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?" »

An Alton, Illinois nursing home worker has been charged with criminal abuse or neglect of an elderly person and unlawful possession of a controlled substance.

The 41 year old employee of the Bethalto, Illinois nursing home, which remains unnamed, reportedly removed a Fentanyl pain patch from an 87 year old resident on Friday for her own personal use. Fentanyl, a powerful pain killer often administered through patches, is frequently used illicitly because it reportedly affects the body in ways similar to heroin.

According to the Madison County State's Attorney's Office, the nursing home staff reportedly noticed the absence of the woman's pain-killing patch and replaced it.

Sadly, this is an all too common story. Many nursing homes do little, if any, background searches on potential employees. Far too often, as a result, individuals with criminal backgrounds, drug problems, or worse are allowed to be in a close physical and often intimate, contact with vulnerable senior citizens. To make matters worse, nursing home staffing levels are often cut so deep that many employees have virtually no supervision.

If your loved on is in a nursing home, check them often, ask questions, insist on answers and be suspicious of every single employee. It is a sad, but true, fact of life.

The Terry Law Firm is experienced in handling cases of nursing home abuse and neglect. If you suspect that your loved one may be experiencing abuse or neglect at the hands of nursing home staff and need advice, contact Illinois Nursing Home Abuse and Neglect Attorney David Terry at (888) 317-2525 for a FREE, no obligation consultation.

An Illinois nursing home's Director of Nursing is dead following a drug overdose, according to published reports.

Forty-one year old James Scooler, the Director of Nursing for Timbercreek Rehab & Healthcare Center, died on April 1, 2011 at the facility. Scooler was found on his knees in a restroom near his office after facility employees noticed he was missing for approximately two hours. The deputy coroner pronounced him dead around 9:59 p.m. Upon examining the body, the deputy coroner found a syringe in Scooler's right sock filled with a Fentanyl patch and saline solution. The autopsy examination also revealed a Fentanyl patch wrapper in Scooler's left sock and fresh puncture wounds between Scooler's thigh and groin. Scooler reportedly died from a Fentanyl overdose after he took the medicine from a lock box used to temporarily hold prescriptions of patients whose medications have changed or who have died.

At the time of his death, Scooler was on probation with the Illinois Department of Professional Regulation for substance abuse. He had been suspended from May 25, 2007 through November 18, 2008 for "failure to abide by the terms of his care, counseling, and treatment agreement". He was restored to probationary status on November 18, 2008 for three years.

As troubling as Mr. Schooler's death is, it is equally troubling that Timbercreek Rehab & Healthcare was aware of Scooler's probationary status but reportedly did not drug test him because "it assumed the IDPR would be monitoring him". Not only did they refuse to drug test a person with known drug problems, they also put Scooler in charge of disposing the facility's narcotic medications. In my mind, this is equivalent to putting an alcoholic in charge of stocking a bar. At best, this was horrific judgment on the part of Timbercreek management and ownership. A file cabinet containing those drugs was found in Scooler's office with a padlock on it. Because the key could not be located, the lock was cut off and Pekin Police Detective Matt Damron found evidence that the medications were not being disposed of and some of the medications dated back to January 2011.

If you or a loved one has suffered abuse or neglect at the hands of an Illinois nursing home, contact David Terry at the Terry Law Firm at 314-878-9797 or 888-317-2525 to schedule your free no obligation consultation.

We discussed Angela Almore and her role in an overdose death at Britthaven, a North Carolina Nursing home, in previous blogs.

Almore was indicted on six counts of patient abuse for reportedly giving residents morphine who were not prescribed the drug, causing one resident to die. In that case, she has been indicted for second degree murder. The State has alleged that Almore gave the drug to the residents to keep them sedated. Almore was observed passing out small cups to the residents and telling them it was vitamins.

Almore remains free on bond pending her September 12 trial date. She has pleaded not guilty to the charges.

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.

We discussed a Kansas nurse suspected of nursing home drug tampering in our previous blog.

Deborah Riggs, a narcotics charge nurse at Halstead Health and Rehabilitation Center in Kansas, pleaded guilty on December 13, 2010 to one count of consumer product tampering and one count of adulteration of a drug. She faces up to ten years in prison and a maximum fine of $250,000 on the tampering charge and up to three years in prison and a maximum fine of $10,000 on the adulteration count. Under the plea deal, the other charges against Riggs have been dropped. Sentencing is set for March 7, 2011.

Officials at the nursing home facility reportedly noticed broken seals on the morphine-based solution bottles and sent them to a lab for testing; nursing home officials also alerted federal authorities of a potential drug tampering problem.

As a narcotics charge nurse, Riggs was in a position of authority. She held keys to the narcotic medications room and cabinet where the drugs were stored. According to information in Riggs' plea agreement, she acknowledged that she diluted between 32% and 62% of morphine sulfate solutions and replaced it with another substance in December 2009.

Riggs has had problems with controlled substances in the past. According to information in the Kansas City Star, Riggs has a history of convictions and nursing license suspensions for mismanaging or stealing controlled substances.

Riggs was convicted in federal court in 1998 of felony possession of a controlled substances by fraud. She was sentenced to four months of home detention and two years' probation in that conviction. Her nursing license was suspended in February 2000 for forging prescriptions; unfortunately, her suspension was stayed and Riggs was allowed to continue working as a nurse.

In 2008, Riggs' nursing license was suspended again for drug abuse and narcotic theft that occurred while she was working as a nurse at a Wichita, Kansas hospital. Once again, the Kansas Board of Nursing stayed Riggs' suspension and allowed her to continue working.

A Kansas nurse accused of tampering with drugs at a Kansas nursing home wants a plea deal.

Deborah J. Riggs, 55, has had a previous drug conviction and has had her nursing license suspended twice after allegations of stealing controlled substances. In this instance, Riggs is accused of diluting morphine solutions which were intended for five residents of Halstead Health and Rehabilitation Center and faces a 10-count indictment for tampering with a consumer product and adulteration of drugs.

Riggs is scheduled for a change-of-plea hearing on December 13, 2010 in U.S. District Court.

A nursing supervisor in Washington state admitted to stealing pain medication from her defenseless nursing home residents.

Jolene Larsen admitted to stealing morphine on multiple occasions from prescription vials and replacing the missing contents with water. The thefts occurred between November 2009 and May 2010 when she worked as a nursing supervisor at Merry Haven Care Center in Snohomish, Washington.

Larsen faces up to ten years in prison and a possible fine.

The real question here is whether the nursing home facility knew or should have known of Larsen's thefts. Did the nursing home do a background check before Ms. Larsen was hired? Did the nursing home provide adequate staffing or was Larsen alone much of her work day? Was there adequate supervision?

Families whose loved ones have been victimized by nursing home staff should ask those questions. It may be that the offending individual was simply a "bad egg" that was able to get through the system. It also may bae that the nursing home shares some of the blame.

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.

Gramercy Court, a California nursing home facility, was cited with a Class AA citation, the most severe citation possible, and fined $90,000 in connection with a 2007 fatal fall.

A 97 year-old resident was injured when she fell from her bed to the floor after a nurse had turned her back to the resident. The resident was rushed to the hospital with a broken spine, but sadly, she died four days later.

The ensuing investigation found that, had a bed rail been in place, the accidental fall could have been prevented.

This is not the first time that Gramercy Court has been in the eye of the California Department of Public Health. In 2008, the facility was assessed a Class AA citation and fined after a resident died after facility staff failed to keep her hydrated.

Officials at Golden LivingCenter - Walnut Creek, a nursing home in Pennsylvania, are taking aggressive action after a resident was diagnosed with Legionnaires' Disease last week.

According to Leonard Quimby, the Director of Operations for the facility, Legionella bacteria was found in the facility's water. Building disinfection began with hot water being flushed into the facility's pipes throughout the building and bottled water is being distributed to residents.

Legionella bacteria grows well in warm water, such as water found in hot tubs, cooling towers, and large plumbing systems. Those contracting Legionnaires' Disease often get it by breathing in droplets of water or water mist. Legionnaires' Disease is not transmitted through direct contact. Symptoms usually begin two to fourteen days after exposure.

Legionnaires' Disease is a form of pneumonia, so it can be hard to diagnose at first. Signs of the disease can include a cough, high fever, and chills. Some victims may also suffer from muscle aches and headaches. Chest X-rays are needed to find the pneumonia caused by the bacteria, and other tests can be done on sputum (phlegm), as well as blood or urine to find evidence of the bacteria in the body.

Illinois CNA Jeremiah Healless pleaded guilty to unlawful possession of a controlled substance as part of an agreement in which he was also ordered to undergo substance abuse treatment while in jail. He was sentenced to two years in prison.

Healless was a CNA at Fair Oaks Health Care Center in Crystal Lake, Illinois when he entered a ninety-two year old Alzheimer resident's room, poked holes in her Fentanyl patch, pinched it to get the drug to come out, and licked the painkiller off of his fingers. According to the woman's son, the Fentanyl pain patch was the only way that his mother could remain pain-free. Healless was caught on video tampering with the woman's pain patch. To read more about this incident, click here to read our blog.

Tampering with pain medication is abuse. Unfortunately, more and more Illinois residents are suffering abuse and neglect at the hands of those paid to care for them. If you would like to receive a free book entitled 5 Things You Must Know About Nursing Home Abuse and Neglect in Illinois written by Illinois nursing home abuse attorney David Terry, go to www.IllinoisNursingHomeABuseBook.com. There is no cost to you and no obligation.

Marlene Delp

Muliple defenseless nursing home residents were left to suffer in pain after a nurse caring for them reportedly stole their pain medications.

Marlene Delp was arrested and charged in August 2010 on suspicion of stealing medications from almost twenty residents of The Terraces of Roseville, a California nursing home facility. The owner of The Terraces at Roseville suspected that Delp was stealing resident medications and alerted local police, who began an investigation.

Police searched the apartment in which Delp resided at The Terraces and found a variety of medication prescribed to 28 different people, 19 of whom were facility residents. Reportedly, she was replacing the residents' painkillers with over-the-counter medications.

She has been released from jail and a restraining order forbids her from working at the facility.

Alesha Neault faces two felony counts of unlawfully possessing a controlled drug and two misdemeanor counts of abusing a facility resident after she reportedly removed Fentanyl patches from two nursing home residents. Neault allegedly kept the patches for her own use.

What is Fentanyl?

Fentanyl is a powerful painkiller that is 100 times more potent than morphine. Typically used to help control severe, persistent pain, such as postoperative pain or pain due to cancer, the Fentanyl pain patch delivers a controlled dose of the drug through the skin into the bloodstream over a period of three days.

Sadly, drug addicts are misusing the pain patch. Nursing homes often use the Fentanyl pain patch to help keep their chronically pain-ridden residents comfortable. As you read above, some nursing home employees are stealing Fentanyl patches from their defenseless residents and leaving them to suffer excruciating pain so they can use the patches themselves. Reportedly, drug abusers are able to withdraw the full dosage of the drug and take the entire dose at one time, either through injection, ingestion, or smoking.