The L.A. Times reported that a nursing home was fined only $75,000 for the wrongful death of a resident.  The nursing home was well aware that the resident had a history of swallowing problems but did nothing to prevent him from choking to death on a snadwich that never should have been given to him.  .  In fact, the nursing home failed to immediately treat the resident when he began choking.

The patient had dementia and a known history of having difficulty with swallowing. The patient’s care plan at Anaheim Crest Nursing Center said he should only be given pureed food.  The state investigation documented two incidents Sept. 9 when the patient ate solid food. At dinner, he was fed an incorrect meal and given a spoonful of vegetables and rice. After he started coughing, a nursing assistant performed the Heimlich maneuver and a "tomato-like" material was coughed up.  Later that same evening, the patient got  a sandwich and began to eat it and began choking and turning colors.

According to the state, there was no documented evidence that the patient received emergency treatment for choking.  It is the standard in all nursing homes that if something was not documented then it wasn’t done.  Nurses are trained in school on this principle and every nursing home in the country abides by the principle.  Despite this standard, the nursing home is now claiming that the staff did attempt the Heimlich maneuver, administered cardiopulmonary resuscitation and called 911. 

The nursing home tried to claim that the death was a result of a heart attack, and that they had not been informed the patient had a choking incident just before his death.  If that is true, then why did they allegedly try to do the Heimlich maneuver.  They can’t keep their lies and cover-up straight!

After the coroner determined that the patient had choked on a piece of food found in his larynx, a subsequent internal investigation uncovered the second, and ultimately fatal, choking incident.

 

 Fox8.com out of Cleveland had a recent story about a nursing home resident who was left unattended and allowed to leave the facility unsupervised.  The resident ended up walking on the road and getting hit by a car.  She died from injuries sustained in the  "hit and run" accident.  What is amazing about this story is how the article concentrates blame on the driver of the vehicle instead of the nursing home which was responsible for keeping this resident safe and out of harm’s way.  The nursing home should have been watching her and not allow her to leave the premises unsupervised.

Citing declining health, her family recently convinced her to check into the nursing home.   She was very unhappy there and wanted to return home.  This is a clear sign of a risk for wandering.  Her family says she was supposed to be staying in a "locked-down area" when she somehow was allowed to escape.

"There was a security door in her room that she was able to disable at 87 years old. They appear to be very short staffed at night. We were told there was a loud alarm going off but no one went looking to see what was going on," says Meldrum.

According to the Avon Police Department, several 911 calls came in Friday evening alerting them of a car versus pedestrian crash in front of the Good Samaritan Skilled Nursing & Rehabilitation Center on Detroit Road. When officers arrived to the scene, they found Warren lying on the side of the road.  Police say the suspect vehicle did not stop after the accident and drove away from the scene.

Is there any investigation as to why and how she was able to leave the nursing home without being noticed?  how long was she missing?  Why didn’t anyone hear the alarm or respond to it? Was the nursing home short-staffed?

The San Diego Union-Tribune had an article about a nursing home which received the most severe citation and a $90,000 fine after an investigation found that poor treatment and supervision resulted in a resident choking to death last year.   Escondido Care Center, a 180-bed facility, failed to adjust the patient’s meal plan to meet his changing dietary needs. The resident suffocated when food became stuck in his windpipe and the right main bronchial stem. He was eating a lunch of beef with barbecue sauce, mashed potatoes, and steamed cabbage and carrots. During lunch, the patient coughed repeatedly until he became unresponsive and slumped over in his wheelchair. The patient died.

The facility was well aware that the resident had swallowing problems and was at risk for choking.  His physician had ordered a strict diet to avoid problems with chewing and swallowing.
On two occasions in November, the facility’s dietary supervisor, registered dietitian and a nurse wrote in the patient’s file that he was having difficulty chewing and that he was coughing while drinking “thin liquids.”   No records exist to show that any staff member alerted the resident’s doctor or tried to alter the man’s diet or supervise it more closely.

 

Often when maggotts are found in a resident’s pressure ulcer (normally caused by the lack of proper wound care and cleaning), the nursing home tries to argue to the family that the maggotts are a method of cleaning the wound and that the nursing home intended the maggotts to clean the wound (despite no physician order typically).  Well, that frivolous argument has now been proved wrong.

Reuters had an article about a recent study in the British Medical Journal of the world’s first controlled clinical trial of maggot medicine.  Maggotts may clean wounds quicker than normal treatment but this does not lead to faster healing. Some patients also found so-called "larval therapy" more painful. 

To find out more, researchers at Britain’s University of York recruited 267 patients with venous leg ulcers and treated them either with maggots or hydrogel, a standard wound-cleaning product. They found no significant difference in outcomes or cost.  Larval therapy works because maggots eat only dead and rotting tissue, leaving a clean wound. They do not burrow into healthy flesh, preferring to eat each other when they run out of food. 

 

 

The New york Times had an article explaining the Obama administration’s plan to overhaul financial regulation by subjecting hedge funds and traders of exotic financial instruments to potentially strict new government supervision. Many of these hedge funds and financial instruments own or have a financial stake in numerous nursing homes around the country.  It states that the government would have the power to peer into the inner workings of companies that currently escape most federal supervision, and specifically cites "private equity firms like the Carlyle Group."   

The Carlyle Group bought out Manor Care a couple of years ago and have created sham L.L.C.s to protect themselves from liability while cutting the budgets of the nursing homes that they own.  In fact, two men who worked in the New York State comptroller’s office were arrested recently after it was discovered they took millions of dollars in kickbacks from private equity and hedge funds.  David Loglisci, who was the top investment officer of the state’s $122 billion pension fund, along with Henry Morris, who fund-raised for former comptroller Alan Hevesi, were nailed in a 123-count indictment, which included charges of money laundering, securities fraud and bribery. It was discovered that over 20 transactions made by the pension fund involved kickbacks, with five of those coming from the renowned private equity fund The Carlyle Group. Morris, who was released after posting a $1 million cash bail, allegedly received $13 million from The Carlyle Group, from investments that totaled $730 million.

The administration would require that all standardized derivatives be traded through a regulated clearinghouse. Traders would be required to provide documentation on their collateral and borrowings. They would also be subject to new eligibility requirements, and their trading and settlement practices would be subject to new standards.

 

Keloland.com had an article about the sexual abuse allegations at an elderly home in Hot Springs, S.D.  Many family members are appropriately concerned. The DCI is finally looking into reports dating back to January at the Castle Manor Nursing home.  Hospital officials say they know of more victims. Board President of Castle Manor Rich Nelson knows of at least three victims and has received several other complaints. The suspect is a male nursing assistant.  Family members of the alleged victims claim Fall River Health Services tried to cover up the abuse.

When sisters Sharon Deboer and Gwendolyn Ketterer needed a long-term care facility for their mother two-and-a-half years ago, they had no doubts about the care at Castle Manor. That changed when the 84-year-old dementia patient started acting out of character late last year when a male nursing assistant began taking care of her.

"I just felt that there was something with him that I just couldn’t put my finger on. I couldn’t put my finger on it but I suspected that type of thing. It was just a feeling," Deboer said.  On January 17, Deboer’s suspicions were confirmed.  "One of the staff called me and told me she had to talk to me, that she had something to tell me. She told me right when we met that this CNA, this male CNA, had been molesting my mom," Deboer said.

That was the only type of notification the sisters received from Castle Manor, despite an abuse report filed with the Department of Health three days earlier. The suspect stayed on as an employee for weeks before Manor officials say he was finally let go. That was part of Fall River Health Service’s efforts to cover up the abuse.

How many others suffered abuse silently while Manor staff looked the other way.

 

The Hour had an article about Connecticut Governor M. Jodi Rell announcement that her administration has given the Legislature’s Public Health Committee testimony in support of her bill to provide greater state oversight over nursing home administration and management including ongoing financial monitoring and expanded quality of care reviews of nursing homes.

An Act Concerning Oversight of Nursing Homes would:

1.  identify areas of the state which either need or have a surplus of nursing home beds;

2. create an oversight committee to focus on financial solvency and quality of care issues;

3.  enhance the public’s access to important nursing home data;

4.  provide for greater oversight by the Department of Social Services when there is an application for a change of ownership;

5.  require expanded financial reporting to DSS;

6.   require that nursing homes submit quarterly reports of accounts payable to DSS — as unpaid bills are a key indicator of financial health; and provide state regulatory agencies with expanded subpoena authority.

"Placing a loved one in a nursing home is often a necessary, but difficult decision and family members deserve the peace of mind of knowing that the finances and the quality of care issues of these facilities are closely monitored," Rell said. "When a nursing home goes out of business due to financial issues, both patients and their families must suffer through the turmoil of a new placement.

"Nursing homes are an important part of the network of care and services for Connecticut residents and quality of care issues are paramount to individuals who have a family member in a nursing facility," the governor said. "We must do everything in our power to ensure a standard of care that instills confidence in the people who are entrusting loved ones to a nursing facility."
 

I wish every State especially South Carolina would pass similar legislation.

The Chattanooga Free Times Press had an article about the arrest of a nursing home employee who neglected and caused the death of a nursing home resident.   Walter Small is charged with criminally negligent homicide in the death of Robert A. Young on Nov. 12, 2007.  The nursing home was almost successful covering this crime up.  The arrest was made in connection with the 2007 homicide of a cerebral palsy patient, a case that almost ended with no investigation into the victim’s unexpected death and his burial just days later in a pauper’s grave.

 A timeline of the case reveals it was Mr. Young’s family members who initially questioned the circumstances of his death, which took place while he was living at the Health Center at Standifer Place.  Authorities eventually exhumed Mr. Young’s body last summer, and the autopsy performed one year after his death indicated Mr. Young died of blunt force trauma to the head.

County Medical Examiner Frank King said he did not initially perform an autopsy because of representations made to him that the victim had fallen and fractured his skull as the result of a seizure. But medical records didn’t support that theory, Dr. King said, and Mr. Young’s sister, Rana Reynolds, would end up suing Standifer Place as well as the Tennessee Department of Human Services in November 2008, alleging that both were in “collusion” to “hide the death and burial” of Mr. Young.

According to the two lawsuits filed in Hamilton County Circuit Court, not only did a Standifer Place employee kill Mr. Young, but when family members called to check up on him, employees didn’t even tell the family he was dead for more than a month.  After Mr. Young’s death, “Standifer Place told each person, on each call, that (Mr. Young) was OK, and to come see him,” court documents state.

 

The Lexington Herald-Leader had an article about a recent lawsuit filed against a nursing home with a history of neglect and violations.  The facts behind the lawsuit suggest that the nursing home’s failure to assess the respiratory condition of a 54-year-old man led to his death after a six-day stay.   The Winchester Centre for Health and Rehabilitation has faced numerous state and federal sanctions in the past two years and was threatened with the loss of Medicare and Medicaid funding.

On Jan. 25, 2008, William Baker was admitted to the nursing home.  The facility failed to assess and monitor Baker’s respiratory condition or to suction him. Baker developed breathing problems and was transferred to a Lexington hospital where he died on Jan. 31, 2008.  "The lack of care and attention caused Mr. Baker to suffer in a most traumatic fashion and ultimately die," the lawsuit said.  The lawsuit also the said the facility "established staffing levels that created recklessly high nurse/resident ratios."

The lawsuit is the latest in a series of problems for the facility, which in 2008 received two type A citations — the most serious the state can give. One, in August, was for not calling a doctor when a man lost more than 87 pounds in 19 days. At the end of the 19 days, the man was found unresponsive and was taken to the hospital, according to the citation from the Kentucky Cabinet for Health and Family Services

A second type A citation was issued Jan. 12 after a patient received the wrong dose of an anti-seizure medication for 40 days in November and December, an error that wasn’t discovered until the patient suffered a seizure.  The facility didn’t have a system to make sure that medications were administered properly, according to the Jan. 12 citation.

 

McKnight’s had another article on the Fairness in Nursing Home Arbitration Act.  This bill would prevent nursing homes from using pre-dispute arbitration agreements as a way to take away residents’ rights to a jury trial. The bill is supported by both Republicans and Democrats and should be able to pass without much difficulty. 

Sens. Mel Martinez (R-FL) and Herb Kohl (D-WI) reintroduced their measure in an effort to "restore the original intent of arbitration laws [and] ensure that families will not have to choose between quality care and forgoing their rights within the judicial system."    The version of the bill introduced in the last session of Congress was approved by the Senate Judiciary Committee, but never came to a full floor vote. The bill does not prohibit the use of all arbitration agreements by nursing homes, only pre-dispute agreements.   Arbitration agreements could still be used after a dispute arises, though the bill would make them a voluntary matter.