Articles Posted in nursing home abuse

Allegations of rampant abuse and neglect at a large and renowned Florida brain rehabilitation center have sparked outcry, leading to a range of criminal charges, civil actions and state and federal probes.

West Palm Beach nursing home neglect lawyers know that the facility doesn’t cater specifically to the elderly, they are charged with caring for vulnerable adults and, based on some 2,000 pages of court documents, state investigations, police records and autopsy reports, it appears the facility failed miserably.

The case that brought it all to light was a young man who suffered a brain injury. He was taken to the Florida Institute for Neurologic Rehabilitation and then made a desperate attempt to facilitate a rescue. First, he called his sister and told her that staffers had beat him mercilessly. But because there are so few facilities that can handle adults with brain injuries, removal from the center was slow-going. So while at an outing to a local mega-store, he reportedly suffered abuse requiring emergency surgery. Only after the surgery was he allowed to transfer.

Since then, 20 former and current patients and their families have come forward with similar tales of abuse at the 196-bed center, which is located just outside of Tampa.

This is no fly-by-night operation: Patients and their family members often paid upward of $1,900 a day to receive care and treatment there.

And yet, the Florida Department of Children and Families reports receiving more than 475 allegations of neglect or abuse at the facility just in the last seven years. Of those, at least 36 were verified by investigators. Those cases were then referred to law enforcement, but the department didn’t keep track of what happened to them from there.

One case that law enforcement is pressing forward with is the abuse of a young autistic man, reportedly captured on video. In the footage, two workers are seen pummeling the smaller patient at least 30 times. When the patient is heard moaning and crying from the abuse, one of the staffers tell him to shut up because he was making it difficult for him to watch television. Those two staffers have been charged criminally.

Another case involves a second autistic man who is thrown by his seat by an employee who then proceeded to kick him. That incident too was captured on video, and he too has been criminally charged.

Another incident resulted in the death of a brain-injured Marine who was reportedly suffocated by employees who pinned him down until he was unable to breathe. His family was awarded a $5 million verdict from a jury back in 2005.

Since then, two more deaths resulted in negligence lawsuits that ultimately ended in confidential settlements. In one of those instances, an employee plead guilty to battery for punching a patient unconscious after he scratched him while the employee was attempting to restrain him.

Another man’s daughter alleged that her father died after an employee gave him food that he was not able to eat. He choked to death, according to his autopsy.

Other states and districts, including the District of Columbia, has pulled out a large number of patients from the facility after investigations found that the facility was improperly confining patients in their rooms or using drugs as a means of restraint.

And yet, the facility remains open.

Given that a number of these allegations have been verified in court, that is truly the most disturbing fact of all.
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Back in 2010, Florida’s then-Gov. Charlie Crist signed a law that required background checks for seniors, the disabled and children.

Parkland nursing home abuse lawyers know that it passed unanimously by the Legislature, and employees in Florida nursing home facilities have to pass a nationwide background check before they can start work.

However, subsequent research by the U.S. Department of Health and Human Services indicates that more than 90 percent of nursing home facilities across the country employ at least one worker with a criminal conviction.

The department conducted its research by obtaining the names of more than 35,000 nursing home employees. They then ran those names through the criminal database of the Federal Bureau of Investigation to determine whether they had a criminal record.

That same study further revealed that almost 50 percent of all nursing homes across the country had five or more employees with at least one criminal conviction. In a startling example, one facility that had approximately 165 workers had nearly 35 workers who had at least one criminal conviction on their record. That’s a rate of 21 percent, and could potentially leave a huge gap in the level of care for our most vulnerable residents.

The study did not break down state-by-state data of the findings, but noted that of the states involved in the research, 10 had federal background check requirements and another 33 had state background check requirements. The rest had no specified requirements for background checks.

Prior to Gov. Crist’s signing of the law in 2010, Florida was among those states that required a state-wide check. But obviously such a search wouldn’t pick up convictions – often for serious offenses – handed down in other states. As of yet, there is no federal law mandating such checks.

The hope of course is that now the system is much better-equipped to catch potential nursing home predators, but of course, no method is full-proof. For example, such a check wouldn’t necessarily pick up an arrest for a felony crime – only a conviction. As any defense attorney will tell you, having a good lawyer can make it easy to beat the rap, particularly if the alleged victims were older and suffered some form of dementia.

In this study, of those who did have criminal convictions, their crimes varied. Nearly 45 percent had committed some form of property crime, such as vandalism, theft or writing bad checks. Another 15 percent or so had convictions for drug-related crimes. Roughly 13 percent had convictions for crimes against people – and those included sexual assaults and other similar offenses.

In most cases, the convictions occurred prior to landing employment at the nursing home. But in 16 percent of cases, employees had convictions after they started working at the facility. What that means is that even pre-employment background screenings won’t stop these individuals from landing a job in a nursing home, and law enforcement isn’t required to notify employers if a worker has been arrested. Most facilities likely don’t have the resources to periodically check on their own.

Federal laws do bar nursing homes from hiring someone who has been convicted of neglecting, abusing or otherwise mistreating a patient. The problem is that FBI records don’t always show who the victim was. It’s up to employers to dig deeper into a conviction to learn what really happened. They don’t always do that.

The bottom line is that while we’re in better shape than we were a few years ago, family members can’t afford to be lax in following up on their loved ones’ care. While you won’t likely be able to background check all the employees your relative comes in contact with, you can press the facility about how they conduct theirs. And always keep a close eye out for possible abuse or neglect.
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New research shows that elder abuse in West Palm Beach and across the country may be perpetuated by the fact that very few home health aides are properly vetted before they’re hired – or trained.

It’s a fact that comes at no surprise to us, but it’s important for those considering a home health care option to become informed about the reality of what – and to whom – they are opening their doors.

The analysis, conducted by researchers at Northwestern University’s Feinberg School of Medicine, indicates that there is no uniform policy for background checks, drug testing and training for those individuals we trust to care for the most vulnerable among us.

In a number of cases, it appears the employee gets virtually zero supervision from his or her employing agency once they’ve been hired and placed.

Most agencies self-reported that they hire most of their aides through advertising recruitment efforts – including Internet sites such as Craigslist. What’s more, a number of agencies reportedly falsified information regarding how they screened their employees, as well as the qualifying education of those workers.

As a consumer, one of the first things you need to understand is that a home health care aid is not a nurse. They do not have a degree in nursing and they don’t even necessarily have to have any medical training whatsoever to hold the title. In most cases, they are actually forbidden by law from distributing medication precisely because they don’t have a medical degree.

Generally, these are lower-paid individuals whose job duties formally consist of making sure the patient is eating, scheduling doctor’s appointments, reminding the person to take their medication (but again, not distributing it), and sometimes housekeeping.

This is an arrangement that can work well for someone who is, for the most part, able to maintain their independence, but needs a little extra help. The problem is that because of a lack of quality controls, it opens up the elderly or disabled person to potential abuse and neglect – particularly if he or she is in a state where they are entirely dependent on the aide to fulfill basic needs.

The study, published July 13 in the Journal of American Geriatrics Society, focused on 180 home health care agencies from seven states throughout the country – including Florida – chosen for their higher elderly populations.

Researchers discovered that little more than 55 percent of agencies said they performed federal background checks. Only a third said they tested for drugs. Training ranged from a weeks-worth to nothing at all.

Supervision from the employing agency? In a number of cases, there was none at all. This is particularly troubling when you consider that two-thirds of these aides were allowed to assist the patient with financial transactions, such as bill-paying.

As if all this wasn’t enough to raise the warning flags, a number of agencies were apparently dishonest with regard to their screening process. At least two agencies referenced performing assessment tests that don’t even exist.

The typical profile for an aide was a recent female immigrant who earned about $7.25 hourly. Those hired as live-in help were paid even less: about $5.45 an hour.

The idea here is not to unduly scare you, but to open your eyes. You need to be wary of who you trust to care for your elderly relatives and be vigilant with regard to any potential abuses.
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An analysis of 15,000 nursing home ratings over the last three years show that more facilities are earning higher ratings, but those that performed poorly have made little to no improvements.

Our Oakland Park nursing home abuse attorneys read with interest USA Today’s recent report, which looked at the ratings handed down by the federal government and based on yearly surveys, inspections and overall quality of care measures. These ratings factor everything from how much individual time staffers spend with patients to whether there have been any indications of nursing home abuse or neglect of patients. Each of the five categories is given a star.

The good news was that the number of one-and-two-star nursing homes dropped last year to 35 percent – down from 40 percent a few years earlier. But consider what this number also means: That there are still more than one-third of nursing homes receiving one-and-two-star-ratings out of a five-star point system. That’s a huge number to be performing below average. And these aren’t just numbers: These are more than one-third of your mothers, fathers, grandparents and elderly loved ones who are suffering.

In Florida, the paper analyzed the ratings of a sampling of about 650 nursing homes across the state. Of those, roughly 65 were given a one-star rating. That’s one in every 10 nursing homes. Additionally, there were more than 120 two-star-rated facilities in the state’s sampling, which equals about 19 percent.

This puts Florida at only a slightly better average than the overall national ratings – but it’s still pretty awful.

Among those areas with the worst-ranked nursing homes: Wellington, West Palm Beach, Plantation, Lakeland, Sunrise, Stuart, Boynton Beach, Jupiter, Hollywood, Lantana and Palm Beach Gardens. Keep in mind, though, these are just part of a sampling – it doesn’t mean there aren’t similarly-ranked, poorly-performing homes in other areas of Florida as well.

What’s also important to note is that those figures are not stagnant throughout the year. They are ever-changing, so just because a facility has a good rating one month does not mean it will be the same the following month.

This is why if you are considering placing your loved one in assisted living or a nursing home facility, it’s important to thoroughly research that agency and get the most up-to-date analysis from the Centers for Medicare & Medicaid Services, the agency that issues the ratings.

Of course, there is no 100 percent, full-proof way to prevent abuse of your loved one if they live in a nursing home. There are, however, things you can do to reduce the chances of it.

Those include:

1. Choose a facility that is nearby. This will allow you frequent access to stop by, unexpected, at varying hours. This gives you a chance to monitor the quality of care on different shifts, different days and to regularly note the demeanor of your loved one during these times. Plus, there is a lot your loved one may be unwilling or unable to communicate over the phone that you can pick up on in person.

2. Before making the commitment, be sure to note the staffing levels. Even if the staff is caring and compassionate, if there aren’t enough of them, the quality of care is going to inevitably suffer. As about the ratio of patients to aides and nurses. The minimum recommendation by the CMS is that each patient has a daily minimum of about 3 hours of nursing aid time and about 1 hour 15 minutes with either a licensed practical nurse or an RN.

3. Poke around. Wander around the facility and peek in on other rooms. Note the cheerfulness of the patients as well as the staff. Look for safety violations. Make sure the facilities have enough hot water. See that the restrooms and kitchens are clean. Stay for a meal and taste the food. Ask how dietary restrictions are handled. Any place that objects to you probing should be checked off your list.
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Nursing home abuse lawyers in Palm City know that there are many staffers at these facilities who genuinely want to do the right thing.

However, sometimes nursing home abuse and neglect in Palm City comes down to a lack of training or not having enough staff to cover all that needs to be done.

Whatever the reason, when you start really delving into the research that has so far been conducted on this societal ill, a startling picture begins to emerge.

For example, in 2008, more than 90 percent of all nursing homes had at least one deficiency. For-profit homes were more likely to have problems than other types, but in nearly 20 percent of those cases, the deficiencies reported were the kind that would cause actual harm or immediate jeopardy to patients. These were things like medication mix-ups, infected bedsores, outright abuse or neglect and poor nutrition.

That same year, inspectors received more than 37,000 complaints, with roughly 40 percent of those substantiated.

In the inspector general reported that nearly 95 percent of nursing homes that are for-profit were cited for deficiencies, compared to roughly 90 percent of non-profit homes and about the same of government homes that were cited.

There have been an astonishing 5,000 deaths since 1999 that have been directly attributable to neglect or negligence in nursing homes. These would be instances such as bedsores, starvation and dehydration.

Another statistic that may surprise you is that only 20 percent of incidents are ever reported. In a vast majority of cases, patients are either afraid to report it or don’t understand what’s happening. What’s more, less than half of all nursing home residents have a close family member or friend that they could turn to even if they were able to reveal what was happening.

When you consider also that more than 90 percent of all nursing homes employ at least one convicted felon. This has a lot to do with the fact that there is no national standard for nursing home background checks.

Then consider that you may have a single nursing aid in charge of caring for some 30 patients. That far exceeds the recommended levels, and points to the next issue: That 9 out of 10 nursing homes aren’t staffed to adequate levels. This is even considering that the average cost to stay at a private facility is expected to soar to more than $170,000 per year in the next decade.

What’s more, one quarter of all nursing homes are cited for some injury or death – each year.

Given all of this, you need an aggressive attorney who is 100 percent behind you.
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Parkland nursing home abuse lawyers were appalled to hear of a case of abuse out of North Carolina in which a nurse reportedly drugged nursing home patients so she “wouldn’t have to deal with them.”

As a result of this nursing home abuse, one of those patients died and more than a dozen others were hospitalized.

Although out-of-state, this story is very relevant here in Florida, where we have more than 85,000 nursing home beds. There may be other cases that we are not aware of simply because they are not reported.

Over-medication is a huge problem not only here but throughout the country, as we recently reported in our Boynton Beach Nursing Home Abuse Lawyer Blog.

In this case, the incident happened two years ago, over the span of two evening shifts in mid-February in the facility’s Alzheimer’s unit.

The first night, there were no reports of anything unusual. However on the second night, one of the patients in that ward began having severe breathing problems and she was rushed to the hospital. Doctors tested her blood for anything unusual and discovered she tested positive for opiates. Problem was, she had never been prescribed any opiates, and as an 84-year-old Alzheimer’s patient, she was unlikely to be using them recreationally.

The big-tip off that led to this particular nurse, though, was that a total of 14 patients in that unit were all suffering similar symptoms: breathing problems, chest pain and fatigue. The others were rushed to the hospital as well, each testing positive for opiates, although only one actually had a prescription for such a drug.

It wasn’t until an investigation was launched by the state’s top investigation bureau that other employees revealed they had seen the nurse handing out orange liquids to the patients, which she had apparently said would relax them, telling her co-workers she knock their (expletive) out. The other workers did not recognize this substance as having been prescribed to these patients.

Now, to digress for just a moment: These other workers saw that these patients were being systematically given something they should not have been, these other workers recognized it and said nothing until a woman’s dead and state investigators come knocking. This is deeply disturbing.

Criminal charges were eventually brought against the nurse, who ultimately pleaded guilty to involuntary manslaughter and was sentenced to five months in prison and 30 months of probation.

During the sentencing hearing, relatives of the woman who passed away said they had tried to care for her on their own, but she had wandered away in the middle of the night several times. It was then, they realized, that she would need full-time care. They believed they were getting that with this facility.

In speaking directly to the former nurse, the victim’s daughter told her that she betrayed the family’s trust and that of “an elderly, child-like person who didn’t know you were hurting her and didn’t know you were doing things to her that you shouldn’t have been doing.”
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If nursing home workers knew someone could tune in to watch them at any moment, would we have anywhere near the levels of nursing home abuse in Florida that we do?

Our Belle Glade nursing home abuse lawyers have been watching closely the push for such a move in Australia, where representatives with local advocacy groups there are trying to make it a part of national policy.

We in the U.S. and Florida are a long way off from any such move (and our counterparts Down Under may be as well). However, it’s an important point to note: If you suspect abuse, but your loved one can’t tell you and you can’t prove it, why not explore filming or audio recording it?

Of course, you will want to consult with a Belle Grade nursing home abuse lawyer before taking such a drastic step, but it can be one way of finding solid proof of your suspicions.

Australian advocates for making this a uniform measure say that roughly 60 percent of all allegations of sexual or physical abuse are filed against staff members. Another 15 percent involved another resident in about 10 percent of the cases, the offender was unknown. (The rest involved relatives or someone else known to the older person.)

However, these are merely the cases that were reported. The actual numbers are much higher, and we can all but assure that many more cases aren’t reported by the resident out of fear of retaliation or worsened abuse.

That’s because even when abuse is reported, residents fear they won’t be believed. Even family members may have a difficult time convincing someone to act, particularly if their loved on is on Medicare and can’t afford to have their relative moved to a different facility or care for them on their own.

Many often feel it may be their word against the staff’s, and oftentimes, the staff will be given the benefit of the doubt. With video or audio proof, there could be no question of what occurred. This can be powerful evidence in both criminal and civil cases.

Of course, those within the industry are going to say that this is an extreme response to a relatively small number of extreme cases. However, consider that recent statistics indicate that of the roughly 2.6 million people living in nursing homes, about 30 percent will suffer some form of abuse or neglect during their time there.

Not only is that asinine – it’s possible to prevent.

Of course, you can’t be there every waking hour. That’s why it may be time to consider legislation that will allow us to install these preventative measures in all Florida facilities.
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Nursing home abuse is one of those crimes made all the more egregious because it involves preying upon someone who is unable or afraid to speak for themselves.

That’s why our Lauderhill nursing home abuse lawyers want to underscore the importance of family members becoming educated about what nursing home abuse and neglect is and how they can spot it. Nursing home residents rarely have other advocates.

And as was the case in a pattern of abuse reported in a Missouri nursing home, it was family members who blew the whistle on the situation.

Now even though this case was in another state, the same basic principles and laws apply.

As reported by KMOV Channel 4, the first incident involved an 82-year-old woman who had to be hospitalized due to severe abuse.

However, she might never have received treatment, had her daughter not took note of the extensive bruising on the woman’s abdomen and elsewhere. The woman was taken to the hospital, where she spent two days receiving treatment. Her daughter also contacted the local police department, who launched a criminal investigation.

This, amid another family’s claims that their relative also had to be hospitalized due to alleged neglect. In that case, a 68-year-old woman was taken to the hospital – but only after her daughter called a doctor because her mother’s arm was turning green. This followed several days in which the woman had trouble moving her arm. As it turned out, her shoulder was separated and her elbow was fractured.

However, even after the daughter of that woman spoke to a doctor, who advised that she be rushed to the emergency room, it took staff at the hospital more than two hours to contact an ambulance to take her.

The daughter couldn’t be sure exactly how her mother came to be injured, as her mother can’t communicate that to her. However, she suspects maybe her mother fell and the wound was never treated.

The director of the facility told the local media that the woman, who also suffered bruising and deep lacerations, had fallen while being transferred from her wheelchair to her bed. The patient was not, the director claims, a victim of abuse.

Now, our Lauderhill nursing home abuse lawyers are somewhat skeptical of this, but only because we know first of all that it can be very difficult for family members to accept that someone you trust is harming your loved one, and secondly, these facilities will do whatever they need to do to try to avoid financial repercussions.

Both patients have since been removed from the nursing home.

Perhaps unsurprising, the families later discovered that the nursing home has had several wrongful death lawsuits filed against it in recent years.

The state health department declined to say whether it was conducting an investigation, but police have indicated theirs is ongoing.

Because these cases can sometimes be difficult to prove according to the high standards that must be met in the criminal arena, in some cases a civil lawsuit is the best way to hold an agency such as this accountable.
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If you have a loved one in a nursing home facility, you’re likely aware of the guardianship program.

What you may not be aware of is a form of Broward nursing home abuse that involves financial exploitation by those designated to look after your elderly relative.

Our Broward nursing home abuse attorneys know that in a lot of cases, it’s a relative or close friend who takes over legal guardianship of an individual who is no longer capable of handling their own affairs, usually due to dementia, Alzheimer’s disease or some similar ailment.

However, in some cases, the court will appoint an outsider who might be a professional, such as a home health aide or paid caregiver, to handle the elderly person’s daily finances.

While the majority of these individuals likely have altruistic motives of simply wanting to help, that’s sadly not always the case.

In fact, there have been more than 800 reports of elderly exploitation in Broward over the last year and nearly 650 in Palm Beach County. For both, that was an increase of nearly 15 percent, according to a recent report by The Sun-Sentinel.

With about 2,700 elderly guardianships in Palm Beach County alone, that’s a pretty significant opportunity for potential fraud, especially given that our 85-and-over population is rapidly expanding.

While family members may wish to press criminal sanctions against individuals who take advantage of their elderly relative, if the losses are significant or if the perpetrator worked for an agency that you trusted to care for your loved one, his or her estate may be entitled to some form of compensation by the company who employed that person.

Part of catching senior exploitation, however, is knowing what you should look for.

Essentially, financial exploitation of an elderly person is defined as the wrongful use of someone else’s property or finances by someone else.

Some indications that your loved one may be suffering financial exploitation by their Broward nursing home caregivers:

–Sudden or unexplained changes in the older relative’s bank account;

–The addition of other names on the elder’s bank account;

–Unauthorized withdrawals from their account from their ATM;

–Odd or abrupt changes to your loved one’s will or other legal or financial documents;

–Bills that are not paid, despite the fact that your loved one should have plenty of money;

–Signatures that appear forged on financial titles or transactions that seem suspicious;

–Unexplained transfers of certain assets;

–Substandard care;

–Expensive items, purchased without the consent of the elder;

–Isolation of the elder person (lack of attendance at activities they once enjoyed or difficulty reaching them by phone).

The state has an abuse hotline, as does Palm Beach County. However, if you should also contact an attorney as soon as possible to explore your legal options.
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A long-term care corporation in Kentucky is pulling its chain from that state – but still has facilities in Florida – following the conviction of three staffers on charges of nursing home abuse.

As our Plantation nursing home abuse lawyers understand it, the decision has as much to do with the criminal case as the fact that Kentucky legislators did not pass a bill that would have made it more difficult for victims’ families to file civil lawsuits against negligent nursing homes.

A spokesman for the company, Extendicare Health Services Inc., was quoted by the Lexington Herald-Leader as saying that Kentucky has become a “battleground” for greedy attorneys targeting large, for-profit nursing homes.

The truth of the matter appears to be that this company seeks to avoid responsibility for the negligent and abusive actions of its staffers. Focusing their resources in states where there is less accountability and oversight (Florida included) appears to be their goal.

So this Canadian-based company, with facilities in South Florida, is certainly one to watch.

In the incident that prompted Extendicare’s extrication from Kentucky, three nursing home aides were arrested, charged and convicted of abuse, related to the death of an Alzheimer’s patient in her 80s.

The abuse was downright sadistic – but it wasn’t discovered until after her family members installed a hidden camera in her room to prove their suspicions that she was being harmed by staffers. The 84-year-old woman was losing weight at a rapid clip, and had bruises that were extensive and unexplained.

What they discovered was sickening.

One of the aides put her at great risk for infection by improperly and inadequately cleaning her.

Another aide refused to feed her. Instead, she would eat the woman’s meals herself – in front of her.

And yet another was witnessed abusing her both verbally and physically.

The woman ultimately passed away in 2008. The video footage of the abuse was sent to the state’s attorney general, who launched a misconduct investigation. The woman’s estate also filed a civil lawsuit seeking personal injury and punitive damages.

Those three staffers were ultimately convicted of wanton abuse of an adult and reckless abuse of an adult. Each received a one-year sentence, but all three of those sentences were suspended, in lieu of probation and assuming good behavior.

It’s a slap on the wrist, really.

But now, the agency that employed these three is acting as if this is some kind of a witch hunt. Consider, however, some of the other cases that have been cropping up in that state:

A former group-home worker who has pleaded guilty to manslaughter in the beating death of a mentally disabled man, who died of internal abdominal bleeding. The 21-year-old staffer initially told police he had seen another resident choking the victim, leading to the other resident’s arrest. However, it wasn’t until an autopsy revealed the true cause of death that investigators ultimately honed in on the staffer.

Another case involved the death of a 32-year-old man suffering from brain damage due to a childhood injury. He was staying in a long-term care facility, and was found dead near a river, about four weeks after he went missing. It’s not exactly clear what happened, but we do know this: staff should never have lost sight of him long enough for it to happen. His death has led to two proposals for legislation change.

The fact that the organization that harbored the three abusive aides has made it a point to say they desire to operate in less litigious states – given the severity of what is happening in Kentucky – should be a huge red flag.
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