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Last year, Jehl Law Group represented the family of a nursing home resident, who was neglected so badly that she developed pressure sores on her foot that were bone-deep. The condition of her foot was ignored. Eventually, the wounds became infected with multiple bugs that are found in fecal matter, and her leg had to be amputated. She passed away two months later.

The nursing home, its owners, and their attorneys were responsible for multiple continuances of the trial, but after years, our clients finally got their day in court. Following a five-week trial where nursing home employees testified to chronic short-staffing and fraudulent record-keeping, a jury of twelve people from Shelby County awarded our clients approximately $2,000,000 for their mother’s injuries, pain, and suffering. The jury also determined that the nursing home and its owners had acted so badly that they needed to be punished to prevent them from behaving like this again. After seeing how much money the owners made each year from their terrible behavior, the jury awarded a $28,000,000 punitive damage award designed to deter the nursing home and its owners from ever doing this again.

Our clients’ mother suffered horrific injuries because of the behavior of the defendants.  A jury determined that she had suffered immense amounts of pain and that the nursing home and its owners deserved to be punished for their behavior. Even the judge, who heard all the proof, found that the jury’s decision to punish the nursing home and its owners should stand. However, if members of the House have their way, our clients would have only recovered approximately $300,000.

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This past March, Signature HealthCARE at St. Francis, located at 6007 Park Ave. in Memphis, TN, which is not affiliated with the hospital but is on the same campus, proved to be yet another disturbing example of a nursing home’s consistent failure to provide its patients with an acceptable level of care.  An “acceptable level of care” is the minimum amount of care all nursing homes are required to provide patients in exchange for receiving state and federal funds.

Signature HealthCARE at St. Francis has had a history of inspection failures and delivering substandard care to its residents. In order to continue receiving government funds, the nursing home not only paid out $1.2 million in fines in 2015 but also agreed to correct its numerous areas of non-compliance. The facility failed to live up to its end of the bargain. Consequently, the Centers for Medicare and Medicaid Services (CMS) terminated their contract with Signature HealthCARE at St Francis on March 8th, 2017. By April 25th only 9 of the 140 patients remained.

Signature HealthCARE at Saint Francis ratings from medicare.gov are below:

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Several weeks ago, nursing home residents across the country won a big victory when the U.S. Department of Health and Human Services (HHS) announced that it will be instituting a ban on pre-dispute arbitration agreements in nursing homes that accept government funding.

These agreements have long been used by nursing homes to deny the constitutional right of a trial by jury to nursing home residents who have suffered abuse and neglect.  Even if residents are severely injured or die as a result of a nursing home’s negligent care, these agreements protect nursing homes from having to go into court and defend their actions.  HHS actually acknowledged that these agreements allow nursing homes to keep their abuse and neglect hidden from the public eye.

To get nursing home residents and their families to sign these agreements, nursing homes typically include them in their admission paperwork, sometimes even requiring them for admission.  HHS pointed to the unequal bargaining power that exists when these agreements are given to residents or their families.

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When a 98 year-old woman entered a nursing home several years ago, her family dreamed that she might return to the assisted-living facility that she had called home for many years.  Unfortunately, unable to walk and suffering from dementia, she had reached a point where she needed around-the-clock care.   At the nursing home, her condition worsened, and she contracted an infection that caused diarrhea and required isolation from other residents.  After five weeks, she passed away at the nursing home.

Despite her condition, her records show that she was receiving more than 5 hours of therapy per day.  On the day that she passed away, the nursing home claims that she received more than 2 hours of therapy.  If you’re thinking that doesn’t make sense, you’re right. Here at the Jehl Law Group, we see nursing homes committing fraud like this all too often.  We have seen nursing homes bill for therapy and other services that they don’t actually provide.

Earlier this year, Kindred Healthcare Inc. and two of its subsidiaries agreed to pay the federal government $125 million to settle an ongoing fraud lawsuit. Kindred Healthcare Inc. is one of the larger nursing home chains in the country, and the government alleged that they were fraudulently billing for unnecessary therapy services. Life Care Centers of America, another large nursing home chain, is also being sued for these same practices.

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A recent audit conducted by the Tennessee Comptroller’s Office confirms what we often see in cases that we handle at the Jehl Law Group: in many cases the State of Tennessee is failing to hold nursing homes accountable for abusing or neglecting seniors. The audit examines the activities of the Board for Licensing Health Care Facilities, which is responsible for licensing, inspecting, and surveying nursing homes in the State of Tennessee. The audit relied on a random sample of 25 facilities that included, 17 nursing homes, 3 hospitals, 3 assisted-care living facilities, 1 home health agency, and 1 residential home for the aged.

Federal and state regulations require investigations into complaints received by the Office of Health Care Facilities. When complaints come into that office, they are categorized by how urgent or serious the complaint is. The audit examined the two most serious types of complaints:

  • Immediate Jeopardy (IJ)- Meaning that a nursing home’s actions or failure to comply with federal regulations has caused or is likely to cause serious injury, harm, impairment or death to a resident, and
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Early in the history of this nation, disputes were often resolved in barbaric fashion.  An individual might challenge someone who had grieved him to a duel which could occasionally result in injury or death. In 1804, the Vice President of the United States killed Founding Father Alexander Hamilton in one of these duels after accusing him of slander. But when the Founders drafted the Constitution, they incorporated an essential doctrine of law that would provide a more civilized and fair way of settling such complaints. That method was the jury trial, and every Americans’ right to a trial is enshrined in the Seventh Amendment of United States Constitution. But today that right is being threatened by manipulative practices of corporations who want to play by different rules.

Arbitration agreements are everywhere. You can find them in credit card agreements, insurance policies, or those dreaded privacy policies that pop up when you install software. But one place you may not expect to see them is in admissions paperwork for a nursing home or assisted living facility. These documents typically take the form of a several pages but may be as small as a clause or line in a contract. No matter their size, they can have a profound impact on your ability to seek legal recourse when you have been wronged.

Corporations tend to favor arbitration because it essentially allows them to opt out of the legal system. When they are negligent and cause injury or death, they are not required to answer to a judge or jury in a courtroom. Instead, they are allowed to make their case in front of an arbitrator who often provides results which are much friendlier to corporate parties.

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Too often at the Jehl Law Group we see cases of neglect and abuse of seniors. We hear about loved ones who have had infected wounds, broken bones, and other traumatic injuries. Sadly, clients tell us tales of people left for hours on end unattended, who are found lying in their own excrement by family members who come to visit them at healthcare facilities. Most often we hear about nursing home residents who develop pressure sores or bed sores, which are wounds that develop destroying the skin and underlying tissue when nursing home staff fail to turn or reposition residents with limited ability to move. In such cases, the testimony of a witness describing the wounds or lack of care can be very powerful, but oftentimes a photograph can have even greater impact. However, there are several things to keep in mind when obtaining a photograph to make sure that it is admissible at trial and also helpful in your loved one’s case.

In order for a photograph to be used in court, it has to be properly authenticated, which is a legal term that basically means a judge has to determine that a picture shows what you claim it shows. The court wants to make sure that the photograph is not photo-shopped or a picture of someone or something else. That might sound complicated, but it is actually pretty simple. In order to “properly authenticate” a photo, the person that actually took the picture or someone else that was present when the picture was taken needs to be able to testify that the picture accurately represents what the picture shows. For example, if the picture is of a wound, the person who took the picture or a person who was present when the picture was taken simply needs to testify that the picture accurately depicts the condition of the wound at the time the picture was taken.  In order to do that, it is helpful if the person testifying can answer these questions: when was the picture taken (the more specific the better), where was the picture taken, and does the picture accurately depict the wound?  Thus, it is always best to ask a health care provider to take and provide you with photographs of any wounds.  You should not remove bandages yourself or touch a wound, as this can increase the risk of infection.

Just because something is admissible, does not mean that it will be useful in your loved one’s case. Here are a few things to keep in mind:

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In July, the Centers for Medicare and Medicaid Services (CMS) proposed multiple rule changes applicable to nursing homes that accept funding from Medicare and Medicaid. Today we address the use of psychotropic drugs in nursing homes and the proposed rule changes to protect against their abuse. Psychotropic drugs include a broad range of drug categories, including anti-psychotic, anti-depressant, anti-anxiety, hypnotics, and opioid analgesic. These drugs have very important uses when prescribed correctly, but they also carry dangerous side effects, especially for people suffering from dementia.

Dementia patients frequently experience behavioral and psychological symptoms of dementia (BPSD) including agitation, aggression, cursing and swearing, anxiety, depression, psychosis, and wandering. As you can probably imagine or might have experienced personally, these symptoms make it more difficult to care for someone, but they can oftentimes be prevented or managed without the use of medication. However, these alternative approaches take time, effort, and patience. As a result, we often see these drugs overused in nursing home cases that we handle at Jehl Law Group.  Particularly, facilities that are under staffed or short staffed may use these drugs in excess as a way to chemically restrain residents.

These drugs carry serious side effects, especially for seniors. In particular, anti-psychotics can be dangerous if not FDA-approved “for the treatment of dementia-related psychosis.” It has been further warned by the FDA that these drugs can place dementia patients at “an increased risk of death.”[1] Not all the side effects are that serious, but most of the drugs carry risk of sedation (which is why they are used as chemical restraints), dizziness, and increased confusion. These side effects greatly increase the likelihood of falls, which oftentimes result in fractures and injuries that can be deadly to seniors. There are numerous other side effects associated with each specific psychotropic drug.

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In July, the Centers for Medicare and Medicaid Services (CMS) proposed rule changes that would improve the quality of life, care, and services in nursing home facilities that receive funding from Medicare and Medicaid. In an effort to protect residents and keep them safe, the Department of Health and Human Services is aiming to impose rules to protect seniors from abuse, mistreatment, neglect, and fraud. Over the next couple of weeks, the Jehl Law Group will be diving into some of the specifics of the possible rule changes so that you can be more informed as you consider moving your loved ones into a nursing home.

Let’s start by addressing the proposed rule changes regarding arbitration agreements (also known as alternative dispute resolution agreements). In the simplest terms, these agreements state that residents give up their right to a jury trial even if they are injured or die due to the nursing home’s negligent care. Oftentimes, nursing homes put these agreements in their admission paperwork, and residents or their representatives simply sign them without realizing that they are giving up their right to sue in court. The proposed changes try to address this issue by requiring nursing homes to explain what an arbitration agreement is “in a form and manner…that the resident understands.” They also state that the agreement “should not be contained within any other agreement or paperwork.”

In some states (including Tennessee), nursing home facilities go beyond hiding these agreements in admission paperwork, and they actually require that residents sign these agreements in order to gain admission. Nursing homes are allowed to take advantage of people who might not have any other options when a loved one is in need of immediate care by saying sign the agreement that takes away your right to sue or find another facility. The proposed changes also explicitly address this issue: “Admission to the facility must not be contingent upon the resident or the resident representative signing a binding arbitration agreement.” Essentially, if the proposed rule changes go into effect, nursing homes will no longer be allowed to force you into signing an arbitration agreement; instead it must “be entered into by the resident voluntarily.”

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Two Signature Healthcare nursing homes in Memphis, Signature Healthcare at St. Peter Villa in Midtown and Signature Healthcare at St. Francis on the campus of St. Francis Hospital on Park Avenue, have been the subject of recent scrutiny by the Tennessee Department of Health.  Thanks to the reporting of WREG in Memphis, the mismanagement and mistreatment of patients at these Memphis nursing homes has been brought to the public’s attention.  Unfortunately, we at the Jehl Law Group have seen a number of cases involving residents who have been neglected at these facilities over the years.

The evidence of the mistreatment of patients that Signature Healthcare has caused is available in public surveys conducted by the State of Tennessee and the Center for Medicare and Medicaid Services.  These surveys provide an essential monitoring of nursing homes and often expose neglect and abuse of residents.  These surveys are essential in gauging how nursing homes may have mistreated their patients and/or misused money received through Medicare and Medicaid.

Due to recent findings by State Surveyors, Signature Healthcare at St. Francis had its payments from Medicare temporarily revoked last week for what was described as mismanagement.  As a result, the facility had to move many of its patients to other facilities.