WNBC.com had a story about how a nursing home lied to a resident’s family regarding her death at the facility.  This typeof cover up oftens happens in nursing homes. The staff is typically the only ones who really know what happened to a resident.   The staff are worried about their job or are instructed by their corporate masters to mislead or cover up the neglect and abuse.

Olive Chase was 94 when she died at Sunrise at Fleetwood, an expensive assisted-living home in Mount Vernon, in February 2007.  The nursing home told Chase’s son that she had died in her sleep. The nursing home created an elaborate story that his mother had breakfast, was left alone at one point, and the aide returned to find she had died peacefully in her sleep.  The staff said Chase was sleeping at 7:30 a.m., but was "unresponsive" four hours later. Days after Chase was cremated, however, her family got a tip from someone with second hand knowledge of her death that the woman did not die peacefully.

Bob Chase, son of the woman who died, spoke with some of the staff and to the source who was the first nurse on the scene after his mother’s death.   The nurse saw Olive’s head caught between the bars of her hospital bed with her feet hanging off the side. The nurse said it appeared as if she struggled and then died of strangulation.

"Her tongue was protruding. It was purple," the nurse said.

The nurse said one of the maintenance workers then lifted Olive’s legs while she held onto one of her shoulders.

"We brought her up, laid her flat on her bed," said the nurse. "I brushed her hair. This nursing coordinator told us, ‘Don’t say anything.’"

The nurse said the last person to treat Olive for a bedsore raised the bed for the treatment but did not lower it after, despite instructions to do so. Olive was known to wander, the nurse said.

"We had a sign on the top of the bed, readily visible, stating to lower the bed at its lowest level when finishing care," the nurse said.

An anonymous call to the state Department of Health days after Olive’s death reported that the woman appeared to have died of asphyxiation after her head was caught in the bars, which triggered an investigation. The department concluded the caller’s complaint was valid. The department found that Olive’s body had been rearranged after her death, but it was not reported that way in Sunrise’s records.

San Mateo Daily Journal had an article about a settlement three years after a mentally disabled woman was scalded nearly to death in a Redwood City nursing home.  The resolution came May 13, one day after the county was set to square off in court with Res-Care and employees, including Oretha Ocansey who was criminally convicted for her role in the severe burning of Theresa Rodriguez in May 2004.

The county, which is Rodriguez’s legal guardian, sought both punitive and actual damages for Rodriguez who was left so badly injured her hospital care costs $3,000 a day.  The lawsuit was filed after Ocansey was sentenced for placing the woman in the boiling hot stream of water but the defendants argued the entire company was not responsible for the actions of the single employee.

On May 4, 2004, Rodriguez was seated in the shower at Res-Care, located on McGarvey Avenue, when 145-degree water poured onto her lap. Rodriguez, who is unable to speak or walk, suffered third-degree burns over 60 percent of her body. Nurse’s aide Oretha Ocansey placed a diaper on Rodriguez and did not alert a supervisor for two hours. An hour after the supervisor learned of the situation, Rodriguez was airlifted to a Santa Clara County hospital and spent more than two hours on life support.

During the investigation in Ocansey’s role, prosecutors learned that Res-Care forbid workers from calling 911 until they first contacted a supervisor. Prosecutors still considered Ocansey culpable, however, for waiting two hours before even contacting her boss.  In August 2004, Ocansey pleaded no contest to felony elder abuse in return for an immediate sentence of the 34 days she had already served plus probation and a ban from working at health-care facilities. The plea bargain spared her trial and up to four years in prison if convicted by a jury.

The county went after the nursing home and its corporate owners the following January, claiming the facility knew of the water temperature problem for six days before Ocansey placed her in the shower.

Pantagraph.com had an article about a Bloomington nursing home paying a reduced $14,500 fine for failing to protect residents from a sex offender who was a patient at the facility.  This is outrageous and shows why lawsuits are necessary to insure that nursing homes are held accountable for their negligence and gross stupidity. 

Asta Care, 1509 N. Calhoun St., failed to screen a male resident who made inappropriate sexual advances to staff and two mentally disabled residents. The acts were noted in nursing records dating to October 2006 at the 117-skilled bed facility but were ignored by management.  The man, who was identified as a sexual offender,  was allowed to remain at Asta Care even after complaints were made by staff. 

Clearly this situation was avoidable if the nursing home simply checked the man’s background.  It is shocking that the nursing home only had to pay a small fine for such outrageous conduct.

Newport News Dailypress.com had an article about a suspicious death of a resident of a nursing home.  There appears to be a link between his death and medicine he got the day before.

A nurse who gave unauthorized medicine last week to a nursing home resident who later died has been fired.  Police are considering whether the medication caused or contributed to the death of John P. Stratton, 76, of Newport News, who was staying at the James River Convalescent and Rehabilitation Center.  Stratton was given the medicine on May 5, and died about 4 a.m. on May 6.

The nurse’s decision to give Stratton the medicine was not an accident.   "She intentionally gave him the medication," police said. "Her intent in giving it to him will have to come out later."

Police are trying to find out whether Stratton was given an increased dose of a medicine he was prescribed, or medicine he wasn’t supposed to get at all.

Joseph Law, James River Convalescent’s administrator, said the nurse — whom he declined to identify — was fired after an internal investigation. The actual reason for her firing, Law said, was separate from the issue surrounding Stratton’s death. "The nurse was terminated because of facility protocol," Law said. "During our investigation some other information was discovered." He did not elaborate. What a bunch of nonsense. Clearly the facility does not want to admit what happened or what they found out in their "internal investigation". 

It could take a month or longer for the toxicology results.  The examination will include any possible interaction between the medicine the nurse gave him and other drugs Stratton was taking.

One of Stratton’s daughters, Denise Barnes of Newport News, said the family doesn’t know what drug or drugs the nurse gave her father.   A staffer at the home brought to his attention the possible link between the medication and Stratton’s death. He then called police and state agencies.

I’m surprised they didn’t fire the staffer who refused to cover it up.

Knoxville News had an article about a nursing home resident who lost a leg due to the nursing home’s neglect.    Neglect of a resident at Hillcrest-West nursing home led to the amputation of her leg last month, according to state reports quoting a doctor who consulted on the case.

The state has censured Hillcrest nursing homes for providing substandard care three times in the past two years.   Obviously the corporate managers ignored the problems and did nothing to correct them.

Now, as in the past, Hillcrest is in danger of losing federal funding if problems aren’t corrected. Hillcrest-West has until May 25 to submit a detailed plan of correction, said Lee Millman, a spokeswoman for the Centers for Medicare and Medicaid Services.   During a survey conducted April 28 through May 2, the state found violations of "resident protection, administration, records and reporting, and nursing services standards."

Details in the recent state report on Hillcrest-West state that the amputee’s pressure wound was at the most severe level when first noted by staff Feb. 7. The leg was amputated above the knee April 22. Doctors said the bone likely was infected and the wound was "exquisitely (intensely) painful" when manipulated.

A podiatrist said the pressure wound was the "result of neglect … the worst wound I have seen in 12 years," and the surgeon who removed the leg concurred, the report states.   The same patient didn’t get the amount of tube-fed nutrition and saline ordered by her doctor, with feedings skipped repeatedly, the report notes. Also, the family was not informed of the pressure wound and was shocked when they learned of the pending amputation, the state report said.

State inspections from 2006 and 2007 report Hillcrest-West patients found on the floor after apparently falling from beds or wheelchairs, failure to properly use restraints or alarms, patients who were unclean, and inadequate staffing.

The North Country Gazette had an article about a recent jury verdict involving a nursing home’s negligence.  A Washington jury ordered Washington County to pay $300,000 to the family of a woman who died as the result of a fall at the county-owned Pleasant Valley Adult Home in Argyle.

Former Fort Edward resident Esther Nolan, 75, died at the adult home in March 2003 following a fall from a toilet. The woman’s death was caused by inadequate staffing and the improper installation of the toilet seat.

This is not a post about a nursing home case.  But it is interesting.  I was emailed a blurb about an article on how the VA is directing their staff (presumably doctors) to avoid diagnosing patients with Post Traumatic Stress disorder. 

The email was titled "suggestion" – and it "suggested" diagnosing patients with a diagnosis which would provide lower disability payments.  Now, of course, the email doesn’t come out and say that – it does, however, come out and say that they should consider a diagnosis of "Adjustment disorder R/O PTSD" – Adjustment disorder certainly sounds less expensive. 

I think all of us have had or will have adjustment disorder ~ adjusting to a new job, adjusting to a new marriage, adjusting to a new divorce, adjusting to a new baby, adjusting to a new house . . . . This is a far cry different from what some of our Soldiers returning home from war experience.  Adjustment disorder doesn’t seem to accurately cover it.


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Here is a link to the recent GAO Report that shows a lack of investigation into nursing home neglect and abuse.  The NY Times ran a great article on this report.  Below are some excerpts from that article.

Nursing home inspectors routinely overlook or minimize problems that pose a serious, immediate threat to patients, Congressional investigators say in a new report.   In the report, the investigators from the Government Accountability Office, say they have found widespread “understatement of deficiencies,” including malnutrition, severe bedsores, overuse of prescription medications and abuse of nursing home residents.

The accountability office found that state employees had missed at least one serious deficiency in 15 percent of the inspections checked by federal officials. In nine states, inspectors missed serious problems in more than 25 percent of the surveys analyzed from 2002 to 2007.

The nine states most likely to miss serious deficiencies were Alabama, Arizona, Missouri, New Mexico, Oklahoma, South Carolina, South Dakota, Tennessee and Wyoming, the report said.

“Poor quality of care — worsening pressure sores or untreated weight loss — in a small but unacceptably high number of nursing homes continues to harm residents or place them in immediate jeopardy, that is, at risk of death or serious injury,” the report said.   Nursing homes must meet federal standards as a condition of participating in Medicaid and Medicare.

Lewis Morris, chief counsel to the inspector general of the Department of Health and Human Services, said he had often been frustrated in trying to identify the owners of nursing homes that provided substandard care.  “We have found nursing home residents who were grossly dehydrated or malnourished,” Mr. Morris said. “We’ve found patients with maggot infestations in wounds and dead flesh. We’ve found residents with broken bones that went unmended.”

Tucson Citizen had an article about a recent jury verdict where a jury awarded a Tucson family $6 million for a death involving an 81-year-old relative who died of a morphine overdose.  Mary Culpepper and two other relatives were awarded $2 million each.  Culpepper sued Manor Care, TMC, a doctor, nurse and pharmacy over the Dec. 8, 2003, death of her mother, Sylvia Culpepper.

She was admitted to TMC on Dec. 2, 2003, suffering from sciatica, a painful nerve condition.
On Dec. 4, 2003, she was prescribed 15 milligrams of morphine twice a day. Two days later, her dosage increased to 30 milligrams, twice a day.   When Culpepper was transferred from TMC to Manor Care, prescription orders contained both dosages.

The Manor Care staff failed to note the discrepancy in the prescriptions and gave her both dosages, both twice a day causing her death.  An autopsy determined that Culpepper died of acute morphine intoxication.

According to the jury’s verdicts, the doctor, nurse and pharmacy weren’t to blame for the death. The nursing home had the ultimate rersponsibility for the medications given to the resident at their facility.

Kathleen Glanville, a writer for The Oregonian, wrote an article about a $900,000 verdict for a resident who was treated ridiculously bad by a nursing home.  The jury ruled that an 86-year-old woman with Alzheimer’s disease suffered a loss of dignity when Lake Oswego police forced her to the floor of her nursing home and handcuffed her.   The jury awarded more than $900,000 to the family of the late Elvera Stephan for the way she was treated the night of April 13, 2006, at The Pearl at Kruse Way in Lake Oswego.

The jury agreed that Avamere Health Services, the corporate owner of the Alzheimer’s care center, had acted with malice or reckless indifference.  Stephan’s children moved her into the Alzheimer’s care center in early April 2006 after her husband became seriously ill and was hospitalized. Within a few days she became agitated, wandering the nursing home barefoot in her pajamas, confused and, according to her caretakers, dangerously aggressive.

The staff notified a registered nurse in another part of the nursing home, who called the woman’s doctor for guidance. He said Stephan should be taken to the emergency room for evaluation and medication.  The nurse called 9-1-1 to summon an ambulance, and because she told the emergency dispatcher that the patient was extremely aggressive, Lake Oswego police responded as well.

But jurors said she didn’t look dangerous on a surveillance video from the nursing home. She was gesturing with a telephone receiver but didn’t try to hit anyone with it.

Two officers forced the elderly woman to the floor, where they rolled her onto her stomach and handcuffed her hands behind her back. She remained on the floor on her stomach for six minutes until paramedics put her on a stretcher and took her to the hospital, according to Kocher. She returned to The Pearl the next day, when a nurse reported that her wrists were bruised.

A state investigator found the nursing home at fault for failing to assess the woman’s condition and intervene in a timely manner.   Stephan’s son, James, testified that he didn’t learn about what had happened to his mother for six days, when he was told by the relatives of another patient at The Pearl.

The video of the police subduing the woman was played for the jury.   Kocher had asked the jury to award Stephan’s family $1 million to send a message to corporations that care for Oregon’s elderly and vulnerable.

The jury agreed on $4,200 in economic damages — the cost of Stephan’s shared room for a month — and $400,000 in noneconomic damages. The jury then awarded $500,000 in punitive damages. Under state law, 60 percent of punitive damages go to the state victims assistance fund.