Dave Abels, Author at Abels & Annes, P.C.

Researchers Claim Dementia Patients at Increased Risk of Death Following an Emergency Evacuation

Although nursing home residents in Chicago are unlikely to be evacuated due to a hurricane, any number of unexpected disasters may potentially cause them to become displaced. A study recently presented at the Gerontological Society of America’s yearly meeting found that long-term care facility patients with dementia were 218 percent more likely to die within 30 days of a hurricane evacuation than at any other time. In addition, the same population allegedly experienced a 158 percent increase in mortality within 90 days of an evacuation.

The three-year study reportedly tracked and evaluated more than 21,000 residents of skilled nursing facilities situated along the nation’s Gulf Coast. The lead author of the study, Lisa Brown, a Professor of Aging Studies at the University of South Florida-Tampa, said it is unclear why death rates are higher for certain nursing home patients following an evacuation. Brown stated although government guidelines currently emphasize physical safety during an evacuation, mental health issues are not being sufficiently addressed. According to Brown and her colleagues, between 50 and 70 percent of the estimated 1.6 million skilled nursing facility residents nationwide suffer from Alzheimer’s disease or another dementia disorder. Brown said the high risks related to relocating such patients merit “sheltering in place” during a natural disaster.

All federally certified nursing homes must provide workers with emergency preparedness training and have a written emergency plan in place. Unfortunately, a survey of long-term care facilities allegedly found that most are not sufficiently prepared for a disaster and failed to include about half of all necessary tasks on emergency checklists. According to Brown, a succession of natural disasters like those that recently occurred following Hurricane Sandy also make nursing home residents and employees less resilient. She reportedly believes further research regarding how to best maintain the mental health of both populations should be conducted in the future.

Most skilled nursing and other long-term care facilities in Illinois receive Medicare and Medicaid funds. This means they are certified nursing homes. As a result, caregivers and administrators who are employed at Illinois certified nursing homes must adhere to both state and federal laws and regulations. Although most nursing homes in our state provide quality patient care, some may fall through the cracks. If you believe a friend or loved one died as a result of the conditions they were subjected to while in the care of an Illinois long-term care facility, you should discuss your concerns with an experienced attorney.
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Nursing Homes in Illinois and Throughout the Nation Are Often Not Equipped to Handle Brain-Injury Patients

by Dave Abels

A 57-year-old resident of the Cobden Rehabilitation and Nursing Center in Illinois is allegedly no longer allowed to walk and can barely speak. When the brain-injury victim entered the facility, however, he could reportedly walk with assistance and was undergoing speech therapy. According to reports, the man now spends his days slumped in a wheelchair. In addition, his speech therapy sessions allegedly ended not long after he became a resident of the facility. Sadly, the nursing home appears to be ill-equipped to properly care for the man.

According to federal Medicaid and Medicare patient data compiled by Bloomberg, the 57-year-old man is one of an estimated 244,000 individuals who are residing in nursing homes across the nation as a result of an unexpected brain-injury. More than four million people nationwide reportedly suffer from a long-term disability that was caused by a brain-injury. Although an injury to the brain may result from a motor vehicle crash, fall, stroke, assault, and a number of other events, victims are frequently left without access to the most effective specialized care and therapies. Many brain-injury victims are reportedly housed in nursing homes that were designed instead to care for an aging population.

Unfortunately, the bulk of Americans do not have health insurance that will pay for brain trauma rehabilitation facilities. Instead, those who suffer a severe and disabling injury to the brain often rely on public insurance that is paid for by the state and federal government. Although Medicaid will cover the cost of a nursing home, the program will only pay for a limited number of patients to enter rehabilitation centers. Unfortunately, a long waiting list currently exists for the 19,000 nationwide slots.

Although nursing homes can be the best option for some brain-injury patients, most reportedly need therapies that skilled nursing facilities rarely provide. Scott Schuster, President of Wingate Healthcare, oversees 18 nursing homes in two states. He said less than one in 10 skilled nursing facilities can properly care for brain-injury patients. To make matters worse, many nursing homes do not want to take on the care of patients who suffered a brain-injury. In fact, Wingate Healthcare recently closed a 125-bed Massachusetts facility that specialized in treating individuals who suffered a brain-injury due to the low rate of Medicaid compensation.

Abuse and neglect can result when patients enter nursing facilities that are not equipped to properly care for them. The Illinois Nursing Home Care Act was established to protect the rights of senior citizens and other individuals who live in long-term care facilities throughout the state. Those rights include the right to be free from abuse or neglect, the right to various levels of self-determination, and the right to privacy. Under the Act, residents of skilled nursing facilities located in Illinois are supposed to enjoy freedom from unauthorized restraint, the ability to entertain visitors, the opportunity to choose their own healthcare providers, and other rights. Additionally, nursing homes have a duty to ensure the rights enumerated in the Act are not violated. If you feel your friend or loved one was abused or neglected by a nursing home agent or employee, you should contact a quality nursing home abuse and neglect attorney to discuss your concerns.
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Scientists Create Carpet Designed to Help Reduce Falls in Nursing Homes in Illinois and Throughout the World

by Dave Abels

Scientists at the University of Manchester in England have developed a carpet that could alert staff at nursing homes and other care facilities that a resident is likely to fall. The so-called “magic carpet” reportedly has special plastic fibers attached to the bottom that bend and send signals to a computer when someone walks on it. In the future, the signals may be used to identify walking behavior changes and alert care staff to a sudden trip or fall.

About half of all hospital admissions for seniors are reportedly caused by a fall. In addition, an estimated 40 percent of individuals who reside in a long-term care facility experience a fall injury in any given year. Researchers believe the carpet technology could be used to prevent falls in skilled nursing and assisted living facilities as well as the personal homes of senior citizens. In addition, the carpet may allow doctors or caregivers to analyze an elderly person’s gait to identify potential issues before they arise. The lead scientist on the project, Dr. Patricia Scully, said the carpet was designed to be low-cost, non-intrusive, and adaptable. Because of this, Scully believes the technology may be useful in a variety of settings and retrofitted as needed by the elderly and others who may be prone to falling.

Falls in skilled nursing facilities may be caused by a number of factors including improperly fitted beds and wheelchairs, environmental hazards such as poor lighting and wet floors, and underlying health problems. In addition, a failure on the part of nursing home caregivers to monitor the elderly and disabled after medication and other changes can contribute to resident falls. The nation’s Centers for Disease Control and Prevention claims that employee education, safety equipment, and proper medical care for residents can have a dramatic impact on fall rates at long-term care facilities throughout the United States.

Unfortunately, nursing home patients also risk falling when facilities fail to employ enough certified nursing assistants and other direct care staff. The Illinois Nursing Home Care Act required that skilled nursing facilities operating within the state increase the number of employees to a level that sufficiently meets the needs of all residents. Despite the legislation, inadequate or poorly trained staff is frequently a factor in nursing home abuse or neglect cases in our state. If your loved one was hurt or died at skilled nursing facility in Illinois, you should discuss your concerns with a nursing home abuse and neglect attorney immediately.
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Study Claims Disrespect is Number One Factor in Nursing Home Staff Turnover Rates in Illinois and Nationwide

by Dave Abels

Initial data collected by researchers from the University of Pittsburgh recently found that about 82 percent of certified nursing assistants (CNAs) surveyed enjoy their jobs. In addition, approximately 80 percent claim to be loyal to their workplace and a whopping 90 percent reportedly feel that what they do for a living makes the world a better place. Oddly, the very same workforce also has a surprisingly high turnover rate.

As part of a long-term study, researchers at the University’s Center for Health and Care Work surveyed 1,400 CNAs and other direct care workers in an effort to ascertain why employees choose to stay at or leave their jobs. The currently ongoing study was designed to last for a period of two years and direct care employees who participated in the initial survey will reportedly be interviewed again in a series of nine-month intervals. In the future, researchers hope to examine whether employees who resigned also changed industries.

Despite often low pay and difficult work, most CNAs who responded to the survey reported high levels of job satisfaction. Still, few opportunities for advancement, understaffing, inadequate continuing education, and a lack of mentorship reportedly contributed to direct care worker dissatisfaction. According to researchers, however, the number one reason CNAs and other direct care staff leave a care facility is a disrespectful management team. CNAs surveyed reportedly told researchers that they most often leave a particular job due to unrealistic expectations regarding the amount of daily work that can successfully be accomplished.

A high rate of direct care staff turnover can have a dramatic impact upon the quality of care nursing home residents in Illinois and throughout the nation receive. An inadequate number of CNAs or quickly and poorly trained workers can also have a significant effect on resident health and safety. Although the problems associated with low staff retention rates are allegedly recognized by most administrators and managers of skilled nursing facilities throughout the country, the University of Pittsburgh study illustrates that there may still be a long way to go before the issue can be fully addressed.

A stable workforce is an important indicator of quality elder care. Sadly, insufficient staffing levels are a common factor in nursing home abuse or neglect in Illinois and nationwide. The Illinois Nursing Home Care Act required nursing homes to increase the number of direct care hours provided to residents in order to adequately meet their needs. If your friend or loved one was harmed while residing in an Illinois skilled nursing facility, you should contact a qualified nursing home abuse and neglect lawyer to discuss your concerns.
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Illinois Ranks Third in Nation for Suspended Federal Payments Over Serious Nursing Home Violations

by Dave Abels

According to information recently compiled by non-profit corporation ProPublica, Illinois ranks third in the nation for suspended federal Medicare and Medicaid payments due to serious nursing home deficiencies. Over the last three years, federal skilled nursing facility payments were purportedly suspended nearly 100 times at 78 homes throughout the state. Normally, Medicare and Medicaid payments are only suspended when conditions at a long-term care facility require immediate improvement. In addition, Illinois reportedly ranked near the middle of states with regard to the number of serious deficiencies and fines issued per nursing home.

The Illinois Department of Public Health surveys and rates skilled nursing facilities at least once each year and when specific complaints are filed. Ratings of A to L are assigned to each nursing home based on facility conditions. An A assignment is the highest rating and an L assignment indicates the most severe level of deficiency. A J score reportedly indicates an isolated, immediate risk to a patient’s health or safety was found. Meanwhile, K indicates that such a condition exists as part of a pattern while an L means a state surveyor noted widespread and immediate risks to resident health and safety exist at a particular skilled nursing facility.

In the last three years, 144 of the 773 nursing homes throughout Illinois purportedly received at least one J, K, or L citation. Additionally, 199 nursing homes incurred $2.43 million in fines during the same time period. The largest fine was issued to a Chicago nursing home that allegedly committed 53 simultaneous violations. Federal payments were suspended twice over the last three years at one long-term care facility in Joliet. The same nursing home also reportedly received 82 deficiency citations and was ordered to address resident care deficiencies through a special focus program. According to a representative for the nursing home, all previously identified deficiencies were corrected and a new administrator and other staff members were hired. Still, a number of other nursing homes in Illinois have similar track records.

A statement from the Illinois Department of Public Health claims the state is committed to ensuring that skilled nursing facilities throughout Illinois meet both state and federal standards. The majority of nursing homes in Illinois are held to a high standard of care under both state and federal law. Although most skilled nursing facilities in the state are certified, the Illinois Nursing Home Care Act does not require it. A certified facility is one that is under contract to receive federal Medicare or Medicaid funds. The Illinois Department of Public Health regulates standards of care for all nursing homes in the state whether or not a facility receives federal funds.
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Illinois Nursing Home Residents at Risk for Contracting Deadly Drug-Resistant Superbug

by Dave Abels

An often fatal superbug is increasingly being found in hospitals and nursing homes across the country. A formerly obscure drug-resistant bacteria, Carbapenem-Resistant Enterobacteriaceae (CRE), has been found in health care facilities throughout the nation’s largest cities such as New York, Los Angeles, and Chicago. The deadly family of bacteria was named for its ability to fight off carbapenem antibiotics which are normally a medical provider’s last line of defense against superbugs. Since 2008, thousands of hospital and nursing home patient deaths were purportedly caused by CRE. Earlier this year, a strain of the bacteria reportedly killed seven, including a 16-year-old, at the National Institutes of Health Clinical Center.

The first known case of CRE was described in 2001. Since then, the superbug has allegedly shown up at hospitals and skilled nursing facilities in at least 41 states. At this time, the reported rate of death for patients who contract CRE is about 40 percent. Because CRE infection may affect a nursing home resident’s intestines, urinary tract, or cause pneumonia, many cases likely go undiagnosed. The Centers for Disease Control and Prevention’s Arjun Srinivasan said CRE is currently the most serious threat to hospital and skilled nursing facility patients across the country.

Unfortunately, CRE can allegedly remain in an individual’s system without any symptoms until the immune system of an infected person is compromised. According to Dr. Mary Hayden, Director of Clinical Microbiology at Rush University Medical Center, studies show that about three percent of hospital intensive care patients in Chicago carry CRE. In addition, the same studies show that up to 30 percent of long-term care facility residents in the area are infected. The bacteria can allegedly be transmitted to others by mere contact. Dr. Hayden stated CRE is especially dangerous for nursing home residents due the easy manner in which it is spread. She believes implementing a universal patient record system that tracks both CRE and facility changes might help keep the elderly and disabled in Illinois safer.

At this time, most long-term care facilities purportedly lack the capacity to properly identify, screen, and isolate residents who are infected with CRE. In addition, the Medicaid and Medicare federal systems do not report cases of CRE. A 2008 study regarding CRE infection rates in New York skilled nursing facilities allegedly found that many facilities do not keep abreast of most drug-resistant bacteria despite that the risk for infection is allegedly high for nursing home residents. According to physicians, heavy vigilance with regard to hand washing and other infection-control measures can help control dangerous CRE and other disease outbreaks.

Skilled nursing facility residents normally live in close proximity to one another. Because of this, communicable diseases are often spread easily in nursing homes. Although Illinois nursing home employees are required to take precautionary measures designed to control the spread of disease, many fail to do so. Unfortunately, such failures can have disastrous consequences for facility residents.

Appropriate sanitation is vital to the health of long-term care facility residents in Illinois and elsewhere. It is both unnecessary and negligent for skilled nursing facility staff to fail to adhere to recommended sanitation procedures. Additionally, all nursing homes in the State of Illinois must designate an infection prevention and control professional to create and implement policies that are designed to reduce and limit the spread of communicable diseases. If your relative died after he or she contracted a preventable disease due to nursing home caregiver negligence, you are advised to discuss the situation with a nursing home abuse and neglect attorney.
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Illinois Nursing Home Advocates Concerned Residents May be Neglected as a Result of New Law

by Dave Abels

Recent legislation that included Illinois nursing home Medicaid rate cuts has reportedly angered resident advocates across the state. Although nursing home industry spokesperson Pat Comstock, Executive Director at the Health Care Council of Illinois, stated the recently signed Senate Bill 2840 will not affect the level of care required by sweeping nursing home legislation that was passed in 2010, others disagree. Wendy Meltzer, Director at Illinois Citizens for Better Care in Chicago, said the new law’s staffing level requirements are not only confusing, but will also be tough to enforce. According to Meltzer, many long-term care facility residents will likely suffer neglect as a result of the law.

The nursing home reform legislation was reportedly introduced as a result of a number of newspaper articles regarding dangerous conditions and inadequate staffing levels at skilled nursing facilities located throughout the state. Although resident advocacy groups allegedly agreed to determine what sort of care facility employees would be used to meet the requirements of the new law after the legislation was passed, disagreements arose once the matter was before the state legislature’s Joint Committee on Administrative Rules. In addition, despite that research purportedly demonstrates that 20 percent of nursing and personal care should be provided by registered nurses (RNs), the Health Care Council advocacy group allegedly disagreed. Instead of asking skilled nursing facilities to utilize federal matching funds to pay the estimated $105 million required to meet the suggested 20 percent RN resident care level, the Health Care Council reportedly argued that only 10 percent of patient care should be provided by RNs.

As part of recent state budget negotiations, the 10 percent RN care rule advocated for by the Health Care Council was adopted. Some believe the RN staffing level adopted is too low and disabled and senior residents throughout Illinois will suffer. Still, according to Comstock, many of the approximately 800 nursing homes in Illinois will be required to employ additional RNs as a result of the law. Resident advocates also argue that the way in which RN staffing levels will be tied to the overall nursing home reimbursement system may make it more difficult for inspectors to effectively determine whether a long-term care facility is adequately staffed. Meltzer conceded that RN staffing levels will increase under the law but she reportedly believes nursing home residents with dementia and other difficult to manage disorders are likely to suffer neglect.

Insufficient staffing levels are a frequent cause of nursing home abuse or neglect in Illinois and throughout the nation. The Illinois Nursing Home Care Act required long-term care facilities to increase staff numbers in an effort to fully meet the needs of all skilled nursing facility residents. The law required all nursing homes in Illinois to provide at least 2.5 hours of direct care staffing for every resident by July 1, 2010. In addition, elder and disabled care facilities operating in the state must provide 3.8 hours of direct care staffing for each patient by January 1, 2014.
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Study Finds Anti-Psychotic Drugs Are Over-Prescribed in Veterans Affairs Nursing Homes Located in Illinois and Throughout the Nation

by Dave Abels

A study recently published in the journal Medical Care reportedly found that anti-psychotic drugs are being overused in Veterans Affairs (VA) nursing homes at about the same rate as other long-term care facilities. According to researchers at the University of Pittsburgh, about 25 percent of elderly and disabled veterans who are living in VA skilled nursing facilities are currently taking anti-psychotic drugs. The study claims that at least 40 percent of the individuals who are prescribed anti-psychotic medications while residing in VA nursing homes are taking the drugs unnecessarily.

As part of the study, researchers reportedly compiled information regarding almost 4,000 patients who were admitted to one of the 133 VA nursing homes across the nation for at least 90 days between January 2004 and June 2005. Study authors purportedly found that only 59.3 percent of the elderly and disabled veterans who were administered an anti-psychotic medication had an evidence-based reason such as schizophrenia or bipolar disorder for the prescription. According to one study author, University of Pittsburgh Assistant Professor of Health Policy and Management Walid Gellad, veterans who were diagnosed with dementia or Alzheimer’s disease were 66 percent more likely to receive an anti-psychotic than other facility residents. In addition, patients who exhibited aggressive behavior were allegedly three times more likely to receive an anti-psychotic drug than other nursing home residents.

Anti-psychotic drugs allegedly do little to alleviate behavioral issues in individuals who suffer from dementia. In addition, the nation’s Food and Drug Administration has issued a warning that use of such pharmaceuticals in dementia patients is associated with an increased death rate. Gellad reportedly believes the overuse of anti-psychotics results from the difficulty many nursing home employees have in dealing with the behavioral symptoms often associated with dementia disorders. He said although skilled nursing facility staff may be attempting to maintain the safety and comfort of residents, better alternatives than sometimes dangerous anti-psychotic medications should be used.

Sadly, nursing home neglect or abuse is not always easy to identify. Administering inappropriate medications to a skilled nursing facility resident in order to make caring for them easier on untrained or insufficient staff is not acceptable. Similarly, the over-medication of long-term care facility residents is generally a recipe for abuse. If you believe a nursing home patient was the victim of abuse or neglect, you should speak to an experienced attorney regarding your concerns.
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Top Nursing Home Violations in Illinois and Nationwide Now Available Online

by Dave Abels

Last month, non-profit corporation ProPublica updated the organization’s Nursing Home Inspect tool to include more than 250,000 deficiencies identified by the U.S. Centers for Medicare and Medicaid Services at nursing homes across the nation over the last three years. The information was reportedly taken from detailed narrative reports of problems uncovered following annual long-term care facility inspections. The Nursing Home Inspect tool was purportedly created in an effort to make it easier for the public to search for problems or other care trends at skilled nursing facilities in Illinois and across the nation. Normally, a long-term care facility will be inspected by a state agency only once per year unless the agency receives a complaint regarding nursing home conditions. Any deficiencies noted are then ranked based upon the deemed level of severity.

The top five violations listed in the Nursing Home Inspect database include failure to ensure a skilled nursing facility is free from accident hazards, failure to ensure an effective infection control program is in place, failure to provide the best necessary resident care as is practicable, unsanitary food preparation or distribution, and failure to create comprehensive patient care plans. In addition, other failures such as meeting professional standards with regard to services and record-keeping, employing individuals who have committed abuse, maintaining a drug regimen that includes unnecessary patient medications, and failure to ensure the dignity of residents is protected were also allegedly noted frequently by nursing home inspectors.

Unfortunately, nursing home patients risk serious injury and death when long-term care facilities fail to maintain an environment that is free from fall and other accident hazards. Additionally, residents are placed at risk for abuse or neglect when a nursing home does not employ a sufficient number of well-trained direct care staff. In Illinois, the Nursing Home Care Act requires skilled nursing facilities throughout the state to employ enough workers to meet the needs of all patients. Sadly, inadequate or poorly trained staff commonly factor into nursing home abuse or neglect cases. If you feel your friend or loved one was harmed or died as a result of nursing home abuse or neglect, you should contact a skilled nursing home abuse and neglect attorney to discuss your concerns.
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Newly Privatized Libertyville Nursing Home Receives 14 Citations from State Inspectors

by Dave Abels

Two recent state inspections noted 14 total deficiencies at a skilled nursing facility located in Libertyville. The deficiencies found at the recently privatized county facility included patient falls from both wheelchairs and beds, a lack of fall prevention measures, improper maintenance of medical equipment, assistance buttons placed in such a way it was impossible for residents to reach them, insufficient overnight staffing levels, inadequate staff training, poor sanitation, improper handling of patient medication, and other issues. In addition, Illinois Department of Health and Human Services inspectors also noted a number of elderly Winchester House residents were improperly prescribed anti-psychotic medications.

According to the Lake County nursing home’s Facility Administrator, Richard Curtis, each of the issues cited by state inspectors was remedied within four weeks of the annual license and certification survey completed in October. He said many of the problems noted at the facility were typical and Winchester House took the violations seriously. Curtis also added that three years ago, before the facility was privatized, the nursing home received 21 citations following a similar unannounced state inspection.

Currently, Winchester House provides long-term care to 177 residents and employs approximately 160 people. Three-fourths of facility employees are reportedly registered nurses. Last December, Health Dimensions Group took over management of the certified nursing home. Still, an advisory board that includes two members of the Lake County Board assists with facility oversight. According to Lake County Administrator Barry Burton, Health Dimensions Group violated only minor state requirements and is highly focused on cost containment measures.

In Illinois, most nursing homes and other long-term care facilities receive Medicare and Medicaid funds. This means they are considered certified skilled nursing facilities. Doctors who treat residents at Illinois certified nursing homes must adhere to both state and federal laws and regulations. Too often, physicians and other nursing home caregivers choose to provide patients with inappropriate pharmaceutical drugs in order to compensate for understaffing. Because many elderly and disabled nursing home patients cannot advocate on their own behalf, any suspected over-medication or other resident abuse should always be discussed with an experienced lawyer.
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