According to the survey findings, Morningside House failed to ensure that an investigation was conducted for a resident sustained a left ankle fracture which was an injury of unknown origin. As a result of no investigation, the facility did not discover the cause of the nursing home injury or put into effect steps to prevent future similar incidents.
The facility failed to ensure that the residents were protected from environmental hazards, specifically, the potential for burns and scalding injuries related to excessive hot water temperature. In addition, the facility failed to maintain water temperature within the acceptable range of 90-120 degrees Fahrenheit. This was evident in 8 community showers and bathrooms and 4 pantry room sinks located in 1 of 2 resident care buildings, which had the potential to affect the 141 residents who are ambulatory and independent, and those requiring toileting assistance.
Morningside House was also cited for failing to ensure that nurse aides are able to demonstrate competency in skills and techniques necessary to care for residents'
needs, as identified through resident assessments, and described in the plan of care.
Morningide House received 36 deficiencies, 7 of which were related to actual harm or immediate jeopardy, the most serious category of deficiencies available to surveyors.
]]>The case proceeded to a trial on damages. After the trial, the jury awarded $14 million in damages and $100 million in punitive damages to Jackson's family. The verdict is reportedly one of the largest in Polk County history.
$114 Million Awarded in Abuse Case, The Ledger, Jason Geary, July 22, 2010.
]]>Judge Roland Candee rejected Horizon West Healthcare's arguments for a new trial or significantly reduced damages. Candee said "overwhelming" and "devastatingly powerful" evidence in the trial in May supported the jury's verdict and damage awards against Horizon, which owns 33 nursing homes mostly in California.
The jury ruled that Horizon and Colonial committed elder abuse and awarded $1.1 million in damages for Tanner's pain and suffering and for her daughter's loss of companionship. A day later, after hearing evidence about the corporation's finances including its net worth of about $200 million, the panel made the $28 million punitive award.
Candee reduced the pain and suffering damages to $800,000. Including $1.2 million in attorney's fees, the total judgment is for $29.1 million, believed to be the largest ever for an elder abuse case in Sacramento County.
Website Resource:
$29 million verdict upheld against Rocklin nursing home firm, Sacramento Bee, Cynthia Hubert, July 15, 2010.
]]>Loretto Utica Residential
1445 Kemble Street
Utica NY
Northwoods Rehab At Hilltop
1805 Providence Avenue
Niskayuna, NY
Northwoods Rehabilitation has been on the SFF list for over 35 months. Below please find a complete explanation of the Centers for Medicare & Medicaid Services ("CMS") Special Focus Facility Initiative.
Background
CMS and States visit nursing homes on a regular basis to determine if the nursing homes are providing the quality of care that Medicare and Medicaid requires. These "survey" or "inspection" teams will identify deficiencies in the quality of care that is provided. They also identify any deficiencies in meeting CMS safety requirements (such as protection from fire hazards). When deficiencies are identified, we require that the problems be corrected. If serious problems are not corrected, we may terminate the nursing home's participation in Medicare and Medicaid.
Most nursing homes have some deficiencies, with the average being 6-7 deficiencies per survey. Most nursing homes correct their problems within a reasonable period of time. However, we have found that a minority of nursing homes have:
• More problems than other nursing homes (about twice the average number of
deficiencies),
• More serious problems than most other nursing homes (including harm or injury
experienced by residents), and
• A pattern of serious problems that has persisted over a long period of time (as measured over the three years before the date the nursing home was first put on the SFF list).
Although such nursing homes would periodically institute enough improvements in the
presenting problems that they would be in substantial compliance on one survey, significant problems would often re-surface by the time of the next survey. Such facilities with a "yo-yo" or "in and out" compliance history rarely addressed underlying systemic problems that were giving rise to repeated cycles of serious deficiencies. To address this problem CMS created the "Special Focus Facility" (SFF) initiative.
How the Special Focus Facility (SFF) Initiative Works
CMS requires that SFF nursing homes be visited in person by survey teams twice as frequently as other nursing homes (about twice per year). The longer the problems persist, the more stringent we are in the enforcement actions that will be taken. Examples of such enforcement actions are civil monetary penalties ("fines") or termination from Medicare and Medicaid. Within about 18-24 months after a facility is identified by CMS as an SFF nursing home, we expect that there will be one of 3 possible outcomes:
(a) Improvement & Graduation: The nursing home graduates from the SFF program
because it has made significant improvements in quality of care - and those
improvements are continued over time;
(b) Termination from Medicare: The nursing home is terminated from participation in the
Medicare and Medicaid programs. While such a nursing home may continue to operate
(depending on State law), usually it will close once Medicare and Medicaid funding is
discontinued. In such a case the State Medicaid Agency (and others) will assist all
nursing home residents to transition to another residence that can provide a better and
acceptable quality of care. This may include a variety of possibilities, such as another
nursing home, a community-based setting, or apartment with good support services.
(c) Extension of Time: The nursing home is provided with some additional time to continue in the SFF program because there has been very promising progress, such as the sale of the nursing home to another owner with a much better track record of providing quality care.
Website Resources:
CMS Special Focus Facility Ceritification and Compliance, 2010.
]]>This is a very common fact pattern in the nursing home neglect cases we handle on a daily basis. Many nursing home facilities respond to falls by telling family members that the fall was unavoidable. They explain, "Elderly people fall. It happens." This is not an acceptable explanation. It may true that the elderly are more prone to suffering falls. However, families place their loved ones in nursing homes for a reason (usually because they could not provide 24 hour are on their own and felt that medical professionals would be better suited to provide the necessary care/supervision). The nursing home staff should be held accountable for properly assessing the resident for falls, as well as properly implementing an appropriate plan of care to prevent falls.
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The vast majority of the violations stemmed from the death of an 81-year-old male resident due to a medication error. The man was reportedly admitted to the nursing home facility from a nearby hospital in Saranac Lake. Upon discharge from the hospital, 0.125 milligrams of Xanax, an anti-anxiety drug, every two hours was mistakenly transcribed as 1.25 mg every two hours by an Uihelm staff member.
The resident was given two 1.25 mg doses of Xanax and fell into a coma. Five hours then passed before the situation was reported to a physician.
Website Resource:
Uihlein draws major fine, Adirondack Daily Enterprise, Jessica Collier, June 17, 2009.
]]>The surveyors uncovered that a cognitively impaired resident who had eloped from the facility 2 days prior, eloped again during the night, and was found approximately 3 ½ hours later more than 3 miles from the facility by a staff member on her way to work. The staff had not placed a Wanderguard, a monitoring device, on the resident as would have been appropriate given her medical history. Elant at Brandywine received an immediate jeopardy citation, the most serious classification, as a result of this incident.
Elopement occurs when a nursing home resident, usually a resident with Alzheimer's or dementia, is allowed to exit the facility without supervision. Elopement of cognitively impaired nursing home residents can result in falls, fractures, brain injuries, hypothermia or heat stroke.
Website Resources:
New York State Dept. of Health, Elant at Brandywine, September 2, 2009 Survey.
Long-Term-Care Community Coalition, 9/09-12/09 NY Enforcement Action Report.
Website Resource:
Long-Term-Care Community Coalition Quarterly Report, Winter 2009.
]]>The jury on Wednesday found Colonial Healthcare of Auburn and its parent company, Horizon West of Rocklin, guilty of elder abuse in the death of Frances Tanner, 79, a Stockton native and lifelong civil servant. They heard testimony about the corporation's finances today before deciding punitive damages.
Sacramento lawyer Ed Dudensing, who represented Tanner's daughter Elizabeth Pao in the case, urged jurors to make sure that Horizon paid dearly for the lapses that he argued led to Tanner's death. Plaintiffs contended that the nursing home corporation made profits their priority as opposed to quality patient care. The nursing home claimed that appropriate care was provided to Ms. Tanner. Representatives of Colonial Healthcare have vowed to appeal the verdicts.
Website Resources:
Jury hits Auburn nursing home with $28 million in punitive damages, Modesto Bee, Cynthia Hubert, May 13, 2010.
]]>More generally, the facility was also cited for failing to ensure that all alleged violations involving mistreatment, neglect, or abuse, including injuries of unknown source are thoroughly investigated, and reported to the New York State Department of Health.
As a result of these and other violations of nursing home regulations and statutes, the Bronx nursing home was fined $50,175.00 according to the Long-Term-Care Community Coalition report of 9/1/2009 - 11/30/2009.
]]>At trial, the plaintiffs' experts argued that there was no need to have railings on D'Aust's bed and that the facility was negligent in failing to utilize a bed alarm that would have allowed D'Aust to summon help. The defense contended that the bed met FDA guidelines and that monitors often cause more problems than they solve. The matter settled for $190,000 during jury deliberations.
Resource:
Verdictsearch, April 29, 2010.
]]>In the lawsuit, plaintiffs accuse Skilled Healthcare Group Inc. of violating the California law that requires nursing homes provide at least 3.2 nursing hours per resident per day. The lack of adequate staff at the homes, the lawsuit contends, has a direct effect on the quality of care for the residents. The suit is seeking punitive and statutory damages for each day the nursing homes are found out of compliance.
Website Resource:
Valley nursing homes hit in staffing lawsuit, The Fresno Bee, Barbara Anderson, April 17, 2010.
]]>Attorney General Cuomo explained, "With the consent of family members, we put hidden cameras in nursing homes across the state, watching over the vulnerable who often cannot advocate for themselves. My office is strongly committed to using all the tools at our disposal to make sure people are getting the medical treatment and the care they deserve."
The hidden cameras at Northwoods Rehabilitation and Extended Care Facility in Troy revealed that staff routinely failed to turn and position an immobile resident, often leaving the resident in the same position for an entire shift over a six-week period. Nursing staff failed to administer medications, as well as treat the resident's bedsores (decubitus ulcers, pressure sores). In addition, the nursing staff member allegedly falsified resident medical records to conceal their neglect. A physician's assistant also created a phony record of an annual medical exam that never happened.
Six Licensed Practical Nurses and seven Certified Nurse Aides were charged with multiple counts of Falsifying Business Records in the First Degree (class E felony) and Willful Violation of the Public Health Law (unclassified misdemeanor) in complaints filed in Schaghticoke Town Court. In addition, the LPNs were charged with multiple counts of Endangering the Welfare of a Physically Disabled Person (class A misdemeanor). The physician's assistant was charged with one count each of the above charges. A class E felony carries a maximum penalty of 4 years in prison and the misdemeanors carry a maximum penalty of one year in jail.
The investigation along with surveillance video taken at Williamsville Suburban Nursing Home in Amherst over a seven-week period revealed that staff routinely failed to properly transfer the resident in and out of bed, putting the resident at risk of injury. Staff was required to use a mechanical lift with the assistance of two caregivers. Video footage also revealed that one aide failed to provide range of motion therapy and two nurses failed to administer insulin, provide skin and wound treatment, and failed to check the resident's vital signs. In addition, the resident's medical records show that employees falsified records to conceal the resident's neglect and endangerment.
Two Licensed Practical Nurses and one Certified Nurse Aide were charged with Falsifying Business Records in the First Degree (class E felony) in complaints filed in Amherst Town Court. The charge carries a maximum penalty of 4 years in prison. Five other Certified Nurse Aides were charged with Endangering the Welfare of an Incompetent or Physically Disabled Person (class A misdemeanor), with a maximum penalty of one year in jail. The Certified Nurse Aide who falsified the resident's medical record failed to perform range of motion exercises on the resident's extremities, which were required to prevent muscle contracture.
Website Resource:
CUOMO'S HIDDEN-CAMERA INVESTIGATION LEADS TO 22 ARRESTS FOR PATIENT NEGLECT AT WNY AND CAPITAL REGION NURSING HOMES, NYS Attorney General, March 31, 2010.
]]>The facility failed to ensure staff members were knowledgeable of resident's advance directives and knowledgeable of the facility's cardiopulmonary resuscitation (CPR) procedure. The administration of the home failed to develop and implement effective policies and procedures for responding to emergent situations. Sutton Park reportedly had three different policies and procedures for CPR.
Additionally, the facility failed to ensure that adequate CPR trained staff were present on all shifts. More specifically, a staff member failed to provide CPR when a resident was found unresponsive and identified by the LPN with advance directives for resuscitation.
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