Articles Posted in Neglect

The reporting at one nursing home in New York is intensifying as more allegations of neglect and abuse continue to surface. A steady drumbeat of news reports has thrust Sodus Rehabilitation and Nursing Center in the Buffalo area and its mistreated residents into the spotlight over the last year. As the dangerous and unhygienic conditions have come to light, outrage in the community has grown and families of the residents say they are scared for their loved ones.

The nursing home, previously named Blossom View, first received attention from the local news last year when one man came to visit his father and found him dead. Admitted only two weeks earlier, the nursing home resident had fallen several times, suffered multiple bruises, head injuries, and even several broken bones during his short stay. The staff told the son they already knew and simply forgot to notify the family or remove the body.

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More senior citizens are dying from falls each year, a problem that is only expected to get worse as the country’s population continues to age. According to a report by the Centers for Disease Control and Prevention, almost 30,000 Americans over the age of 65 died as the result of a fall. To put that into perspective, falls killed 61 out of every 100,000 senior citizens in 2016, the year with the most recent data available. In 2007, only 47 out of every 100,000 deaths were caused by a fall. This means fall-related deaths have increased 37 percent in less than a decade.

About one in every four elderly Americans has a serious fall each year, according to experts. These falls typically result in broken bones or traumatic brain injuries. The risk of death caused by a serious fall increases with age. Americans between 65 and 74 only have 15 fatal falls for every 100,000. For those that are over the age of 75, that statistic increases to 248 per 100,000, according to the data released by the CDC. Women are at a higher risk than men of both falling and dying from a fall. If the fall-related mortality rate continues at the same pace then 59,000 senior citizens will die from a fall in 2030, according to The Los Angeles Times.

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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 rarity only a few decades ago, nursing homes operating for profit have exploded across the country. According to NPQ, for-profit nursing homes account for over 70 percent of all facilities across the country. According to elder care advocates, the rapid takeover of the nursing home system has harmed America’s vulnerable senior citizens. Instead of focusing on providing the best quality care for a reasonable price, for-profit nursing homes choose to maximize their income while limiting their costs and the resulting legal liability from their cost-cutting measures.

In general, the rise of for-profit nursing homes has coincided with the consolidation of the nursing home industry which means a senior citizen is more likely to choose a corporate nursing home chain than the once-ubiquitous retirement communities that operated solely for the best interest of their residents. Considering the deep pockets of a corporate chain, it would be reasonable to assume the potential for large settlements in the cases of mistreatment or elder abuse would incentivize these corporations to treat their residents with the utmost respect.

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In response to insufficient medical and nursing staff, Medicare has lowered ratings for 1 out of every 11 nursing homes across the country. The lowered ratings come after the government agency retooled the way it calculates the nursing staff at each nursing home. Under the new method, which requires nursing homes to submit payroll information every quarter, nursing staff numbers appeared grossly deficient at facilities across the country. After Medicare warned nursing homes in April about a possible reduction in their rating without an increase in nursing staff, the government agency followed through last week and reduced the star-rating for nearly 1,400 nursing homes across the country.

For the most part, the nursing homes with recently reduced ratings lacked a sufficient number of registered nurses, which are the “highest-trained caregivers” and responsible for managing other nurses. Under Medicare guidelines, a nursing home only needs to have a single registered nurse working eight hours per day. However, most nursing homes are not meeting these simple guidelines or could not provide payroll information proving the requirement was satisfied. According to Medicare officials, payroll information is not usually “taken seriously” by nursing homes and forcing the facilities to provide proof through their payroll system will hopefully force nursing homes to take their record keeping more seriously.

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After increased regulation under the Obama administration, President Trump has whittled away at federal regulations targeting nursing homes and meant to prevent nursing home abuse across the country. At the same time, the country’s aging population is putting more senior citizens in nursing homes. According to research by Morningstar, by 2020, a full 40 percent of all deaths will occur in a nursing home. Elder care advocates worry about an increasing number of Americans being allowed into a decreasingly regulated nursing home system.

According to elder care advocates, their worry is not misplaced. Between 2013 and 2018, almost four out of every 10 nursing homes in the country received a citation for a “serious violation” that could endanger nursing home residents. Under previous administrations, these violations would typically come levied with a serious fine – hopefully high enough to deter future behavior. Under the Trump administration, however, the amount of these fines has been significantly reduced through new guidelines issued in December 2017. In an example cited by the Kaiser Foundation, a nursing home was fined $300,000 in 2013 after a nursing home resident died because the staff failed to effectively monitor and treat a wound. Under the new guidelines, the maximum fine the nursing home could receive is $21,000.

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A Canadian man is telling the story of a short-term hospital stay that turned into a year-long nightmare after he developed a pressure ulcer, also known as a decubitus ulcer or bedsore. The senior citizen, Vinal Michaud, was admitted to the hospital for kidney stones – a fairly routine medical procedure. After spending ten days at the hospital in June 2007, Michaud was released back to his home. It was only when he returned home that he discovered the pressure ulcer.

Michaud, who is a paraplegic and does not feel sensation below his waist, only discovered bedsore when his at-home nurse saw the wound and alerted him. According to Michaud, the nurse told him “We’re going to have to look at that right away.” A doctor visit diagnosed the pressure ulcer as a Stage IV bedsore – the most serious categorization. Michaud, who said he could not feel the pressure ulcer developing because he has been unable to walk since his spinal cord was crushed in a tractor accident when he was ten-years-old, began medication and ointments immediately.

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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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Over the past four years, the Franklin Center for Rehabilitation and Nursing received 26 citations from the New York State Department of Health. All of these citations related to violations concerning the treatment and health of the senior citizens at the Queens nursing home. Compared to the state average, this facility received approximately the average number of citations. However, residents of this facility were more likely to be physically restrained (4.6 percent of all residents) and more likely to have a catheter inserted (1.4 percent of all residents), according to the New York Department of Health. In addition to these issues, the government agency cited the elder care facility for the following violations:

1. The nursing home failed to adequately prevent pressure sores.

Franklin Center for Rehabilitation and Nursing did not adequately protect its residents from pressure sores, or bed sores in violation of Section 415.12(c)(2) of the New York Code. Under this New York regulation, each nursing home in New York must ensure that their residents do not develop pressure sores while at their facility, unless unavoidable.

For residents who enter the nursing home or elder care facility with pressure ulcers, or bed sores, the nursing home must provide “necessary treatment and services to promote healing, prevent infection, and prevent new sores from developing.”

Franklin Center violated this regulation when one of the residents, with a stage-four pressure ulcer, the most severe type, did not receive necessary treatment. Specifically, the health examiner noted that the nurse applied a “dressing appliance that was too small, and she dried the wound using improper technique.” When asked by the health examiner to explain her actions, the nurse admitted she should have “patted the wound dry instead of wiping in order to prevent tissue damage.”

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