New York Nursing Home Abuse Lawyer Blog

New York State Veterans Home in Queens (NYC) received immediate jeopardy deficiencies (immediate jeopardy are the most severe) resulting from incidents of substandard quality of care for failing to keep the facility free from accident hazards, and for failing to implement policies and procedures related to resident smoking practices. These findings were part of a June 29, 2009 NYS Department of Health survey.

The surveyors found that the Queens nursing home staff and administration failed to implement appropriate policies and procedures related to resident smoking practices; failed to adequately assess/reassess the residents smoking abilities and update care plans; failed to provide supervision for residents who smoke in the designated smoking areas; failed to ensure that the residents were utilizing the appropriate receptacle to extinguish cigarettes/smoking materials; and failed to ensure that the designated smoking area was maintained free of litter of cigarettes butts.

As a result of the deficiencies, New York State took the following action according to a Long-Term Community Care Coalition report:

1) Civil Money Penalty: State recommends to CMS;
2) State Monitoring: state sends in a monitor to oversee correction;
3) Directed Plan Of Correction (DPOC): A plan that is developed by the State or the Federal regional office to require a facility to take action within specified timeframes. In New York State the facility is directed to analyze the reasons for the deficiencies and identify steps to correct the problems and ways to measure whether its efforts are successful;
4) In-Service Training: State directs in-service training for staff; the facility needs to go outside for help; and
5) Denial of Payments for New Admissions (DoPNA): Facility will not be paid for any new Medicare or Medicaid residents until correction is in place.

Beth Abraham Health Services, a Bronx (NYC) nursing home facility, was recently fined $21,150 by the federal government based on findings of substandard care in a April 27, 2009 inspection, according to a Long-Term Care Community Coalition report. The facility was sanctioned due to its failure to properly monitor and act upon a 66 year-old resident's PT/INR levels.

The staff at the Bronx facility failed to obtain PT/INR readings for a 7 day period. The resident was administered her normal Coumadin doses over the 7 days. Coumadin is an anticoagulant with a known risk of causing bleeds. The resident presented at a nearby hospital with critical lab values (an INR of 10 - normal range is 2-3), and then died at the hospital 2 days later from a bleed in the brain.

The facility was also cited for not having a written policy in place regarding the reporting of critical lab values.

The U.S. government estimates that over 5 million people are victimized by elder abuse each year. Furthermore, it is estimated that 84% of cases go unreported. Elder abuse comes in many forms including, physical or sexual abuse, neglect and financial exploitation. Below is a video promoting the passing of the Elder Justice Act.

A recent study conducted by the Journal of the American Medical Directors Association (JAMDA) indicates that surveyors routinely failed to detect quality care issues with respect to the assistance provided by nursing home staff members at mealtime. As we have discussed many times on this blog, malnutrition and dehydration are two of the most common and most important issues facing nursing home residents.

According to the JAMDA website, "Guidelines written for government surveyors who assess nursing home (NH) compliance with federal standards contain instructions to observe the quality of mealtime assistance. However, these instructions are vague and no protocol is provided for surveyors to record observational data. This study compared government survey staff observations of mealtime assistance quality to observations by research staff using a standardized protocol that met basic standards for accurate behavioral measurement."

The study found that nutritional care (or lack thereof) is a significant problem in long-term care facilities, and noted that it is underdetected in the survey process. The researchers that conducted the study call for surveyor training on this issue that fosters more accurate and consistent observation of feeding assistance issues and a "standardized protocol to organize and guide" surveyor observations.

The family of a resident at a California nursing home, Fillmore Convalescent Center, was recently awarded $7.75 million in a case involving nursing home abuse. The resident was a 71-year-old stroke victim.

The attorneys for the resident and her family showed the jury a secret videotape of the woman being abused. Members of the residents family became suspicious after they noticed that their mother was bruised. They complained to management at the facility, but apparently the facility failed to investigate. As a result, the family took it upon themselves to set-up the hidden camera.

She videotape reportedly showed a member of the nursing staff slapping the resident, pulling her around by the hair, bending her neck, fingers and wrists, and treating her violently in a shower chair. The jury deliberated for two days before announcing the verdict: $2.75 million in actual damages and $5 million in punitive damages.

Website Resources:

$7.75 million awarded in abuse case - Elderly victim a patient at Fillmore facility, Ventura County Star, Stephanie Hoops, December 11, 2009.

In a March 9, 2009 survey conducted at Rivington House - The Nicholas A. Rango Health Care Facility , a Manhattan (NYC) nursing facility, surveyors found that the NYC facility failed to develop and implement policy and procedures to track and monitor laboratory orders and results. The 52 year-old resident that was the subject of the investigation was admitted to the facility with a medical history of Coronary Artery Disease, status post a bypass graft, and Hypercholesteremia.

The resident had been prescribed Coumadin for DVT prophylaxis after the bypass graft surgery. However, PT/INR (Prothrombin Time/ International Normalized Ratio) tests were not performed for two consecutive weeks as ordered. Once recognized, the resident was admitted to the hospital with critical lab values, and then subsequently expired at the hospital due to a cerebral hemorrhage.

The surveyors found that the NYC facility had no system in place to ensure that all physician laboratory orders, specifically standing orders, are completed. They also found that Rivington House failed to implement a system to ensure that the labs were actually drawn and the results subsequently obtained. As a result of the surveyors' findings and the facility's neglect, Rivington House was fined $45,750 in federal sanctions.

A former nursing assistant in an Illinois nursing home recently admitted in court that she failed to properly ascertain the whereabouts of all residents after a door alarm sounded at approximately 2 am in the winter. Instead of conducting a bed check after the alarm sounded, the nursing assistant returned to watching television. She later conducted a bed check at approximately 5 am and found that an 89 year-old resident was missing.

The resident's frozen body was discovered in the courtyard of the facility. She had fallen and injured her chin and leg, and eventually died from hypothermia. Local police also reported that the aide tried to cover-up the incident by returning her to her bed and changing her clothes. A civil lawsuit has been commenced by the resident's family alleging nursing home neglect and abuse and wrongful death.