Nursing Home Staff

Read full Chicago Tribune article here:

Level of Nurse Staffing

At least one adequate measure for evaluating the quality of care provided by nursing homes is the “level of nurse staffing.”  Nurse staffing should be measured both in terms of the quality of the staff as well as the sheer numbers of the staff.  Unfortunately, unlike the home in this article, nursing homes frequently cut corners with the level of nurse staffing—all to maximize profits.

To provide proper care, nursing homes must hire competent staff—from nurse aides to registered nurses to nursing home directors or administrators.  In the course of our nursing home litigation practice, we routinely encounter unqualified staff charged with the duty to provide skilled care to residents:   Nurse aides with little or no experience and training, and registered nurses who repeatedly fail to train, or even communicate with, these nurse aides. 

This is a critical failure for many nursing homes.  Nurse aides are the ones that provide the majority of daily care for residents.  And as such, it is imperative that the charge or floor nurses appropriately train and communicate with these aides.  For instance, consider the all-to-common nursing home resident at risk for pressure sores or ulcers.  It is the nurse aide who has the responsibility to re-position and appropriately turn the residents every one to two hours.  The re-positioning of residents at risk for pressure sores is a key component of care to avoid such sores.  When the aides are inept or not properly trained, or where the charge nurses fail to instruct or otherwise communicate with aides on their re-positioning responsibilities and techniques, nursing home residents inevitably suffer severe and debilitating skin wounds.

The same is true regarding the numbers of staff employed.  Many nursing home companies repeatedly save money by limiting the numbers of nurses and nurse aides to staff their nursing homes.  This is a critical omission of care in exchange for increased corporate profits.  The nursing staff is charged with responsibilities of providing all-encompassing care for residents, including assisting residents with their activities of daily living, such as bathing, feeding, dressing, etc.  This same limited staff, as mentioned above, is responsible to provide care to avoid future injury or harm, such as frequent re-positioning to prevent pressure sores.  Where limited staff are charged with these responsibilities, the unfortunate outcomes are predictable.

For more information about Nursing Home Abuse and Neglect, contact our office today or call 800-594-7433

If you are considering a nursing home for a loved one, you must certainly consider the level of nurse staffing.  One helpful source on this point is Medicare website:  http://www.medicare.gov/NursingHomeCompare/About/Whatis/What-Is-NHC.aspx. 

Read full Chicago Tribune article here:

"Tort Reform” Laws Further Harm Long-Term Care Residents

A Wisconsin tort reform law passed two years ago made state inspection reports of nursing homes and other health care facilities inadmissible as evidence in civil and criminal cases. Proponents of the law say it lets providers discuss problems more openly, but critics argue it puts the elderly and vulnerable at risk. This woman, whose family asked that she not be identified, was a resident at a Sauk City nursing home. / Lukas Keapproth/WCIJ

This is a story that is all too common for long-term care facilities and those individuals who have entrusted their care to such facilities.  As described in the article, Joshua Wahl has spina bifida, is brain-injured and is paralyzed.  He was living at a group residential home in Wisconsin, where he was found to have a half-dollar size bedsore sore.  It developed into a huge crater—to the point that his skin, fat and muscle had rotten away.  And the wound was contaminated with feces.  Due to the severity of the injury, Joshua may be permanently bed-ridden now.  

As part of a formal investigation, the Wisconsin health department determined that Joshua had the bedsore for four (4) months before being hospitalized.  But because of new laws signed by Governor Scott Walker, Joshua Wahl and his attorneys are completely barred from using any part of the State’s investigation in a civil or criminal prosecution against the facility.  The laws were passed as part of “tort reform”—admittedly designed to protect the businesses, at the expense of severely injured long-term care residents like Joshua.

The Long-Term Care Industry has supported these and related tort reform laws all across the country, including Illinois.  In an attempt to justify these laws, proponents contend the laws are required to eliminate frivolous lawsuits against responsible and conscientious businesses.  But there is absolutely no truth to this contention.  These tort reform law are nothing more than a governmental shield and “cover” for the negligence and improper care provided by these facilities. 

Consider Joshua’s circumstances.  Because of the facilities improper care—and worst, the intentional concealment of that improper care—Joshua suffered significant harm and disability.  Can  anyone honestly argue that Joshua’s claim is frivolous?  Or can it be argued that the facility here was acting responsible in concealing his injuries?  This is not a frivolous claim.  In Joshua’s case, as in most cases, these tort reform measures further harm the innocent, while affirmatively protecting the perpetrators.

Indeed, the contention that this particular law will prevent frivolous lawsuits is likewise ludicrous in light of the very nature of such state health investigations.  If a claim is frivolous, then there will be no state health investigation finding that a facility provided neglectful, improper, or sanctionable care.  Accordingly, it is difficult to even imagine how there could be an isolated, damaging investigative report in relation to a frivolous claim.  Simply put, that just does not happen.

Moreover, such investigations routinely provide crucial pieces of evidence for victims of such facilities who cannot, or are unable, to testify to the circumstances of their injuries.  To withhold such evidence from innocent vicitims is plainly unjust.

Bottom line:  Be wary of the tort reform argument.  Such laws are specifically designed to limit your right to fully and fairly prosecute your case.  Nothing more, nothing less.

For more information please call our office toll free at 800-594-7433 or visit our WEBSITE.

Read full article HERE

Lost Nursing Home Resident Found Safe

In Illinois, a “lost” nursing home resident was recently found.  Fortunately, the resident was safe and unharmed.  But that begs the question:  

Why was the resident—a known dementia patient—allowed to wander off?  

The answer likely lies with the lack of care required of such residents.

As our population finds itself increasingly growing older, many of the elderly are forced to turn to nursing homes for long-term care.  In looking to nursing homes, potential nursing home residents present with a variety of physical maladies and cognitive limitations.  And the cognitive limitations of such individuals can be considerable, including conditions such as advanced dementia or Alzheimer’s, obviously requiring specialized and appropriate care.  To provide the needed care for such nursing home residents, nursing homes must be committed to serving these residents—both with qualified staff and a financial commitment.

There are numerous nursing homes within the State of Illinois, but some are more equipped, and some less equipped, to deal with the challenges of caring for the cognitively impaired resident.  And while many nursing homes claim they are capable of caring for such residents, that is simply not the case.  Many of these nursing homes simply do the not have the staff, either in numbers or qualifications, to care for the mentally impaired.  Additionally, providing the appropriate care for such residents is not limited to having the sufficient numbers of qualified staff; appropriate care also requires having in place the physical equipment and security devices to ensure that all such residents will remain safe.

Under Illinois law, nursing homes must provide to each resident the “individualized” care the resident requires for his or her well-being and safety.  And this individualized care certainly includes care specifically designed to care for the cognitively impaired resident.  If a nursing home fails to provide such care, it is in violation of the Illinois Nursing Home Care Act (210 ILCS 45/1 et seq.)

If you have concerns for a famility member that is in a nursing home please call our office today. 800-594-7433 or send us a confidential inquiry. 

Details in Article

Sign of Nursing Home Abuse and Neglect

Since the residents of a nursing home often are unable to fully communicate it is important to know what signs of physical, emotional, and verbal abuse and neglect to look for whenever you visit your loved one.

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• Signs of Neglect

• Dehydration, malnutrition, and bed sores
• Lack of personal hygiene, food, clothing, or shelter
• Unsanitary and unclean conditions
• Infections

Signs of Physical Abuse

• Unreasonable physical restraint
• Over-medication
• Open wounds, cuts, bruises, or welts
• Slapping, pushing, shaking, or beating
• Unexplained injuries

Signs of Verbal and Emotional Abuse

• Emotionally upset or agitated
• Extremely withdrawn and non-communicative
• Unusual behavior (sucking, biting, rocking)
• Humiliating, insulting, frightening, threatening or ignoring behavior towards family and friends
• Wanting to be isolated from other people

For more information about Nursing Home neglect and abuse please go to our website 

or call 800-594-7433

She Took Care of Us . . .

Frequently Asked Question

Declining Strength is a Call-To-Action!

Question:
My mother’s physical strength has changed, but it doesn’t seem that the routine of care is keeping up. Can I request more?

Find the answer HERE or read below.

Answer:
Yes…and you should.

Changes to a patient’s overall physical strength, which is often associated with a decrease in activity after entering a skilled nursing facility, can be responsible for a vast array of preventable medical issues and contributing factors in declining health.
Sudden weakness (typically relating to one side of the face and/or body) can suggest a more emergent problem, such as a stroke, and requires immediate intervention and evaluation by a physician.

Progressive weakness however, while not life-threatening, can lead to bed sores, pneumonia, bowel obstructions, urinary infections and other conditions that pose a threat of infection; often severe and indeed, life-threatening. In most cases, these infections can be easily prevented.

A physically-regressive individual will often experience an increased level of depression and loss of appetite, contributing further to an overall decline in physical and mental health.

Family members should begin a “diary” if you will, when a loved one first enters any level of skilled nursing or long-term care environment. They should ask for an opportunity to view and discuss the Minimum Data Set of functional measurements, which must be (by law) evaluated within 14 days after admission. The MDS should also state the level of care and supportive measures to be applied at that time.

Skilled nursing and long-term care facilities are required to review MDS assessments every three months, and completely re-assess patients every 12 months …or, promptly after a significant change in their physical or mental condition. You can, and should request a reassessment now.

Questions that you need to ask include, but are not limited to:

• What type of scheduled daily physical activity does your mother receive?
• Who provides that care?
• What extra steps are taken to ensure her physical safety during exercise?
• What extra steps are taken to ensure her safety during trips to the bathroom, the dining hall (if available), and getting in and out of bed while in a weakened state?
• How often is she assisted with re-positioning while in bed, a chair, a wheelchair …to prevent the risk of pressure sores (bed sores)?
• Has her fluid intake been increased to prevent dehydration, or measured, and if so, ask to view such documentation to record in your diary.
• What changes are being made to her diet to promote muscle strength?
• And most importantly …what medications are being administered; how much and how often? WRITE IT DOWN!

When patients show signs of depression (physical or mental), ongoing research and investigations are revealing that many are being over-medicated, either by design to keep patients quiet and still (requiring less hands-on care for reduced staffing levels), or simply because the administering and documentation policies of the facility are weak, resulting in double (sometimes triple) dosing by different staff members.

Know what medications your mother is taking and request (in writing) to be notified when any changes occur …either to the dose of a current medication, or the addition of a new medication. If you have questions regarding medications, discuss them immediately with the physician in charge of her care. It is also important to request to see verification of the record for written orders; documentation that a physician ordered the change/addition of a new medication. What date was it ordered and why?

Decreased physical strength and changes in mental alertness should never be dismissed as a normal and expected part of the aging process without a complete evaluation of cause.

Residents of facilities that make physical activity (at various levels, even for bed-ridden patients) a priority with support systems and staffing levels in place, experience better overall health, strength, and mental agility with greatly reduced risk factors associated with unnecessary and dangerous infections.

Unfortunately, our system of care today demands that family members stay active, aware and informed with detailed records of their own to support increased levels of care if needed.

A Little Advice...