Audit raises concerns about nursing home staffing levels.

A recent audit (report here) by the Pennsylvania Auditor General raises serious concerns about nursing home operation in Pennsylvania. The audit covered the period of January 1, 2014 through October 31, 2015. The report broke the key issues up into three areas of focus.

In the first (and most important) area of focus, the audit revealed that the Department of Health did not have sufficient policies and procedures to ensure that nursing homes provided the required 2.7 hours of direct patient care per day. The hours of direct patient care were often self-reported and not backed-up of adequate supporting documentation. In addition, the audit revealed that the minimum number of 2.7 hours might be too low.

The second area of focus deals with the Department of Health’s handling of complaints. The Department has a policy of disregarding anonymous complaint about nursing homes. The audit also found deficiencies in the Departments documentation and prioritization practices. These practices can lead to a mishandling or rejection of serious and urgent complaints.

The third area of focus deals with imposition of sanctions by the Department. The audit revealed that, in cases where the department administered education, rather than fines, to facilities that had severe violations, the decision making process was not adequately documented.

These findings should alarm anyone with a loved one in a nursing home. It is important to keep in mind that any legislation limiting the ability to bring private lawsuits against nursing homes will only make this problem worse. It is therefore important to strongly protect the rights of individuals to bring lawsuits, allowing them to recover adequate damages and perform their own investigations, when nursing home abuse occurs.

Golden Living nursing homes kill two in Minnesota.

This article from the Minnesota StarTribune describes two recent deaths at Golden Living facilities in Minnesota. One occurred after a resident’s prescription for a blood-thinner was given to the wrong person. The resident who went without the proper medication died of blood clots in the brain. The second death occurred when a resident was given ten-times the prescribed amount of morphine. State investigators concluded that Golden Living “was not monitoring the performance of the nurses and had not conducted annual medication competencies of the nurses.”

Golden Living, one of the nation’s largest for-profit nursing home chains, has had its share of troubles in the past. It should come as no surprise that errors such as these occur in a company where Pennsylvania nursing employees had to fight to earn $15 per hour. Given the tendency of for-profit nursing home chains to value profit over quality care (as noted in this article), private causes of action against these facilities are the main tool to deter abusive conduct.

Discussing the Limitations of PA State Nursing Home Inspections

Here is a good article from ABC27 News about the nursing home state inspection process. The article describes how Golden Living nursing homes might be inappropriately adjusting staffing levels during inspections. The article notes that, although inspections are supposed to be unannounced, the Pennsylvania Attorney General’s lawsuit against Golden Living alleges that Golden Living increases staff numbers when inspections occur. Sometimes office and administrative staff are used to “provide direct care to residents.” This activity is confirmed by witnesses quoted in the article who had family members staying in Golden Living homes. Continue reading

Hall v. Episcopal Long Term Care

I was recently reading Hall v. Episcopal Long Term Care, 54 A.3d 381 (Pa.Super. 2012). This case does a nice job of describing the deplorable conditions that we see in nursing home abuse cases, and the conditions that can lead to punitive damages and damages for corporate negligence.

Hall involved a resident who suffered from neglect while at the Philadelphia Nursing Home, which was managed by Episcopal Long Term Care. The resident died on January 17, 2005 from cerebral vascular disease. Continue reading

Nursing Home Arbitration Clauses: Be Careful When Signing

Dealbook has an interesting article on nursing home arbitration clauses. The article tells the story of Elizabeth Barrow, who was strangled by her roommate in a Massachusetts nursing home. The nursing home had notice of the roommate’s potential to harm others, yet still placed her with Ms. Barrow.

When Ms. Barrow’s son tried to bring a lawsuit against the nursing home, he learned that he had signed admissions paperwork on his mother’s behalf that contained a clause requiring disputes to be submitted to private arbitration. The case proceeded to private arbitration. That process revealed something that is an ongoing concern in cases involving large companies and the private arbitration process: The arbitration firm had previously handled 400 cases for the nursing home’s law firm, calling into question its ability to be impartial in the matter. In Ms. Barrow’s case, the arbitration firm ruled in the nursing home’s favor without comment. Continue reading

More Bad News for Golden Living Nursing Homes

The news keeps getting worse for Golden Living, which operates thirty-six skilled nursing facilities in Pennsylvania. Golden Living is defendant in an action filed by the Pennsylvania Attorney General’s Office. Complaints in that matter were filed in July and September 2015. The amended complaint can be found here.

That action alleges, among other things, that continent residents were left in diapers because they could not be helped to go to the bathroom. Residents were left in dirty diapers, were not properly repositioned, were not properly cleaned or dressed, did not receive proper exercises, and were not provided all meals. The facilities are alleged to be understaffed, with increases in the number of staff during state inspections. It is also alleged that records are falsified under direction or fear of management.

It is now being reported that, at an October 22, 2015 inspection of a Golden Living facility in East Pennsboro Township, Pennsylvania, maggots were found in a patient’s feeding tube.

For those of us who practice in the area of nursing home abuse, this conduct is not surprising. For individuals who support tort reform, it is important to keep these situations in mind. As we limit the ability of victims to bring lawsuits against facilities like Golden Living, we increase the likelihood that this conduct will continue.