Nursing Home Abuse Lawyer Blog

In Rockford, Illinois, nursing home competition is fierce. Rockford is considered "overbedded" due to an overabundance of nursing care and rehabilitation beds. The average occupancy rate in an Illinois nursing home is 80 - 82%, which means 14,000 vacancies per 100,000 beds. Nursing home officials are learning how to deal with the situation and adapt in a market full of senior care options.

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

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

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

The LaSalle County Nursing Home continues to be plagued with problems, the most recent of which is a CNA has been reportedly accused of abuse. We've discussed this nursing home in previous blogs. In the past two years, the facility has been forced to deal with a multitude of problems, including the molestation of multiple defenseless residents by another resident.

Now, an investigation of a CNA is underway for abuse/molestation. According to Illinois Department of Public Health (IDPH) spokeswoman Melaney Arnold, "IDPH did receive an incident report from the facility regarding a CNA (certified nurse assistant) and abuse. IDPH is reviewing the evidence to determine what action, if any, will be taken."

Many Illinois nursing homes have been plagued by the physical abuse and sexual abuse of nursing home residents. Nursing home abuse and neglect attorney David Terry has successfully handled many cases against the nursing home industry. If you are ain Illinois resident and would like a copy of David's new book, Five Things You Must Know About Nursing Home Abuse and Neglect in Illinois at no cost to you, call our office toll-free at (888) 317-2525 or order online here. The book is free if you live in Illinois or the nursing home you are concerned about is located in Illinois.

Elmer Huntsman was admitted to Elmwood Nursing and Rehabilitation Center on August 26, 2008. Huntsman was required to sleep with a continuous positive airway pressure system device (CPAP), which forced air into his lungs and helped him to breathe at night.

Early in the morning on October 5, 2008, Huntsman began suffering distress, severe oxygen desaturation, and shortness of breath. He called for help from facility staff members, but they refused. Instead, the day staff called for a non-emergent hospital transfer the next morning. By the time Huntsman got to the hospital around 9:15 a.m., he had fixed and dilated pupils and his body showed signs of lividity. Huntsman also had a urinary tract infection, weight loss, and Stage 2, 3, and 4 pressure sores on his buttocks and coccyx.

Huntsman's family filed an 18-count lawsuit in Madison County, Illinois against the facility, its owners, and Fox Med-Equip, the maker of the CPAP machine. The lawsuit alleges that Elmwood failed to properly assess Huntsman's condition, failed to adequately supervise him, and failed to recognize and treat his condition. Fox Med-Equip is accused of failing to have adequate procedures in place to ensure its equipment performed satisfactorily, failed to provide appropriate monitoring of its equipment to ensure it was used in accordance with doctor's orders, and failed to provide adequate documentation for the set up of the machinery and proper staff training.

The lawsuit seeks compensatory damages for pain, suffering, disability, disfigurement, mental anguish, inconvenience, physical impairment, loss of capacity to enjoy life, loss of chance of survival and loss of remainder of life. Michael Huntsman, his son, also seeks a judgment of more than $800,000 plus punitive damages and attorney's fees.

Columbus Manor Residential Care Home, a nursing home in Chicago, Illinois, faces a possible loss of its license. The facility is home to approximately 130 mentally ill residents.

The facility was recently cited for many violations, some of which include resident safety. Reportedly, residents at the facility were attacking each other and a female resident allegedly had to fight off a sexual assault at the hands of a male resident. Additionally, facility staff reportedly failed to advise a resident's doctor of his illness and the resident later died.

A hearing has been scheduled for December 6, 2010 in Chicago. The facility faces minimum fines of $100,000.

"Operation Guardian" was successful recently at Alden Park Strathmoor. "Operation Guardian"
is a compliance check system initiated by Illinois Attorney General Lisa Madigan to put nursing home owners and operators throughout the state on alert that state officials can visit any facility at any time without notification to ensure the safety of the adults that live at the facilities.

A recent inspection at Alden Park Strathmoore revealed four residents of the facility had outstanding criminal warrants. A fifty-one year old resident was arrested for a DUI in Cook County and a forty-four year old resident was arrested for failing to appear in court and for stolen property in Will County. Two other nursing home residents had warrants for contempt of court, failing to appear, and fraud, but they weren't taken into custody due to medical reasons.

According to Alden Park officials, they "'comply with state law and conducts criminal background checks of its residents through the Illinois State Police, in accordance with Illinois law and regulations. Unfortunately, criminal background checks do not provide nursing homes with arrest warrant information. As always, Alden is committed to providing quality care. Our residents, families and all those we serve are our top priority.'" According to Attorney General Madigan, "They appeared to have the information about people with criminal backgrounds but they had not shared that information as they are required by law with the department of public health."

The facility could face fines for breaking the law.

The Collinsville Rehabilitation & Health Care Center is appealing more than $25,000 in state and federal fines assessed earlier this year. The fines were the result of a December 5, 2009 incident where a male resident reportedly entered a female resident's room and pulled up her skirt. The man only left when the woman screamed.

According to the Illinois Department of Public Health (IDPH), the nursing home facility failed to provide a safe living environment for the female resident, who reportedly feared sexual assault from a male resident. Melanie Arnold, an IDPH spokesperson, reported that the nursing home failed to conduct a criminal background check as required by law when the man was admitted. The man was placed at the facility by the Illinois Department of Corrections. Because the facility failed to report the incident to the Centers for Medicare and Medicaid, they were assessed a $5,300 fine.

Whether the facts in this case were accurately reported or not, there is no doubt that sexual assault of nursing home residents in Illinois is a terrible problem. As an Illinois nursing home abuse attorney, I work daily to address the rights of the elderly in Illinois nursing homes. If you would like to receive a free book I wrote entitled Five Things You Must Know About Nursing Home Abuse and Neglect in Illinois, order your free copy here.

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.

A surprise inspection yesterday at an Illinois nursing home yielded an unusual find: a Missouri fugitive.

Illinois Attorney General Lisa Madigan, accompanied by St. Clair County Sheriff Mearl Justus, Illinois State Police officials, officials from the Illinois Department of Public Health, the Illinois Department on Aging, and the Illinois Department of Professional Regulation, made the unannounced inspection at Virgil Calvert Nursing & Rehabilitation Center in East St. Louis, Illinois on Thursday, June 24, 2010 around 10:00 a.m. The facility experienced problems earlier this year with health and safety issues.

During a review of resident backgrounds at the facility, investigators uncovered that resident Rothford Darden, 61, was wanted on an active Missouri drug warrant. Darden was taken into custody by St. Clair County Sheriff's Deputies. According to Attorney General spokeswoman Cara Smith, "He knew he was wanted. He seemed perfectly able-bodied. These nursing homes have been turning out to be the perfect place for hiding out. We've found wanted people in every one" (that has been checked so far). According to Madigan's office, in the twelve facilities inspected to date, 61 people under active warrants were living in the facilities and 17 arrests were made immediately at the facilities.

By law, nursing homes are required to perform background checks on their residents and staff and make arrangements if housing residents with criminal histories, such as sexual offenders and others who could harm fellow residents.

An Illinois nursing home faces a lawsuit filed by the administrator of a deceased resident's estate for negligence. The Lincoln Home, a nursing home facility located in Belleville, Illinois, reportedly violated the rights of resident Wealthie Lee Lockett during her the time of her residency, January 18, 2008 through the date of her death on December 18, 2008.

Annie McClatchery, the administrator of Ms. Lockett's estate, filed a lawsuit on May 25, 2010 in St. Clair County Circuit Court against The Lincoln Home and Weiss Management Group. During Ms. Lockett's residency, she sustained a comminuted left femur fracture and other injuries, as well as mental anguish and emotional distress.

The suit seeks in excess of $100,000 plus attorney's fees and costs.

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.

An Illinois nursing home faces a lawsuit in St. Clair County Circuit Court after a resident died while in their care.

The lawsuit was filed May 4, 2010 by Shirley McManus against Caseyville Nursing and Rehabilitation Center and Caseyville Property alleging that Newton J. McManus, Jr. died after the facility failed to provide adequate care, failed to protect him from abuse and neglect, failed to notify his physician of significant changes in his condition, failed to institute a regular treatment program to address his pressure sores, and failed to ensure that he maintained his body weight.

Newton J. McManus, Jr. was admitted to Caseyville Nursing and Rehabiltation Center on May 8, 2008 and developed ischemia, a condition characterized by pain, gangrene, and non-healing wounds. Additionally, Mr. McManus developed a urinary tract infection, decubitus ulcers, and suffered from malnutrition and dehydration. He died on May 31, 2008, not even a month after his admission to the facility.

Shirley McManus is seeking a judgment of more than $150,000 in addition to attorney's fees and expenses.

Beginning on Monday, June 7, 2010, Jonathon Rosenfeld and I will do a series of blog entries on 6 common factors that result in bed sores. Bed sores are devastating injuries that commonly affect elderly residents in nursing homes and hospitals. In most cases, bed sores can be prevented. However, prevention measures take time, patience, and persistence, all of which require attentive caregivers. All too often, nursing home owners are unwilling to provide the budget necessary to have a sufficient staff that can tend to the needs of nursing home residents, including measures necessary to prevent the development of bed sores.

The six factors that we will address are:

(1) Dehydration
(2) Nutrition
(3) Incontinence/cleanliness
(4) Contractures
(5) Turning and repositioning
(6) Lack of pressure relieving devices

Throughout this blog series, bed sores may be referred to as pressure sores, pressure ulcers, and decubitus ulcers. Keep in mind that each of those terms are usually used interchangeably when discussing bed sores. Bed sores are typically discussed by stages. Stage 1 is the earliest stage of a bed sore and the easiest to correct. Essentially, a Stage 1 bed sore presents as a red spot on the skin, usually over a bony prominence. Stage 2 bed sores usually present as a shallow open wound with a pink bed. If caught quickly, Stage 2 bed sores can easily be healed. A Stage 3 bed sore is an open wound where subcutaneous fat can be visualized. While a Stage 3 wound can have tunneling and undermining, bone and tendons are typically not yet visible. Stage 4 bed sores are the most serious and most difficult to heal. With a Stage 4 bed sore, one can often see the bone in addition to tunneling, eschar and slough. For pictures and more information on bed sores in general, visit the Terry Law Firm website here or Jonathon Rosenfeld's Nursing Home Abuse blog here.

It was a good day for the plaintiff's attorneys present in Judge Andreas Matoesian's courtroom on June 2, 2010.

Doug Mendenhall represented the family of Jane Schwartz, a Rosewood Care Center of Alton resident who was severely injured in a fall at the facility in which she broke her wrist and hip. A lawsuit was filed in Madison County, Illinois after her death by Clifford Emons, the Special Administrator of Schwartz's estate, to preserve the statute of limitations.

The 2004 case went to jury trial in September 2009. The jury only considered the damages portion of the case after Judge Matoesian struck the defense's pleadings and directed the verdict in favor of the plaintiff. The jury subsequently awarded $5,000 for negligence and $15,000 violations of the Nursing Home Care Act.

Plaintiff's attorneys asked for $87,625 in fees and $11,943.82 in court costs. The fees were based off of an hourly fee of $275. Defense counsel Dennis McCubbin argued that a $99,000 fee would set a bad precedent to award such a fee in a case with such a small jury award. According to McCubbin, plaintiffs would refuse to settle cases knowing they could obtain "outlandlishly larger" attorney's fee awards if they drug their feet and suggested that Judge Matoesian award attorney's fees only in the amount of the jury damages award or at most twice that amount.

Judge Matoesian stated that Illinois' Nursing Home Care Act and its fee provisions were designed to encourage attorneys to take the often difficult cases. "It should not be based on a percentage," according to Matoesian.

Another nursing home owned by Eric Rothner, an Illinois nursing home operator, has come under the scrutiny of the Centers for Medicare and Medicaid for poor performance.

Sebo's Nursing and Rehabiltiation Center in Hobart, Indiana was recently placed on the "Special Focus Facilities" list kept by the Centers for Medicare and Medicaid. Nursing home facilities are placed on the "Special Focus Facilities (SFF)" list after they have demonstrated a pattern of serious problems over a period of time without adequate corrective action. According to Medicare.gov, "a Special Focus Facility is a nursing home with a recent history of persistent poor quality of care, as indicated by the findings of state or Federal inspection teams. Based on inspection findings for the most recent three-year period, CMS selects a group of nursing homes with the worst repeated inspections as SFFs. Sometimes a nursing home will fix a sufficient number of problems in order to pass one inspection, only to fail the next one. Often, many of these same problems show up in inspections again and again. This is a sign that the nursing home didn’t address the underlying problems that were causing these repeated serious deficiencies. Many SFFs respond to the recognition of their past poor performance by making concerted efforts to improve. CMS records indicate that approximately 50% of SFFs significantly improve their quality of care within the subsequent 30 months."

In fact, two years ago, Sebo's scored a 956 report card grade in the Indiana State Department of Health's Nursing Home Report Card, the worst score in the state. Their current score of 769 remains almost four times higher than the average Indiana nursing home score of 177.

Eric Rothner has owned the nursing home facility since 1996 and Sebo's problems appear to date back to at least 1999. Between 2007 and 2009, sixteen substantiated complaints were received on the facility. Immediate jeopardy citations were assessed to the facility in 2005, 2006, 2007, and 2009.

When asked about possible changes at the facility, Monti Montgomery, Sebo's new Administrator as of December 2009, said, "Directives come from the home office and I have no comment on those." The "home" office is Rothner's Extended Care Clinical.

Rothner's facilities are not strangers to the "Special Focus Facilties" list. His facility, Northlake Nursing and Rehabiltiation Center in Merrillville, Indiana, resided on the "Special Focus Facilities" list before closing earlier this month after being decertified from participating in Medicare and Medicaid programs. Another of his facilities, South Shore Nursing and Rehabiltiation Center in Chicago, remains on the list. Rothner, his family members, and their related companies have interests in nearly 24 facilities in four states.

An Illinois pharmacist was sentenced on Friday, May 14, 2010 for misbranding medications that were sent to a nursing home.

Ted Thalmann received three years probation, including six months of house arrest, after sending medications to a nursing home with incorrect expiration dates. He was also fined $2,000 and ordered to perform 250 hours of community service. Thalmann owns the Medicine Shoppe in Edwardsville, Illinois. His business was fined $16,000 and given five years probation.

Thalmann and his business, The Four L's, Inc., each pleaded guilty to a misdemeanor branding charge.

An Illinois nursing home was subjected to a random sweep checking for violations of regulations and state law.

Golden Moments, a Jacksonville, Illinois nursing home, was raided on Monday, May 24, 2010 by fourteen police and state officials. Among those involved were the Illinois State Police, the Illinois Attorney General's Office, the Illinois Department of Public Health, the Department of Aging, the Jacksonville Police Department, and the Illinois Department of Financial and Professional Regulation. During the 2 1/2 hour inspection, no one was arrested or fined, but this visit did not involve checking residents for outstanding warrants, as was the case in some previous sweeps.

Five former sex offenders call Golden Moments home. In accordance with a 2006 state law requiring background checks, those residents have individual rooms, but the mandatory "risk assessments" required by that law were not completed for three of the five former offenders.

Golden Moments was fined $50,000 earlier this year for poor care after a 74 year old resident died on October 3, 2009 after choking on food, a fine that Melvin Siegel, part owner and operator of Golden Moments, finds "excessive". Golden Moments has not paid the fine and is disputing its amount.