Nursing Home Abuse Lawyer Blog

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.

An Arkansas CNA faces manslaughter charges after a resident under her care had unexplained burns on his body.

The CNA was arrested on Wednesday and charged with manslaughter in the death of a 65 year-old resident at Three Rivers Healthcare and Rehabilitation Center. The resident, who was paralyzed, was found unresponsive in his electric wheelchair at a cemetery located approximately one mile from the facility.

The man was transported to a local hospital and then taken to The Med in Memphis, Tennessee, where he died on June 4. An autopsy revealed that the man had severe burns on the lower half of his body.

According to the police investigation, the CNA had given the man a bath on June 4 in a whirlpool often used for residents confined to wheelchairs. The resident's body had areas that were unburned on his body that were consistent with straps used to keep him stable in the chair while bathing. According to the prosecuting attorney, "The medical examiner said his death was related to the burns. We found that the CNA was responsible for the bath. She didn't treat or dress the burns and she failed to notify anyone about the burns.

The CNA is set to enter a plea to the charges on July 25, 2011.

Elderly nursing home residents often have fragile skin. Subsequently, nursing home staff must employ all safety measures possible when bathing residents, especially paralyzed residents who are unable to feel extremes in temperature. It is the responsibility of the nursing home and its related corporate entities to ensure that facility staff are properly in-serviced on the sensitive job of bathing the elderly residents. Included in that training should be the appropriate temperature for bathing residents. Sadly, injuries such as this are not uncommon.

This injury could have and should have been avoided. Facility staff should be familiar with facility policies for proper bath water temperatures to insure that residents are not accidentally scalded. If policies and procedures fail to address appropriate temperatures, then staff should test the water before the elderly resident is bathed. If the water is hot to the point of being uncomfortable to their touch, then they know that it will be uncomfortable for the elderly resident.

TheTerry Law Firm is experienced in handling cases of nursing home abuse and neglect. If you or a loved one has suffered injury at the hands of nursing home staff, contact David Terry at 1-888-317-2525 to schedule your FREE, no obligation consultation today.

The St. Louis Veterans' Administration Medical Center (VAMC) is known as a "national disgrace" and ranks dead last in patient satisfaction among all VA facilities in the nation, according to a recent article published in the St. Louis Post Dispatch.

Problems found at the VAMC make a long list. Most recently, there have been sterilization problems in the operating rooms, which forced the facility to close its surgery center until they could be resolved. In the not too distant past, the VA Dental Clinic was forced to shut down after 1,800 veterans were exposed to HIV and hepatitis after problems with sterilization procedures at the clinic.

Sadly, (but thankfully!) the employees themselves have become whistleblowers on the facility that should be honoring our veterans, not degrading them. According to facility employees, veterans sit in soiled linens for days, supplies are not provided, and patients have to use broken equipment, if it can be found at all. Wes Gordon, a nurse at John Cochran, said, "It took me two years and three months to get applesauce for the patients that can swallow their pills." Imagine that. These men and women put their lives on the line for our freedom and it takes their medical provider two years for a simple request.

According to the medical center's director, Rima Nelson, "Every veteran watching should know and feel assured that the care we deliver here when we deliver it is of the highest quality."

Two federal investigations into the condition at the facility are underway and should be completed by mid-spring. Hopefully, the results of those investigations will prompt those in charge of John Cochran to provide better, more quality care for the special people we have entrusted to their care.

It's a fact: older people have a tendency to fall due to changes in their bodies, such as vision decline, hearing impairment, or decline in coordination. Injury from their falls is increased due to their age and weakened bones, medication side effects, chronic illness, or injured feet. Each year, one out of three adults 65 and older fall. Falls are a leading cause of death from an injury and are responsible for more than 90% of hip fractures in people over age 70.

There are many basic steps that nursing homes can and should be taking to protect our fragile loved ones:

• Encourage exercise to improve strength, balance, and muscle tone
• Schedule regular eye and hearing appointments
• Know the side effects of the medications your loved one has been prescribed
• Encourage the use of a walker or cane for support, if warranted.
• Use nonskid adhesive strips in areas that could be a slip-hazard, such as bathrooms, bathtubs, or next to beds
• Make sure floors are clear of debris, electrical cords and wires and are not highly waxed
• Make sure all rugs have good nonskid backing and that all carpets have no loose ends or rips
• Ensure the living area has good lighting, especially in stairwells, porches, or garages
• Install handrails in bathrooms and bathtubs for stability, if needed
• Provide the number of individuals necessary to help them ambulate safely

Unfortunately, too many nursing homes are so short-staffed that they are unable to provide the level of care and supervision many elderly residents need. As a result, residents fall. Thankfully, most falls do not result in serious injury. However, falls can have serious consequences up to and including death.

If your loved one needs help walking or transferring, make sure you talk to the nursing home employees and tell them that you expect them to staff the facility to meet the needs of the residents. Follow up often and, if tney are not doing so, complain to those in charge. Don't hesitate to take your loved one to a different facility.

In a tragic accident, a 78 year-old nursing home resident was struck and killed after he eloped from an Illinois nursing home facility.

William Spears, a seven year resident of Emeritus at Prospect Heights, walked out of the facility late in the evening on February 23, 2011. Spears, who uses a walker, was attempting to cross Euclid Avenue when a driver stopped and tried to assist him out of the roadway. Spears reportedly refused assistance and was struck by an SUV in the eastbound lane of Euclid. He was rushed to Advocate Lutheran General Hospital, where he was pronounced dead.

The Illinois Department of Public Health and Prospect Heights police continue to investigate how Spears managed to leave the nursing home facility without assistance.

While we don't know the specifics in this case, it is not uncommon for nursing home residents with dementia to become confused, wander and try to leave nursing home facilities. Nursing home residents suffering from dementia are challenging to care for, but nursing homes know that this is a part of the day-to-day care they are to provide. In fact, many nursing homes advertise that they specialize in caring for those with dementia. To that end, nursing homes are required to assess each resident to determine their risk for wandering. If the risk is there, the facility is to initiate a plan of care specifically designed to care for the residents at high risk for wandering and elopement.

Some aspects to such care plans include:

•To consistently monitor doors—especially during shift changes where residents are particularly inclined to wander
•Place residents that have been characterized "at risk" for wandering closer to nursing stations so that they can be more closely monitored
•Using alarms on the resident's bed, wheelchair or door as well as the residents themselves
•Exit doors should be alarmed to notify staff when residents leave the facility
•Using "Wanderguard" bracelets that sound an alarm if a resident passes a designated spot.

If you suspect that a loved one in a nursing home may be at risk for elopement, contact Illinois Nursing Home Abuse and Neglect Attorney David Terry for a free no-obligation consultation at 1-888-317-2525 or 314-878-9797. For more details about wandering and elopement of nursing home residents, go here.

In Part 1 of our review of Embassy, we described the facility's general problems and its assignment to the Special Focus Facility list of perpetually underachieving nursing homes. Today, we delve into some specifics that should concern those who have loved ones in this facility. In Part 2 of this review, we will break down the deficiencies and what they mean for residents and their families.

Embassy Health Care Center was cited for Mistreatment Deficiencies in 2008 and 2010 when it failed to keep each resident free from physical restraints, unless necessary for medical treatment. Both bed rails and wheelchair lap belts are considered to be physical restraints. While the exact nature of the violations at Embassy Health Care Center is unknown, families of nursing home residents need to know that unless doctor's orders are in place to use safety devices such as bed rails or wheelchair lap belts, facility staff members are not allowed to implement safety devices. This is for the protection of the residents. Embassy Health Care also was cited for Mistreatment Deficiencies on March 17, 2008 and again on November 19, 2010 when it failed to hire people who have no legal history of abusing, neglecting, or mistreating residents or failed to report or investigate any acts or reports of abuse, neglect, or mistreatment of residents.

Embassy Health Care Center racked up an amazing 22 deficiencies in the area of Quality Care during the last three years. According to detailed inspection results, the facililty consistently failed to provide residents with services that meet a professional standard of quality. It also consistently failed to give each resident the care and services to get or keep the highest quality of life possible for the resident. In fact, one or more residents were actually harmed on June 10, 2010, when the facility failed in this respect. All facility residents were placed in immediate jeopardy on December 16, 2010 when the facility once again did not provide appropriate services. One or more residents were harmed in March 2008 and again in June 2010 when the facility did not provide the appropriate treatment to residents suffering from bed sores to heal the existing bed sore or to prevent new bed sores from forming. Appropriate treatments to be considered for resident suffering from bedsores or that have the potential to develop bedsores are medicated creams that promote healing, air mattresses, and simple turning of the resident's body approximately every two hours. Sometimes, due to a resident's diagnosed ailments, a resident may require special rehabilitation and a physician may order it to be placed in the resident's Care Plan. Due to the multiple deficiencies the facility received in this area, including on March 26, 2010 when a facilty resident was actually harmed, it appears that facility staff may not know the contents of each resident's specific Care Plan or may not know that a Care Plan exists.

Proper diet and nutrition is vital for everyone, but is especially important for nursing home residents who rely upon nursing home staff for all of their dietary needs. On June 10, 2010, one of the residents at Embassy Health Care Center was harmed when their nutritional needs were not met.

Medication errors can be fatal. At the very least, a medical error can can cause severe impairment and illness. Medication errors include providing a resident with the wrong drug, wrong dose, and/or at the wrong time. Therefore, it is very important that nursing home staff make sure that pharmacy error rates remain as low as possible and no higher than 5%. Embassy Health Care Center did not keep the rate of mediation errors, which include wrong drug, wrong dose, and wrong time, to less than 5% in November 2007 and June 2010. On December 16, 2010, state investigators found that an Embassy resident suffered actual harm when facility staff failed either to ensure that residents taking medication were not given too many doses or for too long, failed to make sure that the use of the drugs was carefully monitored, or failed to stop or change medications that caused unwanted side effects.

The nursing home environment should be clean, safe, and homelike. Residents residing at Embassy Health Care Center were actually harmed multiple times in 2008 and 2010 when facility staff did not make sure that the nursing home area was free of dangers that could cause accidents. While we don't know what specifically happened at Embassy Health Care Center, some common dangers that are found in nursing home environments are overly long telephone cords that become trip hazards or puddles of urine or water in hallways or walkpaths which become slip and fall hazard.

If you have a loved one at Embassy Health Care Center and are concerned about the care they are receiving, you should contact an Illinois Nursing Home Abuse Lawyeras soon as possible. 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 employees, please contact us for a FREE no obligation consultation toll-free at 1-888-317-2525 or order David Terry's book, 5 Things You Must Know About Nursing Home Abuse and Neglect in Illinois, click here.

Embassy Health Care Center, a nursing home facility located in Wilmington, Illinois, is a for-proft nursing home facility with 169 certified beds. Owned by Jack L. Rajchenback, Nachshon Draimain, and Samuel Lipshitz, this facility is rated overall as a one-star facility, which is "much below average", according to the rating system instituted by The Centers for Medicare and Medicaid (CMS). This terrible rating is due primarily to poor results on Health Inspections.

The average number of health deficiencies found at Illinois nursing home facilities is 8, which is the same average number of health deficiencies found nationwide. During the last three complaint reporting periods, Embassy Health Care Center has consistently performed substantially worse than the Illinois average, racking up nearly twice the number of deficiencies for average facilities in Illinois and nationwide. For the 2010 reporting period, the nursing home inspectors cited the facility for 15 separate deficiencies while 14 deficiencies were found in the 2009 reporting period. And, in 2008, a whopping 20 deficiencies were assessed against this facililty.

Ask any honest Illinois Nursing Home Abuse Lawyer and they will admit that most nursing homes are going to have some deficiencies and many nursing homes are good about correcting any identified problems within a short period of time. However, there are a few nursing homes that experience substantially more problems than other nursing homes with more serious citations. These nursing homes tend to present with a pattern of problems that have existed over a long period of time. When state inspectors find a facility meeting this criteria, the nursing home is often placed on what is known as the Special Focus Facility list and inspectors for CMS institute new criteria for the facility. For instance, once a nursing home lands on the Special Focus Facility list, the facility will be inspected twice a year, rather than the normal one time per year survey inspection. The longer problems exist, the more stringent enforcement actions, such as monetary fines, will be. According to CMS, within 18-24 months after a facility is placed on the Special Focus Facility list, the outcome will be one of three things:

(1) The best case scenario is that the facility makes significant strides in improvement and
graduates from the SFF program.

(2) The facility is provided with additional time to continue to make improvements under the
SFF program.

(3) The nursing home is terminated from Medicare and Medicaid programs. While a facility
may continue to operate without the benefit of these programs, usually a facility closes
upon loss of funding.

Due to its consistently poor performance, Embassy Health Care Center has resided on the "Special Focus Facility" list maintained by The Centers for Medicare and Medicaid for 43 months. It is currently known as a facility that has shown no improvement.

Continue reading "Illinois Nursing Home Lawyer Weighs In On The Problems At Embassy Health Care Center: Part 1" »

A problem Chicago, Illinois area nursing home faces loss of funding and possible closure after reports of bloody fights and drug abuse occurring at the facility.

Wincrest Nursing Center, a nursing home primarily housing adults suffering from mental illness, has been a long-standing community problem. A 2009 Chicago Tribune article revealed that the facility failed to notify state officials that the facility was home to dozens of residents with felony records. In late February 2011, a 21 page report from the U.S. Center for Medicare and Medicaid Services was sent to the facility and its contents were not good.

Reportedly, the inspectors found that facility staff was poorly trained and failed to properly supervise dangerous residents or provide them with much needed psychiatric services "to prevent avoidable mental deterioration". It further reported that some facility residents were "often found in the facility intoxicated or under the influence of drugs" and other residents failed to receive prescribed psychotropic drugs.

A December 2010 report from the Illinois Department of Public Health reportedly found that a female facility resident was prostituting herself in the neighborhood and using the money to purchase crack cocaine. A male resident of the facility threatened another resident with a foot-long knife. While the knife was confiscated, inspectors later found another knife in the man's room in full view. According to the report, Wincrest's policy and procedure manual "was about 45 years old" and, amazingly enough, the facility Administrator, Narad Persadsingh, could not name the facility's Medical Director.

WIncrest has been slapped with more than $400,000 in federal and state fines since December 2010 and, as of February 9, 2011, faces an ongoing $10,000 per day fine. Wincrest faces loss of their Medicaid funding on March 20 if the "immediate jeopardy" citations are not properly corrected. As Wincrest depends on Medicaid for approximately 99% of its funding, cutoff of Medicaid funding will likely force Wincrest to shut its doors.

According to State Rep. Harry Osterman, "This action is long overdue. Wincrest has been a problem nursing home in our neighborhood for a number of years."

Golden LivingCenter - Smithville is a 120 bed nursing home facility located in Smithville, Missouri. In the past three years, the inspection deficiency record for Golden LivingCenter - Smithville has hovered around the average number of health deficiencies in Missouri twice. Golden LivingCenter - Smithville was cited for seven deficiences in 2010 and six deficiencies in 2008. In 2009, they recorded eleven deficiencies. The average number of nursing home deficiencies in Missouri is seven. Currently, Golden LivingCenter - Smithville has an overall rating of three-stars, according to the system instituted by the Centers for Medicare and Medicaid. A three-star rating indicates that the facility is an "average" nursing home facility. On Health Inspections and Staffing, they received two-stars, which is "below average", however, a "much above average" five-star rating for Quality Measures, helped their overall rating.

No one would argue that nursing home residents should be treated fairly and humanely. Golden LivingCenter - Smithville amassed thre Mistreatment Deficiencies in the past three years when it failed twice to write and use policies that forbid mistreatment, neglect, and abuse of residents and theft of residents' property. The citations also involved the facility's failure to hire only people who have no legal history of abusing, neglecting, or mistreating residents or failed to report and investigate any acts or reports of resident abuse, neglect or mistreatment.

Golden LivingCenter - Smithville was cited twice on January 8, 2009, when an inspection revealed Resident Rights deficiencies. State investigators determined that Golden LivingCenter - Smithville failed to properly hold, secure, and manage each resident's personal money which is deposited with the facility for the resident's use. Investigators found that the facility also failed to quickly give a resident's personal money to the head of his/her estate upon the resident's death. Monetary issues are so import and should be carefully monitored by family. This facility's failures in this area is inexcusable. The facility received another Resident Rights citation on November 12, 2009 when facility staff failed to provide care in such a way that it keeps or builds a resident's dignity and self-respect.

Another area of concern is the providing of professional services. Golden LivingCenter - Smithville has consistently failed its residents in this area over the past two years, as it has been cited twice in two years in this area alone. Other deficiencies cited in the area of Quality Care include failure to provide each resident with the care and services to get or keep the highest quality of life possible. In fact, Golden LivingCenter - Smithville received a citation of "actual harm" on December 11, 2008 when one or more residents were injured as a result of its failure to comply with this regulation. State investigators cited the facility with a Level 3, which is known as "actual harm". The facility was cited a second time just three months later for the same deficiency, only this time it was cited with a Level 4, which indicates "immediate jeopardy to resident health or safety". In both instances, it took approximately two months for the nursing home to correct these serious deficiencies. Other serious citations included failure to ensure each resident entering the facility without a catheter is not given a catheter unless necessary and failure to give residents proper treatment to prevent new bed sores or heal existing bed sores. In the area of bed sore treatment, the facility was cited with a Level 3, or "actual harm" citation.

Bed sore can almost always be tracked to insufficient staffing levels. If there are enough trained staff members available, bed sores rarely occur. However, many nursing home corporations fail to provide a sufficient budget for nursing home staffing, choosing instead to bolster profit at the expense of vulnerable residents.

Continue reading "March 2011 Nursing Home Report Card: Golden LivingCenter - Smithville" »

Golden LivingCenter - Dexter is a 73 bed nursing home facility located in Dexter, Missouri. For the past three years, Golden LivingCenter - Dexter's inspection deficiency record has increasingly worsened. During the 2010 inspection period, which is the most recent information available, Golden LivingCenter - Dexter was cited for seventeen deficiencies. It received seven deficiencies during the 2009 inspection period and just five deficiencies during the 2008 inspection period. Nationwide, the average number of health deficiencies found at a nursing home facility is eight, while the average number of deficiencies found in Missouri nursing homes is seven. Based upon its current inspection results, Golden LivingCenter - Dexter far surpasses the national average by double the number of deficiencies, an accomplishment that, no doubt, factors into the one-star rating Golden LivingCenter - Dexter received in the rating system instituted by The Centers for Medicare and Medicaid.

Suspicions of abuse, neglect, and mistreatment are serious allegations and all nursing home facilities are required to report all instances of suspected abuse, neglect, or mistreatment, whether it be from staff, a fellow resident, or from another source. Golden LivingCenter - Dexter was cited in 2008 for failing to protect its residents from abuse when it was learned that some residents were not kept free from physical restraints unless necessary for medical treatment. That same year, the facility was cited for failing to give professional services that meet a professional standard of quality, and for its failure to have a sufficient program to prevent infections from spreading.

As we can imagine, infection can be a serious problem in a nursing home where the residents are often vulnerable, rely totally on the care given by facility employees, and are unable to protect themselves from infection. The failure to have a program that sufficiently prevents infections may result in serious injuries and potentially death to a nursing home resident.

The facility was assessed a Mistreatment Deficiency again in 2009 when it failed to write and use policies that forbid mistreatment, neglect, and abuse of residents and theft of resident property. This is another administrative failure in procedure. In 2008, they failed to implement a proper infection control policy. In 2009, they failed to have policies on abuse and neglect. These failures represent a serious and systemic problem at the highest levels at Golden LivingCenter - Dexter.

All nursing home residents are entitled to the best care possible. Golden LivingCenter - Dexter has amassed a series of citations in the area of quality care. In 2008 and 2010, the facility was cited for failing to provide professional services to residents with feeding tubes to prevent problems, such as aspiration pneumonia, vomiting, and dehydration. At least one Golden LivingCenter - Dexter resident suffered actual harm on November 25, 2009, when inspectors determined that the facility failed to give each resident the care and services necessary to get or keep the highest quality of life possible. Despite this actual injury, just five months later, on April 8, 2010, the facility was cited again in this area. Other citations assessed to the facility during the 2010 reporting period were failure to provide proper treatment to prevent bedsores or heal existing bedsores, failure to ensure that residents who cannot care for themselves receive help with activities of daily living, and failure to have enough nurses to care for every resident in a way that maximizes the resident's well-being.

Continue reading "March 2011 Report Card: Golden LivingCenter - Dexter" »

Golden LivingCenter - Colonial Manor of Albany is a 60 bed nursing home facility located in Albany, Missouri. In the past three years, Golden LivingCenter - Colonial Manor of Albany's inspection deficiency record has met or surpassed the average number of health deficiencies in Missouri. For the reporting periods of 2009 and 2010, the facility received seven citations. It received eight citations in the 2008 reporting period. The average number of nursing home deficiencies in Missouri is seven. Currently, Golden LivingCenter - Colonial Manor of Albany has an overall rating of four stars, according to the system instituted by The Centers for Medicare and Medicaid, although has just a three star rating specifically regarding its Health Inspections.

A few years ago, The Centers for Medicare and Medicaid created a new way of rating nursing homes known as the Five Star Quality Rating System. This system uses information from three key areas to rate the facility as a whole: health inspections, staffing, and quality measures. For example, when reviewing information on Golden LivingCenter - Colonial Manor of Albany, nursing home staffing received four stars, quality measures received four stars, and health inspections received three stars. Digging deeper into information used to compile health inspection results, the Terry Law Firm noted that during an inspection on October 9, 2009, state investigators found an incident involving actual harm to one or more of the residents of the facility. Two years earlier, the facility faced an "Immediate Jeopardy" citation, which is the worst classification of citation available. Both of these citations involved making sure that the nursing home is free of dangers that cause accidents.

State health inspections are comprised of approximately 180 different items in the major aspects of care that state health inspectors review and inspect each time they visit the facility. Under Mistreatment Deficiencies, Golden LivingCenter - Colonial Manor of Albany was cited three separate times in three years. In 2010, the facility placed its residents at risk for harm when it either failed to hire only people who have no legal history of abusing, neglecting, or mistreating residents or it failed to investigate any acts or reports of resident abuse, neglect, or mistreatment. This facility again placed its residents at risk for harm on October 30, 2009, when it failed to keep all residents free from physical restraints unless necessary for medical treatment. During the 2008 inspection reporting period, the Golden LivingCenter - Colonial Manor of Albany was cited by state investigators for placing its residents at risk for harm when it failed to write and use policies that forbid mistreatment, neglect, and abuse of residents or theft of their property.

Golden LivingCenter - Colonial Manor of Albany was cited several times in 2009 and 2008 in the area of Quality Care. Residents with reduced range of motion require a great deal of assistance to keep and increase their range of motion. The facility failed to assist its residents in this respect in 2009. A year earlier, state investigators found that the facility failed to provide services that meet a professional standard of quality for its residents and failed to provide social services for related medical problems to help each resident achieve the highest possible quality of life. Facility staff also was cited in 2008 for failing to ensure that residents entering the nursing home without a catheter were not given a catheter unless absolutely necessary.

Continue reading "March 2011 Nursing Home Report Card: Golden LivingCenter - Colonial Manor of Albany" »

A Golden Living spokesperson announced on Wednesday, March 9 that the company headquarters is moving to Dallas, Texas.

Operating a conglomerate of healthcare companies, which include Aegis Therapies, Asera CareHospice, AseraCare Home Health, Golden LivingCenters, Golden Living Communities, 360 Healthcare Staffing, and Ceres Purchasing Solutions, Golden Living is currently based in Fort Smith, Arkansas. The company announced that lower level administrative jobs will remain in Fort Smith, while high level executive jobs will be moving to a 26,000 square foot building in Dallas. More information on this move is expected to be released shortly.

Golden Living operates seventeen nursing homes in Missouri, three of which have an overall rating of one-star, based on the Medicare.gov star-rating system. A one-star rating indicates that Medicare has deemed the facility to be "much below average". Our Missouri Nursing Home Abuse Attorney at the Terry Law Firm has recently reviewed the available information on the one-star Golden Living facilities and blogged on them. For more information about these facilities, click on the name of the facility below:

Golden LivingCenter - Dexter

Golden LivingCenter - Dexter is located in Dexter, Missouri and is a 73 bed facility. It is a for-profit facility and most recently received a one-star rating for staffing, a two-star rating for health inspections, and a three-star rating for quality measures. It's overall rating is one-star.

Golden LivingCenter - Branson

Golden LivingCenter - Branson is located in Branson, Missouri. It has 100 certified beds, is a for-profit facility, and is deemed a "much below average" facility by Medicare.gov.

Golden LivingCenter - New Madrid

Golden LivingCenter - New Madrid is located in New Madrid, Missouri on Interstate 55. While it received a four-star rating for Quality Measures, its one-star rating for staffing and two-star ratingn for Health Inspections contributed heavilty to its overall one-star rating.

The Terry Law Firm has handled numerous cases against Golden Living facilities. If you have a loved one in a Golden Living nursing home and are concerned about the care they are receiving, call us toll-free at 1-888-317-2525.

Golden LivingCenter - Jefferson City is an 87 bed nursing home facility located in Jefferson City, Missouri. Currently, Golden LivingCenter - Jefferson City has an overall rating of "three stars", according to the system instituted by the Centers for Medicare and Medicaid. A three-star rating indicates that the facility is an "average" nursing home facility. So, why is this just an "average" facility? One need look no further than its three year history of inspection surveys, during which Golden LivingCenter - Jefferson City has hovered round the average number of health deficiencies in Missouri. Golden LivingCenter - Jefferson City was cited for eight deficiencies in 2010, seven deficiencies in 2009, and eight deficiencies in 2008. The average number of nursing home deficiencies in Missouri is seven.

Nursing homes are required to treat their residents fairly and humanely. This includes keeping all residents free of physical restraints unless necessary for medical treatment. Golden LivingCenter - Jefferson City was cited by state investigators on December 11, 2008 for failing to comply with this regulation. While we don't know the specifics of that citation, the use of physical restraints often refers to bedside railings or wheelchair belts. Before a restraint can be placed on a resident, there must first be an assessment to determine if the restraint poses more harm than good. Residents who do not have sufficient comprehension of the purpose of the restraint may be injured or even killed by the device that is designed to help them. For example, bedrails can pose a significant risk for asphyxiation if the resident is not properly assessed and care for.

Nursing home residents are supposed to receive nursing services that meet a professional standard of quality. Golden LivingCenter - Jefferson City has been cited seven times in the past three years in this area alone, meaning that they have failed consistently to provide quality care to their residents. Some citations are more serious than others. On February 4, 2008, Golden LivingCenter - Jefferson City was cited for the most severe deficiency possible - Immediate Jeopardy. An "immediate jeopardy" citation indicates that one or more residents experienced actual harm as a direct result of the nursing home's actions or inactions. Needless to say, an immediate jeopardy citation is something that should be carefully looked at by families of prospective residents.

The law requires that nursing home residents be treated fairly and maintain certain human rights. In the past two years, Golden LivingCenter - Jefferson City was cited for failing to protect a resident from a transfer or discharge that was not wanted or needed, not allowing a private telephone for resident use, and failing to promptly send and deliver unopened mail to residents.

Golden LivingCenter - Jefferson City is also required by law to provide nutrition, dietary, and housekeeping services to maintain a sanitary, orderly, and comfortable facility. This facility failed to have an infection prevention program in place in both 2008 and 2009. The facility also failed to ensure that the facility was kept safe, clean, and homelike in its surroundings and was deficient in providing much needed housekeeping and maintenance. The facility did not prepare food that was nutritional, appetizing, and cooked at the right temperature in at least one instance and failed to ensure that attending physicians ordered special diets for residents with special needs. Golden LivingCenter - Jefferson City was also cited on more than one occasion for failing to store, cook, and distribute food in a safe and clean way.

Missouri Nursing Home Abuse Lawyer David Terry has spent the last ten years working for the rights of Missouri's nursing home residents. He has written a book that answers many of the questions his clients regularly ask him entitled 5 Things You Must Know About Nursing Home Abuse and Neglect in Missouri. If you have a loved one in a nursing home or are considering nursing homes, we will send you this book FREE of charge. Simply call our office at 1-888-317-2525 and ask for your free copy and we will send it to you right away.

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.

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.”

Illinois Governor Pat Quinn signed Senate Bill 326 into law at 2:00 p.m. today. The new legislation is designed to improve the quality of life in nearly 800 nursing homes in Illinois.

Among other things, the new legislation will require nursing home owners to hire more staff members to care for residents, the number of nursing home inspectors will nearly double by 2013, and hospitals would have to initiate criminal background checks prior to transferring patients into nursing homes.

In the fifth of our series on 6 common causes of bed sores, Chicago attorney Jonathan Rosenfeld focuses his attention on turning and repositioning. If a nursing home resident or hospital patient is prone to the development of bed sores, that patient must be turned and repositioned regularly. Jonathan addresses that issue in detail today on his nursing home abuse blog. To read his important entry, go here.

This is part 4 of a series Jonathan Rosenfeld and I are doing regarding 6 common causes of bed sores in nursing home and hospital patients. Today, we are discussing contractures.

What are contractures? People who are physically inactive for long periods of time are at risk for developing contractures. Obviously, many nursing home residents suffer from inactivity due to mental infirmities or physical limitations. As a direct result of physical inactivity and the failure to regularly move a limb or joint through its full range of motion, muscle fibers begin to break down and joints begin to stiffen, which can lead to the affected limb slowly pulling toward the body and becoming rigid. It is not uncommon to see nursing home residents with contracted hands, arms, or legs, oftentimes leaving them in the "fetal position" making it very difficult to give them the care they require.

Are contractures preventable? Contractures are very painful and the process of restoring a person's range of motion can be excruciating. Consequently, prevention is substantially better than restoration. Sadly, many nursing home residents who suffer from contractions do so because some nursing home facilities lack a sufficient number of staff members or the staff members fail to provide the proper preventive measures. To prevent contractures, the nursing staff should properly assess the resident's risk for contractures and implement an individualized care plan. The purpose of the care plan is to make all nurses aware of the methods to use for that particular resident to prevent the resident from developing contractures. Periodically, the resident should be re-assessed and an updated care plan prepared, if needed.

Using the following methods can help prevent or lessen the severity of contractures:

EXERCISE

Range of motion exercises are arguably the most important weapon in preventing contractures. For residents in nursing homes, facility staff need to take the time to properly exercise and stretch the limbs and joints of immobile residents. Passive range of motion exercises (those which involve gently rotating the at-risk body parts clockwise and counterclockwise) should be performed at least twice a day. For example, to prevent hand contractures, each finger should be gently stretched and rotated as far as possible. Properly trained nurses and nurse aides should understand the dangers of contractures, the simple exercises that can be done to prevent them and the short amount of time it takes to perform these exercises. Nurse aides can perform some of these exercises while bathing the individual or while changing their clothes. Physical therapists, obviously, are more aware of the dangers of contractures and the exercises used to prevent them. For those residents at risk of developing contractures, nurses should seek assistance from the physical therapy staff.

POSITIONING

The position of nursing home residents is crucial. If a nursing home resident can sit in a chair, staff should make sure that the resident is properly seated with their feet resting comfortably on a flat surface, such as a foot lift. Dangling feet can lead to "tip-toe" contractures. To prevent leg contractures, the resident should not be allowed to sleep with her legs in a bent or twisted position. Rather, pillows or cushions should be placed between the legs to help prevent contractures.

SPLINTING

Splinting devices can be very useful in helping prevent painful and debilitating contractures. Examples of such devices include special boots and wrist splints can be used to help prevent fingers and toes from drawing up and stiffening. Knee and elbow braces are also an option to help keep those joints from stiffening in place, but will still allow the resident free range of motion.

Contractures can develop quickly and frequently affect the hands, feet, legs, and arms. In the event of a person who has severely contracted, restoration, if possible, can take up to one year and can be an excruciating process of the affected person. Splinting devices can help prevent your loved one from having to go through the pain of trying to reverse contractures.

If you have a loved one who is at risk for contractures or who has contractures, what should the nursing staff do?

According to nurse Suzanne Frederick, "Nurses should follow the nursing process by properly assessing the resident's risk for contractures and implementing an individualized care plan to prevent and/or treat the limited range of motion or contracture. Once a resident is recognized as at risk for contractures through proper assessments, the nursing staff should implement a range of motion exercise program for the resident based on his/her functional ability. The consistent implementation of the range of motion exercise program should be documented in order to evaluate the resident's response to this treatment."

In addition to common sense nursing practices, nursing homes should follow the federal regulations that apply to residents who have or who are at risk for contractures. For example, federal regulation 42 CFR §483.25(e)(2) states:

"Based on the comprehensive assessment of a resident, the facility must ensure
that -- A resident with a limited range of motion receives appropriate treatment and
services to increase range of motion and/or to prevent further decrease in range of
motion."

If you have a loved one who is at risk for contractures or who has contractures, what should you do?

• Insist that your loved one receive stretching exercises twice daily.
• Insist that all necessary preventive devices are used.
• Visit often and make sure that staff members are attentive to the needs of your loved one.
• Be respectful, but firm that your loved one receives the care they deserve.

Unlike some problems and physical limitations that can be easily reversed, contractures are an especially troublesome issue given the difficulty associated with reversing the process. Family members should not hesitate to ensure that their loved ones receive the care they need and are required.

In the third installment of our series on 6 Common Causes of Bed Sores, Chicago attorney Jonathan Rosenfeld addresses the important issue of how the lack of cleanliness and incontinence contributes to the development and worsening of bed sores. He also provides 4 important tips to caregivers on how to keep a resident clean and how to reduce the danger to a resident who may be prone to episodes of incontinence.

This is the second in a six part Series I am doing with Chicago, Illinois attorney Jonathan Rosenfeld on 6 common causes of bed sore development.

Some studies have shows that 35 to 85 percent of nursing home residents are malnourished. The causes vary as to why so many nursing home residents suffer from malnourishment. In most cases, the cause of malnourishment is not that nursing homes don't provide proper diets; in most cases they do. Rather, the root cause appears to be an inadequate level of food intake by the nursing home resident. So, what causes nursing home residents to take in less food than they need? Cognitive and physical impairments can certainly affect a resident's ability to eat. Swallowing disorders (dysphagia), poor oral health, medications, and changes to taste and smell can all contribute to a lack of desire to eat. However, many of these impairments can be overcome with an attentive and active nursing home staff. For example, a 1988 study of nursing home residents determined that 55% had some degree of dysphagia that affected their food intake. Yet, only 22% of those residents had been assessed by the nursing home and referred for evaluation to a speech therapist. In short, nearly 80% of those in the study found to have mild to profound dysphagia were not recognized by the nursing home staff as having any correctable problems with respect to nutrition intake. While the two may seem polar opposites, insufficient staffing within nursing homes can also have a direct effect on nutrition deficiencies of nursing home residents.

In many nursing homes, staff members fall woefully short of standards set forth in the Nursing Home Reform Act of 1987 (also known as the Omnibus Budget Reconciliation Act of 1987 or "OBRA"). While the law requires that the nutritional needs of nursing home residents be met, oftentimes, the results simply do not match the requirements.

It is well known that the lack of adequate nutrition can result in malnourishment which, in turn, can lead to a host of physical and mental problems, including increasing the risk of developing bed sores. (For more general information on bed sores, visit Terry Law Firm, LLC or visit Jonathan Rosenfeld's Nursing Homes Abuse Blog.) In fact, according to nutritionist Janet McKee of Nutritious Lifestyles, Inc., "Involuntary weight loss of 4% or greater is correlated with negative outcomes and the development of pressure ulcers in the geriatric population." When a person becomes malnourished, they tend to lose body fat, which provides a barrier between the skin and bone in our bodies. That barrier allows blood to freely flow throughout the body. When the body fat disappears and pressure is placed on that area of the body, the flow of blood is inhibited. When blood flow is depressed, the skin begins to die, creating the beginnings of a bed sore.

How Can Bed Sores Caused By Nutritional Deficiencies Be Treated?

When nutritional deficiencies are the likely cause of a bed sore, the best way to treat the problem is to fix the problem. Obviously, when a resident has developed a bed sore, the bed sore must be treated by a health care provider proficient in wound care. Nutritionally, there must be a thorough review of the resident nutritional needs, taking into account the nutrients being lost through the wound itself. Janet McKee states that "adequate protein intake is an essential component for skin integrity and pressure wound healing. Accordingly, protein recommendations to promote healing are 1.2 - 1.5 grams protein per kilogram of current body weight." Only the nursing home facilities can arrange for the resident to receive a full nutritional assessment so the bed sore can be properly healed.

One of the big fallacies surrounding bed sores is that once you have one, it is virtually impossible to heal. That is simply not true. With proper nursing care and nutrition, even deep, Stage IV bed sores can be healed.