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Elderly women choked at San Antonio Nursing Home

Beth Janicek — Tue, 13 Oct 2009 10:58:23 GMT

Janice Maier, 77, was a sleep in her bed at a senior care facility when she was awaken early Saturday morning when a man entered her room, climbed into her bed and began to choke her and repeatedly hit her in the face. The attack occurred at Clare Bridge Specialized Memory Care, a Brookdale Senior Living facility on the Northeast side. Maier was transported to the hospital and was in stable condition on Saturday night.

The San Antonio Police Department incident report said that Maier had never seen her alleged attacker before. Daniel Villarreal, 25, was arrested at the scene after employees called police when they saw him covered in blood in the living facility and then discovered Maier, also covered in blood, on the floor of her bedroom. Maier told police that Villarreal hit her and choked her until she huddled inside a blanket on the floor beside her bed, where he started kicking her. It is unclear how Villarreal gained entry to the facility, which requires key code access.

The police asked Villarreal why he was there and he stated that he was “looking for something.” When asked what he was looking for, he replied, “A lady to choke.” He was “mad at his life and wanted to choke someone.” As of Saturday evening, Villarreal was in the Bexar County Jail on a first-degree felony charge of injury to the elderly with serious bodily injury.

This incident needs to be investigated and the facility should be held responsible for lack of security. Residents are entrusted to their care, and it is their obligation to provide a safe living environment. In addition, an employee should have spotted Mr. Villarreal before he ever made it into a resident’s room. This may be an issue of lack of training, or even a sign that the facility is understaffed. Whatever it is, there is no excuse for this type of attack to occur.

Originally posted at InjuryBoard by Beth Janicek

Update on La Salle County Nursing Home Sex Abuse Investigation

Beth Janicek — Fri, 07 Aug 2009 12:42:30 GMT

Recently I blogged about a La Salle County Nursing Home under investigation due to a male resident molesting 10 female residents. The nursing home now faces monetary damages from federal and possibly state health authorities. The Illinois Department of Public Health (IDPH) has since sent a recommendation to U.S. Centers for Medicare and Medicaid Services that it fine the county $20,000 plus $100 for each day between June 6^th, when the complaint was filed, and July 6^th, when the review showed the nursing home was in “substantial compliance.” IDPH spokesman Melaney Arnold said the IDPH is also still considering fining the nursing home.

The IDPH released a 61-page report after conducting an investigation of the nursing home. The report detailed how the male resident targeted female dementia patients, sometimes those who were non-verbal, and other female residents in an attempt to perform sexual acts on them. The male resident succeeded on 10 different occasions without proper action being taken by nursing home administration officials. IDPH officials determined that the nursing home failed six state requirements including failing to protect current residents and failing to prevent repeated occurrences of sexual abuse.

In Texas, our regulatory agency is Texas Department of Aging and Disability Services (TDADS). TDADS needs to be vigilant in protecting the elderly and properly overseeing these nursing homes to ensure the vulnerable elderly are not abused by sexual predators.

Originally posted at InjuryBoard by Beth Janicek

Sex Offenders in Nursing Homes

Beth Janicek — Sat, 11 Jul 2009 10:38:00 GMT

A male resident at La Salle County Nursing Home who molested 10 female residents earlier this year has been moved from the nursing home to an unidentified psychiatric facility. Incidents, such as this one, have led to the questions:

Can sex offenders live in county homes?
What has the county done to protect women at nursing homes?

The La Salle County Nursing Home has taken more than a dozen steps after the Illinois Department of Public Health said that administrators failed to protect female residents from the molestations of a male resident. Steps included four staff meetings addressing matters of abuse prevention, resident rights, and incident investigation. Female residents were questioned and care plans were updated. In addition, the chairman of the La Salle County Board’s Nursing Home Committee will start directly supervising and overseeing the homes administration.

Even though the male resident has since been removed from the home, according to records there is still a registered sex offender in the county home. There is no indication that he had anything to do with the series of incidents involving a resident molesting several female residents. However, there are specific guidelines that must be followed by nursing homes involving sex offenders.

In Illinois, the nursing home is required to tell the Illinois Department of Public Health about any resident who is a sex offender and must do a “risk analysis” of the offender to determine whether staff will be able to care for the offender and to prepare a care plan. The sex offender must be placed in a private room and the home is required to tell residents, prospective residents, and families they can ask whether an offender lives at the home.

I am currently handling a claim involving the nursing homes standard of care in protecting residents from sexual assault. A male resident returned home from a baseball game after being served alcohol, gained entrance to a cognitively impaired female resident’s room and sexually assaulted her. The nursing home failed to protect the resident from being sexually assaulted resulting in the physical and mental injury of the resident. It is exceptionally important for facilities to properly monitor and supervise to ensure the safety of all their residents.

Originally posted at InjuryBoard by Beth Janicek

Alzheimer’s-Ridden Pro-wrestling Legend Kills Fellow Nursing Home Resident

Beth Janicek — Fri, 27 Feb 2009 15:25:23 GMT

Verne Gagne, an 82 year old wrestling legend is under investigation after the death of 97 years old, Helmut R. Gutmann, who lived with Gagne in Friendship Village, a Bloomington living facility. Both men suffer from Alzheimer’s related dementia.

Gagne and Gutmann allegedly got into a fight on January 26^th, in which Gutmann suffered a broken leg and a head injury. He was hospitalized, then released, then later re-hospitalized due to complications and later died.

Helmut R. Gutmann had escaped Nazi Germany and was a former cancer research scientist at the University of Minnesota.

Verge Gagne entered the world of wrestling in 1949, and became the perennial champion and owner/promoter of the American Wrestling Association. He later went on to host the weekly TV show, All-Star Wrestling. Gagne was inducted into the World Pro Wrestling Hall of Fame in 1999.

Bloomington Police are investigating the death as suspicious. A manner of death has not officially been determined, but it is believed that Gutmann was body slammed. Gagne was dismissed from the living facility, but due to his mental state it is unknown whether charges will be pressed. A full account of this unfortunate story can be seen here.

It is my belief that incompetent people should not be held responsible or charged with criminal intent if they do not know what they are doing. From what I have read thus far, it appears Mr. Gagne did not have the mental capability to form criminal intent so it is not likely the police will charge him with a crime. Nursing homes need to protect their residents from being injured by other residents. I have not seen an investigation as to what the nursing staff was doing to protect the residents and prevent an incident such as this from ever occurring.

Originally posted at InjuryBoard by Beth Janicek

Stabilizing the CNA Workforce

Beth Janicek — Mon, 25 May 2009 09:44:06 GMT

Certified Nursing Assistants (CNAs) handle the direct care of 1.5 million nursing home residents in the United States, providing about 8 out of every 10 hours of resident care. According to the study “The National Nursing Assistant Survey: Improving the Evidence Base for Policy Initiatives to Strengthen the Certified Nursing Assistant Workforce” current demographic, economic, and policy trends suggest that the supply of CNAs could significantly worsen in the coming decades.

The study found that almost half of CNAs are minority and the vast majority is female with no more than a high school diploma, or GED. The median average wage found in 2004 was $10.04. Almost half of the CNAs were living on a single income due to being divorced, separated, widowed, or never married. Although it was found that CNAs work full time (36.8 hr/week), almost 2/3 lived on an annual family income of less than $30,000, and between 20% and 40% had at some point received public benefits, such as food stamps or rental subsidies. About 16% of CNAs working in nursing homes were uninsured, and in addition to that, 42% did not participate in their employer-offered health insurance because they could not afford the plan.

The study stated,

“More than half (56%) of CNAs incurred at least one injury on the job in the previous year. Among the CNAs injured, almost half (45%) sustained scratches, open wounds, or cuts; about one fifth had back injuries (18%), black eyes or other bruising (16%), or other strains or pulls (16%); and about one tenth had human bites (12%) or other injuries (7%; not shown). Of the CNAs who had been injured at least once in the previous year, almost one quarter were unable to work for at least 1 day due to the injury.”

Some of the main reasons for CNA injuries are lack of equipment (ex. for lifting and transferring residents), lack of training on the proper use of equipment, lack of training on managing resident behaviors, and working short staffed. This study makes it possible to do a closer examination of and comparison between facility and CNA reports of when injuries occur, injury prevention training offered, availability of safety equipment, frequency of working short staffed, and extent of vacancies and turnover.

Findings from this study will hopefully allow policymakers to assess and plan for sustainable solutions for the CNA nursing home workforce. It has been found that low wages contribute to high turnover and the need of working overtime or even working an additional job. Long hours may add to mistakes, affecting the residents’ safety and the quality of care. The elderly deserve better care.

Originally posted at InjuryBoard by Beth Janicek

Centers of Medicare Name Worst Nursing Homes

Beth Janicek — Thu, 14 Feb 2008 10:44:00 GMT

Here is the list of the worst nursing homes.

Originally posted at InjuryBoard by Beth Janicek

Nursing Home in Oklahoma Lost its Certification Due to Violations

Beth Janicek — Thu, 28 May 2009 10:38:27 GMT

Care Living Center in Edmond, Oklahoma is having its certification pulled because of deficiencies found by state health inspectors, resulting in more than two dozen Medicare and Medicaid residents being forced to move. Officials said that the deficiencies centered on medical and nursing neglect.

Mary Fleming, the state health department’s director of survey, said examples of neglect included some residents who were not being turned or cleaned and in some instances were not fed. Inspectors found one resident with 17 pressure ulcers and who was not receiving appropriate treatment ordered by a physician. Fleming also said that there was no one to answer residents’ call lights and that staff members were not trained appropriately.

“They were not following doctor’s orders to care for medical problems, like not monitoring blood glucose for diabetics, not monitoring blood pressure for residents with hypertension or strokes, and not putting people in isolation that had infectious diseases.”

In addition, two residents had wandered away from the facility and were found several blocks away.

Home administrator, Vincent Dike, said the new owners, Quality Health Care LLC, only took over the nursing home in November and needed more time to correct the problems.

Dike said, “This facility had problems in the past before the new management came in, but we worked aggressively and corrected most of the deficiencies. We were hoping within the next visit that we would be in good standing. But to our surprise, they said ‘We have given you three chances, and that’s all the state allows you to have.’”

The federal agency that administers Medicare and Medicaid, Centers for Medicare and Medicaid Services, allows a maximum of three revisits to a facility, and then they terminate. The facility can work out the deficiencies and apply for recertification, but it will be a long process.

The facility is losing Medicaid patients and Medicare patients. The termination does not affect 18 of the facility’s private pay residents, but Dike said that the owners may find it difficult to keep the doors open.

I would like to see the Texas regulatory agency, TDADS, be this aggressive with facilities. It is very difficult on the residents to move facilities, but it is in the best interest of the residents for these regulatory agencies to be vigilant in protecting the vulnerable patients.

Originally posted at InjuryBoard by Beth Janicek

$11 Million Verdict in Assisted Living Case

Beth Janicek — Tue, 31 Mar 2009 10:11:02 GMT

An Arizona jury awarded $11 million, the largest verdict ever awarded against an assisted living facility in the United States, to the widow of a 36-year-old man with a traumatic brain injury who died after ingesting foreign objects while in the care of Liberty Manor Residency. The verdict included $2 million for the decedent, $5 million for the wife, and $4 million in punitive damages. Lydia Scherrer, widow of Earl Scherrer, said “I want this to be a lasting victory for all individuals with TBI or other disabilities living in assisted living centers or group homes.”

Earl Scherrer suffered a severe traumatic brain injury as a result of a car accident in 1996. He remained in a coma for 16 months before he began to slowly emerge. Mrs. Scherrer worked with her husband every day and eventually he slowly started to speak. She devoted many hours a week to her husband’s recovery, but was forced to turn to an assisted living facility to provide the 24-hour care that her husband required. For years she visited him faithfully, even checking him out of the facility and taking him home on her days off, every Tuesday and Wednesday.

Mrs. Scherrer placed her husband in Liberty Manor Residency on April 7, 2006, a facility that claimed to provide 24-hour supervision of its residents. Exactly one month later, on May 7, 2006, Mrs. Scherrer received a call saying that her husband had been vomiting. She rushed over to Liberty Manor and brought her husband home and gave him a bath. Within minutes he began vomiting black matter and died in her arms.

The autopsy results showed plastic bags, unopened catsup packets, candy wrappers, and paper towels were found in Earl Scherrer’s stomach and small intestine. The medical examiner determined that these objects were significant contributing factors to his death. The autopsy report read “hypertensive heart disease due to mechanical obstruction of the gastrointestinal tract from foreign objects.”

At trial it was proven that Liberty Manor made numerous false entries in its charts with respect to Mr. Scherrer’s care. There were notations of care on days when Mrs. Scherrer had checked him out of the facility, and Liberty Manor was unable to produce Mr. Scherrer’s alleged caregiver.

Lydia Scherrer’s attorney Craig Knapp said, “Lydia Scherrer did not walk away from her husband, in life or in death. Her hope is that this verdict will force the assisted living facility industry to set and meet higher standards of care for their residents, resulting in enhanced protections for the defenseless individuals trusted to the care of others.”

Cases like this one should not happen. It is enormously important for assisted living facilities, as well as nursing homes, to provide the care that they promise. If Liberty Manor Residency could not provide the 24-hour supervision of Mr. Scherrer, he should have immediately been transferred. Most cases, such as this one, are based on the fact that the assisted living facility failed to transfer the resident once it became apparent that they were no longer capable of caring for them. In addition to failing to provide the promised 24-hour supervision of Mr. Scherrer, Liberty Manor Residency falsified nursing documents in an attempt to cover up that fact that he was not receiving adequate supervision.

Originally posted at InjuryBoard by Beth Janicek

Texas Nursing Homes Get Low Rankings from Federal Government

Beth Janicek — Wed, 24 Dec 2008 12:10:05 GMT

Making the decision to put a loved one in a nursing home can be extremely difficult and sometimes even more difficult is trying to choose the right nursing home. In a previous post about nursing home abuse, I talked about tools for researching nursing homes such as, looking up state-specific inspections, checking the sex offenders’ registry, and talking to current residents and their families. An additional tool that may be a helpful starting point is the national rating system.

USA Today reported on a star rating system the federal government uses to rank nursing homes that receive Medicare funding. The star ratings can help family members who are searching for a nursing home, but there is also the hope that the lower ranked facilities will work to improve their quality of care.

Unfortunately Texas has one of the highest numbers of facilities which received the lowest ranking of only one star. Out of the 1114 Texas homes ranked, 306 received a one-star rating, compare that to only 110 Texas nursing homes which received a five-star rating. These numbers raise more concerns about the quality of care in Texas nursing homes. As I’ve noted before, due to law suit caps in Texas and the lack of any thorough state investigations, our nursing homes are not being held accountable for the poor care they are giving some of our most fragile citizens.

When searching for a nursing home, one of the most important tools is talking to other residents and their family members. In addition, there are a couple of resources that may be helpful for initial evaluations. The Department of Aging and Disability Department has guidelines for choosing a nursing home with contact numbers and links to other researching tools. The Department also has a site where you can look up individual nursing homes and also read how the homes are evaluated. There are good nursing homes in Texas; it just may take a little extra work to find one.

Originally posted at InjuryBoard by Beth Janicek

Nursing Homes Making Money while Providing Less Care

Beth Janicek — Tue, 30 Sep 2008 13:43:20 GMT

A recent New York Times article exposes some scary numbers regarding nursing home care. They report 94 percent of for-profit nursing homes were cited for deficiencies of care last year. This raises the question: how are these nursing homes making their profit? Are they charging more because they give better care or are they making a profit because they are skimping and cutting corners on the quality of care they provide? Daniel R. Levinson, the inspector general of the Department of Health and Human Services states, “For-profit nursing homes had a higher average number of deficiencies than the other types of nursing homes.” This leads one to believe the for-profit homes are making money by providing less care instead of the higher quality of care their profit margins might suggest.

One possibility is some for-profit homes may have smaller staffs, which are inadequate to provide the needed attention to their elderly patients. Researchers have found that people receive better care at homes with a higher ratio of nursing staff members to patients. In addition, the Inspector General found some cases in which nursing homes billed Medicare and Medicaid for services that “were not provided, or were so wholly deficient that they amounted to no care at all.” Basically the homes are getting the money, but the patients are not getting the care.

With more than 15 million people living in 15,000 nursing homes, and two-thirds of those 15,000 being for-profit, these citations for poor care are unacceptable. All nursing homes that receive Medicare and Medicaid must comply with Federal Standards and are inspected once a year. However, yearly inspections may not be enough, and the public should remain alert and aware and demand better care for our elderly population.

Also for-profit homes are not the only ones with problems. The inspector general’s report found 88 percent of nonprofit homes were cited for deficiencies of care and 91 percent of government homes were cited. Mr. Levinson said. “In 2007, for-profit nursing homes averaged 7.6 deficiencies per home, while not-for-profit and government homes averaged 5.7 and 6.3, respectively.”

Originally posted at InjuryBoard by Beth Janicek