Nursing Home Abuse Advocate : Idaho Nursing Home Abuse Lawyers & Attorneys : Kormanik Hallam & Sneed Law Firm : ID Assisted Living Neglect, Nursing Home Injuries : Boise, Nampa, Caldwell

According to a recent Wall Street Journal Market Watch press release, the nursing home industry is doing just fine, thank you very much. This is true despite the fact Medicare reimbursements were reduced back in 2011.

Families for Better Care, Inc. is a citizen advocacy organization dedicated to quality resident care in nursing homes and other long-term care settings. Executive Director Brian Lee served as Florida’s State Long-Term Care Ombudsman for most of the past decade. According to Mr. Lee: “The industry’s analysts framed the Medicare adjustment as an eventual doomsday for the nation’s nursing home market. But the industry’s own reports show quite the opposite, revealing surging revenues, strong profits, and expansion through acquisitions. The industry is wallowing in strong profits while failing to consistently provide quality care.”

The release goes on to note: "A recent study by the University of California-San Francisco shows a steady decline in nursing hours for Medicare-licensed facilities and an unacceptably high level of deficiencies."

Do not let the nursing home industry fool you by crying poverty due to funding cutbacks. The numbers don't lie. In 2011, one company, Adcare Health Systems posted record annual revenues of $151.4 million, which is an increase of 198% over the previous year. Another company, Kindred Health Care, reported an increase in consolidated revenues of 27% to $5.5 billion compared to $4.4 billion in previous year. If that's "hard times" ...don't we all wish our times were that hard?

Staffing cutbacks effect nursing home residents every day. No matter what the industry says, those cutbacks are not because of a lack of funding. They are nothing more than a business decision...a decision that puts profits over people.

• Email This
• Print
• Comments
• Trackbacks
• Share Link

Let me get this straight: The California Department of Public Health performed investigations into the deaths of residents at the following facilities: Fountain View Subacute and Nursing Center in Los Angeles; Motion Picture and Television Hospital in Woodland Hills; and Downey Care Center in Downey. The Department found conditions at the facilities contributed to the deaths of three residents. So what did the Department do? It imposed fines on the facilities. FINES?!

According to an article in the Los Angeles Times, The resident at Fountain View: "The patient, who had a history of falls, was not properly supervised at the nursing home. When he was found on the floor, no one knew how long he had been there, according to the department." For this, the Department levied a fine of $75,000.00.

The Motion Picture and Television Hospital was fined $80,0000.00 when "a 90-year-old Alzheimer's patient who was in a wheelchair died a week after falling down a stairwell, according to a report. She had previously fallen down the same set of stairs."

Downey Care Center received a $75,000.00 fine for for "failing to monitor a patient's blood glucose level after she was released from a hospital in 2010. The woman died from a diabetic coma."

Each and every one of these deaths was preventable. Each and every one of the families of the residents were irreversibly and unnecessarily harmed by the facility's negligence. Each and every one of these families likely has grounds for a lawsuit against the facility.

In this era of personal accountability, I hope the fines imposed by the California Department of Public Health were just the beginning of holding the facility accountable for its negligence. Making sure nursing homes and assisted living facilities are accountable for their negligence in caring for their residents is what I do. I do it because I believe when a loved one's care is entrusted to a Nursing home or assisted living facility, they have a duty to make sure they do every reasonable thing to ensure no harm comes to that resident.

• Email This
• Print
• Comments
• Trackbacks
• Share Link

In a recent New York Times "The New Old Age" post, author Paula Span broached the subject of drinking problems in assisted living facilities. Ms. Span references a study performed by a University of Pittsburgh "team" to determine whether there is, indeed, a problem. The short answer remains: No one really knows.

The "study" referenced by Ms. Span was conducted by interviewing "[m]ore than 800 aides working in assisted living facilities in Pennsylvania." Why weren't the actual residents interviewed? First, funding was insufficient to conduct such a study. Second, there's a little thing called denial! The specter of alcohol abuse in assisted living facilities is certainly raised in article, however. Consider these statistics:

• Nearly 70 percent of assisted living residents drank alcohol.
• More than a third drank daily.
• Twelve percent had abused alcohol (defined as drinking enough to cause “physical or psychosocial harm”) in the past three months.
• Almost 20 percent had experienced an apparent influence on their health from alcohol use in the past three months.

Ms. Span also points out the fact that, because so many assisted living facility residents are on medications, the interaction between alcohol and medicine is a real problem. Finally, the research reveals what we all know...as you age, you can no longer drink as much as you used to be able to drink without adverse affect.

As Ms. Span says: "So might the two or three beers with friends that caused no harm 30 years ago be contributing to your father’s falls now that he is in assisted living? Guess who has been elected to start that conversation." 

It is up to you! Check on your loved one. Just because an assisted living facility allows drinking, does not mean it is the right thing to do! On the other hand, it may not be as bad as you think!

• Email This
• Print
• Comments
• Trackbacks
• Share Link

In an article in yesterday's Los Angeles Times, Karen Ravin provides some helpful information for those of us who have aging parents or loved ones. As Ms. Ravin correctly points out: Our desire for our loved ones to be safe (possibly in an assisted living facility or nursing home) must compete against our loved one's desire for independence. Ms. Ravin has some great ideas in ensuring the "competition" between these two forces can still result in our loved one living at home. Here are a few recommendations:

• Hire an occupational therapist to perform a safety assessment of the home. This will ensure that things which we may never think of as being a danger, such as throw rugs or slippery shower floors, are addressed. Remember...an ounce of prevention is worth a pound of cure.
• Stay connected. As I have talked about before, regular phone calls or visits to your loved one are invaluable. If hearing or sight is impaired, you can look into getting a phone with amplified speakers or large buttons to dial.
• Food. Sure, we presume our loved ones are eating properly because they tell us they are, right? Well, that may not be the case. If food and nutrition are a concern, look into having a program like Meals on Wheels deliver to the house. In the Treasure Valley, Elks Meals on Wheels provides such a service.
• Housekeeping/chores. Let's face it: there are few, if any, people who really enjoy housekeeping and/or chores. If it will help your loved one maintain their independence, why not look into hiring professional help for this? It certainly does not have to be an every-day sort of thing...perhaps a few times a week is all that is needed.
• Take care of yourself. According to Myra Hyatt, a specialist clinical social worker at the Landon Center on Aging at the University of Kansas Medical Center in Kansas City, caring for a loved one can just flat wear you down. "You can become isolated yourself and find yourself thinking, 'I want my life back.'" That's where a support group can help you continue to live your life while helping your loved one maintain his or her independence.

Of course, this list is not the be-all-end-all to resources. In fact, if you have some other ideas, please share them with me. I will, in turn, share them with my readers. After all, we want the picture above to remain true with our loved one maintaining her or his independence.

• Email This
• Print
• Comments
• Trackbacks
• Share Link

You may have wondered where we've been. First, please accept my apologies for not posting information in quite a while. I will be here regularly from here on.

I wanted to let you know Kormanik Hallam & Sneed, LLP, has relocated. We have purchased an old house on the east side of downtown Boise. The house, located at 206 W Jefferson Street in Boise is fully handicap accessible for your convenience.

As I said, my apologies for not posting useful information for you in a while. I look forward to doing so again in the very-near future.

• Email This
• Print
• Comments
• Trackbacks
• Share Link

Although I am a lawyer, I do not typically write on "ins-and-outs" of nursing home or assisted facility law. Frankly, the laws can be complicated and do not typically lend themselves to a relatively "short" (for a lawyer, anyway) post on this site. I'm going to change it up a little today, though, because I think there is something you need to know.

Did you know that, unlike many other matters, in order to bring a lawsuit against a licensed nursing home or assisted living facility in the state of Idaho, you must first jump through a hoop? This hoop is known as a "Prelitigation Screening Panel."

As defined by Idaho law, and in the context of a claim against a license nursing facility, the prelitigation screening process generally can be described as follows:

• Any claim for "alleged negligence or wrongful death" against a "licensed nursing facility," must go through the process;
• A panel serves in the nature of a "special civil grand jury";
• The panel consists of 3 people: 1 person who is a licensed administrator of a nursing facility in the state of Idaho; 1 person who is an attorney, appointed by the commissioners of the Idaho State Bar; and a layperson selected by the two members listed above;
• The process is "informal" and, other than the panel's final decision, there are no records of the proceedings kept;
• The process is nonbinding;
• The process is compulsory, which means you cannot sue a licensed nursing facility for its wrongful acts unless and until you have gone through this process.

You might ask, if the process is nonbinding, what happens if I "loose" -- get an unfavorable result from the prelitigation screening panel -- to my case? Does that mean I cannot proceed? The answer is an emphatic "no." Because the process is nonbinding, you simply are required to go through it, whatever answer you receive from the panel, you can still choose to proceed with litigation against the licensed nursing facility.

Should you decide you would like to hold a nursing home or assisted living facility accountable for its wrongful acts, there are some steps you should take. First, contact an experienced nursing home abuse lawyer, like the lawyers at Kormanik Hallam & Sneed LLP. Second, remember, you need to go through the prelitigation screening process prior to filing a lawsuit against a licensed nursing facility.

• Email This
• Print
• Comments
• Trackbacks
• Share Link

Imagine walking into a traditional nursing home for the first time. There is a reception area at the front door. Turn right and walk down a hallway - there are resident rooms on both sides. There is typically a nurse's station. in amongst the rooms. There may be medication carts in the hallway. There may even be food carts for those residents who cannot make it to the dining hall. Imagine walking into this traditional nursing for the first time...and being told: "This is your new home." Well, that ain't like any home I've ever lived in...it's a hospital...it's an institutional facility...it is definitely NOT a "home." 

In a article in yesterday's New York Times, Laurie Tarkin explains a relatively new movement in the nursing home industry - Green Houses. These "green houses" are not the kind you grow plants in. They are not even particularly "green" as in environmentally sound. Instead, the Green House theory of nursing home care places residents in real, honest-to-goodness (although slightly modified) homes on the property of the main facility. The article describes the Green Houses as:

• Front door opening into a large living and dining area;
• A hearth surrounded by upholstered chairs;
• A long communal dining table where meals are served;
• Kitchens that open to the dining table so caregivers can chat with residents while preparing meals;
• Private bedrooms and bathrooms;
• Front porch and back deck with tables and chairs.

Perhaps, more importantly, are the items not present in a Green House. There are no: corridors, nursing stations, medicine carts, trays of food delivered to residents in their rooms.

In this environment, staff actually gets to know their residents. They spend more time, on average, with their residents and, according to the article, are more able to build a personal bond with their residents.

There are approximately 117 of these Green Houses across the country. I wonder if there are any here in Idaho? I haven't heard of any such facilities here. If you know of one, I'd like to hear from you.

Imagine walking into a Craftsman-style bungalow. You walk up the porch and notice the rocking chairs. You walk in the front door and notice a hearth ablaze in a warming glow and your new housemate seated in a nice chair in front of it. You see a friendly staff member cooking your first meal in the kitchen. You drop your belongings off in your room and return to the main living room. Your loved one, maybe your son or daughter, reaches over to you and says: "This is your new home." You smile and say: "Yes it is." 

Will the Green House movement accelerate? Will it fall by the wayside as an expensive experiment? Who knows. Is the care received as good or better than that provided in a traditional nursing home? The studies referred to in the article seem to indicate it is.

If you or a loved one is in such a facility, I would love to hear from you about the experience. What are the pluses or minuses? I can't wait to hear from you!

• Email This
• Print
• Comments
• Trackbacks
• Share Link

Did you know: Changing nursing home or assisted living facilities can be hazardous to a resident's health? That would certainly appear to be the case and now there is science to back that fact up.

A recent article in the Science Daily, describes the results of a study by the University of Pennsylvania School of Nursing. The study concerned nursing home residents who required evacuation from their facilities and who were relocated to another facility. Of course, because the residents were relocated, they received care from different people than they were otherwise used to.

"The displaced participants experienced delirium, cognitive changes, hospitalizations, and death." Although the study sample size was small-17 long-term care residents-its results are still worth noting. "The study, published in September 2011 issue, found that more than half the residents were negatively affected by evacuation and showed signs of delirium within the two weeks immediately following -- two participants were hospitalized and one died."

According to Pamela Cacchione, PhD, APRN, GNP, BC, the lead author of the study: "Older adults often have visual and hearing deficits, making it more difficult to interpret their environments and precipitating increased stress," which can also "exacerbate chronic illnesses, further precipitating delirium."

It would seem to me, no matter the reason for a nursing home resident's relocation--evacuation due to natural disaster or a simple change of facilities--the concerns would be the same. If the decision has been made to change facilities, make certain extra care is taken at the new facility so that your loved one is properly cared for during and following the oftentimes difficult transition.   

• Email This
• Print
• Comments
• Trackbacks
• Share Link

A recent story by Matt Sedensky, addresses the use of antipsychotic medications in treating dementia in nursing home residents. The story begins with the story of Hazel Eng, a resident of the Ecumen home in North Branch, Minn. "Day after day, Hazel Eng sat on her couch, a blank stare on her face. The powerful antipsychotics she was taking often cloaked her in sedation. And when they didn't, the 89-year-old lashed out at her nursing home's aides with such anger and frequency her daughter wondered if her mother would be better off dead." When Ms. Eng was transferred to another section of the facility and was removed from her antipsychotic medications, there was a dramatic change. "She now beams as she ambles the hallways, reads the newspaper, tells stories and constantly laughs."

According to Mr. Sedensky: "Antipsychotics are meant primarily to help control hallucinations, delusions and other abnormal behavior in people suffering from schizophrenia and bipolar disorder, but they're also given to hundreds of thousands of elderly nursing home patients in the U.S. to pacify aggressive and paranoid behavior related to dementia."

The use of antipsychotic medications to treat dementia is an "off-label" use. According to a 2007 government audit, approximately 83% of Medicare claims for antipsychotic drugs were for purposes including the treatment of dementia.

So what, you might ask. Isn't it better to medicate a resident suffering from dementia so they do not harm themselves or others? The answer is an absolute and resounding: NO! Use of antipsychotic medicine to "treat" the symptoms of dementia creates its own set of issues. "The drugs can limit seniors' ability to effectively communicate, socialize or participate in everyday life."

Thankfully, according to the article, the off-label use of antipsychotic medications to treat dementia in the nursing home setting has decreased over the past decade.

If you have a loved one who suffers from dementia and is receiving antipsychotic medicine, you should speak with your physician. Make sure the medications are necessary and are being used correctly. If your loved one seems "out-of-it" during visits, it may very well be the result of the medications he or she is receiving. It is up to you to make sure each and every medication prescribed to a loved one is absolutely necessary.

• Email This
• Print
• Comments
• Trackbacks
• Share Link