Nursing homes are adapting the changing senior lifestyle choices by offering more care options. New business is being be attracted by transforming available nursing home wings into adult day care centers or adding short-term rehabilitation beds. In fact, two of the most popular business trends in Illinois today are short-term rehabilitation and late-stage Alzheimer's round-the-clock care.

Years ago, a senior fractured hip called for hospitalization for at least three months to heal and rehabilitate. Today, the same injury requires a two to three day hospitalization and then a stay at a short-term care facility for rehabilitation. According to Terry Sullivan, the regulatory director at the Health Care Council of Illinois, "Short-term rehab is 'a big part of nursing home business these days'" because a hospitalization is much more costly. Sullivan also said, "More facilities are specializing in one or the other. Many are licensed to do both, and a number of facilities went for a variance only to serve Alzheimer's residents...But there are higher standards that have to be met."

According to Nancy Nelson, AARP Illinois senior manager for advocacy, "advocates are trying to balance the protections for seniors in long-term care facilities with the rules and regulations those facilities face when trying to change their business models."

Ms. Hendrix was found lying in a pool of blood with broken facial bones, bleeding in her brain, a swollen eye, a cut lip, and a 4 cm laceration on her forehead. She was hospitalized for three weeks and nearly died. Pretty severe injuries for "just a fall".

The case was reportedly investigated but closed without the nursing home being cited for Type A abuse, which is when a resident is placed in imminent danger or faces substantial abuse or neglect. Hendrix's family wonders why.

While they are suing the nursing home for Hendrix's injuries, they have also asked the Kentucky Attorney General's Office to reopen the investigation into her injuries. According to Hendrix's attorney, Scott Owens, this is a case of an abuse or neglect investigation at a Kentucky nursing home that "simply didn't go deep enough. There was enough evidence to raise a flag that there was a possibility that she could have been attacked...And we know that wasn't investigated at all."

All Kentucky nursing home abuse cases are investigated by the Attorney General's Office, the Cabinet for Health and Family Services' Office of Inspector General, and the Adult Protective Services branch of the Cabinet for Health and Family Services. It appears that the right hand doesn't know what the left hand is doing in this instance.

According to the Attorney General's investigator, the cabinet's adult protection worker believed the injuries were accidental. The adult protection worker determined that Hendrix was the victim of caretaker neglect and had been exposed to an extreme safety risk.

Investigators from the state agencies were told by nursing home staff that Hendrix was missing on January 21, 2009, while in her merry walker. Unfortunately, each investigator reported varying information, including where Hendrix was found. The Attorney General's investigator called the room where Hendrix was found a "physical therapy room 'set up similar to a residential room'". The Office of the Inspector General's investigators called the room "an empty resident's room" and the adult protection worker called the room "an area with storage equipment". Information about how Hendrix fell also were conflicting: one report said she fell over a wheelchair and one stated that she was found in the merry walker with her face "to the floor". The Attorney General's investigator was told by nursing home staff members that they thought her walker had caught the door frame or raised threshold and it caused her to fall and land on her face with the merry walker on top of her.

According to Owens, his investigation has found that there have been resident-on-resident assaults at the facility and he and the family want investigators to re-examine the incident to determine if someone could have attacked Hendrix.

Barbara Lefforge was at St. Edna Subacute & Rehabilitation Center in Santa Ana, California a mere 5 1/2 hours when she was accidentally overdosed on morphine.

Lefforge went to St. Edna on September 17, 2007 after a tendon repair surgery. Her podiatrist prescribed 50 mg of morphine for pain instead of 50 mg of Demerol. According to her attorney, the medication error should have been noted by facility staff. Reportedly, the pharmacist warned that the prescribed dosage was too high. Nurses at the facility were unable to administer the full dose, so 30 mg was obtained from an office emergency kit and administered. Lefforge suffered an overdose, but no one monitored her or took her to the hospital. By the time Lefforge reached a hospital, she was barely breathing and had already suffered a brain injury.

A jury deliberated for two days before returning a unanimous verdict that St. Edna was 90% responsible for the damages fifty-seven year old Lefforge suffered and her physician, Wesley Kobayashi, was responsible for 10%. She was awarded $2 million for pain and suffering and $1.1 for medical costs. Punitive damages were also awarded and a hearing on those damages is set for August 24, 2010.

St. Edna Subacute & Rehabilitation Center is one of 25 California Covenant Care facilities.

Emeritus at Silver Pines was slapped with $13,000 fines after an investigation by the DIA revealed that the facility was falsely portraying itself as an assisted living facility rather than as a residential care facility. According to the state, Silver Pines is only licensed to provide personal assistance and supervision, not high levels of medical care required at an assisted living facility. The facility also received 17 other violations for violations involving medical records, training, etc. It received 14 similar violations back in March 2010. The average number of health deficiency violations for an Iowa nursing home facility is 7.

The facility's owners were also ordered to hire a new administrator after the state determined that the current administrator was not qualified to hold that position.

The Murfreesboro Police have launched an investigation into the cause of Ms. Butler's injuries, which will include an investigation into the nursing home facility in which she lived: Boulevard Terrace Rehabilitation and Nursing Center. According to Officer David Norton, Ms. Butler's "injuries appeared suspicious enough to launch an investigation". Norton also reported that a Tennessee Adult Protective Services case worker told him "the pressure sores would require some time to become this severe, indicating possible neglect or abuse".

According to facility Administrator Amanda Pullias, the nursing home is also looking into the cause of Ms. Butler's injuries but "we have not found any suspicious findings".

Butler had entered the facility in July 2010 to recover from a broken femur.

In 2008, the facility was forbidden new admissions after state inspectors found problems at the facility in nursing services and administration.

Attorney David Hoey represents Mr. Donahue’s family. After years of legal wrangling, including a battle to invalidate an arbitration agreement Mr. Donahue signed when he was 91 years old and suffering from delusions, a jury in Plymouth Superior court in Brockton, Massachusetts found that negligence at the Kindred-owned facility was a substantial contributing factor to Mr. Donahue's injury and awarded his step-daughter $400,000 plus interest. Attorney Hoey stated, “By giving that kind of verdict, the jury is saying this type of conduct is not acceptable in our community, ‘Don’t do it,’ According to Christopher Lavoie, attorney for Kindred, "it was an unfortunate accident that happened during a transfer". Kindred no longer owns the facility.

By all accounts, plaintiff’s attorney David Hoey did a great job in representing the family of Mr. Donohue. You can learn more about Attorney Hoey and his law firm here