Chairman Tom Latham (R-IA) believes that “inspections for facilities can be ‘duplicative with state and local health and safety codes and at times even contradictory’ under the National Housing Act,” according to one article.

There are no exact statistics relating how many nursing home residents have been neglected or abused while at a nursing home facility. Yet numerous congressional reports say that nearly one-third of nursing homes have been cited for abuse.

In his report to the Subcommittee, Latham instructed Housing and Urban Development (HUD) to issue regulations limiting its inspections to nursing home facilities that either state and local governments do not inspect or they don’t provide sufficient inspections in compliance with the Centers for Medicare & Medicaid Services requirements.

It is not outlined how this should be done or how Latham feels that this will better protect vulnerable nursing home residents from abusive and neglectful nursing homes.

2. Remain calm and professional anytime you are working with a nursing home staff. Establishing calm and even friendly relationships with the nursing home staff at your loved one’s long-term care facility allows you to better monitor their care. It also means that the nursing home staff is more likely to respect and respond to any questions or concerns that you may have about your loved ones long-term care.

3. Be vocal. Ask questions about your loved ones care. Get involved in creating and implementing their treatment plan. Encourage the nursing home to develop new activities for residents. Become a part of the facility’s Nursing Home Family Council.

4. Try and go to as many of your loved ones doctors’ appointments as possible. Attending doctors’ visits and being present during hospital stays allows you to better understand and prioritize your loved ones medical needs. It also means that you know the doctor has all of the facts so that he can best diagnose and develop a treatment plan.

5. Familiarize yourself with your State’s Long-Term Care Ombudsmen. These offices and services have been established to help provide the best and most efficient care for your loved one. Knowing exactly who your State’s Ombudsman is, and what they can do if you are concerned about the care your loved one is receiving, empowers you to advocate properly.

6. File all complaints in writing. If you really want to ensure that someone reads and responds to your complaint, put it in writing. This also ensures that there is a document trail should you ever need to prove that the issue was not handled or not handled appropriately.

For a free, no-obligation consultation, contact the elder abuse attorneys at Garcia, Artigliere & Shadrack.

After analyzing Medicare records of approximately 475,000 patients, the team, led by Dr. Joan Teno, M.D., found that nearly 20 percent of dementia patients were transferred from their nursing homes into hospitals for questionable reasons.

Typically, long-term care facilities will move advanced dementia patients to hospitals when they develop pneumonia, problems with swallowing, or infections. The researchers suspect that in many cases, money and Medicare reimbursements are playing a role for earlier transfers.

Medicare pays more than $500 per day when residents with dementia are transferred back to a nursing home after a hospitalization lasting three days or more.

Burdensome and potentially life-threatening for the transferred patients, the hospital stays hasten the depletion of Medicare-reimbursed care. Despite this, the data set shows no evidence of wrongdoing in the nursing homes or hospitals.

Researchers observed a wide range in the rate of transfers from state to state.

The study was published on September 29 in the New England Journal of Medicine.

Although devices that monitor movements, habits and temperature have been used in nursing homes for years, the iPad is one of the first high-tech devices to truly interact with residents.

After a year of using the iPad 2 tablet PC many memory care residents have become more engaged in nursing home activities.

Well designed for older users who may not be able to use a mouse and keyboard, the tablet has also helped many Alzheimer’s and dementia patients interact more with other residents and visitors.

The Winter Garden, Florida, nursing home that reported the findings says that staff members have noted that while other technology has helped to improve residents’ monitoring and safety, few tools have been as successful in getting the elderly residents to interact with nursing home activities or with other residents.

According to an article examining the findings, “These devices have an increased potential to aid people in preserve their memory. They can monitor progress and, in a way, back you up,” said technology researcher Tony Marsh, Ph.D., a health and exercise-science professor at Wake Forest University in North Carolina who, in 2010, helped develop the Mobility Assessment Tool for the iPad.

The legislation comes despite increasing numbers of nursing home residents who have been killed because of poorly administered, or over-administered, painkillers.

Loudly condemned by the American Health Care Association, the bill would negate painkiller-dispensing regulations enforced by the United States Drug Enforcement Agency under the Controlled Substances Act, and completely bypass existent painkiller administration laws.

Currently, doctors must submit prescriptions for controlled painkillers in writing before they can be dispensed. If the new legislation passes, doctors would be allowed to telephone nurses in nursing homes and prescribe painkillers over the telephone. This would mean that there would be little written documentation of the doctor’s orders.

Coming on the heels of investigations into record falsification and modification at nursing homes throughout the United States, the legislation has the potential to further contribute to the abuse or to medical malpractice in many long-term care facilities.

If you believe that your loved one is being abused by nursing home staff who are over- or under-medicating them, you can look for signs of medication abuse. Signs may include:

• Unusual weight loss, malnutrition, or dehydration
• Untreated or unexplained medical problems, such as bedsores (also known as pressure sores)
• Unexplained mood swings
• The nursing home staff cannot adequately explain your loved one’s physical or mental conditions.
• The nursing home staff suggests vague symptoms you haven’t noticed or heard of as a way to administer more medication
• The nursing home administration insists on medication over all other treatment options

Confirming previous studies and guidelines from the Centers for Disease Control and Prevention, the University of Oklahoma study found that when between 51 and 75 percent of direct caregivers are vaccinated against the flu, the odds of a flu outbreak in that facility decreased by a dramatic 87 percent.

In an unexpected finding, the study also found that when a high number of residents were vaccinated against the flu, an outbreak was more likely to occur. Researchers suggest that this may be because those facilities place too great of a reliance on the flu vaccine and do little else to prevent an outbreak.

Since people ages 65 and older stand a greater chance of developing complications in a flu outbreak, it is important to take all steps to prevent a flu outbreak.

It is estimated that 90 percent of seasonal flu-related deaths and more than 60 percent of seasonal flu-related hospitalizations in the United Sates each year occur in people age 65 and older.

To help prevent a deadly influenza outbreak in your loved ones nursing home residence, you can:

• Have the nursing home offer a flu vaccine to all residents.
• Make sure that your loved one gets their flu shot early.
• Encourage the nursing home to teach residents about everyday preventative actions like hand washing, covering a cough, and avoiding people who are sick.
• Make sure that your loved one gets medical care quickly if they begin experiencing flu-like symptoms.

Using a ranking system that compared each state on its overall success in the areas of: quality of life, quality of care and accessibility of care, “Raising Expectations: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers” was recently published by the AARP Public Policy Institute, the Commonwealth Fund, and the SCAN Foundation.

It also compares in each state sub-categories, such as affordability and access, patient choice about their long-term care, and quality of life and care. The “Scorecard” is described as the first of its kind.

In sub-categories, out of 51 states, Florida ranks:

• Affordability and Access to Care 35
• Choice of Setting and Provider 37
• Support for Family Caregivers 41
• Quality of Life and Quality of Care 44

The study considers any percentage of high risk residents developing pressure sores to be inappropriate. Therefore, Florida’s statistic of just over 12 percent of high risk residents developing pressure sores is unacceptable.

Similarly, the study believes that long-term care should be of such quality that hospitalization rates should be excessively low. In Florida, almost 25 percent of long-stay nursing home residents require at least one hospital stay during their residency. Florida is no longer a retiree’s paradise

The next “Scorecard” will likely be released in two years.

Even when the fall does not result in injury, most elderly people who fall develop an acute fear of falling again.

Elderly nursing home residents are at a high risk for fall-related injury because with their aging comes numerous physical changes, including:

• Poor vision
• Confusion
• Certain medications
• Poor balance
• Weak muscles
• Some diseases, such as Alzheimer’s or dementia
• Slower reaction time

Falls are the most common cause of nonfatal injuries and hospital admissions for trauma among elderly nursing home residents. To reduce the risk of falls, make sure the nursing home implements the following programs:

• Offers a regular exercise program – adapted to each residents’ abilities and condition – to help improve balance, strength, and their walking ability.
• Living and public spaces are kept safe by reducing clutter and being kept clear.
• Handrails in living and public areas and grab rails in bathrooms are kept unimpeded and well maintained.
• Nursing home residents are encouraged to wear shoes with good support and with nonslip soles.
• Medical staff reviews all medications to either prevent combinations that cause drowsiness or light-headedness or monitor carefully residents taking such combinations.

If your loved one has suffered from a fall-related injury because of nursing home abuse or neglect, contact an experienced nursing home abuse lawyer at Garcia, Artigliere & Schadrack for a free, no-obligation consultation.

After noticing blood on the seat of Violet’s wheelchair, her parents rushed her to a nearby hospital. Hospital staff confirmed that her injuries were consistent with a sexual assault. Violet also had been infected with a sexually transmitted disease.

A 2006 car accident left Violet with a severe brain injury, leaving her dependent on life support and incapable of any physical movement or of speech. Obviously Townsend did not consent to sex.

No one knows how many times Violet was raped or by who. Her father says that even before the blood was noticed, Violet would shake and cry when anyone attempted to touch her. These incidents multiplied until even her parents could not touch her.

The State of Ohio collected a rape kit and investigated the nursing home. Though there is DNA evidence, it has not been linked to anyone at this point. The bottom line is that no one knows who attacked and raped Violet Townsend.

Stories of sexual abuse against dependent adults and other people with disabilities in nursing homes are all too common.

A dependent adult is any person over the age of 18, who is not yet an elder, who is unable to care for themselves or to protect themselves. The adult often has serious developmental disabilities, physical disabilities, or a medical condition such as being in a coma.

Signs of sexual abuse that may indicate your loved one is a victim of sexual assault in a nursing home include:

• Bruises around the breasts or genital area.
• Unexplained sexually transmitted diseases or infections.
• Unexplained bleeding.
• Torn, stained, or bloody underclothing.
• A significant change in your loved one’s behavior, including unexplainable fear, crying, or shaking.
• Fear when a specific person enters a room.

To report sexual abuse of a dependent adult, contact your local Long Term Care Ombudsman or your state’s 24-hour Adult Protective Services help line, which will refer you to the office in your neighborhood.

A dependent adult who is being sexually assaulted can be protected under all of the elder abuse laws. Contact Garcia, Artigliere & Shadrack for a free, no-obligation consultation.

Left homeless, many are then forced to seek attorney representation and wait in the hospital until a new placement can be found. This often has devastating effects on the elderly person’s physical and mental health.

Residents dependent on Medicaid (Medi-Cal in California), are particularly vulnerable to eviction. Medicaid (or Medi-Cal) pay nursing homes as little as half the amount of money that a long-term care facility gets from private insurance or Medicare or from residents who pay out-of-pocket. Those long-term care facilities that put profits over people, look for reasons to evict lower paying residents.

Although all nursing home residents are given strong protection on paper, evicted residents often spend months looking for a new residence facility because few states bring punitive action against nursing homes convicted of illegally evicting residents.

For many of these evicted residents being forced into a new, unfamiliar environment can also be “the beginning of the end.” Researchers find that nursing home dumping has a direct effect on the lives of residents. They become more prone to getting hurt, becoming depressed, or dying in a new nursing home.

No national figures on nursing home dumping exists. But discharge-related complaints recorded by the federal Administration on Aging more than doubled in the decade before 2006, rising 177%. That’s nearly twice the growth for complaints overall.

Facilities are only legally allowed to evict residents for six reasons:

• Failure to pay
• A resident no longer needs nursing home care
• A resident’s needs cannot be met in that nursing home
• A resident is endangering the safety of others
• A residents is endangering the health of others
• The facility is going out of business and has given up its license

Even if a resident has met one of the legally eligible reasons for eviction, the facility must provide 30-day written notice of the eviction and provide facts supporting it.

Included in eviction notices must be telephone numbers of the nursing home inspection and licensing authorities and instructions about how to appeal the eviction. The nursing home also must put together a plan to ensure that the move will not harm the evicted resident.

To protect your loved one from being illegally evicted after a hospital stay:

• Carefully read all admissions documents and ensure that the facility has not tried to illegally force you to sign away your loved ones bed in the event of a hospital stay.
• Make sure you have a written certification from the nursing home that they will hold your loved ones bed while they are in the hospital.
• Contact your loved ones insurance to find out how many days they will pay for the nursing home to hold your loved ones bed per year.
• Before signing admission papers, ask the facility if they will evict your loved one if they are on Medicare (Medi-Cal) or if your loved one has an emergency hospitalization. If they say “no”, get it writing.

If your loved one has been illegally evicted from their nursing home after a hospital stay, you may have an elder abuse case. Contact Garcia, Artigliere & Schadrack for a free consultation.