Nursing Home Abuse Lawyer Blog

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.