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

Senate Bill Seeks to Protect Elderly Dementia Patients in Illinois, Throughout Nation

In September, Senate Bill S. 3604 entitled Improving Dementia Care Treatment for Older Adults Act of 2012 was introduced by Senators Kohl, Grassley, and Blumenthal. The bill is reportedly aimed at limiting the use of antipsychotic medications in senior citizens who suffer from dementia and reside in certified skilled nursing facilities throughout the United States.

According to the National Consumer Voice for Quality Long-Term Care, antipsychotic medications are frequently misused in elderly Americans who suffer from dementia. The drugs are reportedly often used as a means to control a nursing home resident’s behavior when a care facility lacks a sufficient number of well-trained staff. Despite that antipsychotic drugs are not approved for use in patients who suffer from dementia, an estimated 40 percent of nursing home residents diagnosed with the disease allegedly receive such drugs. Additionally, the nation’s Food and Drug Administration (FDA) has issued a black box warning regarding the use of antipsychotics in senior patients. A black box warning is the highest warning the FDA issues without removing a drug from the market. When used in the aged, antipsychotics may reportedly cause stroke, confusion, increased falls, and death.

If passed, Senate Bill S. 3604 would require informed consent from a nursing home resident or personal representative before a facility could administer an antipsychotic. Additionally, it would require long-term care facilities to track antipsychotic drug use in residents on a monthly basis, create a national physician education program about drug use in elderly dementia patients, and direct a long-term study regarding the use of antipsychotics in senior citizens in a variety of settings including nursing homes and hospitals.

In Illinois, most nursing home and other long-term care facilities are held to a high standard of care by various laws and regulations. Facilities that receive funds from Medicaid and Medicare programs are considered certified skilled nursing facilities and must adhere to federal regulations. Because most nursing homes in Illinois are certified, laws such as the one proposed by Senate Bill S. 3604 would offer additional protections to elderly dementia patients in our state.

Abuse and neglect in a skilled nursing facility is not always easy to identify. Improperly medicating a resident in order to make up for staff shortcomings is wholly unacceptable. Likewise, over-medication is normally a recipe for abuse. If you suspect a long-term care facility resident was the victim of elder abuse or neglect, you should discuss your concerns with a capable lawyer.
Continue reading “Senate Bill Seeks to Protect Elderly Dementia Patients in Illinois, Throughout Nation”

Illinois Nursing Home Cited for Violating the Voting Rights of Residents

by Dave Abels

Surveys conducted by the Centers for Medicare and Medicaid Services reportedly show that nursing homes across the nation are increasingly being cited for violating the voting rights of residents. In November 2010, a nursing home near Peoria, Illinois reportedly failed to make it possible for 12 facility residents to vote. According to an inspection report, two additional residents at the Timbercreek Rehab and Healthcare Center were only allowed to vote after obtaining assistance from a relative.

Reports of failure to provide long-term care facility residents with the opportunity to register to vote, vote in person, or obtain absentee ballots exist throughout the country. According to Robyn Grant, Public Policy Director at the National Consumer Voice for Quality Long-Term Care, many nursing home residents feel they lost a number of their rights the moment they moved into a care facility. She added that long-term care facility residents tend to take their right to vote seriously. Nina Kohn, Professor of Law at Syracuse University, stated the facility itself generally has a tremendous impact on whether a resident is able to exercise his or her right to vote because nursing home employees may be called upon to assist or remind residents about voting. Kohn said since there is no capacity test for voting in the United States, a long-term care facility may not decide who should be allowed to vote.

Unfortunately, elderly and disabled residents are often left distraught when they are unable to exercise their constitutional voting rights. Congress passed the Nursing Home Reform Act of 1987 to protect the rights of residents living in long-term care facilities in the U.S. Under the Act, nursing homes that are Medicare-certified are required to make residents aware of their right to vote and assist them in both registering and voting. The Illinois Act on the Aging was also implemented in order to protect the rights of the elderly, including nursing home residents.

Long-term care facility abuse and neglect is not always easy to identify. In addition to physical abuse, nursing home residents may experience emotional abuse and distress. When a resident’s rights are violated, he or she may become depressed, exhibit a loss of appetite, and attempt to alert family members to the situation. Signs of physical abuse may include unexplained bruises, broken bones, bedsores, and an increased number of accidents. All suspected instances of nursing home abuse or neglect should be taken seriously and reported.
Continue reading “Illinois Nursing Home Cited for Violating the Voting Rights of Residents”

Chicago Nursing Assistant Jailed in Cook County Over Alleged Nursing Home Resident Abuse

by Dave Abels

In late October, a Chicago nursing assistant was arrested after he was accused of slapping and choking a 92-year-old long-term care facility resident. Following the incident, the 51-year-old West Side man was charged with aggravated battery to a senior citizen and is currently being held in the Cook County Jail on a $100,000 bond.

The nursing assistant was taken into custody after local police responded to a call from the Park House, Ltd. nursing home located in the Little Village neighborhood. A co-worker reportedly witnessed the man slap the wheelchair-bound senior resident twice in the face. The nursing assistant then allegedly grabbed the resident, who suffers from dementia, by his neck and pulled him up after the elderly man cowered away from him. The co-worker reportedly yelled at the alleged abuser and insisted that he immediately leave the resident’s room. Following the incident, the co-worker purportedly notified supervisors who then summoned law enforcement officers to the facility. A Sergeant from the Area Central Violence Crimes Division also investigated the alleged abuse incident.

The Illinois Elder Abuse and Neglect Act was passed in 1988 and was designed to respond to any instance of abuse of a senior citizen who resides in the state. The Illinois Department of Public Health is responsible for investigating and responding to reports of elder neglect or abuse in a long-term care setting. Since 1999, medical, law enforcement, and social service professionals are required to report all instances of suspected abuse or neglect of a senior citizen who is unable to self report. Additionally, such personnel may also choose to provide a voluntary report regarding any suspected elder mistreatment.

In 2010, the Illinois Governor signed into law nursing home safety measures designed to protect the residents of long-term care facilities from abuse. In addition to increased nurse staffing requirements, the law requires nursing homes to perform thorough background checks on new residents and mandated the hiring of additional state nursing home inspectors.

As this unfortunate case demonstrates, abuse still occurs despite a number of laws designed to protect nursing home residents. Nursing home abuse may include physical violence, withholding of food or medication, or simple neglect. Too often, long-term care facility abuse results from a lack of competent, well-trained staff. If you suspect a nursing home resident is being abused, you should speak with a quality nursing home abuse and neglect attorney about your concerns.
Continue reading “Chicago Nursing Assistant Jailed in Cook County Over Alleged Nursing Home Resident Abuse”

Research Study Finds Seniors With Bedsores at Increased Risk of Death in Illinois, Nationwide

by Dave Abels

A common sign of nursing home abuse in Illinois and nationwide is the presence of bedsores on a resident. Bedsores are pressure ulcers normally caused by remaining in the same position for too long. With proper care, nursing home and other long-term care facility residents should not suffer from bedsores. Research that was recently published in the Journal of the American Geriatrics Society demonstrates that pressure ulcers can signal much more than patient abuse. The study, led by Dr. Courtney Lyder, Dean of the School of Nursing at the University of California, Los Angeles, reportedly found that bedsores are also associated with increased hospitalization and patient death.

The study analyzed the impact of bedsores acquired in hospitals on more than 51,000 randomly chosen Medicare patients nationwide. The research study, which utilized data taken directly from patient medical records created in 2006 and 2007, was reported to be the first of its kind. Investigators found that seniors and other patients who acquired bedsores during their hospital visit had longer hospital stays, were more likely to die during their stay, and were more likely to be readmitted within one month of being discharged.

According to Dr. Lyder, the research study demonstrated that bedsores acquired in hospitals were a direct risk factor in patient death. Dr. Lyder stated patients with chronic conditions like diabetes, obesity, heart disease, pulmonary disease, and others are at the highest risk for developing bedsores when placed in a medical care setting. He also reportedly believes hospitals and other care facilities have a responsibility to identify patients who are at an increased risk for pressure ulcers upon admission. Dr. Lyder said such information should be utilized to prevent patient bedsores before they have the opportunity to develop.

Researchers stated they chose to use Medicare claim data because the national surveillance system was designed to identify adverse events such as pressure ulcers among hospitalized Medicare patients. Such data was analyzed to determine the pattern and cause of patient bedsores. According to the research, about 4.5 percent of patients evaluated acquired bedsores during their hospital stay. Additionally, a 16.7 percent of patients who entered the hospital with a pressure ulcer acquired another one during their stay.

Bedsores can have life-threatening consequences for not only hospital patients, but also nursing home residents. The recently published study found that bedsores most commonly began on a patient’s tailbone, hip, buttocks, and heels. Reasonable standards of care demand that such areas be closely monitored by nursing home and other long-term care facility staff. Steps should always be taken to lower the risk of pressure ulcers and treat them appropriately if they do develop.
Continue reading “Research Study Finds Seniors With Bedsores at Increased Risk of Death in Illinois, Nationwide”

A Prescription for Abuse in Chicago Nursing Homes: Too Many Medicated Residents

by Dave Abels

As we age, we take more medications.

We also lose muscle mass and mobility, which increases our risk for a fall accident. Nursing home falls have reached epidemic proportions in this country. Not surprisingly, those most likely to fall — those with mobility issues — are also most likely to be placed in the professional care of a nursing home.But it’s the over reliance on medication — and the side effects and interactions of such medications — that an increasing number of elder care advocates are contending is to blame for a significant number of fall accidents, unsupervised injuries and other dangerous nursing home incidents. Chicago nursing home attorneys believe a significant number of such cases involve prescription medications.

The New York Times reports a recent study looking at Medicaid patients in Florida nursing homes found 71 percent — or 7 in 10 — were receiving prescription medication to treat mental health issues despite the fact that most were not on such medication before entering the home.

Fifteen percent of residents were taking 4 or more of such medications, which include antidepressants, anti-psychotic drugs, and dementia medications.

Elder care advocates say having more than 7 in 10 residents so heavily medicated is an indictment of the system and illustrative of poor resident care. However, mental-health issues are also a common reason for nursing home admittance. So officials must walk a fine line — ensuring residents receive proper medical care while guarding against overmedication.

Because the average resident is already taking 10 or more prescriptions. And such mental health drugs are known for problematic side-effects and poor reactions with other medications.

Congress has been concerned for decades about overmedication in the nation’s nursing homes. The Omnibus Budget Reconciliation Act of 1987 began requiring that new residents be assessed for mental illness and encourages use of non pharmaceutical treatments. However, patients transferred from hospitals are exempt from screening. As a result, only about half of all residents ever receive the mandated assessments.

Only about half of nursing homes have professional mental health staff, including psychiatrists and psychologists. And the fact of the matter is that over reliance on such powerful antipsychotic medications can have all sorts of unintended consequences, including falls, broken bones and joints, cognitive decline, weight loss and withdraw.

And that’s not the only way prescription medication issues can lead to neglect or abuse.Recently Ohio Attorney General Mike DeWine announced a crackdown on nursing home prescription drug theft. Prescription drug abuse has exploded in this country. As a consequence, the elderly are too often left without pain medication. DeWine reminded Ohio nursing homes of the obligation to report suspected criminal activity and noted the state will help with prosecuting offenders for prescription drug abuse.

“Every time this happens a real patient is deprived of the medication they need to get well,” DeWine said in a statement. “This is why my office is now contacting facility administrators throughout the state. We want to remind them that we can help.”

Ohio has seen a recent string of cases in which nursing home employees were caught stealing an elderly resident’s pain medications. In both Cleveland and Columbus, nurses have been convicted of stealing Oxycodone. Other medication, including Percocet and pain patches, has also been involved in cases of prescription drug theft from nursing homes.
Continue reading “A Prescription for Abuse in Chicago Nursing Homes: Too Many Medicated Residents”

Malnutrition a Concern in Chicago Nursing Homes

by Dave Abels

Malnutrition is not a sign of normal aging.

Our body may not move the way it once did. We may become frailer, less agile. We may even start to shrink a little in stature. Our mind may not be as whip-sharp as it once was.

But we shouldn’t be starving.

That, our Chicago nursing home lawyers know, is the result of poor or negligent care. Nursing homes are unfortunately notorious for providing poor or improper nutrition to patients – with sometimes deadly consequences.

Each nursing home resident, before they are admitted, should have a thorough evaluation of his or her nutrition needs. A plan should be tailored specifically to meet those needs.

This will include allergies, of course, and hopefully preferences. But it should also include how much they need to eat on a daily basis, as well as their ability to consume.

For example, a 180-pound man will need more nutrition than a 90-pound woman.

Also, if someone doesn’t have their teeth, they probably can’t eat corn on the cob. Many nursing home residents and long-term care patients require diets designed so they don’t choke. Often, this means having food that is mashed or pureed. Some have to be monitored closely throughout the entire meal, and others have to be fed through a tube.

However, it is far too often the case that nursing homes do not heed these instructions, usually because of carelessness or lack of proper training or not having enough staff on hand to ensure nutrition plans are carried out.

This has resulted in tragedies throughout the country.

In Connecticut, for example, three nursing home residents choked to death in as many months because they were fed solid foods (ranging from meatballs to marshmallows) when their diets had been restricted for various reasons.

Additionally, nutrition plans need to be updated and reviewed on a regular basis. As people age, needs change. What was fine two years ago may no longer be adequate – or safe.

It’s been more than a decade since the Centers for Medicare and Medicaid Services began sending out packets of information to nursing homes, aimed at training caregivers to spot malnutrition – and how to address it. When a facility is trusted with the care of someone, there is no excuse for not providing care as basic as meeting a patient’s nutritional needs.

In rare cases, malnutrition may be a malicious act. In Oregon, for example, two employees were recently charged in the death of a patient who died of malnutrition. They’ve been charged with criminal mistreatment and criminally negligent homicide.

Nursing homes have a responsibility to:

–Serve nutritious foods that the patient like and which are within his or her religious or cultural preferences;

–Serve foods that taste good and are prepared to a proper temperature;

–Ensure that food items have been safely prepared;

–Serve meals in a timely manner and provide prompt and courteous help with eating;

–Provide eating utensils that are specifically designed to meet a patient’s special needs;

–Provide another equally nutritious food if you don’t like what is offered.
Continue reading “Malnutrition a Concern in Chicago Nursing Homes”

Chicago Nursing Home Nelgect: About Bedsores and Pressure Ulcers

by Dave Abels

Bedsores are a common sign of Chicago nursing home neglect and an often misunderstood medical condition that can be life-threatening if left untreated.

Our Illinois nursing home attorneys continue to monitor moves by the state and federal legislature and the nursing home industry as it relates to staffing levels and the supervision and care of state nursing home residents.In July, Abels & Annes announced a $300,000 settlement on a case the firm served as co-counsel with another law firm against a Chicago nursing home, where an elderly developed bed sores after not receiving the proper care. Her son had become concerned about her treatment and the facility had received several complaints about the development of bedsores due to the resident being left immobile.

Staff was instructed to inspect the patient’s heels on a weekly basis after blanchable redness was detected, commonly the first sign of developing bedsores. The home failed to properly monitor her condition, failed to care and treat the sores and failed to timely seek additional medical care once sores developed.

The truth of the matter is that bedsores are not unavoidable, even with elderly, infirm or immobile patients. Inadequate care, soiled linens and poor hygiene can exacerbate a patient’s condition.

Left untreated, bedsores and pressure ulcers can lead to disfigurement and even death.

Bedsore Stages:

Stage I: blanching, change in skin sensation, temperature or firmness. Uncared for, the condition worsens quickly.

Stage II: Sore, blister or abrasion forms. Bedsores or pressure ulcers become harder to treat if allowed to progress.

Stage III: Deep craters form, resulting in substantial skin loss.

Stage IV: Sore may involve bone or muscle and resembles a deep wound.

A survey by the Centers for Disease Control and Prevention found more than 10 percent of nursing home patients — nearly 160,000 residents nationwide — suffered from pressure ulcers, with Stage II ulcers being the most common. The same study found as many as one-third of all nursing homes had patients with bedsores.

New nursing home residents were also more likely to develop bedsores, compared to those who had resided at a home for 12 months or longer.

The National Institutes of Health reports bedsore neglect often leads to a worsening of the condition by stages and can ultimately be life threatening. Primary treatment is release of pressure, which for wheelchair bound patients can lead to bed rest, which in turn presents it’s own risk factor for bedsores.

Infection may result, including sepsis, which can result in organ failure. And surgery to repair Stage IV ulcers may be complicated by bone infection.

Proper daily patient care can prevent bedsores from forming. And early medical treatment can reduce severity and prevent medical complications. There is no reason nursing home residents should be made to suffer with advanced bedsores.
Continue reading “Chicago Nursing Home Nelgect: About Bedsores and Pressure Ulcers”

Cost-Profit Equation Illustrates Risk of Nursing Home Neglect in Chicago

by Dave Abels

Chicago nursing home lawyers are concerned as state and federal policymakers continue to impact nursing home care in Illinois. And, unfortunately, ever-tightening budgets may negatively impact the care a home’s residents receive.

Lobbyists and organizations like the American Health Care Association — an organization of more than 11,000 non-profit and for-profit nursing home facilities — continue to warn of the consequences of ongoing cuts to Medicaid and other funding sources. Illinois nursing home neglect attorneys understand abuse or neglect of the elderly is most likely to occur when a facility puts profits ahead of the health and safety of its residents.”In these uncertain times, nursing homes need a reliable funding stream; one that ensures continued quality care can be delivered to Illinois seniors,” said AHCA CEO Mark Parkinson. “Efforts to trim or limit that Medicaid funding will have lasting, unintentional effects.”

The organization contends per-patient, per-day nursing home care costs have risen from $138.65 to $144.64 per day over the last two years, while reimbursement rates have climbed less than half that much — from $117.29 to $120.30. The nearly $25 a day shortfall between cost and reimbursement costs the industry some $417 million annually.

So says the industry. And therein lies the problem. These reports depend upon who is determining costs or whether a reasonable profit is factored into such “costs.”

The fact of the matter is that nursing homes are big business in this country. More than half of the nation’s 2 million nursing home beds are owned by large chain corporations and two-thirds of nursing homes are run as for-profit companies.

What too often happens is advocates for a rich and powerful industry have the ear of politicians and the health and safety of residents becomes a casualty. Take the ongoing fight over reforms in the wake of a series of stories in the Chicago Tribune detailing abuse to Illinois nursing home residents by residents and staff members with felony criminal records.

That fight has now moved to the capitol, where the State Journal-Register reports the industry is now arguing about the definition of “direct-care staffing” as it relates to landmark reforms passed in 2010. Essentially, the industry wants to use practical nurses and certified nurse assistants, rather than the more costly and professional care provided by registered nurses.

It’s about reducing costs, in other words. Not what’s best for the patient.

That’s why it’s incumbent upon each of us who visit these facilities to remain vigilant for possible signs of neglect or abuse. And, of course, thorough review upon placing a loved one is always warranted. We make the difficult decision to place an aging relative in professional care because we want to do what we can to ensure their wellbeing. Each resident deserves to live out his or her days in peace and dignity.

Neglect or abuse can take many forms. However, most often it is simple neglect that occurs because of a lack of proper training, staff turnover, or short-staffing issues. Remaining active in your older adult’s life can help make sure they are getting the kind of care and treatment for which they are paying.
Continue reading “Cost-Profit Equation Illustrates Risk of Nursing Home Neglect in Chicago”

Negligent Supervision Increases risk for Nursing Home Falls in Chicago

by Dave Abels

Chicago nursing home lawyers at Abels & Annes understand the risks associated with fall accidents in nursing homes.

A fall accident always has the potential to be serious, even when the victim is a child or healthy adult. About 50 percent of those who die each year in fall accidents are killed by a traumatic brain injury. Broken bones and joints are also common.But when the victim is an elderly adult in a nursing home, injuries often result in a permanent reduction in quality of life, increased issues with mobility, emotional issues associated with the fear of falling, and premature death.

Chicago nursing home neglect attorneys know that many fall accidents can be prevented with proper staffing and equipment, by ensuring residents keep as active as possible, and by periodic review of medications for complications and side effects. The truth of the matter is that we put older loved ones in nursing homes because of the professional care available — and we do it in an effort to prevent just such an accident from occurring.

Unfortunately, reports continue to show that nursing home falls are an epidemic. Recently, the Journal of the American Geriatrics Society reported 1 in 5 newly admitted nursing home residents will suffer a fall accident during their stay.

The study from the University of Southern California in Los Angeles looked at 230,730 residents who entered nursing homes in 2006 for the first time. Nearly 50,000 suffered at least one nursing home fall accident during the reporting period.

“A fall can delay or permanently prevent the patient from returning to the community, said Natalie E. Leland, Ph. D., in a statement accompanying the study’s release. “Identifying risk of falling is essential for implementing fall prevention strategies and facilitating successful discharge back to the community.”

The Centers for Disease Control and Prevention reports 20,000 older adults die in fall accidents each year — a number that has increased steadily for years. Another 2.2 million are seen in emergency rooms for fall-related injuries. Nationwide, one-third of adults over the age of 65 fall each year. That makes fall accidents the leading cause of accidental death among older adults.

Common Causes of Nursing Home Fall Accidents in Chicago

-Lack of Supervision -Lack of proper equipment, including poor bed-height -Missing or inadequate handrails/assist devices -Inactivity of patient -Side-effects/complications of medication -Poor footwear -Wet floors/obstacles -Poor hydration or nutrition
In some cases, fall accidents may go unreported or untreated, which can also lead to medical complications, including reduced function and quality of life. While it’s true those in nursing homes may be frailer and more prone to fall accidents, they deserve the professional care and supervision for which they are paying. And that alone is frequently enough to prevent an accident from occurring.
Continue reading “Negligent Supervision Increases risk for Nursing Home Falls in Chicago”

Illinois Nursing Home Neglect: Advocates lose fight over minimum staffing levels

by Dave Abels

Minimum staffing levels in nursing homes help guard against the possibility of nursing home neglect in Chicago and throughout the state.

So it was particularly frustrating to elder advocates when Illinois lawmakers sided with the nursing home industry — putting corporate profits ahead of the welfare of our most vulnerable adults. After a two-year debate, the Illinois General Assembly passed a bill without the input of advocates.While a spokesperson for the nursing home industry said it won’t infringe upon rights passed in the state’s 2010 nursing home reform law, others are convinced industry influence in Springfield will always prevail.

A Chicago nursing home neglect attorney understands the need for oversight. Too few large corporations control the majority of the nursing home beds in Illinois. A long history of abuse and neglect in Illinois nursing homes — including the housing of mentally ill felons with vulnerable older adult populations — has finally led to some reform.

But the truth of the matter is these corporations wield tremendous power and influence. Nationwide, over half the nursing home beds are owned by chain corporations and two-thirds are operated as for-profit companies. Combining political influence with shrinking state and federal dollars can be a recipe for disaster.

The State Journal-Register reported the nursing home industry contends Senate Bill 2840 will actually increase staffing beyond the requirements provided in the 2010 law.

The 2010 reforms call for a gradual increase through 2014 in the amount of personal and nursing care that a patient must receive. Left up in the air was what type of nurse would provide the additional care. Earlier this year, the Illinois Department of Public Health proposed requiring at least 20 percent of the care be provided by registered nurses.

Advocates supported the 20 percent requirement, contending patients would receive better, more experienced care than if fulfilling the requirements was left to staff with less training and experience. Holding the industry to such requirements would also help justify the additional $105 million in Medicaid funding facilities are set to receive after Illinois lawmakers approved a new bed tax in January 2011.

The final bill send to Governor Pat Quinn includes the industry’s preferred 10 percent requirement and spares the industry from all but 2.7 percent of a proposed 15 percent funding cut.

Illinois Sen. Jacqueline Collins, D-Chicago, said Chicago nursing homes are at particularly high risk for staffing issues. She said the issue was not resolved out in the open, but rather cut in a back room deal with the nursing home industry, which is one of the largest contributors to political campaigns in Illinois.

Still, most of Illinois’ nursing homes will be required to hire more registered nurses because of the law. And more professional staff is a primary way to reduce the risk of nursing home neglect or abuse in Illinois nursing homes.

We guess from that standpoint the glass is at least half full.
Continue reading “Illinois Nursing Home Neglect: Advocates lose fight over minimum staffing levels”