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The attorneys at the Law Offices of Thomas L. Gallivan, PLLC provide effective, aggressive representation to individuals injured in the New York area. Our priority is to maximize the recovery of our clients injured due to the neglect of others.

A Virginia nursing home is being sued after ignoring one of their former resident’s growing infection and bedsores. The family of the former patient alleges the nursing home’s neglect of Casey Lamont was so severe that it caused his death after just six months at the long-term care facility. The lawsuit seeks damages related to the medical costs incurred by the nursing home’s alleged negligence and Lamont’s pain and suffering.

Lamont was admitted to the nursing home, Envoy of Williamsburg, in November 2013. According to the medical history provided to the nursing home, Lamont would be susceptible to bedsores and pressures and therefore, the nursing home should take preventative measures, which generally include moving the patient around every few hours. Unfortunately, the nursing home appears to have neglected their responsibility to care for Lamont and within two months he developed “life-threatening bedsores,” according to The Virginia Gazette.

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Nursing home residents may need family members or advocates to report cases of elder abuse. According to The National Elder Abuse Incident Study, only 20 percent of neglect, exploitation, abuse or self-neglect is reported to state authorities. The nonprofit agency which conducted this study, The Center for Elder Abuse, said that an estimated 2.5 million cases of elder abuse occurred at nursing homes across the country in just the last year. This means that 2 million nursing home abuse cases go unreported and unpunished. This eye-wateringly high number indicates a substantial problem on its own but considering the aging population in America, unreported elder abuse could increase to even higher levels.

While victims can be any age, race, gender, or with any kind of diagnosis, the nonprofit elder care group said that common characteristics of nursing home abuse victims include anyone over the age of 80, elderly women, people with cognitive impairments, and people who are physically or psychologically aggressive. Nursing homes are the most common place for unreported elder abuse, although adult day care centers and hospitals are common locations for this horrific crime, too.

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The federal government fined a New Jersey nursing home for $600k after a deadly adenovirus outbreak killed 11 children and infected 37 other residents, according to NJ.com. The nursing home, Wanaque Center for Nursing and Rehabilitation, is a long-term care facility in northern New Jersey with senior citizens and children who require around-the-clock care and monitoring. According to federal regulators, insufficient safety protocols led to the deadly outbreak and permitted its rapid spread across the assisted living facility.

In a scathing report released last week, the federal government cited numerous safety violations that enabled the rapid spread of the virus. The protocols at the retirement home were so insufficient that medical staff did not even realize an outbreak was occurring until the fourth child died. The federal report details violations including a lack of infection control plan, a “void of leadership,” and an off-site medical director who was so disengaged she only checked on the facility weekly.

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Victims of nursing home abuse and industry stakeholders gathered in Washington this month for a Senate hearing on the nursing home industry. In addition to hearing testimony from the families of nursing home abuse, the federal legislators sounded the alarm over a looming fight over Medicaid funding. According to Skilled Nursing News, the Trump administration will propose its plans to convert Medicaid funding into a “block-grant model.”

According to proponents of the new model of funding, Medicaid spending has spiraled out-of-control and the federal health insurance scheme is no longer sustainable. Instead of continuing with the current open-ended model, the federal government will fund a predetermined amount each year for a state’s Medicaid program. The amount will likely depend on the number of Medicaid beneficiaries in the state, among other factors. The idea for overhauling Medicaid’s open-ended funding model into a block grant system has been favored by Republicans for a long time and finally reached a fever-pitch during the Affordable Care debate in 2017.

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New York State is proactively training nursing home staff how to be “better whistleblowers” whenever nursing home abuse or neglect is suspected. Describing the training as “the first of its kind” across the country, The Buffalo News said the New York Department of Health trained nursing home workers on submitting reports with important details, which include the “time and location of the alleged infractions” as well as any possible witnesses or other relevant information. The health department, which is responsible for overseeing nursing homes in New York, encouraged filing these “comprehensive complaints” in certain situations such as when the nursing home lacked adequate staffing, when important medical devices are malfunctioning, or anything else that puts the health and safety of nursing home patients in jeopardy.

Currently, anyone can file an anonymous report with the state health department. While staffers are obligated to report some instances of nursing home abuse under the state’s “mandatory reporter” laws, elder care advocates say this law is difficult to enforce. The state also prevents nursing homes from retaliating against any employee who files a report or cooperates with an investigation against the facility.

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The Senate Finance Committee examined the “crisis” of nursing home abuse in an emotional hearing this month. Families of abused nursing home patients told their tragic stories and frustrations with the lack of government oversight. In one of the testimonies before the Senators, Maya Fischer tearily detailed the sexual assault her mother suffered at a five-star rated nursing home in Minnesota. According to prosecutors who later charged a nursing home staffer for the rape, the predator had been suspended three times by the nursing home while they investigated sexual assault allegations. In two of these instances, the nursing home staffer who attacked Fischer’s mother was the main suspect.

Fischer described her “final memories of my mother’s life… watching her bang uncontrollably on her private parts for days after the rape, with tears rolling down her eyes, apparently trying to tell me what had been done to her but unable to speak due to her disease.” According to CNN, Fischer’s mother suffered from Alzheimer’s disease. Fischer says she is now speaking out to prevent her family’s tragedy from occurring to anyone else.

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In an exhaustive report by Care.com on the current state of America’s nursing home industry, the well-researched guide compiles data from various private studies, data published by the government, and even included a recent analysis of approximately 1,000 Medicare patients. While the detailed and illuminating guide to elder care facilities is worth reading in full, these are the highlights:

  • The Scope of the Nursing Home Industry. According to the report, there are 1.7 million nursing home beds in America and 79 percent of these are occupied each day. Nursing home residents receive an average of four hours of personalized care each day. Of these four hours, only 45 minutes are spent with a registered nurse each day.
  • Nursing Home Visitors. A nursing home resident can expect six visits from their relatives each month and spend an average of 1 hour and 27 minutes each visit. A majority – 55 percent – of nursing home patients wish their family would visit them more frequently. Nursing home patients satisfied with their family’s visitation habits report an average of nine visits each month. Apparently, family members feel guilty about their infrequent visiting habits – 14 percent described feeling “extremely guilty” and 21 percent felt “moderately guilty” for rarely visiting their loved one.

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Medicare’s transition to a new pricing model will reduce the risk of fraud, but likely lower the quality of care for some patients. A report by Skilled Nursing News begins by detailing the new payment scheme implemented by Medicare named Patient-Driven Payment Model, or PDPM. Under PDPM’s new pricing structure, Medicare sets reimbursement rates according to a patient’s healthcare needs. Previously, healthcare providers billed Medicare individually for every service, procedure, or medication. To provide a practical example, if an elderly woman sustained a mild fracture at her nursing home then Medicare would reimburse her nursing home a predetermined amount for similarly-healthy patients who suffer minor fractures. Previously, Medicare would reimburse the nursing home for each itemized healthcare service provided to the injured woman – physical therapy sessions, x-rays, medication, etc. The federal healthcare agency says the reimbursement amount depends on numerous factors including the patient’s health, diagnosis, and care plan.

According to the federal government, the former “pay-for-service” model led to widespread fraud, where healthcare providers provided medically unnecessary services and procedures to their patients just to increase their Medicare billing. Artificially inflated therapy services appear to the most common for the fraudsters. Last year, Signature HealthCARE, the owner of 115 nursing homes across the country, agreed to pay a $30 million fine for defrauding Medicare. In Alabama, SNF Management agreed to a $10 million fine the next month.

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Sen. Chuck Grassley issued a statement demanding that the Centers for Medicare and Medicaid Services (CMS) provide the Senate with a thorough report on the “comprehensive review” the agency plans to conduct on its nursing home oversight. Last month, the Republican Senator held a hearing on nursing home abuse and excoriated the nursing home industry and its grossly inadequate government oversight. In response to the spectacle on Capitol Hill, Administrator Seema Verma announced the agency would perform a “comprehensive review” of its nursing home oversight. In a statement issued by his office, Sen. Grassley described the news as “encouraging” but also directed the government to prepare a report on its planned changes.

After a fiery attack on the nursing home industry, Sen. Grassley does not plan on letting the government-funded industry to continue with its blatant violations. Speaking to McKnight’s Long Term Care News, Sen. Grassley said, “As chairman of the Senate Finance Committee, I’ll continue conducting diligent oversight of the nursing home industry. Once these reports are available and I’ve had time to review their findings, I intend to hold another hearing to learn the facts and find workable solutions.” The Senator from Iowa directed both the Department of Health and Human Services and CMS to prepare reports for a Senate hearing later this year.

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Outrage continues to grow at the poor quality of care being delivered at a New York nursing home. According to an investigation by News10NBC, Sodus Rehabilitation and Nursing Center in Sodus, New York is still violating numerous state regulations about the treatment of its senior citizens. The local news agency began investigating Sodus Rehab several years ago and, unfortunately, it does not appear that the quality of care has improved over time. According to the New York Department of Health, the nursing home received 90 citations for health and safety violations in just the last four years. In New York, the average number of violations per nursing home is approximately 30.

After undercover investigations by News10NBC last year showed unsafe and unsanitary conditions, Sodus Rehab says they “cleaned house” and brought in new administrators. Unfortunately, the new staffers do not appear to have fixed any of the nursing home’s problems. In one particularly egregious example cited by the news, Bill Tanner, a nursing home resident with leukemia, dementia and “other health issues,” developed bedsores that one doctor described as “some of the worst” he had ever seen. Bedsores, also called pressure ulcers, could have been easily prevented in Tanner, according to the doctors. Perhaps even more horrifically, the bedsores were only noticed because a former neighbor visiting Tanner noticed a foul smell in the room. According to the neighbor, she asked for a registered nurse and a licensed practical nurse to attend to the elderly man. Sodus Rehab staff said that neither was on-duty at the time.

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