Articles Posted in Wrongful Death

New York nursing homes breathed a sigh of relief last week when a New York Supreme Court judge stopped the state from cutting Medicaid reimbursement funds to facilities across the state. Speaking on behalf of the nursing home industry, Ami Schnauber of LeadingAge New York told McKnight’s Long-Term Care News that the ruling is a “big relief” for its members across the state. The ruling comes after the New York Department of Health revamped its formula for determining Medicaid reimbursement rates. According to state officials, the new rates create a “more fair and accurate picture of [the needs of] nursing home patients.” 

The nursing home industry disagrees and says the state is trying to plug an unrelated budget shortfall by cutting necessary funding to the 80,000 New Yorkers who rely on Medicaid to pay for their nursing homes. While the health department says it does “not expect this change to result in any disruption to nursing home residents and the care they receive,” the nursing home industry disagreed and sued the state. In their arguments before Supreme Court Justice Kimberly O’Connor, the nursing homes said the $246 million cuts would cause “irreparable harm” to nursing home patients and force short-staffed nursing homes to lay off even more workers

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Fieldston Lodge Care Center received 38 citations for violations of public health laws between 2015 and 2019, according to New York State Department of Health records accessed on November 14, 2019. That figure is six greater than the statewide average of 32 citations. The Bronx nursing home’s citations resulted from a total of five inspections by state authorities. The violations they describe include the following:

1. The nursing home did not take adequate measures to prevent and control infection. Section 483.80 of the Federal Code stipulates that nursing home facilities “must establish and maintain an infection prevention and control program… to help prevent the development and transmission of communicable diseases and infections.” A July 2019 citation found that Fieldston Lodge Care Center failed to properly implement its disease prevention guidelines by neglecting to properly clean poles for hanging gastrostomy tube feeding, and by allowing oxygen tubing to run along the floor in spite of protocol requiring that it be maintained off the floor. A state inspector found that this lapse had the “potential to cause more than minimal harm.”

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Manhattanville Health Care Center received 21 citations for violations of public health laws between 2015 and 2019, according to New York State Department of Health records accessed on November 14, 2019. The Bronx nursing home also received Federal Civil Money Penalties of $19,505 and $12,678.25 for citations found on a May 9, 2018 survey and a May 14, 2018 survey, respectively, according to the Long Term Care Community Coalition. Federal Civil Money Penalties are one of several mechanisms state and federal authorities are empowered to enforce when nursing home facilities are found to fall short of minimum health and safety standards. Manhattanville Health Care Center’s 21 citations result from six inspections by state inspectors. The violations they describe include the following:

1. The nursing home failed to ensure it adequately administrated itself in a manner that provided for the highest possible resident well being. Section 483.70 of the Federal Code requires nursing home facilities to administer themselves in a fashion that enables the most effective and efficient use of their resources “to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident.” A May 14, 2018 inspection found that Manhattanville Care Center failed to operate itself in a manner that timely provided basic life support to a resident who needed emergency care. An inspector observed a resident “unresponsive and not breathing.” A redacted number of minutes passed before staff administered CPR, and “approximately 5 minutes [passed] before 911 was activated.” The inspection found that this lapse “resulted in actual harm and the potential for serious harm to the health and safety of all residents in the facility.”

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Over one-third of nursing homes in the country saw their star rating drop last year after the Centers for Medicare and Medicaid retooled their star-based rating system, which judges nursing homes based on the quality of care provided to their patients. A nursing home receives a rating between one and five stars, with five stars representing the highest quality of care. While the majority of nursing home ratings changed for the worse, the retooled metrics used by the nursing home regulator did increase the ratings of approximately 15 percent of nursing homes in the country, according to Skilled Nursing News.

According to the industry watchdog, the new rating metric emphasizes whether a sufficient number of nurses are staffed at the nursing home. According to multiple studies and elder care advocates, the number of nurses is the strongest predictor of the quality of care provided to nursing home residents. The federal agency’s revision came after a report last summer by The New York Times showed that many nursing homes suffered from a nursing shortage and often inaccurately reported their staffing to government regulators. In addition to changing its rating system, CMS also said it would conduct more unannounced inspections on weekends when staffing shortages were reportedly more common.

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The federal government fined a New Jersey nursing home for $600k after a deadly adenovirus outbreak killed 11 children and infected 37 other residents, according to NJ.com. The nursing home, Wanaque Center for Nursing and Rehabilitation, is a long-term care facility in northern New Jersey with senior citizens and children who require around-the-clock care and monitoring. According to federal regulators, insufficient safety protocols led to the deadly outbreak and permitted its rapid spread across the assisted living facility.

In a scathing report released last week, the federal government cited numerous safety violations that enabled the rapid spread of the virus. The protocols at the retirement home were so insufficient that medical staff did not even realize an outbreak was occurring until the fourth child died. The federal report details violations including a lack of infection control plan, a “void of leadership,” and an off-site medical director who was so disengaged she only checked on the facility weekly.

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State prosecutors charged seven nursing home employees with involuntary manslaughter after a patient died from a bedsore in 2017. The nursing home employees, which includes one nurse, are collectively charged with 37 crimes for their gross mistreatment and neglect of two nursing home patients during their time working at Whetstone Gardens and Care Center in Ohio. Announcing the charges, Attorney General Dave Yost says, “Evidence shows these nurses forced the victims to endure awful mistreatment and then lied about it.”

Yost says first patient “literally rotted to death” after developing a preventable bedsore or “pressure injury” in 2017. The patient, who entered the facility on a short-term basis, developed several bedsores after nursing staff failed to move the patient every few hours. Once the bedsores developed, the staff continued to ignore the nursing home resident and failed to treat the sores, also called pressure injuries or ulcers. Within weeks of developing the bedsore, the patient’s bedsores became infected with gangrene. The nursing home resident passed away just weeks later after the staffers at the nursing home failed to take “any medically appropriate steps.”

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The Department of Veteran Affairs released its first report on the status of its nursing homes this month and the results show widespread neglect and abuse at the government-run facilities, perhaps even worse than the well-documented problems seen in its private-care counterpart. The federal government is responsible for caring for the country’s 40,000 veterans and, according to its own report, is doing a poor job. The report analyzed 99 VA nursing homes across the country and reported the findings of surprise inspections conducted by outside contractors. The VA spokesperson said that releasing the report in its entirety is part of a new push by the agency for transparency and accountability.

The findings of the report are daunting. Eleven of the 99 nursing homes were so unsafe that veteran safety was in “immediate jeopardy.” More than half of the nursing homes (52) were deficient enough to cause “actual harm” to their veteran residents. “That is really bad. It’s really bad,” Richard Mollot, executive director of the Long Term Care Community Coalition, a nursing home advocacy nonprofit told USA Today.

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Recent data published by Nursing Home 411 shows America’s nursing homes continue to struggle with low levels of nursing staff. Adequate staffing is one of the most important factors in providing quality care to nursing home residents. Unfortunately, the nursing home industry has a widespread problem in staffing their facilities with a sufficient number of nurses and medical personnel. The data analyzed by the nonprofit group included all nursing homes receiving Medicare in 2018. The highlights published by Nursing Home 411 include:

  • Nursing homes spend an average of just 3.5 staff hours with each resident, per day. According to the nursing home advocacy group, the federal government states a minimum of 4.1 hours is required for the average resident.

 

  • Nursing homes spend only 0.5 registered nurse staff hours with each resident, per day. A registered nurse is typically more capable and better educated compared to certified nursing assistants. Another federal study cited by Nursing Home 411 recommended increasing registered nurse hours by 10 to 50 percent each day to satisfactorily meet each nursing home resident’s healthcare needs.

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After what one upstate nursing home doctor called the “worst bedsore ever seen” killed a once-healthy resident, the elderly man’s son is demanding accountability from the negligent nursing home. Four months after entering Safire Rehabilitation of Northtowns, the 82-year-old Frank L. Williams passed away from an entirely preventable bedsore, also called a pressure ulcer. According to The Buffalo News, Williams’ hospital records list cardiac arrest caused by sepsis, a deadly infection resulting from his bedsores, as the cause of death. According to the New York Department of Health, the number of residents developing bedsores at Safire Rehabilitation is almost double the state average. In the last few years, the number of bedsores has increased at the nursing home.

Speaking to The Buffalo News, Williams son describes his father’s experience at Safire Rehabilitation as a nightmare from the beginning. After suffering a stroke, Williams was released by the local hospital to Safire Rehabilitation. The nursing home apparently accepted the elderly man without having space to treat him, which caused him to spend his first three days in long-term care instead of the rehabilitation unit. Williams son describes the nursing home as windowless and reeking of urine. The nursing staff ignored his father’s pleas to move him around, necessary to prevent a bedsore from developing. After spending three months at Safire Rehabilitation, Williams doctors told his son there was a “little pressure sore” and refused to let the son see the wound.

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Two registered nurses and one certified nurse aid were convicted in a Nassau County courtroom for willful violation of health laws in a tragic case that led to the death of an 81-year-old nursing home resident at A. Holly Patterson Extended Care Facility in Unionville, NY, according to LongIsland.com. According to prosecutors, the elderly resident – both ventilator-dependent and in a wheelchair – somehow became disconnected from his ventilator, rending him unable to breathe.

In situations of life-and-death, the nursing home utilizes distinct auditory and visual alarms that sound throughout the unit. Despite the sounding of the alarm and its ubiquity across the entire nursing home, the two nurses, Sijimole Reji and Annieamma Augustine, along with the certified nurse aid, Martine Morland, did not respond for a full nine minutes. By the time the ventilator was reconnected, the elderly woman was unconscious and passed away the next day.

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