Nursing Home Abuse

Report Recommends CMS to Fine Britthaven Nursing Home for Wrongful Death

August 17, 2010 | Lebowitz & Mzhen

In a related blog, our Baltimore nursing home injury attorneys discussed the use of chemical restraints in nursing homes, and the recent indictment of a registered nurse from Britthaven of Chapel Hill Nursing Home, after a nursing home resident died from a morphine overdose. The nurse, 44-year-old Angela Almore was charged last month with one count of second-degree murder, and six counts of felony resident abuse, for over-medicating residents with morphine, that allegedly caused hospitalization and wrongful death.

The North Carolina Department of Health and Human Services announced last week that they are recommending that the Centers for Medicare and Medicaid Services should fine Britthaven nursing home the maximum allowed fine by federal law, $20,000.

The nearly 100-page report based on the investigation performed by the North Carolina Nursing Home Licensure and Certificate Section reportedly revealed details of patient lethargy and altered states with the residents who tested positive for opiates.

The Herald-Sun reports that further investigation from the toxicology reports indicate that 14 residents out of 29 in the Alzheimer’s wing at Britthaven tested positive for opiates in February. Not one of these patients had prescriptions for opiate medication. Rachel Holliday, an 84-year old resident, and one of the hospitalized patients with high levels of morphine in her system, died on February 16, 2010 from pneumonia due to reported morphine toxicity.

Britthaven was reportedly investigated after patients were hospitalized from the Alzheimer’s wing of the nursing home, which lead to the discovery of opiates in their blood. A criminal investigation was launched in February by the Attorney General’s Medicaid Investigations Unit, and The North Carolina State Bureau of Investigation (SBI), to investigate for nursing home abuse or neglect, over-medication, or chemical restraint in an effort to make the nursing home residents more manageable.

Report Shows Less Physical Restraint in Nursing Homes

August 13, 2010 | Lebowitz & Mzhen

According to a report from the Agency for Healthcare Research and Quality (AHRQ), the number of American residents living in nursing homes who are subjected to physical restraint has dropped by more than half, from 1999 to 2007. This reportedly came from part of the National Healthcare Quality & Disparities Report from 2009.

The report states that the number of physically restrained nursing home residents dropped from around 10.4% in 2000 to 5% in 2007. As our Maryland nursing home attorneys reported in a recent blog, physical restraints can be used to keep a resident or patient from moving freely, and is only allowed when medically necessary, as it can also cause patients to become weak or develop other health complications. Common restraints include belts, wrist ties or bands, vests, bedside rails, or special chairs.

The report also discovered that number of Asian and Hispanic residents living in nursing homes who were physically restrained fell from around 16% in 1999 to around 7% in 2007.

According to Karen K. Ho, MHS, research analyst for Maryland’s Center for Quality Improvement and Patient Safety at AHRQ, there is a disparity between white and Asian populations being restrained in nursing homes. Ho claimed that the report shows that Asians and Hispanics are reportedly more likely to be restrained in nursing homes, and this could be because of language and literature issues. Ho claims that the ability to communicate with a health care provider, and the ability for the health care provider to talk to the patient is hugely important. If there is a language barrier and communication problems arise, the patient will most likely not get the care that they would like, or that is recommended.

Kentucky Governor Orders a Review of Nursing Home Sexual Abuse Cases

August 5, 2010 | Lebowitz & Mzhen

Our Nursing Home Abuse Attorneys in Washington D.C. have been following the recent news from state of Kentucky, that Governor Beshear has asked for an investigation on how Kentucky is handling nursing home neglect and abuse reports, after a recent investigation by the Lexington Herald-Leader found serious problems with the system, as reported in our previous blog.

According to the Lexington Herald-Leader, from 2007 to 2010, 107 citations were issued by the Cabinet for Health and Family Services that endangered the health and safety of nursing home residents. The newspaper discovered that only seven out of the over 100 cases of nursing home abuse or deaths were ever prosecuted criminally.

Although the state reportedly hands serious violations of nursing home laws and regulations to the attorney general’s office, the attorney general can only prosecute if the local prosecutors grant the attorney general permission. And the local prosecutors claim that they are rarely made aware of such cases. Also, police and coroners are reportedly rarely alerted of nursing home deaths or serious injuries in nursing homes.

The Herald-Leader reported that of the 107 citations that were investigated, there were eighteen deaths, thirty occurrences of hospitalization, 5 incidents involving residents with bones broken, and two instances of amputation that reportedly were a result of nursing home state law and regulation violations. The citations also claimed that three residents experienced nursing home injuries after staff members failed to provide proper health care.

Sexual Abuse in Kentucky Nursing Homes

July 31, 2010 | Lebowitz & Mzhen

In recent news, that our Hartford, Maryland Nursing Home Injury Attorneys have been following, a nursing home abuse lawsuit has brought to light the problem of unreported sexual abuse incidents in Kentucky nursing homes.

According to the Lexington Herald-Leader, Mae Campbell, an 88-year old, was sexually abused two times while being a resident at Hazard Nursing Home. Campbell suffers from Alzheimer’s disease, and was reportedly sitting in a hallway last year, in view of other staff members and a nursing supervisor, when a male nursing home resident sexually assaulted her by ejaculating onto her face. She was reportedly sexually abused three months later by another male resident of the home who had allegedly entered her room to perform a similar sexual act. The nurse on duty was told by her supervisor not to discuss the incident with anyone because Campbell had not been harmed.

Under Kentucky law, staff members and officials of nursing homes are legally mandated to report nursing home neglect or abuse. The Cabinet for Health and Family Services issued the home a Type A citation, claiming that Hazard Nursing Home did not follow state regulations and failed to protect Campbell from sexual contact that was unwanted, failed to protect her health and safety as a resident, failed to report the sexual abuse allegations to the necessary state agencies, and failed to investigate the sexual abuse allegations thoroughly.

The Herald-Leader reported that Campbell’s sexual abuse was only discovered after depositions in a wrongful death case led to a former nurse’s aide’s description of Campbell’s sexual assault, where the former employee claimed that she stopped working at Hazard Nursing Home after the incident, as she thought the home should have protected Campbell better. Another former nurse also admitted to witnessing Campbell’s other assault. She was told not to discuss it with anybody—because Campbell had not been harmed.

Resident Assault Leads to Wrongful Death Lawsuit

July 27, 2010 | Lebowitz & Mzhen

In recent news that our Maryland Nursing Home Injury Attorneys have been following, an assisted-living facility in Rochester, Minnesota is being sued for negligence, wrongful death and medical malpractice, after a resident with dementia was allegedly assaulted and died.

According to the civil lawsuit, Donald R. Salli, 78, was assaulted by another resident in September of last year. The complaint claims that Salli was found by the staff at Sunrise Cottages on the floor on September 19th, with a resident assaulting him. Salli allegedly had a large hematoma on his head, as well as a red area from where he had been kicked in the back. He was reportedly not evaluated by a licensed nurse until seven hours after the attack.

The lawsuit also claims that the next day, Salli was found on the floor of his cottage apartment by three staff members, crying and in a great amount of pain, and was unable to walk on his own. He was documented as being unresponsive, sleeping through the day, was unable to stand or communicate, and yelled in pain when his back was touched.

After Salli’s daughter, Elizabeth Pulsifer, asked that Salli be sent to the emergency room, they discovered that he had suffered a fractured skull with internal bleeding and three ribs were fractured. He reportedly remained in the intensive care unit until he was transferred to hospice care, where he died on October 7, from a brain injury. According to the Minnesota Department of Health, neglect was the direct cause of his demise and they cited the facility for negligence.

Maryland OHCQ Issues Code Red Heat Alert for Nursing Homes

July 14, 2010 | Lebowitz & Mzhen

In a recent blog, our Baltimore, Maryland Nursing Home Abuse and Neglect Attorneys discussed the recent relocation of 220 nursing home residents, after an unprecedented heat wave in Baltimore lead to air conditioning malfunctions that closed two nursing homes—in an effort to protect the health and safety of the residents until the center’s heating and cooling systems are repaired.

The Maryland Office of Health Care Quality (OHCQ) issued a “Code Red – Heat Alert” last week, along with the Baltimore City Health Department, cautioning all Maryland licensed health care and residential facilities to implement appropriate plans to ensure the health and safety of residents while the outside temperatures are near or above 100°F.

The health department made recommendations for nursing homes to:

• Relocate resident activities to cooler areas, and caution nursing home residents to cut back on outdoor activities during the extremely hot days to prevent nursing home injury or illness.
• Monitor and address the behavior of dementia patients, or confused patients who may want to be wrapped in blankets, or wear too many clothes.
• Make sure the cold water is constantly available for residents, and offer it frequently.
• To keep residents cool, offer ice packs, or washcloths that are cool and wet, to help them endure the heat. Also give residents baths or shower that are cool, or lukewarm in temperature.
• As nursing home A/C systems will be operating at their maximum potential during the heat wave, contact maintenance staff to check the A/C systems, and perform required maintenance measures in advance, to prevent system failures.
• Rearrange any nursing home equipment or furniture that may be blocking any vents on the walls or floor to improve air circulation and make sure that the movement of air is not obstructed.
• Check the operation of all refrigerators and ice makers in facilities that do not have A/C or where kitchens are not cooled with A/C, to make sure that the refrigeration units are maintaining the correct temperatures.
• Make sure all medications for residents are stored at the temperatures listen on the packaging or prescription labels. Relocate the drugs to secure storage if necessary, to prevent any nursing home negligence or injury.
• Turn off any unnecessary lights that do not impact any activity for residents or staff, and close the curtains to keep out the hot sun. Also avoid the use of heat producing equipment like vacuums, stoves, or ovens.

Maryland Residents Moved Out of Nursing Home After A/C Malfunctions

July 12, 2010 | Lebowitz & Mzhen

In recent Baltimore, Maryland nursing home news, the Ravenwood Nursing Home and Rehabilitation Center in downtown Baltimore closed its doors last week, moving 150 residents out of the center due to safety concerns—after the building’s air conditioning system malfunctioned, failing to keep residents cool in the city’s scorching heat.

Although many residents claimed that the malfunction occurred on Friday, July 2, it was determined by authorities to occur on Sunday. Many residents claimed that their complaints were not heard, until a Ravenwood resident called 911 on Monday for help. The temperature inside the building was reportedly 92 degrees at the time.

The center could reportedly face new environmental deficiencies, as it did not report the issues until a few days after the nursing home had been without air conditioning. Ravenwood is currently under investigation by the state Office of Health Care and Quality to make sure that the home followed proper procedure, to ensure the health and safety of the residents.

The Ravenwood staff claimed to do everything that they could to make sure that the residents were not in medical danger during the period of time without air conditioning. Many of the residents are vulnerable adults who need special medical attention, some of whom are under 65 and suffer from a variety of medical conditions, including amputation, HIV/AIDS, and paralysis.

Resident Death and Antipsychotic Drug Violations in Nursing Homes

June 30, 2010 | Lebowitz & Mzhen

Our Washington D.C. Nursing Home Abuse Attorneys recently discussed the topic of chemical restraints in a blog, and the unnecessary use of antipsychotics in nursing homes. The Food and Drug Administration (FDA) estimates that around 15,000 nursing home deaths occur every year from the off-label use of antipsychotic medications that are unapproved by the FDA.

Center for Medicare Advocacy Senior Policy Attorney Toby Edelman, recently released a statement in reaction to a Senate Special Committee on Aging hearing, claiming that nursing home residents die every day from the inappropriate use of antipsychotic medications given to residents who have no diagnosis of psychosis. Edelman claims that nursing home facilities are violating the Controlled Substances Act and the 1987 Nursing Home Reform Law, by failing to provide the residents with proper medical attention, and physicians who are available to treat them 24 hrs a day.

According to the statement, under the 1987 Nursing Home Reform Law, every resident must be under the care of a physician, and each nursing home must provide a physician for medical care in case of an emergency, with another physician on-call. Edelman claims that nursing homes and long-term care pharmacies have long been relying on the practice of “chart orders,” for medications, where nurses assess the nursing home resident’s changed condition, and contact the physician—who then prescribes pain medication recommendations.

The Drug Enforcement Administration (DEA) has reportedly begun to enforce the rules and policy of the Controlled Substances Act, requiring physicians to write and sign prescriptions, sending nursing home and nursing home pharmacy industries into a frenzy, claiming that without these practices, residents will not receive the pain medication they need.

Jury Awards $4.85 Million to Family in Nursing Home Wrongful Death Lawsuit

June 29, 2010 | Lebowitz & Mzhen

In recent news that our Baltimore, Maryland Nursing Home Neglect Attorneys have been following, the family of a patient who died from an overdose of morphine while receiving physical therapy at a nursing home, has been awarded $4.85 million—after accusing the home of nursing home negligence and wrongful death in a lawsuit.

According to the civil lawsuit filed by the family in 2005, Burr Needham, arrived in the center on April 26, 2002, to receive physical therapy for a hip fracture, and was administered a lethal overdose of morphine. The suit accused Dr. Arun Gupta and a staff of five nurses at the home of nursing home negligence, causing the 76-year-old’s wrongful death on May 2nd.

According to the medical examiner, the death was a homicide, caused by severe morphine intoxication. The documentation in the suit showed that the staff at the nursing home was unable to account for the dosage of morphine administered to Needham.

The jury ruled that the staff was professionally negligent, and awarded Mrs. Needham, who died of cancer in 2007, $3 million for the loss of companionship she experienced after her husband died. The jury also awarded $1.5 million for Needham’s suffering and pain, and $350,000 in damages.

Nurse Indicted for Chemical Restraint Leading to Nursing Home Resident’s Death

June 28, 2010 | Lebowitz & Mzhen

In recent blog, our Baltimore, Maryland Nursing Home Attorneys discussed the topic of chemical restraints, in regard to a February case, where Britthaven of Chapel Hill Nursing Home was investigated by local and state authorities after Alzheimer’s patients tested positive for opiates that had not been prescribed to them.

This month, Angela Almore, a 44-year old registered nurse, was indicted in the case, on one count of second-degree murder in relation to the death of Rachel Holliday, a resident of the nursing home who died after being given a heavy dose of morphine. Almore was also charged with six counts of felony resident abuse, related to administering morphine to several patients of the nursing home, causing hospitalization.

The investigation reportedly began after a few patients from the Alzheimer’s wing of the nursing home were hospitalized for odd behavior, which led to the discovery of opiates in their blood. The North Carolina State Bureau of Investigation (SBI) and the Attorney General’s Medicaid Investigations Unit, with the Orange County District Attorney, launched a criminal investigation of the nursing home in February to determine if the patients were being over-medicated, abused or neglected, or being subjected to chemical restraint.

The North Carolina Attorney General’s Office claims that after testing, nine out of over twenty-five Alzheimer’s patients at the nursing home tested positive for opiates in February. Holliday, one of the hospitalized patients with high levels of morphine in her system, died on February 16, 2010.