Nursing Home Lawyer & Attorney : Stark & Stark Law Firm : Elder Care, Senior Care

In any nursing negligence claim, it is advisable to retain a nurse – who is not necessarily the ultimate expert in the case – to provide a detailed timeline to examine all claims and all sites of alleged negligence or manifestation of injury to determine the proper players in the case. This is frequently inexpensive and provides an excellent foundation for all of the future litigation from either the plaintiff or defendant’s point of view.

You can read more practice tips in my chapter Screening the Nursing Malpractice Case, in a text edited by Patricia Iyer, RN MSN LNCC. More information about Nursing Malpractice, Third Edition, 2007 may be found at here.

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Poor work conditions represents one of the most significant hurdles facing nursing home residents today. Workers who lack job satisfaction and who feel a sense that the management company is not providing them the support they need simply cannot deliver the level of care that our elderly deserve. When conditions reach a critical level, workers will literally leave the job. This happened as recently as August of this year at a Veterans home in Menlo Park, New Jersey. A union representative noted “people don’t want to come to work anymore, it’s so bad…we just want to be able to do our job in peace.” One worker claimed that she was on suspension for utilizing six work days, even though her contract authorized fifteen sick days. This represents a classic example of management failing to protect nursing home residents through fair and equitable treatment of its own employees.

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It is common with nursing neglect claims to focus on nursing negligence and this hinge on the review of a nursing expert. However, it is critical to determine early on whether or not it is possible to have a physician specifically relate wrongful death or other claims to the negligence at hand. Similarly, the defense should shore up its defenses, which do not relate the ultimate outcome to the act of nursing neglect.

You can read more practice tips in my chapter Screening the Nursing Malpractice Case, in a text edited by Patricia Iyer, RN MSN LNCC. More information about Nursing Malpractice, Third Edition, 2007 may be found at here.

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With infection and indeed all other medical claims, nearly all courts will not permit a nurse to address causation issues. It is essential to have a physician on behalf of either plaintiff or defendant to relate an injury to the asserted act of negligence. A burgeoning and narrow exception to this relates to skin care. Some experts agree that wound care nurses might ultimately be qualified to relate skin interruption with negligence. However, it remains prudent for either side of a litigated matter to have a physician to address theses issues.

You can read more practice tips in my chapter Screening the Nursing Malpractice Case, in a text edited by Patricia Iyer, RN MSN LNCC. More information about Nursing Malpractice, Third Edition, 2007 may be found at here.

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A pending bill before the State Assembly in New Jersey would require the State to make available to the public more information about the ownership of long-term care facilities. This represents an excellent initiative in allowing consumers to better research the facilities which may ultimately provide care for their loved ones. The bill, A-2029, would require the Department of Health and Senior Services to make available through its website all information regarding the ownership of long-term care facilities which are licensed by that department. It would also require the listing of any owners who hold at least a 10% interest in the facility. It would similarly list the names of any other licensed long-term care facilities in New Jersey owned by the same individual or corporation. In the end, this can provide for greater accountability for those who own the facilities.

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Some nursing homes are simply motivated by profit. The more residents the nursing home has in beds the more revenue is generated. This causes some administrators and case managers to engage in rather shameful behavior. For example, after forty-four years of long-term care facility, Country Manor in Dover Township recently closed its doors. Once word was out that Country Manor was closing, the facility was inundated with telephone calls by administrators, case managers and social workers of other facilities interested in taking their residents. Some of those persons arrived at the facility uninvited and began soliciting residents. Others called asking for a list of public guardians. Another administrator reputedly called requesting access to residents to distribute brochures. When told this would not be permitted, he simply walked in the front door and began handing out brochures. The entire process became very stressful for many of the residents, many of whom weren’t able to understand what was occurring at Country Manor and where they are going. Apparently none of these professionals showed any compassion or concern for the residents. Their only objective appeared to be filling beds in their own facilities. When choosing a nursing home, always keep a vigilant eye out for those who appear to be putting a higher priority on profit than on the individual residents.

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An interesting study recently revealed an exorbitant amount of money is being spent on an annual basis for insomnia. Specifically, it has been estimated that as a nation, we spend approximately fourteen billion dollars a year on the direct costs of insomnia. This includes treatment, healthcare services, hospital and nursing home care. Insomnia represents a significant problem in the long-term care industry, in that multiple health issues arise from the inadequate sleep patterns that many nursing home residents suffer from. It is imperative for family members to work closely with nursing home personnel to address this important health issue.

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In all cases involving infection, the practitioner should consult with a physician to address causation issues involving the relationship between that infection and the injuries more directly involved in whatever items of negligence are in the case. Do not assume that all infections result from negligence.

You can read more practice tips in my chapter Screening the Nursing Malpractice Case, in a text edited by Patricia Iyer, RN MSN LNCC. More information about Nursing Malpractice, Third Edition, 2007 may be found at here.

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Assisted living facilities offer a special combination of housing, personalized support services and healthcare design to accommodate those who need help with the activities of daily living, but may not require the type of care provided in a nursing home. In selecting an assisted living facility in New Jersey, consult the State of New Jersey Department of Health and Senior Services website. There you will find a checklist of issues to be concerned with, including contracts, cost and finances, medication and healthcare, services, recreational activities, food and dining, and atmosphere. Assisted living facilities in the State of New Jersey are regulated by the New Jersey Department of Health and Senior Services. They are licensed facilities and are, therefore, held to a higher standard. The New Jersey Department of Health and Senior Services regularly inspect assisted living facilities throughout the state.

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For those considering moving a loved one to an assisted living facility in the State of New Jersey, Chelsea Senior Living in Summit, New Jersey, has been named one of the top forty assisted living chains in the country. This, according to a survey found on the website for the National Center for Assisted Living. This survey takes into consideration the following factors: occupancy rates; revenue sources; and services offered.

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According to the September 2, 2006 Wall Street Journal, the average assisted living center cost rose approximately one-third from 2002 up to $35,000.00 a year in 2005. That same article noted that assisted living centers are reaching a near saturation point, with a 95% occupancy rate. Many of these facilities have extensive waiting lists. Despite its popularity, the allure of the assisted living option represents a number of dangers to the unwary consumer. As I have lectured across the country, many assisted living facilities accept patients that they are not capable of properly protecting, while others are simply too slow in discharging those who are more appropriate for nursing home residency. It is essential to assure that a qualified physician not only performs an assessment upon a potential admission into an assisted living facility (ALF), but also that reassessments occur on a regular basis to ensure that the combined deteriorating effects of age and disease processes do not make ALF residency problematic. We will have many more entries on this emerging issue in the weeks and months to come.

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For cases involving nursing home are, it is a clear violation of the federal regulations (OBRA) for a nurse to fail in complying with a physician’s admission order. These same regulations also strongly suggest that the failure to follow any physician’s order, such as the administration of medication, will constitute a violation of a resident’s nursing home resident rights. Should any documents have been intentionally altered, this may also give rise to a federal criminal prosecution.

You can read more practice tips in my chapter Screening the Nursing Malpractice Case, in a text edited by Patricia Iyer, RN MSN LNCC. More information about Nursing Malpractice, Third Edition, 2007 may be found at here.

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In choosing a nursing home in the State of New Jersey it is advisable that you go to the State of New Jersey Department of Health and Senior Services website. There you will find a New Jersey report card for nursing homes. Each year, the Department conducts approximately 400 complete on-site licensure and Medicare/Medicaid certification inspections called "surveys", of nursing homes. These surveys are unannounced and are done during one three to seven day period every nine to fifteen months for each facility. They serve to evaluate the quality of care and services provided, as well as the appropriateness of the facility’s building, equipment, staffing, policies, procedures and finances. They are a "snapshot" of the facilities performance at the point in time when the survey is conducted.

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Assisted Living Facilities and Nursing Homes cannot offer the same level of care. Assisted Living Facilities do not offer specialty care. They have fewer nurses, fewer CNAs, and less overall oversight of the individual resident. Thus, Assisted Living Facilities generally have residents who are more independent. However, due to desire to fill beds and generate more revenue, Assisted Living administrators sometimes take residents they cannot necessarily care for. Such is the case with a matter our firm is currently handling. In this particular case, the resident was brought into an Assisted Living Facility even though there was documentation that showing the resident had fallen thirty seven times at a previous nursing home. This resident was clearly a high risk for falls. Assisted Living Facilities are simply not equipped to provide the kind of care that this individual needed. Consequently, within three days after being admitted to the Assisted Living Facility, this resident fell and severely fractured her wrist.

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In all aspiration cases, it is important to have a physician carefully scrutinize all X-ray reports. These often provide a significant set of clues as to the nature of the aspiration and whether or not it is causally related to the asserted negligence.

You can read more practice tips in my chapter Screening the Nursing Malpractice Case, in a text edited by Patricia Iyer, RN MSN LNCC. More information about Nursing Malpractice, Third Edition, 2007 may be found at here.

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Immigrants are quickly taking on greater and greater roles as caregivers in this country for weak and infirm seniors. Interestingly, as the demand for such care rapidly increases, the demands from naturalized U.S. citizens have greatly diminished. Immigrants, both documented and undocumented, have been making up the shortfall. In many circumstances, these undocumented workers form tremendous bonds with the families. These caregivers need to be strong and have the appropriate skills to care for people who often cannot provide for their own personal needs, such as grooming, bathing and eating. This always has been and always will be a very human endeavor, which technology simply cannot address. An often ignored side effect of the raging debate in this country on immigration is its impact on the needs of our most infirm citizens.

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Ocean View Center of Rehabilitation located at 2721 Route 9 in Ocean View, New Jersey, has recently been named by Consumer Reports as one of the twelve most deficient nursing homes in the nation. Ocean View has appeared on all four of Consumer Reports Nursing Home Watch Lists published between 2000 and 2005. For those four lists, Consumer Reports examined state inspection surveys for deficiencies that, in their judgment, raised questions about the quality of care delivered to residents. Consumer Reports examined staffing levels and other quality indicators as well as fines received by Ocean View. If you have a relative who lives in this home, you need to be extra vigilant about the care that person receives. It is advised that you visit often and stay involved in the care planning. And finally, speak up if you notice poor care. Report any concerns to your local long-term-care ombudsman and state regulatory agency.

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For cases involving drops during transfer, one should carefully scrutinize issues related to short staffing. Many of theses cases involve a very clear order requiring a two-person transfer, with the actual incident only involving one person. Nearly as common are transfers being attempted by people who simply are not physically strong enough to assist a large patient.

You can read more practice tips in my chapter Screening the Nursing Malpractice Case, in a text edited by Patricia Iyer, RN MSN LNCC. More information about Nursing Malpractice, Third Edition, 2007 may be found at here.

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