Nursing Home Negligence

Vote Yes on Question 1 and Keep Nurses and Patients Safe

Unfortunately, ballot questions in Massachusetts have become less about the issue concerned, and more about whoever has the better ad campaign.  This year’s Question 1 is not different.  But when you study the issue, I can’t see how anyone could credibly vote No.  Nurses, who are actually the ones  in the best position to weigh in on the issue seem to overwhelmingly support the measure.  And when all is said and done, the insurance company’s position in opposing the initiative is solely based on cost.  Insurance companies see this as something that will cut into profits.  They then invariably intimate if not explicit state, that they will pass these costs onto the consumer.  With profits and wages and astronomical levels, they do show a certain amount of unmitigated gall when then state that Question 1, if passed, will cause insurance rates to rise.  At its barest essence, Question 1 is about reasonableness and, in the end, safety.  There is only so much that a nurse can safely accomplish when dealing with these high stress matters that require laser focus; and often life and/or death hang in the balance.  Limiting their patients to a manageable number is a safety measure based in reasonableness and experience.  I would strongly urge people to Vote Yes on 1.

Massachusetts Question 1 has Nurses Divided

Few ballot questions have vexed Massachusetts voters more in recent times than Ballot Question #1 which seeks to put strict limits on the number of patients that nurses care for in a hospital setting.  How can we say that it is so controversial?  A WBUR poll of 500 registered nurses reveals that 48 percent plan to vote for the ballot question that would establish maximum nurse-to-patient ratios in state law, and 45 percent say they’ll vote against the very same measure. Only seven percent are undecided.  “Nurses are split on the question,” says pollster Steve Koczela, president of the MassINC Polling Group, which conducted the survey for WBUR.

Those in favor of the measure believe it will enhance patient safety while those against claim that a “one size fits all” approach is too inflexible and will lead to a host of unintended consequences from greater waiting times in emergency rooms to forcing smaller, rural hospitals to close due to their inability to afford the extra nursing staff that will be required.  Should the measure pass, the maximum patient to nurse ratio would be set at 4 to 1 but that ratio can vary depending on the condition of the patient or the unit that they’re in.  For example, in units with post-anesthesia care or operating room patients, the measure would mandate a ratio of one patient under anesthesia per nurse or a maximum of two post anesthesia patients per nurse.

While everyone desires a safer hospital environment for patients, there is no consensus that passing Ballot Question #1 will serve that end.

To Avoid Nursing Home Negligence, Know Your “Rights”

TO AVOID NURSING HOME NEGLIGENCE, KNOW YOUR “RIGHTS”

 

 

Making the decision to admit a loved one to a nursing home can be an agonizing experience.  We are tempted to think of the care rendered by such facilities as impersonal and vastly inferior to that which we would provide to our loved one at home.  This is not always true, of course.  It is an undeniable fact, however, that the resources and attention offered by these facilities are often being stretched beyond the limits of what is safe.  As life expectancy increases, incidents of dementia and Alzheimer’s disease have commensurately risen as well.  Population in the nation’s nursing homes has therefore swollen in recent times.  Most alarmingly, perhaps, is that these numbers are projected to dramatically increase over the course of the next several decades.  Our seniors find themselves at increased risk while a patient at these facilities.  The best guard against neglect, is to “know your rights.”  Massachusetts General Laws c. 111 section 70E provides a “bill of rights” that protects every patient.  While the statute is long and comprehensive, several provisions are particularly helpful to nursing home patients.

 

Massachusetts General Laws c. 111 section 70 E provides, in part:

 

Every patient or resident of a facility shall have the right:

*to privacy during medical treatment or other rendering of care within the capacity of the facility;

*to prompt life saving treatment in an emergency without discrimination on account of economic status or

source of payment and without delaying treatment for purposes of prior discussion of the source of payment                                                                  unless such delay can be imposed without material risk to his health, and this right shall also extend to those persons not already patients or residents of a facility if said facility has a certified emergency care unit;

* to informed consent to the extent provided by law;

* upon request, to obtain from the facility in charge of his care the name and specialty, if any, of

the physician or other person responsible for his care or the coordination of his care;

*to confidentiality of all records and communications to the extent provided by law;

Recognizing and Stopping Elder Abuse

The National Center on Elder Abuse has come out with their most recent statistics and the results are truly staggering. It begins by acknowledging that the “Boomer Generation” effect will continue for decades and predicts that between 2012 and 2050, the United States will experience considerable growth in its older population.  In fact, by 2050, the population aged 65 and over is projected to rise to 83.7 million souls, which is almost double its current population.  Older women will continue to outpace older men.

The survey concentrates on all forms of elder abuse and ranks the most common in the following order: financial, neglect, emotional, physical and sexual mistreatment.  Low social support is most commonly associated with elder abuse and seniors who are afflicted with dementia are 50% more likely to be exploited than their counterparts.  Approximately half of all people over the age of 85, the fastest growing segment of the population, have been diagnosed with Alzheimer’s disease or another form of dementia.  In addition, this trend continues to   ascend.  Seniors who have previously suffered domestic violence were found to be at increased risk for emotional, sexual and financial mistreatment and women were at greater risk to be abused in this regard than were men.  Who are the perpetrators?  Surprisingly, family members were identified as most likely to engage in financial exploitation (57.9%) followed by friends and neighbors (16.9%) and home health care aides (14.9%).

Perhaps most alarming, however, are the statistics on abuse by caregivers, the very people who are charged with caring for the elderly.  The particular study cited revealed that 47% of the participants with dementia had been mistreated by their caregivers.  A previous study revealed that 50% of the people with dementia experienced some kind of abuse at the hands of their caregivers.

The study concluded by estimating the associated Medicaid costs of elder injuries at $5.3 billion per annum.

Discouraging elder abuse requires vigilance and action.  As is now a common societal refrain,  “if you see something, say something.”

 

Dino M. Colucci, Esquire, is the founder of Colucci, Colucci, Marcus & Flavin, P.C., a law firm dedicated to representing victims of nursing home neglect. For many years he has lectured and served as an adjunct Professor of Law at Suffolk University Law School.  He has also been consistently named as a “Super Lawyer” by his peers as published by Boston Magazine.

 

 

 

Tales From Our Files: Nursing Home Abuse Is A Crime

A substantial portion of our clients are seniors who have unfortunately been neglected or abused while living as patients in a nursing home.  While the resulting harm may prove to be the same, there is a stark difference between the concepts of “negligence” and “abuse” in a nursing home setting.  Nursing home staff members are considered “negligent” if they fail to employ proper precautions in keeping their residents safe.  This can take many forms: accidentally dropping a patient; failing to dispense proper medication; giving a patient with a recognized choking risk foods that are notoriously hard to swallow, (like a hot dog or “sticky” bun).  “Abuse” on the other hand is a more sinister phenomenon which may also prove to be criminal in nature. One such act of cruelty was recently brought to our attention for redress. Suspicious that aides were abusing their loved one, our client secretly placed a “nanny cam” in their grandmother’s room.  The camera recorded video only, (as recording audio without the express permission of the participants is itself a crime).  Sure enough, the hidden video demonstrated aides brutally manhandling, slapping and pulling the hair of an aged and defenseless Alzheimer patient.  As a result of exposing this reprehensible conduct, the aides were promptly dismissed and criminally prosecuted.  Our clients promptly sought to remove their relative from the facility and we prosecuted a civil claim for money damages as a result.

Do I recommend that hiding a camera is always the appropriate solution?  No.  Nor would most facilities welcome such clandestine efforts. Rather, ordinary vigilance by family members is the key to assuring quality care and a safe living environment. By being intimately involved in the care of your loved one, you serve notice that you are closely watching what goes on.  You are also ensuring that the nursing home staff are taking the proper precautions to keep their residents safe.

If you suspect that your loved one has been abused while a resident of a nursing home, you should promptly consult an attorney to review your options.

Dino M. Colucci, Esquire, is the founder of Colucci, Colucci, Marcus & Flavin, P.C., a law firm dedicated to representing victims of neglect. For many years he has lectured and served as an adjunct Professor of Law at Suffolk University Law School.  He has also been consistently named as a “Super Lawyer” by his peers as published by Boston Magazine.

 

 

 

Tales From Our Files: Lessons Learned Concerning Nursing Home Negligence

“Walter” was an 87 year old gentleman who suffered Alzheimer’s disease and became a full time resident at the defendant’s assisted living facility.

Internal documents obtained from the defendant during litigation revealed that “Walter” was last seen in the hallway outside his room at 2:30 a.m.  He was uneventfully redirected back to his room by a staff member.  At 7:00 a.m. a routine bed check revealed that he was missing and a search of the facility ensued.  Documents obtained in discovery revealed that the defendant had previously promulgated a “Missing Resident” policy which mandated that “a resident’s whereabouts are to be known at all times.”  In addition, the aforesaid policy provided that preliminary search efforts by the staff should last no longer than approximately one hour from the time that the resident was first reported missing.  After that time, the policy mandates that the staff contact the local authorities.   Moreover, documents obtained by our office revealed that the facility waited nearly four hours before contacting police once their initial search proved unsuccessful.  We argued that this delay enabled “Walter” to elope from the facility and slowly wander ever deeper into nearby woods.  During the time that he was missing, he was unable to avail himself of the basic necessities of life including sustenance, hydration, shelter and his daily medications which included Coumadin, a medicine used to thin the blood to prevent a stroke.  To compound his unfortunate circumstance, the area received substantial rain during the entirety of the time that the he was lost in the woods and we were prepared to demonstrate this fact with the assistance of climactic records from the National Weather Service.  A massive search was thereafter undertaken and “Walter” was finally recovered deep in the woods approximately 36 hours after it was first noticed that he was missing.  He was rushed to a nearby hospital and treated.  Sadly, he suffered a stroke the following day and later died.

Accordingly, we maintained that the facility’s negligence (1) allowed “Walter” to elope from his building (2) thereby preventing him from ingesting his ordinary dosage of Coumadin and (3) leading to his eventual stroke and death.  The case settled at mediation.

Nursing homes and assisted living facilities must take appropriate precautions to guard against the common phenomenon of residents seeking to wander or elope entirely.  As a concerned family member of a nursing home resident, you should make it a point to ask the facility’s director about the precautions that they take to avoid these serious problems.  Do they utilize and monitor closed circuit television?  Is there a staff person posted at the front door 24 hours per day?  Do they utilize a personal alarm for those residents who are known wandering risks?  How often do they “make the rounds” within the facility?  All of these are important questions that demand honest answers.

As always, vigilance is the key to safety.

Tales From Our Files: Undocumented Nursing Home Accidents

Regular readers of this column know that our office routinely undertakes the representation of senior citizens who have been injured and, in some cases, killed, due to nursing home abuse or neglect.  The facts that comprise each individual case are universally sad and nearly always preventable.  One recent case illustrates this point.

On May 22, 2015, an elderly and long term Alzheimer’s patient, was transported from her residence at a nursing home to the emergency room of a nearby hospital with an obvious deformation of her right leg.  Her medical records at the nursing home revealed that she had been completely dependent on her caretakers for all activities of daily living.  She was mostly bed bound, and could only transfer to a chair via a Hoyer lift.  Upon arrival at the hospital, it was determined that she had sustained a displaced femur fracture.  The treating physician noted that this injury had the appearance of possibly having existed for days prior to his examination.  The resident’s family alleged that they had not been timely notified of any kind of accident or fall. Indeed, the resident’s medical chart at the nursing home made absolutely no mention of or reference to any sort of accident that may have occurred.  Upon examination at the hospital, the emergency room physician also noted that the resident’s bones were “diffusely demineralized.”  This compromised condition, the defense ultimately alleged, likely caused the bone to break organically, rather than as a result of an external trauma.  Throughout the pendency of negotiations, the defendant refused to acknowledge that an undocumented accident had in fact occurred.

As a result of her injuries, the decedent underwent a right femur debridement closed reduction pinning external fixator surgery on her open fracture.   Unfortunately, five days later, the resident died for unrelated reasons. 

Several well-known Boston law firms declined to accept this case, particularly because the resident’s death was seemingly unrelated to the injury she sustained while at the nursing home.  The fact that the resident suffered with this injury for only 5 days before her death was also a factor in persuading these “ivory tower” law firms to pass on accepting this case. 

It has never been our practice to reject what we believe to be a meritorious nursing home negligence case merely because the elderly victim’s suffering was limited to a finite period of time.  Rather, we felt honored to represent this senior citizen and to hold the facility fully accountable for their negligence and their purposeful failure to properly document their resident’s accident and resulting injuries.  

We ultimately settled the above case for nearly $200,000, (which had the concomitant effect of allowing surviving family members to feel somewhat vindicated after being ignored by the facility for so long).  What was perhaps even more satisfying, however, is that we successfully persuaded the facility to offer to the family a formal apology for their improper conduct.

 

Staffing Issues that Can Contribute to Nursing Home Negligence

Read Before Signing – What You Need to Know About Nursing Home Admissions

Nursing homes exist to care for the most frail and vulnerable members of our society. Placing a loved one in a nursing home is never an easy decision, but family members typically find peace in making such a decision with the knowledge that their loved one will be kept safe.

Most nursing home residents are well cared for throughout their stay, but sometimes things go wrong. When things go wrong, nursing home residents can suffer catastrophic injuries.  They can be abused, and they can be neglected.

Because such things can and do happen, most large nursing home chains frequently have new residents or their family members sign pre-dispute arbitration agreements to keep civil claims arising from such injuries, abuse or neglect out of the court system.

More often than not, the residents and their family members are never aware that an arbitration agreement was included in the stack of paperwork that was signed during the admission process. If and when they do find out, it is almost always after something has gone wrong, and at that point, their avenues of legal recourse are limited.

It is never wrong to read nursing home admission paperwork before signing it, and it is never wrong to ask questions about it. If the questions are not answered to your satisfaction, or if you have any other concerns, there is nothing wrong with consulting with an attorney.

The law firm of Colucci, Colucci, Marcus & Flavin, P.C. has been recognized by Newsweek.com as one of the Top 10 Best Law Firms for Personal Injury in the Country. Attorney Darin Colucci has also been recognized by Newsweek.com for 3 consecutive years as one of the Top 10 Best Personal Injury Attorneys in the Country.

Staffing Issues that Can Contribute to Nursing Home Negligence

Staffing Issues That Can Contribute to Nursing Home Negligence

It is always a tough situation when a loved one must transition to a nursing home. As a relative, you no doubt research nursing homes in your area in order to find the most suitable living environment, with the assurance that your loved one’s needs will be met and that they will be well taken care of.

However, quite often those living in a nursing home face abuse and neglect. When such circumstances occur to someone you love, you feel a great deal of anger. While you may not be able to reverse the damage that has been done, be it physical or mental, but legal action can ensure that you and your loved one receives just compensation, as well as assurance that those responsible for the negligence are held responsible.

You can also hopefully avoid any such negligent behavior by choosing a nursing home that is adequately staffed. While there may be a variety of reasons staff members elect to neglect the patients in their care, it is understaffing itself that more often than not directly contributes to nursing home negligence.

Reasons Why a Nursing Home May Be Understaffed

There are many reasons while a nursing home may experience staffing issues and a general shortage of competent staff. For starters, there is a shortage of healthcare workers and nurse practitioners in the United States, with a great need to fill thousands of future positions in nursing homes and healthcare facilities.

The growth of nursing homes across the United States has created many positions that just aren’t being filled quickly enough. A new nursing home may appear clean, efficient and appealing, but you should also be sure that it is fully staffed before choosing to administer a loved one there.

A nursing home may also be understaffed if its employees aren’t paid fairly. Low wages can lead to a high turnover rate (not to mention the fact that it doesn’t give workers a great incentive to perform their job well). A high turnover rate also means new staff must be trained, which essentially means staff that is unfamiliar with your loved one’s particular needs and daily routine. Low pay could also result in not too many applicants accepting a position, as they may seek a position elsewhere for higher pay.

When visiting nursing homes for consideration, ask some of the staff how long they have been there, if they enjoy working there and if much of the staff has been there very long. If they answer honestly, you can get a good idea of how well the place may be staffed and if the staff is happy there.

A nursing home may also expect too much of its staff. A staff member who must handle multiple responsibilities that are better served by additional staff members is unlikely to have the time to sufficiently see to the need of his or her patients.

And finally, nursing home management may simply refuse to hire the proper amount of staff in order to keep profits high.

Negligence: The Unfortunate Consequence of Nursing Home Understaffing

As you might have now realized (or even experienced already with a loved one currently in a nursing home), understaffing can cause serious problems in a nursing home, especially patient neglect. Such neglect isn’t always intentional — as mentioned above, staff members can often be overwhelmed with many responsibilities and daily tasks, making it hard to give their patients the time and care they require.

Additionally, staff that isn’t treated properly by management or paid poorly can become disgruntled. As employee morale suffers, so too does their work ethic, and the overall work dynamic can lead to instances of abuse or neglect.

With many patients dependent upon nursing home staff for a large amount of care, neglect can lead to physical injury, psychological trauma and even death. Patients that are suffering from limited mobility are dependent upon their caregivers to help them move in order to avoid maladies such as atrophy or bedsores.

Additionally, receiving medication and food at the proper times, being provided with regular bathing and grooming, and help with going to the bathroom are all basic needs that can be overlooked or neglected due to understaffing.

Legal Repercussions of Nursing Home Understaffing

Nursing homes have a legal obligation to provide proper care for the patients within their walls. Failure to do so can often result in strict fines, and rampant episodes of neglect and abuse have served to shut down many nursing homes. Additionally, nursing homes have been sued for wrongful death and/or illness of patients in their care that suffered due to neglect.

With understaffing being recognized as one of the leading causes of abuse and neglect in nursing homes, it is being viewed more and more as a crime. Staffing violations should be reported so as to ensure that no patient suffers needlessly.

If you or a loved one has experienced abuse or neglect in a nursing home, contact the law office of Colucci Colucci Marcus & Flavin, PC. Our personal injury attorneys can help you take the necessary steps to receive just compensation and/or justice in cases relating to nursing home understaffing and neglect. You may call us at (617) 698-6000, or you can also contact us online to set up your free initial consultation.

Nursing Home Abuse

Tales From Our Files – Unreported Nursing Home Abuse

Both state and federal laws mandate that nursing home facilities report serious cases of abuse to local police, yet a recent National Public Radio report citing an investigation conducted by the Office of Inspector General reveals that more than one-quarter of serious cases of nursing home abuse were not reported to authorities. Shockingly, some of these unreported cases of abuse involved injuries that were so severe that their victims ultimately required emergency room care.

Federal Law Mandates

Some of the cases are particularly infuriating. One elderly woman was sexually abused after being brutally beaten. Federal law mandates that an event of this magnitude be reported to police “within two hours” or risk a $300,000 fine. The nursing home purposely failed to comply with this rule, however. “Instead”, says Curtis Roy, Assistant Regional Inspector General of the Department of Health and Human Services, “…they cleaned off the victim, [and] in doing so, they destroyed all of the evidence that law enforcement could have used as part of an investigation into this crime.” Remarkably, the nursing home didn’t alert the victim’s family until the following day. Equally shocking, it was the victim’s family that first alerted the police, not the facility. Once local police became involved, the nursing home actively tried to dissuade any ongoing investigation into the attack.

Unreported Nursing Home Abuse

Mr. Roy’s comprehensive investigation, which covered 33 states, revealed that the majority of the unreported cases involved sexual abuse of elderly patients.   Mr. Roy concluded that a relatively simple change of protocol by the Centers for Medicare and Medicaid Services likely holds the key to uncovering a facility’s unscrupulous practice of failing to report abuse to the authorities. By merely cross referencing a nursing home patient’s Medicare claims with their contemporaneous claims from an emergency room visit, an incident of abuse or neglect can be suspected or inferred. Once a patient’s emergency room diagnosis is scrutinized, authorities can better appreciate whether a resident was a victim of a crime such as physical or sexual assault.

By most estimates, approximately 1.4 million Americans currently reside in our nation’s nursing homes. That number is expected to balloon as more from the “baby boomer” generation reaches retirement age.

It is important to point out that abuse in a nursing home setting is not the norm nor is it inevitable. By employing simple awareness and vigilance, however, a resident’s family can discourage, prevent and/or detect incidence of nursing home abuse.

Dino M. Colucci, Esquire, is the founder of Colucci, Colucci, Marcus & Flavin, P.C., a law firm dedicated to representing victims of nursing home neglect. For many years he has lectured and served as an adjunct Professor of Law at Suffolk University Law School. He has also been consistently named as a “Super Lawyer” by his peers as published by Boston Magazine.