A resident of an assisted living facility in Sandy Springs, Georgia, died after the nursing home failed to prevent the ant bites over her body.  Betty Perloe and her personal aide saw ants in Perloe’s bathroom and closet at Somerby Senior Living of Sandy Springs and the aide reported the infestation to staff.  Nothing was done.

Perloe was found suffering from bites, with ants on her body and in her bed.  Then the next day, Perloe was found again with ants on her body and pus-filled bites across her midsection, underneath her breasts and on other areas.

Perloe, a retired nurse, was “agitated,” “moaning” and “scratching” the blistered areas, according to the lawsuit, and she was put on morphine and other pain medications to chemically restrain her.  She died days later.

Lance Lourie, the attorney representing the family, said the most important aspect of this case is not that Perloe’s death was accelerated. “It’s about the way she died, in an undignified and painful way that was unnecessary.”

Roughly 36% of skilled nursing facilities saw a drop in their overall star ratings after planned fixes to the Centers for Medicare & Medicaid Services’ (CMS) Nursing Home Compare system took effect last month. About 16% of providers gained at least one star under the ratings overhaul.  Approximately 47% of skilled nursing facilities had no change in their overall rating, but slightly more lost one or more stars on the quality measure, Martin told SNN.

Roughly 48% of providers lost one or more stars in the quality domain, and that’s largely driving the decrease in overall stars.  A building’s five-star score consists of three separate metrics, each of which CMS also ranks from one to five: survey, quality, and staffing.

Staffing had taken center stage in CMS’s ratings overhaul, particularly after a New York Times investigation last summer revealed that operators may have been less than accurate in reporting nurse coverage information. Federal officials responded by slapping 1,400 facilities with one-star ratings on staffing.

Both the staffing measure and the survey measure are important, with survey having the most weight. Still, practically speaking, providers receive one standard survey a year. And improving staffing will require extra funds coming in from somewhere, as well as the effort of finding competent employees in a major workforce crunch.  Improving a SNF’s quality metrics, however, can begin much more quickly.

SNFs can also take steps to improve how they keep track of patients when they are discharged. Readmission penalties are assessed 30 days after hospital discharge, and so SNFs could be on the hook for any complications that arise after a patient leaves their care.

 

Current Minnesota law is silent on whether nursing home residents can install “granny cams.”  This is true in South Carolina as well.  However, a new bill authored by state Sen. Karin Housley, a St. Paul Republican, makes the right explicit and spells out the steps for obtaining consent to install them.  Residents of nursing homes or assisted living facilities would be allowed to install cameras in their rooms to monitor and deter possible abuse under this bill.

People believe that hidden cameras are permitted in such facilities, but many facilities don’t allow their use, Sean Burke, public policy director of Minnesota Elder Justice Center, told a Senate committee.

“Electronic monitoring can be a helpful tool to prevent maltreatment of older adults,” said Libbie Chapuran with LeadingAge Minnesota. “It can also improve the care and communications between family members and the providers of that care.”

 “We believe that protecting vulnerable adults is the core of our work,” Burke said.

Such tools are used in other states and are seen as an effective means to protect vulnerable adults against abuse. In the U.S., one in 10 people are victims of elder abuse. For those with cognitive impairments, the ratio is one in five.

One of the reasons behind the use of granny cams is that employees of assisted-living facilities are less likely to abuse residents if they know that their actions are being monitored.  But the bill also allows a resident to keep the camera secret from the facility out of fear of retaliation.

The law would make it illegal for a facility to remove a resident for placing a recording device in their room. It also makes it a crime for a person to tamper with or destroy such equipment. The cost of purchasing, installing and maintaining the camera is the responsibility of the resident.

A jury awarded more than $37 million in damages to a woman who filed a lawsuit against George D. Houser, a former nursing home operator.  Houser was sued by Loretta Terhune because her father, Morris Ellison, was neglected and died in Moran Lake Nursing and Rehabilitation Center.  Ellison was placed in Moran Lake after being treated for a blood clot in his leg. Terhune said he was never supposed to be there more than a few months.

According to testimony by a medical expert, when Ellison died he was dehydrated, malnourished and his hip had been broken for 10 days.

Christie Fuqua, former director of nursing for Moran Lake, testified that at the time the facility ran low on food supplies, didn’t have hot water and patients slept in broken beds next to walls smeared with fecal matter.  Fuqua also testified that often staff paychecks would bounce, and it became chaotic on payday when staff members left the facility in a mad dash to get checks cashed before they could be declined. Fuqua cried on the stand as she described what it felt like when she heard that the patients had been removed from the facility after it was ordered to be closed in 2007.

Terhune told the jury that her father was all the family she had, and the two of them had a close relationship ever since he adopted her when she was just a year old.

“We loved to eat and play cards together. He spoiled me. We never went one day without talking,” Terhune said.

Steve Lowry, an attorney assisting the lead plaintiff’s attorney in the case, said Houser’s argument that Ellison was old and had a limited lifespan does not negate the fact that the plaintiff has suffered from the loss of her father.

We are not the sum of what we earn,” Lowry said. “Our value is the time we spend with our family, playing cards, going out to dinner. We can not judge (Ellison) based on what his earning potential was.

The jury found that Houser’s actions caused harm to Ellison. The jury also ruled that Houser violated fair business practices and misused funds intended for patient care.  It took just two hours for the jury to reach the verdict, and Terhune was awarded more than $37 million in punitive damages, pain and suffering and medical expense recovery.

 

Almost six years ago, nursing home resident Bertha Davis fell and was injured at the Pensacola Health Care Facility. The fall caused a blood vessel to burst and blood to begin pooling in a portion of her brain. As a consequence, Bertha dies 4 days later.  Her three children filed a civil lawsuit against the nursing home’s parent company, SV/Jupiter Properties Inc., doing business as the Pensacola Health Care Facility, and its management company, S/V Home Office Inc.

Recently, a jury returned a verdict ruling that not only did the fall ultimately kill Davis, but that the nursing home was negligent in its care and allowed the fall to occur. The jury also awarded a total of $200,000 to Davis’ children.  It took a long time but justice was done.

 Attorney Samuel Bearman represented the estate of Bertha Davis.

“I think the jury’s ruling was that the nursing home had not done everything that it could have done — and that should have done — to prevent Ms. Davis from falling,” Bearman said. “The nursing home failed to follow its own care plan, designed to prevent Ms. Davis from falling.”

When the Institute of Medicine — now known as the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine — put out a major 1999 report titled To Err Is Humanit became the norm to focus less on punishment and more on learning from mistakes.  Disciplinary action is warranted only when there’s evidence that staff acted irresponsibly or recklessly.  Now times have changed.

A nurse, RaDonda Vaught, at Vanderbilt University Medical Center in Nashville, Tenn., was arrested and charged with reckless homicide and abuse in February for giving the wrong medication to a patient which proved fatal.  Vaught was allegedly trying to give the patient, Charlene Murphey, a dose of an anti-anxiety medication, midazolam (brand name Versed),  during a December 2017 hospital stay, the report states. Vaught instead gave Murphey vecuronium, a paralytic drug used during anesthesia that had the same first two letters, according to the report. Murphey died in an intensive care unit the following day.

The Nashville District Attorney’s office told the Tennessean it made the decision to bring criminal charges against Vaught specifically because she administered the fatal medication after overriding the safety mechanism in the dispensing machine.

The district attorney’s decision to charge Vaught comes after both the Tennessee Department of Health and the federal Centers for Medicare and Medicaid Services investigated the incident. The CMS report emphasizes the hospital’s responsibility in the mistake. “The hospital failed to ensure all patients received care in a safe setting,” the report says.

Medical errors are common. Some researchers estimate they’re the third leading cause of death in the United States. And many in the patient safety community say they don’t understand what prompted the DA’s office to prosecute this case in particular.

Criminal charges for a medical error are rare and unusual, patient safety experts say. Most high-profile cases tend to involve death, a significant injury or a patient well-known in the community, he says. And prosecutors tend to focus on nurses, he says, rather than physicians or hospital administrators, though he’s not sure why.

Some are voicing concern that the move sets a precedent that may actually make hospitals less safe by making people hesitant to report errors. The American Nurses Association issued a statement criticizing the charges, saying that “the criminalization of medical errors could have a chilling effect” on health care workers’ willingness to report errors.

Most medical errors occur because of systemic problems. Human error is inevitable and nursing homes and hospitals should account for that by instituting safety checks and protocols.  Problems tend to happen in busy and short-staffed.  When nurses are fatigued or have many tasks occupying their attention, that’s when safety checks are most important.

 

 

Steven M. Levin, one of the best nursing home trial lawyers in the country, wrote the following for The Southern Illinoisan.  I could not agree with him more!

Corporate nursing home facilities are often chronically understaffed. This increases the risk of tragic consequences; residents can suffer and even die because there are not enough staff members to provide necessary care. These facilities must be held accountable for failing to meet residents’ needs.

To combat this problem, Illinois State Sen. Jacqueline Collins, D-Chicago, is sponsoring SB 1510, the Nursing Home Residents’ Quality Care Initiative, which will financially penalize facilities that breach the minimum number of staffing requirements, curb the use of psychotropic drugs and increase public transparency of nursing home violations.

This legislation must be passed to keep our most at-risk seniors safe.

“This initiative sets forth some much-needed measures to ensure that no family has to see their loved one suffer unnecessarily in a place where they are supposed to be cared for,” Collins said.

But inadequate staffing levels are a common problem statewide. According to U.S. Centers for Medicare and Medicaid Services data, Illinois facilities were fined more than $6 million since 2016 for numerous violations that put residents at risk of negligence and abuse. Aperion Care Cairo nursing home in Cairo was fined nearly $140,000 for 35 violations, one of which was considered serious.

Many studies show that facilities that provide adequate staffing levels deliver better care and better results to residents. Yet a lack of federal requirements for nursing home staffing levels means that facility owners — increasingly for-profit companies — are free to set their own standards. At some corporate-owned facilities, this translates to low staffing numbers, inexperienced workers with inadequate training, a failure to follow industry guidelines and Illinois laws and ignoring reports of abuse and neglect.

Nursing home residents are our parents, siblings and friends. They are some of the most vulnerable members of our society. We can start protecting them here in Illinois by passing SB 1510. It’s time for facilities and policymakers to follow the actions experts recommend and ensure that nursing home residents receive the safest, best possible care.

 

A caregiver of an assisted living facility has been charged with raping an 84-year-old resident of Waterford assisted living facility, according to News 5 affiliate WSYX.  Donald Chinn was arrested at his home and was charged with one count of rape. Chinn has a record of drug offenses, including drug trafficking, stretching back to at least 1999, according to WSYX.  Why did they hire this guy?

The daughter of the alleged victim alerted authorities about the alleged rape, and the executive director called 911.

A spokesperson for the facility sent a statement to WSYX stating in part that the management is “disappointed and concerned.”

 

 

CBS17 had a sad story about a North Carolina facility neglecting a resident.  Tracey Ervin wants answers about the conditions she saw her mother in at a retirement home. Her mother is in the nursing home for 24-hour care. She says she found her mother soaked in urine at Whispering Pines Nursing Home almost every day for nearly a week.  This happens a lot in short-staffed facilities and can cause skin breakdown, depression, and urinary tract infections.

“If you only knew what has gone through my mind every time I walk into that facility,” said Tracey Ervin, who is a patient’s daughter.  “I’m angry. I’m frustrated,” she said. “All the above, and then more.”

She took the problem straight to the nursing home and filed a complaint with the state. Her complaint will be added to a list of complaints against Whispering Pines.  The complaints on file with the state that date back to 2011. There are at least of 21 complaints in that time period.

“I’m the one that changed my mother’s sheets. I’m the one that changed her. I’m the one that washed her face,” Ervin said.  “Them people that’s neglected my mother, out. Director of nursing, out. I’m tired of it,” Ervin said.

Charlene Hunter James, President of AARP Texas, wrote the following for TribTalk, a publication of the Texas Tribune.

Imagine the horror of living in a deep fog day in and day out. Your steps, if you’re able to walk, are wobbly. Your memories are confused. Your grasp of reality is lost.

And to discover that you’ve been purposefully sedated for no legitimate reason.

Federal reports show that thousands of nursing home residents in Texas are being inappropriately prescribed antipsychotics. They’re not given the drugs because of psychiatric conditions for which they can legitimately be prescribed. Rather, they are being administered for other causes. Sometimes, it’s merely for the convenience of nursing home staff.

It’s called a chemical restraint and it’s akin to the way people were handled in the Dark Ages.

This is a misuse of one of the most powerful classes of psychiatric drugs. For those with dementia, which is not uncommon among nursing home residents, receiving antipsychotics is especially dangerous, even deadly. That’s why the Food and Drug Administration gives these medicines a black-box warning: an alert of an increased risk of death among people with dementia.

No one disputes that providing daily care for nursing home residents is a patience- and stamina-testing ordeal. Attending to these moms, dads, grandparents and other loved ones is a truly honorable profession. Working with those who have Alzheimer’s and other dementia adds greatly to the frustrations.

Through music and memory programs, and other therapies, Texas and some other states have made progress over recent years in reducing inappropriate use of antipsychotics among nursing home residents. But this crisis in care has by no means been eradicated.

So, it’s exasperating that lobbyists for the nursing home and medical industries this legislative session are opposing reasonable proposals to rectify the problem.

Today, the law says that nursing home residents must give consent for antipsychotics to be administered. And yet, all too often, family members of nursing home residents still report a lack of awareness of these drugs being administered. They see sudden and solemn changes in the mental well-being of their loved ones. Later they learn — or come to suspect — a culprit: antipsychotics being administered without their knowledge.

A stronger consent law that would require written consent of a nursing home resident or a legal decision-maker. And that’s essentially what’s offered in Senate Bill 1212 by Sen. Kelly Hancock, R-North Richland Hills and House Bill 2050 by Rep. Chris Paddie, R-Marshall.

To improve nursing home safety, please ask your state representative and senator to support those bills.

Disclosure: AARP has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism.