Articles Posted in Nursing Home Abuse

A new report based on an Atlanta Journal Constitution (“AJC”) review of inspection reports for Georgia’s assisted living communities (which includes nursing homes and senior living facilities) and large personal care homes revealed hundreds of recent infractions, including 140 violations of residents’ rights, 51 citations for failing to report serious incidents and dozens of medication errors and cases where residents with dementia went missing. Yet, despite these horrific incidents of negligence and malpractice, these very same facilities are benefitting from laxer oversight and accountability in the form of recent legislation to protect them against lawsuits.

The AJC review also exposed 180 new cases with violations involving residents being harmed or placed at high risk of harm. The details of these and hundreds of other new violations are available through an updated version of the AJC’s senior care ratings site. I highly recommend scouring these (not just browsing) before making any decisions as to whether you want to place your loved one into one of these facilities, and if so, which one. I would also look at the number of government web sites which compile statistics on these facilities. If you do this, you will see a pattern and, while you may not be able to settle on the very best one, you will certainly be able to discern a pattern of sloppiness and negligence on the part of the worst ones.

Some of the reports date to spring 2018, though state regulators only made them public in recent months. The AJC unveiled its website last fall as part of its investigation of the state’s senior care industry. This was met with a lot of publicity and well deserved credit to the AJC for helping expose the sloppy care and abuse that is rampant in this industry.

The number of Atlanta Nursing Home Abuse cases has soared in the last 20 years. Driven in part by more diligent oversight by family member and the state of Georgia, the number of cases and the egregiousness of the malpractice is eye-opening.

In response to these new revelations, the Georgia legislature is contemplating new laws to put some teeth into enforcement of nursing home abuse. A bill that would increase fines and require more staffing and training was overwhelmingly approved last month by the Georgia House.

Georgia House Bill 987 is expected to be taken up by the Senate in the coming days. Gov. Brian Kemp has said he supports the effort to improve standards for the state’s senior care providers, and many within the industry also support the bill. So, this is a no-lose proposition that should easily sale through the legislative process and become law.

The AJC has recently run a series of articles which explores just how bad the nursing home industry is in Georgia. While this is something that we have known about for many years (it does not seem to be getting any better), it is good that the public is seeing in print what we have been seeing in lawsuits for decades. Among the (not so surprising) findings which simply underscore the general picture that Georgia fails to adequately protect seniors in assisted living communities and large personal care homes:

■ Nursing care homes in Georgia largely rely on low-wage workers who may not be properly vetted or trained and who may be given unreasonable workloads. Two out of every five homes were cited for training violations.

■ A fourth of all Georgia nursing homes have been cited for failing to complete criminal background checks of workers. Eleven of these facilities were cited for employing someone whose criminal record should have barred them from working in senior care facilities. In other words, the nursing homes are hiring criminals to take care of their patrons.

According to a recent article in the Boston Globe, when veterans need nursing home care, the VA can place them in agency nursing homes or in other facilities at VA expense. Taxpayers pay $1,125 each night to house a veteran in VA nursing homes. That’s far higher than the average $296 each night in private facilities or $174 in state-run nursing homes where the VA pays a portion of the cost, according to agency budget documents. VA officials said the rates are not directly comparable because VA nursing home costs include hospital care and “more expensive medical services that just aren’t available in most non-VA facilities.” The agency told the Government Accountability Office in 2013 that about 40 percent of VA nursing home costs account for “core” services and would be comparable. At that percentage, the current VA core cost would be $450 a night, still 52 percent more than the agency’s cost for private placement. Despite the sizable public spending on VA nursing homes – more than $3.6 billion in 2018 – the agency until recently had kept the findings of inspections of its nursing homes confidential.

Despite the extremely high costs and apparent secrecy, according to the article, at the Veterans Affairs nursing home in Brockton, Massachusetts, a severely impaired veteran with dementia sat trapped in his wheelchair for hours, his right foot stuck between the foot rests. Inspectors watched as staff walked past the struggling man without helping. Veterans moaned in pain without adequate medication at VA nursing homes in Dayton, Ohio, and Augusta, Maine. A unit at the VA nursing home in Lyons, New Jersey, had no functional call system for residents to summon caregivers.

In another example cited in the article, a severely impaired veteran with Parkinson’s disease went without adequate pain medication day after day at the VA nursing home in Augusta, Maine, as nursing staff treated a sore at the base of his spine that had penetrated to the bone. “The resident moaned throughout the wound care and the moaning increased during wound cleansing and measuring,” noted an inspector who witnessed the episodes in July. Inspectors cited the Augusta facility and 28 other VA nursing homes for failing to ensure veterans didn’t suffer from serious pain. This is barbaric and would not be tolerated in any other facility in the country, unless it was a VA facility. The issue has been a long-standing problem at VA nursing homes – flagged more than seven years ago by the GAO, which found a high percentage of veterans were in pain. Specialists said caregivers should assess and adjust medications or try other methods to make sure residents get relief.

Ventilator alarm fatigue, or overexposure to ventilator and cardiac monitor alarms which increases the risk of errors, is finally getting the attention it deserves. The ECRI Institute now ranks ventilator alarm-related hazards right at the top of its annual list of health technology hazards. New data by the Food and Drug Administration also suggests that the time is right for a spotlighting of this phenomenon. According to the agency, more than 800 ventilator alarm-related errors occur in 2010 alone. Many of these occur in nursing homes and result in a form of nursing home abuse (neglect).

A new analysis by the Boston Globe finds that over the past 6 years, more than 100 people have died from ventilator alarm-related errors. According to the analysis, most of these errors occurred due to nurses’ failure to respond to a beeping alarm, and not the result of defective alarms. According to ABC News,  many nursing homes are so understaffed they may be endangering the welfare of their patients, according to a new report by federal health officials. The report, which will be presented to Congress later this month, recommends stricter guidelines that would require thousands of nursing homes to hire more nurses and nurses’ aides, The New York Times reported today. After eight years of research, health officials concluded that under-staffing has contributed to increased incidences of severe bedsores, malnutrition, and abnormal weight loss among nursing home patients.

Over exposure to ventilator alarms is definitely a phenomenon that deserves attention. During any given working day in a hospital, nurses are exposed to hundreds of frequently beeping ventilator and monitor alarms. Many alarms sound an alert even for slight changes in measurements that may not be serious. When this happens, nurses get used to the sound of alarms, and begin neglecting alerts. In fact, as the Boston Globe analysis shows, most of the ventilator alarm-related errors were the result of failing to respond to an alert, and occurred when the alarms were not set properly.
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We all want our parents and elderly relatives to live with dignity, integrity, and independence, even if we find ourselves having to place them in nursing homes. As an Atlanta Elder Abuse Lawyer, however, I know that nursing home residents sometimes face mistreatment and abuse. Because many of these nursing home residents have limited abilities to communicate, identifying potential abuse requires perseverance, careful monitoring and persistence.

Signs of mistreatment include unsanitary and unclean conditions, frequent illnesses, infections, bed sores, dehydration, excessive weight loss, unreasonable physical constraints, the use of chemical restraints or of medication for any purpose inconsistent with that authorized by a physician, as well as unusual behavior such as rocking, biting, or sucking, or wanting to be isolated from other people. While no one want to believe that their elderly love ones are being neglected by the nursing home staff (or, worse, abused), the sad fact is that this does happen more than one might be lead to believe. Many time, the abuse is the direct result of the nursing home not properly screening the staff hires, which results in someone being hired to care for your parents, who is not qualified to render care to elderly patients, or worse yet, has a criminal record and/or a checkered work past and who should not, under any circumstance be left alone with someone who is vulnerable. Still others are caused by a lack of adequate policies and procedures in place to direct the staff on how they need to care for the residents so that the level of care does not fall below that which is considered adequate under the circumstances.

If you are worried about possible mistreatment of your elderly relative, you can report your concerns to your state licensing and certification body, which is required to investigate complaints filed by family members, as well as the National Center on Elder Abuse. However, you should know that regulatory investigations take time, are not always very thorough, and rarely provide adequate relief for individual nursing home residents. Sometimes by the time an investigator interviews a victim of abuse, the injuries have healed and the resident has forgotten the details of the incident (especially where patients are suffering from memory loss or dementia), leaving the investigator feeling he has insufficient proof to write up the home for a deficiency.

Businesses and designers across the country are becoming conscious that we have an elder population. People are living longer, and living with the handicaps of age longer, creating a need for products that accommodate those handicaps. An article in the New York times reports that some companies are finally designing products to meet that need, and in the process, creating better products for any age.

An exciting aspect of the development of better products for the elderly is the design of products that will allow people to live at home longer, rather than be moved to a nursing home. The relocation of an aging parent or relative can be extremely painful for many reasons; leaving a cherished home, loss of independence, fear of a new place, and the possibility of negligence or abuse at the hands of the new caretakers.
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As an experienced medical malpractice lawyer in Georgia, I am often asked to recommend a good nursing home. While I am reluctant to give specific recommendations, I do understand how important this decision is and offer some helpful advice here. First, the Georgia Department of Community Health maintains records on nursing and assisted living homes/facilities. Second, Georgia nursing homes are governed by O.C.G.A. 31-8-130. Finally, and most important by far, get as many references as you can from each facility and actually follow-up with the references.

Considering the horrific accounts of neglect, abuse and mistreatment that are reported about many Georgia nursing homes, mental institutions and treatment facilities, the above steps are important. Not only is there not enough staff to care for the residents, many times the staff members that are on duty do not possess the training and skills to properly carry out their duties. This leads to inattentiveness, mistakes and, ultimately, inadequate care.

A good checklist of important factors to consider when looking into nursing home choices is published by medicare.Is the nursing home Medicare certified? Some, but certainly not all important considerations are: