California Nursing Home Abuse Lawyers Blog

Nursing Home Neglect and Abuse
There are many excellent nursing homes that provide tremendous care to residents. However, there are also many nursing homes where the abuse and neglect of residents occurs. With many private-equity firms treating nursing homes only as money-making ventures, it is possible that the overall quality of care provided may be falling says California Nursing Home Abuse and Neglect Lawyer Steven Peck. Abuse and neglect can happen for any number of reasons, including under-staffing, failure to train staff, or neglecting to conduct background checks while hiring staff. If it is suspected that a loved one is being abused or neglected, watch for these common signs of abuse and neglect:
- Bed sores (pressure ulcers) or open wounds
- Unusual bruising
- Unexplained broken bones or injuries
- Weight loss
- Dehydration and malnutrition - Changes in behavior

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Bedsores (pressure sores or decubitus ulcers) are painful skin ulcers which develop when constant pressure on a body part shuts down blood supply to that skin area says Nursing Home Abuse Attorney Steven Peck.

This happens when we sit or lie in the same position for too long. Affected skin becomes starved of oxygen and nutrients.

The skin breaks down and an ulcer (sore) is formed. Friction between skin and clothing or bedding may cause bedsore formation. Areas along the backbone, shoulder blades, heels, hips, and elbows are common ground for bedsores.

Healthy people don't usually develop bedsores since we're constantly adjusting posture and position, shifting the 'pressure' of body weight around. We tend to acquire pressure sores when we are unable to recognise or say that we are uncomfortable (e.g. in dementia, Alzheimer's or mental illness), or we are physically unable to reposition ourselves (paralysed, bedridden or wheelchair bound). Seniors are at risk.

If skin is kept excessively dry or moist (in sweat, urine, or feces, and breeding bacteria) it is likely to break down when faced with friction or pressure. Complications leading to death can happen when bacteria enter the wound then the blood, infecting body parts including the brain

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Understaffing is being alleged in many cases based upon Nursing Home and Long Term Care and Neglect. The failure to adequately staff violates the Patients Bill of Rights, which includes the right to be in a facility that has sufficient staff to care for the needs of patients.

That bill of rights also lays out minimum state staffing requirements - including 3.2 nursing hours per day per patient - many long term care facilities violate the law concerning the nursing hours per day per patient.

California Nursing Home Abuse and Neglect Lawyer Steven Peck says that convalescent facilities received an extra $1 billion in reimbursements between 2004 and 2008, but failed to use that money to comply with the legal staffing requirements.

Peck says that nursing home staff commonly are underpaid and have no health benefits, and as a consequence there is high turnover.

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Pass The Nursing Home Patient Protection and Standards Act of 2011. Assure that nursing home residents are properly cared for, and that facility owners and administrators are accountable for the care of these residents.

Millions of Americans - those who are elderly, ill and frail - currently reside in nursing homes. The decision to move into a nursing home is often emotionally painful, as individuals must accept their lack of independence and unfamiliar surroundings because they are no longer able to care for themselves. However, these most vulnerable Americans are often abused and neglected in the very facilities that are intended to provide care. These individuals must be protected through our legislative process.

House Bill 2522 was recently referred to the House Subcommittee on Health and Human Services. Passage of this legislation would amend sections of the Social Security Act to allow for improved oversight of nursing home care provided under Medicaid and Medicare programs. In addition, protection against retaliation for whistleblowers - employees who report inappropriate treatment or conditions in nursing homes - would be put in place.

The process of checking into a nursing care facility does not include relinquishing one's rights to dignity and proper care. In fact, these rights are included in many existing federal and state statutes. Some of these rights include treatment with respect, consideration and personal dignity which is adequate and appropriate, given the resident's condition, and freedom from mental and physical abuse. However, existing statutes do not go far enough and do not include sufficient punitive measures for caregivers, administrators, and facility owners to assure that proper conditions exist. Sadly, the elderly and infirm in American society are viewed as a nuisance. This lack of respect, coupled with the greed in the nursing home industry, leads to cutting corners, inappropriate staffing and resident neglect.

Please urge Congress to enact nursing home reforms so that elderly and ill residents are protected from undue suffering and humiliation.

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In the nursing home environment, the prevalence of pressure ulcers is in the range of 2.6-24%.The incidence is 25% in residents admitted from an acute care hospital.

Patients with preexisting pressure ulcers demonstrate a 26% incidence of additional pressure ulcer formation over a 6-month period. The incidence in chronic care hospitals is reported to be 10.8%,whereas 33% of those admitted to a chronic care hospital have pressure ulcers.Long-term follow-up demonstrates that most ulcers healed within a year.

Persons with spinal cord injury (SCI) and associated comorbidity are also at increased risk. The incidence of pressure ulcers in this population is in the range of 25-66%.

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A nursing home falsified medical records to make it seem as if their family member had been checked on more than he actually was in a recent matter handled by the Peck law Group. It was also claimed that the elder victim was suffering from malnutrition and dehydration while supposedly being cared for by nursing home staff members. All of the neglect in care was due in large part to the understaffing at the facility, caused by the owner's drive for maximized profits.

Many of the most common signs of poor nursing home care were exhibited here: bedsores, malnutrition and dehydration, and understaffing. Of course, when employees attempt to falsify medical records at a facility, it becomes increasingly difficult to prove misconduct. It is often a real struggle to get at the truth in these situations, which is why it is vital to contact experienced Peck Law Group Nursing home lawyers to help if you or your loved one has been hurt by poor care at one of these facilities.

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Bedsores are also known as pressure sores, pressure ulcers are basically skin wounds and generally form in those areas where a person can have the least padding of muscle and fat.

These wounds arise by the pressure on the skin in contact with a bed or wheelchair and they are mighty painful. They take long time to heal and are often considered as preordination of life-threatening complications such as severe infection in your skin, blood and in your bones.

The infections that an elder or dependant adult receive from bedsores can and will cause pain and suffering and in many instances wrongful death.

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The U.S. Department of Health insurance and Human Services' Office of Inspector General investigated the number of individuals with criminal records working in nursing homes. To conduct the investigation, the OIG selected a stratified random sample of 260 nursing facilities from more than 15,000 Medicare-certified nursing facilities and performed Federal Bureau of Investigation background checks on the employees of those 260 nursing homes. Long-term care facilities like hospices weren't investigated, and contract workers at nursing facilities were also not considered.

Study Finds Most Nursing Homes Have Employees With Criminal Convictions says Los Angeles Nursing Home Abuse and Neglect Lawyer Steven Peck.

Based on a government report, a lot more than 90 percent of nursing facilities have employees with criminal records. The current patchwork system of criminal-background checks may bring about the high number of individuals with criminal convictions working in nursing homes, and it leaves vulnerable nursing-home residents at risk of harm.

Criminals in Nursing Homes
The analysis says, in 2009, 92 percent from the nursing homes employed at least one person with a criminal conviction. Further, almost 1 / 2 of the nursing homes employed five or even more people with criminal convictions.

At one facility with a total of 164 employees, 34 employees had a minumum of one conviction each, said Daniel R. Levinson, Inspector General from the U.S. Department of Health and Human Services.

Seven registered sex offenders were working at five different nursing homes, and 13 percent from the employees with criminal convictions were found guilty of crimes against people. The majority of the employees' convictions, 44 percent, were for crimes against property such as shoplifting, burglary or writing bad checks.

Medicare and Medicaid Regulations
Federal regulations report that nursing homes that receive Medicare and Medicaid payments cannot employ people convicted of "abusing, neglecting or mistreating" nursing-home residents and can't employ people entered in state nurse-aide registries for neglect, abuse or mistreatment of nursing-home residents, including theft of resident property.

The Centers for Medicare and Medicaid Services' guidelines suggest that nursing homes "must be thorough within their investigations of the past histories of people they are considering hiring." However, criminal-background checks are not required by federal law. Individual states may create their own background-check standards, but the insufficient centralized screening of nursing-home employees puts nursing-home residents at risk.

Patient Safety Risks
Currently, only ten states require pre-employment state and FBI criminal-background checks. Because only the FBI background check reports criminal convictions in multiple states, someone with a conviction in one state may find employment in a elderly care in a different state that does not use FBI criminal-background checks.

Senator Herb Kohl, D-Wisconsin, Chairman of the Senate Special Committee on Aging, said the current background-check system is "haphazard, inconsistent and full of gaping holes in many states. Predators can certainly evade detection throughout the hiring process, securing jobs that permit them to assault, abuse and steal from defenseless elders."

Additionally, AARP spokesman Jim Dau said, "There are still potentially-dangerous gaps in the system accustomed to determine who will be responsible for providing care for many people during vulnerable points within their lives."

Since nursing-home employees often work unsupervised in close connection with people who are less in a position to protect their property and defend themselves, a background-check system -- or lack thereof -- which allows people with criminal convictions to slip through the cracks puts family members at risk for theft and, even worse, maltreatment or nursing-home abuse.

National Criminal record check Program
On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act. According to the OIG report, the Patient Protection and Affordable Care Act requires the Secretary of Health insurance and Human Services to implement a nationwide program for individual states to conduct both state and FBI background checks for nursing-home employees with immediate access to nursing-home residents.

Because criminal convictions are occasionally under different names, the National Background Check Program will work fingerprint-based searches of state and federal criminal-conviction records. However, FBI records generally do not indicate whether the victim of the crime was a nursing-home resident. Therefore, additional information on a potential nursing-home employee's criminal conviction is necessary.

Improvements to nursing-home employee screening ought to be made quickly so elderly and vulnerable residents are not harmed by people with criminal convictions. If you suspect that a relative or loved one in a nursing home might be suffering neglect, abuse or maltreatment from nursing-home employees, contact an experienced nursing home attorney in your area to discuss your legal options.

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Bed sores also go by the identify of decubitus ulcers and they are ulcers of the skin that appear due to prolonged pressure. Bed sores are easier to prevent than to treat and this short report will share preventative measures you can take and information about the medical symptoms, causes and treatments available if bed sores are already present says Los Angeles Nursing Home Abuse and Neglect Attorney Steven Peck.

Bed Sores:

Indications of bed sores start as an region of red skin, which is usually over a bony prominence.

If a particular person is confined to bed rest, the prevalence of these sores could be greater overlying the hips, spine, lower back, shoulder blades, elbows and heels.

If a particular person is in a wheelchair, bed sores also known as pressure sores and decubitus ulcers, may be noticed on the buttocks or tailbone, lower back, lower limbs, heels and feet.

If the pressure is not eliminated from these red areas an ulcer can develop. This ulcer could have a foul odor, tenderness, be warm to touch and feasibly drain fluid.

The blistered sores are normally allowed to advance due to the fact most persons who succumb to decubitus ulcers are chronically ill, bed ridden, and/or possess very poor circulation or sensation. These elements make the individual not aware of the increasing ulcer.

For avoidance of bed sores it is crucial to frequently change the position of the individual. A bed sore can begin to form in just a few hrs of immobility. It's ideal to have the individual adjust positions each 15 mins particularly if they are in a wheelchair and just about every 2 hrs if they are bed ridden, even throughout the night.

Other bed sores avoidance steps involve:

Lying on your side at a 30 degree angle to stay away from direct pressure on the hipbones

Inserting a foam pad or cushion beneath the legs from the mid-calf to the ankle (not behind the knees in which it can restrict blood movement) when lying on your back

Utilizing a small pillow or pad to stop knees and ankles from touching

Maintaining an incline bed at less than 30 degrees to stop possible friction from slipping down.

Employing a mattress specially developed to lessen pressure. Examine your choices with your doctor.

As for treatment, considering the impacted particular person may already have bad blood flow to the spot of the ulcer, healing could be slow. It is quite crucial to minimize any further pressure on the damaged place. This can be achieved in bed ridden persons by repositioning each and every 1-2 hours. Wheel chair individuals could additionally be repositioned frequently. A prescription ointment can be applied through the day and anti-biotics can help combat any infection.

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A wrongful death case is a civil case that is brought against another individual, a hospital, nursing home, because their negligence or willful act caused the death of a loved one. In most states, the deceased must be a close family member or a life partner, and the family member must suffer some emotional or financial trauma as a result. Types of cases include accidental deaths, occupational hazards, medical malpractice, Nursing Home Abuse and Neglect or even criminal acts says California Nursing Home Abuse and Neglect Lawyer Steven Peck.

Because laws in a wrongful death case might differ from state to state, family members need to pay attention and contact a lawyer immediately.

In California, the Statute of Limitations against a health care provider is one year from the date of death pursuant to Code of Civil Procedure 340.5 and against a non-health care provider two years from the date of death pursuant to Code of Civil Procedure 335.1. Time is critical due to statues of limitations, which if missed can result in losing the legal right to sue.

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When somebody is bed-bound, it is needed for them to change position periodically to stop bed sores. Bedsores happen when a patient lies motionless for an extended period of time. Constant pressure on spots on that person\'s body can trigger the skin underneath the contact point to die, making a hole in the person\'s skin. If they are caught early, bedsores can be treated simply. But if they are overlooked, they can lead to massive infections and death says Los Angeles Nursing Home Abuse and Neglect Attorney Steven Peck.

Any spot the patient\'s body that experiences pressure whilst that person is motionless can develop a bed sore if the conditions are proper. For example, if the person is lying in a position where component of the bed's frame is in constant contact with the person's knee, the sustained pressure of the frame on the leg can cut off blood supply to that tiny area of skin. If blood flow is cut off for too lengthy, the skin underneath the contact point will die.

Sadly bed sores are specially frequent in nursing homes. Nursing houses are designed to care for patients who can not take care of themselves, and patients typically live there for years. A substantial portion of nursing home patients might be unable to leave their beds. Nurses are expected to frequently help patients reorient their bodies and to check for bedsores, but some facilities fail to safeguard their patients indicates California Nursing Home Abuse and Neglect Lawyer Steven Peck.

Early-stage bedsores, if they are detected, only trigger damage to the upper layers of skin. Over time, the tissue death proceeds deeper and deeper. Beyond a certain point, the body can't recover on its own. Treating a bed sore demands surgically removing the dead tissue and applying anti-microbial dressings to maintain it covered. Severe wounds call for skin grafts or comparable surgery, as the body can not close the hole on its own.

The causes, nature, and effects of bedsores are well known. Nursing homes, hospitals, and other care facilities have an obligation to ensure that bed-bound patients do not develop bedsores. If their negligence causes a patient wonderful suffering, that individual and their loved ones have the appropriate to seek compensation for their suffering.

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Sepsis describes a bacterial infection of the blood which can become fatal without treatment. The elderly often present a high risk for developing sepsis due to having weak immune systems especially if they have also pre-existing medical conditions. Improper or neglectful nursing home care of residents with bed sores, surgical or slow healing wounds, or using intravenous lines or catheters can result in a septic infection says California Nursing Home Abuse and Neglect Lawyer Steven Peck.

Cause of Sepsis::
Sepsis is caused by bacterial infection which spreads from any vulnerable point of the body into the bloodstream. Some symptoms of sepsis include irregular body temperature, and respiration, nausea, vomiting, seizures and body pains.

Bed Sores and Skin Ulcers:
Bed ridden or incapacitated residents are vulnerable to skin ulcers or bed sores. Some treatments include relieving pressure in affect areas, antibiotics, and cleaning and covering of wounds. Without treatment these wounds can blister, break open, and become infected. The infection can eventually develop into sepsis indicates Elder Abuse Attorney Peck.

Surgical and Slow Healing Wounds::
Residents recovering from surgical or slow healing wounds may require antibiotics, regular cleaning and changing of bandages to help reduce possibility of infection. Improper or neglectful attention, to these residents, can increase potential for a bacterial infection which can spread from the wound to surrounding tissue and into the bloodstream causing sepsis.

Intravenous Lines (IV Lines)::
Intravenous treatments carry a risk of infection due to direct contact into the blood stream through the vein. It is an aseptic procedure which requires regular changing and cleaning of the insertion site. However, improper care can lead to bacterial infection from foreign objects within the line and contaminated equipment. Accumulation of moisture, around the insertion site, can also result in an infection which can grow into sepsis.

Treatment:
Treatment for sepsis includes aggressive intravenous antibiotics to kill the infection. A more severe case may require ventilation for respiratory failure, vasopressor treatment to stabilize blood pressure, painkillers, and medications to control blood sugar and immune response. Invasive surgical procedures may also be required to drain or remove the source of infection.

Prevention:
Nursing home attendants can help reduce risk of sepsis through regular bathing of incapacitated residents, proper attention and cleaning of surgical wounds and bed sores, and regular changing of IV lines.

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the California Court of Appeal (Second Appellate District, Division Five) permits a plaintiff in an employment case to seek punitive damages from her employer.

The plaintiff, a drug store employee, accused her supervisor of sexual harassment. She sued her employer for compensatory and punitive damages, but the trial court granted the defendant's motion for summary adjudication on the issue of punitive damages. The court ruled that the plaintiff presented no evidence that her supervisor's misconduct was was approved by a corporate "managing agent," as required to obtain punitive damages against a corporation under California Civil Code section 3294 says California Nursing Home Abuse and Neglect Attorney Steven Peck.

The Court of Appeal disagreed. It said the plaintiff presented evidence that she complained to the defendant's regional manager, who was responsible for managing every aspect of the day-to-day operations at approximately 25 stores. The court said this evidence demonstrated a sufficient level of independent discretionary authority to support a finding that the regional manager was a managing agent. Curiously, the court did not cite Roby v. McKesson, the California Supreme Court's latest decision on the requirements for establishing managing agent status.

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Pressure ulcers

Pressure ulcers are also referred to as pressure sores, bedsores, and decubitus ulcers. A pressure ulcer can range from a very mild pink coloration to the skin which disappears in a few hours after the pressure is relieved, to a very deep wound extending to and sometimes through a bone into internal organs.

All pressure ulcers have a course of injury similar to a burn wound. This can be a mild redness of the skin and/or blistering such as a first degree burn to a deep open wound with a lot of blackened tissue in it such as a third or fourth degree burn. This black tissue is called eschar.

The primary cause of pressure ulcers is unrelieved pressure. It can also occur from friction by rubbing against something such as a bed sheet, cast, brace, etc. or from prolonged exposure to cold. Any area of tissue that lies just over a bone is more likely to form a pressure ulcer. These areas include the spine, coccyx or "tailbone", hips, heels, and elbows. Other contributing factors to the development of pressure ulcers is poor nutrition, weight loss, diabetes, poor hygiene, and dehydration.

Prevention, is the most important component of pressure ulcer management. Removing all pressure from the involved areas to prevent further decay of tissue and promote healing is the primary method of treatment. Frequent turning is mandatory to alleviate pressure on the wound and to promote healing. The individual must have increased nutrition to allow for proper healing of the wounds.

Another key aspect of treatment is keeping the area clean and removing dead or necrotic tissue which can form a breeding ground for infection. Some deep wounds require surgical removal, called debridement, of dead tissue.

Without all of these elements being in place the wounds will not heal properly and will very likely worsen.

The development of pressure ulcers may be an indication of potential problems in the care being delivered to the nursing home resident. Even in good nursing homes, small wounds may develop, but with quick attention, these wounds will heal and not progress to massive wounds. According to federal law, in most situations there is no medically valid reason for a pressure ulcer to progress to a Stage IV situation (a massive deep open wound).

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