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

A new study confirms that a large percentage of nursing home residents are prescribed anti-depressants, or selective serotonin reuptake inhibitors (SSRIs). While in most cases, anti-depressants are beneficial to the well being of the residents, in patients suffering from dementia, they can significantly increase the risk of falls - leading to serious injuries, and even death.

Researchers from the Netherlands recently reported that a study, which included 248 nursing homes, shows that anti-depressants were used on over 13,000 patients of which more than 650 sustained injuries. These falls occurred in 152 out of the 248 nursing homes included in the study. Additionally, 38 residents fell once during the time of the study, while 114 had multiple falls. Of those 650 falls, 220 resulted in serious injury, or even death.

It is imperative that these facilities conduct interdisciplinary care meetings to ensure that the proper protocols are followed, in order to reduce the risk of life-threatening accidents.

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While nursing homes should always look to prevent bed sores – a painful and sometimes deadly condition – a recent study conducted revealed that the prevention of bed sores is also cost effective.

Foam mattresses which reduce pressure were found to be cost-effective 82% of the time as opposed to using standard mattresses. This simple change could save on average $115 per resident. Additionally, foam cleansers for incontinence were found to be cost-effective 94% of the time, as opposed to traditional soap and water, which results in an average savings of $179 per resident.

On average, roughly 10% of residents in long-term care facilities have a pressure ulcer. And for those residents, treatments are critical early on in order to prevent a serious, and even life-threatening condition. A better solution to this problem is prevention. Nursing homes and assisted living facilities can, and should, prevent these problems from happening rather than treating them after the fact. Most importantly, not only are these prevention techniques the right thing to do, but they also save money for the facility!

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A recent article in the Star Ledger, Stronger safeguards needed in N.J. hospitals, nursing homes, asks the questions, “Should corporate lobbyists decide whether safe equipment and procedures are needed if you or a loved one have to go to a hospital or nursing home? Or should health care professionals make those decisions?”

All too often high power corporate interests utilize lobbyists to cut corners, increase profits and put patients at tremendous risk. In this recent article, we see how this plays out in ways that not only harm nursing home residents and hospital patients, but also places healthcare workers at risk. 

 

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I have had cases where a person suffers from a bed sore that is so large the spinal column is visible, and yet the cause of death listed on the death certificate states, “natural causes”, or “dementia”, or “Alzheimer’s”.  While we may still pursue a claim to hold those responsible for the large and painful wound accountable, it is frustrating to the family that the bed sore is not listed on the death certificate. 

We are currently prosecuting cases where had a resident not been taken to the hospital and died in the nursing home, the true cause of death would have never been discovered. 

Unfortunately, this situation is far from unusual. As reported in ProPublica, suspicious elder deaths are rarely investigated.  According to the article, autopsies performed on seniors are increasingly rare even though the United States population aged 65 and older has grown. From 1972-2007, the number of autopsies performed on seniors dropped from 37% to just 17% percent. Additionally, of the 1.8 million seniors who died in 2008, autopsies were performed on only 2%, and only performed on 1% for those elderly who passed away in nursing homes or care facilities.

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The Federal Government has joined in a Whistleblower suit, which alleges that AseraCare, a national hospice company owned by Golden Living, wrongly took advantage of Medicare’s hospice benefit by pressuring its employees to place people into hospice who weren’t dying. The suit states that AseraCare first recruited patients who are eligible for skilled nursing care for 20 days, for which Medicare pays the entire bill. After 20 days, when Medicare requires patients pick up a part of the tab, AseraCare had the nursing homes send the patients to hospice, according to the lawsuit. In hospice, AseraCare would collect a flat payment from Medicare for each day they are enrolled.

We will follow this story on our blog and the recurring problem that appears to be growing on a national basis throughout both nursing homes and assisted living facilities. Here is an article relating to the government’s press release on the suit.

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With the passing of the Affordable Care Act (ACA), this nation has seen the beginning of a dramatic shift in both the delivery of healthcare and the means by which payment is made for medical services.  Under the ACA, a new type of medical agency was created, known as Accountable Care Organizations (ACO). These entities are required to coordinate all levels of care in a fashion that is both more efficient and better focused on the provision of quality care.

As we have written on our blog, hospitals will no longer be paid to rectify medical errors which have been deemed as “never events.” This is a class of medical error which non-profit research groups and the federal government alike have determined to be wholly unacceptable in the hospital context. ACO’s are being organized to help prevent the occurrence of never events.

At present, we may be at a crossroads in terms of whether ACO’s will be lead by physicians or hospitals.  Either scenario has its share of opportunities and pitfalls. The New England Journal of Medicine has been following ACO issues and includes some excellent commentary.

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