Nursing Home Negligence

Mandatory Arbitration Clauses in Maryland Nursing Home Admissions

October 3, 2012 | Lebowitz & Mzhen

People involved in legal disputes may choose, instead of litigation, to submit their case to a process like mediation, where a neutral person tries to help all sides in a dispute reach a mutually agreeable settlement; or arbitration, where one or more neutral individuals hear arguments from all sides to a dispute and propose a solution. Arbitration can be non-binding, meaning any party can reject the arbitrator’s decision and proceed to litigation; or binding, in which case no party may challenge the arbitrator’s decision in a court of law. These practices can offer an efficient means for settling grievances, but in some cases, people who might prefer litigation find themselves contractually bound to arbitration, often binding. Maryland and federal law generally allow nursing homes to include arbitration provisions in their contracts with residents with some limitations. Anyone signing admission papers for a nursing home, for themselves or someone else, should review them very carefully.

NBC News recently reported on a man who checked his father into a nursing home after his father suffered a stroke. When his father died due to alleged negligence, the man sought advice as to his legal rights. He learned that an arbitration agreement was among the many papers he had signed during his father’s admission, thus barring him from the courthouse.

Arbitration can be an expensive process for individuals, with the arbitrator’s fees often split equally between the parties. Arbitrators are often former attorneys or judges with high hourly rates, unlike judges in the judicial system, whose paycheck comes from taxpayers. The process can lack the transparency of the court system, where most documents are public record. Arbitration is a private transaction, occurring behind closed doors. For reasons that remain a subject of dispute, studies cited by NBC have shown that arbitrations result in fewer monetary awards for patients or their families than litigation.

Lawsuit Against Nursing Home May Proceed on an Ordinary Negligence Claim After Court Dismisses Medical Malpractice and ADA Claims

September 25, 2012 | Lebowitz & Mzhen

A woman may replead her lawsuit against a Tennessee nursing home for the death of her mother as an ordinary negligence claim, according to a ruling from the Sixth Circuit Court of Appeals in Southwell v. Summit View of Farragut. She filed suit claiming medical malpractice and violations of the Americans with Disabilities Act (ADA), and the defendant obtained a dismissal of both claims. The appellate court remanded the case to allow the plaintiff to plead ordinary negligence.

The plaintiff’s mother, Claudia Atkins, who had hearing and sight impairments, was receiving treatment at the University of Tennessee Medical Center for cancer and emphysema. She was transferred to Summit View of Farragut, a nursing home in Knoxville, on December 11, 2009. She died on October 6, 2010. The plaintiff sued Summit View on November 23, 2010 in state court, asserting causes of action for “negligence-medical malpractice” and wrongful death.

Summit View removed the case to federal court in December 2010 based on diversity jurisdiction, as the plaintiff was a Florida resident, and her mother remained a legal Florida resident despite her stay in a Tennessee nursing home. The defendant then filed a motion to dismiss under Rule 12(b)(6) of the Federal Rules of Civil Procedure. The district court granted the motion, and the plaintiff appealed to the Sixth Circuit.

Baltimore Nursing Home Closes After Owner Files Bankruptcy; Almost Seventy Residents Must Relocate

September 12, 2012 | Lebowitz & Mzhen

A Baltimore nursing home announced that it will shut its doors by the end of September 2012. The nursing home’s parent company, Ravenwood Healthcare, Inc. of Baton Rouge, Louisiana, filed for bankruptcy earlier this year. The facility lost its Medicare and Medicaid funding, and Ravenwood has been unsuccessful in locating a buyer. Residents received notice to relocate within thirty days, leaving many of them in an extremely difficult situation.

According to the Baltimore Sun, Harborside Nursing and Rehabilitation Center was the first nursing home in Maryland to accept patients suffering from AIDS in 1985. Despite this history, the facility has had difficulties with health and safety inspections over the years. The building was originally a hotel, and it has had difficulties over the years adapting to use as a nursing home and to modern structural standards. Inspectors with the state’s health department reportedly conducted an inspection of the nursing home during the period from February 29 to March 9, 2012. They identified more than thirty deficiencies, many of which were safety problems due to structural issues. As a result, the Sun reported, the Centers for Medicare and Medicaid Services (CMS) cut off Medicare and Medicaid funding to the nursing home, effective in September.

CMS’s “Nursing Home Compare” website gives Harborside one out of five stars, meaning “Much Below Average,” for both its overall rating and its health inspection results. It identifies the nursing home as a “Special Focus Facility,” meaning it has a “recent history of persistent poor quality of care” as determined by CMS inspectors. The last “standard health inspection” at Harborside, according to the website, took place on December 7, 2010. The site states that the facility has twenty health deficiencies, well above the state average of 10.6 and the national average of 7.5.

Nursing Home Could Lose Medicare and Medicaid Funding Due to Multiple Alleged Deficiencies

September 4, 2012 | Lebowitz & Mzhen

A nursing home in Greenwood, Mississippi could lose all of its funding through the Medicare and Medicaid programs if it fails to correct certain problems alleged by the federal government. The Centers for Medicare and Medicaid Services (CMS), the federal agency that administers both programs, recently notified Greenwood’s Golden Age Nursing Home of multiple deficiencies, including allegations of criminal conduct by nursing home staffers. The number and nature of the deficiencies, in large part because of the effect they have on the safety of the nursing home’s residents, put its participation in Medicare and Medicaid in jeopardy.

The Jackson Clarion-Ledger reported that CMS notified the nursing home in late August 2012 of twenty-four deficiencies occurring over the past fifteen months. It stated that it will continue to make payments for the nursing home’s residents until September 29 but will not pay for residents admitted after August 30. This gives the facility thirty days to remedy the deficiencies.

CMS reported that it had conducted three surveys of the facility in response to complaints in the past fifteen months. It compared the total number of deficiencies in the facility, twenty-four, to the national average of 7.5. The average number of deficiencies for facilities in Mississippi is six. The most recent survey of the nursing home, conducted on February 10, 2012, identified deficiencies in eight broad categories based on the regulatory requirements for participation in the Medicare and Medicaid programs:
1. Privacy and confidentiality of residents’ personal and medical information and records;
2. Provision of care that maintains “dignity and respect of individuality”;
3. Adequate housekeeping and maintenance;
4. Safety and cleanliness in food handling;
5. Labeling of drugs and maintenance of drug records in accordance with professional standards;
6. Effective planning to control the spread of infections;
7. Monitoring of nurse aides to ensure they can provide for resident needs; and
8. Recordkeeping on individual residents that meets accepted professional standards.

Appeals Court Reinstates Class Action Lawsuit Against Nursing Home Operator Alleging Rights Violations

August 29, 2012 | Lebowitz & Mzhen

A California appeals court has reinstated a putative class action lawsuit filed by patients at sixteen nursing homes located in Alameda County. The defendants in Shuts v. Covenant Holdco, LLC, et al are related business entities that own and operate the homes. The plaintiffs allege various violations of state regulations regarding the quality of care provided to nursing home residents. After a superior court judge dismissed the case based on the defendants’ argument that only state regulators have the right to enforce nursing home standards, the court of appeals reversed and reinstated the case.

Covenant Care, a company based in Orange County, operates forty-five nursing homes in seven states. At least sixteen are located in Alameda County, California. The plaintiffs presented themselves as a putative class of people who resided in Covenant’s nursing homes during a “class period” from December 15, 2006 until December 16, 2010. State law, according to the appeals court, allows a current or former nursing home resident to file suit against the facility’s licensed operator for violations of the Patients’ Bill of Rights or other rights under state or federal law. The plaintiffs claimed that Covenant routinely understaffed its facilities in violation of state law, which they said requires a nursing home to provide each patient with at least 3.2 hours of skilled nursing care per day. Covenant allegedly failed to meet this requirement on at least thirty-five percent of the days in the class period.

Covenant’s demurrer to the complaint argued that the plaintiffs’ entire case relied on allegations of a breach of the minimum-nursing-hour requirement, but that the California Department of Health had the exclusive authority to enforce the requirement. The defendants also asserted the doctrine of equitable abstention, which allows a court to abstain from hearing a case that would require the court to act in the capacity of an administrative agency. The circuit court dismissed the plaintiffs’ case without leave to amend the pleadings. The plaintiffs appealed to the First Appellate District.

Nursing Home Administrator Receives 20-Year Prison Sentence for Health Care Fraud

August 22, 2012 | Lebowitz & Mzhen

A former nursing home operator received a twenty-year prison sentence from a federal district judge in Atlanta, Georgia on August 14, 2012. George Houser, age 64, was convicted in April of defrauding state Medicare and Medicaid programs. As a result of the fraudulent scheme, nursing home residents went without adequate care for years.

According to the U.S. Attorney’s Office, Houser and his wife ran two nursing homes in Rome, Georgia from July 2004 to July 2007, and another home in Brunswick from September 2004 to September 2007. The two Rome nursing homes each housed about one hundred residents, and the Brunswick facility had 204 beds. Houser submitted bills to Medicare and Medicaid for about $39.4 million during the period from July 2004 to September 2007. He certified to the government that he was providing health care, a clean living environment, and a good quality of life for the residents of the three homes. He received $32.9 million in payments from Medicare and Medicaid.

Of the total amount received from the federal government, prosecutors alleged that Houser appropriated over $8 million for personal use. This included $2.7 million to purchase real estate as part of a planned hotel in Rome, as well as plans for hotels in Brunswick and Atlanta. He also allegedly bought a $1.4 million house for his ex-wife, and put her on the payroll of one of the nursing homes in lieu of alimony.

During this time, conditions for the residents in the three nursing homes were described repeatedly as “inadequate.” Numerous staff members reportedly resigned after paychecks started bouncing. As employees left, few applicants sought the open positions. This left the facilities significantly understaffed. The facilities also fell into disrepair, with few resources applied towards upkeep of the buildings. Roof leaks and broken air conditioning units became common. As a result of non-payment to the nursing homes’ vendors, the facilities experienced shortages of food, medicine, and even cleaning supplies. Some employees used their own funds to buy food for residents.

Contractor Kickbacks Result in Prison Sentence for Former Nursing Home Executive

July 27, 2012 | Lebowitz & Mzhen

A former executive with a nursing home company based in Roanoke, Virginina has been sentenced to just over five years in prison after pleading guilty to multiple counts involving mail fraud and tax evasion. He was accused of receiving more than half a million dollars in kickbacks from contractors, awarding contracts based on payments rather than on bids, and falsifying tax returns in order to conceal such income. Four contractors have also faced prosecution for payment of kickbacks. The case is important to advocates for victims of nursing home abuse and negligence because of the importance of maintaining adequate facilities for the care of nursing home residents. Kickbacks and other forms of corruption compromise the ability of nursing home administrators to effectively care for their patients.

Roanoke-based Medical Facilities of America (MFA) operates over forty nursing homes located around North Carolina and Virginia. John D. Henderson worked for MFA as its director of maintenance and renovations. According to prosecutors, he demanded and received $541,821 in kickbacks from three or more companies between 1998 and 2006. Those companies then received more than $5 million in contracts from MFA for construction work at its facilities. Henderson allegedly created false records of higher bids from competitors to create the appearance of a competitive bidding process. He was also accused of filing fraudulent tax returns to conceal over $400,000 in income. MFA fired Henderson in 2006 after learning about the kickback scheme.

Choking Deaths in Nursing Homes Lead to Calls for More Staff Training

June 27, 2012 | Lebowitz & Mzhen

An unusually high number of cases of nursing home residents choking to death in Connecticut has led to calls for improved training for staff members. The state has fined three nursing homes in three unrelated choking deaths, all occurring within a period of three months. In each incident, nursing home staff left the resident unattended while eating. In two of the cases, the resident had food obtained from outside the nursing home either without the knowledge or permission of the staff. Nursing homes owe a duty to their residents to keep them safe and protect them from unusually dangerous conditions, which includes special needs regarding food.

An elderly resident of the Torrington Health and Rehabilitation Center in Torrington, Connecticut choked to death on a peanut butter and jelly sandwich on February 3, 2012. An investigation determined that nursing home staff left the resident unattended with the sandwich. The resident had strict diet restrictions and required close supervision while eating. The state health department fined the nursing home $510, although the fine could have been as much as $3,000.

Lawsuit Claims Abuse and Neglect at School

June 21, 2012 | Lebowitz & Mzhen

A federal lawsuit brought by the parents of several students against a Kansas military school alleges multiple acts of abuse and neglect. Although fellow students committed many of the alleged acts of abuse, the lawsuit claims that adult staff members often knew about the abuse, and that some were even present for some incidents. Faculty, staff, and administrators did not intervene, according to the complaint, thus breaching their duty to protect their students. The claims are similar to claims brought for alleged nursing home abuse and neglect, since both involve a duty to care for vulnerable individuals, and liability for failure to protect people under their care from harm. This could include failures to protect nursing home residents from abuse by staff members or other residents.

A group of parents first filed suit on March 5, 2012 in the U.S. District Court for the District of Kansas. Their children were students at St. John’s Military School, a residential boarding school in Salina. The school teaches grades 6 through 12 and houses all of its students on its premises.

The plaintiffs allege that the school puts incoming students through a series of physical training and other initiation procedures, and that it places significant disciplinary authority in its senior students. This gives the older students powers over the younger students more properly exercised by adults, the complaint says. The school allegedly knows of abuses that occur within this system, including many that result in physical injury to students, but does nothing to address it.

Nursing Home Fined After Staffers Failed to Help Resident Who Fell Down for Nearly an Hour

May 29, 2012 | Lebowitz & Mzhen

A nursing home in Iowa must pay a $15,000 fine for failing to provide needed treatment to a resident who fell and suffered a head injury. The resident reportedly lay on the floor for almost an hour while staffers attended a holiday party nearby. Nursing home administrators say they plan to appeal the state’s order, and they dispute the state’s interpretation of the video, saying that investigators viewed it “out of context.”
The incident occurred during the afternoon of December 23, 2011 in the dementia unit at All-American Restorative Care in Washington, Iowa. According to state investigators who viewed footage from the facility’s video-monitoring system, a female resident stumbled backwards and fell while walking down a hallway at 2:51 p.m. No one on the staff witnessed the fall, but within seconds, two employees reportedly appeared at a nurse’s station with a view of the fallen woman. Although the woman was “barely moving,” neither staffer appears to have offered her assistance. One of the staffers reportedly told investigators later that she called to the woman to ask if she was alright, and that the woman said “Yes.” The second staffer reported that this particular resident being on the floor was a “recurring situation.”
The resident remained on the floor for another thirty minutes on the video, and then a third staffer appeared. This staffer did not offer any assistance to the resident, according to investigators. A fourth employee appeared on the video at 3:37 p.m., forty-six minutes after the fall. Three staffers enter the video two minutes later and lift the woman up, reportedly without first assessing her neurological condition, and take her to her room. One of these staffers later told investigators that the woman was “pretty out of it” at this point. Nursing home staffers took the woman to the hospital at around 5:00 p.m. for a head wound. She had a cut on the back of her head that required four staples.