Nursing Home Abuse Lawyer Blog

When most people think of a nursing home, they envision a building full of elderly, bedridden people all of whom have multiple medical problems that need care around the clock. And, in a sense, they are right. Individuals that need 24/7 care would likely need the level of care that can be found in a skilled nursing facility which is what most people think of when they think of a nursing home. However, not everyone that needs help with their daily care requires the level of care provided at a skilled nursing facility. There are, in fact, different levels of long term care available to people who need some daily assistance but are not totally dependant upon others. For those who are looking for facilities to help their family members, this is welcome news.

Skilled Nursing Care v. Residential Care

Skilled Nursing Facility

Missouri has 1,146 long term care facilities. Of those, 495 are considered skilled nursing facilities while 471 are deemed residential care facilities. According to the Missouri Department of Health and Senior Services website, a skilled nursing facility is required to have a licensed nursing home administrator and is the kind of facility that provides 24 hour care for at least three severely compromised individuals. Of course, most nursing homes have far more than three patients, but the state of Missouri requires that the facility have at least three people for the facility to meet the definition of a skilled nursing facility. A skilled nursing facility may only provide skilled nursing care under the supervision of a registered professional nurse. Moreover, medication administration must be administered only after receiving a prescription by a licensed physician. Failure to comply with any of these requirements leaves the facility at risk for license revocation.

Residential Care Facility

Residential care facilities are divided into two categories; RCF 1 and RCF 2. An RCF 1 facility provides at least three individuals with room, board and care. These are individuals who do not need the skilled nursing care provided at nursing homes, but rather those who may need some additional supervision during a short term illness or for recuperation after an operation, a fall or similar event. Each resident must have the knowledge and physical ability to exit the building safely without the assistance of other individuals. No licensed nursing home administrator is required.

An RCF 2 facility provides additional assistance that is not provided by an RCF 1 facility, but still not to the level of a skilled nursing facility. To qualify as an RCF 2, the facility must provide 24-hour accommodation, board, and care to at least three individuals. Each individual will need or is provided with diet supervision, help with personal care as well as assistance with medication. Typically, this involves assistance with diets, personal care (i.e. getting dressed, grooming, bathing, etc...) and the use of medication. All assistance with health care must be done under the direction of a licensed physician. Like an RCF 1 facility, all residents must be able to make a path to safety without assistance. However, unlike an RCF 1 facility, a license nursing home administrator is required at an RCF 2 facility.

Continue reading "What Are The Different Kinds Of Nursing Homes In Missouri?" »

"I wish I had known what to do when I suspected abuse." As an Rockford nursing home negligence lawyer, this is just one of the many statements I hear when I meet with families members of a nursing home resident. Too often, those meetings take place after their loved one's funeral. There are way too many nursing home residents who are suffering from neglect and abuse at Illinois nursing homes. Many family members don't know how to look for abuse or neglect. Rarely, do family members know the signs and symptoms of malnutrition or dehydration. Sons don't feel comfortable checking their mothers for bedsores. And no one wants to believe that nursing home residents are commonly targes for sexual abuse by nursing home employees. Too often families are concerned about complaining too much for fear that their loved one will suffer retaliation by an overworked and underpaid staff.

After hearing so many of these concerns and answering many of the same questions, Rockford personal injury lawyer David Terry decided to write a book that is designed to help family members before and after their loved one becomes a nursing home resident. 5 Things You Must Know About Nursing Home Abuse and Neglect in Illinois is an easy to read book that will help family members as they face one of the most difficult decisions they will face. You will receive guidance on:

* What to look for when deciding the best nursing home for your loved one;

* What to do when you suspect abuse or neglect of your loved one;

* Key signs that abuse or neglect has occurred.

I also go into great detail about the business model many nursing home companies now use which is designed solely for the financial benefit of the owners. Nursing home owners will tell you that their number one priority is providing quality care for their residents. However, when you look at their corporate structure, you will see that they have created multiple corporate entities designed to take money from the nursing home (that could be used for patient care) and into the bank account of the owners. Many of these owners then claim that they do not have enough money to purchase liability insurance.

If you would like a FREE copy of 5 Things You Must Know About Nursing Home Abuse And Neglect In Illinois simply call the Terry Law Firm at 1-888-317-2525 or visit one of our websites: www.IllinoisNursingHomeAbuseBook.com.

My personal experience as a Missouri Nursing Home Lawyer is that far too many nursing home residents are overmedicated by those responsible for providing quality care. In my job I often meet with residents and their families in nursing homes. On some of those occasions, the residents simply could not wake up. Their eyes fluttered as though they were struggling to wake up and participate in the conversation happening around them. Sadly, the government has determined that my experience is not unique.

The U.S. Department of Health and Senior Services recently prepared a report entitled Medicare Atypical Antipsychotic Drug Claims For Elderly Nursing Home Residents that found that too many nursing home institutions failed to comply with regulations designed to prevent overmedication. It is well known that prescribing antipsychotic medication to elderly residents with dementia is potentially lethal, yet 88% of these individuals receive such prescriptions.

Family members must make certain that they know what medications their loved one is receiving. They must educate themselves on the medications and the proper dosages. They must regularly ask questions of the caregivers and insist upon answers. Family members must know what the possible side effects are and should closely monitor their loved one for any signs of side effects.

Why would a nursing home overmedicate a resident? First, to be fair to the nursing home industry, many times the overmedication is completely unintentional. Elderly residents are more much more susceptible to overmedication than are younger people. The second reason is an indictment of the nursing home industry. Overmedicated residents do complain and are, therefore, easier to care for with a reduced staff. Residents who ask to be taken to the restroom, or who need more water or need help walking down the hallway often require assistance from staff members. When a nursing home operates on reduced staff (as most nursing homes do) drugged residents are easier to manage than those who are alert and active.

If you are concerned about the care your loved one is receiving in a nursing home, call our St. Louis personal injury lawyer David Terry for a free consultation at 1-888-317-2525.

A California class action lawsuit seeks to shed light on the lack of care given to nursing home residents by Golden Living Centers in California. The primary allegation is that Golden Living Centers systematically refused to follow the state mandated staffing regulations that require 3.2 hours of nursing care per patient per day. Rather, according to the allegations, Golden Living Centers staffed it's facilities at a lower per patient day amount resulting in neglected and injured residents.

Even though this is a California case, it has significant implications in Missouri as well. As a nursing home abuse lawyer I have handled several cases against Golden Living nursing homes and have seen first hand the lack of care that happens in these facilities. If the California case is successful, every single Golden Living facility will be under pressure to improve their staff to patient ratio, even in states like Missouri where there is no minimum staffing requirement.

Staffing is a key component in the care received by nursing home residents. I am regularly amazed at how many nursing homes refuse to admit that their staffing levels have a direct correlation to the number of injuries suffered by their residents. It doesn't take a rocket scientist to know that one CNA cannot provide adequate care for ten nursing home patients each of whom requires a substantial level of care.

Let's take a closer look at Missouri Golden Living Centers and how they compare with state and national averages with respect to staffing: According to statistics provided by Medicare, the national average for CNA care for nursing home residents is 2 hours and 24 minutes per patient per day. For Missouri nursing homes, that average is 2 hours and 30 minutes per patient per day. A review of some of the Golden Living Centers in Missouri shows few, if any, meet either the national or Missouri averages. Here is the staffing information for six Golden Living facilities in Missouri:

Golden Living Center - Bloomfield: 2 hours and 5 minutes of CNA care per patient per day.
Golden Living Center - Branson: 1 hour and 49 minutes of CNA care per patient per day.
Golden Living Center - Dexter: 2 hours and 23 minutes of CNA care per patient per day.
Golden Living Center - Pin Oaks: 1 hour and 50 minutes of CNA care per patient per day.
Golden Living Center - Westwood: 1 hour and 47 minutes of CNA care per patient per day.
Golden Living Center - Independence: 2 hours and 13 minutes of CNA care per patient per day.

Continue reading "Golden Living Centers Faces Class Action Lawsuit" »

A Walker County, Georgia jury's recent award spoke volumes about what they thought about the wrongful death case presented to them.

Fifty-one year old Charlotte Pauline Dean suffered from cerebral palsy. She relied upon Hutcheson Home Health Care for weekly medical treatment. Her family hired Country Crossing Assisted Living to provide Dean with around-the-clock care. Sadly, Dean died on January 19, 2006, after being transported to Hutcheson Medical Center, also known as Hutcheson Home Health. Dean had multiple infected pressure sores on various parts of her body.

Dean's family filed a wrongful death lawsuit against both entities and Travis Thompson, the owner of Country Crossing Assisted Living, alleging that they were only treating one pressure ulcer rather than the multiple infected sores that Dean had all over her body. After a week-long trial, the jury awarded Dean's family $4 million for pain and suffering, $5.5 million on the wrongful death claim, and $2,683 in funeral expenses.

According to Ken Bruce, one of the family's attorneys, "When you see a verdict like this, by definition it reflects a jury's belief that there was some very bad treatment and bad conduct by the defendants."

Sadly, many politicians will deny this verdict as another "runaway jury" requiring the need for more tort reform. The better way to view a verdict like this is a wake-up call for nursing home owners to either better fund and better staff their facilities so they can provide quality care or shut down.

I applaude the Georgia jury that sent the right message in this case.

The Dressel family has alleged that a Lebanon, Illinois nursing home facility contributed to cause a loved one's death. Beverly Dressel alleges that Covenant Care Midwest, doing business as Cedar Ridge Health Care and Rehab Center, failed to properly care for her mother, which resulted in the elderly woman developing bedsores, an infection, and sepsis.

Betty Dressell, suffering from Alzheimer's, entered the facility on October 1, 2008. She remained there until December 5, 2008, when Almost Family and National Health Industries, doing business as Mederi-Caretenders, was hired to care for her. While under the care of Almost Family and National Health Industries and Covenant Care, Ms. Dressel is alleged to have developed pressure sores on her back, buttocks, leg, and feet. She subsequently developed a severe infection, which led to sepsis. Ms. Dressel died from her injuries on April 14, 2009.

The lawsuit, filed January 10, 2011, alleges that while Ms. Dressel was being cared for by Almost Family and Covenant Care, employees failed to recognize symptoms of decubitous ulcers, failed to diagnose the decubitous ulcers, and failed to refer Ms. Dressel to a wound care specialist for treatment. The 51 count complaint alleges medical negligence/wrongful death, statutory negligence, breach of contract, breach of fiduciary duty, and loss of consortium and is seeking a judgment in excess of $2.55 million plus costs.

If nursing home employees fail to implement procedures to prevent pressure sores or do not adequately treat existing pressure sores, the likelihood is that residents will develop pressure sores that can cause the resident a serious injury and substantial pain. If employees fail to provide adequate care, there should be substantial penalties against their employer and them personally.

Residents at risk for pressure sores should be:

- turned and repositioned at least every two hours
- provided medication and creams to keep skin soft and supple
- bathed regularly
- kept clean and dry and free from long-term exposure to urine and feces
- provided pads to keep at risk body parts from hard surfaces

A recently released study by the Inspector General's Office of the Department of Health and Human Services revealed that, over the last two years, for-profit nursing home facilities have greatly increased the percentage of facility residents classified as needing the highest levels of care in order to collect larger Medicare payments.

The study, entitled "Questionable Billing by Skilled Nursing Facilities" found that from 2006 to 2008, the percentage of residents classified in the highest therapy groups jumped from 17 percent to 28 percent, despite little change in diagnoses or demographics. The result? A cost of an additional $5 billion cost to Medicare.

Costs incurred by individuals entering nursing homes after a hospitalization, which is paid for by Medicare Part A, are classified in a category known as a resource utilization groups (RUGs). The group the individuals are placed in is dependent upon how much therapy is needed and how much assistance with activities of daily living is required for the resident. The higher the RUG category, the more Medicare is required to pay.

For-profit nursing homes constitute more than 2/3 of nursing homes in the United States. Nearly 1/3 of residents in for-profit nursing homes were placed in the highest RUGs, while nonprofit facilities had 18% and government facilities had 13%. For-profit facilities were found to keep residents longer, up to 29 days opposed to 23 days at nonprofit facilities. According to the recently released report, "These billing patterns indicate that certain [skilled nursing facilities] may be routinely placing beneficiaries into higher paying RUGs...or keeping beneficiaries in Part A [stays] longer than necessary."

The Inspector General's Office made multiple recommendations to the Centers for Medicare and Medicaid Services for improvement and referred the 348 worst offenders to Medicare officials for action.

A Kentucky nursing home was hit with a $42,750,000 verdict yesterday in a nursing home wrongful death and negligence lawsuit.

A Hopkins County Circuit Court jury found in favor of the plaintiff and against Harborside Healthcare, a Kentucky nursing home. The case involved Mr. James Offutt, a 92 year old resident of the facility. Mr. Offutt, who suffered from cancer, lived at the facility a mere 9 days prior to his death from dehydration, despite the presence of a feeding tube. According to attorneys prosecuting the case, Mr. Offutt also developed painful sores on his body.

The jury awarded one million dollars for negligence resulting in a death, one million seven hundred fifty thousand dollars for wrongful loss of consortium for Pearline Offutt, and forty million dollars in punitive damages.

The nursing home plans to appeal the verdict.

The Oklahoma State Department of Health has posted more than three million documents about nursing homes online for public viewing. The records can be searched using city, county, zip code, or facility name and can be located here on the Oklahoma State Department of Health website.

The ability to view these documents is crucial when attempting to make a decision on what facility would best suit your loved one. Keep in mind that utilizing this site is only one of several steps you should take when considering nursing home placement for your loved one. You should view the nursing home compare information located on the Medicare.gov website. Visit the prospective nursing home several times at different times and talk to a variety of people - both residents and staff members - to get a better idea of life at the facility. Then, schedule a tour with the Administrator of the facility and ask any questions you might have.

An Arkansas jury returned a $10.45 million verdict in Valentine vs. Little Rock Health and Rehab and Heartland Personnel Leasing, Inc..

Seventy-three year old Minnie Lee Valentine was a resident of Little Rock Health Care and Rehab for a mere three months. During her residency, she suffered excruciating pain from bedsores, urinary tract infections, and MRSA and VRE infections that she developed while at the facility. Ms. Valentine also suffered from dehydration and poor hygiene. Her family filed a lawsuit alleging negligence, medical malpractice, and violations of the resident's rights act.

After hearing evidence and testimony that Brad Bedell, the owner of Little Rock Health and Rehab, failed to provide the facility with adequate policies and procedures to prevent injury, the jury awarded the family of Minnie Valentine $10.45 million, with the award against Brad Bedell personally totaling $5 million. The case was prosecuted by two Arkansas law firms.

Although not involved in the Valentine case, the Terry Law Firm recently filed a wrongful death lawsuit in Scott County, Missouri against another nursing home facility owned by Brad Bedell, in which he was named personally, along with other individuals and corporations owned by Mr. Bedell, including the facility, Hunter Acres Caring Center in Sikeston, Missouri.

In our case, Nancy Kinder was a resident of Hunter Acres Caring Center who was struck by a train just outside of the nursing home facility. The Kinder lawsuit alleges that the nursing home and its owners and operators failed to provide Ms. Kinder with a safe environment and failed to provide proper care and supervision, which ultimately led to her untimely death.

When Nancy Kinder was admitted to Hunter Acres Caring Center in December 2004, she was a known elopement risk. Less than 24 hours after her initial admission, Nancy walked away from Hunter Acres without anyone noticing. A passing motorist saw her walking down the street and contacted the facility. Nancy was able to elope from the nursing home facility several more times before Hunter Acres developed a Care Plan.

At least four separate times before her death, she was found walking toward the railroad tracks that run behind the nursing home facility. There was no fence or other barrier to prevent eloping nursing home residents from reaching the railroad tracks.

Early in the morning on March 18, 2010, Nancy eloped from Hunter Acres and walked toward the railroad tracks behind the facility. She reached the railroad tracks and walked into the path of an oncoming train, which struck her. Nancy's injuries were extensive: multiple broken bones, lacerations, extensive injuries to her left shoulder, right groin, left hip, right upper thigh, left lower leg, left upper thigh, and right hip. She also suffered a open wound to her leg, a comminuted fracture of the mid-right femur and multiple rib fractures. Hospital records indicated an "obvious deformity" to her lower extemity. After suffering excruciating pain for several hours, Nancy died.

After Nancy's death, the Missouri Department of Health and Senior Services investigated the manner in which she died and Hunter Acres was cited with an "Immediate Jeopardy" citation.

According to attorney David Terry, “If the owners had authorized money for more staff members or simply built a fence around this property, there is no way that Nancy would have been able to wander away from the facility as she often did and certainly would not have been able to reach the railroad tracks.”

Attorney David W. Terry of the Terry Law Firm recently filed a wrongful death lawsuit against Parkwood Skilled Nursing and Rehabilitation Center and related entities in the Circuit Court of St. Louis County, Missouri on behalf of Angela Thompson, the granddaughter of Nellie Wilks. Ms. Wilks died after developing two severe pressure sores on her sacrum. Those wounds were so deep that she also developed osteomylitis, which is an infection in the bone.

Parkwood Skilled Nursing and Rehabilitation Center was cited in 2008 by the Missouri Department of Health and Senior Services for failing to make sure that each resident's nutritional needs were met, failing to make sure that residents with reduced range of motion get proper treatment and services to increase range of motion, failing to ensure that residents to cannot care for themselves receive help with eating/drinking, grooming, and hygiene, failing to give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores, and failing to provide professional services that meet a professional standard of quality.

Ms. Wilks was admitted to Parkwood Skilled Nursing and Rehabilitation Center in July 2008. Upon admission, she had no pressure sores or open areas on her skin and was able to feel pain. Ms. Wilks was admitted with a gastric tube in place to help provide her with sufficient nourishment. It was also noted that Ms. Wilks could benefit from restorative care and a repositioning program, although facility staff failed to complete these processes in a timely and meaningful way.

Nine days after her admission, facility staff completed a dietary evaluation that found that Ms. Wilks' current nutrition intake was insufficient to meet her daily caloric and nutritional needs. Despite this determination, no changes were made to Ms. Wilks' diet. Sadly, no follow-up dietary assessment for Ms. Wilks' was performed until 35 days later, well after facility staff determined that Ms. Wilks' daily nutritional needs were not being met. During these 35 days, records reflected that Ms. Wilks lost 24 pounds and developed a severe sacral pressure ulcer. Ms. Wilks' family physician and family members were not notified that she was not receiving proper nutrition or of her significant weight loss.

Thirteen days after her admission, a Care Plan was developed that identified that Ms. Wilks was at risk for developing pressure sores due to decreased mobility and incontinence of bowel and bladder. Unfortunately, facility staff failed to complete the necessary steps to ensure Ms. Wilks' remained well-nourished and free of pressure sores. Sadly, Nellie Wilks died on October 26, 2008, leaving behind her closest relative, granddaughter Angela Thompson.

The lawsuit also names the owners of Parkwood Skilled Nursing and Rehabilitiation Center as well as several related companies. The allegations contained in the 29 page Petition are that the owners set up multiple companies to engage in business dealings with the Parkwood facility for the financial benefit of the owners. Owner Charles J. Riley is alleged to have "negotiated with himself" by signing a Management Agreement on behalf of both parties to the agreement that purportedly provided consulting to the Parkwood facility.

"Many facility owners see this as a way of pulling more money from the facility and into their own pockets," said attorney David Terry. "When an owner signs a Management Agreement on behalf of two different companies, he is essentially making an agreement with himself to give himself management advice. And that advice isn't free. The nursing home is required to pay for that advice, which means more money for the owner and less money for the nursing home residents."

The Terry Law Firm, L.L.C. concentrates its energy on prosecuting personal injury and wrongful death cases. If you have questions about a possible case, please contact David Terry at 314.878.9797 or visit www.TerryLawOffice.com for more information.

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If you are interested in learning more about this lawsuit, contact Karen at the Terry Law Firm to set up a time to speak with David Terry.

Seventy-six year old Emilio Gonzalez was first admitted to Southwest General Hospital in July 2007 suffering from severe dehydration. Gonzalez's health was failing as he had decreased mobility due to a stroke and suffered from Parkinson's disease and terminal lung cancer.

His attorneys concede that he may have developed a small bedsore while in the hospital, but they contend that after his return to Retama Manor Nursing Center, his home of six years, and prior to his re-admittance to the hospital on August 20, 2007, his wounds became life-threatening. He died in November 2007.

Gonzalez's daughter, Mary Koenig, testified at trial last week that his bedsores went to the bone prior to his death. Former facility employees testified that the facility was understaffed that that charts reportedly had been falsified. According to Babe Wilson, a nursing assistant, residents were lucky if they were turned once during an eight hour shift, rather than every two hours as was mandated. Nurse David Smith recalled Mr. Gonzalez's painful moans and the "dead-animal" smell emanating from his wounds. Plaintiff's nursing care expert believed federal and state laws were violated due to the inadequate care Gonzalez reportedly received.

Medical experts for nursing home counsel contend that bedsores, dehydration, and lack of nourishment all can be part of the dying process and Dr. Louis Lux found that the biggest oversight was that Mr. Gonzalez did not receive hospice care immediately upon his lung cancer diagnosis. According to Dr. Lux, "He did exactly what a cancer patient would do. There's a slow unraveling of the body here. It affects your skin health. The cancer is robbing his body of nutrition and not allowing him to heal."

The trial continues.