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

In a recent New York Times' article, Robert Pear writes about a disturbing fact: More than 90% of nursing homes in the United States "employ one or more people who have been convicted of at least one crime." Frankly, I find that disconcerting.

Mr. Pear's story is based upon a report issued by Daniel R. Levinson, inspector general of the Department of Health and Human Services, who obtained the names of more than 35,000 nursing home employees and then checked with the Federal Bureau of Investigation to see if they had criminal records.According to Mr. Levinson: “Our analysis of F.B.I. criminal history records revealed that 92 percent of nursing facilities employed at least one individual with at least one criminal conviction.” He went on to say: “Nearly half of nursing facilities employed five or more individuals with at least one conviction. For example, a nursing facility with a total of 164 employees had 34 employees with at least one conviction each.

The rules that govern Idaho nursing homes and assisted living facilities require criminal background checks be performed. There are also certain "disqualifying crimes" which prohibit a person from working in a nursing home such as abuse or neglect of a vulnerable adult, among many others. Although the potential employee must "self-report" any criminal convictions, they must also provide finger prints for their criminal background investigation.

No system is fool-proof, however. Make sure to report any suspicious activity to your nursing home or assisted living facility. As the Department of Health and Human Services' survey reveals, nursing homes and assisted living facilities are hiding a "dirty little secret": they employ some unsavory characters.

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In a story from today's Los Angeles Times, it is reported that a nursing home has been fined the maximum amount allowable by California law for a death attributed to the facility's failure to adequately maintain its equipment.

The resident, who was 60-years-old, had a heart condition, diabetes and a muscle wasting disease and was confined to a wheelchair. Because of her condition, the resident needed help getting up and into bed. The staff of the nursing home, Eskaton Care Center Manzanita, in Northern California, was using a type of mechanical lift to assist the resident from her wheelchair into her bed. The sling used to transfer the resident broke and she fell, hitting her head on a nearby door. She was taken to the hospital where it was discovered she suffered bleeding in her brain, brain damage and a short time later, a stroke. Tragically, the resident died four days after she was injured at the facility. The consequence to the company who runs the facility -- a $100,000.00 fine. Don't feel too bad for the company, though; the company, Eskaton, operates 35 properties and programs serving 14,000 people annually, including about 3,000 residents.

Make sure if you or a loved one is a resident of a nursing home or assisted living facility, the staff is not only properly trained in the correct use of equipment, but that the equipment is subject to regular and rigorous inspection. As this tragic incident demonstrates: A faulty piece of equipment is just as dangerous as unskilled staff.

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In a previous blog post, I wrote about how increased staffing levels equate with improved nursing home resident safety. Well, a company has found out the hard way: follow the law requiring minimum levels of nursing care or pay the price.

According to a story in the Contra Costa (California) Times, the jury in a class action lawsuit against Skilled Healthcare has reached its first verdict. According to the article: "Skilled Healthcare is one of the largest nursing home chains in the country, employing approximately 14,000 people. The company is based in Southern California, and operates 78 nursing facilities in seven states."

The jury awarded $677 million for violations of the California law requiring a certain number of nursing hours per resident per day in the facilities. Interestingly, Skilled Healthcare's attorney was not even in the courtroom when the verdict was read; instead he sent out his reaction to the jury verdict via an e-mail!

The case was brought on behalf of residents of the five facilities owned by Skilled Healthcare in Humboldt County and covered the period of 2003 - 2009. There were approximately 32,000 residents represented in the class action. 

I say this is the jury's "first" verdict because, now, the jury will receive evidence concerning what additional punitive damages should be awarded against Skilled Healthcare. Punitive damages are meant to punish the company so that it does not repeat its conduct and to dissuade others from doing so. I will let you know the outcome of that phase of the lawsuit when the information becomes available.

For the residents of facilities of Skilled Healthcare facilities, justice is being served. Perhaps other large, for-profit, nursing home companies will get the message. Follow the law or pay the price.

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You would think state legislators would be on the side of vulnerable nursing home residents. According to  a recent story by Clark Kauffman in the Des Moines Register, you could be wrong. At least one Iowa state representative allegedly exerted pressure to recertify a facility. The problem was, the facility had been the subject of at least $21,500 in fines for its neglect of residents.

Mr. Kauffman's story concerns ManorCare Nursing Home, located in West Des Moines, Iowa, and West Des Moines state senator Pat Ward. Apparently, Senator Ward telephoned Dean Lerner, the head of Iowa Department of Inspections and Appeals and told him ManorCare was providing a "very high" level of care and urged Mr.Lerner "to recertify it as quickly as possible." Unfortunately for Senator Ward, at the very moment he was on the telephone with Mr. Lerner, inspectors were at ManorCare. Those inspectors were in the process of compiling a list of additional violations, which would result in $500 in fines. The article indicates this is was not the first time an Iowa politician had interfered in an inspection of a nursing home facility.

Mr. Kauffman also references a U.S. Government Accountability Office report from 2009. According to Mr. Kauffman, the GAO believed "legislative pressure and other factors were contributing to nursing home inspections that minimized the problems found in care facilities through the nation. Seven states told the GAO that pressure from the industry or from state legislators might have compromised their entire inspection process."  

Shouldn't your state legislators be on the side of those who need it the most? I ask you, who needs protection more: ManorCare or its residents. The answer, at least to me, is obvious. The residents of ManorCare deserve the protection of strong legislation and independent inspectors who hold facilities accountable for neglectful conduct. Is Idaho one of the seven states that complained to the GAO about political pressure? I will investigate and get back to you.

At the end of the day, it is up to all of us to hold our state legislators accountable. If they are not in favor of protecting nursing home residents, let them know you do not approve. This is truly a subject where the state legislator is either "for" nursing home residents, or "against" them. 

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It is simply amazing what a person can do with a little knowledge, a computer, and bad intentions. A story by Mariann Martin out of Jackson, Tennessee reveals the lengths one person went to in order to hide her identity. The story, featured on the Jackson Sun's website reports on the arrest of Sheila Watson, who was the "social director" at Bells Nursing Home, in Bells, Tennessee.

According to the article, Ms. Watson, if that is indeed her name, had provided the facility with forged copies of "a University of Memphis diploma, college transcripts, a letter and a Social Security card" when she applied for her job. Apparently Ms. Watson had worked at the nursing home since July 2009. Why would Ms. Watson go through so much trouble to land the social director position? It seems she has a long criminal history including a conviction of identity theft, among others. 

Although the nursing home has, to date, been unable to unearth any evidence Ms. Watson was attempting to defraud the facility, the story does not address the obvious question: Did Ms. Watson go through all that trouble to create an identity not to defraud the facility, but to befriend and, perhaps financially exploit, the vulnerable residents of the Bells Nursing Home?

It just goes to show you; it is difficult to ensure the staff at your nursing home are who they represent themselves to be. Could Bells Nursing Home have done a more thorough background investigation before placing Ms. Watson in a position of trust? What steps does your nursing home facility take to ensure its employees are who they purport to be? 

Ms. Watson's cover was blown when the nursing home received a call from a state agency which, in turn, had received a "tip" about her. Ms. Watson may never have been discovered if not for the concern of the tipster. If you know someone working in a nursing home is not who they claim to be, report it. If you observe anything out of the ordinary concerning the staff of your nursing home, again, report it. The facility has an obligation to hire qualified individuals to provide care for its residents. You can help ensure the nursing home does so.

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In an interesting article in today's New York Times, Paula Span, writes on the dangers bed rails pose to nursing home residents. Although many people, including Ms. Span, believe bed rails keep nursing home residents safe, actually, the opposite is true.

According to geriatrician and bioethicist Steven Miles of the University of Minnesota: Although side rails"decrease your risk of falling by 10 to 15 percent...they {actually] increase the risk of injury by about 20 percent." This is so because confused or residents with dementia, who try to climb over the rails, are apt to fall farther and strike their heads if side rails are in use. A greater risk than falls, however, is "entrapment." This occurs where patients get stuck within the rails or between the rail and the mattress. Mr. Miles has some advice for those of you looking for a quality and safe nursing home: “Count off 10 beds. See how many have rails in use. If more than one or two in 10 beds have rails up, walk out of the facility.”

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As a resident of a nursing home or assisted living facility, there are many things you rely upon the facility to help you with. One of the most important, perhaps, is the administration of prescription or over-the-counter medications. If the facility gives you the wrong medication, the consequences can be dire, even fatal.

In an article posted today, KSAX, an ABC affiliate in Minnesota, reports on such a medication error. According to reporter Megan Matthews, the facility gave another's medication to a resident. The result was death. According to the CEO of Fair Oaks Lodge, Mr. Joel Beiswenger, the medication error and resulting death was "just one of those things that happened. Nobody intended to do anything, and it was the human making the tragic error."  a 

Mr. Beiswenger appears to either honestly miss, or simply ignore, an important point: Similar medication errors have occurred no fewer than two other times at the facility. This facts leads me to question whether Mr. Beiswenger or Fair Oaks Lodge have taken adequate steps to find the root cause of such errors. Was the facility adequately staffed for the number and acquity of the residents? Was the staff adequately trained to ensure medications were given only to the proper resident? Were there safeguards in place to prevent a medication error which led to a resident's death?

If you are a resident of a nursing home or assisted living facility, make sure the medications you receive are, in fact, your own. Make sure you receive them in the correct dosages at the proper times. The life you save may be your own. If you are the family member of a nursing home or assisted living facility resident, make sure the facility takes adequate precautions to prevent medication errors. Such medication errors can and do occur and, as demonstrated by the incident at Fair Oaks Lodge, the results can be catastrophic.

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The Idaho Department of Health and Welfare, Bureau of Facility Standards is the state agency that conducts "surveys" of Idaho's nursing homes to make sure they are in compliance with all applicable federal and state regulations. It may surprise you that in the most recent survey available, for the period of January through June 2009, there were seven (7) citations issued for facilities who hired staff "guilty of abuse." Although this may not seem like a large number of citations, remember two things: (1) This survey was for a six month period; and (2) There were only 64 surveys conducted.

What drives facilities to make such an egregious and potentially harmful hiring decision? First and foremost, facilities often do not conduct appropriate and thorough background checks on applicants. Second, many facilities do not pay for quality staff and, thus, they "scrape the bottom of the barrel" of the employee pool. Third, some facilities simply need to "fill the void" when existing staff leave and may believe that some staff is better than no staff. Of course, none of these "excuses" for hiring staff "guilty of abuse" are "reasons" for substandard hiring practices.

Before choosing a nursing home, make sure you ask the appropriate administrator what type of background checks are conducted on potential employment candidates. Also ask if the facility has received any citations from the Idaho Department of Health and Welfare's Bureau of Facility Standards. If the facility has received any citations, ask to see them and what the facility did to correct its conduct.

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According to a December 12, 2009, online article by Jeffrey Wolf and Kevin Torres of Colorado's 9news.com, 87 year old Eldon Foster "strayed away" from his assisted living facility in the freezing temperatures and, ultimately died of exposure. What is shocking is that Mr. Foster was found by an employee of the facility and returned to his bed; he did not die in the outdoors.

The circumstances of Mr. Foster's death are, indeed, tragic. Mr. Foster had been diagnosed with Alzheimer's disease. According to the article, Mr. Foster wandered away from the facility, wearing only a T-shirt and his underwear,at around 2:30 a.m.; the temperature outside was 3 degrees Fahrenheit. The aide found him Mr. Foster lying on the sidewalk "about 15 feet from the door" with a cut on his head. Instead of calling 911, however, she simply assisted Mr. Foster back to his bed. The aide checked on Mr. Foster again after about an hour; he was unresponsive. Only then did the aide call 911.

Although the owners of the assisted living facility say this was a tragic "accident that could have been prevented," because of the facility's policies, what is more telling is the fact that the aide had worked for the facility "on and off for nine years." This fact leads me to believe the aide was simply not properly trained to perform her job. If the facility had properly trained her, there would have been no doubt in the aide's mind about what needed to be done when she found Mr. Foster. I am sure the assisted living facility, no doubt, conducted a training session immediately after this tragedy. Unfortunately, for Mr. Foster and his family, that training came too late.

If you or a family member is a resident of an assisted living facility or nursing home, be sure to ask about the training staff receives concerning the facility's policies and procedures. This not-so-gentle reminder may lead to proper training of the staff and, ultimately, save a life.

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With all the news about H1N1 "Swine Flu," focus has turned to methods to protect ourselves from becoming infected. The Swine Flu is serious, no doubt, but the methods for protecting yourself from becoming infected with the Swine Flu apply to ensuring you are not infected by just about any similar contagious disease.

RISKS OF BECOMING INFECTED WITH THE FLU VIRUS

According to the Centers for Disease Control and Prevention (CDC), although people 65 years old and older are least likely to become infected with the H1N1 Swine Flu virus, if such a person does get infected, they are at "high risk" to develop serious complications from the virus. Additionally, the CDC believes those 65 years and older are at "increased risk" for serious complications from the seasonal flu as well. As a nursing home or assisted living facility resident, how can you protect yourself? Simple, wash your hands and make sure all those who come in contact with you do the same.

PROPER HANDWASHING IS A SIMPLE AND EFFECTIVE PREVENTATIVE MEASURE

The CDC believes: "Handwashing is a simple thing and it is the best way to prevent infection and illness." Although handwashing seems like a simple process, which all of us have seemingly been doing since we were 2 years old, the CDC provides the following guidelines for effective and proper handwashing:

When washing hands with soap and water:

• Wet your hands with clean running water and apply soap. Use warm water if it is available.
• Rub hands together to make a lather and scrub all surfaces.
• Continue rubbing hands for 15-20 seconds. Need a timer? Imagine singing "Happy Birthday" twice through to a friend.
• Rinse hands well under running water.
• Dry your hands using a paper towel or air dryer. If possible, use your paper towel to turn off the faucet.
• Always use soap and water if your hands are visibly dirty.
• If soap and clean water are not available, use an alcohol-based hand rub to clean your hands. Alcohol-based hand rubs significantly reduce the number of germs on skin and are fast-acting.

When using an alcohol-based hand sanitizer:

• Apply product to the palm of one hand.
• Rub hands together.
• Rub the product over all surfaces of hands and fingers until hands are dry. 

A simple and effective method of ensuring people wash their hands is to purchase a container of alcohol-based hand sanitizer and put it on a table in your room. Do not be shy about asking people to use it! It is up to you to make sure people who come into your room wash their hands.

Protect yourself from infection by making sure those who come in contact with you, whether they be staff caring for you or friends and family visiting you, wash their hands. The alternative, becoming infected with a contagious disease to save a few minutes of time just is not worth the risk. 

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