Chicago Nursing Home Abuse Lawyer Blog
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Recently, police, along with state public health officials, in downstate Alton, Illinois have been investigating the alleged abuse of a 93 year old nursing home patient. The daughter of this nursing home patient has claimed that her mother was physically abused to the point of bruising, was intimidated by staff and left in her own feces. Carol Fredrick, 72, the nursing home patient’s daughter stated that after finding her mother in the condition she was in that “none of us slept last night, we were so upset.” After discovering these conditions, Ms. Frederick relocated her mother to a rehabilitation facility and called Alton police to report the physical and emotional abuse and neglect her mother had reportedly encountered at the nursing home.

Once the Alton police became involved they photographed the older woman’s brusies on the back of her arms and interviewed the nursing home workers who are alleged to have committed the abuse and neglect. The older woman’s daughter, Ms. Frederick, claims that two certified nursing assistants (CNAs) at the nursing home inflicted the bruises while “roughing up” her mother as they dressed her. Not only that, Ms. Frederick claims that the nurses “got in her [mother’s] face and lifted their name tags with their thumbs,” so the older woman could not read their names. Frederick claims her mother reported all of this to her, and that her mother is alert, sharp and lucid.

The obvious question to all of this is why these nurses, who are supposed to care for the elderly at these facilities, would act in such a way? Ms. Frederick claims it was because her mother angered the healthcare workers by repeatedly activating her call button for help in using the restroom and getting into bed. While this may seem like an outlandish reason to treat someone in such a way, it is not surprising. Often times at facilities, such as this one in Alton, Illinois, nurses and staff are overworked, understaffed, and not paid as much as they should be. As a result of their stress and anxiety, they may act in a way that punishes the elderly patients. Obviously, this is no excuse to abuse and neglect anyone, especially elderly patients. These nursing homes and their staff need to be held accountable for their actions towards their patients.

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A sobering report released by the World Health Organization (WHO) this week highlights the systemic levels of abuse that the world’s elderly population encounters each month. The United Nations News Centre reported that millions of elderly disclosed significant levels of abuse across the world. These numbers are worrisome for two reasons. First and foremost because they illustrate the widespread and rampant abuse of the elderly population, but also because there are likely many amongst the elderly population whose abuse is never reported for fear of reprisal or inability to report their abuse. As a result, untold numbers of elderly nursing home residents and those being cared for around the world are forced to suffer silently.

The World Health Organization details that abuse in institutions, such as nursing homes, may include “physically restraining patients, depriving them of dignity (by for instance leaving them in soiled clothes) and choice over daily affairs, intentionally providing insufficient care (such as allowing them to develop pressure sores), over- and under-medicating and withholding medication from patients; and emotional neglect and abuse.”

The report went onto note that here in the United States, in a survey of nursing home staff, thirty-six percent had witnessed at least one incident of physical abuse of an elderly resident or patient in the previous year; ten percent admitted to committing at least one act of physical abuse towards and elderly patient; and forty percent of staff had admitted to psychologically abusing patients. Taken together, this report showcases a worrying trend that nursing home abuse may only be getting worse throughout the country and world.
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According to a recent newspaper report, an employee at an Illinois nursing home has been given a notice to appear in court after allegedly striking a 74-year-old resident on November 24, 2014. The employee has been suspended. A State’s Attorney said she is investigating whether to file a criminal complaint against her.

The report indicates that the incident was documented in an internal memo from a nursing home manager. The memo states that a 74-year-old resident with a diagnosis of Parkinson’s and dementia was being washed up with the assistance of two CNAs and a nurse. While being washed up, the resident punched one of the CNAs in the chest. The CNA that was hit reacted by punching the resident in the upper arm. No immediate injury or bruising was noted. The other CNA and nurse witnessed the incident. It is questionable that this behavior by the CNA could be justified as self defense given the medical status of the resident.

The sheriff’s office was notified. The CNA was not arrested, but was given a notice to appear in court later this month. The incident also will require reporting to the Illinois Department of Public Health.
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We previously reported that a Center for Public Integrity investigation revealed how a federal website administered by the Centers for Medicare and Medicaid, called Nursing Home Compare, has not been accurately reporting staffing levels at nursing homes across the country. This was due to a reliance on information self-reported by facilities rather than Medicare reports that reflect more accurate staffing levels. In some cases homes were self-reporting more than double their actual staff level, and the problem is particularly pronounced in many southern states. Such discrepancies led to inaccurate reporting on the Nursing Home Compare website, which is meant to provide information on nursing homes such as ratings, investigation-related information, and staffing levels for consumers to use in searching for the right facility. The Center for Public Integrity investigation also revealed that staffing levels were particularly lower in nursing homes that served minority communities of residents.

The report revealed majority-white nursing homes have about 34% higher staffing levels than facilities with mainly African-American residents, and how those same homes had 60% higher staffing level than nursing homes mainly comprised of Latino residents. According to the statistics, “[h]undreds of majority-black homes” nationwide reported through Nursing Home Compare that their registered nurses provided on average just over 30 minutes of care time to each resident every day. However, according to the Medicare reports, this figure was really only about 20 minutes per day. In some Latino nursing homes the average time spent on care per day was only 10 minutes.
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A recent study by lead author Karl Pillemer, professor of gerontology in medicine at Weill Cornell College of Medicine in New York shockingly reveals that aggression among residents of nursing homes is widespread and “extremely high rates of conflict and violence” are common. In fact, Professor Pillemer discovered that one out of every five residents living in the nursing facilities studied was involved in at least one “negative and aggressive encounter” with another resident within a four-week period of time. These disturbing findings were made public earlier this month at the annual meeting of the Gerontological Society of America in Washington, D. C.

The study, the first of its kind to look at the scope of negative aggression between residents, was conducted by researchers who examined patient records at ten nursing homes in the state of New York, interviewed staff and residents, and directly observed and recorded incidents of conflict, abuse or mistreatment. According to CommonHealth, of the more than 2000 nursing home residents involved in the study, researchers found that “16 percent were involved in incidents of cursing, screaming, or yelling; about 6 percent in physical violence such as hitting, kicking, or biting; one percent in “sexual incidents, such as exposing one’s genitals, touching other residents, or attempting to gain sexual favors”; and 10.5 percent in events” labeled “other,” such as, residents entering rooms uninvited or rummaging through others’ belongings.

Often the reason for such aggression is due to obvious health problems, such as dementia, which can cause an individual’s behavior to be less inhibited. However, there are other factors that are believed to contribute to conflict and violence among nursing home residents as well. The study found “higher rates of mistreatment in more crowded facilities, and in areas within facilities where residents were more densely gathered” and “higher rates of resident-on-resident aggression in nursing homes with lower staff-to-resident ratios.” Professor Pillemer also notes that nursing home staff can become blind to the problem because of its frequency, which contributes to the problem, and that aggression between residents is cyclical in nature in that this negative behavior and its effects are “contagious.” In other words, “[s]eeing these incidents causes other residents to be fearful, anxious, concerned–and that can lead to more of the behavior.”
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Families for Better Care recently released its “Nursing Home Report Cards” for 2014 and the results for Illinois are not good.

Illinois was ranked 44th out of 50 states and the District of Columbia for Nursing Home Quality, or 8th worst. Furthermore, Illinois received a failing grade of “F” and lowered its ranking from last year by two spots, falling from 42nd to 44th.

Families for Better Care determines its rankings by analyzing staffing data from the Kaiser Health Foundation, evaluating performance indicators from the Center for Medicare and Medicaid Services’ Nursing Home Compare and tracking complaint statistics from the Office of State Long-Term Care Ombudsman. The main factor that contributes to quality of care is staffing. As the report states, “the difference between quality nursing home care and subpar care boils down to an average of 22 extra minutes of direct care per resident daily.”

Some appalling statistics stand out from this study. Nursing homes in Illinois average less than 2 hours and 15 minutes of direct resident care per day, leading to an “F” grade under the Direct Staffing Care Hours category. Also notable is the fact that one quarter of nursing homes in Illinois reported having a “severe deficiency”, leading to a “D” grade under that category.

Should you or a loved one have concerns or questions regarding treatment or conditions at a nursing home or long-term care facility, please contact our experienced attorneys at Ed Fox & Associates today for a free consultation.

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Three former employees of a nursing home owned by Genesis Healthcare have been criminally charged based on allegations that they abused and neglected two women.

The three former employees were hit with multiple criminal charges after being accused of abusing residents at the nursing home. State Police and other agencies engaged in an investigation of the nursing home where the alleged abuse and neglect occurred, leading to the criminal charges. One employee faces 14 counts each of criminal abuse and knowingly abusing or neglecting an adult. That same individual has also been charged with two counts of wanton endangerment.

The second employee was charged with four counts of criminal abuse in the first degree and of knowingly abusing or neglecting an adult in the first degree. That individual also faces fourth degree assault charges and two counts of second-degree wanton endangerment. A third employee also has been charged with the same crimes. All of the defendants have pleaded not guilty.
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The long-term consequences of frequent falls in nursing homes are not always immediately apparent. A recent study published in the medical journal JAMA Internal Medicine found that half of residents who suffer a hip fracture after falling either pass away or lose mobility completely. Researchers at the University of Pennsylvania’s Perelman School of Medicine observed more than 60,000 nursing home residents who were hospitalized for hip fractures in a four-year period. The researchers found that residents above the age of 90, and those who did not undergo surgery for the fracture, were most likely to pass away or become disabled.

Most of the nursing home residents observed for this study were able to move around on their own before they suffered a hip fracture. Six months after hospitalization, about one in three nursing home residents had passed away. A year after the injury about half of the patients had died. Moreover, those who survived suffered from many different types of disabilities. Among the residents who survived, nearly 30% had to depend on others to help them get around, to get in and out of bed, and to perform personal hygiene. This significantly restricted their ability to participate in nursing home activities so they spent more time in bed, which increased their risk for developing other. This reinforces the need to focus on preventing falls in the first place.

Families with a loved one in a nursing home should be aware that, if a fall does occur and the patient suffers a hip fracture, they are unlikely to return to their pre-injury health state. It may also be helpful to encourage residents to undergo surgery for the fracture, even if they express hesitation. In these and other areas, families should begin planning for the future care of their loved one, who may become newly dependent on nursing home staff to get around.
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President Obama recently signed into law the Improving Medicare Post-Acute Care Transformation Act (IMPACT), which means that soon when trying to locate a nursing home for yourself or a loved one, CMS’ rating will actually reflect the quality of the facility. At the present time, Medicare relies on self-reported and unverified information from nursing homes as well as its own citation data to rank facilities. Thus, comparing nursing homes ranked by Medicare on its website primarily depends on the accuracy and completeness of the information provided by the facilities. These self-reporting practices have been often criticized leading experts to question CMS’ rating system as a true indication of the quality of care provided by the nursing home facilities.

Medicare’s five-star rating system came under fire after an August 2014 report was released by the U.S. Department of Health and Human Services Office of Inspector General. The report found that in a random sampling of 245 nursing homes, only fifty-three percent (53%) of allegations of abuse or neglect were reported as federally required. These findings clearly indicate the unreliability of nursing home facilities’ self-reported data upon which the five-star rating system is based.

Changes in the rating system are scheduled to begin in January and will include adding measurable data. For example, nursing homes will be rated on the percentage of residents re-admitted to a hospital and the percentage receiving antipsychotic drugs. CMS will also start gathering data regarding staffing numbers and turnover rates directly from payroll records rather than relying on a facility’s self-reported numbers. Cheryl Phillips, M.D., LeadingAge’s senior vice president of public policy told Long-Term Living Magazine that “[t]he inclusion of verified staffing information based on payroll data is especially important, as staffing levels are often the best proxy [indicator] for quality.”
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