Articles Posted in Pressure Sores

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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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

A new report by Time Magazine shines a harsh light on the hospice care industry in America – reporting that 21 percent of hospices, accounting for more than 84,000 patients, failed to provide critical care to patients in 2015.  The report, which includes vivid and heartbreaking stories, points towards a largely unregulated industry that received almost $16 billion in federal Medicare dollars last year.

sick-man-nursing-home-300x200Hospice is provided to Medicaid patients if they are expected to pass away within six months. Starting in the 1970s, hospice care focuses on relieving the symptoms of a patient and providing “comfort care.” The use of hospice care has become increasingly popular in the last couple decades.  According to the National Hospice and Palliative Care Organization, enrollment in hospice care has more than doubled since 2000.

While most Americans think of hospice as a location, the reality is that most Americans utilize hospice care so they can pass away in their own home. With 86 percent of Americans saying they want to die at home, the trend is unlikely to reverse anytime soon, either.

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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

A new report details the chronic deficiencies in nursing home care and its effect on the elderly and disabled Americans that live in these facilities. The report, published by the Long Term Care Community Coalition, details nursing home facilities that are woefully understaffed and failing to meet the needs of its residents. Because nursing homes receive funds by Medicare and Medicaid, they are largely regulated by the government. The report, consequently, mostly blames bureaucratic incompetence and under-funding for its failure to effectively monitor these facilities.

According to the report, the breadth and consequences of the government’s failure to take care of our elderly and disabled are vast. As the so-called “Baby Boomers” enter into their twilight years, an estimated 40 percent of Americans will at some point spend time in a nursing home that is subject to federal oversight.

A substantial portion of the problem is blamed on the so-called “yo-yo” phenomenon. This occurs when a nursing home or other assisted living facility is found to be out of compliance, but then only corrects the problem temporarily. In an effort to fix the problem, The Center for Medicare and Medicaid Services (CMS), created the Special Focus Facility Program (SFF) which was meant to monitor facilities that have racked up multiple compliance violations. Because of under-staffing and insufficient funding and a requirement that states help fix the problem, the program has failed to fix the problem. Continue reading

The Inspector General for the Department of Health and Human Services (HHS) released a report stating that at least one in four instances of elder abuse or neglect are not reported. While horrific in scope, the results are not entirely surprising – other, smaller samples have found that 15 to 20 percent of elder abuse cases were not reported to the proper authorities or government agencies. The most recent study, released by the HHS Inspector General, based its findings on a large sampling of cases spanning 33 states. The study, which pegged the underreporting rate at exactly 28 percent, was released with a demand that Medicare take “corrective action right away.”

Despite mandatory reporting laws by both the federal government virtually all states, the rathelpe of under-reporting remains stubbornly high. On the federal level, nursing homes are required to report any incidents involving a suspected crime immediately and any other case of suspected elder abuse within 24 hours. The Centers for Medicare and Medicaid Services (CMS) can fine nursing homes up to $300,000 for failing to comply with the law. While such a strict timeline and the possibility of hefty fines would typically discourage non-compliance, the HHS report shows that the law requiring reporting of any elder abuse – whether physical, financial, sexual or otherwise – is mostly unenforced by CMS.
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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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