New York Nursing Home Abuse Lawyer Blog

Petite Fleur, a Sayville, New York based nursing home, was cited by the Department of Health for multiple pressure sore violations in a recently released report. The survey, taken April 9, 2010, detailed a resident whose pressure ulcer (bedsore, decubitis ulcer) went undocumented until it had reached Stage 3. The resident had scored a "15" on the Braden Scale Assessment, indicating a risk for the development of a pressure sore.

Title 42 of the Code of Federal Regulations section 483.25(c) states that "the facility must ensure that (1) A resident who enters the facility without pressure sores does not develop pressure sores unless the individual's clinical condition demonstrates that they were unavoidable; and (2) A resident having pressure sores receives necessary treatment and services to promote healing, prevent infection and prevent new sores from developing."

In this case, the resident was considered "at risk" as determined by on the Braden Assessment. Certainly this does not mean that development of a pressure ulcer is unavoidable. However, due to the risk factors present, the facility should have monitored the resident's skin and put a plan of care in place in order to prevent the development and/or deterioration of pressure ulcers. Failure to chart an ulcer until it has reached Stage 3, at which point there is full thickness tissue loss, is unacceptable. Additionally, the resident had already developed several other pressure sores which should have made the staff more vigilant in the resident's care and treatment.

The complete Department of Health survey can be found here.

Bellhaven Center for Rehabilitation and Nursing Care in Brookhaven, New York was found deficient by the DOH in a number of areas, according to a survey of August 8, 2011. The areas receiving less than adequate marks were clinical record keeping, accident reporting, proficiency of nurses aides, and avoidance of unnecessary catheterization.

As is often the case in these DOH deficiency reports, the study references Title 42 of the CFR. Section 483.75(l)(1) states that the facility must maintain complete clinical records for each patient, in accordance with accepted professional standards and practices. The study details two incidents at Bellhaven in which physicians ordered medication for residents, however there was no documentation that the medications were actually administered to the patients. Proper record taking is essential to the safety and well-being of nursing home residents. Quite often, a resident is unable to communicate accurately with a member of the staff. Failing to document what type of medication is administered to a patient, as well as when and where such medication was administered can lead not only to sloppy records, but sickness or death for the patient.

Section 483.10(b)(11) of the Code makes clear that: "[A] facility must immediately inform the resident; consult with the resident's physician; and if known, notify the resident's legal representative or an interested family member when there is an accident involving the resident which results in injury and has the potential for requiring physician intervention." In the incident cited by the report, a resident was scheduled for a dermatology appointment. Not only was the resident's family not informed of this appointment, the resident herself was never picked up to attend the appointment. The patient was not told why the appointment was missed.

In most, if not all cases, an individual is placed in a nursing home because he or she no longer has the full ability to care for him or herself. In such cases, it is a necessity to maintain open and clear lines of communication both internally within the facility and externally to family members or legal guardians. Failure to do so is unacceptable, and can lead to dire consequences for the most vulnerable member of the equation: the patient.

The entire DOH report can be found here.

Grandell Rehabilitation and Nursing in Long Beach, New York was fined for several deficiencies after surveys taken in January and July of last year. Among the numerous violations found during the survey were:

• CFR 483.7(h)(3) Corridors have firmly secured handrails. The study found that not only did the facility lack the requisite number of handrails, but also not all handrails were securely fastened in place. Due to a propensity for falls by residents of nursing homes, and for increased damage to an elderly resident who suffers a fall, securely fastened handrails are an absolute necessity in elder care facilities. A fall can lead to injuries such as bruising and bone fractures. Additionally, the long term reduced mobility resulting from a fall can lead to advanced medical issues, such as bedsores (pressure sores / decubitis ulcers) for an elderly resident. The effects, both direct and indirect, of a fall can be deadly for an elderly nursing home resident. All precautions must be taken to ensure that avoidable falls are, in fact, avoided.

• CFR 483.65 Facility Establishes Infection Control Program. An infection in an elderly patient can have dire consequences. As such, all necessary precautions must be taken by resident facilities to avoid preventable infections. Instances such as failure to wash hands before administering medicine, failure to replace a visibly soiled cervical collar, and failure to employ sanitary methods of taking blood (all noted in the deficiency report) can each lead to an infection. Simple precautions like these, which an individual would almost certainly take if administering medicine or taking blood from him or herself, were not taken on several occassions during the period of time monitored by the survey.

As mentioned above, there were numerous additional violations found in the DOH survey. These can be found in the link to the site below. According to the Long-Term-Care Community Coalition, Grandell was fined $34,000 as a result of the deficiencies noted in the surveys.

Website Resource: New York State Department of Health

A Georgia jury recently awarded $1,250,000 in a nursing home case to a plaintiff who suffered bedsores (pressure sores, decubiti), weight loss, infection, and eventually death while a resident. The plaintiff-decedent developed a Stage IV bedsore on her buttocks that progreesed to the point where it infected the bone. At trial, the plaintiff introduced evidence that the facility did not employ a sufficient number of nurses and/or nurse's aides in order to provide adequate care. Evidence was also introduced indicating that the facility's nurses failed to turn and position the decedent in proper intervals.

Gallivan & Gallivan provides aggressive, yet compassionate representation of victims of elder abuse and/or neglect. Please contact us if you or a loved one has suffered as a result of understaffing at nursing homes.

A 76-year-old resident in a New Mexico nursing home was placed on a bed pan and left unattended for 24 hours. As a result of the staff's failure to remove the resident from the bedpan, it become lodged in the resident's skin. An open wound developed and became infected. The resident died from the infection 5 days later. The resident had been admitted to the facility for rehabilitation after her had suffered a broken hip. The incident occured on Christmas Day in 2005.

The owner of the facility has been found guilty of elder abuse and neglect. The facility faces up to a $5,000 fine and may be excluded from receiving reimbursement from Medicare/Medicaid.

Website Resource:

Nursing Home Owner Convicted in Bedpan Death, www.wiredprnews.com, February 22, 2009.