Florida Nursing Home Lawyer Blog

Jupiter nursing home abuse attorneys know that it’s not enough for a Florida elder care facility to acknowledge and take action in the wake of allegations of abuse, neglect or negligence – though that is the least it should do.

A facility on the Florida panhandle is currently facing fines and state-mandated probation not only for failing to implement procedures to prevent future abuse but also for failing to report previous abuse allegations to state authorities.

In a final order issued by the Agency for Health Care Administration, the government chastised the Crestview-area home for failing to properly report allegations of patient abuse.

Back in the fall of 2012, the state conducted a routine survey of the facility. Inspectors interviewed both staffers and residents and reviewed the home’s records to ensure compliance with basic standards of care. However, it was determined in the course of that survey that three of the 60 clients may have suffered abuse. A number of staffers knew that there was intentional rudeness and refusal of treatment, care and services on the part of other workers toward certain patients. And yet, these staffers had never done anything to address these actions. What’s more, they didn’t report these violations to state agencies.

The firsthand accounts from residents are heartbreaking. One was from an elderly man with Parkinson’s disease, which affects a person’s muscle movements. He needed assistance in using the restroom. One of the female staffers told him to do it himself. Another finally wheeled him into the restroom, then roughly shoved his wheelchair up against the wall. When he was finished, she ordered him to move his feet. When he couldn’t, she ran over his feet.

Cases like this are very telling because many nursing home residents are unable to so clearly recall the mistreatment they suffer. In fact, many staffers target those whom they know won’t be able to tell. That staffers would do this to someone who is cognizant enough to recall what happened in detail is deeply troubling when considering how those same staffers might then treat someone with dementia or some other mental disability.

In another case at this same facility, one female staffer is accused of physically hitting a number of residents. Some had described her as “rough” or “having an attitude,” but there had been reports of her physically striking patients. A couple of administrators conceded knowledge that a few of the patients “had issues” with this woman, but nothing had ever been done to address those problems. The director of nursing denied awareness of any contention.

Florida Statute 400.022(1) holds that each nursing home resident in the state has the right to be treated courteously, fairly and with the fullest measure of dignity. Demanding someone with physical disabilities get up and use the bathroom on their own is none of these things. Certainly, neither is outright physical abuse.

This facility faces the possibility of a fine for failure to comply with state law. However, the real travesty is the amount of that fine: $13,500. What that basically means is that it’s cheaper for nursing home facilities to simply pay these kinds of fines for violations as a cost of doing business, rather than address and correct problems at the front end by doing all they can to ensure patient safety and well-being.
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A nursing home in West Virginia tried recently to fight a $90 million verdict – but a judge upheld it, saying that the amount was not excessive nor unconstitutional and that it was intended to accomplish punishment and deterrence.

Riviera Beach nursing home abuse lawyers know that verdicts this high aren’t necessarily the norm, but they aren’t unheard of either, particularly in cases where the abuse was especially egregious or resulted in serious injury or death.

That’s what happened here, according to court records on the case.

The patient in question was 87, and she was brought to the facility suffering from Parkinson’s, Alzheimer’s and dementia, among a few other conditions. There is no question that her health was failing. But that doesn’t mean she deserved sub-par treatment.

Prior to her move to the nursing home, she had been staying with her son after a long hospital stint. While there, she had recovered to a point that she was able to walk, talk and even recognize family members.

But as is the case with many who struggle to balance caring for an ailing, elderly parent and managing their own lives, her son made the difficult decision to place her in a nursing home. He had to place her in one facility while waiting for another to open.

She was at the first just three weeks before she died.

There were signs of problems almost immediately, her son says. Soon after he checked her in, he says, the staff labeled her a fall risk. As such, she was restrained to her wheelchair.

Over the course of those three weeks, her decline was rapid. She lost 15 pounds. She was no longer able to walk or speak. She was suffering from renal failure.

By the time she was transferred to the second nursing home, she was unresponsive and so dehydrated she was close to death, which came just days later, at a nearby hospice center.

During the trial, it was revealed that the nursing home that had cared for her during those three weeks did not have enough nurses on staff. A number of workers took the stand to testify that the facility’s staffing levels made it all but impossible to properly care for all of the residents. The employee turnover rate in 2009, the year this woman died, was 112 percent. In fact, prospective employees were bailing on the job after a cursory glimpse of the conditions. That says a lot.

This is a prime example of what can happen when for-profit facilities are more focused on the size of the bottom line, rather than the quality of the care. The goal, workers say, was to keep the number of residents high and the number of staffers low.

The nursing home attacked the testimony of former employees, saying their credibility was shot and one had been fired over an issue of stolen medication.

This is a facility that is owned by a corporation that controls hundreds of nursing homes nationwide. In fact, the firm’s parent company reported about $4 billion in earnings in 2009 and assets of approximately $8 billion that same year.

So while a verdict of $90 million might seem excessive, it’s actually not as substantial as it might seem on the surface for this facility. It’s certainly not going to put them out of business. And given the number of facilities they run, the judge is correct in his finding that such an amount can serve as a powerful deterrent for the corporation in the future.

While we in no way fault the son for what happened, there may have been some red flags to note prior to her check-in. The facility was given one out of five stars for overall care in its Medicaid ranking and previous state inspections had revealed nearly 30 deficiencies in the home, which is more than double the state’s average.

Still, he was expecting the stay to be temporary and he expected at least a basic level of care would be provided to his mother. She deserved that much. She clearly didn’t receive it.
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Another nursing home abuse case made headlines recently, this time of an 85-year-old dementia patient from Ontario, whose family captured on video her horrific mistreatment at the hands of four different caregivers.

Our Lauderdale Lakes nursing home abuse attorneys were deeply saddened and angered by the abuse these images portrayed.

In one instance, one of the nurses is seen shoving a rag stained with feces into the face of the patient.

In another, a staffer is seen blowing her nose in the patient’s bed sheets.

Another image showed the woman being treated with a complete lack of dignity, as her diaper is changed with her bedroom door wide open.

All of this was just in a short, three-week time span. Prior to that, the woman’s family said they had grown suspicious of what was happening behind closed doors at the facility after they noticed she had an unexplained black eye. The family inquired to the staff at the nursing home about what had happened, but no one could provide an answer.

The woman, plagued with dementia, was unable to speak for herself.

So her children allowed the video footage to do the talking.

Now, the provincial ministry of health is investigating the incident, though no arrests have been made.

This case started like so many others in that something simply didn’t sit right with family members. They had a feeling something was wrong. Too often or sometimes for too long, people choose to ignore that nagging feeling because we find it’s easier to believe that it’s all in our heads. We don’t want to think that anyone would be cruel to the ones we love so much.

Deep down, though, we know that we owe it to those who once cared for us to make sure that they too are in good hands. So when there is a suspicion that they’re being harmed, we have a responsibility to act on it.

The truth of the matter is, incidents such as this aren’t isolated. An ABC News report last year revealed that 1 out of every 3 nursing homes has been identified as having some kind of abuse. The special Investigations Division of the House Government Reform Committee found that nearly 9,000 of 5,280 nursing home facilities – about 30 percent – had been cited for instances of abuse over a recent two-year period.

Most commonly, the problems involved bedsores, malnutrition, inadequate medical care, preventable accidents, inadequate sanitation and hygiene and dehydration.

But you may not be able to tell the exact violations just by looking around. Here are some warning signs of elderly abuse to watch for:
–Unexplained bruises, cuts, wounds, broken bones or other injuries;
–Your loved one becomes emotionally agitated, upset, withdrawn or uncommunicative;
–Unnecessary physical restraints (and they usually are unnecessary);
–Frequent illnesses;
–Evidence of bedsores, malnutrition or dehydration;
–Lack of personal hygiene;
–Rapid weight loss or weight gain;
–Caretakers who are unable to explain behaviors or injuries adequately;
–Unexpected or unexplained death.

If you suspect your loved one has been abused, it’s time to reach out to a Lauderdale Lakes personal injury team with experience.
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Lawmakers in Oklahoma have passed a law allowing nursing home residents and/or their family members to install electronic monitoring systems in their loved one’s rooms.

Our Port St. Lucie nursing home abuse lawyers understand that this legislation came about after a series of incidents in which abuse of elderly victims was uncovered only after the installation of a hidden camera.

In one case, a staff member is seen shoving a latex glove into the mouth of an elderly woman before violently tossing her onto a nearby bed. Family members had suspected something had been going on for a while. What they actually believed was that someone was stealing from her. But they had no proof until they installed that camera.

The woman, they said, suffered from dementia and couldn’t tell them what was happening.

The camera spoke for her. It told a story that was far more disturbing than the one they had initially suspected. Two staffers at the facility were later arrested, with that video becoming the primary evidence in both of those criminal cases.

Incidents such as these are far from isolated, which is why lawmakers in Oklahoma made the Protect Our Loved Ones Act a priority. It’s been proposed every year for the last 12, and finally this year received enough support for passage.

Per the law, the in-room cameras won’t be required, but will be allowed by family or residents who wish to cover the cost out-of-pocket.

Nursing homes would be required to record video only in common areas of the nursing home, while bathrooms and bathing areas would include audio-only recording devices, to protect the privacy of the residents.

Nursing home advocates worry that the cost to install video cameras could potentially put facilities out of business. This is not something we believe is likely to happen. Consider that a report late last year by federal health care inspectors reported that nursing homes in the U.S. raked in $105 billion in revenues in 2010 – a nearly 75 percent increase from the amount they made in 2002.

Trust us: No matter what weak line industry representatives may give to try to curb regulations, these facilities aren’t hurting for money.

Believe it or not, Florida used to be on the front lines of this nursing home camera debate.

Back in 2002, legislators grappled with SB 1714, which called for a year-long pilot program to test the impact of cameras in nursing homes, and whether it could help to curb the instances of neglect, exploitation and abuse of elderly residents. The proposal would have resulted in cameras being installed in common areas and also in private rooms, the latter only if requested by the resident and/or guardian and approved by any roommates.

The cost of the room cameras would have been between $200 and $500, and would have to have been covered by family members. The state would have covered the expected cost of $10,000 per nursing home to have the devices installed in common areas.

However, the bill was vigorously opposed by the Florida Health Care Association, the Florida Medical Directors Association and the Florida Life Care Residents Association. Of course, these were groups with a lot to lose, and they launched an aggressive campaign to have the measure stricken.

They succeeded. The measure was shelved and hasn’t been picked back up again since, despite continued support by the Tallahassee-based Coalition to Protect America’s Elders.

The question of whether it is legal for families who suspect Florida nursing home abuse to install private room cameras has been raised numerous times since. Technically under Florida law, it’s a crime to record someone’s voice without his or her consent.

However, a recent court case, Minotty v. Baudo, held that it is legal to video tape someone, so long as you aren’t recording their voice. In that case, the court even commented that “nanny cams” were in fact a proper way to catch people engaged in suspected misdeeds.

Still, it’s advisable if you suspect abuse of your loved one to first contact an experienced Port St. Lucie nursing home abuse lawyer. This way, you can be sure that your own actions will be on the right side of the law and that whatever evidence you do uncover may be used in court.
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Senate Bill 1384, the measure that would have made it tougher for Floridians to sue nursing homes who had neglected and abused their elderly loved ones, has failed.

Our Delray Beach nursing home abuse lawyers are happy to report that at least for now, the issue is dead.

The controversial measure would have made it more difficult for loved ones to hold negligent nursing homes responsible, even when their actions – or lack of action – led directly to serious injury or death.

SB 1384, which was introduced by Sen. Bill Galvano (R-Bradenton), would have required claims for punitive damages to go through a special, rigorous proceedings. Punitive damages are those awarded to the plaintiff that are intended to punish the defendant for especially egregious errors, oversights or misdeeds. It exceeds simple compensation.

Rather than having that issue decided in court, by a jury, this bill would have required plaintiffs to get special approval from a judge PRIOR to the trial. The standard for this would have been that the plaintiff would have had to have proven “clear and convincing evidence” that the corporation or a certain person had knowingly and actively participated in misconduct that was intentional or conduct that amounted to gross negligence. If the judge denied the plaintiff, the claim could still move forward but the potential for monetary damages would be significantly diminished.

This bill was of course backed strongly by the nursing home industry lobbyists, but fiercely opposed by prior victims of abuse and advocates for older citizens, such as the AARP and the Florida Justice Association. Those within the nursing home industry said it was necessary to protect the industry from “predatory lawyers” for plaintiffs. That’s an unsurprising tactic and it’s nothing new. The reality, however, is that it’s already difficult to obtain punitive damages, especially in any significant sum. Making it any harder would have essentially taken away the nursing homes’ incentive to prevent abuse and neglect in the future.

Those who had experienced or had loved ones experience the abuse firsthand testified passionately before lawmakers not to pass the bill.

Still, it had advanced at a rather steady clip, all the way through the Health Policy Committee, though it eventually died on calendar May 3. Had it passed, it would have become effective July 1.

Companion House Bill 869 suffered the same fate, dying in the Health Innovation Subcommittee on May 3. Prior to that, it had survived both the Civil Justice Subcommittee and the Judiciary Committee.

While we are certainly thrilled that these measures sputtered out, we still have concern that they made it as far as they did. We hope this does not foreshadow difficult battles in future legislative sessions over the same issue.

Punitive damages exist in the first place because some conduct is so flagrantly atrocious or nefarious as to warrant special punishment. It’s a high standard to reach. Making it even harder would have only served to help those who hold the welfare of our elderly loved ones in the lowest regard.
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A Broward County husband-and-wife have been sentenced to seven years behind bars, following their jury conviction in March for exploitation of the elderly.

Our Hollywood elder abuse lawyers know that the pair could have faced up to 30 years in prison.

The case highlights an all-too-common phenomenon of elderly financial abuse, something to which many seniors are vulnerable.

In this case, the married couple, the husband 48 and the wife 52, befriended a 94-year-old woman in their Hollywood neighborhood. They then convinced her to allow them to take on the role of her financial advisers. The wife may have been especially convincing, as she worked as a stock broker.

However, rather than responsibly managing the elder woman’s finances, they attempted to swindle her out of her $10 million estate.

Witnesses say the two convinced the older woman to disinherit beloved family members. Later, she was lured into turning her money over to them.

The woman was reportedly suffering from dementia. Like many others her age, she lacked the capacity to make sound decisions. The couple knew this, prosecutors said, and marched her over to an attorney in order to have her alter the will to include them in it.

However, the woman’s son was more vigilant than the pair anticipated. He had been tracking his mother’s financial status, and contacted police when he found that the two were essentially helping themselves to anywhere from $500 to $5,000 at a time.

In all, the couple were reportedly able to trick the woman – and her elderly sister – into handing over $100,000 to them. They then put themselves in a position to receive more from the inheritance, once the woman died.

Defense attorneys had attempted to argue that the elder woman’s deposits were genuine displays of both appreciation and affection for the two, for whom she had grown to care after developing a deep personal bond.

Thankfully, the jury wasn’t buying it.

Sadly, cases like this are far from isolated, even if the victim doesn’t have a multi-million dollar estate hanging in the balance.

Financial exploitation is every bit as abusive as a physical wound. It robs a person of their dignity, their independence and all too often, everything they have worked so hard for. One person’s greed can leave them destitute.

Recognizing this type of abuse can be a bit tougher. There are no bruises or scars. Relatives or loved ones may not think to closely follow their elderly loved ones’ finances because they assume there is nothing to worry about, particularly if he or she is a resident at a nursing home.

The U.S. Government Accountability Office released a study last year indicating that in 2010, the cost of older adult financial exploitation in this country cost nearly $3 billion annually.

Perhaps the best line of defense in these cases are friends and family members who remain watchful and unafraid to follow up and press for more details.

It can be difficult to spot, but some of the potential indicators could include:

–Your elderly loved one seems to be strongly influenced by a friend or relative or nursing home caregiver. Be mindful that this individual could be trying to get control of the elder person’s finances, while keeping them in a passive role.

–You notice sudden changes to your loved one’s individual financial accounts or life insurance policies.

–You become aware that accounts belonging to your elderly loved one now have joint account holders or authorized signers.

–A caregiver at any point requests access to bank accounts or other assets – including as a condition of providing care.

–You take note of a sudden change in your older loved one’s individual financial status or the account activity.

–Your elderly loved one has recently made changes to property titles.

–Your older loved one has new financial arrangements about which they seem unable to explain or just generally confused about.

–You notice a lack of personal care in terms of hygiene or in other areas, despite the fact that his or her financial means would suggest the standard of care should be elevated.
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