Philadelphia Nursing Home Abuse Lawyer
Pennsylvania has the fourth largest older adult population in the United States, roughly accounting for 21.4 percent of the total population. At any given time approximately 1.5 million people are residents in a nursing home. It is illegal in Pennsylvania and New Jersey for a nursing home to allow their staff to abuse or neglect a resident or to allow another resident to abuse or place a resident in imminent harm. The experienced attorneys at Rosenbaum & Associates have over 25 years experience holding negligent nursing homes accountable for the injury caused to their residents so contact us to speak with a caring Philadelphia nursing home abuse lawyer.
How Common Is Elder Abuse?
Elder abuse is a highly under-reported act. While it may be difficult to place a definitive number on the percentage of elders impacted, it is believed that 1 in 10 elders suffer abuse or neglect, but only 1 in 5 cases are ever reported. Fear of retaliation, loss of freedom, or familial connection, can play a role in the under-reporting of elder neglect and abuse. More often than not, elder abuse occurs at the hand of a caregiver, family member, or someone that the older adult has grown to trust. A recent study by SeniorLAW Center found that older Americans who have suffered some form of elder abuse, neglect, sexual assault, or financial exploitation had three times the heightened risk of dying prematurely as compared to older Americans who had not suffered any harm. Elder abuse can take place in any living condition be it a nursing home, long-term care facility, or in-home care.
What Is Nursing Home Abuse?
Nursing home negligence occurs when a resident is abused or neglected by nursing home employees. Unfortunately, this neglect or abuse can result in significant injuries including wrongful death. Because the nursing home industry has become a multi-billion dollar business comprised of major corporations, efficiency and profitability have become more important than administering proper care. For this reason, both federal and state governments have introduced legislation to protect residents of nursing homes.
In some homes, signs of abuse show in small ways that can become big – for example, understaffing leads to overworked staff members who make dangerous mistakes. At the most extreme, nursing homes that skimp in vital areas can expose their residents to abusive or criminal staffers; uncontrolled infections; and neglect of some of the basics of patient care. Our Philadelphia nursing home abuse attorneys are proud to represent residents and family members seeking to hold nursing homes responsible for mistreatment.
Types of Nursing Home Abuse
- Nursing home falls & fractures
- Elder financial abuse and nursing homes
- Sexual assault in nursing homes
- Nursing home infections
- Understaffing nursing home facilities
- Excessive force in the nursing home
- Medication errors
When most people think of improper patient care in nursing homes, they think of physical abuse. This is a serious problem in nursing homes and can lead to injuries, illnesses, and other severe complications to the victim’s health. However, what is more common is the neglect of the nursing home resident’s basic needs. Staff members are overworked, under-trained, unqualified, or just don’t care.
Medication problems are another serious problem in nursing homes. The concentration of powerful drugs in nursing homes invites abuse by unscrupulous staff members. Too much of a medication, too little, or the wrong kind of medication can lead to severe and unnecessary side effects or suffering from untreated health conditions. Our Philadelphia nursing home abuse lawyers handle all types of medication mistake cases, including cases of:
- Prescribing the wrong drug or filling a prescription with the wrong drug
- Dispensing too much or not enough of the correct drug
- Failing to detect drug interactions, allergies, or side effects
- Withholding necessary drugs
- Not monitoring patients for side effects
- Dispensing a drug known to be dangerous or defective
These are not harmless mistakes. Many prescription drugs have very powerful effects or side effects. A blood thinner can save the life of a person who needs it, but in the wrong person, it can cause dangerous internal bleeding. Drugs that are safe for a patient to use on their own may be deadly when mixed. A 2005 study in Massachusetts found that almost one out of every 10 nursing home patients in that state suffered an injury because of a medication error. They included wrongful death and internal bleeding as well as hallucinations, confusion, and over-sedation, which can be deadly if it slows the patient’s heart rate and breathing.
As with other forms of negligence in nursing homes, some cases of medication errors arise from cost-cutting by the home’s management. Nurses and pharmacists who don’t have much time to spend on each patient may misread directions and prescriptions in their haste. This is especially likely if high turnover means the nursing home’s staff is brand-new at the job every few weeks or months. Other cases of drug errors arise from simple inattention. Nursing home patients who are hospitalized may also be affected by medication mistakes by a hospital or its staff.
The 1987 Nursing Home Reform Act specifically says that nursing home patients should not fall victim to mistakes with their medications. Our Philadelphia medical malpractice attorneys are glad that patients are protected by law, but we don’t believe nursing homes should need extra instructions to avoid medication errors. Medication errors are a form of medical malpractice, which means a mistake so serious that it falls below our medical community’s standards of care. Medication errors are one of the most preventable forms of injury and wrongful death at nursing homes and can cost families thousands of dollars.
Nursing Home Falls
Falls are a threat at any age and can lead to serious injury. Unfortunately, they are both more likely and more devastating as we get older. Nursing home residents are especially vulnerable because they tend to have health conditions that make falls more likely. Some nursing homes can make these problems worse by providing an environment that makes falls more likely. And because our bones lose density as they age, a fall is more likely to cause a disabling broken bone or head injury that can rob the victim of mobility and independence. Because residents are so vulnerable, our Philadelphia nursing home abuse lawyers believe nursing homes have a special duty to prevent falls.
According to the Centers for Disease Control and Prevention, as many as three out of four nursing home residents fall each year. That’s twice as often as older people in other living situations. In fact, nursing home residents fall disproportionately compared to people the same age. Even though only 5% of adults ages 65 and older live in nursing homes, 20% of the people in that age group who fall are nursing home residents. That’s partly because they tend to have health conditions that make them particularly vulnerable to falling, such as physical disabilities, tremors and mental confusion. Medications that affect the central nervous system, such as sedatives and anti-anxiety drugs, may also increase the chances of a fall.
For nursing home residents, the same fall that would cause a younger person no harm can be physically and emotionally devastating. Among nursing home residents who fall, the CDC estimates that 1,800 die each year. Another 10% to 20% suffer serious injuries, causing disabilities, a decline in their ability to function and a reduced quality of life. In fact, some older people are so afraid of falls that the fear is enough to reduce their quality of life, by isolating them and making them feel helpless.
Under the law, nursing homes are required to prevent falls by providing adequate care and equipment for vulnerable residents. Nonetheless, the CDC reports that environmental hazards cause 16% to 27% of falls in nursing homes. These can include the same hazards that might trip anyone, such as objects left on the ground, as well as care-specific hazards like defective walkers or inadequate attention from nurses. Nursing homes may also be responsible for causing falls if they misuse powerful sedative or psychiatric medications as “chemical restraints“, or allow patients to develop conditions like dehydration, which can cause a dizzying “head rush” (orthostatic hypotension) when the patient gets up.
Sexual Abuse in Nursing Homes
Nursing homes should be a place of refuge for elderly residents. Sexual abuse in nursing homes is a heinous form of abuse committed upon a person who has trusted that the facility will care for their needs as they age. Elder sexual abuse is any form of unwanted, non-consensual sexual act, including inappropriate touching, rape, sodomy, forced participation in or forced viewing of sexually explicit photography or video. Sexual deviants specifically prey upon nursing home residents who are unable to communicate or have a difficult time remembering events from dementia or their medications.
While there is limited research available as to the gravity of the problem, the Department of Justice conducted a study in 2000 on Crimes Against Persons Age 65 or Older; they found that only 30 percent of those 65 and older that were sexually abused reported the violation to the police. Over half of elder sexual abuse victims within one year from the time of their assault will die as a result of the trauma. While it is not standard policy for all nursing homes to mandate that any visitor must sign in before entering, an undocumented stranger can gain access to a nursing home when a staff member leaves, unless the nursing home establishes strict safety guidelines.
One of the complex issues facing elder sexual abuse is in tracking and reporting. Often cited as a “tip of the iceberg” theory, elder sexual abuse can often be discrete, and the least acknowledged type of abuse. Any sexual assault is a sensitive matter that closely touches upon a person’s dignity and privacy, and can often make the victim feel ashamed. Social silence as to the extent of occurrence of elder sexual abuse only helps to perpetuate the unspoken abuse. If the nursing home staff is aware that a sexual assault has occurred they must take all necessary precautions to ensure the safety and general welfare of their residents.
If you suspect that your loved one is being sexually abused while at a nursing home, contact the authorities to ensure their safety and to have their claim documented so that the situation can be investigated immediately. We understand that no amount of compensation will ever reverse the harm caused to you or your loved ones, but a Philadelphia nursing home abuse lawyer at our firm will work to hold the guilty party accountable for all of the injuries sustained from their neglect or reckless act.
Nursing Home Infections
Infections are a common occurrence in nursing homes. Grouped residence, understaffing, as well as the age and individual health of a resident, help favor the spread of infectious diseases in nursing homes. Residents clustered together in confined living quarters and activity rooms are prone to spread potentially life-threatening infections without the implementation of daily basic hygiene, preventive care, and the use of fundamental principles of infection control by the entire staff. Common infectious diseases in a nursing home are urinary tract infections, respiratory infections, skin and soft tissue infections such as pressure ulcers also known as bedsores, pneumonia, methicillin-resistant Staphylococcus aureus (MRSA), and sepsis. If you or a loved one recently was diagnosed with an infection while residing in a nursing home you may want to discuss with a Philadelphia nursing home abuse lawyer whether the infection was a direct cause of nursing home neglect or abuse.
Some signs that the infection may be a sign of neglect is the general upkeep and cleanliness of the facility, including the daily sanitation of common areas. Other factors to consider in whether a nursing home is upholding their duty to maintain a clean environment for their residents is whether the linens are washed and how frequently, as well as whether residents are left to sit in unsanitary clothes, and most importantly if the nursing home staff seems understaffed or overstretched in their duties. Infections can spread quickly as older adults tend to have a compromised immune system or an illness that places them at a heightened risk for infection. The Nursing Home Reform Act of 1987 governs the rules for which any nursing home that receives federal funding must abide by. Included in the basic tenants of the Act is for the care of residents in a way that promotes maintenance or enhancement of their quality of life including sufficient cleaning, bathing, hydration, and health. Pennsylvania courts look to the nursing home’s complete chart and individualized care plan in determining whether the facility is properly staffed and whether preventative practices were followed. Infections are the leading cause of nursing home deaths with nearly 400,000 fatalities caused each year. Approximately fifteen percent of nursing homes in the United States receive deficiency citations for infection control each year, as reported by the American Journal of Infection Control. When a nursing home fails to provide sufficient care and a serious infection forms, the results can be devastating and potentially fatal for the resident.
Understaffed Nursing Home Facilities
When a nursing home is unable to provide sufficient staffing, the resident’s quality of life is directly impacted. Nearly 1.4 million people currently live in nursing homes in the United States, with a steady projected growth expected as the population continues to age. According to the National Center on Elder Abuse, half of all nursing homes in the United States are understaffed and as a result are unable to meet the daily demands of their residents nor adequately maintain the facility. According to the American Association for Justice, attorney Mark Kosleradski sites profit increases as a driving force for many corporate nursing home owner’s decision to save money by actively choosing to understaff their facility.
Understaffing also greatly impacts the nursing home’s employees as it can often lead to them being overworked and stressed and more likely to take shortcuts on an individual’s treatment plan. Such a shortcut may be evidenced in a certified nursing assistant skipping a resident’s repositioning, which normally is required every two hours. Repositioning is required for resident’s who have limited mobility. If repositioning continues to be overlooked or ignored, a resident can suffer bedsores, urinary tract infection, and even a wrongful death.
The Federal Nursing Home Reform Act, part of the Omnibus Budget Reconciliation Act of 1987, requires all nursing homes that receive federal funding to have “sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident.” According to the National Center on Elder Abuse (“NCEA”), approximately 1 in 10 elders suffer abuse or neglect, but only 1 in 5 cases are ever reported. Often fear of retaliation or loss of freedom can play a role in the underreporting of elder neglect and abuse. Elder neglect is considered to occur when a “caregiver’s failure to provide for a vulnerable elder’s safety, physical, or emotional needs,” as defined by the NCEA. If you or a loved one has suffered harm caused by understaffing at a nursing home you may be entitled to compensation for your injuries and should consult a nursing home abuse lawyer in Philadelphia. Before choosing a nursing home look to the staff employee ratio as studies repeatedly show the quality of life of resident’s in higher staffed facilities far surpass those of understaffed ones.
Warning Signs of Nursing Home Abuse
The are many indicators of neglect including: rapid weight loss, bed/pressure sores, multiple falls, poor hygiene. If more than one of these conditions exit, then it may indicate an overall staff inattention and should be immediately addressed. If you suspect neglect contact a qualified Philadelphia nursing home abuse attorney to review your concerns.
Bedsores, also called pressure sores and decubitus ulcers, form when someone with limited or no mobility is left in the same position for too long. After a long while in the same position, the pressure of the person’s body weight cuts off blood flow to the area, especially in bony areas. If left undisturbed long enough, this leads to the death of body tissues in the area. Healthy people do not get pressure sores because they can simply change positions when they feel uncomfortable. But patients who are bed-bound or wheelchair-bound need the help of a caregiver to change their positions.
Bedsores are simple to prevent. In well-run nursing homes, caregivers simply turn the patient every two hours. When detected early, bedsores are also simple to treat. However, bedsores can develop into serious health threats when they are left untreated too long. In later stages, bedsores look like large blisters, and the area of dead tissue can extend all the way to the muscle or bone. At these stages, the wound may be full of dead skin cells and is extremely susceptible to an infection. To treat the wound, doctors will have to surgically remove the dead tissue and address any infection. There is also significant pain to the patient, which gets worse the further the wound progresses.
Because they are often caused by failure to meet basic standards of care, bedsores may be the result of negligence committed by the nursing home staff. However, they can also be worsened by other forms of nursing home negligence, including malnutrition and poor hygiene leading to excess moisture or soiled skin in the area. Neglect can also complicate bedsores, because the longer they are left untreated, the worse the patient’s prognosis can be. Bedsores are an invitation to infection, which can have catastrophic effects on the patient’s already compromised immune system. In the most severe cases, complications include death. And the further the sores have progressed, the longer they take to heal. In fact, only a small majority of the latest-stage bedsores ever heal.
Scientists believe that about a quarter of all patients in long-term care have bedsores at any particular time. For this reason, federal law specifically requires nursing homes to have a plan to prevent bedsores. Nonetheless, bedsores are still one of the most common forms of illness caused by medical care (along with medication errors). That’s particularly true among nursing home patients, who frequently have compromised immune systems and limited mobility. Because the need is so clear, the results so terrible and the prevention so easy, our Philadelphia nursing home abuse lawyers believe there’s no good reason for nursing homes to allow patients to develop late-stage bedsores.
Families of nursing home residents should ask questions when they see bruises on a loved one’s body. Bruises – actually pools of blood from broken capillaries – heal slowly in people with poor circulation. Bruises often occur when a nursing home resident is struck by a member of the nursing home staff or when the resident falls. Any bruise or cut requires both medical attention and evaluation to determine its cause.
The most common complaint about nursing homes, as reported to state and federal agencies, is that the homes fail to respond to complaints. Your loved one is in a nursing home because she needs care and supervision she can’t get elsewhere. If the staff is too overworked to respond to the call button, then problems will multiply.
When the staff can’t respond then mistakes happen. Pills are given too often or not at all. Patient hygiene suffers. Signs of serious illness are overlooked.
Many people need the care of a nursing home because of Alzheimer’s disease or other dementia. People with these conditions often wander. Nursing home facilities must be held accountable when individuals wander. Staff inattention is to blame, not the patient.
Nursing home residents who are visited often tend to get better care. If you can’t visit, try to call and talk to the people who take care of your loved one. Make friends with other residents and ask them to look out for your loved one.
Nutritional well-being is an important part of successful aging. Improper nutrition or malnutrition can lead to infections, confusion, and muscle weakness resulting in immobility and falls, pressure ulcers, pneumonia, and decreased immunity to bacteria and viruses. Malnutrition is costly, lowers the quality of nursing home residents’ lives, and is often avoidable.
Based on the nutritional assessment, the facility must take steps to ensure that the resident maintains good nutritional health and must provide residents with a well-balanced, palatable meal. The following will help you determine whether your loved one is demonstrating signs of malnutrition:
- Cracks around the mouth
- Lips and mouth look pale
- Dentures no longer fit
- Wounds seem to take longer to heal
- Appears confused
- Skin breaking down
- Eyes look sunken
- Losing weight
- Adverse drug effects such as nausea, vomiting, diarrhea, cognitive disturbances, or sleepiness
- Food and drug interactions which decrease the ability of the body to absorb vitamins and minerals
- Swallowing disorders
- Mouth problems such as tooth loss, dentures that do not fit properly, mouth sores, and mouth pain
- Tremors, which affect the residents’ ability to feed themselves
- Inadequate attention from staff for residents who need assistance eating
- Staff who are uneducated about malnutrition and proper ways to feed residents who need help
- Reliance on liquid supplements
- Special diets
What to Watch for If You Suspect Nursing Home Abuse
- Problems with basic hygiene – dirty sheets, dirty clothes, bad smells
- Unsanitary bathrooms and kitchens
- Unexplained weight loss or conditions caused by malnutrition
- Signs of dehydration which include sunken eyes, irritability, unexpected confusion, dizziness and a drop in number of bathroom visits
- A sudden increase in hospital visits
- An illness or injury that has advanced significantly before the home seeks treatment
- Irrational residents allowed to wander, or uncontrolled residents who seem to inspire fear in others
- Obvious, uncorrected tripping or safety hazards that could lead to falls
- No guard at the front door
In homes with abuse, signs may be harder to see because staff members will take steps to cover their tracks. Family members should watch for:
- Any use of physical restraints that seems unusual
- Changes in medication that don’t match the patient’s medical condition, especially if the medication is a sedative, painkiller or psychiatric drug
- Running out of medication too soon, or unexplained leftover medication
- Unexpected injuries to the resident, especially if the staff can’t offer a good explanation
- Nervous, controlling or overly affectionate behavior by nursing home staff
- Staff members trying to keep family from being alone with the resident
- Signs that the resident is anxious to keep you from leaving
- Childlike behaviors, like rocking and sucking
- Emotionally or even physically withdrawn behavior
To keep the nursing home staff from hiding incriminating signs before you visit, it’s ideal to drop by unannounced, and at different times of day if possible. And don’t be afraid to visit often. Studies show that nursing home residents get better care when their loved ones visit often. If this is not feasible, you can also try hiding a camera in the resident’s room, especially if he or she has limited mobility. Not only can these cameras uncover the way staff members behave when they think no one’s looking, but they can provide valuable evidence to pursue an elder abuse claim.
3 Ways to Help Ensure Quality Care in Nursing Homes
Elder abuse affects everyone, from the victim, to their family who loses a loved one before their time. The National Center on Elder Abuse estimates that over 40 percent of people over the age of 65 will enter a nursing home before they die. Under reporting has been a known hurdle in battling elder abuse in nursing homes. A 2006 study entitled, “Nursing Home Complaint Investigations” presented to the U.S. Department of Health and Human Services and the Office of Inspector General stated that, “Studies of the process States use to detect, investigate, resolve, and prevent elder mistreatment in nursing homes, assisted living facilities, and board and care homes are deeply flawed. As a result, the estimates of elder abuse and neglect are lower than the actual prevalence, and the processes must be strengthened to protect residents.”
If you have a loved one in a nursing home or are considering the option, here are a few quick tips in ways you can help ensure that your loved one is going to receive quality care.
- Research all viable options, ratings, and costs benefits online to help get a better picture of what to expect prior to visiting. The 2014 U.S. News & World Report recently released their state and regional ratings of nursing homes. It is an easy to use online tool full of valuable information, including each nursing home’s state inspection results.
- Schedule a visit and if possible drop by an additional time during visiting hours unannounced. When you are touring a nursing home make sure to take note of the condition of other residents. Are they well groomed? Do they look nourished and well cared for? Do they have visitors? Does the nursing home look and smell nice? All of these questions help to shape the projected care that your loved one will receive when you are not present.
- Do your best to visit and stay in communication with the nursing staff and administration, especially if you live out of state or if you are unable to make visiting hours as often as you would like. Studies show that if the nursing staff knows that a loved one or family member often looks after a resident’s well-being, there are less instances of abuse or neglect.
The Older Adults Protective Services Act, established a uniform statewide reporting, and investigating system for suspected abuse, neglect, exploitation, or abandonment of Pennsylvania’s older residents. The federal Older Americans Act mandates state Ombudsman to work to promote the rights and quality of life for all people who reside in nursing homes. Nursing home abuse can be reported to the Office of the State Long-Term Care Ombudsman, of the Pennsylvania Department of Aging, through their number 1-717-783-8975, or through their regional numbers. The Southeast Region Ombudsman, can also be reached at 1-570-784-4420.
Rosenbaum & Associates | Nursing Home Abuse Attorneys in Philadelphia
After abuse or neglect is discovered at a nursing home, the negligent staff members may be criminally prosecuted, and the home or staffers may suffer professional and administrative consequences. However, none of this is certain – and none of it offers financial compensation for victims and families that suffered an avoidable hospitalization, health problems, and sudden need for replacement care. Nursing home residents and their families in this position may also choose to pursue a nursing home negligence lawsuit, to hold the careless nursing home and staffers are held responsible and that you are able to recover compensation for their negligence.
Our law firm has offices throughout Pennsylvania and New Jersey, including Philadelphia. Our team of Philadelphia nursing home abuse lawyers are dedicated to helping personal injury victims make a full monetary recovery to ease the financial stress that is often associated with significant personal injury.
If you would like more information please call us at (215) 569-0200 or click here for a free consultation.