Articles Posted in Neglect

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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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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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Between 2014 and 2018 Beach Gardens Rehab and Nursing Center in Queens, New York received 92 complaints by its residents and 19 citations by the New York Department of Health. The Department of Health inspects all nursing homes throughout the state every 9 to 15 months to ensure their compliance with all laws regulating nursing homes and the treatment of their residents. These are several of the citations the Queens nursing home received over the last few years:

1. The nursing home failed to prevent pressure ulcers or bed sores.
Beach Gardens Rehab and Nursing Center received a citation in June 2017 for failing to prevent its residents from receiving pressure ulcers. Under Section 483.25(c) of the Federal Code, all nursing homes must “ensure that a resident who enters the facility without pressure sores does not develop pressure sores…” Further, if a resident does have pressure sores then the nursing home is obligated to provide “necessary treatment to promote healing, prevent infection and prevent new sores from developing.” In this instance, the New York Health inspector randomly sampled three residents at the facility that had not entered with pressure ulcers. According to the inspector, one of these residents later developed a pressure ulcer on their left heel after the nursing home failed to use preventative measures, despite documentation that the resident posed a moderate risk for pressure ulcers.

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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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A Pennsylvania judge allowed a lawsuit against a nursing home seeking punitive damages over a patient’s pressure ulcer to proceed to trial, according to Law360.com. The lawsuit, filed in 2016, alleges that a nursing home’s reckless behavior allowed for a resident to develop multiple pressure sores. Sadly, these pressure ulcers, now referred to as pressure injuries, caused the nursing home resident’s death only months afterward.

The nursing home resident, Mary Ann Miller, entered the nursing home in November 2015 after a broken hip. According to nursing home regulations, Miller’s broken hip and resulting immobility qualified her as “high-risk” for developing pressure ulcers, or bedsores. Unfortunately, the nursing home did not sufficiently monitor Miller, who was originally only intended for a short-term stay while her hip healed. Unable to move and not properly cared for by the retirement home, Miller developed multiple pressure ulcers on her back and heels. After causing the pressure ulcers through its negligence, the lawsuit further alleges the nursing home failed to adequately treat the bedsores.

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A recent report released by Kaiser Health News shines a light on the diminished quality of care received by many senior citizens at for-profit nursing homes. The Kaiser Health study found that the average for-profit nursing home receives twice as many complaints by its residents and their families. Further, the research group also found that:

For-profit nursing home chains had an average of 8 percent fewer nurses per residents when compared to independent nursing homes.  Nursing homes that operated for a profit received almost twice as many validated complaints.  For-profit nursing homes received 22 percent more fines, and the fines levied against them were 7 percent higher.

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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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