Corporate Neglect in Nursing Homes

A recent article published in Trial magazine entitled “Corporate Neglect in Nursing Homes” catalogues the ways in which increased corporate ownership and focus on corporate profits have contributed to abuse and neglect of nursing home residents and frustrated victims’ ability to hold the nursing homes accountable.   For instance:

 

• Evidence shows a direct link between nursing home staff hours and problems.  That is, as the number of staff hours declines relative to the number of residents, problems rise.  The profit goal creates pressure to keep staff hours low and occupancy high—even when it is apparent that additional staff is necessary to ensure quality care.

 

• Nursing home operators often create a Byzantine ownership structure to ensure that the operating company has little, if any, assets available to compensate the victims of neglect or abuse.  Instead, revenues flow out of the operating company to parent or affiliated corporations.  The operating company may carry only minimal insurance.

 

One way to overcome the attempt by the nursing homes to insulate themselves from responsibility is to pursue claims against both the operating company and the parent or corporate affiliate that shares in the profits or revenues.  This may require showing that the parent or affiliate was involved in the budgetary decisions which compromised resident care.  The evidence will support this theory in most cases, because the parent or affiliate exercises tight control over the operating company in order to maximize profitability.

Article: Evaluating Nursing Home Cases

With the aging population, retirement of the baby boomers and increasing population of nursing homes, Maine lawyers undoubtedly will face a growing number of questions from clients concerning negligence, abuse and neglect of nursing home residents. Elders who reside in nursing homes are among the most vulnerable members of our population. As lawyers, we have a responsibility to help champion and protect them. To do so, we must understand the duties and obligations of the nursing homes and be willing to fight to ensure that those duties and obligations are met.  

Read the rest of the rest of the article.  http://www.bermansimmons.com/news/summer-2008.php

 

Pressure Ulcers

There are strict Federal and State regulations prescribing what steps a nursing home and its staff must take to prevent and heal pressure ulcers.  The regulations specify that no resident who enters a facility without pressure ulcers should develop pressure ulcers while at the facility unless it is “unavoidable.”  It is never unavoidable unless the ulcer develops despite adequate assessment, planning, implementation and monitoring of the resident’s condition.  Some residents may be more susceptible to pressure ulcers due to decreased mobility, diabetes or vascular disease, but even in those cases, pressure ulcers are usually avoidable with proper care and treatment.  Pressure ulcers range from Stage I ulcers, which are characterized by reddish skin following prolonged pressure, to Stage IV ulcers characterized by open sores which run through the skin and down into the tissue or bone beneath.  Pressure ulcers can become infected, leading to sepsis and death.  The bottom line is that in most cases, nursing homes should be able to prevent the development or worsening of pressure ulcers, and the regulations require that.  Ulcers occur because staff leave residents lying in one position or in urine or fecal matter too long.  This happens because some nursing homes are chronically understaffed, and CNAs simply do not have sufficient time to reposition residents frequently enough to prevent bed sores.  In addition, residents may be malnourished or dehydrated, thereby lacking the protein, caloric and water intake necessary to heal their skin.  Residents and their loved ones must be vigilant to make sure that nursing home staff are taking the necessary steps – the steps mandated by law – to protect against pressure ulcers.

New York Times: Doctors Say Medication Overprescribed For Dementia

The New York Times recently reported that doctors have found the anti-psychotic medications are overprescribed for dementia and alzheimers patients, particularly those who are residents of nursing homes. http://www.nytimes.com/2008/06/24/health/24deme.html?_r=1&adxnnl=1&oref=slogin&adxnnlx=1214618341-mX42KSg/N0jjqNLeiWyVYw

 

The Times reported that about one-third of all nursing home residents have been prescribed anti-psychotic drugs.  The drugs are often prescribed “off label,” because they have not been FDA approved for use by elders.

 

 

Soft Diets

There have been a number of nursing home residents who have choked and been injured or died as a result of the failure of the nursing home and its staff to follow orders to provide the resident with a soft diet or mechanical soft diet.  These diets are intended for residents who are unable for various reasons to consume certain difficult to chew and swallow foods.  For a more detailed description of soft diets, please see http://www.gicare.com/pated/edtgs35.htm.  Often, the reason that the diet is not followed is that there are insufficient staff or staff who are not adequately trained to meet resident needs.

Antipsychotic Medications

A recent study found that “elderly dementia patients prescribed antipsychotic drugs are at three times the risk of a serious health problem or dying within a month of treatment, compared to those not given the drug.” 

Strangulation Death & Cover Up

Here is a story about a woman nursing home resident in Mt. Vernon, New York who was asphyxiated and died when her head was caught in the bars of her bed after nursing home staff failed to lower the bed as required. http://www.wnbc.com/news/16320692/detail.html Other nursing home staff re-arranged the resident’s body in an effort to cover up their negligence. However, one staff member made an anonymous call to the government regulators to report the incident, and the regulators later investigated and confirmed the report.