Articles Posted in Falls & Fractures

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The government recently adopted a more accurate measurement for determining when a nursing home has sufficient staffing levels and the results show a glaring problem across the nursing home industry. According to Kaiser Health News, the new method of recording hospital staffing shows a 12 percent decrease in hospital staffs. Further, there seems to be a severe fluctuation at many nursing homes which have sufficient nurses during the week but insufficient staff on the weekends. The new evidence shows that despite the minimal Medicaid requirements on the nursing staff levels at nursing homes, many nursing homes are still failing.

Under the previous method for calculating nursing staff, nursing homes would be required to provide all payroll information for the previous two weeks and government regulators would tally and report on the number of nurses employed during that time period. Because nursing homes sometimes knew when an inspection would occur ahead of time, this method was not generally considered accurate. Under the new method for calculating nursing staff, which Medicare began in April of this year, nursing homes must provide a report to Medicaid on staffing throughout the entire year.

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State investigators in Raleigh, North Carolina have captured several nurses cruelly abuse an elderly man at a retirement home on a hidden camera. The hidden camera was set up after an elderly man told his daughter that the orderlies had been “tormenting and neglecting him,” according to WRAL. In response to the incident, state investigators are investigating the nursing home.

According to the news station, the video shows Richard Johnson, 68 years old and recovering from a stroke, fall out of his bed. After crying out for help, several orderlies pass by and ignore the elderly man for over an hour. When staff members finally arrive they immediately begin berating and cruelly taunting the senior citizen, asking “What are you doing there? Why are you on the floor?” Another nurse joined in on bashing the vulnerable man, stating “You had to do something very wrong with your life. What did you do? You’re suffering so bad, so you’ve done something wrong. Yes, you did.”

According to Richard Johnson’s daughter, Johnson even went to the bathroom while on the floor waiting for help. This unfortunate incident prompted a third member of the nursing staff to scold him, saying “How old are you? One? You’re supposed to be enjoying your retirement. Instead, look what you are doing, pooping on yourself. Shame on you.”

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Mirroring national trends, elderly Americans are beginning to use more addictive prescription drugs. In a report by the New York Times, the number of prescriptions for benzodiazepines, a class of anxiety drugs which includes Xanax and opioids have markedly increased in the last couple decades. Not only do these addictive drugs have serious side effects, they can be deadly to the user, sometimes even when taken as prescribed.

According to the newspaper, the number of benzodiazepine prescriptions for Americans over the age of 65 increased 8.7 percent between 2003 and 2010, the year with the most recent data available. A 2008 study indicated that about 9 percent of adults between 65 and 80 took one of these anti-anxiety drugs. The Centers for Disease Control (CDC) paints an even more ominous picture of the problem – the number of deaths caused by benzodiazepines in Americans over the age of 65 rose from 63 deaths in 1999 to 431 in 2015. In 1999, opioids were a contributing cause of 29 percent of these deaths. A mere fifteen years later, opioid drugs now contribute to two-thirds of deaths caused by benzodiazepines.

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gavel-bed-300x199The Martine Center for Rehabilitation and Nursing, previously the Schnurmacher Center, in White Plains, New York received 60 complaints and 15 citations for violating New York and federal law, according to the New York State Department of Health. The Department of Health inspects each nursing home facility in the state every 9 to 15 months and publishes the results of these inspections. According to the state health care agency, the nursing home violated the following state or federal regulations on nursing home safety:

1. The nursing home did not perform criminal background checks on all of its employees. Under Section 402.6(b) of the New York Code, nursing homes must run a criminal history background check on all of its employees who come in contact with its residents. This includes completing a form and submitting two sets of the employee’s fingerprints to the Department of Health. The health inspector found that the nursing home violated this provision by forgoing a criminal background check on an employee who had direct contact with nursing home residents. Continue reading

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resident-left-in-empty-hallOver the previous four years, the United Hebrew Geriatric Center in Westchester County received 22 citations for violating New York law on nursing home safety. The violations were all categorized as “moderately severe”, according to the New York Department of Health.

While the quality of care received by patients at the facility was higher in some areas of treatment compared to the rest of New York state, the facility scored below the state average in the number of residents who experienced a major fall (2.3 percent) and the percent of residents whose ability to move independently worsened during their long-term stay (14.4 percent). Further, according to the New York State Department of Health, 2.1 percent of nursing home residents received a diagnosis of pressure ulcers, or bed sores – a largely preventable type of harm.

According to the state’s inspectors, the following laws and regulations were violated by the United Hebrew Geriatric Center in the last several years: Continue reading

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Nursing homes and assisted living facilities have become increasingly focused on their bottom line in recent years to the detriment of their elderly patients. A recent piece by the New York Times describes the trend where nursing homes have transitioned from non-profits to corporate behemoths – focused on outsourcing and consolidating to minimize costs, reduce their tax liability, and reduce their liability in lawsuits.

According to the nursing homes, consolidation provides a cost-effective way to deliver care to their elderly residents. Through a complex web of corporate ownership, nursing home businesses can reduce their tax liability. According to these nursing homes, those savings are passed on to the residents.

missing-patient-300x196There are also legal benefits to the owners of these nursing home chains – often coming at the expense of the elderly residents. Whenever a person is injured in a nursing home, a complex web of corporate ownership may help the nursing home avoid liability for the harm it has caused. By siphoning the profits of a nursing home into unrelated corporations, injured victims of elder abuse may not be able to hold their nursing home responsible for their damages. Continue reading

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As part of President Trump’s promise to roll-back federal regulations, the Trump administration has announced its intention to scrap a federal rule prohibiting nursing homes from requiring their residents to pursue legal claims through arbitration.

In the simplest terms, arbitration is a catch-all term for a dispute-resolution that, while legally binding, does not utilize the court system. The practice has exploded in popularity in recent decades – especially among larger corporations and nursing homes. These entities prefer arbitration because the costs are generally lower, the dispute resolution process moves much faster than the courts, and parties generally do not have a right to appeal thus providing both parties some finality to their dispwalking-out-300x225ute. Opponents of arbitration say the extra-judicial process favors corporate interests and curtails the rights of victims – from limiting discovery to removing the opportunity to appeal. Further, arbitration also removes the right for a person to have their case heard before a jury, and instead substitutes a so-called “neutral arbitrator.”
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With toothless regulations and ineffective oversight, many nursing homes are still failing the neediest patients. With its budget for overseeing nursing homes slashed in half, the Center for Medicare and Medicaid Services (CMS) has failed to identify failing nursing homes and keep them accountable. As a consequence, some nursing homes are choosing to accept the infrequent fines instead of changing their behavior.

helpCMS is responsible for overseeing all nursing homes that receive benefits from these federal entitlement programs. CMS routinely inspects nursing homes for any violations, if a violation is found, then CMS has two options. First, CMS can put the facility on “special focus” status – reserved for the worst offenders. A nursing home with this designation would be routinely inspected more often and, supposedly, would be punished more severely for any violations. Unfortunately, federal budget cuts have blunted the amount of nursing homes that can be put under “special focus.” Since 2012, the budget for inspecting facilities with this designation has dropped by half. Consequently, despite regulators identifying 435 facilities that warranted this designation, only 88 nursing homes were actually put on the watchlist. Further, once a Continue reading

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physical-abuse-300x169A Berkshires caretaker has been charged with elder abuse after an 84-year-old man told hospital staff that his two broken ribs were caused by being “thrown around like a rag doll.” The 52-year-old man, Anthony Marcella II, was arraigned in Central Berkshire District Court on charges of assault and battery on a person over 60 or disabled, witness intimidation, caretaker abuse of an elder, and caretaker abuse of an elder causing serious bodily harm. Marcella has pleaded not-guilty to all charges and was released on a bail.

On May 22 or 23, Marcella was allegedly “rough” when picking up the elderly victim (whose name is not provided) after he fell down. According to court documents, Marcella squeezed him in an aggressive manner and proceeded to throw him around “like a rag doll.” The elderly victim suffered two broken ribs as a result of his caretaker’s abusive treatment. Continue reading

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On Christmas morning, a certified nursing assistant (CNA) at Woodbriar Health Care in Wilmington, Massachusetts improperly placed a resident in a mechanical lift when transferring her from bed to wheelchair, causing the resident to slip out of the lift and fall, breaking both her legs. The CNA attempted the transfer alone in violation of an important safety rule related to mechanical lifts.

The resident, Mary Meuse, was visited by her youngest daughter on Christmas and told by a staff member X-rays showed no broken bones. As a retired nurse who once cared for the elderly, she did not want to be hospitalized during the holiday. However, the next morning she received a phone call saying her mother was in a lot of pain and needed to be taken to the hospital immediately; the family learned of her injuries upon arrival. Continue reading

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