Articles Posted in Nursing Home Residents

M.A. was 76 years old when he was first admitted to a skilled nursing facility for rehabilitation after knee surgery. M.A. underwent physical therapy and began to recover.

He later developed shortness of breath and was administered oxygen and other therapy.

Over the next several days, M.A. experienced shortness of breath, which continued, sweating and a gray skin tone.

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It is not new that nursing home residents are too often at risk for abuse, neglect and injury in the more than 17,000 nursing home facilities operating in the United States. Too many times these facilities are understaffed or staffed with untrained or unskilled workers. All of this results in many reports of serious physical, verbal and even sexual abuse in Illinois nursing homes and in other states.

It has been more than a decade since there was a two-year investigative study completed that found more than 9,000 instances of abuse. The most common abuse problems are untreated bedsores followed by inadequate medical care, malnutrition, dehydration, falls, inadequate hygiene and cases of wandering residents.

The aging of adult Americans places even more stress on nursing home facilities and long-term care facilities in which the aging are most likely to be residing. The cost of maintaining a resident at a qualified nursing home is now out of reach for many families. Many times a family member or a loved one becomes unmanageable at home because of illness, injury, age, dementia or other onset of the conditions related to aging.

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As the baby boom generation ages, the population of nursing homes is also expanding. Elderly Americans and Illinois residents who reside in nursing homes are likely the most vulnerable members of this aging society. Nursing home cases should not be confused with medical malpractice cases. A medical malpractice case typically concerns particular acts of negligence, such as a failed surgery or misdiagnosis. In contrast, nursing home cases do not involve a particular or discreet act of negligence. Rather, a nursing home abuse case in Illinois involves a pattern of sub-standard care, abuse or neglect.

For example, a nursing home abuse case may involve bedsores. Bedsores can be wounds of the flesh that take form over many days, weeks or even months. A nursing home resident who is dehydrated or suffers from malnutrition would not be the result of a single wrongful act.

Many nursing home cases arise from substandard care, abuse or neglect. Often nursing homes in Illinois operate without a single on-site treating physician; instead, they have only one who may make regular rounds. At the same time, most well-run nursing home facilities provide treatment by a resident physician, a nursing home administrator, a well-trained nursing staff, CNAs, physical and occupational therapists, speech pathologists, wound care doctors, dieticians and other medical and nursing providers.

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The owners of a chain of nursing homes housed in multiple states around the United States have been held to have committed fraudulent transactions in an attempt to transfer liabilities to a “shell company.” The owners of Fundamental Long Term Care Inc. have been the subject of multiple wrongful death cases related to negligence in handling nursing home residents.

Liabilities that included many judgments in Florida have never been paid to the families of the residents who died at the hands of the nursing home personnel. There were reports of four wrongful death judgments in Florida alone. The company filed for bankruptcy protection, but not without careful scrutiny by the court and the judgment creditors.

The U.S. Bankruptcy Court judge in Tampa, Fla., ruled that the owners of Fundamental Long-Term Care Holdings LLC engaged in a “carefully orchestrated sham transaction” by selling a unit of the company in 2006 to a retired graphic artist who didn’t even know he had purchased the shares of the company.

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John Tully, 80, had a history of an unsteady gait. He was living at a nursing home owned and managed by the California Department of Veteran Affairs. Tully had fallen twice within a 10-day period and, as a result of his last fall, he fractured his spine. Complications from that fall included the loss of use of his legs; he now requires a catheter to urinate and must undergo a fecal removal procedure three times a week.

Aided by his attorneys, Stephen Garcia and William M. Artigliere, Tully filed a lawsuit against the Veterans Administration alleging that its nursing care was negligent in allowing him to walk without the assistance of a walker, which resulted in his first fall. They also alleged that the facility’s nursing assistant attempted to transfer Tully using a mechanical lift without proper knowledge on how to do so, which led to his second and most damaging fall.

The lawsuit also alleged that the defendant’s employees chose not to provide a proper medical evaluation after the first fall and did not timely inform Tully’s family about these two incidents. The defendant denied the allegations of the lawsuit; however, the case settled before trial for $1,250,000.

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Peter Piel, 62, resided at the Mirajoy Home. When a nurse’s aide attempted to transfer Piel from his bed to a shower chair, he fell, hitting his head, fracturing his left hip and injuring his right leg. He required surgery for the hip and was diagnosed as having brain damage and chronic pain. His injuries and permanent condition are all related to his fall at the assisted living facility.

Through his guardian, Piel filed a lawsuit against the nursing home and its owner claiming improper staffing and training. Among other things, the lawsuit claimed that there should have been two aides transferring Piel to that shower chair.

The defendants argued that his injuries were not related to his fall. They contended that the aide had caught him before he hit the floor and that his injuries were not as significant as claimed. Before the case went to trial, the parties settled for $1,500,000. The attorneys representing Piel’s guardian were Michael F. Moran and Alexander H. Feldman.

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An appellate court in Ohio has ruled that a family’s motion to compel was wrongly granted because there had not been an in camera inspection of the requested documents under that state’s peer review laws.

In this case, the nursing home decedent was living at Manor Care of Mayfield Heights. Her health had deteriorated while living there. The family sued Manor Care and others claiming negligence, statutory violations under the laws of the nursing home care law of the state and other claims. During the course of the litigation, the family of the decedent moved to compel production of documents related to an alleged investigation into the nursing home resident’s death. The trial judge granted that motion.

The appellate court reversed the trial court noting that although 42 C.F.R. §483.10 provides nursing home residents with timely access to their own records, under 42 U.S.C. §13.96(r) disclosure of records from a quality assessment and assurance committee is limited.

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In a measure passed by the Florida State Senate, lawsuits that allege nursing home abuse could be subject to smaller awards.  The bill would shield many private equity firms that own nursing homes around the state of Florida.  The bill is directed to shield from financial exposure in lawsuits for those in ownership positions and take no active role in the management of the facilities.  It would limit actions against any ownership party who had no impact on the day-to-day activities in the nursing home facility. 

The proponents of the bills say its purpose is to allow for private equity firms and other private investors to take a more active role in investing in nursing home facilities in the state.

According to the report, this bill was targeted at Tampa attorney James Wilkes, who has a reputation for successfully representing plaintiffs in nursing home abuse cases. The bill has the support of the Florida Healthcare Association, AARP, the Florida Justice Association, which represents a host of Florida trial lawyers. 

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Marie Gardiner purchased a long-term care policy from insurance company giant CNA in 1993.  The idea was to have security in knowing that in the event of her need for a nursing home or an assisted living facility to take care of her, she would have this policy in place.  Gardiner unfortunately broke her hip in 2008 and moved into The Village at Buckland Court (Village).  She then filed a claim with CNA, and it was approved.  When her health improved, CNA terminated the coverage for the claim in 2011 advising Gardiner that if her “care needs change or increase in the future,” the company would review her policy.

In 2012, Gardiner fell down a flight of stairs and fractured her sacrum.  She reapplied for benefits at CNA under the long-term healthcare policy.  CNA denied her claim, noting that the Village was “not a qualified provider.”

In the lawsuit Gardiner filed against CNA, she stated that a company representative denied her claim because a nurse was not on the premises at all times and because the Village was a “managed residential community,” not a licensed assisted living services agency.

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The internal documentation that is recorded and housed by the owners and/or management companies responsible for operation of a nursing home is vitally important in litigating against a nursing home. This internal documentation may be the framework of a successful prosecution of the case.  Nursing home documentation varies from nursing home to nursing home. Most nursing homes record data in three major categories:

  • Staffing/payroll
  • Clinical issues
  • Financial analysis

One of the most common causes of nursing home resident injury or abuse is the lack of staffing or a shortfall in competent staffing. Internal documentation of the nursing home can be revealing about staffing and payroll information. The largest expense of operating a nursing home is the cost of its labor force. Therefore, to be more profitable, nursing homes will reduce labor in an effort to increase its profit margins. Accordingly, there is detailed information stored by the nursing homes showing labor costs in comparison to other years.

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