Maryland Nursing Home Lawyer Blog

Rating Nursing Homes—The Five-Star Quality Rating System

December 1, 2009 | Lebowitz & Mzhen

In a previous post from this week, our Maryland Nursing Home Attorneys reported on basic planning tips for families searching for the right nursing home environment that promotes proper care, protects the health and safety of the resident, and is free from nursing home neglect and abuse.

One recommendation was for families to search Nursing Home Compare, the database from the from the U.S. Department of Health & Human Services’ Centers for Medicare and Medicare Services (CMS), that ranks around 16,000 Medicare and Medicaid-certified nursing homes in the country on a Five-Star Quality Rating.

The Five-Star Quality Rating was developed to help residents, families, and caregivers compare nursing facilities by giving them a snapshot of the current status of health inspections, staffing for each nursing home, and quality measures. This rating system developed as a direct result of the continued efforts made since the nursing home reform law enacted in 1987, the Omnibus Reconciliation Act (OBRA ’87).

The Nursing Home Compare Website uses this quality rating system to give each nursing home a score ranging from one to five stars. One star gives a much below average quality ranking, whereas a five star rating gives a much above average quality ranking.

Home vs. Hospital—Basic Planning to Choose the Right Nursing Home Care

November 30, 2009 | Lebowitz & Mzhen

Our nursing home attorneys have been following a recent report covering the importance of choosing a nursing home in the Maryland and the Washington D.C. area. Choosing a nursing home should be a carefully thought out process, carried out by family members who have a clear sense of the patient’s wishes. Unfortunately, families often have a limited amount of time in which to make this decision, often 48 hours or less—when a family member is about to be discharged from the hospital, and is on the path to needing nursing home care.

The report recommends basic planning tips from experts, so that families on deadline can make the right choice and find the right nursing home environment that provides proper care, promotes resident rights, and is free from nursing home neglect and abuse.

Sarah Wells, the executive director of The National Consumer Voice for Quality Long-Term Care (NCCNHR), a Washington-based nonprofit organization that represents consumers looking for long-term care, stressed the importance of discussing nursing home care expectations—if a family member becomes unable to care for themselves at any state or age of life—so there is a clear understanding of the resident’s preferences and priorities. Wells suggested talking about the most important issues of the nursing home care experience, like meals, music, proximity to family members, and visitor accessibility.

Because many important long-term care nursing home decisions are made in a matter of days and not weeks, many decisions become chaotic and hasty. Families are encouraged to use resources like the federal government’s Nursing Home Compare Website and state nursing-home ombudsmen for advice and data. Wells recommends that families should try and visit a nursing facility at lease twice, and compare the ratings and reports to what they actually experience.

Nursing Home Worker Charged with Neglect and Force-feeding

November 24, 2009 | Lebowitz & Mzhen

In a recent nursing home abuse case that our Maryland attorneys at Lebowitz and Mzhen Personal Injury Lawyers have been following, a 56-year mentally disabled resident in Minnesota was physically abused by being force-fed against her will.

According to a Fox 9 News report, an employee from the Homeward Bound Group Home was charged last week for allegedly physically abusing the nursing home resident by forcing her to eat against her will. The Minnesota Health Department investigated the case over a period of four months, and concluded that the resident—who is mentally retarded, has cerebral palsy, and swallowing problems—was forced to eat by an employee, even when she was not hungry.

According to the Minnesota Health Department report, Alemayehu Seboka Abdi, placed his hand on the victim’s head while he would force-feed her, even when she nodded that she did not want food, and tried to stop the employee. He was reportedly seen retelling the story to other employees and laughing about his forceful behavior.

In an incident from May of this year, Abdi allegedly took the woman outside in the cold, wearing only a t-shirt, and forced her to eat— pushing her head back, forcing large quantities of food down her throat with a spoon that was larger than what the resident would normally use to eat. Abdi would then let her head drop forward.

By shaking her head in response to questions asked by investigators, the resident communicated that it was very difficult to breathe during the force-feeding. Because she had swallowing difficulties, she claimed that it was necessary for her to take small bites to eat. She told investigators that the physical abuse left her feeling scared, upset and sad for a week.

Negligence Lawsuit Demands Nursing Homes Install Patient Care Devices

November 17, 2009 | Lebowitz & Mzhen

In recent nursing home patient safety and technology news, our Maryland Nursing Home Abuse and Negligence Lawyers have been following the required development of electronic point-of-care devices, to be installed in Vestal Nursing Center, along with eight other nursing homes in New York. This nursing home healthcare technology development was as part of a deal made with the state Attorney General’s Office, after 14 employees were convicted of criminal charges for falsely testifying that they had provided appropriate care to patients—and were caught on a surveillance camera doing otherwise.

In 2005, Feliz Ortiz suspected that his father, a dementia patient resident at the Rochester nursing home wasn’t getting the proper care he deserved. His family was visiting him every day, and suspected serious nursing home abuse and neglect. After the state Department of Health checked the records of his care and suspected that the records were doctored, the state Attorney’s Office installed a hidden surveillance camera in his father’s room—to investigate of the level of care being provided.

The video results corroborated with Ortiz’s suspicions—his father wasn’t being turned every two hours to prevent bed sores, wasn’t being hydrated properly, and was left for hours on end lying in his own waste, while the nursing home caregivers claimed to be treating him properly. Employees were found allegedly sleeping, smoking, watching movies and not providing the promised nursing home care.

Point-of-care technology uses electronic devices to record services at health-care facilities, like the turning of a bed-ridden patient and the dispensing of patient medication in actual time. The new system of technology will also allow the nursing home caregivers to record information about the residents in their rooms, instead of having to walk back and forth to the nursing station—a process that will save time spent on paperwork, and give more time to the patients.

Electronic records will then be created for patients’ medical charts with the necessary information that can be easily accessible in the future after the implementation of electronic medical records occurs—where patient information for doctor visits, nursing homes, and critical care-facilities are all available electronically.

Nursing Home Negligence Causes Pregnancy—Daughter of Schizophrenic Resident Sues

November 13, 2009 | Lebowitz & Mzhen

As Nursing Home Neglect Attorneys in Maryland, and the Washington D.C. area, we have been following a recent lawsuit, where the daughter of a schizophrenic woman is suing a nursing home for neglecting to take proper care of her mother—who was impregnated under the nursing home’s care.

Tekia Daniels filed a nursing home negligence lawsuit against Monroe Pavilion Health and Treatment Center, after her mother Felicia Daniels became pregnant. According to Daniels, the staff claimed that her mother had engaged in consensual sex, and that many patients have relationships in the center.

Daniels claimed that her mother is mentally unstable, incapable of consent, and unable make decisions for herself—that it is the job of the nursing home facility to protect her from the sexual advances of others and from sexual activity. The lawsuit seeks damages in excess of $50,000.

According to the suit, the long-term residential care facility for the mentally ill has violated the Illinois Nursing Home Care Act by neglecting to prevent a resident or employee from engaging in sexual actions with the patient. Under the act, a resident is not deprived of any of the benefits, rights or privileges guaranteed by law, by the Constitution of the State of Illinois, or the by the Constitution of the United States—based on the status of being a resident of a facility.

Nursing Home Injury and Wrongful Death from Decubitus Ulcer Complications

November 6, 2009 | Lebowitz & Mzhen

In a previous post from this week, our Maryland Nursing Home Abuse and Neglect Lawyers discussed the serious problem of Decubitus ulcers in nursing homes—pressure sores or bedsores that develop when immobile residents go for too long without being moved.

If a decubitus ulcer is not detected, the nursing home injury can become infected and progress to a more advanced stage, causing extensive damage to the deeper structures under the skin. These infections are often very difficult and painful for nursing home residents, as they take a long time to heal, and can cause complications, or even death.

One serious complication that comes from pressure sores is blood poisoning, or septicemia. Many residents also develop osteomyelitis, an inflammation of the bones that is caused by bacteria that enters the body through the open wound and attacks the bone. If not treated, osteomyelitis can spread into the bone marrow and the surrounding joints. The mortality rate for people with osteomyelitis is extremely high.

Treatment of serious decubitus ulcers may include drying out the wound, or surgical debridement, where a surgeon uses a scalpel to remove the dead tissue, bone and fluid from the area around the bedsore, and administers systemic antibiotics to the resident.

Surgical debridement of the bedsore can also be accompanied by ‘flap reconstruction’ to cover the open wound with healthy tissue to avoid infection. The surgery is done to make sure that the skin is free of dead or damaged tissue, to promote healing. This reconstruction is considered a last resort in cases involving advanced stage bedsores, as it has an extremely high complication rate, and recovery from the procedure is often slow and painful.

The Risk of Decubitus Ulcers—Resident Abuse and Negligence in Nursing Homes

November 4, 2009 | Lebowitz & Mzhen

Decubitus ulcers, also known as bedsores or pressure sores, are a serious problem in nursing homes today—a leading cause of nursing home injury that affects nearly one million Americans every year. Decubitus ulcers develop when the blood supply to a resident’s skin is cut off, due to unrelieved pressure on the skin, from staying too long in one position without movement or shifting weight.

All stages of decubitus ulcers are preventable, as long as nursing home residents are provided with appropriate care. Elderly residents in nursing homes who are immobile or confined to wheelchairs are some of the most vulnerable to pressure ulcers, and the frequency of these sores can be seen as an indicator of the quality of care in many nursing home facilities. Many advanced decubitus ulcer cases are often the result of nursing home abuse and neglect, and can end in wrongful death.

According to data from the National Nursing Survey from 2004, one out of ten nursing home residents in this country have pressure sores. Of the study’s 1.5 million nursing home residents evaluated, 159,000, or 11%, had pressure ulcers. Around sixty thousand people die each year from complications of some of the more advanced stages of bedsores.

When residents are left lying or sitting for long periods of time in the same position, their skin begins to break down, and pressure sores can quickly develop. Pressure ulcers commonly develop over bony areas that are close to the skin and are less padded by muscle and fat—like heels, ankles, hips, tailbones, shoulders, elbows, backs, and the back of the head. One small irritation can quickly develop into a crater that is painful, difficult to heal, and can become a life-threatening nursing home injury.

Violence in Nursing Homes—Protecting Elderly Residents from Criminals and the Mentally Ill

October 30, 2009 | Lebowitz & Mzhen

In yesterday’s post, our Maryland Nursing Home Injury Attorneys wrote about the difficulty of maintaining resident safety in nursing homes that take in mentally ill patients and violent criminals. Elderly nursing home residents who are often weak and unable to protect themselves from the violent actions of younger, mentally ill patients.

In the Chicago Tribune’s ongoing reporting on security and safety reform in nursing homes, today’s article recommends a serious overhaul of nursing home operations, to better protect elderly residents in nursing homes from the violence of mentally ill residents and convicted felons.

Nursing homes have become known as “dumping grounds” for young and middle aged individuals with mental illnesses, according to U.S. data and Associated Press interviews. The placement of mentally ill patients into nursing homes in this country has increased by 41% between the years of 2002 and 2008, as well as the incidents of nursing home crime and violence.

The Centers for Medicare and Medicaid Services (CMS), released data earlier this year that nearly 125,000 individuals with mental illnesses like schizophrenia, depression, or bipolar disorder lived in U.S. nursing homes last year—many of whom moved directly into homes from jail cells, shelters and psychiatric wards.

According to the Associated Press, many states are mixing the mentally ill with the elderly because the federal government will help pay for resident care under Medicaid regardless of their age—as long as the nursing home’s mentally ill residents stay under 50%.

Nursing Home Rape Leads to Resident Safety Concerns

October 29, 2009 | Lebowitz & Mzhen

A brutal nursing home assault in Illinois recently shed light on an ongoing problem many nursing homes are facing today—how to maintain resident safety in homes that take in violent mentally ill patients and criminals.

In January of this year, a 69-year old female resident of Maplewood care nursing home in Elgin, Illinois was found crying and terrified in her room, moaning in pain. According to police reports, 21-year old Christopher Shelton, a mentally ill patient from the second floor, had assaulted the woman—raping her, as she begged him to stop.

Although psychiatric patients are not an inherent threat in homes, some residents have criminal records, and if not carefully assessed, treated or monitored, can be a big concern for resident safety. At Maplewood, officials had reserved rooms on the nursing home’s second floor for psychiatric patients—but the separation between floors was not safely protected or monitored.

When Shelton, who suffers from bipolar disorder, moved into the nursing home, he had a violent history including an aggravated battery conviction, as well as other aggression related arrests. According to an article in the Chicago Tribune, Shelton was arrested three times last year for alleged offenses that all included nursing home violence.

Before Shelton entered the home at the end of last year, the facility staff didn’t properly check his criminal background, or listen to the director’s warnings from the previous nursing home on his violent and disturbing behavior. After the resident assault and injury, facility officials told the state investigators that Shelton and the woman had been involved in “consensual” sex—a suggestion that the emergency room staff, the prosecutors as well as the police vehemently rejected.

Unnecessary Drugging in Nursing Homes Threatens Lives of Residents

October 28, 2009 | Lebowitz & Mzhen

As Maryland Nursing Home Injury Attorneys, we have been following the Chicago Tribune article published yesterday about an epidemic of unnecessary and dangerous drugging going on in nursing homes—causing nursing home injury and threatening the lives of elderly residents.

The report details that many vulnerable elderly residents in nursing homes are being given strong psychotropic drugs that they neither need or want—leaving them with dangerous side effects like tremors, severe lethargy, and a high possibility for falls or wrongful death.

This review of more than 40,000 federal and state inspection reports found that a wide variety of nursing homes ranging from high end facilities to run down centers, are in violation for improperly treating patients with psychotropic drugs. The violations included chemical restraint, unnecessary drug administering, dosages exceeding safety standards, and cases where dosages led to nursing home resident falls.

Since 2001, the Tribune identified 1,200 nursing home violations that involved psychotropic medications. These infractions reportedly affected 2,900 residents, although the actual statistics are likely to be far higher, as regulation inspections are only enforced once every 15 months.

Congress passed landmark laws protecting patients from unnecessary drugs in 1987—and since then, it is unlawful for facilities to give psychotropic drugs to patients without a doctor’s orders, patient’s consent and treatment justification.