Elderly nursing home residents are especially prone to developing contractures due to frailty, such as brittle bones or weakened muscles, or medical conditions. Often, bedridden residents suffer contractures due to their inability to ambulate to receive adequate exercise.

There are several methods that can be used to help prevent contractures or lessen their severity.

POSITIONING

Positioning is important in nursing home residents. Make sure that your loved one is seated properly in chairs, wheelchairs, and beds. You may need to use pillows or cushions to achieve the proper sitting position.

SPLINTING

Often, nursing home facilities utilize splinting devices, such as special boots, wrist cushions, or pads, to help keep the resident's hands or feet from drawing up. Knee and elbow braces are also available to keep knees and elbows from stiffening, while allowing the resident free range of motion. Occasionally, special boots or splints may be used to help prevent toes and fingers from drawing up.

EXERCISE

The most important weapon in preventing contractures is exercise. Nurses, nurse aides, and physical therapy staff are fully aware of contractures and how to help prevent them. Range of motion exercise is very important and staff must take the time to assist immobile residents. Passive range of motion exercises involve gently rotating the affected joint clockwise and counterclockwise and should be performed at least two to three times per day.

The Madison County Elder Abuse-Fatality Review Team is the first of its kind in the Metro East and only the second one in the State of Illinois. The team will review cases of suspected or alleged abuse, neglect, or exploitation of the elderly. The team is headed by Maryville Police Chief Richard Schardan and consists of members of law enforcement and health care communities. Nonn said, "We see this team has having two primary benefits. First and foremost, several sets of eyes are looking at a case with each individual viewing it from a different perspective. Second, it serves as a remarkable information-gathering tool that enables us to discover gaps in the system and services provided for our senior population."

On January 14, 2010, moisture and mildew were found in the facility's C Wing. According to the IDPH investigation, "a notice from the city of Streator Fire Chief (Tom Risley) dated January 14, 2010, sent to the facility's owner states that the city received a complaint regarding roof leakage and water damage at the facility. The notice indicates (the fire chief) performed an inspection at the facility on December 29, 2010, and found the building was in violation related to the roof and interior surface sections of the city code. The notice indicates that the violations are of a serious nature, and that 'signs of rust and water damage' are present on light fixtures and electrical switches on the northeast wing of the building." Additionally, several facility employees reportedly advised the IDPH that "mold/mildew" smell near the nurse's desk.

A January 12, 2010 state inspection revealed "black mildew was present on the wall in the space approximately six inches high between the suspended ceiling tiles and the bottom of the concrete ceiling near the video camera located just inside the fire doors for C wing. An area of sagging, darkly-stained ceiling, approximately 2 1/2 feet square was present in the assisted feeding area near the wall adjacent to the C wing common area. Another inspection performed on January 14, 2010 found "black mildew was present under the layers of peeling paint at the top right side of the door jamb of the activity office, where water was dripping down at the time. Black mildew was present on the inside of the drywall up approximately two feet from the floor, visible in an approximate 16-inch wide area where...had removed a section of wet drywall in room C12 alongside the entry door to the right."

Crystal Lopez, a CNA at the facility for 13 years, believes the facility's environment is causing problems for the residents. She said, "People have been having rashes, headaches, itchy and watery eyes, asthma and difficulty breathing." She said the symptoms have been increasing over the last few weeks, but no one was taken to the hospital.

Michael Lerner, owner of GEM Healthcare in Chicago, disputes the mildew findings, saying, "It was accumulated dust. We cleaned it up and are back in business. We replaced the ceiling tiles."

According to the IDPH, an investigation at the facility continues concerning "safety and health conditions".

New admissions were suspended at Serene Manor Medical Center, effective February 1, 2010, until further notice. A recent complaint inspection found problems with administration, nursing services, and performance improvement. Until problems are corrected in these areas, the facility faces a federal fine of $5,050 per day. The facility also faces a one- time state fine of $1,500. A monitor has also been appointed to observe daily facility operations.

Police checked the fingerprint and found that Sharon Bines Kaiser was an employee of Cypress Village and could access the victim's room. After further investigation, police determined that Kaiser had pawned ninety items since March 2009.

Kaiser was arrested and charged with dealing in stolen property, giving verification of ownership on pawned items, and elderly abuse without bodily harm. She faces similar charges in the other thefts.

Adam Waeltz was a seventy-four year old developmentally disabled resident of Golden Moments Senior Care Center in Jacksonville, Illinois. Waeltz often ate and drank too quickly and was known to be at risk for choking on food. According to an Illinois Department of Public Health report, Waeltz, who had no teeth, was given ham that was torn into pieces, instead of receiving ham that was ground up. He collapsed and died. The coroner responding at the scene found ham pieces and mashed potatoes from Waeltz's mouth lying next to his body. His autopsy revealed a wad of ham pieces the "size of a tangerine" in Waeltz's windpipe. Coroner Jeff Lair filed a complaint with the Department of Public health that triggered the investigation.

State officials fined Golden Moments Senior Care Center $50,000 related to the poor care that was provided to Adam Waeltz.

The 2005 law capped "pain and suffering" jury awards against physicians at $500,000 and hospitals at $1 million. Today's ruling essentially stated that the law infringed on an issue that is supposed to be decided through the court system.

Illinois' medical and business industries have long held that out-of-control jury awards against physicians and hospitals led to skyrocketing medical malpractice rates and forced Illinois physicians to move their practices elsewhere, especially in the Metro East, which is nationally known for high malpractice jury awards. Lawyers and labor and patient rights groups point the finger at the insurance industry for the high malpractice rates.

In an unusual development, some of the Illinois justices apepared to take personal shots at each other in their written opinions. Maryjane Wurth, president of the Illinois Hospital Association, said, "The hospital community is deeply concerned that this decision will renew the malpractice lawsuit crisis and make it more difficult for Illinoisans to access or afford health care." Peter Flowers, the president of the Illinois Trial Lawyers Association, said, "With this decision, we can now focus on the real issue - providing meaningful insurance reform that will keep costs down for doctors and patients alike."

Two former caregivers at Community Presence, Inc., a Kentucky nursing home facility, were sentenced for their roles in the abuse of a resident, who died.

On October 14, 2007, Michael Price, a mentally handicapped resident of Community Presence, Inc. for seven years, died after caregivers placed him in a prone restraint. Price, who also suffered from cerebral palsy, stopped breathing and died after caregiver Matthew Bortles laid on his back for more than 30 minutes. After the caregivers discovered Price's death, they conspired to cover it up.

Todd Gribbens and Earl Pelphrey pleaded guilty on December 4, 2009. As part of their plea agreement, they both received one year for wanton abuse of an adult, first degree wanton endangerment, and first degree unlawful imprisonment. Their sentences are diverted for five years. Both are forbidden to work as caregivers of vulnerable adults or children. Two other men went to prison for their roles in Price's death.

Attorneys for Rosewood Care Center argued in front of Illinois' Fourth District Appellate Court of Appeals concerning a recent ruling by Sangamon County Circuit Judge Leo Zappa. Springfield attorney Daniel Maher argued that state officials should not be allowed "absolute discretion" in deciding how much to fine nursing homes for substandard care. Instead, Maher feels that the Illinois Department of Public Health (IDPH) should be limited to a maximum fine of $10,000 when imposing a flat fine on a nursing home facility.

State officials maintain that the enhanced fines are legal. A 1991 state law calls for fines "not less than $5,000" and "not less than $10,000", depending upon the severity of harm to the nursing home resident. Illinois Attorney General Jan Hughes holds that the $10,000 cap hinders the department's ability to protect defenseless nursing home residents.

The Appellate Panel has the option to throw out the $25,000 fine due to a technicality connected to the IDPH's delay in issuing a final fine against the facility. If the panel opts to throw out the fine, then the panel is also obligated to void Judge Zappa's ruling for the $10,000 cap on nursing home fines. The panel, which consists of Judge Carol Pope of Petersburg, Judge Sue Myerscough of Springfield, and Judge John Turner of Atlanta, is expected to rule on this matter within the next few months.

A manager at St. Clare Meadows called the police due to the possible theft and advised police that the facility had a problem with Fentanyl patches (a powerful painkiller) being removed from residents who were unable to speak or communicate. The patches are designed to release the painkiller gradually over a period of three days.

In one instance, a resident had a Fentanyl patch in place, but 45 minutes later the patch was gone. A security camera recorded only Pierce and another employee entering the room during that time. As the patch was applied to the resident's back, only another person could have removed it. When questioned by police, Pierce admitted that she removed the pain patch and flushed it down the toilet when she discovered that the manager was looking into the theft.

Pierce is to appear before the Court on February 18, 2010. If convicted, she faces a maximum sentence of three years, six months in prison and a $10,000 fine.

The Centers for Medicare and Medicaid Services conducted a ten day investigation at the facility and, at its conclusion, threatened the facility with termination from Medicare and Medicaid if the problems are not corrected within 23 days. Federal fines of $6,050 are accruing daily against the facility. The Public Health Department began the process to revoke the facility's state nursing home license last week. According to a Public Health Department spokesperson, "This happens very infrequently. This is the most serious thing the state can do." The facility has requested a hearing to contest the license revocation saying "the well-being of our residents, the community and our 250 employees is of paramount importance to us and we are committed to resolving these matters and moving forward."

Somerset specializes in caring for mentally ill adults. Among its 400 residents, Somerset housed 66 felons. From April 2008 to July 2009, police investigated 15 alleged assaults and/or batteries, five criminal sexual assaults, and five narcotic possessions - all within the facility. One Somerset resident, Maratta Walker, had been prostituting herself and using cocaine while a resident at the facility.

Somerset reported profits of approximately $2.3 million on revenues of $15.5 million in 2008, almost all of it from Medicaid.

Current Ohio law only requires that anyone living within 1,000 feet of the sex offender be notified. The law does not require nursing home administrators to inform residents, family, or guardians.

The bill calls for a $100 per day violation for facilities that fail to comply with the new legislation.

Case documents indicate that prescription drugs were repackaged from the original manufacturer's bottle and placed into blister packs. Those packs were labeled with incorrect expiration dates and provided to area nursing homes from March 2007 to March 2008.

Thalmann faces up to one year of imprisonment, one year of supervised release, and a fine of $100,000. The corporation faces a maximum sentence of five years probation and a fine of $500,000.

Dr. Pham treated residents at nursing homes and residences for elderly adults. The facilities he provided services to were: Abbey Care Center, Alexian Court Apartments, Beverly Farm (IL), Claru Deville Nursing Center, Columbia Convalescent Center (IL), Creve Coeur Manor, Delmar Gardens of Chesterfield, Four Fountains Convalescent Center (IL), Grand Manor Nursing and Rehabilitation, Hillside Manor Healthcare and Rehab Center, Normandy Nursing Center, Ozark Manor Residential Care Center, Parkview Apartments, Rancho Manor Health Care and Rehab Center, Rosewood Care Center (IL), St. Paul's Home (IL), St. Elizabeth Healthcare, The Cedars at the JCA, and University Forest Nursing Care Center.

After discovering he was being investigated for health care fraud, Dr. Pham created false treatment notes to support the claim that services that had been provided, when in fact they had not. Responding to a subpoena from the United States Department of Health and Human Services, Office of the Inspector General, these notes were provided. Dr. Pham, a podiatrist, allegedly submitted claims for treating the feet of patients who had undergone amputation prior to the date of service. He also falsely claimed to have provided services to nursing home residents who were hospitalized on the dates he reportedly provided his services. Dr. Pham's assistant, who is unlicensed as a physician or a nurse, was also allowed to provide services. Reportedly, Dr. Pham submitted false claims and medical records to Medicare and Medicaid for at least five years.

Eighty-eight year old Eva Carriveau was hospitalized when she woke up during the night and found someone in her room. She asked what the person was doing and was told that she was straightening the room. Carriveau, who is hard of hearing and couldn't see, was unaware that her credit card had been stolen until she was billed in April 2009 for charges she couldn't possibly have made.

Mota faces three years in prison and approximately $6,000 in fines.