Articles Posted in Evidences of Abuse

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In 2012, the Centers for Medicare and Medicaid Services implemented new regulations in order to cut back the number of antipsychotic drugs prescribed in nursing homes. Despite their efforts, a recently released study conducted by the Human Rights Watch, and reported in The Washington Post, revealed that antipsychotics are still often misused as chemical restraints to keep patients docile and free from inconvenient behavioral disturbances. Perhaps more shockingly, they are sometimes administered without patient or familial consent.

Though some cutbacks in the drugs’ use have been made, it is estimated that nearly 179,000 nursing home residents are still being improperly prescribed the medications on a regular basis.

Antipsychotics, when used appropriately, can have profound effects for those suffering from schizophrenia, bipolar disorder or psychotic depression. However, the Food and Drug Administration never declared these drugs safe for the elderly suffering from dementia. In fact, they did the opposite.

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A 2016 Harvard University study found that nursing homes across America have been changing ownership at an alarming rate. On average, 1,500 nursing facilities were sold to a different corporation per year between 1993 and 2010. While change of ownership is not believed to directly cause turmoil and poor care, the study concluded that many nursing homes that already have a history of deficiencies and violations are more likely to be sold and rebranded.

David Grabowski, lead researcher and health care policy professor at Harvard Medical School, pointed out that nursing homes with a history of consistent, uniform ownership typically have fewer citations from inspectors, unlike their lower-quality counterparts, which more often have mergers, acquisitions or changes of ownership on their record.

More often than not, corporate chains are involved in the acquisition of failing health care facilities.

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Ashton Place Health and Rehabilitation, a Midtown nursing home with a history of abused and neglected residents, proved to be a hotbed of even more controversy in mid-October after a resident at the facility was found lying in a pile of his excretion while also dealing with an open leg wound that became a home for maggots. He was taken to a hospital and later passed away.

The incident, which unfortunately is not the only one of its kind, caught the attention of both medical examiners and the Memphis Police. In certain instances, victims reached out to lawyers as well, including Jehl Law Group, where we currently have pending cases against the Rehabilitation Center.

Other allegations brought against the nursing home included a patient who had pressure sores, a patient who fell multiple times and died, and a complaint of a sexual assault.

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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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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.

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Another week and another disturbing practice is revealed about nursing homes taking advantage of their residents. A report from the New York Times found that nursing homes in New York and several other states have been using a legal tactic to take control of their resident’s assets in an attempt to recover for unpaid medical bills when an issue arises with insurance payment. These nursing homes have been filing guardianship petitions that essentially grant them full authority over both the patient and their money. Through the Times’ reporting we are able to glimpse a troubling  practice that often takes place in the shadows of the legal system. Many of these cases are closed to public view because of privacy issues and it is difficult not only to ascertain how common the practice is but to what extent it takes place throughout the United States.

The nursing homes that were the subject of the story appeared to be using the practice in vindictive ways. For example, one resident found herself to be the subject of a guardianship petition after lodging complaints about the nursing home’s treatment. If nursing homes attempt to silence those who would speak up about inadequacies in patient care using such strong-arm tactics there can be little to no accountability for putting patients at risk.

What is most troubling about this practice is that nursing homes are taking advantage of their patient’s infirmness and blatantly taking control of the patients away from their families. When it comes to patients who can no longer make decisions for themselves it is outrageous to see that the wishes of their loved ones may be circumvented in a shortsighted effort to recoup losses for the nursing home. Many of these incidents involve disputes over insurance and could be resolved without sacrificing the legal rights and dignity of the patients by having control of their lives handed over to a corporation.

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A recent survey conducted by the Tennessee Department of Health of Signature Healthcare at St. Peter Villa in Memphis, Tennessee, revealed multiple deficiencies.  The survey, completed on August 27, 2014, concluded that the nursing home neglected to take required precautions for resident care, which resulted in immediate jeopardy to multiple residents.  According to the survey, the facility neglected to perform the Heimlich maneuver when a resident began choking.  This resulted in a finding of immediate jeopardy to the resident who subsequently choked to death.

The survey revealed that the resident had been put on a physician ordered “mechanical soft diet with pureed meat,” due to a swallowing problem.  Interviews conducted by the surveyor revealed that the facility neglected to ensure that the resident received the proper diet.  Surveyors found that the resident received non-pureed meat and was left alone to eat in his room.

In another deficiency cited in the same survey, the surveyors found that the facility failed to properly investigate and report an alleged rape.  Additionally, the survey found that the facility failed to take proper steps to prevent further potential abuse during the investigation.  Federal law requires a long term nursing facility to ensure that all alleged violations of neglect or abuse are reported through established procedures.  The surveyors found that the facility failed to meet this requirement, placing the resident in immediate jeopardy of further potential abuse.

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Disturbing findings were made during a recent survey conducted at Golden Living Center-Union City.  In the survey, completed on September 24, 2014, significant deficiencies in care at the facility were noted. In the survey, it was stated that the facility “neglected to provide emergency resuscitation” for one of the residents at the facility.  According to the survey, the employees then failed to timely report the incident to the administrator and the administrator failed to properly report the incident to the state agency charged with monitoring nursing home care.

The patient that the facility was charged with protecting was “full code,” meaning that life saving measures should have been taken by the staff if he or she was found unresponsive.  Instead, state surveyors found that the staff failed to check the code status for the patient and did not provide CPR as the policy at the facility would have demanded.  In interviews conducted by the surveyor, the nurses who had attended to the patient stated that they had assumed the patient was DNR or “do not resuscitate” and did not even attempt to resuscitate the resident.

It is tragic to think that a facility charged with protecting the most vulnerable can neglect their responsibilities when they are needed most. While many patients in nursing homes are approaching the end of life, they deserve the dignity of life saving measures as much as any healthy and active person.

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