Above the Law had an article about a corporate insurance defense lawyer getting caught coaching his client during a deposition.   It all started in July, when Florida law firm Rasco Klock sent a paralegal to Wilmington for a deposition. The firm is representing a plaintiff suing an insurance company, but one of their lead attorneys, Juan Carlos Antorcha, had to remain in Miami and conduct the deposition by video, with the paralegal handling the exhibits in person.  During the deposition of a witness for the defense, a strange noise caught the attention of the Perceptive Paralegal. After hearing clicking, he peeked beneath the table and saw a defense attorney’s foot tapping the foot of the deponent. He snapped a photo with his smartphone and sent it to Antorcha, who confronted the defense and halted the deposition. Rasco Klock then filed a very angry motion for sanctions, accusing the defense attorney of coaching the witness through foot tapping.

The lawyer accused of foot-tapping is Brown Sims shareholder Kenneth Engerrand. On every single page of the 13-page motion for sanctions against him is the incriminating footsie photo. 
Here’s one of the photos.  This guy is a disgrace and should be sanctioned.

You can find the Motion here and here and Defendant’s Reply here.


The Orange County Register reported the jury verdcit in conservative Orange County of $3.1 million to Barbara Lefforge who suffered a brain-damaging morphine overdose at St. Edna skilled nursing home.   Lefforge went to St. Edna on Sept. 17, 2007, to recuperate from tendon repair surgery.  Her doctor, Kobayashi, mistakenly recommended 50 mg of morphine for pain instead of 50 mg of Demerol.  The mistake clearly should have been caught by staff at St. Edna’s. The pharmacist warned that the dosage was too high.  But nurses at the facility, unable to immediately retrieve the full dose, obtained 30 mg from an office emergency kit and gave it to Lefforge.  The woman suffered an overdose but was not monitored or taken to the hospital until the next morning, causing brain injury.

St. Edna Subacute & Rehabilitation Center is one of 25 homes in California owned by Covenant Care.  After two days of deliberation, the jury found that St. Edna was 90 percent responsible for the damages and Kobayashi was 10 percent responsible. Jurors awarded Lefforge $2 million for pain and suffering and $1.1 million in medical costs, Wacker said.  The unanimous jury also awarded punitive damages — which will be set on Tuesday –who was barely at the hospital 5 1/2 hours when the overdose occurred.

Covenant Care facilities are among hundreds of California skilled nursing centers that received $880 million in additional compensation from the state since 2004 to increase staffing and wages at homes that serve Medi-Cal patients. An analysis by the non-profit newsroom California Watch found 232 of those homes statewide slashed staff and let nursing ratios fall below the state minimum.  St. Edna and 12 other homes in the Aliso Viejo-based Covenant Care chain stood out: they accepted $15 million in additional compensation from the state — but still cut caregivers.






The Times-Tribune reported a lawsuit filed on behalf of former Jewish Home resident Elizabeth LaCoste against the Scranton nursing home, claiming aides were negligent when they left Mrs. LaCoste unattended in her wheelchair, which rolled away and crashed, throwing her onto the street. Mrs. LaCoste suffered a broken collarbone, a head injury, bruises and abrasions.

The preventable incident occurred after Mrs. LaCoste and several other residents had been driven from the nursing home to center city Scranton to watch a musical performance. Sometime between 1 and 1:30 p.m., Mrs. LaCoste was left alone and unsupervised in her wheelchair on a sidewalk that pitched toward Spruce Street. The wheelchair rolled toward the street and jumped the curb, heaving her out of the wheelchair and onto the street.  She suffered significant injuries and died months later.


CBS reported an investigation into food inspections at Florida hospital and nursing homes.  No one is inspecting food preparations at Florida’s hospitals and nursing homes. The inspections were halted as a way to save money due to budget limitations. Food borne illnesses linked to these facilities have sickened hundreds of Florida consumers in at least 15 separate outbreaks since 1995. Experts say people at these facilities are the most vulnerable for foodborne illnesses.

The decision to end the inspections due to lack of funding came after the federal government gave more inspection authority to the states. The health department had inspected facilities four times a year before they stopped this year.


The Tennessean had an article about the arrest of Regina Jacobs.  The nursing home employee is charged with stealing more than $400,000 from the nursing home where she
worked for more than 10 years. I wonder how long it was going on?  How could she be so greedy?

Officers with the Tennessee Bureau of Investigation arrested her after she was indicted by the Wilson County grand jury on three counts of theft over $60,000, two counts of theft over $10,000 and one count of theft over $1,000.

In December 2008, the nursing home, Quality Care Health Center, finally discovered that Jacobs, a business office manager, had been cashing checks intended to cover patient costs and keeping the money.  An internal investigation and audit at the nursing home revealed that about 70 patients’ accounts had been affected.


There have been numerous news articles discussing how different states are proposing alternatives to nursing homes.  The number of Americans 65 and older is expected to more than double to 89 million by 2050.  The oldest of 79 million Baby Boomers turn 65 next year, a turning point that will begin to put pressure on social services, retirement homes and assisted-living facilities.  The percentage of people 65 and older is projected to climb from 13% today to 19% by 2050, while the share of adults age 20 to 64 is expected to drop from 60% to 55%, the Census Bureau says.  Everyone agrees that we must do something to keep its exploding elderly population out of nursing homes for as long as possible to curtail the crushing costs of extended institutional care.

USA Today’s article referenced grass roots "Villages" sprouting up in neighborhoods across the country to help people age in their own homes.  More than 50 villages in a neighbor-helping-neighbor system have emerged. They are run by volunteers and funded by grants and membership fees to provide services from transportation and grocery delivery to home repairs and dog walking.

How villages operate:

•Residents pay a membership fee that varies from $25 to $600 or more a year, depending on the types of services members want. Some villages have paid staff members; others are run completely by volunteers.

•Most villages are opening in more upscale neighborhoods in cities and suburbs, but they all provide discount dues for lower-income elderly.

Capitol Hill Village, which began operating three years ago and is the oldest of six such villages in the nation’s capital send folks to clean gardens, install railings, fix windows, bring groceries and run other errands.

Beacon Hill Village in Boston was the first in the movement, created by residents in 2001. It charges annual dues and delivers paid and volunteer help. The village movement is "consumer-driven and consumer-run," says Judith Willett, Beacon Hill’s executive director. Beacon Hill partnered with NCB Capital Impact, a non-profit community development group, to launch the national Village-to-Village Network to help other areas. It is backed by funders such as the MetLife Foundation.

The Minnesota Star-Tribune had an article about Minnesota’s Living at Home Network which includes 43 local programs and thousands of volunteers to assist the elderly in simple household tasks.  The Living at Home Network, once called the Block Nurse Program and the Elderberry Institute, dates to 1981.  Recently renamed, the loosely organized network just changed its budgeting and management to reaffirm its original mission, which allows localities to develop unique programs that all push the common goal of keeping the elderly out of nursing homes.

The network kept 1,222 elderly Minnesotans out of nursing homes in 2008-09.  Keeping people out of nursing homes also costs less. Caring for those same clients in nursing
homes would have cost an additional $20 million from taxpayers.  Multiply that by the thousands of other frail, elderly Minnesotans and the sums grow large.

Tax dollars spent on seniors’ long-term care are projected to grow from roughly $1 billion in 2010 to $5 billion in 2035. In fiscal 2010, Minnesota spent $720 million on nursing home care for the elderly, compared with $333 million on non-institutional care. By 2035, the state hopes to reverse the ratio, spending $3.5 billion on non-institutional care and $1.5 billion on nursing homes.

Living at home is almost always cheaper and more comfortable than living in an institutional setting, said Kristen Whittenbaugh. She directs Nokomis Healthy Seniors, which serves 502 senior citizens on an annual budget of $165,000.

By comparison, in 2009 the average cost of a private room in a Minnesota nursing home was $54,750 a year, according to MetLife insurance company. In the Twin Cities, the annual average was $62,780.



North Carolina’s  Department of Health and Human Services issued a recommendation for $20,000 in penalties against Britthaven of Chapel Hill nursing home where a nurse is accused of murder and patient abuse related to morphine overdoses. Incredibly $20,000 represents the federal maximum the two centers can legally fine the facility for the violations that occurred.

The violations are connected to the activities by Angela Almore. Almore was a registered nurse at the facility charged with second-degree murder and patient-abuse surrounding Rachel Holliday’s death.  Holliday died of pneumonia from asphyxiation; the morphine levels in her body were believed to have contributed to her death.  Injuries involving morphine and six other patients are also involved.  Prosecutors say Almore drugged patients to make them more manageable.  Of note, none of the patients were prescribed the potent pain reliever.

See articles here and here.


The Patriot Ledger reported a recent $508,000 verdict against Kindred in Massachusetts by the great trial attorney David Hoey.  The case involved a 93 year old John J. Donahue, a former patient at Brockton’s Embassy Rehabilitation and Health Center.   He was hit in the eye with the cradle bar of the Hoyer Lift. The CNA was not properly trained and was using the lift by herself when it required two people. The facility waited 18 hours before they sent him to hospital where as a result of the damage to his eye it had to be removed.  Donahue died 47 days later, but the jury did not find that the injury contributed to his death.

A Brockton Superior Court civil jury ordered Kindred Healthcare to pay the damages to Marlene Owens.  Donahue’s eye was crushed iwhen he was struck by a piece of a Hoyer lift, a device designed to help injured or disabled people move between their beds and chairs.

Donahue had suffered a debilitating stroke and required assistance moving back and forth from his chair and bed, said Hoey, who has specialized in nursing-home cases for 14 years.

 Considering their recent financial returns, Kindred should have no problem paying the verdict.  Consolidated revenues rose 1% to $1.1 billion.  Each operating division reported revenue growth compared to last year.  See article here.


The Hartford Courant had an article about the use of a robotic seal to help dementia patients. Sea Sea, a white-furred robotic baby harp seal, was introduced to the residents and staff at McLean, a state-of-the-art care facility in Simsbury, Ct.. The seal is used primarily to calm patients with dementia in nursing homes and long-term care facilities. There are only 40 in the country today, according to Freddi Hoffmann, vice president of marketing at McLean.  Using animals to calm patients in a nursing-home setting is not a new idea. But only recently have advances in technology made it possible to replace living animals with their robotic counterparts.  Hopefully, these will become standard in most nursing homes.

The seal purrs and paddles its flippers when petted and opens its eyes and moves its head toward you when you talk. It has significant weight to it and when held against your chest you can feel it vibrate, simulating a heartbeat.

One of the most dramatic effects of Sea Sea’s therapy was seen in Eileen, a non-verbal patient who often doesn’t respond to verbal stimulation or acknowledge those around her. "She was lying in bed for about half an hour talking to her and stroking Sea Sea," Cookson said. "Eileen seemed calmed by the noise Sea Sea was making, she sat there laughing and talking with her the entire time."

It is through two microprocessors underneath her fur that Sea Sea is able to interpret and react to her environment. Cookson said that over time Sea Sea will learn to respond to her name and other phrases.

McLean was able to purchase Sea Sea through funds from the Sorenson Technology Center.  McLean is already looking to purchase more of the robotic seals.