Nursing Home Abuse Advocate

Overmedication Of Assisted Living Facility Resident Is Homicide

John R Kormanik — Thu, 04 Jun 2015 15:47:06 +0000

At Kormanik Hallam & Sneed, LLP, we see our fair share, which is to say, too many, cases of overmedication of assist living and nursing home residents. Not too long ago, an article in the Chicago Tribune was noteworthy because of the conclusion of the medical examiner, who ruled the resident’s death a “homicide.”

According to the article written by Tara Kadioglu, Dorothy Byrd’s death was caused by morphine and hydrocodone toxicity, combined with hypertensive and atherosclerotic cardiovascular disease. Her death was, apparently, suspicious because she “died the day after six residents of Holland Home for unknown causes.” Two of those residents eventually died as well. Ms. Byrd was a resident of Holland Home, an assisted living facility owned by Villa Care, whose slogan is “Service with Dignity, Staffed with Love and Managed with Care.” A spokesperson for the company indicated it was fully cooperating with law enforcement. According to another source, three employees, a nurse and two nursing assistants, were fired.

Ms. Byrd’s death is tragic regardless of whether it was due to a criminal act – someone purposefully giving her a lethal overdose of medication – or because of negligence. These types of incidents, even those which result in death, are indeed properly classified as homicides. Facilities must do more to protect those left in their care.

If you believe someone you know who is a resident of an assisted living facility or nursing home has been overmedicated, contact: (1) the resident’s physician; (2) the facility administrator; and (3) law enforcement. You may also want to consider contacting an attorney versed in these types of cases.

Overmedicating Nursing Home Residents – Part 1

John R Kormanik — Tue, 16 Dec 2014 17:31:40 +0000

Recently, National Public Radio (NPR) has done a series of stories on the problem of overmedication of nursing home residents and what some facilities are doing right in this area. I thought I’d take the opportunity to share with you these stories, give you the links to the themand the audio of the original stories so you can be educated on this very serious issue. Part 1 of this series of posts deals with a story titled: “Old and Overmedicated: The Real Drug Problems in Nursing Homes,” reported by Ina Jaffe and Robert Benincasa.

A brief refresher: According to Bradley Williams, who teaches pharmacy and gerontology at the University of Southern California, “antipsychotics should only be used as a last resort, and just for a month or so, before gradually being eliminated.” Professor Williams also told NPR antipsychotics “blunt behaviors. They can cause sedation…[and] increases [the]risk for falls.” Commonsense, right?

What I found most shocking about this story was not the fact over 300,000 nursing home residents are still being overmedicated by facilities using drugs which are not supposed to be used to treat Alzheimers. After all, I posted in September 2014 and October 2014 about this issue. What shocked me was the total disregard the physicians who worked for the nursing homes had for their patients’ rights.

Jody Moore, a California attorney who specializes in elder law, was interviewed by NPR as well. Ms. Moore brought a class-action lawsuit against a nursing home for using chemically restraining its residents without informed consent. “Informed consent” means the patient or their decision-maker is fully informed of the risks and benefits of a medical procedure, including the prescribing of antipsychotic medications. Indeed, the law requires a nursing home facility to obtain informed consent. According to Ms. Moore: “We learned that the families really weren’t told anything other than, ‘The doctor has ordered this medication for you; please come sign a form,’ ” says Moore. “And families did.” During the lawsuit, Ms. Moore had the chance to question a physician under oath about informed consent and whether his practice was to get it from the resident or resident’s medical decision-maker. The doctor…that’s right…the DOCTOR, testified: “not only do I not get informed consent, but I don’t know of any doctor who does, and you’re crazy to think that that’s my job.” NOT YOUR JOB??!! I’m sorry to tell you, sir, but it is your job. Of course, the facility settled the lawsuit.

At the end of the day, residents need to protect themselves. If they cannot, loved ones must do so. You must demand nursing home residents are protected and appropriately cared for. If you believe you or a loved one is being chemically restrained, or is being given antipsychotics improperly, inform the facility of your concerns, in writing. Contact the state Ombudsman and the Idaho Department of Health and Welfare. And, finally, if you are so inclined, contact Kormanik Hallam & Sneed LLP for a consultation.

California Enacts A 100-Fold Increase In Assisted Living Facility Fines…That Just Tells You The Fines Were Too Small To Begin With

John R Kormanik — Mon, 27 Oct 2014 15:52:22 +0000

In a recent San Diego Union Tribune article, Deborah Schoch noted California has just raised the fine the state can impose for violations which cause the death of an assisted living facility resident 100-fold. Sounds GREAT…doesn’t it? Well, dig a little deeper and you’ll find although it is a remarkable increase…the reason is that the fines were so low to begin with. Prior to the enactment of the current law, the most the State of California could fine a facility when it caused the death, thorough abuse or neglect, of a resident was $150.00. Unbelievable! Now, California can fine a facility $15,000.00. While that is a more respectable number…is it really enough?

In Idaho, according to the most recent Idaho Department of Health and Welfare regulations, the fines imposed on assisted living facilities are tied to the number of beds and the length of the alleged violation. Also, if the violation “places the health or safety of its residents in danger,” the state has the ability to remove all residents from the facility and appoint temporary management.

At the end of the day, it us up to the families of assisted living facility residents to protect the resident’s safety. If a resident dies due to abuse or neglect in an assisted living facility, the family should contact an attorney to be sure just compensation is obtained.

Big Pharma – Follow Up

John R Kormanik — Mon, 13 Oct 2014 16:18:31 +0000

In a recent post, I wrote about how “Big Pharma,” or pharmaceutical companies, have been pushing antipsychotic medications on nursing home residents as a method of making individuals who suffer from dementia more “manageable” for facilities who don’t have adequate staff or properly trained staff. Apparently, nursing homes are worried about the bad publicity.

In an article in The Hill: “Nursing homes are promising to reduce their use of antipsychotic medications on dementia patients 25 percent by 2016 and 30 percent by 2017.” The questions are: (1) Is that “enough” of a reduction; and (2) With the amount of money involved, can we actually trust the nursing home industry to make the cuts?

The Hill article quotes Patrick Conway, chief medical officer with Medicare and Medicaid: “We know that many of the diagnoses in nursing home residents do not merit antipsychotics, but they were being used anyway.” If even one redident suffereing from dementia receives antipsychotic medication in an effort to control their behavior…that is too many. Shouldn’t the goal be “Zero tolerance”?

The amount of money made by Big Pharma in this area is staggering. My original post mentioned the $2.2 billion fine leveled by the federal government against Johnson & Johnson in 2013 for pushing antipsychotics to nursing homes to use on residents suffereing from dementia. Although not mentioned in my original post, this was not the first time Big Pharma had been fined. In fact, the AARP reports: “Back in 2009, Eli Lilly did the same thing with its antipsychotic Zyprexa, marketing to older people in nursing homes and assisted living facilities, federal prosecutors charged. In a settlement, the company agreed to pay $1.4 billion. At the time, Patrick Doyle, special agent in charge of the Office of Inspector General for the U.S. Department of Health and Human Services in Philadelphia, said: “This case should serve as still another warning to all those who break the law in order to improve their profits.”

I may have a very jaded view, but here it is: There’s simply too much money to be made by Big Pharma for companies to give up this lucrative albeit illegal market. A $1.4 billion fine on a competitor wasn’t enough of a fine to prevent Johnson & Johnson from going down this path. Big Pharma is in the business of making money…the companies will do anything to improve their bottom line.

I do not expect this is the last you will hear from me about this issue.

Idaho Nursing Homes Are More Dangerous Than Last Year

John R Kormanik — Mon, 06 Oct 2014 16:51:00 +0000

Families for Better Care is a “non-profit citizen advocacy group dedicated to creating public awareness of the conditions in the nation’s nursing homes and other long-term care settings and developing effective solutions for improving quality of life and care.” According to Families, Idaho no longer ranks in the top-ten states for nursing home care.

Families “Nursing Home Report Card” uses data compiled by the Kaiser Family Foundation, performance measures utilized in Medicare and Medicaid’s Nursing Home Compare and the Office of State Long-Term Ombudsman complaint data. Basically, Families looks at lots of data and comes up with letter grades for the states. This link will take you to the page describing exactly how Families does its evaluation.

Let’s look at Idaho’s Report Card. In 2013, Idaho received an overall grade of “A” and was in the top ten states in the nation with a rank of 8th. In 2014, Idaho receives an overall grade of “B” and therefore is no longer in the top ten states, instead, Idaho now ranks 15th in the nation.

I think Families’ most disturbing findings are that “Severe deficiencies in Idaho nursing homes swelled 11 percent over the last year, pushing the number of potentially dangerous nursing homes to nearly one in every two” and “Verified ombudsman complaints increased 10 percent over the previous year, indicative of growing problems in nursing homes.”

What does this say about Idaho nursing home facilities? It says they are not as safe as they were. If you or a loved one is injured in an Idaho nursing home or assisted living facility, consider contacting the attorneys of Kormanik Hallam & Sneed LLP to discuss your potential options.

Surveillance In Nursing Homes: Shouldn’t The Facility Foot The Bill?

John R Kormanik — Mon, 29 Sep 2014 16:14:00 +0000

A recent article by Wes Venteicher in the Chicago Tribune caught my eye. The story is about some legislation in Illinois, which, if enacted, would allow cameras or audio recording devices in nursing home resident’s rooms, if the resident consents and the cost is covered. The legislation would also allow the recordings to be used in court and would include penalties for anyone who tried to obstruct or disable the device.

Illinois Attorney General Lisa Madigan announced the legislation and is quoted as follows: "The work that I have done … as attorney general has unfortunately proven that too often when our loved ones are in a nursing home they are not always safe and they are not always well cared-for."

My question is this: If the nursing home or assisted living facility is responsible for providing a safe and caring environment…why should the residents or their families bear the cost of monitoring? It doesn’t seem appropriate to shift the cost away from the facility to the family who, quite frankly, may not be able to bear the cost. What do you think?

Three Key Signs Of Nursing Home Abuse

John R Kormanik — Mon, 22 Sep 2014 16:46:41 +0000

I am constantly reminded that abuse of nursing home residents is a significant problem. This post serves as a great reminder to all those who have loved ones or friends in nursing home facilities: There are at least three key signs of nursing home abuse:

Bedsores. Bedsores, or "decubitus ulcers," are NOT normal, no matter how bedridden a nursing home resident is. Unless a doctor indicates bedsores are unavoidable, which should never be the case, a person who enters a nursing home or other facility without bedsores should not develop them during their time in the facility. Bedsores can lead to serious infection and even death.

Unexplained Injuries. Skin tears, bruises and fractured bones may be caused by inadequate care or physical abuse. Careless transport to and from bed is often the culprit as is physical abuse. Improper or inadequate staffing levels oftentimes lead to these types of injuries.

Inexplicable Depression. Mental abuse doesn’t leave any physical marks, but is nevertheless a problem in nursing home facilities. When a resident is spoken to in belittling, derogatory, intimidating or disrespectful ways, this constitutes mental and emotional abuse.

If you have a loved one or friend in a nursing home facility, please be alert to these signs and symptoms of abuse. Oftentimes, nursing home residents can’t protect themselves let alone communicate abuse is occurring. It is up to all of us to be alert.

If you suspect your loved one or friend is the victim of abuse, contact the administrator of the facility, law enforcement and the state authorities. If an attorney is needed, please consider Kormanik Hallam & Sneed.

If A Coroner Is Called To A Nursing Home Following A Death, Will More Cases Of Abuse Or Neglect Be Found?

John R Kormanik — Thu, 23 Sep 2010 14:14:59 +0000

The Lexington Herald Leader (Kentucky) is reporting on a proposed law which would require the coroner whenever a resident passes away. The thought behind the law is pretty simple: If a coroner is called, it is much more likely deaths which result from abuse and neglect will be discovered and appropriately prosecuted. Seems to make sense, doesn’t it?

After reading this article, I researched Idaho law to see if we were ahead of Kentucky. Much to my chagrin, Idaho is not. In the State of Idaho, there are only three instances which mandate a corner be called to the scene of a death: (1) death occurring as a result of violence; (2) death occurred under suspicious or unexplainable circumstances; and (3) the death of a child in certain circumstances. Of course, in any case where a coroner is required to be called, the scene must be preserved in order to allow the recovery of evidence.

I have to wonder, if Idaho was to amend the law to mandate a coroner be called in the event of a nursing home resident’s death, would more nursing home abuse and neglect be discovered? The answer is virtually certain to be "yes."

If this subject interests you, I urge you to contact your state legislator to discuss it with them. Rest assured, I will be doing the same in advance of the 2011 legislative session.

Are Idaho’s Certified Family Homes Safe?

John R Kormanik — Fri, 17 Sep 2010 18:05:34 +0000

In an alarming article in the Seattle Times, Michael J. Berens reported that "over the past five years, at least 357 of the adult family homes in [Washington] have concealed cases of abuse or neglect of their residents. Many of those cases involved serious injury or death." Mr. Berens’ report tells the story of Audrey Hopkins, "a stroke-and emphysema-hobbled 68-year-old who had lived in the TLC Adult Family Home for six months at the time of the March 2007" event where she was badly burned. It seems Ms. Hopkins was smoking a cigarette which set fire to the oxygen delivery system she was utilizing. The problem according to the article: Ms. Hopkins would have been physically incapable of lighting her own cigarette. Additionally, it was later discovered the staff had lied to investigators concerning how Ms. Hopkins obtained her cigarette, lit it, and the fact she was on oxygen at the time.

In Idaho, we have similar facilities known as "Certified Family Homes" which provide a family-styled living environment in which 2 or fewer adults live who are not able to reside in their own home and who require care, help in daily living, protection and security, supervision, personal assistance and encouragement toward independence. Residents of such "family homes" have many of the same rights as those who reside in assisted living facilities and nursing homes. These homes are regulated by the Idaho Department of Health and Welfare.

Let’s hope the IDHW is doing a better job policing Idaho’s certified family homes than the State of Washington is. You cannot count on that fact in these difficult economic times. It is up to you to research any facility to which you are going to trust your care or the care of a loved one.

Update to “Yes, Elder Abuse Happens…Even In Idaho”

John R Kormanik — Thu, 08 Jul 2010 14:00:00 +0000

Back in January 2010, I wrote about the tragic death of Verda Nicks. Recall, Ms. Nicks was found because of the actions of a friend who was unable to get hold of Ms. Nicks. Unfortunately, Ms. Nicks was found emaciated and immobile on a urine-soaked bed in a house filled with feces, files and an unbearable stench. She died about six weeks later. Ms. Nicks’ adult sons, David and Danny Nicks were charged by the Canyon County Prosecutor with felony criminal neglect in their care of their mother. The brothers were to be tried separately.

According to Kristen Rodine’s article in the Idaho Statesman, on May 5, 2010, David Nicks was found guilty. According to the Statesman, David Nicks’ attorney, Bill Schwartz did not call any witnesses for the defense during the two-day trial. Instead, Mr. Schwartz argued his client was not a "caretaker" and, thus, not responsible for the conditions, which he admitted were terrible. The jury didn’t buy it and took less than 2 hours to deliberate and reach their unanimous guilty verdict. David Nicks plans to appeal.

Now it is Danny Nicks’ turn. His trial is to begin on Monday, May 24, 2010. Mr. Schwartz is also Danny’s defense attorney. Stay tuned for the result of this case.

Although there has been a conviction in this matter, Ms. Nicks’ death remains a tragic tale. It also serves as a reminder to all of us to check on our elderly neighbors and friends to make certain they are well. Who knows, perhaps Ms. Nicks’ life could have been saved if the authorities had been notified sooner.

UPDATE – According to a story on KTVB.com, Danny Nicks has pled guilty to one count of felony neglect. Mr. Nicks’ guilty plea came on the second day of his second trial. His first trial resulted in a mistrial due to a deadlocked jury. The story indicates appeals of the convictions will follow. I will keep you posted on the appeals; such things, however, take quite a bit of time.