Articles Posted in Nursing Home Abuse

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The coronavirus presents new and challenging concerns for many sectors of our society.  This is all the more so with nursing homes. Because the virus is easily spread among people living in close proximity, and because it is especially deadly for older persons with health issues, nursing homes provide fertile ground for catastrophe.  As a stunning example, a Life Care Center nursing home in Seattle has had thirty residents test positive for the virus with another nineteen having already died.

Viral infections in nursing homes are nothing new; however, one big variant is that there is no vaccine currently available for the coronavirus.  Despite these challenges, nursing homes are required to take all measures possible to avoid the infection and spread of any virus.

It is not acceptable for a nursing home to claim that it cannot control the spread of the coronavirus because there is no vaccine.  As detailed below, nursing homes in Jacksonville are already routinely cited for failing to implement standard infection control measures.  This means that nursing home staff are not properly trained in preventing the spread of disease.  The result is that infection is spread by: unwashed hands; gloves used by staff on more than one resident; insufficient isolation protocols for contagious residents; improper housecleaning and laundry service; and a lack of training to identify residents suffering from a contagious illness.

Simply put, when you add a pre-existing wholesale lack of preparation with the challenges presented by a new illness, you get a disaster that could have been prevented or minimized.  The coronavirus was not unforeseeable.  To the contrary, new viruses appear all the time, with recent examples including SARS, MERS, Zika, the bird flu and the swine flu.  In fact, the coronavirus presents the exact scenario that infection control measures are designed to address.

In the greater Jacksonville and Northeast Florida area, fifty-two of the nursing homes have been cited for insufficient infection control measures. One of the measures used to rank nursing homes by the Centers for Medicare and Medicaid Services relate to infection control measures in place at each nursing home.

In assessing the nursing homes’ infection control measures, state inspectors employed by Florida’s Agency for Healthcare Administration focus on:

-transmission precautions;

-training of staff in transmission precautions to be taken;

-use of personal protective equipment;

-hand washing and glove use;

-laundering of linens and towels; and

-measures in place to detect the spread of infections.

Our lawyers have handled many infection cases against Jacksonville area nursing homes including: urinary tract infections; clostridium difficile (“C. diff.”) infections; pulmonary infections; scabies; and infected bedsores.  One thing we have noticed in almost every infection case is that signs and symptoms of the infection were overlooked or ignored.  With elderly and infirm people, it only takes a few days for an infection to turn into deadly septic shock.

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One of the most common types of nursing home abuse cases that our lawyers handle involve bedsores.  Bedsores, also known as decubitus ulcers, form when bony prominences of the body are subjected to prolonged pressure with a mattress, bedding or a medical device.  Most commonly, bedsores occur on the sacrum, which is the lower back just above the buttocks.  Other common locations for bedsores include the feet, ankles, toes and elbows.

Bedsores can be horrific. If not treated, they can lead to unrelenting pain, disfigurement, hospitalization, surgical procedures, severe infection and death.  Our Jacksonville nursing home abuse attorneys have seen cases of bedsores so large and deep that the affected body part is hard to recognize.

A nursing home must take precautions to prevent bedsores and must respond promptly if a bedsore does develop.

First, a resident must be assessed regarding his or her risk of skin breakdown.  The “Braden” assessment scale is the most common method for determining this risk. The Braden scale uses a point system for various risk factors including: the resident’s sensory perception (if a resident has a limited ability to feel pain, he or she will be less likely to move, or seek help moving, in order to relieve the pressure point); exposure to moisture (if a resident is likely to have consistently moist skin in an area, for ex., a person with urinary incontinence who is not using a catheter, that person is much more likely to develop a bedsore in the moist area); vascular status (a resident with restricted blood flow is more likely to develop bedsores); activity levels (residents who are bed-bound are more likely to develop sores than those who are more mobile); and nutrition (residents with nutrition challenges such as kidney disease which limits their protein intake are more likely to develop bedsores).

It is necessary that a nursing home complete the Braden scale for every resident. For those with medium or high risk scores, preventative measures must be taken.  A deflating air mattress can be used which, as it loses air, changes the areas of the body that are impacting the bed.  Further, nutrition must be monitored and blood tests should be performed to demonstrate that protein consumption is optimal (measured by albumin and pre-albumin levels).  Further, changing the resident’s position should be performed on every shift and documented in his or her chart.  Finally, frequent examinations of all skin areas must be made with charting reflecting any areas of concern.  Any areas of concern should be brought to the attention of the resident’s doctor so that all measures can be put in place to prevent the sore from worsening and to promote healing.

For some people, bedsores are inevitable.  Sometimes, when a person is near the end of life, his or her skin may be one of the first organs that fails.  In these circumstances, a nursing home is not negligent if non-healing bedsores develop.  However, it is critical that the nursing home chart all of the steps taken above and have the doctor chart regarding both the efforts being made and the support for the notion that the resident is experiencing bedsores that cannot be prevented or healed despite best efforts.

Unfortunately, the scenarios most often seen by our nursing home neglect lawyers for cases in the Jacksonville area, involve little to no compliance with: performing a proper Braden assessment; creating an appropriate care plan to address skin breakdown risks; following through with required precautions; and responding appropriately once a bedsore develops.  When we review a case, we study the records to look for such entries.  If they are not there, we then have the case reviewed by an expert witness who is a registered nurse.  If that expert finds neglect, then we are ready to start the pre-suit notice process.

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Consulate Health Care is the sixth largest nursing home operator in the United States and is the largest in the State of Florida.  Unfortunately, here in Jacksonville, their nursing homes rank very poorly.  As nursing home abuse attorneys in Jacksonville, we get calls from residents and concerned family members about Consulate homes more than any other chain.

Consulate homes have been in the media numerous times regarding substandard care, including: www.naplesnews.com/story/news/special-reports/2018/05/31/neglected-fraud-and-abuse-nursing-homes-florida/542609002/ ; www.theledger.com/news/20180419/55-consulate-nursing-home-licenses-spared-in-agreement ; and www.wftv.com/news/9-investigates/-money-won-t-bring-her-back-families-worried-about-care-at-states-largest-nursing-home-chain/925498186/.

The Centers for Medicare and Medicaid Services (CMS) ranks every nursing home that accepts Medicare or Medicaid payment on a scale of one to five, with one being the worst.  The rankings are made up of several factors including: health inspections; staffing; and quality measures.  Those rankings are located here: www.medicare.gov/nursinghomecompare/search.html.

Consulate’s scores are strikingly bad and alarmingly consistent.  Consulate operates five nursing homes in the Jacksonville area, including one in Orange Park and one in Green Cove Springs.  Not one of these nursing homes has more than a two star rating.  Consulate Health Care nursing homes earning the lowest score of one star are: Governor’s Creek Health and Rehabilitation, located on Oak Street in Green Cove Springs; Consulate Health Care of Orange Park, located on Kingsley Avenue in Orange Park; and San Jose Health and Rehabilitation, located on San Jose Boulevard in Jacksonville.  The remainder of the Consulate homes in the Jacksonville area are rated at only two stars: Harts Harbor Health Care Center, located on Harts Road in Jacksonville; and Consulate Health Care of Jacksonville, located on Southpoint Drive.

Our nursing home abuse attorneys in Jacksonville have handled multiple claims against these nursing homes including claims for: failure to adequately treat a resident who breathed through a tracheostomy tube resulting in  wrongful death; failure to provide prescribed medications resulting in death; failing to respond to infection resulting in sepsis and wrongful death; and the failure to properly treat bedsores.  In contrast, our firm has never filed suit against a five star facility.

Nursing homes not operated by Consulate that also received a one-star rating include: Signature Health Care Center of Orange Park; Signature Health Care of Jacksonville, located on Hyde Park Road; and St. Augustine Health and Rehabilitation, located on Sunrise Boulevard in St. Augustine.   Nursing homes not operated by Consulate in the area earning only two stars include: Regents Park, on A.C. Skinner Parkway; St. Catherine Laboure Manor, located on Stockton Street; Heartland Health Care Center of South Jacksonville on University Boulevard; Heartland Health Care Center Orange Park, located on Wells Road; and Heartland Health Care Center Jacksonville on Normandy Boulevard.

Something that can be taken from this is that it is very important to consider the CMS compare website before placing a loved in a nursing home.  While that should only be one factor in your decision-making process, it is one that should not be ignored.

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Florida’s Agency for Health Care Administration is the state agency that licenses nursing homes.  The number of nursing homes in the state is strictly regulated through a “certificate of need” program, which greatly limits the number of new nursing homes in the state.  Creating an artificially low number of nursing homes is adverse to the free market and has a very negative effect on consumers of nursing home care.  As lawyers handling nursing home cases throughout the greater Jacksonville area, we have seen this firsthand.

The free market should dictate how many nursing homes are in operation through standard principles of supply and demand.  If there are too many nursing homes and they are having trouble filling their beds, investors will not be encouraged to open new ones.  On the reverse side, if investors see that poor quality nursing homes are essentially full, they will open new nursing homes to provide better care and obtain a significant market share.  This is how almost all commerce happens in the United States,whether it be restaurants, gas stations or new home construction.

However, this is not the case with nursing homes.  The total number of nursing home “beds” in the state is keep at such a low level that even the worst nursing homes have high occupancy rates.  This is because the nicer nursing homes are full and people are left with no other option but to reside in an inferior, underfunded and often outdated facility.

Here in the greater Jacksonville area, AHCA has received the highest number of new applications for nursing homes in St. Johns County, one of the fastest growing counties in the entire United States.  Close to 20% of St. Johns County residents are over 65 years old. There are currently 8 skilled nursing facilities in operation in the county.  Applications have been filed for six additional facilities in the county.  So far, only one application has been approved despite the quickly growing population.

One would think the State of Florida would be very accommodating to its senior population as the state derives significant economic benefit from the huge number of retirees that move into the state.  It is not.  This is because the nursing home lobby dwarfs the voices of the elder population.  That lobby, with its extensive connections and funding, has kept Florida friendly to nursing home operators at the expense of the quality of care provided to nursing home residents.

One example, is that, while the Florida legislature felt the obvious pressure to require that nursing homes carry professional liability insurance, it passed a law requiring such insurance; however, there is no minimum level of coverage required by the statute. Technically, a single dollar of coverage satisfies this condition, and, frankly, this is essentially what we see.

An insurance policy of nominal value, say $25,000.00 of single limit aggregate coverage for multiple nursing homes, is very common and satisfies the requirement yet provides no meaningful coverage whatsoever.  Sound farfetched?  In the majority of cases handled by our Jacksonville nursing home neglect attorneys, there is no recovery made from an insurer.  Rather, the recovery must come from the nursing home operators directly.

Many of the nursing home operators are merely shell companies designed to limit the parent companies’ legal exposure.  A shell company with little to no assets cannot fund settlements or pay verdicts in the event of neglect or abuse resulting in injury or death.  The end result is that the consequences of nursing home neglect are minimized resulting in a decreased incentive to provide high quality care. Continue reading

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Two certified nurse assistants working at the Macclenny Nursing and Rehab Center were arrested this week on charges of physically abusing a resident.  More specifically, the CNAs were accused of forcefully pushing the resident into her bed, pulling her up by a shirt wrapped around her neck, throwing her into a wheelchair and slapping her.  The resident is 85 years old, blind and suffering from a spinal injury.  The incident was captured on surveillance video footage.  The CNAs were fired.

Macclenny Nursing and Rehab Center is rated two out of five stars by the Centers for Medicaid and Medicare Services, which is considered “below average.”  It received only one star for “health inspections.”  Macclenny is located one county to the west of Jacksonville’s Duval County.  CMS’ website is located at www.medicare.gov/nursinghomecompare.

Video footage is much more common today than in the past and it is greatly changing how we perceive claims of abuse, whether it occurs in the context of nursing home care or the degree of forced used by law enforcement.  This is a very good thing. Our Jacksonville nursing home injury lawyers routinely investigate and prosecute nursing home abuse and neglect cases; however, unless there is video footage, situations in which intentional assault by nursing home staff can be proven is very rare.

When there is no footage of the actual abuse, these cases rarely see the light of day.  Often, the victims of abuse suffer from cognitive decline and make poor historians.  They may forget the abuse occurred or otherwise be unable to express themselves in a clear manner.  Of course, video footage changes all of this.

While it has not been reported how the video footage in this case was obtained, we have seen an increase in family members, who are suspicious of abuse, putting “nanny cams” in a resident’s room to catch an abuser.  News stories across the country reflect many instances of assault by nursing home staff being caught by hidden cameras.

When handling nursing home abuse cases, it is very important that an attorney investigate the hiring process used by the operators of the nursing home to determine the suitability of the candidate.  While criminal background checks are almost always done, is is common that contact to prior employers is not done.  When we contact those prior employers, we may learn of previous conduct on the part of the employee that would have been disqualifying had the nursing home performed its due diligence.

In addition, it is important to review other complaints of abuse against the same employees.  We often find that claims of abuse are not taken seriously by nursing home operators.  The failure to fully investigate prior allegations of abuse can lead to damning evidence against the managers and operators of the nursing home.

Macclenny Nursing and Rehab Center is a 120 bed nursing home operated by the Sovereign Healthcare Holdings, Inc., which manages 28 nursing homes in Florida and Georgia.  In the Northeast Florida area, Sovereign operates the following nursing homes: Jacksonville Nursing and Rehab Center located at 4134 Dunn Avenue Jacksonville;  Macclenny Nursing And Rehab Center located at 755 S 5th St, Macclenny; and Moultrie Creek Nursing And Rehab Center located at 200 Mariner Health Way in Saint Augustine.

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On April 9, 2019, a 71 year old veteran died after being attacked while residing at the St. Augustine Health and Rehabilitation nursing home.  The man’s 84 year old roommate was found on top of him striking him in the face and head.  The man was rushed to Orange Park Hospital and then to another hospital in Jacksonville; however, tragically, he died from his injuries.

According to the St. Johns County Sheriff’s Office, the medical examiner confirmed the man died from the attack due to blunt force trauma.  His injuries included a fractured skull, broken bones and injuries to his eyes.  The death has been ruled a homicide.

The victim had suffered a stroke years before that left him bed bound and partially paralyzed rendering him essentially defenseless. The reason for the attack has not been disclosed; however, the mental health of the other resident is, of course, being considered.

Tragic incidents such as this are largely preventable as an assault with this degree of violence is rarely a nursing home resident’s first sign of aggressive behavior.  Rather, aggression may begin with verbal threats and progress to physical acts such as shoving or pushing.  It is necessary that this type of behavior be recognized by nursing home staff and dealt with immediately in order to keep the other nursing home residents safe.

Resident on resident assaults can happen in nursing homes and steps must be taken by the nursing home operators in an effort to prevent these types of incidents.  Many nursing home residents suffer from a degree of dementia.  Some people suffering from dementia become aggressive even though they were never aggressive before.  As such, it is very important that nurses and nurse assistants at nursing homes are always on the lookout for aggressive behavior on the part of any resident in order that responsive measures can be taken to protect the other residents.

For a lawyer handling a resident on resident assault case against a nursing home, it is important to obtain a complete clinical picture of the assailant’s behavior prior to the assault.  Next, the attorney must determine what steps, if any, the nursing home took in response to any previous instances of aggression on the part of the assailant.  In addition, it is important to look at the assailant’s criminal background and any history of aggressive behavior.   Finally, the nursing home’s policies and training must be reviewed to determine if employees were properly trained and instructed on: screening residents to determine who is inappropriate for a nursing home setting; identifying signs of aggressive behavior on the part of a resident; and responding to such aggression.

Of the nursing homes we investigate, most of the time we find that they are understaffed.  Because of this, CNAs and nurses do not have time needed to tend to each resident.  Actions that require additional time, such as responding to, or reporting, the first signs of aggression by a resident, can often be pushed to the side with devastating consequences.  In fact, in our experience, understaffing is the most common cause of nursing home neglect injuries and death.

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We have previously blogged about the unfortunate frequency of sexual assault in nursing homes or skilled nursing facilities.  Sadly, this week a news story has grabbed headlines that highlights this problem.  A woman who has been in a vegetative state since she was three years old has recently gave birth in late December of 2018.  Given her condition, it is impossible for her to have consented to sexual activity.

Investigators ran DNA tests on the people working at the nursing home and found a match with a male licensed practical nurse who cared for the impregnated woman.  The thirty-six year old man has been arrested and charged with sexual assault.  That man has worked at the nursing home since 2011.  Police are uncertain at this time if there are other victims.

Police are also investigating whether the facility was aware of the assault.  The chief executive officer of the company that operated the nursing home has resigned.  In addition, one of the doctors that cared for the woman has resigned, and another doctor has been suspended.

The concerns involving the nursing home are not limited to the sexual assault itself as the nursing home was not even aware that the twenty-nine year old woman was pregnant until she unexpectedly gave birth.  This raises a host of concerns regarding how closely her health and conditions were being monitored.

Here in Jacksonville, the recent rape of a nursing home resident also made headlines.  No arrests have been made in that case and it is uncertain whether the perpetrator worked in the nursing home or entered posing as a visitor.

Residents of Florida nursing homes have, according to both common sense and Florida’s Nursing Home Resident’s Bill of Rights, the right to a safe environment.  More specifically, the Bill of Rights provides, in part: “Every resident of a facility shall have the right to: Live in a safe and decent living environment, free from abuse and neglect.”

Obviously, sexual assault is a violation of this right and nursing homes must take sufficient preventative measures.  First, every employee must be screened for any prior arrests or convictions.  Their prior employers must be consulted to make sure there were no concerns regarding the individual’s work history.  while the employee is working at the nursing home, all complaints of inappropriate behavior must be taken very seriously even if the victim is not certain of details as many nursing home residents suffer from cognitive impairment.  This is one reason why such perpetrators prey on the elderly.

These background investigations must also be performed for contract workers and independent contractors who do not work directly for the nursing home, but are nevertheless brought in to provide care.   Nursing homes commonly employ nurses and nurse assistants from  agencies if the nursing home is short on staff.  Due to the high level of employee turnover in Florida nursing homes, staffing agencies are commonly used to fill in gaps to meet statutorily mandated staffing levels.

In addition, nursing homes must not allow persons to enter the facility who have no business being there.  All points of entry must be conspicuously videotaped.  In this manner, potential assailants are made aware that evidence of their entry has been recorded.

Furthermore, resident on resident sexual assaults can occur in nursing homes.  For this reason, it is necessary that nursing homes be aware of the criminal past of residents before admission and must respond appropriately to any occurrences of sexual or aggressive misbehavior.  Finally, the nursing staff must monitor residents frequently so that a perpetrator does not have the time necessary to commit a sexual assault without being detected.  Continue reading

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A ninety-four year old woman reported being sexually assaulted by an unknown male at the Brookdale Atrium Way 2  nursing home in the Regency area of Jacksonville last April.  According to the victim, the perpetrator was wearing scrubs.  At the hospital, it was confirmed that she was sexually assaulted.  According to her lawyers, DNA testing suggests that the assailant may not have been an employee of the nursing home.  No one has been arrested.

The woman has hired lawyers to file a lawsuit for nursing home neglect. Notably, two other residents have reported being assaulted at the same nursing home this year, including one other rape and one attempted rape.  Descriptions of the perpetrator in each instance have been vague.  Family members and residents have expressed concerns and questions remain whether they were not fully informed of the nature of the attacks.

Assuming the assailant was not an employee, the woman’s lawsuit will focus on the security measures taken to ensure strangers do not walk into the nursing home without being screened – which can prove to be a difficult task for nursing home operators.   If it turns out that the assailant was an employee, the lawsuit will focus on whether that employee was appropriately screened and whether there were prior incidents or complaints regarding his behavior.

Nursing homes can provide an environment attractive to opportunistic predators.  There are a lot of people coming and going in a nursing home including family members, medical providers that are not employed by the nursing home, employees brought in from a temp agency, and private nurses and assistants hired by family members.  In addition, there is a lot of employee turnover at nursing homes so new people in scrubs are a common sight.   A person in scrubs can easily walk into almost any nursing home, past the information desk and into a resident’s room.

Sexual assaults in nursing homes are a significant problem.  Elderly people can be targeted due to physical and cognitive infirmities, making getting away with such a crime more likely.  All nursing homes are aware of this potential problem and are charged with the duty to take necessary measures in an effort to prevent sexual assaults.

Generally speaking, Brookdale Atrium Way 2 receives fairly good ratings from the Centers for Medicare and Medicaid Services as reflected on its Nursing Home Compare website, which has assigned it an overall rating of four out of five stars.  It received a “quality measures” rating of five stars, a “staffing rating” of four stars and a “health inspection rating” of only two stars.

“Quality measures” ratings are based on various factors regarding the health of residents including: how often residents have to be sent to a hospital; how often residents have to be sent to the emergency room; the number of residents receiving anti-psychotic medications; and the development or worsening of bedsores. “Staffing ratings” are based on each nursing home’s report of the number of nurses and nurse assistants that worked during a given time frame compared to the number of residents living at the nursing home.  The “health inspection” rating focuses on the safety of the building, food service, medication management, housekeeping and maintenance.  Continue reading

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Private nursing homes deserve to make a profit – a fair profit.  Nursing home operators, like those managing any other type of business, take steps necessary to maximize profit.  However, far too often, the methods used to do so run afoul of nursing homes’ statutory and moral obligation to “attain or maintain the highest practicable physical, mental and psycho-social well-being” for their residents.

Many of the expenses in operating a nursing home are fixed – meaning there is nothing the operators can do to decrease them.  Expenses such as rent, food, supplies, and electricity are not easily decreased. On the other hand, staffing is an area where money can be saved; however, often at the expense of the residents.

In the clinical setting, nursing homes typically have registered nurses, licensed professional nurses and certified nursing assistants.  They may also have physical therapists, occupational therapists and speech therapists. The highest expense for a nursing home is staffing and the most expensive employees are registered nurses.

Our Jacksonville nursing home abuse and neglect lawyers see the effects of understaffing in nearly every case we handle.  Most commonly, we see the number of registered nurses cut to the bare minimum. Why does this matter?  It takes at least two years of college to become a registered nurse and many have a four year bachelor’s degree.  In contrast, it takes about one year of schooling to become an LPN.

Florida’s Nurse Practice Act spells out the resulting difference: RNs are able to make assessments of patients’ conditions; while LPNs are not.  This means that an RN has the training and experience to consider what is going on with a nursing home resident and make, or suggest, changes to his or her care plan, medication or treatments.  LPNs, on the other hand, are not trained to make such assessments.

Many people think that the resident’s doctor will make rounds and perform global assessments on a frequent basis.  This is not accurate.  After an initial visit, it is common that doctors only see residents when a concern is brought to their attention.  Without registered nurses performing assessments, a patient’s decline, whether it be from infection, malnutrition or dehydration, often goes unnoticed until it is too late.

We have seen many examples of this here in Jacksonville.  In 2016, we resolved a wrongful death case against a large chain nursing home operator whose employees apparently did not notice its resident had an infection until it had gotten so bad that he was rendered unconscious by sepsis.  He died within a day of being transferred to Memorial Hospital Jacksonville.   Notably, the nursing home could not produce a single nurse’s note for the last week of his life.  Had a registered nurse seen him, his infection may have been caught and treated before he became terminally ill.  That nursing home was severely understaffed, and was found to be especially lacking in registered nurses.  The man was only 61 years old.

Attending doctors will not take up the slack.  It is important to understand that the doctors that make rounds at nursing homes are typically not employees of the nursing homes.  Most residents are assigned a doctor by the nursing home.  The nursing home chooses among several that it has contracts with; however, the doctor is not an employee of the nursing home.  Further, any neglect on the part of the doctor is not attributable to the nursing home.

Florida has standards that require a minimum number of LPNs and CNAs.  A nursing home’s failure to meet these standards can result in a moratorium on new admissions.  In just about every nursing home case we litigate, we find that the nursing home staffed only to the level of these minimums regardless of  how serious the needs of their residents are.  We have also found examples where a nursing home inflated the number of staff performing direct care to the residents in order to make it appear that the standards were met.  Continue reading

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As Florida’s largest,  and the country’s sixth largest, nursing home operator, Consulate Health Care operates approximately 77 nursing homes in Florida and approximately 210 nationwide.  Statewide, Consulate has had a spate of regulatory and judicial troubles as outlined by the this article in the Naples Daily News: https://www.naplesnews.com/story/news/special-reports/2018/05/31/neglected-fraud-and-abuse-nursing-homes-florida/542609002/.

Highlighting those troubles is a judgment entered against Consulate in February of this year for $347.8 million arising out of allegations of Medicare and Medicaid fraud.  While that judgment was set aside by the Federal trial Court, an appeal is pending.

In the Jacksonville area, Consulate operates five nursing homes: Consulate Health Care of Jacksonville; San Jose Health and Rehabilitation; Harts Harbor Health Care Center; Consulate Health Care of Orange Park; and Governors Creek Health and Rehabilitation.   None of these nursing homes has received more than 2 stars on a one to five star scale set by the Centers for Medicare and Medicaid Services.  Governors Creek Health and Rehabilitation Center in Green Cove Springs, Florida, has a one star ranking.  The remaining four nursing homes each have a two star ranking.

Medicare ranks every nursing home in the country that receives payment from Medicare on the one to five star scale.  Rankings are based on  criteria including: health inspections; staffing levels; and 16 different quality measures.

Health inspections are conducted by Florida’s Agency for Healthcare Administration.  Approximately once a year, each nursing home is subjected to an unannounced survey.  In addition, AHCA may also survey a nursing home in response to a complaint.  During a survey, the inspectors review random resident records, staffing reports and the nursing home’s policies and procedures.  Inspectors also interview residents and family members.  In addition, building issues, such as cleanliness and fire protection equipment are evaluated.

Staffing levels are assessed based on “per patient day” averaging.  The number of registered nurse, licensed practical nurse and certified nurse assistants employed are broken down on a per patient day average.

The quality measures include: the percent of residents who report moderate to severe pain; the percent of residents with new or worsened pressure ulcers (bedsores); the percent of residents who were given the flu vaccine; the percent of residents given anti-psychotic medication; the percent of residents experiencing falls causing major injuries; the percent of residents with urinary tract infections; the percent of residents who develop bowel or bladder incontinence; the percent of residents requiring an indwelling urinary catheter; the percent of residents who were physically restrained; the percent of residents whose need for assistance with activities of daily living has increased; the percent of residents losing an excessive amount of weight; and the percent of residents suffering from depression.

Here in Jacksonville, our nursing home abuse lawyers have handled three wrongful death cases against Consulate’s Jacksonville area nursing homes.  In comparison, we have never accepted a case against any of the five star facilities in the Jacksonville area.  Continue reading