Articles Posted in Medical Malpractice

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Only two weeks after putting a Buffalo nursing home under conservatorship, the New York Department of Health announced that Emerald North and Emerald South Nursing and Rehabilitation Center will be closing their doors. The closure follows a long line of missteps and scandals by the formerly for-profit nursing homes, according to The Buffalo News. In the last year, an elderly woman was beaten to death in the facility’s dementia unit and another nursing home resident died after falling from a third-story window. The two nursing homes, which are owned by the same for-profit organization, were fined over $100,000 in 2017 for not maintaining accurate records on whether patients wanted to be revived in the event of a medical emergency. Tragically, the nursing home’s gross misstep was only discovered after a revived patient was found to have a “do not resuscitate” order.

The nursing homes, which have below average ratings by Medicare, continued to operate with the blessing of the Department of Health for almost an entire year after these scandals. Last month, the Department of Health finally appointed Grand Healthcare System as the nursing homes new operator. At the time of the government agency’s appointment, nursing home residents and their families criticized the appointment of another for-profit nursing home system. Their concerns proved well-founded when Grand Healthcare System announced it would be shutting down both nursing homes and opening new facilities under a different name.

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Following several scathing investigations and reports, veterans’ groups are demanding better care at the nursing homes run by the beleaguered Department of Veteran Affairs. While public condemnation has mounted for the past few years over the VA’s ability to care for the country’s 20.4 million veterans, criticism of the nursing homes run by the government agency began last summer when a report found that 70 percent of the VA’s nursing homes received failing grades. Perhaps even worse, more than half of these nursing homes received the lowest grade possible. According to news organizations, the government has collected quality reports and grades for each nursing home run by the federal agency each year. Until the rankings leaked this year, the government had chosen not to publish the results.

In a follow-up investigation reported by The Boston Globe this week, news reporters found a VA nursing home filled with sleeping staffers and a closed cafeteria. Other examples the substandard level of care found at VA nursing homes include a veteran with undiagnosed scabies, a veteran who had sat in soiled sheets for hours, and a veteran writhing in pain because he had not received his scheduled medication, according to USA Today. The national newspaper also reported that a nursing home in Alabama declared a Navy Veteran dead after he simply walked out of a supposedly secure nursing home one night and did not return. Rege Riley, national commander of American Veterans, told USA Today that the “stories being reported about the treatment of some individual veterans at these facilities are nothing short of horrifying.”

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A deadly bloodstream infection, sepsis continues to plague nursing homes in New York and throughout the country. Despite strict federal standards meant to prevent infections and harm to patients, the number of sepsis infections originating in nursing homes continues to increase each year. In a study conducted by Definitive Healthcare, at least 25,000 senior citizens die from sepsis infections received at nursing homes across the country each year. Give the enormous and unnecessary loss of life, nursing home advocates and government regulators are pushing for stricter standards and greater accountability for nursing homes.

An article by Legal Reader recounts the sad and unfortunately common story of one nursing home resident who passed away from sepsis. According to the article, the elderly man’s daughter, Shana Dorsey, found a “purple wound” on her father only a few weeks before he passed away in 2014. Medical staff at the nursing home told Dorsey the wound was a pressure ulcer or bed sore and not serious. Unfortunately, the pressure ulcer was severe and eventually led to the sepsis infection that killed her father. Dorsey then joined the thousands of other families across the country by filing suit against the nursing home because their loved one died of a preventable sepsis infection.

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Sepsis, a deadly bloodstream infection, is a common and largely unreported consequence of pressure inuries/ulcers. According to a recent article by The Chicago Tribune, sepsis was the most common reason that elderly residents are transferred from their nursing home to hospitals. Despite the massive financial and human implications, the newspaper states the problem is largely unreported because lawsuits against nursing homes are frequently settled out-of-court and include confidentiality clauses.

While the number of pressure ulcers leading to sepsis infections is not measured by federal regulators, the number of patients sent from nursing homes to hospitals and then die of the infection is at least 25,000, according to The Chicago-Tribune. This preventable cause of death leads to thousands of lawsuits filed all over the country against nursing homes and hospitals that allow their loved ones to become infected. In addition to the massive human toll, sepsis infections are an expensive burden on the healthcare system. Medicare pays more than $2 billion annually for sepsis treatment.

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An Australian man passed away from a preventable pressure injury/ulcer he received while at an Australian hospital. According to ABC North and West, the pressure ulcer, or bed sore, developed and became so severe that the Australian’s organs shut down. Now, the family of Peter James McBride is demanding answers from the hospital and its staff.

After falling twice on February 7, 2015, McBride’s wife admitted him to the hospital where he spent the next eight weeks on bed rest before transferring to an elder care facility. McBride died only days after arriving at the elder care facility. According to the coroner, the Australian man’s death was entirely preventable and pointed towards several lapses that paint a picture of an incompetent hospital staff and a severe lack of appropriate procedures necessary to prevent pressure injuries/ulcers.

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A Canadian woman developed a stage-four pressure ulcer after spending several weeks at a hospital recovering from hip surgery. The woman, Lola Chiasson Hawkins, had a bed sore so deep it reached to her bone by the time the hospital staff recognized the severity of the problem and took corrective measures. Perhaps even worse, her stage-four bed sore, the most severe kind, was only discovered because of her family’s diligence.

According to her children, Hawkins developed the bed sore after spending fifteen days in the hospital recovering from hip surgery and a bout of pneumonia that followed her surgery. When told by the hospital doctors that their mother had a pressure ulcer from being unable to move during her recovery, the children assumed the doctors would begin treating and caring for the ulcer. Unfortunately, this was not the case. A full 21 days after being originally diagnosed with the pressure ulcer, the children said the room had a smell so foul that it was difficult to even stay inside of the hospital room with their mother. Because the nurses and hospital staff seemed unconcerned, the children began to investigate on their own and learned the pressure ulcer had become much worse – apparently ignored and untreated by the hospital nurses and doctors. One of the children, speaking to CBC.ca, said the sight of the bedsore made him “shocked and sickened.”

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A recent report by StatNews shows that many nursing homes across the country are refusing to admit elderly Americans with opioid addictions, and failing to effectively treat those with addiction already placed in their care. According to the newspaper, elderly Americans who have been prescribed methadone or buprenorphine, medications commonly used to treat opioid addiction, face the “next to impossible” task of being admitted to a nursing home. According to experts cited by the newspaper, many facilities fail to admit these patients because “of stigma, gaps in staff training and a widespread misconception that abstinence is superior to medications for treating addiction.”

Nursing homes appear unaware that denying admission because of an opioid addiction violates the Americans with Disabilities Act. According to a nurse at Boston Medical Center, only two nursing homes in Boston accept patients taking medication for an opioid addiction. According to the Department of Justice, the government is planning to increase enforcement of facilities that discriminate against individuals taking prescription medication for opioid addiction. Currently, the government agency is looking at detention centers and prisons to ensure compliance. However, the Department of Justice has promised to extend the enforcement push to nursing homes within the year.

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Monitoring and reporting of elder abuse is one of the most important responsibilities delegated to New York regulators. However, recent news reports have cast a light on the accuracy and effectiveness of these reports. Advocates for elder care say the data collected by regulators does not effectively represent the harm caused to nursing home patients when the facilities violate state or federal regulations. Based on the evidence provided, it appears these advocates may be correct.

According to the Centers for Medicare and Medicaid Services (CMS), only 4 percent of all regulatory violations result in “actual harm” to a resident at its facility. While the data is collected at a federal level, state regulators are required to perform the inspections and relay the information to CMS. In New York, the legal entity responsible for inspecting nursing homes is the New York Department of Health.

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antipsyhotic-and-elderlyBetween 2013 and 2017, the Northern Manor Geriatric Center in Rockland County, New York received more than double the average number of citations by the New York Department of Health, the entity responsible for performing yearly inspections at all nursing homes in the state.  Compared to the statewide average of 34 citations- relating to either standard health or life safety violations – Northern Manor Geriatric Center received 73 citations by the government agency. Of these 73 citations, two were related to “actual harm or immediate jeopardy” – the most serious of violations issued by New York State.

The following are some of the most serious or most recent violations found by the New York State Department of Health: Continue reading

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nursing-home-1-300x137Bayberry Nursing Home in New Rochelle, New York received 19 citations for violating New York laws on protecting nursing home residents and ensuring their safety over the previous four years. In the last year alone, the Westchester nursing home received five citations, three of which were categorized as “moderately severe” violations. These are the violations found by the New York State Department of Health in just the previous year:

1. The nursing home had a medication error rate over 5 percent. Under Section 483.25(m)(1) of the Federal Code, a nursing home may not have a medication error rate of over 5 percent. A medication error can include an improperly prescribed medication or an improperly administered medication – typically a prescription drug given at the wrong time, in the wrong dosage, or even a wrong drug altogether. The two examples found in this Westchester nursing home include a patient who received a medication without the extended release coating prescribed by their doctor and a patient who received a dosage of B12 that was 10 times stronger (1,000 mcg) than prescribed (100 mcg). When the resident nurse in the second instance was questioned about the stronger dose, she admitted the resident had been receiving the higher, incorrect dosage for a long period of time.  The consequences of medication errors can be catastrophic. Continue reading

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