Nursing home employee Amanda Tibble pleaded guilty to abusing her patients in Washington County, TN Criminal Court. Tibble pleaded guilty to four counts of willful abuse or neglect of an adult at John M. Reed Nursing Home. She only admitted guilt to the mental abuse. She took best interest guilty pleas for the two counts of physical abuse of two male patients. Prosecutors accused Tibble of twisting one man’s hand and bending back another man’s hand.
Meanwhile, lobbyists for the nursing home industry are attempting to manipulate the judicial system in Tennessee to benefit nursing homes guilty of abuse and neglect. Tennessee is moving toward lighter regulation of nursing homes, fewer state investigations and laws that make it more difficult to bring potentially costly lawsuits against operators. The legislature placed strict new limits on the rights of nursing home patients and their families to sue nursing homes for poor care. That law also caps the amount a jury can award. Many nursing homes in Tennessee require patients or their families to sign arbitration agreements waiving their rights to a trial before admission.
The legislature in 2009 reduced oversight of the 325 nursing homes in the state by eliminating regulations mandating that nursing home operators file detailed reports on adverse events affecting patients. Also eliminated were requirements that the state investigate those incidents.
The tort reform bill sets a $750,000 cap on pain and suffering claims against a nursing home. A higher $1 million cap applies to limited types of cases. Caps do not apply if intentional misconduct is found. Nor is there any cap on economic damages, such as doctor and hospital bills or lost wages.
Data compiled by the federal Centers for Medicare & Medicaid Services show Tennessee ranks fourth out of 50 from the bottom in the number of hours per patient per day provided by certified nurse assistants. It ranks seventh from the bottom in registered nurse hours per patient per day, according to the CMS data.
According to state health officials, current law and regulations require licensed nursing personnel to provide only 0.4 hours of direct care per patient each day. Professor John F. Schnelle of the Vanderbilt Center for Quality Aging said studies have shown that increasing the hours of nursing care provided to patients can improve quality. Several published studies, including a report from the Institute of Medicine and one co-authored by Schnelle, have found links between staffing levels and the quality of care provided in licensed nursing homes.
Despite protests from advocates for the elderly, the nursing home provisions in the tort reform bill included a key provision that brings all claims against nursing homes under the strict limits of the medical malpractice law, eliminating separate claims for negligence and requiring plaintiffs to provide certification that the care provided did not meet local standards. Punitive damages also are limited to $500,000 or two times the pain and suffering claims. Claims under a protection from abuse also will be blocked. The sponsors of these bills were all recipients of large campaign contributions from nursing home political action committees. Follow the money.
Tennessee does poorly compared with other states in some key quality measures of nursing homes. Federal officials have said the state has failed in its regulation of such homes. A report issued this year by the U.S. Government Accountability Office gave the state Health Department failing scores for its performance in investigating serious complaints against nursing homes. It said there was a backlog of cases that had gone uninvestigated, and it cited a staff shortage as a factor.
See article at The Tennessean