Author Archives: Ray Mullman

Nursing homes should be required to have a set number of direct care nursing staff to cover the needs and care of patients. New York State is trying to determine how to quantify that number base don the acuity of the residents. However, lobbyists and nursing home apologists are pushing back against any mandatory minimum staffing requirements.

Safe-staffing requirements have been talked about for years. The current version of legislation that addresses it would require nursing homes in New York have a set ratio of at least one nurse for every five patients. Governor Andrew Cuomo this year directed the NYS Department of Health to study the viability of the proposal and see whether it would offer increased safety to patients.

Over the last few years, News10NBC has told dozens of stories about the care and conditions inside some of our local nursing homes. Something we’ve heard consistently from patients and their families is complaints about a lack of proper staffing to provide the kind of care that’s needed.

“We are here today to be a voice for those in nursing homes and hospitals who suffer, and yes die, in silence because of low staffing levels,” said Mary Ann Spring, a registered nurse and member of the Elder Justice Committee.

Marj Donhauser’s mother has been a patient at a local nursing home for the past five years.

“I cry all the way back (home) because I don’t want to leave my mother in that situation because there’s no one to look after her,” she told News10NBC.

The turnover and burnout rate in nursing homes is high. Then there’s the pay. Certified Nursing Assistants and LPN’s are, in some cases, making close to minimum wage.

“You can go to McDonald’s, give somebody a hamburger and say, have a nice day, and get $15 for doing that,” said Donhauser.


Medical malpractice deaths have risen in the past ten years and are now the third-leading cause of death in the United States with more than 250,000 people dying every year from surgical errors and negligence.

Data from 2009 to 2018 shows the following:

  1. Surgical error deaths are the third-leading cause of death in the United States.
  2. At least 250,000 people are killed by medical errors every year.
  3. The average payout for a medical malpractice lawsuit in the past 10 years was $309,908
  4. New York had the highest medical malpractice payouts in the U.S. with $7 Billion between 2009-2018
  5. The state with the lowest medical malpractice payments was North Dakota with $28.35 Million.
  6. Since 2009, a total of $38.5 Billion has been paid out to victims across the United States.
  7. Physicians (MD) are the highest practitioners to be sued for medical malpractice with over 85,000 reports between 2009-2018.
  8. Dentist Hygienists/Assistants have the lowest amount of medical malpractice lawsuits with just 45 lawsuits in the past 10 years.
  9. The largest medical malpractice payout was awarded to a man in Florida for a misdiagnosis of stroke systems. He was paid $216.7 Million.
  10. 2015 had the highest amount of medical malpractice payouts in the past 10 years, with a total of $4.01 Billion in damages collectively awarded to victims.


The HHS Office of the Inspector General (OIG) notes an increase in nursing home complaints last year according to the most recent set of data from the Department of Health and Human Services.  High-priority incidents that were not investigated within the proper timeframe rose 23% in a year.  The number of high-priority grievances that failed to be investigated within the mandatory 10-day period peaked at 6,540 in 2018, as compared to 5,305 the year before.Obviously, the Trump Administration feels these incidents are not a high priority.

The OIG rolled out its 2016-2018 trends in nursing home complaints on individual state surveys — with the most recent 2018 complaint average reaching its highest level in two years at 52.3 out of 1,000 residents, versus the previous year’s 49.9 per 1,000.

On a state-by-state basis, Hawaii received a mere 8.7 complaints per 1,000 for 2018, with only four high-priority incidents. Texas, at the other end of the spectrum, saw 102.3 complaints per 1,000, with 3,043 high-priority complaints — 1,304 of which were not investigated in 10 days — and 10 immediate jeopardy complaints not probed in two days.

Source: HHS OIG

This past week, CMS rolled out a number of new assessment tools — including a rubric and grading scale — for the State Performance Standards System (SPSS), which took effect for the 2020 fiscal year beginning October 1.


No surprise to nursing home abuse and neglect attorneys but a recent study from ProPublica found that South Carolina is among the worst states in the country when it comes to nursing home problems.  A study by the investigative non-profit ‘ProPublica’ finds a high number of serious violations across South Carolina.  A recent ProPublica study found that South Carolina ranks number 13.

Since 2016, SC nursing homes have racked up $5 million dollars in penalties.  SC ranks number 16 when it comes to the average number of fines paid by nursing homes.




A patient at West Vue Nursing and Rehabilitation Center in West Plains reported the sexual contact to police. The victim is a 68-year-old resident who told police that Stroman had had sex with her twice since August. The first encounter was consensual, she said, but the second one was not, according to documents. Another nurse explained to officers the victim “was getting scared” after Stroman had sex with her a second time on Sept. 7. Stroman allegedly gave the patient a pain pill before each encounter.

Police collected an item of clothing from the patient as possible evidence, the West Plains Daily Quill reported.

Stroman agreed to talk to police and initially denied any wrongdoing, the documents said. When police told Stroman that they had clothes from the patient with possible DNA evidence on them, Stroman allegedly said that the patient had inappropriately touched him.

He eventually admitted that there had been sexual contact as the woman described, according to the documents. Stroman had been employed as the weekend nurse supervisor at the facility for one year.




Federal officials have started affixing a bright red “stop” hand icon next to facilities that have received recent abuse citations from the Centers for Medicare & Medicaid Services.

CMS unveiled the labeling plans as part of an unfolding five-pillar plan that includes improving transparency for consumers. Starting Oct. 23, the “Do not proceed” symbol will be placed next to facilities that have been cited for abuse, neglect or exploitation. Authorities call the open-palm display in a red circle “a consumer alert icon.”

It will appear next to facilities that have been given a citation for abuse that led to the harm of a resident within the past year or cited for abuse that could have potentially led to resident harm in each of the previous two years.

The icon will be updated on a monthly basis at the same time as inspection results. CMS said the monthly updating will come quicker than current quarterly updates and ensures that nursing facilities “will not be flagged for longer than necessary if their most recent inspections indicate they have remedied the issues that caused the citations for abuse or potential for abuse and no longer meet the criteria for the icon.”

“Through the ‘transparency’ pillar of our five-part strategy to ensure safety and quality in nursing homes, we are giving residents and families the ability to make informed choices,” CMS Administrator Seema Verma said.

While consumers can already learn about nursing home violations through health inspection reports available through the website, the CMS said they’re too difficult to access now and that the new icon will make it easier for consumers to find out about abuse citations.

She said the added information is meant for “incentivizing nursing homes to compete on cost and quality.

I thought I had seen it all.  I have been a nursing home abuse and neglect lawyer for over 20 years and this latest story surprised even me.

Apparently, three caregivers at a facility owned and operated by the Affinity Living Group have been charged with creating a makeshift fight club at Danby House in North Carolina. Their “fighters” were victims of dementia under their care at Danby House, a facility in Winston-Salem, police say.  The Winston-Salem Police Department received a tip in June about elder abuse at the assisted living and memory-care facility, according to Fox 8.

Marilyn Latish McKey, Tonacia Yvonne Tyson, and Taneshia Deshawn Jordan were arrested and charged with assault on an individual with a disability in early October, according to authorities. McKey, Tyson and Deshawn filmed two residents in Danby House’s “special care unit” for dementia patients and encouraged them to fight.

Resident 8 and Resident 9, as the women are referred to in the documents, fought in Resident 8′s room as the trio of health-care workers encouraged them and and recorded the assault.  The three caregivers can be heard in the video saying, “Stop screaming, [expletive].” Someone also prompts one of the residents to “punch her in the face.” Another is concerned that the phone is actually recording the video, so that it could be sent to her later.  Video shows the patients falling onto a bed in Resident 8′s room as Resident 9 continued her assault, according to court documents reviewed by Journal. The anguished pleas for help were ignored.

Staff members took video of the fight, which led to “one resident being strangled with her face turning red,” and shared it on social media.  The employees let the fight happen because one of the residents “always caused problems.”

They were only charged with Class A misdemeanors, which only come with a maximum penalty of 150 days of incarceration and a discretionary fine. Their next court date is Nov. 14.  Incredible.

Affinity Living Group is the fourth-largest provider of Alzheimer’s care and memory care in the country, according to its website.

McKey faces an additional charge after shoving one of the residents during a separate incident when staff took video while McKey pushed the woman “into a room, turned off the light and yelled to the resident to go to sleep, and then closed the door leaving the resident in the dark room,” according to the report.

A nursing home resident at Oxford Rehabilitation and Health Care Center allegedly beat his roommate to death with a walker Oct. 5. The tragic incident is getting a lot of attention but attorneys who specialize in nursing home abuse and neglect are not shocked because we know these types of assault happen often especially when short-staffing prevents sufficient supervision and monitoring of easily agitated residents.

When police arrived to find Jose Veguilla swinging a bloody walker at staff, Veguilla responded to an officer’s request to drop the walker. Veguilla has dementia and was speaking incoherently. He had not been given his medication that day.

Police then found the victim, Robert Boucher, unresponsive in his room. He had a large cut on his forehead, among other defense wounds. Boucher had been living at the Oxford Manor nursing facility since April after having a leg amputated. He was engaged to be married. He was pronounced dead soon after.

A judge ordered Veguilla to undergo a competency evaluation after he pleaded not guilty to murder on Oct. 7.  The suspect suffered a traumatic brain injury during a fall at his home last year. A court psychologist questioned Veguilla’s competency at his hearing.

Veguilla’s son Henry said his father had not been taking his medicine and that he felt it was the facility’s duty to ensure the health and safety of all their patients.

“How does an 83-year-old man have the time to do what he is being accused of doing and no one stepping in to intervene?” his son said.

Athena Health Care Systems operates the nursing home. Oxford Manor receives a much lower than average rating on and was the subject of a settlement by the Mass. Attorney General earlier this year. They failed to protect patients in the past and now that same state-licensed nursing home is part of an ongoing investigation after an elderly patient is accused of murdering his roommate.

According to state and federal reports obtained by 5 Investigates, the nursing home has a history of problems related to the abuse and care of patients, including patient-on-patient assaults.

The state found the facility failed to protect residents from alleged abuse, including abuse of patients by a resident who was a potential sex offender. In another case, Oxford Rehab waited six months to contact police about an allegation of patient-on-patient sexual assault.

The nursing home even hired back a certified nursing assistant who was previously suspended for verbally and mentally abusing a patient.

As a nursing home abuse and neglect attorney in Spartanburg, S.C., we often attempt to get the real story of what is going on at a nurisng home from talking to former employees.  Current employees are too scared to lose their job to tell the truth.  Former employees have no reason to lie or cover-up the abuse and neglect they witnesses.

Recently a certified nurse aide named Miaya Ramirez at University Heights Rehab & Care in Aurora, Colorado shared her credible concerns. Ramirez worked for University Heights Rehab & Care for several months.

Patients being neglected, not getting showers, not getting fed properly, being left in their room, unsanitary conditions, being left in soiled briefs,” Ramirez explained to Denver7.

The week after she started working, Ramirez says the Director of Nursing asked her to lie on a state report about being understaffed.

We had holes in the staffing book and the DON (Director of Nursing) asked me to fill in people’s names in the staffing book and I told her I didn’t feel comfortable doing that,” she said.

She says the doctor of one patient even called police about the neglect.

“When the doctor pulled the bandages off she couldn’t believe what she saw; she said the wounds were worse,” Ramirez said. “She asked if the dressings were being changed when they were supposed to, if the resident was getting up out of bed when she was supposed to and I told her ‘no,’” Ramirez said.

Ultimately, Ramirez was fired for putting a clean bandage on that patient. She shared recordings of her termination. University Heights said she was operating out of the scope of care.

“What they told me was I should have left the dirty bandage on her backside,” Ramirez said.

Complaints investigated by the Colorado Department of Public Health document multiple instances of alleged neglect and abuse.

In April, there were several complaints of patients being left in their beds overnight or all day not being checked on. One family complained they found their loved one in a soiled bed and briefs and in the same position they left her in the evening before.

In March, a resident said his dressings were not being changed for a pressure ulcer.

Then, there are multiple instances of residents falling out of lifts. Last year, a 61-year-old resident fell out of a lift and had a brain bleed so bad it “contributed to a decline in his ability to eat, drink and breath,” according to one report.

Another resident broke her leg trying to be transferred improperly.

Ramirez says under staffing and lack of training is the problem.

“They will lie and cover up,” Ramirez said. “When I came back from the doctor’s office, the DON was re-doing paperwork to make it look like they were taking care of that resident.”

One of the worse situations we investigate as a nursing home abuse and neglect lawyer in South Carolina is physical abuse by caregivers and resident to resident altercations. Violence and mistreatment between nursing home residents is a common occurrence, according to experts.

In a 2014 study of nursing homes, Cornell University researchers Karl Pillemer and Mark Lachs determined that resident-to-resident elder mistreatment affected nearly 20 percent of residents over a four-week period. Researchers concluded that people who typically engage in resident-on-resident abuse are cognitively disabled to some degree but physically capable of moving around.

Specific types of mistreatment included verbal incidents, such as cursing, screaming or yelling at another person (16 percent); physical incidents, such as hitting, kicking or biting (5.7 percent); and sexual incidents, such as exposing oneself, touching other residents or attempting to gain sexual favors (1.3 percent).

Their underlying dementia or mood disorder often can manifest itself as verbally or physically aggressive behavior, the study found.

In 2015, nursing and residential care facilities were also among the industries with the highest prevalence of nonfatal occupational violence, with a rate of 6.8 per 100 full time workers, according to the U.S. Bureau of Labor Statistics.

One study revealed that nursing assistants at facilities with special units for Alzheimer patients had a significantly high risk for assault injuries and human bites. Thirty-five percent of nursing assistants reported physical injuries caused by aggression from residents, and 12 percent reported experiencing a human bite within the previous 12 months while working.