A former nursing aide who admitted raping and impregnating a profoundly disabled and defenseless woman at a Bloomingdale nursing home three years ago was sentenced Wednesday to 25 years in prison.

Reynaldo Brucal Jr., 20, pleaded guilty in November to aggravated criminal sexual assault of the then-23-year-old woman, who has cerebral palsy, is brain-damaged and has the mental capacity of a 3-year-old. She was in his care at Alden Village Health Facility for Children and Young Adults when the attack occurred in 2004.

Brucal, who is not a U.S. citizen, has been in DuPage County Jail since his 2005 arrest. 
After serving his sentence, he will be deported to his native Philippines.

Staff at the nursing home, where the victim and her twin sister had lived for 13 years, discovered she was expecting in June 2005 when she was more than 28 weeks’ pregnant. A baby girl was delivered by Caesarean section in July 2005.

The twins, who cannot speak or function independently, have been moved to another area nursing facility, and their family has filed a civil lawsuit against Alden that is pending.

The facility also has been fined $10,000 by the Illinois Department of Public Health for lack of oversight and mishandling of the investigation.

According to the probation department’s pre-sentencing report, Brucal admitted assaulting the woman because he was "bored."

But Brucal, who began working at Alden in September 2004 and was 17 at the time of the attack, "didn’t believe he did anything wrong," Berlin said.

Initially, Brucal denied sexual contact but was arrested in November 2005 after admitting such contact, claiming a latex glove he used as a condom had failed.

See article here

States that set high staffing standards for elder care in nursing homes are the only ones that come close to having enough staff nurses to prevent serious safety violations, according to a new study by a professor in the UCSF School of Nursing.

The majority of the nation’s elderly and disabled in nursing homes remain in situations where staffing is well below national recommendations for safe care, the study found. While no states have ideal nursing levels, those states with higher Medicaid reimbursements or higher mandated nursing levels have come closer to meeting the recommendations, according to the analysis published in the June issue of the journal "Health Services Research."

The study’s initial objective was to examine the relationship between Medicaid reimbursement rates, which many states have cut under their cost-containment efforts, and nurse staffing levels in US nursing homes, according to Charlene Harrington, PhD, RN, UCSF professor of sociology and nursing and lead author of the report.

She said previous studies have shown a direct correlation between staffing levels and higher Medicaid reimbursement for nursing homes, but this is the first to show that states with higher mandated staffing standards had substantially higher staffing as well.

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 At a hearing this month concerning the state of the nursing home industry 20 years after the landmark Nursing Home Reform Act (better known as OBRA ‘87), Senate Special Committee on Aging Chairman Herb Kohl (D-WI) addressed the deficiencies of a system that has allowed some poorly performing nursing homes to escape penalties.

Testimony by the Government Accountability Office (GAO) presented at the hearing concludes that many nursing homes shown to be providing substandard care are still not being subjected to any sanctions, and are therefore not be motivated to make the lasting improvements necessary to protect the health and safety of residents.

According to the GAO, in 2006 nearly one in five nursing homes nationwide was cited for poor care or, more specifically, care that can cause actual harm to residents.

“Without question, the Nursing Home Reform Act improved nursing home care in this country. Today, many of the nation’s 16,000 nursing homes are providing adequate or excellent care. But shamefully, quite a few nursing homes are getting away with providing a lot less, putting a good number of the seniors living in long-term care facilities at risk. This is unacceptable, and raises questions about how and why our enforcement system is failing,” said Chairman Kohl. “This committee has a long history of closely scrutinizing the quality of nursing home care, and we intend to reaffirm that commitment.”

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The owner and manager of a Palmetto nursing home has been arrested on a charge of neglecting an elderly person in connection with a large lesion found on the face of a resident there.

According to reports, 85-year-old Ronald Larsen began living at the Palmetto Guest House in June, 2005. Jacqueline Dorelien took over the home in July of the following year.

The lesion was present when Dorelien took charge, but grew during the next few months, eventually rupturing into a large open wound.  The report says Dorelien failed to get medical help for the man, despite the advice of doctors.

The arrest came two days after the state agency that oversees nursing homes started action to revoke the Palmetto Guest House’s license for allegedly failing to provide adequate care.

The Florida Agency for Health Care Administration issued the complaint Wednesday.

In it, the agency accused the facility of:

• Failing to provide care and services appropriate to the residents’ needs.

• Failing to arrange for necessary physician appointments.

• Violating the Assisted Living Facility residents’ bill of rights by failing to provide "adequate and appropriate" health care.

"A facility’s first priority should be the safety and well-being of its residents," AHCA Secretary Andrew Agwunobi said in a statement issued with the complaint. "It is unacceptable when the management of a facility does not take this responsibility seriously. Our action in revoking their license is necessary to protect this most vulnerable population. The agency will continue to monitor this facility during the administrative complaint process to ensure the safety of its residents."

Protecting Loved Ones from Nursing Home Abuse

Solomon & Relihan’s Phoenix based law firm has recently launched NursingHomeAdvocates.com. NursingHomeAdvocates.com is a resource portal designed to assist both family members of nursing home residents, and the patients themselves, who suspect neglect, malpractice, or abuse.

In the United States alone, nursing home malpractice has become a significant problem with growing numbers. Investigations done by the US Government have shown that approximately 30% of nursing home facilities in the US have neglected or abused their patients, resulting in significant harm. Studies also show that nursing home malpractice has resulted in over 4,000 deaths due to malnutrition, dehydration, and bedsores.

Check out the website.

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North Carolina officials say a federal grant will help about 550 older and disabled North Carolinians stay home instead of being placed in nursing homes and hospitals.

The nearly $$17 million grant is part of a larger 5-year federal project that will pay for caregivers to provide services in homes. Officials say one goal is to save money — for example, a nursing home can easily cost $$50,000 a year.

The other goal is to allow people to live at home as they age, which is a growing desire among older people. The program is being designed now. The benefit is expected to be available to people next year.

Hopefully, South Carolina will be able to get funds to help citizens of this State avoid nursing homes.

 I saw this story and thought of all the residents who suffered pain as a result of his intentional act. This is why supervision of nursing home employees is crucial.

A 40-year-old nurse who pleaded guilty to switching out painkillers meant for nursing home patients has been sentenced to just over five years in prison.

Michael Paul Smith of Falmouth was charged with tampering consumer products and health care fraud.  Smith may face mandatory exclusion from working in any federal health care program.

Prosecutors say he removed pills containing oxycodone and morphine by separating the cardboard backing from blistercards and substituted the pills for similar-looking medication nearly two years ago.

He was employed at the Odd Fellows Nursing Home in Worcester at the time.

I just read this article about staffing at night in hospitals.  It starts and ends with a particular incident at the Medical University of South Carolina’s children’s hospital.  This is a truly terrifying account of the lack of staffing in hospitals on night shift. 

Now take this same idea of less staffing to a nursing home setting.  In nursing homes, often the residents can’t speak for themselves, or they can’t make sense out of what’s going on around them – maybe they no longer know how or when to call for help.  And maybe they don’t know the difference when no one comes.  Add to that the number of residents that have no family to check on them during the day, much less at night.

As an example, we recently talked to a gentleman who was in a nursing home for a short time for rehab.  He said that night time was the worst part of it all.  He said that patients call for help half the night, and no one comes.  He said you can hear staff members talking and laughing, but they wait for hours to respond to call bells.  The fact of the matter is, there is no real supervision on night shift, and often the staff does whatever they want.  I know that this is not the case with all nursing homes, but I’ve heard that same story more than once, about more than one facility. 

In the article, a child died  – in large part because there was not good staffing at night.  This child died with his mother sitting beside him, unable to get help.

Put yourself in the position of a nursing home patient, who has no one sitting beside them trying to get help.  The staff is all they have.  That’s why staffing is such an important issue in medical facilities – and its not just about the quantity, its also the quality.

This article is worth reading, if for no other reason than to educate yourself about the dangers of night staffing in medical facilities.  We may all be there one day, or we may be able to help someone that is.

 Senior citizens who do not have children to help care for them are less likely to have to go into a nursing home if they live in a state that spends more on home- and community- based services found.   Researchers at the University of Illinois at Chicago report the finding in the May 11 issue of the Journals of Gerontology: Social Sciences. 

Naoko Muramatsu, associate professor of community health sciences at the UIC School of Public Health and lead author of the study stated  "There has been little evidence, prior to this study, to show that spending more money on these services helps seniors avoid or delay placement in a nursing home."

Some states spend as little as $35 per person each year on home- and community-based services for seniors, while other states spend more than $1,300 per person annually, according to previous research.

Regardless of how much was spent on home- and community-based services, the researchers found that doubling states’ spending on services would reduce the risk of nursing home admission among childless seniors by 35 percent. 

The study was funded by the National Institute on Aging, one of the National Institutes of Health.

See journal article here

A Cleveland, Tenn., nursing home company has settled a lawsuit for neglecting its patients and allowing an elderly woman to lie in her own feces for hours at a time after back surgery.

The woman, Betty Mae Hanzel of Hastings, developed an infection in her wound during her stay at the Life Care Center of Elkhorn that required surgery to reopen her incision and drain the infection and fecal matter in the wound.

Terms of the settlement between Hanzel and Life Care Centers of America of Cleveland, Tenn., were not disclosed.  According to the federal lawsuit, the nursing home staff allowed Hanzel to lie in her own feces and urine for extended periods and told Hanzel to get her own water even though she couldn’t get out of bed.

Near the end of her stay at the home, Hanzel discovered a discharge from her surgical incision, but staff did not tell her doctor about the condition.  Later, she developed blood clots in the arteryleading to her lungs and a "super-infection of the bowel," which led to surgery to remove most of her colon. 

Nurses who used to work at the home in west Omaha said the facility was often short on nurses, and some evenings one registered nurse was responsible for 120 patients, according to depositions taken as part of the lawsuit.

Life Care Centers of America owns and manages more than 260 facilities in 28 states _ including retirement communities, assisted-living facilities and nursing homes.