Articles Posted in Nursing Home Abuse

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A Jacksonville nursing home that our firm has sued on two occasions for causing the death of elderly residents has made the news for another death. As reported by Jacksonville’s Channel Four News , a resident at the Harts Harbor Health Care Center was hit in the head by another resident wielding a dresser drawer. The resident that struck him is reportedly suffers from dementia.

The victim suffered a very serious intracranial hematoma that required surgery.  Tragically, approximately three weeks after the incident, the man passed.  He was only 61 years old.

Nursing homes must be on the lookout for resident on resident violence, especially with residents suffering from dementia.  While some people suffering from dementia are very pleasant, others may exhibit aggressive behavior. Such behavior can be very uncharacteristic of the how the person acted before the onset of dementia.  Depending on the degree of dementia at issue, the person may not even be aware of the nature of his or her actions.

In cases like this, the nursing home must closely monitor the behavior of its residents suffering from dementia.  Often, aggressiveness caused by dementia will escalate over time, which may provide the nursing home the opportunity to catch the behavior before serious injuries occur.  An aggressive resident may not be a good fit in a nursing home environment, and, if other residents’ safety is being compromised, the aggressive resident must be placed elsewhere.

Resident on resident violence is a serious problem in nursing homes.  Several years back, a plaintiff received a judgment for $750,000.00 against a Jacksonville nursing home when a female resident was raped by another resident who had a long history of sexual misconduct.  Unfortunately, that judgment was never paid because shortly after the hard fought judment was received, the nursing home was transferred to new operators and the former company that owned was left essentially insolvent.

In this situation, it is unknown whether the aggressor had prior issues with violent behavior.  If that person demonstrated aggression or violence in the past, and the nursing home did nothing to prevent other residents from being assaulted, then Florida law will allow family members to seek a recovery for their emotional losses.

This incident has been reported to Florida’s Agency for Health Care Administration (AHCA), which oversees skilled nursing facilities and nursing homes in the state.  AHCA has previously fined this facility for insufficiencies regarding safety and resident care.

According to the Centers for Medicare and Medicaid Services Five Star Rating system, Harts Harbor Health Care Center has an overall rating of four stars; however, it has only two out of five stars on “quality measures.”  Quality measures track things like: the prevalence of bed sores or pressure ulcers; the frequency that residents are injured in falls; the number of residents that report the onset of pain; and the rate of infections.

Both of the lawsuits our firm has handled against the Harts Harbor nursing home also resulted from the death of residents.  One action is currently pending. Continue reading

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Florida has a shortage of nursing home beds.  That is bad news for anyone who is in need of placing an elderly relative into the care of a nursing home. While Florida’s Agency for Health Care Administration recently approved the addition of almost one thousand new beds, the state’s demand is outpacing supply at an alarming rate.  The result can lead to limited options for a family in need of nursing home care.

The number of nursing home beds in the state is strictly regulated and some nursing homes benefit tremendously by this.  Basic economics tells us that an artificial limit on supply is not good for consumers.  By keeping the number of beds low, homes providing inferior care still have plenty of residents – those residents often have no other options.

Earlier this year, the Agency for Health Care Administration estimated it needed 3,115 additional nursing home beds to serve Florida’s aging and disabled population, yet less than one thousand additional beds have been approved. Thankfully, most of the new approvals are in North and Central Florida. Before this month’s announcement, it had been more than a decade since the state issued certificates for new nursing home beds.

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Jacksonville has nearly one hundred assisted living facilities (“ALFs”). ALFs are a step between independent living and a nursing home. ALFs provide housing, food and personal services; however, they do not provide medical care. In limited circumstance, an ALF may provide some nursing care and assistance with medications. They allow for greater privacy, and are usually much less expensive, than a nursing home.

ALFs are licensed and inspected by Florida’s Agency for Health Care Administration. Because they do not provide nursing or medical care, ALFs are not as tightly regulated as nursing homes. Unlike nursing homes, the State of Florida does not maintain a rating for assisted living facilities. This can make picking out an ALF a daunting task.

Floridahealthfinder.gov has a list of all licensed ALFs in the state broken down by region and county. Each ALF on the list has links to provide the types of licenses the ALF has, the number of beds, the name of the administrator and inspection results.

Fees for ALFs vary greatly depending mostly on the degree of services being provided. Generally speaking, Medicare or Medicaid will not pay ALF fees.

Other factors to consider when selecting an ALF include: whether the resident will have his or her own room; whether the resident will have to share a bathroom with one or more other residents; whether the resident has kitchen facilities in his or her room; and whether pets are allowed.

Of course, there are alternatives to assisted living facilities including adult day care centers and adult family care homes. Adult day care centers are a day time supplement for persons living at home. They provide opportunities for social activities, counseling, limited training for activities of daily living, and meals.

Adult family care homes provide a home environment for up to five adults who are not related to the owner of the home with the owner of the home residing there as well. These homes provide housing, meals and assistance with health care arrangements, transportation and medication administration.

If the decision has been made to move into an assisted living facility, we recommend the following actions be taken: find ten or more that are in a convenient area for family members to visit (remember that family members are the very best people to notice if an elderly person is experiencing unsatisfactory care or changes that require medical attention – the more convenient it is for family members to visit, the more often they are likely to visit); go to Floridahealthfinder.gov to learn more about the size of the facilities, whether they have special licenses necessary for your situation (for example, a limited mental health care license may be appropriate for a resident showing early signs of dementia) and view inspection reports; visit the facilities; determine cleanliness; evaluate the general condition of the other residents; consider the activities and services provided; and determine the exact room that is available. Meeting with the administrator and staff is also a must. If other resident’s family members are present during your visit, ask them if they are pleased with the facility.
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The State of Florida’s Agency for Healthcare Administration maintains a “watch list” of nursing homes that have either financial or care related concerns. To be placed on the list, a nursing home must have either
Old%20man.jpg filied for bankruptcy protection or that failed to meet minimum standards at the time of an inspection. The list is updated quarterly. Approximately 140 of Florida’s 600 nursing homes are currently on the watch list.

Jacksonville Nursing Homes on the Watch List

In Jacksonville, there are six nursing homes that have been put on the nursing home watch list. The nursing homes that have been added to the watch list are:

– Consulate Health Care of Jacksonville;
– Cypress Village;
– Palm Garden of Jacksonville;
– San Jose Health and Rehabilitation Center;
– Summer Brook Health Care Center; and
– West Jacksonville Health and Rehabilitation Center.

Orange Park Nursing Home on the List:

– Consulate Health Care of Orange Park
St. Augustine Nursing Home on the List:

– St. Augustine Health and Rehabilitation Center

To access the watch list click here.

The items that typically cause a nursing home to be placed on the watch list usually result from one of AHCA’s facility inspections. However, events that have taken place during outside the extremely limited time period of an inspection do not show up on an inspection report.

Because of this, the watch list can be misleading. Many nursing homes that are not on the watch list have been sued for providing substandard care. As a result, the watch list can only be used as one tool in a family’s process of determining which nursing home is appropriate.

Florida’s Agency for Health Care Administration maintains a Nursing Home Guide that provides a rating system based on its inspections ranging from one to five stars on various categories including: Pressure Ulcers; Quality of Care; Nutrition and Hydration; Dignity; Quality of Life; Administration; and Restraints and Abuse.

In addition to considering these documents, we recommend that you visit several nursing homes before a decision is made. During the visit, ask to speak with the Director of Nursing and the Assitant Director of Nursing. Make sure that the nursing home is able to accept the special needs of your family member. For example, some nursing homes do not accept patients who breath via a tracheostomy tube.

While there, ask to see the common areas of the nursing home. Observe the overall cleanliness of the facility and the appearance of the residents.

Finally, once your loved one is admitted, visit regularly and be a care advocate. If you notice something that is not being addressed, bring it to the attention of staff. If it is not corrected promptly, send the administrator a certified letter explaining the situation. Certified letters are almost never ignored because the nursing home administration knows that it is dealing with someone who is not easily appeased and someone that will hold the nursing home accountable for negligence care resulting in injuries.
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We frequently hear from family members who are concerned about the care their relative is receiving at a nursing home. The concerns range from injuries due to falls – to bedsores – to outright abuse. This blog answers some basic questions about what family members can do in this situation.

Your Gut Feelings May be Correct

Many nursing homes provide appropriate care. However, there are numerous instances where neglect or abuse happens and results in a serious decline in a resident’s quality of life. Our experience has been that family members often suspect something is wrong long before things get critical.

Demand a Meeting

If you are uncertain whether your relative is being cared for appropriately, you can request a meeting with the nursing home staff. Request that the Director of Nursing and Assistant Director of Nursing be present.

The nursing home may require that medical information releases be signed by your relative allowing the nurses to discuss the medical conditions at issue. A power of attorney relating to health care issues or a designation of a health care surrogate will allow a specific person to discuss medical conditons with the nurses; however, other family members may not be able to attend. If you do not have forms for a records release or a power of attorney/health care surrogate, our law firm can provide these forms to you free of cost.

The resident should sign such documents while he or she retains the capacity to comprehend what is being signed. Documents executed after the resident no longer has the capacity to understand what has been signed may not be effective.

Residents always have the right to move to a different nursing home. If it is decided that your relative will stay in the same nursing home, write a letter that summarizes the promises made by the staff and mail it to the nursing home’s admininstrator via certified mail. This will get their attention and may turn statements that were only intended to appease you into real action.

Get the Records

It is important to obtain your relative’s nursing home records. You will need a signed release. The nursing home records can be hard to read and signs of negligence or abuse are usually not obvious.

Have a Nurse Review the Nursing Home Records

Having a nurse that is not affiliated with the nursing home review the records may reveal issues of concern or neglect. These nurses routinely review records for nursing home neglect and injury cases and know what to look for in order to determine if neglect is taking place. Our firm can provide you with contact information for nurses in the Jacksonville area who are willing to review records at a reasonable cost.

Call the Abuse Hotline

Florida’s Department of Children and Families investigates abuse or neglect of vulnerable adults, The hotline number is 1(800)96-ABUSE. Calls are answered at any time of the day, 365 days a year. The person with whom you speak can tell you know if the matter will be investigated. Information regarding the hotline is located here.

Call an Attorney that Focuses on Nursing Home Cases

Lawyers are typically willing to consult with you without cost to discuss your situation. If the case seems strong, you will probably be able to retain the nursing home lawyer via a contingency fee agreement, through which you only have to pay attorney fees and costs in the event of a settlement or verdict in your favor.
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When you think of nursing homes and the elderly, good thoughts do not always come to mind. In recent news reports, it seems that Florida nursing homes have done an equally poor job caring for children. Earlier this year, one nursing home was reported to provide inadequate care, resulting in the death of two children residing there. In the face of two pending federal investigations, Florida nursing homes have decided to stop accepting children as patients and are closing their pediatric units, the Miami Herald reports.

Baby.jpg

The State of Florida, as well as several individual nursing homes, has been named in two federal lawsuits, alleging that the State has allowed sick children to be warehoused among the elderly in nursing homes where they received inadequate care. The lawsuits claims that the State of Florida has underfunded patient care for children so much that parents have little choice but to place their children in nursing homes, often far away from the rest of their family. Florida is paying approximately $500 a day per child for nursing home care; double the rate the State pays for its seniors. Opponents of the program also point out that because they are designed with elderly patients’ needs in mind, nursing homes provide little educational, recreational and social stimulation for children.

The U.S. Justice Department’s civil rights division is accusing the State of disobeying the Americans with Disabilities Act, which provides that it is illegal to discriminate against special needs patients of any age. The Justice Department claims Florida is in violation because it does not provide other options, such as affordable home health care, for frail and disabled children. According to the Miami Herald report, many of these children remain in nursing home facilities for long periods of time, even though they could return to their homes if the proper amount of community support and funding were in place.

Read more about nursing home abuse of children at Jacksonville.com.

The most recent nursing homes to close their pediatric wings are doing so incrementally to minimize disruption to sick children and their families. The usual process is to stop accepting new patients, then transfer existing patients to other, more appropriate facilities. Spokespeople for nursing homes say the reason is, in part, due to the ongoing investigation and its interference in the nursing homes’ ability to care for young patients.

Jacksonville nursing homes have a duty to provide adequate care to all patients, young and old. Regardless of how you feel about housing sick children with the elderly in nursing homes, the homes currently have a duty to the children and their families to provide proper levels of care and attention; even if it is not the type of care a nursing home usually provides. In other words, they are not excused because they are inexperienced in caring for sick children. When this necessary care is not provided, the chance for serious injury or death increases.

Photo Credit: dhammza via Compfight cc

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A Florida Jury awarded $1.1 billion to the family of a 69-year-old woman who died in 2007 after receiving care at The Auburndale Oaks Healthcare Center in Auburndale, Florida. This award is considered one of the highest amounts in favor of a nursing home victim‘s family.

The woman’s son, who filed the lawsuit, stated that the nursing home failed to provide adequate supervision and that his elderly mother fell many times while staying at the Florida nursing home. The woman was admitted to the nursing home in 2004 and died in 2007.

Because the companies owning the nursing home stopped participating in the lawsuit, the jurors were asked to determine damages in monetary terms, but were not asked to determine liability. While this is considered a “default judgment,” it still sends a powerful message to nursing homes to comply with the state’s patient care and hygiene standards or risk being found negligent in providing the quality care nursing home patients deserve. The defendant in the lawsuit was Trans Healthcare, Inc. However, Trans Healthcare says it has not operated the facility since 2004. The Auburndale nursing home is currently operated by Encore Healthcare LLC.

The number of lawsuits against nursing homes and assisted living facilities is on the rise in Florida. An increase in the number of for-profit nursing homes is partially fueling the increase in litigation according to a report conducted by Bloomberg News. The news agency reports that the desire for profit is having a negative effect on patient’s quality of care. This trend is escalating as more nursing homes are operating on a for-profit basis rather than not-for-profit. As of 2010, seventy percent of all nursing homes were being operated on a for-profit basis, according to an audit completed by the Medicare Payment Advisory Commission. The study reveals that for-profit nursing homes have higher profit margins; those operating as for-profit had a 21 percent profit margin, compared to just 10 percent for non-profit nursing homes.

Lawsuits awarding large monetary damages to nursing home victims have been in the news lately. HCR ManorCare was issued a $91.5 million judgment, after finding that one of its facilities, Heartland of Charleston, did not care properly for a resident who died after a brief stay. Emeritis, a publicly traded nursing home company, was found guilty of wrongful death after a resident suffered from fatal pressure sores.

With the number of nursing home patients on the rise as the population ages, lawsuits against nursing homes and assisted living facilities are likely to increase. This is especially true in Florida, which has the largest percentage of residents over 65. Currently, there are 1.4 million people living in nursing homes in the United States, with approximately 72,000 residents in Florida nursing homes.

Tragically, many incidents of nursing home and abuse and neglect go unreported. The American Association of Justice reports that just one in 14 incidents of elder abuse are ever reported and that understaffing contributes greatly to nursing home abuse and negligence. A whopping 90 percent of all nursing homes in the United States are considered to have low staffing levels which result in inadequate supervision and medical care, according to the association.

When choosing a nursing home for a loved one, consumers should do their research. The Center for Medicare Advocacy, Inc., reports that compared to non-profit nursing homes, the top ten for-profit nursing home corporations have the lowest staffing levels, the highest number of violations, and the highest number of deficiencies leading to patient harm.

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According to the most recent report issued by the Florida Agency for Healthcare Administration’s Nursing Home Guide, two nursing homes in St. Johns County received low ratings. The nursing homes identified with these low ratings are:

Moultrie Creek Nursing and Rehab Center 200 Mariner Health Way St. Augustine, Florida 32086
Clyde E. Lassen State Veterans Nursing Home 4650 State Road 16 St. Augustine, Florida 32092
Moultrie Creek Nursing and Rehab Center, a 120-bed facility, received the lowest possible rating of just one star for overall inspection. One star means that the facility ranked in the bottom 20 percent of facilities in its region. A five-star rating is the highest a nursing home can earn. Moultrie Creek Nursing and Rehab also received only one star in the quality of life category, as well as one star for nutrition and hydration. In the category of treating residents with dignity and respect, Moultrie Creek Nursing Home and Rehab Center earned two out of five stars.

Clyde E. Lassen State Veteran’s Nursing Home, a 120-bed facility, earned a two-star rating for overall inspection, meaning it ranked in the bottom 21-40 percent compared to other facilities in its region. Like Moultrie Creek, Clyde E. Lassen State Veteran’s Nursing Home also received a two-star rating for treating patients with respect and dignity. In addition, this nursing home received the lowest possible rating of one star in administration, which may include inaccurate assessments of residents’ health status, failing to develop adequate care plans and facility violations, such as inaccessible fire exits. In the quality of care category, the Lassen State Veteran’s Nursing Home earned two out of five stars.

Malnutrition and dehydration are two of the most common conditions resulting from nursing home neglect. Elderly residents, especially those recovering from recent surgeries or battling diseases, are especially sensitive to inadequate hydration and nutrition. A lack of hydration and nutrition can lead to other problems, such as a weakened immune system, infections, bedsores, loss of muscle mass or even death. Unfortunately, Jacksonville nursing homes are not immune to nutritional neglect. Making matters worse, malnutrition and dehydration in nursing homes often go undetected because symptoms, such as memory loss, lethargy and confusion, are not atypical for elderly residents.

Malnutrition and dehydration is even more difficult for family members to detect if a resident is being fed intravenously because it is impossible to know if the fluid contains the right mix of nutrients and calories. If you notice a sudden and drastic change in your loved one’s behavior or personality, ask to talk to the nursing home’s dietitian to ensure his or her nutritional needs are being met.

Considering that one-third of all nursing home residents are unable to feel themselves, understaffing can play a big role in nutritional neglect. In fact, according to the National Center on Elder Abuse, 91 percent of the country’s nursing homes lack adequate staff to properly care for residents. If you suspect nursing home abuse or neglect in the Jacksonville area , register your concern with the Agency for Healthcare Administration at 1-888-419-3456.

Written by Elizabeth Allen Continue reading

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Five of the nine nursing homes in Clay County, Florida, received one- or two-star ratings, the two lowest grades possible issued by The Agency for Health Care Administration’s Nursing Home Guide.

Two Clay County nursing homess received one-star ratings, while three earned two stars for overall inspection. The highest rating possible is five stars.

The following nursing homes received one- or two-star ratings:

Consulate Health Care of Orange Park **
1215 Kingsley Avenue Orange Park, Florida 32073
Doctors Lake Healthcare of Orange Park *
833 Kingsley Avenue Orange Park, Florida 32073
Governors Creek Health and Rehabilitation *
803 Oak Street Green Cove Springs, Florida 32043
Life Care Center of Orange Park **
2145 Kingsley Avenue Orange Park, Florida 32073
Signature Healthcare of Orange Park **
2029 Professional Center Drive Orange Park, Florida 32073
A one-star rating indicates that a nursing home ranked in the lowest 20 percent when compared to other facilities in its geographic region. Clay County is considered part of the Jacksonville nursing home region, which also includes Baker, Duval, Flagler, Nassau, St. Johns and Volusia counties. A two-star rating places a nursing home in the bottom 21-40 percent when compared to others in the area.

Governors Creek Health and Rehabilitation in Green Cove Springs received the lowest scores in all categories, including one-star ratings for quality of care, quality of life and administration. It also received one star for treating residents in a dignified manner, which is one of the most concerning aspects of poor care in nursing homes. The Florida nursing home patient’s rights stipulate that residents have the right to be treated courteously and with the fullest measure of dignity. Unfortunately, this right, along with many others, is too often not observed in Jacksonville area nursing homes and facilities throughout the country.

Not all nursing homes fall short of providing quality care. Three nursing homes in Clay County received four-star ratings, the second-highest rating a nursing home can earn. The following facilities’ overall inspection rating is higher than 61-80 percent compared to others in its region:

Life Care Center at Wells Crossing ****
355 Crossing Boulevard Orange Park, Florida 32073
Life Care Center at Wells Crossing ****
355 Crossing Boulevard Orange Park, Florida 32073
Heartland Health Care Center Orange Park ****
570 Wells Road Orange Park, Florida 32073
None of the nursing homes in Clay County received five stars. If you are interested in learning about a nursing home’s rating, read the Florida Nursing Home Guide, which is updated quarterly.

In addition, Florida law provides that every licensed nursing home post a copy of its most recent review from the Florida Nursing Home Guide prominently in its facility. This includes all up-to-date inspection details for the nursing home, along with “Watchlist’ information, which shows facilities that are operating under bankruptcy or those not meeting the minimum required standards. You can also see whether a nursing home corrected prior violations.

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Our previous blog reported that nine nursing homes in Jacksonville earned one-star ratings, the lowest grade possible in a recent report issued by Florida’s Agency for Health Care Administration. The same report gives similarly low marks – a two-star rating — to four Jacksonville area nursing homes.

An overall inspection rating of two stars is the second-lowest possible grade on a scale of one to five, meaning that a nursing home ranked in the bottom 21 – 40 percent of the facilities in its geographic area.

Jacksonville nursing homes with two-star rankings include:

Avante Villa at Jacksonville Beach, Inc.
1504 Seabreeze Avenue Jacksonville Beach, Florida 32250
Cypress Village 4600 Middleton Park Circle East Jacksonville, Florida 32224
Regents Park of Jacksonville 8700 Skinner Parkway Jacksonville, Florida 32256
San Jose Health and Rehabilitation Center 9355 San Jose Boulevard Jacksonville, Florida 32257
For a complete report of all nursing home rankings in Jacksonville as well as throughout the state, read the Florida Nursing Home Guide released earlier this year. Through on-site nursing home inspections, the annual study rates facilities on a number of measures, including how well residents are cared for, their quality of life, and how well the facility operates at an administrative level. Other indicators include meeting residents’ basic needs for food and water, whether residents are treated with dignity, the use of restraints, and the number of residents suffering from bed sores.

In addition to a two-star overall inspection rating, Avanta Villa at Jacksonville Beach also received just two stars in quality of care and quality of life. While Cypress Village received four stars in quality of care and quality of life categories, it earned just one star in administration. Regents Park of Jacksonville garnered three stars in quality of care, but just one star in quality of life. Regents Park also received the lowest one-star rating in the proliferation of pressure ulcers and dignity. San Jose Health and Rehabilitation received two stars in quality of care and three stars each in quality of life and administration.

The annual Florida Nursing Home Guide is provided by the Agency for Health Care Administration to help family members and caretakers make informed decisions when selecting a nursing home for their loved ones. The report is searchable by region or county and also allows users to search for facilities that provide special services, such as 24-hour onsite Registered Nurse coverage, languages spoken, and adult day care services available.

While all of the nursing homes listed in the Florida Guide meet state licensing requirements, it is readily apparent that there is room for improvement. All too often, we hear of cases in which a nursing home resident is neglected or abused. This poor treatment ranges from inadequate supervision, to improper nutrition, to overmedication, just to name a few. Unsanitary and unsafe conditions are relatively common as well. Unfortunately, it is our firm’s experience Jacksonville nursing homes are no different.
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