KCBD out of Lubbock, Texas reported the investigation into the death of Willie Joe Byers who froze to death at the Tumbleweed Nursing Home. Police concluded that Byers died after being outside for several hours in freezing temperatures. He was finally found by a nursing home employee in the outdoor courtyard.  The staff is supposed to check on residents every two hours. The Texas Department of Aging and Disability requires that if a facility accepts a new resident that is reported to have dementia and/or a history of wandering, the resident should be closely monitored.

Deion Mitchell, Byer’s Nephew, said that he "found out about his Uncle’s death from a family friend, who knew someone that works at the facility. We had no idea that he was even transferred to the Tumbleweed Nursing Home."

According to Byer’s nephew, "Surveillance cameras show that Willie walked out of the facilities back courtyard door and apparently fell and hit his head while outside, and was found lying next to a shed."



In February, Kindred Healthcare Inc., a Louisville-based senior living/health-care company, acquired Rehab Care Group of St. Louis, a leading care provider that operates long-term acute-care hospitals and inpatient rehabilitation facilities, in addition to providing contract rehabilitation services at hospitals and nursing and assisted-living facilities it does not own.

Kindred Healthcare Inc. is now the largest post-acute health-care services company in the United States. The price tag for the acquisition was $900 million in cash and stock.  With this merger, Kindred will have 118 long-term acute-care hospitals; 226 nursing and rehabilitation centers; 121 inpatient rehabilitation facilities; and 1,808 hospital, nursing center and assisted-living rehabilitation therapy service contracts in 46 states.  It will, in essence, become a "one-stop shop" on the continuum of care, with patients moving from a hospital to a longer-term facility for further care or for rehabilitation.

As they merge, Kindred and Rehab Care will face other questions, such as how to provide — and how to define — quality of care.



The Hudson Reporter ran an article about the tragic case of Modesta Alvarado who was abused at the Harborage nursing home in North Bergen when a caregiver was caught on tape allegedly hitting Alvarado the day before her mother died.   The aide who was caught on tape is Julia Galvan.  Based on the video images captured the day before Alvarado’s death, Galvan was charged on March 2 with assault, abandonment, and neglect of the elderly. She was arrested by the Hudson County Prosecutor’s office after Alavarado’s daughter  viewed the tape and reported the alleged abuse to authorities.  The video shows Galvan slapping Modesta Alvarado’s head, then delivering two more fierce blows on Jan. 15. Alvarado’s eyes and mouth opened wide in reaction to the aide’s abuse. Galvan is also seen on the film pulling off Alvarado’s oxygen mask.  Alvarado was found dead by staff less than 24 hours after the alleged attack was caught on tape.

Her family hid a video camera after repeatedly finding bruises on her mother. Gloria Diaz, Alvarado’s daughter, said complaints to the nursing home and calls to state officials got her nowhere. After Alvarado’s death, Diaz said, she viewed the video and found disturbing footage.  Despite visiting daily and knowing her mother’s caregivers at The Harborage nursing home, Diaz decided to tape record what was going on.  The use of recording devices to see if the nurses are taking proper care of loved ones has become more common, and usually provides strong evidence of neglect and sometimes abuse.

Wayne Slater of the Dallas Morning News had an interesting article about a new study that found that the the biggest donors to Texans for Lawsuit Reform – whose agenda is curbing lawsuits against business by injured people — are themselves active users of the court system.  While the group’s agenda has been to limit personal-injury lawsuits against business, it generally has not sought to restrict suits filed by businesses themselves.  The group raised nearly $7 million, which it gave to political candidates. Forty top donors accounted for 81 percent of the group’s money in the 2010 election cycle, according to the study by Texans for Public Justice, a nonprofit group that tracks campaign contributions.

Among those big donors was H. Ross Perot Jr., who went to court to defend his business interests over creation of Victory Park and the American Airlines Center . Perot gave the anti-lawsuit group $250,000. 

Energy Transfer Partners’ Kelcy Warren was among executives of the company who went to court in an unsuccessful bid to recoup money from bankrupt Lehman Brothers. 

Plano banker Andrew Beal has gone to court in fights over a casino and over mortgage loans. Beal supported TLR to the tune of $100,000.

The biggest contributor to Texans for Lawsuit Reform in the last election cycle was Dallas billionaire Harold Simmons, who gave $825,000. Simmons is the developer of a nuclear waste disposal site in West Texas and is seeking permission to import waste from at least 36 states.  


Gaffney Republican state representative Dennis Moss’ district includes Corinth Baptist Church, home to 15 parishioners injured recently when a train for children derailed on a bridge at Spartanburg’s Cleveland Park.  Six-year-old Benji Easler was killed and 27 others injured in the crash including the boy’s parents, siblings and the church’s pastor.  A Spartanburg County insurance adjuster, who told them there is a $600,000 total limit to pay any claims they submitted to pay for bills and other expenses related to the crash.

Moss is now suggesting that lawmakers re-examine a state law that limits how much injured people can seek for damages.


Didn’t the legislature realize this would happen when they passed tort reform?

Marshall Allen wrote an interesting piece for the Washington Monthly about the epidemic of medical malpractice.  We encourage readers to read the whole article but below are some excerpts.

Twelve years ago, the Institute of Medicine issued a landmark report showing that medical errors in U.S. hospitals kill up to 98,000 Americans a year. In 2000, another estimate, published in the Journal of the American Medical Association, which included fatalities resulting from unnecessary surgery, hospital-acquired infections, and other instances of harmful medical practice, put the total annual death toll at 250,000.

By that figure, contact with the U.S. health care system was the third leading cause of death in the United States, just behind all heart disease and all cancer. People responded to the alarm. Task forces were convened, congressional investigations launched, op-eds written. Yet as hard as it may be to believe, American medicine is, if anything, even more dangerous today.

In November 2010, the U.S. Department of Health and Human Services issued a study that covered just the 15 percent of the U.S. population enrolled in Medicare. It found that each month one out of seven Medicare hospital patients is injured—and an estimated 15,000 are killed—by harmful medical practice. Treating the consequences of medical errors cost Medicare a full $324 million in October 2008 alone, or 3.5 percent of all Medicare expenditures for inpatient care. Another recent study looked at the incidence of avoidable medical errors across the entire population and concluded that they affected 1.5 million people and cost the U.S. economy $19.5 billion in 2008. The Centers for Disease Control and Prevention have estimated that almost 100,000 Americans now die from hospital-acquired infections alone, and that most of these are preventable.

In health care, by contrast, patient safety experts often remark that the death toll from medical errors in U.S. hospitals is equivalent to three jumbo jets falling out of the sky and killing all the passengers on board every forty-eight hours. But even the most egregious errors go largely unreported, and when they are reported, they are often buried and ignored. For the most part, all the public gets to hear about are industry-wide estimates and statistical averages of the kind presented above. Because we lack specific knowledge of where these injuries are occurring and under what circumstances, we can’t know precisely what to do about the ongoing catastrophe or whom to reward when specific solutions are found.

Public reporting will be bolstered, to a limited degree, under the fine print of Obama’s Affordable Care Act. The new law says that certain injuries and infections that take place in hospitals will be published on Medicare’s Hospital Compare website. Hospitals will also be rewarded or penalized according to how certain readmission rates and hospital-acquired injuries compare to national averages.

Moreover, the new law applies only to acute care hospitals, leaving out nursing homes and other long-term care facilities. It will only include harm to Medicare patients, a subset of the overall population. And the system will not be able to capture some of the most common types of injuries to patients, such as those caused by medication errors.

Done right, a fully digitalized and integrated medical record system would also by itself prevent many serious errors, such as the thousands that occur every year when pharmacists misread a doctor’s scribbled prescription. Lest you think such matters are no big deal, the Institute of Medicine estimates that the average hospital patient in the U.S. is subject to at least one medication error per day (wrong med, wrong dose, wrong time, wrong patient), and that the financial cost of treating the harm done by these errors conservatively comes to $3.5 billion a year. An integrated digital records system would also make it much easier to monitor and curb the overuse of treatments that are both costly and dangerous. For example, Americans are exposed to so many CT scans, many of them redundant, that, according to the New England Journal of Medicine,the resulting radiation exposure may be responsible for as much as 2 percent of all cancer deaths in the country.

We all understand that medicine is increasingly complicated and that hospitals are increasingly filled with patients who would have died years ago were it not for the wonders of modern medicine. But the Hippocratic oath says, “First do no harm.” Precisely because health care is becoming more and more complex, and therefore inherently dangerous, it will continue to cause more and more and more deaths and injuries until we put safety first.

WebMD had an article about the study (Davidson, G.H. The Journal of the American Medical Association, March 9, 2011; vol 305: pp 1001-1007) that showed trauma patients who survive their initial injuries are at higher risk of dying if they enter a nursing home.  The analysis of more than 120,000 adults treated for trauma in Washington state suggests that hospitals are doing a better job of keep patients alive. But close to one in six patients died within three years of hospital discharge — almost three times the expected death rate for the population. Twice as many non-elderly patients discharged to nursing homes died than did patients who went home following hospitalization.

This mortality difference persisted even after researchers adjusted the data to reflect the fact that the nursing home patients tended to be more functionally impaired than patients who were able to go home.

Among the study’s major findings:

Roughly one in three patients (34%) discharged to nursing homes died within three years.
Almost three times as many patients died following hospital discharge (21,045) as died during their hospital stay (7,243).
Hospitalization deaths dropped steadily during the 14-year study, from 8% in 1995 to 4.9% in 2008.
During the same period, deaths in the years following hospital discharge increased from 4.7% to 7.4%.


State health officials have fined Goldstar Rehabilitation and Nursing Center of Santa Monica, LLC $100,000 after a toothless patient choked on a pork chop and died.   The California Department of Public Health says staffers at the Goldstar Rehabilitation and Nursing Center allowed the 60-year-old man to attempt to eat the pork chop, despite doctor’s orders that he only eat soft food.

The man fed himself, but soon choked and lost consciousness. A 3-to-4 inch piece of meat was later removed from his throat by paramedics. He was transferred to a hospital, where he died a week later.

The facility received an “AA citation, the most severe penalty under state law, from the state of California after an investigation concluded that the inadequate care led to the death of a patient. The facility failed to ensure the health and safety of a patient when they did not follow its patient care policies and procedures which resulted in the patient’s death.

See article at Imperial Valley News here and article at San Jose Mercury News here.

Robert Eugene Price from Eugene, Oregon was sentenced to nearly four years in prison for his attempted abuse of a vulnerable nursing home resident.  Price pleaded guilty to one count of attempted first degree sexual abuse in connection with the sexual assault at Eugene’s Valley West Health Care Center.

Price was interrupted in the act of abusing a disabled “completely nonverbal” female patient.  An employee walked into the 56-year-old resident’s room and saw Price’s hand on the victim’s genital area.

Price has worked at other nursing facilities since the 1980s. His previous local employers include the Farmington Square, Gateway Living, Green Valley and Riverpark nursing facilities.


McKnight’s had an article about a recent report from the Agency for Healthcare Research and Quality about nursing home residents with pressure sores.  The numbers have fallen over the last decade.  "Both long- and short-stay nursing home residents saw improvements in rates of pressure sores, according to the report. Among short-stay patients, the rate fell from 22.6% in 2000 to 18.9% in 2008. The percentage among long-stay patients fell from 13.9% in 2000 to 11.7% in 2008. 

The AHRQ report also found that the percentage of long-stay nursing home residents who require help with activities of daily living has generally held steady since 2000. But while the overall percentage remained at 16.2% between 2000 and 2008, the percentage of long-stay residents up to 64 years old needing help with ADLs did increase from roughly 10% to 12%. AHRQ is an agency within the U.S. Department of Health and Human Services.