Certainly accidents are a source of concern at nursing home facilities. While some accidents may not be preventable, most accidents are preventable if the residents are properly supervised. A resident with decreased cognition and awareness began repeatedly falling and suffering from confusion. The resident’s Care Plan was not updated to identify that the resident was a fall risk nor did it provide any fall prevention approaches. Facility staff were instructed to review the resident Safety Assessments to identify other fall-risk residents. An Interdisciplinary Team was instructed to review all accidents and incidents on a regular basis to ensure Care Plans are current and applicable. Nursing staff received in-service instruction for approaches to fall prevention and supervision to prevent accidents.

Keeping nursing home residents involved and active is important for their mental and physical well-being. In at least one instance, Amberwood Care Center failed a resident in this regard. The resident, who has a history of aggressive behavior and was often to be socially isolated, withdrawn, and depressed, was assessed as having leadership abilities, liking to help others, and was interested in volunteering at the facility. Sadly, he was allowed to remain in his room and the facility failed to provide any activities for him. The state ordered the Activities Director to in-service Activity Assistants on offering residents room activities if the resident opts not to attend group activities and to use participation sheets to document attendance at group activities. The Activities Director was instructed to review activity leisure assessments and Care Plans on a quarterly basis to ensure that interventions were in place should residents choose not to participate in group activities.

The Terry Law Firm is experienced in handling cases of nursing home abuse and neglect. For more information, call us directly at 1 (888) 317-2525 or visit our website at www.nursinghomejustice.com.

Bethany Health Care Center is a 189 bed nursing home facility located in Nashville, Tennessee. In the past three years, Bethany Health Care Center's inspection deficiency record has steadily increased. Bethany Health Care Center received three deficiencies in 2006, four deficiencies in 2007, and five deficiencies in 2008. Currently, Bethany Health Care Center is rated as a three-star nursing home according to the new system instituted by the Centers for Medicare and Medicaid.

Bethany Health Care Center has repeatedly been cited for Quality of Care deficiencies. In the past three years, the facility has been cited for failing to provide professional services that follow written Care Plans, failing to ensure that each resident entering the facility without a catheter is not given a catheter unless necessary, and failing to provide professional services that meet a professional standard of quality. The facility has also been cited for failing to ensure that residents not able to care for themselves receive treatment or services so they may continue to care for themselves and failing to make sure that residents with reduced range of motion get proper services to increase their range of motion.

Bethany Health Care Center has been cited concerning Care Plans. The facility has failed to develop a complete Care Plan within seven days of admission and has failed to update the assessment after a major change in the resident's physical or mental health.

Proper nutrition is vital for nursing home residents as is cleanliness. Bethany Health Care Center received a deficiency citation for failing to store, cook, and distribute food in a safe and clean way. Bethany Health Care Center is required by law to ensure that the nursing home area is free of dangers that cause accidents. In at least one instance, this facility failed to protect its residents in this category and experienced an incident that caused actual harm to some residents. As a result of this failure, Bethany Health Care Center received a deficiency citation.

Johnathan Russell was recently charged with molestation of an elderly nursing home resident. The 70 year old resident lives at Boynton Beach Assisted Living and suffers from dementia. Russell, who is believed to be a resident of the facility, admitted sexually assaulting the victim. The sexual assault was discovered when the elderly resident had been taken to Bethesda Hospital for a slip and fall incident. To read the police report involving the sexual assault, go to Russell Police Report.

Alden Park Strathmoor is a 189 bed nursing home facility located in Rockford, Illinois. In the past two years, Alden Park Strathmoor's inspection deficiency record has surpassed the average number of health deficiencies in Illinois. Alden Park Strathmoor received fourteen deficiencies in 2008 and twenty-seven deficiencies in 2007. The average number of nursing home deficiencies in Illinois is eight. Currently, Alden Park Strathmoor is rated as a one-star nursing home according to the new system instituted by Centers for Medicare & Medicaid.

According to the survey reports, Alden Park Strathmoor failed to protect its residents from mistreatment, neglect, and/or theft of personal property, including at least one Level 4 "Immediate Jeopardy" deficiency. An "Immediate Jeopardy" deficiency is a situation where a resident has been placed in danger. In that instance, a fifty-five year old resident suffering from respiratory failure, chronic obstructive pulmonary disorder, acute renal failure, schizophrenia and bipolar disease was denied a respiratory treatment after running out of oxygen. The tank was empty all night and when the resident asked the nurse for a new tank and respiratory treatment, the nurse told the resident, "I'm not doing anything for you if you don't take a shower." It was 1:00 a.m. and the resident did not want to shower in the middle of the night. The resident called 911 for help. The nurse justified her callous treatment of the resident because he was using profanity and had a very offensive body odor. She did not know how long the resident had been out of oxygen. This resident had a provision in his Care Plan to assist with his resistance to care and the nurse delibrately failed to follow it. This nurse also failed to assess the resident's condition after receiving the information that he was out of oxygen and seeing that he was having difficulty breathing and his skin was pale. The facility had to perform in-service training for its employees' on its own abuse policy and procedure and neglect through withholding of treatment. The Administrator is now required to monitor compliance through resident interviews.

Care Plans must be developed for each resident to meet the resident's medical, nursing, and mental needs. The Care Plan must be routinely assessed and updated to reflect the resident's ongoing needs. Alden Park Strathmoor failed to keep an updated Care Plan in place for a resident that had a left arm PICC line. The Care Plan did not reflect the length of time that the PICC line was to remain in the resident's arm.

Pressure sores are always a concern for bed-bound residents and, if not monitored closely and timely treated, can result in death. At Alden Park Strathmoor, facility staff improperly provided perineal care after a patient's incontinence episode. The patient, completely dependent upon facility staff for all activities of daily living, was washed with bath soap that had been added to water in the water basin. Staff failed to rinse soap from the skin prior to drying the area. No protective barrier was applied to the perineal area before cleaning the rectal-coccyx area. The CNA performing the task advised inspectors that she usually used a second basin to rinse, but failed to do so in this case. The facility was forced to provide additional in-service training for its staff in perinal care, pressure sore prevention, and the healing and treatment of pressure sores.

Proper assessment and documentation of pressure sores is vital to the care and treatment of the affected resident. If the nursing home fails to submit correct information, the resident will continue to go without proper care. In one instance, a resident informed a state inspector that he had two pressure sores on his backside. When the resident's dressings were removed, it was determined that he actually had three pressure sores. The wound care notes only noted one pressure ulcer.

Every nursing home resident is entitled to care and services to ensure the highest level of well-being attainable. Alden Park Strathmoor failed its residents in this area. A resident at the facility tripped over another resident's feet and suffered a head injury. The resident's eye was swollen and discolored and the resident was treated for pain. The resident was monitored for a few days. Seven days after the injury, the resident was lethargic and non-responsive and was sent to the hospital for evaluation. The resident had suffered a massive intracranial hemorrhage with layering of blood. Another resident, suffering from ovarian cancer, was not provided the appropriate medication prior to receiving a chemotherapy treatment and the chemotherapy had to be rescheduled. Facility staff had to be in-serviced on the appropriate procedure to follow regarding accident reporting, which included monitoring resident. Nurses had to be in-serviced regarding carrying forward recurring medication orders from previous months to current month.

Notification of changes in mental or physical condition is important for nursing home residents, especially if the resident is unable to make decisions concerning care. A fifty-seven year old resident was having problems with regurgitation and required frequent suctioning. His tube feeding was shut off to allow his stomach time to calm down. The resident's wife was not informed of his change in condition until the following day, even though there was a note on the front of the chart to notify her of all changes in condition. One diabetic resident suffered from repeated problems with her sugar surging up and down. She fell after tripping over another resident's feet and sustained injuries to her right eye. She complained of pain the next day and her eye was discolored and swollen. Approximately seven days after her fall, there were problems rousing her and she was sent to the hospital, where any intracranial hemorrhage was diagnosed. The Power of Attorney was not called, just her local family. Facility staff had to be in-serviced on what appeared to be obvious signs of resident changes in condition and the facility's very own policy.

Proper nutrition is vital for nursing home residents. In a five month period, one Alden Park Strathmoor resident lost over eleven pounds without any intervention. Another resident had lost over five pounds in a two month period and that resident's weight was supposed to be monitored. Facility staff had to be in-serviced concerning the facility's weight policy, which includes notifying a nursing supervisor or other person in charge concerning weight loss. The Director of Nursing was instructed to oversee and monitor the residents' weight.

As with any other nursing home, Alden Park Strathmoor is required to provide medically-related social services to attain the highest level of well-being for each resident. The facility failed miserably when it failed to assist a resident suffering from ovarian cancer in getting her oncology and surgical referral appointments and failed to ensure that abdominal and pelvic CT scans were performed per physician orders. The facility advised that there was no transportation for the resident to make multiple local appointments. The facility had to in-service its nurses and Social Service Designee regarding how to arrange transportation for residents.

Alden Park Strathmoor is required by law to provide housekeeping services to maintain a sanitary, orderly, and comfortable facility. The facility failed to maintain a refrigerator temperature to avoid freezing the contents, failed to store resident and staff food in an organized and clean manner, and failed to label and date refrigerator contents. The refrigerator temperature was twenty degrees Fahrenheit. Food and other items on the shelves were cluttered and disorderly and dirt was found on shelves and on the bottom of the refrigerator. Refrigerator items were not labeled with resident names or dates. Additionally, multiple soap dispensers in the facility were non-operational in a facility that had ten residents in isolation for communicable diseases and at least two residents with MRSA infections. Facility department managers had to complete rounds to ensure that refrigerators were kept clean, kept at the correct temperature, and ensure that the contents were clearly labeled. In-service instruction was held concerning reporting broken or non-functioning equipment.

The Terry Law Firm is experienced in handling cases of nursing home abuse and neglect. For more information, call us directly at 1 (888) 317-2525 or visit our website at www.nursinghomejustice.com.

Belcourt Terrace Nursing Home is a 49 bed nursing home facility located in Nashville, Tennessee. In the past three years, Belcourt Terrace Nursing Home's inspection track record has grown increasingly worse. Belcourt Terrace received six deficiencies in 2005, ten deficiencies in 2006, and twelve deficiencies in 2007. The average number of nursing home deficiencies in Tennessee is seven. Currently, Belcourt Terrace is rated as a two-star nursing home according to the new system instituted by the Centers for Medicare & Medicaid.

Quality of care deficiencies appear to be a problem at this facility. In fact, according to the government surveys, residents were not provided care and services necessary to keep the highest quality of life possible and were actually harmed by this behavior. In this area, facility personnel also failed to provide professional services that met a standard of quality.

Current and accurate Care Plans are vital for nursing home residents to receive the care that they need and deserve. Upon a resident's admission, a Care Plan is to be completed within seven days of admission and is to be prepared with a care team that consists of a primary nurse, doctor, and resident or resident family. Belcourt Terrace has been cited for problems with its Care Plans. The facility failed to perform a new assessment after a major physical or mental health change.

All residents of nursing homes deserve to be treated with dignity and respect. Belcourt Terrace received deficiencies in 2005, 2006, and 2008 in the area involving resident rights as the facility failed to provide care that keeps or builds each resident's dignity and self-respect.

Nutrition and diet are vital health care concerns for all nursing home residents. Belcourt Terrace was deficient in storing, cooking, and distributing food in a safe and clean way. The facility was also cited for failure to ensure that attending physicians order special diets.

Pharmacy services at all nursing home facilities need to be accurate. Inaccurate services in this area can lead to illness and even death. Belcourt Terrace failed to keep the rate of medication errors (i.e., the wrong drug, wrong dosage, or wrong time) to less than 5%.

Nursing homes are areas where infection can rapidly and easily spread. This facility failed to have a program in place to prevent infection from spreading. The facility also failed to keep the nursing home free from dangers that could cause an accident.

Medical needs of nursing home residents are top priority. Nursing home residents need to receive care, treatment, or testing in a timely manner. Belcourt Terrace was cited for failing to give or obtain lab tests to meet the needs of its residents.

The Alden Alma Nelson Manor nursing home, located in Rockford, Illinois, has repeatedly been cited by the State of Illinois in the past year for deficiencies in quality of care, mistreatment, resident rights, administration, and environment. Early citations do not seem to have created a desire to fix the problem.

In March 2008, Alden Alma was cited for safety when facility staff failed to ensure the side rail of a resident bed was raised before using the rail as an assistive device to turn a resident. The resident, totally dependent on two facility staff for assistance with all activities of daily living, fell from the bed to the floor.

Five days later, the same resident was undergoing routine blood work through an outside laboratory in early afternoon. The lab technician pulled up the resident's shirt sleeve and drew the sample, but failed to release and remove the tourniquet from the resident's arm. Facility staff failed to notice the tourniquet until undressing the resident for bed.

In the past year, this facility also failed to follow its own hiring procedures when hiring new employees. Prior to hire, employees are required to have two completed reference checks to ensure patient safety. The facility failed to complete appropriate reference checks and had to provide training for the person responsible for hiring new staff. Sadly, that training involved orientation to documents required prior to hiring per Alden Alma Nelson Manor's own hiring policy.

Residents of nursing homes deserve professional services at all times and they deserve to be treated with dignity. The State of Illinois has found that this facility failed to provide dignity and professional services to multiple residents. Some residents advised that they were told to "hold" their urine until the next shift if they had to use the restroom after being toileted. Others were put into Depends because facility staff did not toilet them timely. Another resident was told that she had to eat lunch in bed because it was too much of a bother to the staff to get her back up using the required mechanical lift. She reported that she frequently sits in bed wet as a result of staff indifference. Other residents were not treated with dignity. One resident received personal care while her door was open so that facility residents and visitors could see into her room. Facility staff had to be instructed on Alden's Privacy Policy.

Many residents at Alden Alma Nelson Manor stated that they were bored. During an inspection, one resident was found sitting in a wheelchair facing a wall, another was found sitting in front of a television that was turned off, others were not invited to participate in group events in the facility, and it was noted that there were very few one-on-one social visits from facility staff with the residents.

Pressure sores are a known danger for bed-bound residents if the resident does not receive proper treatment (Go here to see pictures of pressure sores). Alden Alma Nelson Manor was cited for failing to provide proper treatment to prevent new pressure sores or heal existing bed sores. One resident suffering from a Stage II sacral pressure sore continued to deteriorate, even though staff purportedly was treating the pressure sore. The resident's ulcer developed into a Stage IV pressure sore and required hospitalization and surgical debridement. At least one resident had a Stage IV sacral pressure sore. After the citation, staff was provided with training for pressure ulcer assessment and prevention and the proper care procedure to be followed for residents at risk for developing pressure sores.

Nursing home resident frequently need assistance with daily hygiene. The Alden Alma Nelson Manor staff often failed to properly hygienically care for a resident. In one instance, a resident needed to have an incontinence pad changed. Facility staff pulled on gloves and wet the end of a towel with water and proceeded to "wipe" the patient. Then, using the same towel, the staff member wiped feces from the resident. The staff member failed to use any soap or periwash and did not dry the resident's skin. Facility staff members did not change their gloves unless they were "really messy" and staff members proceeded to touch other items in the room or scratch their face without removing the unsanitary gloves.

Care Plans are an important part of a resident's care. Each resident should have an up-to-date Care Plan in his or her chart at all times. This facility was cited for failing to give or get special rehabilitation for a resident when it was stated in the resident's Care Plan. The Care Plan for a resident who suffered a neck fracture required a cervical collar to be worn at all times. The resident was found sitting in a wheelchair without the neck brace and no one caring for the resident knew what the Care Plan stated and whether the collar was to be worn or not. Another resident had a catheter in place following a hospitalization. The catheter was removed as a urine culture showed that the resident was suffering from an MRSA infection. The resident's physician ordered a course of antibiotics and re-testing upon completion of the drug course. The resident did not recover after the first drug course and the physician ordered a second treatment and re-testing. The facility failed to obtain a second test as the physician's order was overlooked.

Ensuring a nursing home resident is receiving the appropriate nutrition is vital. At this facility, one resident lost 13.3 pounds in one month. Another resident suffered significant weight loss and the resident's diabetes was out of control. Staff had no idea of the amount of nutrition taken in by another resident because there were no records. The facility was cited for these failures. As a result, the Director of Nursing is now required to review the meal intake sheets, review weights, and review blood glucose reports. The facility staff will be trained on Alden Alma Nelson Manor's Weight Policy, meal monitoring, and intake/output sheet importance. The staff will also be trained on blood glucose sheets and acceptable parameters.

While caring for a resident's physical health is important, it is equally important that a resident's mental health be cared for as well. This facility was cited for failing to meet the needs of residents with mental illness. The residents with mental illness had no special programs in place for their mental health. Instead, mental health patients received the same programs that are provided for all residents of the facility, regardless of its effectiveness. After the citation by the state, Alden Alma Nelson Manor comprehensively assessed residents needing special assistance and were required to initiate appropriate programs to provide mental health rehabilitation services.

Overall, Alden Alma Nelson Manor received nineteen citations in 2008, earning a one-star rating under Medicare's new rating system. A one-star rating is indicative of a facility "much below average", according to Medicare.

The Terry Law Firm is experienced in handling cases of nursing home abuse and neglect. For more information, call us directly at 1 (888) 317-2525 or visit our website at www.nursinghomejustice.com.

We discussed the abuse Armeda Thomas received while a resident of Richmond Health and Rehabilitation Center, also known as Madison Manor Nursing Home, in our previous blog. If you will recall, a "granny cam" came to the rescue of eighty-four year old Armeda Thomas, who suffered from Alzheimer's disease. The video camera was secretly hidden in Ms. Thomas' room at Madison Manor in Richmond, Kentucky in August 2008 after family members discovered dozens of bruises all over her body and could not get any satisfactory answers from facility staff. The first bruises disovered were "handprint" bruises. They were photographed in July 2008. The hidden "granny cam" proved that Ms. Thomas was being abused by her caregivers. In fact, the ensuing investigation revealed that 17 residents suffering cognitive impairment suffered "injuries of unknown origin".

The camera caught facility staff "pulling the resident out of bed by her wrists and neck" and "roughly moving the resident from side to side". Ms. Thomas also suffered fractures in her lumbar vertebrae after a rough handling. Nursing assistants did not clean or feed Ms. Thomas appropriately, resulting in falsified feeding records. The investigation revealed on at least one occasion that a nursing assistant had eaten Ms. Thomas' food and falsely recorded that it was Ms. Thomas who had eaten everything. A staff member showed her fist to Ms. Thomas after she was combative and on another occasion, one staff member danced in front of her while another staff member held her down. The camera also captured Ms. Thomas lying on the floor for an hour before being discovered by staff.

Jaclyn Dawn VanWinkle, a former nurse's aide at the facility, was arrested on December 17, 2008 and charged with wanton neglect. An investigator from the Attorney General's office said that as many of eight of her former co-workers, none of whom still work for the facility, also face criminal charges. VanWinkle was seen on the videotape singing and dancing while another staff member held Ms. Thomas' arms. VanWinkle also failed to use a gait belt while transferring Ms. Thomas from her bed to her wheelchair, which constituted neglect.

The facility faces more problems. The family of Teresa Kay Ritter filed a wrongful death lawsuit against Madison Manor alleging poor care at the facility resulted in the amputation of Ms. Ritter's left foot, renal failure, and death. Ms. Ritter also suffered from unexplained bruising and lacerations during her two month residency at the facility.

Tabor Manor Care Center, located in Tabor, Iowa, faces a $3,000 fine from the Iowa Department of Inspections and Appeals for allowing a resident to sexually assault other residents.

The alleged attacker, who was finally moved to another care facility on October 13, 2008, had a history of alcohol abuse and was involved in five suspicious incidents in sixteen weeks.

In June 2008, a resident reported to facility staff that the man who lived in the room next to her had touched her breasts and genitals.

In July 2008, a facility staff member reported seeing the same man inside the room of a female resident fondling her.

In September 2008, a facility staff member reported seeing the man running from the room of another resident wearing only his underwear into his room across the hall. Finally, following this incident, the facility installed a laser-equipped alarm on the alleged attacker's door.

A few days after the installation of the alarm on the man's door, a resident complained that the man came into her room and grabbed her breast. He walked out of her room laughing when she threatened to hurt him.

In October 2008, a facility employee reported seeing a female resident leaving the man's room with her pants pulled down and fluid dripping down her leg. She told staff members that the man had hurt her. The Director of Nursing assessed the victim and while she believed some of the fluid near the victim's genitals was blood, she elected not to report the incident or report it to the woman's physician. The Director of Nursing finally told a physician about the incident three days later and the doctor elected not to examine the woman as "all the evidence would be washed away by now".

Following the fifth incident, the inspections department investigated and slapped the facility with the $3,000 fine.

Tabor Manor is not a stranger to problems. Earlier this year, the facility was cited for numerous problems, including not having a registered nurse on duty each day. Last year, the facility was fined $3,575 because of a resident's aggressive and threatening behavior.

The Terry Law Firm has handled numerous cases involving sexual assault in nursing homes. For more information, contact us at (314) 878-9797 or at info@terrylawoffice.com.

We discussed abuse at Etowah Health Care Center in our previous blog.

Joyce Stanley, a certified nursing assistant at Etowah Health Care Center in Etowah, Tennessee, was arrested November 5, 2008 and is being held in lieu of $20,000 bond. She faces charges of willful and physical abuse after hitting a seventy-four year old blind woman with a clipboard and an incontinence pad. Reportedly, Ms. Stanley also slapped the victim and pull her hair. Fortunately, the nursing home resident was not seriously injured. The victim and four workers at the nursing home reported Stanley.

The abuse resulted in the State of Tennessee suspending new admissions and the facility was slapped with fines for violation of resident rights as a result of the abuse of an elderly blind woman. The state levied a $1,500 fine against the facility and the facility faces a $3,550 per day fine until the situation is remedied from the federal government.

The State of Tennessee reinstated new admissions on December 3, 2008.

The Centers for Medicare and Medicaid released a new rating system today and, not surprisingly, for-profit U.S. nursing home facilities do not rate well.

The new rating system, which assigns homes one to five stars for quality, staffing, and health inspections, is the result of years of research to develop a rating formula. Results will be updated quarterly and is overseen by an advisory panel.

Scoring reflects tens of thousands of inspection records, complaint investigations, and quality measures, such as nursing staff hours provided to daily to patients, number of patients developing bedsores, and number of patients in restraints. Much of the data used was accumulated in 2008.

For-profit nursing homes did not fare well using the new rating system. Twenty-seven percent of the United States' 10,542 for-profit homes received one star, compared to 9% of the 4,182 non-profit nursing facilities. Nineteen percent of non-profit facilities received five stars, compared with 9% of for-profit nursing facilities. Low staffing at the for-profit homes appears to have contributed to the lower ratings for for-profit facilties.

To see how your loved one's nursing home rates, go to Nursing Home Ratings or Nursing Home Compare.

The Tennessee Bureau of Investigation (TBI) is investigating two allegations of sexual assault at Life Care Center of Tullahoma in Tullahoma, Tennessee, both of which occurred in March 2008. In one instance, a condom allegedly was found in an 88 year-old woman's bed. A physician suspects that the resident was sexually assaulted and TBI was notified on March 6, 2008 about the suspected March 4, 2008 abuse. There is no information about the second reported incident. The Executive Director of the facility stated that the "allegations of abuse" are "unsubstantiated".

To see WSMV video coverage, go to Alleged Assault Occurs at Nursing Home.

Long Prairie Memorial Hospital & C & NC is a long term care facility located in Long Prairie, Minnesota. The facility was recently investigated by the Minnesota Department of Health (MDH) for allegations of abuse, which were substantiated.

On May 15, 2008, a facility employee was changing a resident's incontinence pad with the assistance of two staff members. The resident suffered from dementia with delusions and hallucinations. He is cognitively impaired, non-verbal, and dependent on staff for his activities of daily living, including requiring two staff members for incontinence care. That day, the resident needed to stand in order for his personal care to be completed. He was not fully cooperating and kept attempting to sit down. One of the assistants stated, "I bet if you slapped him in the ass he will stand up straight." The employee changing the incontinence paid slapped the resident on the buttocks with an open hand. The employee witnessing the slap said the slap was very loud and on a scale of one to ten, with ten being use of as much force as possible, rated the slap as a "9". The resident "perked up" and looked at one of the facility staff with tears in his eyes.

The facility terminated both the abuser and the witness to the abuse.

The Minnesota Department of Health (MDH) made an unannounced visit to Golden Living Center Roch/East on June 12, 2008 and, after a thorough investigation, found the facility guilty of neglect.

In MDH's report, a resident suffering from lung cancer with metastasis to the bone was admitted to the facility on May 14, 2008 for pain management, hospice, and dependent care needs. Her physician ordered her pain to be assessed every shift. On the day after her admission, a hospice nurse was notified that the resident was suffering from pain and crying and moaning. The nurse checked medication records and found that she was receiving incorrect amounts of pain medication - Morphine every four hours instead of every hour.

In the ensuing days, the resident continued to suffer from severe pain. Hospice was contacted again on May 18, 2008 by a friend of the resident advising that the resident was not receiving the correct dosage of pain medication. In fact, it was noted on May 19, 2008 that the resident "screams out in severe pain when her body jerks or is moved ever slightly". She continued to suffer from severe pain until she was admitted to the hospital on May 23, 2008. Upon admission, she had an indwelling catheter and showed no urinary output since May 20, 2008. Her abdomen was distended. Hospital staff irrigated her catheter and her output was recorded as 2450 ml. (a full bladder is considered 500 ml). The resident died on May 24, 2008.

Two federal deficiencies were issued for Quality of Care and Urinary Incontinence. The facility was found to be neglectful in that the resident's pain was not managed, the facility failed to identify the location of her pain on multiple days, and her indwelling catheter was not monitored, even though she was having no urinary output.

On June 11, 2008, a facility staff member at Good Sam Society Windom observed a nursing assistant punch a resident on his collar bone with a closed fist. On June 22, 2008, the same nursing assistant was "rough" with the same resident when washing his face. The resident yelled and hit the assistant on the leg. The nursing assistant stepped back from the resident's bed, threw her arms up, and hit the resident's chest with a closed fist. The assistant said there was no reason the resident should be hitting the staff and that is why she hit him saying "maybe then he'll learn to be nice to us". She was suspended on June 25, 2008 and terminated on July 1, 2008.

The nursing assistant was charged with two counts of criminal abuse by a caregiver. She justified her actions to co-workers because the resident hit her all the time.

The Minnesota Department of Health (MDH) paid an unannounced visit to Good Samaritan Society Waconia on August 14, 2008 to investigate an allegation of neglect. The allegation was substantiated through the MDH investigation.

On August 12, 2008, a single facility staff member was transferring a resident from a shower chair to a wheelchair using an E-Z stand lift. The resident was unable to bear weight or walk. The resident's Care Plan indicated that the resident required a full mechanical lift with a two-person assist for transfer, as she was totally dependent on staff for care. The resident could not bear weight and fell down onto her knees, causing her chin and neck to become "hung up" on the arm of the lift. The resident was hanging in mid-air by her safety belt and was turning blue and gasping for air. She was bleeding from her nose, had a cut on her eyelid, and petechia on her forehead. It took four staff members to lift the resident out of the belt and lower her to the floor. She was transferred to the emergency room for evaluation and treatment.

Unfortunately, it was not the first time the resident's Care Plan had been disregarded and she had been transferred using the E-Z stand lift for showering.

MDH cited the facility for two federal deficiencies and two licensing orders involving following the resident's Care Plan and providing necessary supervision and assistive devices to prevent accidents.

Our elderly are living longer due to a variety of factors, such as better diet and health care. While we are fortunate to have our loved ones with us longer, the epidemic of elder abuse - both physical and financial abuse - is growing.

Sadly, many abuse cases occur at home and 45% of the perpetrators in elder abuse cases are family members. Victims are afraid to report abuse. They fear losing the family member's love and/or ability to care for them. They don't want to consider that their loved one could hurt them and they don't want them to go to jail. Caregiver burnout appears tobe an instigator, but of course is not a license to abuse.

It is hard to investigate elder abuse. Adults are often considered fully functioning and at times have medical conditions that can mask the symptoms of abuse, such as bruising, etc. Moreover, it is often easy to take an elderly person's money without anyone knowing.

Education is key to stopping elder abuse. If abuse is suspected, medical professionals, banks and clerks need to provide information to protect the individual involved. Banks need to alert police if they see large or abnormal transactions take place with the accounts of elderly individuals or if someone comes in with the individual and proceeds to do all the talking.

Tips To Prevent Abuse:

- Assign a Power of Attorney over assets and make them responsible to a third-party. Tell others about your choice of Power of Attorney agent and the power entrusted to them.
- Be very specific about the Power of Attorney agent's powers in the Power of Attorney document.
- Make definite decisions about your health care decisions while you are able to. Don't leave it up to chance.

Alfred "Stan" Catherwood, an 86 year-old resident of Capitol Care Center in Springfield, Illinois, was strapped to his wheelchair when he tumbled down eight stairs on September 24, 2008, breaking bones in his face and neck. The facility was cited for failing to prevent an elderly patient from falling down a flight of stairs and received a $3,500 fine.

Minnesota is still reeling from the abuse allegations at Good Samaritan in Albert Lea that led to two teenagers being charged with criminal abuse and sexual assault charges and four other teenagers charged with failure to report abuse. Now, the Minnesota Health Department has released a department report in which six residents suffered physical, sexual, and emotional abuse at the hands of an aide at Luther Haven Nursing Home in St. Paul, Minnesota. Five of the six residents have Alzheimer's disease or another form of dementia and a female victim with cancer died before the abuse was reported.

This most recently discovered abuse is believed to have gone on for approximately six months before a nursing assistant reported to a supervisor what she had seen in July 2008. The accused aide, whose name has not yet been publicly disclosed, has been accused of probing the genitals of a resident with vulvar cancer, providing lap dances for two male residents and making sexual advances toward one of them, including baring her breasts while getting him ready for bed. Other allegations of abuse include dropping a resident approximately four feet onto a bed and laughing, slapping a resident in the face, and emotionally tormenting a female resident by throwing stuffed animals she believed to be her children on the floor.

The aide, who has denied all allegations, was suspended on July 9, 2008 and fired two weeks later. It is possible that the accused aide will get away with the alleged abuse of her victims, according to Chippewa County Attorney Dwayne Knutson. Knutson said that he most likely will not go forward with charges because all but one of the victims has some form of dementia and the man who could discuss the abuse was "embarrassed and didn't want to talk with police".

To watch the MyFox newscast on this developing story, go to Minnesota Abuse.

Champaign County Coroner Duane Northrup investigated the May 2007 death of Mary Coombes at an Urbana hospital. The investigation revealed that septic shock killed Ms. Coombes and was the result of inadequate treatment of a bedsore at Pleasant Meadows Christian Village nursing home in Chrisman, Illinois. His complaint to the Illinois Department of Public Health led to an investigation, which uncovered quality of care problems at the facility. The end result? A $52,500 state fine.

The States of Missouri and Arkansas require all nursing home deaths be reported to local coroners for possible investigation. The State of Illinois does not currently have that law but is considering it. A year long study involving the Illinois counties of Morgan, Champaign, Effingham, Kane, Kankakee, Lake, LaSalle, Lee, McLean, and McHenry has just concluded. Nursing homes in the counties surveyed were instructed to report all resident deaths to the local coroner. Of the 3,669 nursing home deaths, eight suspicious deaths were reported in which investigators for the State of Illinois were able to verify care problems. Coroners were to investigate by phone, fax, or in person to determine if abuse or neglect contributed to a resident death.

Some coroners felt that the study was flawed because it was done using counties where most coroners investigate nursing home deaths. It was felt that there may be less abuse and/or neglect in counties where facilities know that substandard care could be discovered by the coroner. Many coroners would like to see such a law enacted to help prevent cases of passive neglect. The Illinois Coroner's Association is reportedly not going to push for legislation at this time because the results of the pilot project were not strong and such a law probably would not be state-funded.

Since Thanksgiving 2008, Willow Crest Manor, a care facility catering to the elderly and mentally ill, has had two resident deaths that are being investigated by the Montgomery County Coroner.

Joseph Landes, 24, suffered from depression, cerebral palsy, scoliosis, and a nerve disorder called Charcot-Marie-Tooth disease. He was found dead in his bed by his roommate. Staff reported that Mr. Landes appeared fine before and was riding his scooter in the hallways just before his body was found.

Kimberly Curtin, 49, suffered from schizophrenia, a mild personality disorder, and Guillain-Barre syndrome. On November 27, facility staff called police to try to persuade Ms. Curtin to go to the hospital for treatment. No one is quite sure why Ms. Curtin refused treatment for her leg sores. Police came to the facility and pleaded with her to get help, yet, she refused. The police could not make her accept medical treatment. On November 28, staff reported that her hand went limp while they were giving Curtin her morning medications. She was transported by ambulance to Abington Memorial Hospital, where she was pronounced dead. A hospital nurse informed police that there was no evidence of trauma and it appeared that rigor mortis had set in - enough to suspect that Curtin had been dead longer than reported. An autopsy revealed that Curtin had sepsis throughout her body.

Both deaths are considered part of an ongoing investigation by the State Attorney General's Office.

Earlier this year, facility owner Anand Mittal, was charged with choking a 74 year-old resident suffering from Parkinson's Disease. The resident was pounding on a door that led to an outer lobby. Allegedly, Mittal yelled at the man while he choked him for twenty to thirty seconds. An employee who witnessed the incident was so upset that she quit and left the facility. Mittal was charged with assault, disorderly conduct, and harassment in August 2008 and is now forbidden to set foot in any of the four facilities that he owns.

Other allegations were also lodged against the facility this year, such as distribution of recalled medicine, distribution of medication without physician permission, understaffing, and failure to properly dispose of medical waste. Interestingly, police have been dispatched to the home 81 times since January 2008 and 19 times since August.

Because significant problems were found during inspections, Willow Crest is operating on a provisional license. The state Department of Public Welfare advised the facility on November 17, 2008 that it would not renew its six-month operating license on due to state code violations found during inspections and the charges the owner is facing for choking a resident.

Wes Bledsoe, the founder of A Perfect Cause, intends to go Minnesota on Thursday in the wake of the disastrous allegations made against six teenagers who were formerly employed at Good Samaritan of Albert Lea. Bledsoe will host a town hall meeting to discuss the allegations of abuse at the facility.

Bledsoe said the allegations did not surprise him but was disturbed by them. He asked, "Where is the moral compass of these employees?"

Nicole A. Williams, a CNA at Manhattan Nursing Home in Jackson, Mississippi, was arrested on December 8, 2008 for her role in abusing an elderly resident. If convicted, she faces up to 20 years in prison and up to a $1,000.00 fine for her role in abusing an elderly resident. Williams, allegedly struck an elderly woman in the eye.

"Granny" cams are working for New York in catching nursing home abusers. Three more nursing home employee arrests were announced on December 8, 2008 by Attorney General Andrew Cuomo. The accused are as follows:

- Corey Austin, a former CNA at Gowanda Nursing Home, was fired in February 2007 after a violent episode with a resident. Austin used racial epithets and attacked the resident, who had become agitated and defiant when another staff member tried to administer medication. Austin assisted in returning the resident to his room, where he attacked the resident, shoved the resident to the floor, and pinned the resident to his bed using his knee in the resident's back. He was convicted of endangering the welfare of an incompetent or physically disabled person and willful violation of health laws. He faces a maximum of two years in jail when sentenced in January 2009.

- Patricia Penman, a CNA at Rosa Coplon Jewish Home and Infirmary in Getzville, is accused of physically abusing a 100 year-old resident. Penman is accused of slapping the resident, who is unable to care for herself and suffers from dementia and physical disabilities, in the face during care. She has pled not guilty and is due back in Court in December 2008.

- Jeffrey Perry, a CNA at Gowanda Nursing Home, allegedly tied an elderly dementia resident to a chair with a belt for two nights. The resident was found alone in his room tied to a chair on the second night. He has pled not guilty and is due back in Court in December 2008.

- Jeanette Sovereign, a LPN at Gowanda Nursing Home, allegedly knew of the acts of Jeffrey Perry at Gowanda and did not report it. She has pled not guilty and is due back in Court this month.

The "granny" cams also assisted in the arrest of a CNA who stomped on an 84 year-old resident of Kaleida Health Deaconess Skilled Nursing in Buffalo who was lying in a fetal position and the sentencing of a CNA who stole $8,000 from a 97 year-old resident at The Waters of Orchard Park in Orchard Park. The CNA needed the cash to pay a cocaine debt.

Powers of Attorney are typically used by the elderly to assign someone to manage their affairs should they become incapacitated. Typically, power of attorney is granted to a spouse, an adult child, or someone else that the individual trusts implicitly. It permits the individual, or agent, a broad spectrum of financial power over the incapacitated person, such as writing checks or selling property. Powers of Attorney were never intended to fund someone else's lifestyle or increase their wealth. Unfortunately, financial exploitation of the elderly using the cover of the Power of Attorney is increasing. Elderly citizens are losing their life savings and/or homes to untrustworthy individuals.

State laws govern Power of Attorney agents and its broad spectrum of power. Unfortunately, many states do not have safeguards in place to limit or monitor abuse of that power. The Uniform Power of Attorney Act (UPOAA) seems to be the government's answer to that abuse.

Currently, only New Mexico and Idaho have adopted the UPOAA, but twelve state legislatures are expected to consider its adoption in 2009. This law would require that a Power of Attorney document clearly state the agent's dutie, including the individual's responsibility to act in good faith. It would also force an agent abusive with their powers to be liable for any damages.

Other precautions can be taken to protect our elderly. When choosing an individual to hold power of attorney, consider how trustworthy and honest they are. Just because an individual is a relative does not ensure trustworthiness. Next, communicate to other family members who the power of attorney agent is and what the agent's powers should be. It never hurts to have others watching out for your well-being. Finally, consider having the power of attorney agent report to an objective third-party periodically.

Deloras Fleischer fell and broke her hip. Her family moved her to an assisted living facility, where she suffered a head injury in a second fall. In a third fall, she broke her wrist. She was moved to Anoka Care Center, wheelchair-bound and suffering from dementia. There, no one secured her lap belt and she fell again. This time, the injuries were devastating - a broken collar bone, broken ribs and subsequently, she developed pneumonia. She died a week later.

Clarence Jackson, better known as Jack, was a known "frequent faller" at Minneapolis Veterans Home. He was moved closer to the nurse's station and given a chair alarm that would sound any time he attempted to get up. However, no one lowered his bed or took other precautionary measures. In fact, despite having the alarm, the staff often ignored his alarm when it sounded. Jack died from a fall. Multiple patient safety violations were found at this facility, including fall risks. Complaints filed in 2007 indicated the facility's failure to properly care for three other residents who died. The Governor put all five state veterans' homes under new leadership in an attempt to stem the injury rate.

These tragic stories are not unique for Minnesota. Minnesota holds the nation's third-highest rate of fall-related deaths. Fall-related deaths in Minnesota jumped from 346 in 2000 to 522 in 2006. Thousands more falls led to bone breaks, fractures, and brain trauma, among other injuries.

WHY?

Many Minnesota nursing homes fail to meet minimum safety standards. In fact, out of 388 state inspections in 2008, 150 cited nursing homes for accident risks. Forty-six homes have been cited multiple times since 2005 for failing to prevent accidents in a variety of ways from falls and defective equipment to carelessly stored chemicals.

One reason cited for the high rate of falls in MInnesota is that Minnesota has slightly higher rates for use of prescription drugs, possibly making the residents more at risk for falling. Interestingly, unnecessary drug use is found in 50% of Minnesota nursing home inspections. This high number may account for the excessive fall and injury rate.

SOLUTIONS?

Facilities are incorporating fitness training into their routines in the hopes that the seniors will stay healthier longer. The hope is that while falls may increase due to the seniors advancing mobility, but falls with injuries decrease. Other strategies being used are use of floor mats, bed alarms, and grab bars. Facility administrators are trying to plan better around shift changes, when falls seem to be the highest. Perhaps they could consider increasing staffing levels?

47 year-old man suffocated and died 45 minutes after he requested that a nurse suction out his tracheotomy tube.

An 87 year-old female admitted for rehabilitation for a hip fracture was given a drug to which the nursing home knew she was allergic. She died of the resultant allergic reaction.

A 95 year-old resident fell from a sling on a mechanical lift that was too large for her. She hit her head and later died.

Since 2005, fifty-six Wisconsin nursing home residents have died and dozens of nursing homes have been cited for improper care. Hundreds of Wisconsin nursing home residents have been found with bruises, broken bones, and pressure sores - some so deep they go to the bone. Nursing home inspections often do not attribute the deaths to poor care. Sadly, the accusing finger points directly to inadequate training and supervision - things that can easily be fixed if the facility owner is willing to cut his or her profit just a small amount and pay for more staff members.

UGLY FACTS

- Dozens of facilities are cited repeatedly for serious violations, only to have new ones surface while in the process of correcting the previous problems. Approximately 25% of Wisconsin's nursing homes are owned by out of state corporations and 27 of the 54 homes were repeatedly cited for care violations are owned by out of state corporations.

- Deaths and injuries are occurring at higher rates at nursing home facilities with significant turnover rates. Turnover rates can be as high as 200% annually, but the average for any facility is 42%. Amazingly, one problem facility had a nursing assistant staff turnover rate of 257% and led Wisconsin in serious citations.

- Nursing assistants historically are poorly paid with some jobs starting at less than $9 per hour. These jobs involve heavy lifting, are stressful, and involve little opportunity for career advancement.

- Professional nurses caring for our loved ones also have a high turnover rate. The state average for turnover of full-time registered nurses is approximately 32%. In facilities with serious violations, the average turnover rate was 57%, with some facilities having a turnover rate as high as 300%.

- Families often are not told of citations issued after deaths of loved ones. Four families were advised by the Journal Senteniel newspaper of serious citations issued months or years after the deaths.

WHO ARE THE FACILITY OWNERS?

Kindred Healthcare is the owner of 228 nursing facilities nationwide, eleven of which are in Wisconsin. In fact, Kindred is the owner of Mount Carmel Medical and Rehabilitation Center in Burlington, Wisconsin. Mount Carmel has had multiple problems with pressure sores at its facility and has been cited in the past.

For example, Bill Kurth died from pressure ulcers, infection, and malnutrition while a resident of Mount Carmel. His relatives visited daily but were completely unaware that he had ten infected pressures sores distributed over his body. They only discovered the pressure sore situation when he was rushed to the hospital.

Lois Glass also suffered from pressure sores while a resident at Mount Carmel. Her family did know of her bed sores, but were told they were being treated. She later died. Her family did not find out about the poor care she received until more than two years after her death when the state attorney general's office contacted them to advise that the nurse involved was being charged with neglect and Ms. Glass' case was being used as evidence.

Once upon a time, Mount Carmel had a wound care team, but it was disbanded several months before Mr. Kurth developed his pressure sores. That left only one nurse to care for all of the facility's patients and their sores. She was overwhelmed. Reportedly, she falsified records to make it appear that she was treating the residents. She has since been convicted of criminal neglect.

Kindred alleges that "resident care and safety is our number one concern" It purports to take seriously any issues brought to our attention by the state or family members." One may wonder if resident care and safety is the number one concern, why it disbanded the wound care team?

Another corporation in the public eye is Extendicare. Extendicare is one of the largest nursing home chains in the United States with approximately 174 facilities nationwide. It has 26 facilities in Wisconsin, twenty of which have been cited in the past three years for at least one serious violation. In 2005, it paid a whopping $2.3 million to the State of Wisconsin in a civil settlement over serious nursing home violations.

Extendicare's Willows Nursing and Rehabilitation in Sun Prairie was cited for poor care after two resident deaths and paid an incredible $198,045 to the State for the deaths. The facility was also on the federal list of worst homes in the United States. It has since graduated from the program and come off the list. Dorothy Herlitz was a casualty of poor care at the Willows. She went to the Willows for short-term rehabilitation for a fractured ankle and was wearing a soft cast. One week after her admission, she was rushed to the hospital with an infected pressure sore on her fractured ankle. The facility had called a doctor four days earlier when they saw a dark area under the cast, but they never followed up when the doctor did not call back. Tragically, when the soft cast was removed from Ms. Herlitz's ankle, one physician was brought to tears at what was seen. The wound was "dark purple and fluid filled" and Ms. Herlitz's leg exploded with pus, slime, blood, and stench. She died twelve days later.

Sava Senior Care is another repeat offender of poor care. Sava operates 185 homes nationally and 4 in Wisconsin. Interestingly, two of its four homes have been cited with serious violations at least three times since 2005. Virginia Highlands Health and Rehabilitation is one of Sava's homes. Last year, the facility had staff turnover higher than 100% in every nursing and nurse assistant position and led the state in serious violations. It has been cited five times for harming residents or placing them in jeopardy in 2007. There have been six different administrators of the facility since January 2005. The facility has been cited multiple times for failing to have adequate infection control.

Two licensed practical nurses (LPN) at Graceland Care Center in New Albany, Mississippi face criminal charges for elder abuse. Cynthia Hunt faces two felony charges of abuse after a grand jury indictment. She is accused of "pouring aftershave on the genitals of a patient" and administering medication that caused pain. If convicted, she faces a maximum of 40 years in prison and $20,000 in fines.

Kathy Brooks, a second employee, is accused of taking hydrocodone that was meant for more than one patient. Hydrocodone is a strong pain medication. She faces one to five years in prison if convicted.

Attorney General Jim Hood said, "Any person found guilty of torturing a disabled person or stealing their pain medications leaving them to suffer should receive little mercy for such sinful crimes."

After the Wisconsin Department of Justice's Medicaid Fraud Control Unit investigated allegations of sexual abuse, the State Department of Justice charged Kurt Johnson with three counts of second-degree sexual assault. Johnson, who worked as a CNA at Golden Living Center, Wisconsin Dells, was responsible for the care of patients in the Dementia/Alzheimer's unit of the facility. Between September and December 2007, Johnson was caught by three different co-workers fondling the breasts of female residents. Two of the patients were residents of the Dementia/Alzheimer's unit. One of the residents was incapable of communication or reaction, but the second resident was seen physically resisting the assault.

If convicted, Johnson could serve 120 years and pay a $300,000 fine.

The Terry Law Firm has represented many victims of sexual assault and is well-experienced in prosecuting cases this area.

In a horrific discovery of nursing home abuse and neglect, a 65 year old resident of Countryside Healthcare and Rehabilitation was discovered to have mold growing in and around his mouth.

The resident, who is unable to speak due to a medical condition, was being examined for low blood pressure when staff at Maury Regional Medical Center uncovered signs of abuse and neglect. They contacted authorities and the Lawrence County Sheriff's deputy took photographs of what appeared to be mold growing in and around the man's mouth and an open sore on his leg. The Tennessee Bureau of Investigation (TBI) is currently investigating.

The Administrator at Countryside was unaware of any allegations made against the facility.

The facility's most recent inspection in September 2008 uncovered nine health deficiencies. Citations included quality of care and not keeping safe, clean and homelike surroundings. To view the inspection reports, go to Countryside Healthcare.

A well-placed "granny cam" proved abuse of an eighty-eight year old resident of Bay Pointe Terrace, an assisted living facility in Broward County, Florida. Karlene Brown, a CNA, became angered at the resident, who suffers from dementia, grabbed her by her collar and dragged her into her room.

Brown faces one count of abuse of an elderly person, which is a third-degree felony. If she is convicted, she faces up to five years in prison and a $5,000 fine.

We discussed the tragic death of Sister Mary Daniel in our previousblog concerning Summit Park Nursing Care Center.

The Patient-Services Administrator, Aldo Troiani, has stated that he will resign and a maintenance director at the facility has opted to take an early retirement package.

County legislator Ed Day has called for a hearing into the way Summit Park Nursing Care Center is run by Rockland County.

MRSA, or methicillin-resistant Staphylococcus aureus, is a highly contagious bacterial infection spread through touch or contact. This infection, which can cause painful skin lesions and/or enter the bloodstream, is a staff infection that is resistant to antibiotics normally used to fight infection. According to the federal Centers for Disease Control and Prevention, MRSA infections claim at least 18,000 lives per year, which is more deaths than even the AIDS virus. Others that survive the infection are often left with crippling injuries.

Six out of seven people infected with MRSA contract it at a health-care facility, many of which are nursing homes. Sadly, there is a new danger brewing on the horizon known as CA-MRSA, or community-associated methicillin-resistant Staphylococcus aureus. CA-MRSA is found in common, every day life and affects healthy individuals. CA-MRSA appears as an infection of the skin and tissue and resembles a pimple or abscess. It may drain pus or fluid and can be red, swollen and warm and tender to touch. These infections are appearing frequently in people who play contact sports, such as football or wrestling. In fact, in 2003, it was reported that nine percent of the St. Louis Rams football team, which is five out of fifty-eight players, had eight occurrences of this strain of MRSA. So far, this strain of MRSA is easier to treat than the MRSA infection frequently found in hospitals, nursing homes, and other health-care facilities.

There are ways to help prevent occurrences of CA-MRSA. Prevention methods include covering wounds, using hexachlorophene 3% (an antibacterial skin cleaner), discouraging the sharing of person items, such as towels or multiuse lotions, routine cleaning of equipment, and general good hygiene.

Deaths from MRSA infections can often be avoided through simple tests. The first test - a nasal swab test - is quick and painless and its cost is approximately $20. It allows medical providers to see who is a carrier of the MRSA virus and who is actually infected. It would allow the infected person to be isolated and treated. A newer test, known as BD GeneOhm StaphSR Assay, was approved by the FDA recently and is the first rapid blood test available for MRSA screening. Results are available after approximately two hours.

Detection and prevention seem simple, right? Not really. There is no nationwide mandatory testing procedure in place. Some providers feel that screening is unnecessary and that the infection can be controlled through hand-washing, protective garments, and sterilization of equipment. Other providers feel that if people are generally screened upon admission to a hospital facility, then it could be pinpointed as to the origin of the infection.

Grace Living Center in Edmond, Oklahoma placed its residents in immediate jeopardy recently when staff failed to appropriately respond to a sexual assault in the facillity. As a result, the State fined the facility more than $3,000 and the facility is currently ineligible for Medicare or Medicaid benefits.

A resident at Grace Living Center sexually abused a female resident, who had only resided at the facility for 14 hours. She suffers from a medical condition and could not defend herself during the attack.

Staff at the facility noticed a male resident touching the new resident inappropriately. The incident was reported to a charge nurse, who instructed the staff to get the female resident up and dressed. Approximately one hour later, the woman was crying and moaning. Staff assessed her for injuries and noticed bleeding. The facility failed to contact the police or the woman's family for more than an hour and a half. Moreover, the victim was not taken for treatment for over two and a half hours after the incident.

Police said "the facility did a poor job of protecting the evidence...took all of the victim's bed linens and clothing...the perpetrator's clothing and placed the clothing in the soiled laundry, before the police were notified". The police also advised the health department that the administrator felt that the situation was blown out of proportion.

Unfortunately, this is not the first time the perpetrator, a male resident suffering from dementia, has been observed behaving inappropriately. He was a known "wanderer" who "liked to go into women's rooms who couldn't call for help". Two days before the incident, he was "observed touching the leg of another resident who was dependent on staff for assistance". The same day he touched a resident's leg, he was seen pulling up the shirt of another staff-dependent resident.

The Oklahoma District Attorney's Office is considering criminal charges against the former resident.

We discussed the tragedy of abuse and assault at Good Samaritan Society Nursing Home in Albert Lea, Minnesota in our previous blog. A total of eight teenagers were involved in the abuse of facility residents, but only six currently face charges. Two of the six teenagers will be charged as adults and face charges of fifth degree assault, abuse of a vulnerable adult by a caregiver, abuse of a vulnerable adult with sexual contact, disorderly conduct, and failing to report suspected mistreatment. The other four teenagers face charges involving their failure to report the abuse.

According to the criminal complaint, the teenagers tortured at least fifteen residents suffering from Alzheimer's disease or other dementia disorders. The teens are accused of laughing as they spat in residents' mouths, poking and groping their breasts and genitals and taunting the residents until they screamed.

They showed no remorse or fear of being caught. The girls openly discussed the abuse at school and breaks at work and were confident they would not be caught as the "residents did not have their minds".

To read the Complaint/Indictment Supplement, go to The Smoking Gun.

The Terry Law Firm has experience in this area and has handled multiple cases involving sexual abuse in nursing home facilities.

A "granny cam" came to the rescue of eighty-four year old Armeda Thomas, who suffered from Alzheimer's disease. The video camera was secretly hidden in Ms. Thomas' room at Madison Manor in Richmond, Kentucky in August 2008 after family members discovered dozens of bruises all over her body and could not get any satisfactory answers from facility staff. The first bruises were disovered were "handprint" bruises. They were photographed in July 2008. The hidden "granny cam" proved that Ms. Thomas was being abused by her caregivers. In fact, the ensuing investigation revealed that 17 residents suffering cognitive impairment suffered "injuries of unknown origin".

The camera caught facility staff "pulling the resident out of bed by her wrists and neck" and "roughly moving the resident from side to side". Ms. Thomas also suffered fractures in her lumbar vertebrae after a rough handling. Nursing assistants did not clean or feed Ms. Thomas appropriately, resulting in falsified feeding records. The investigation revealed on at least one occasion that a nursing assistant had eaten Ms. Thomas' food and falsely recorded that it was Ms. Thomas who had eaten everything. A staff member showed her fist to Ms. Thomas after she was combative and on another occasion, one staff member danced in front of her while another staff member held her down. The camera also captured Ms. Thomas lying on the floor for an hour before being discovered by staff.

Madison Manor was slapped with a Type A citation by the Cabinet for Health and Family Services (CHFS) for failure to protect their residents and was not allowed to accept any new residents for at least sixty days. Type A violations are the most severe citation possible. Nine staff members were fired and could face criminal charges. The facility has a new Administrator and Director of Nursing and a nursing home ombudsman is present at the facility nearly daily.

Cindi Simpson, the Regional Director of Operations for Extendicare, the owners of the facility, said that the faility is currently in "substantial compliance".

The Thomas family removed Ms. Thomas from the facility after uncovering the abuse and cared for her at home until her November 2008 death.

Jennifer Ann Antonelli picked the wrong nursing home resident to finance her lifestyle.

Antonelli, 28, is a former employee at Andorra Woods Health Care Center in Whitemarsh, Pennsylvania. Antonelli, a nursing assistant, stole a check from a resident's room and began drawing on his checking account to pay household bills such as cable television, PECO Energy, telephone, and credit card bills. In fact, she managed to steal a total of $17,090.17 during the ten month scam. Authorities were alerted when a family member noted that money was missing from the man's account and called police.

Antonelli opened a checking account in her boyfriend's name and paid the bills. She also opened a Capital One account under her ten year old daughter's name and named her boyfriend as an additional accountholder.

Antonelli has pled guilty and faces seven to ten years in prison. She is currently out on bail awaiting sentencing.

We discussed Summit Park nursing home in our previous blog. Sister Mary Daniel, 90, was fatally injured on August 31, 2008 at the facility after a 200 pound freestanding closet fell on her, fracturing her skull and breaking her jaw. She succumbed to her injuries on September 7, 2008.

Her family filed a wrongful death lawsuit in state Supreme Court in New City against the facility alleging "gross recklessness and gross negligence". The family is also investigating the possibility of criminal charges in her death.

Sister Mary's death was preventable. Two other incidents involving closets tipping over had occurred at the facility - one of which occurred mere weeks before Sister Mary's injury. After each of the incidents, the closets were bolted to the wall, but there was never an order that all similar closets at the facility be attached. The suit alleges that both Administrator Aldo Troiani, the Director of Nursing, and the Assistant Director of Nursing attended meetings held after each of the incidents and were aware of the danger.

The facility was not forthcoming with information concerning the accident for Sister Mary's family. After her August 31 injury, someone from the facility contacted her family and told the family that she had "fallen on some furniture in her room". The family was completely unaware that she had been taken to Good Samaritan Hospital until they received a telephone call from a physician at the hospital more than eight hours later. That physician informed the family that her injuries were so serious she was being transferred to Westchester Medical Center.

Family rushed to Westchester Medical Center and were stunned at her condition. Although Sister Mary appeared to recognize her family, physicians told her family that she would never walk or talk again or be able to eat food by mouth - if she survived.

The family continues to struggle emotionally with the knowledge that Sister Mary was alone for hours in the emergency room with no family there to comfort her.

Leah Johnson is the center of a controversy in this tragic case and she is not even aware of it. Mrs. Johnson, 53, became a resident of Divine Savior Nursing Home in Portage, Wisconsin after suffering a debilitating stroke in 2005. She entered the chronic care facility unable to talk or move on her own.

In June 2005, a facility employee reported that David Johnson, Leah Johnson's husband and a former minister, had touched his wife in a way that may have been sexually inappropriate. Johnson had closed-door visits with his wife in the past with the facility's knowledge. The facility policy and state administrative code provide residents and their spouses a right to private visits, but the Administrator of Divine Savior Nursing Home obtained a waiver of the state rule from the Department of Health and Family Services - without advising David Johnson - and went to police. Police obtained a search warrant and placed a hidden video camera in Mrs. Johnson's room. The camera recorded three weeks of surveillance, in which David Johnson was seen having marital relations with his wife. Because Mrs. Johnson is unable to talk or move on her own, she was considered "comatose" and unable to consent to marital relations.

In May 2007, Sauk County Circuit Judge Patrick Taggart ruled that the search warrant was improperly executed and that Mr. Johnson had the right to privacy in his wife's room. The judge further ruled that the videotapes could not be used as evidence in a criminal trial against Johnson. Prosecutors appealed this ruling to the Wisconsin's Fourth District Court of Appeals and the Court of Appeals upheld Judge Taggart's initial ruling. At this point, prosecutors are deciding whether or not to file another appeal and bring the issue before the State Supreme Court or dismiss the charges.

It is unclear whether this case would affect the evidentiary status of a court video placed by a family member suspecting a nursing home of abuse.

Currently, David Johnson faces eight felonies - four counts of second-degree sexual assault of an unconscious person and four counts of third-degree sexual assault.