The Illinois Department of Healthcare and Family Services has adopted an amendment to the Medical Assistance Programs reducing personal need allowances for residents of assisted living facilities. The amendment to 89 Ill. Adm. Code 120 (eff. Aug. 2, 2016), Section 120.61 is entitled “Long Term Care,” which has application to the residents of long term care facilities or state-certified, licensed or contracted residential programs.

A condition of residency at one of these long term facilities is that residents must pay all of their income to the facility unless there is an exception listed in the regulations. One of the allowed deductions is an individual’s personal needs allowance. This is a part of a resident’s income that is reserved solely for the resident to use in any way he or she wishes. The rest of the person’s income is applied to the costs for the resident’s care at the facility. The state or government will pay the rest of the full costs of the residency.

This amendment returns the allowance amount from $60 per month to $50 per month for residents of Community Integrated Living Arrangements and $30 per month for residents of Intermediate Care Facilities for Individuals with Developmental Disabilities. These changes reduce the allowances back to the 2014 level.

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Maria O’Brien was 84 years old and lived at Good Shepherd Health Center. Over a two-and-a-half-year period, she fell eight times at this nursing home facility.

On the day of her last fall, she was left unattended in front of her bathroom sink despite a care plan calling for constant supervision. She fell, suffering a fractured vertebra, which in turn led to immobility and pressure sores.

O’Brien died from dehydration about a year after the last fall. She was survived by her four adult children.

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Jacob Saul was born prematurely with neurological deficiencies. He was later transferred to Cambridge Pediatrics Nursing Home for rehabilitation.

Jacob remained at the nursing home. At eight months of age, he was found unconscious and in respiratory arrest. It was later revealed that Jacob’s tracheostomy tube had dislodged and that his pulse oximeter machine had been turned off.  As a result of this situation, Jacob suffered profound brain damage that led to his blindness, a seizure disorder and deafness. Jacob is now 8 years old.

Jacob’s parents individually, and on his behalf, sued the nursing home alleging that it had negligently cared for Jacob by, among other things, choosing not to ensure that his medical equipment was properly connected. The Saul family’s expert asserted that, but for the improper connection of the equipment and his resulting brain damage, Jacob would have been able to walk with braces and eat without assistance even given his prematurity and neurological injuries.

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Contaminated syringes have been associated with the outbreak of bacteria that infected nearly 150 people since August 2016. Fifty-two of those cases were in New Jersey. According to the Centers for Disease Control (CDC), “the majority of these cases occurred in patients residing at long-term care or rehabilitation facilities who were receiving intravenous (IV) fluids and/or antibiotics through central venous catheters.”

The outbreak of the bacteria from the IV syringes may be linked to six deaths in New York and Pennsylvania. Of the 58 total nursing home facilities that had been affected, the most were located in New York, New Jersey and Pennsylvania. There were several reports of similar outbreaks in Delaware and Maryland.

The bacteria is usually referred to B. cepacia. In most cases, the infections were caused by a pre-filled saline flush syringe, which the manufacturer voluntarily recalled on Oct. 4, 2016. The CDC announced on Nov. 9, 2016 that all nursing homes and other medical facilities should stop using the items, sequester any items in the facility and report all infections to local and state health authorities.

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An appeal was taken from an order entered on June 18, 2015 that denied the motion of the defendants, Manor Care of Carlisle PA, LLC, etc., for reconsideration after the circuit court judge denied their motion to compel arbitration in this nursing home abuse case. It is well-settled that “denial of reconsideration is not subject to appellate review.”

On Dec. 13, 2012, Mary J. Churlick, in her capacity as executrix of the estate of Mary J. Yohn (hereinafter the “decedent”) filed a lawsuit against the defendant nursing home and its parent company. The complaint contained claims in negligence and negligence per se as well as claims under the survival statute and wrongful death statute.

On Sept. 6, 2013, the trial judge overruled the defendants’ preliminary objection and the nature of the motion to compel arbitration. That order was an appealable order.

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Life Care Centers of America, which operates 200 locations and is based in Tennessee, will pay $143 million to settle a False Claims Act (FCA) litigation in which it was alleged that the corporation had billed Medicare for excess treatment. According to the report of the case, this was a record FCA settlement for the nursing home industry.

The consolidated cases arose because of two whistleblower cases as well as an unjust enrichment lawsuit brought by the Department of Justice (DOJ) against the owner of Life Care. The two former employees will share $29 million in the settlement payout.

This settlement was reported to be the largest in the Justice Department’s history involving a skilled nursing home chain. The size of the settlement was based on Life Care’s ability to pay this amount.  The government, which joined in the FCA cases in 2012, alleged excessive treatment of seniors in order to maximize Medicare reimbursements.

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Robert Lankford, 69, underwent abdominal surgery. He was admitted to Life Care Center Pensacola for his recovery period. One of the nursing facility’s nurses mistakenly removed Lankford’s skin staples, which led to a wound infection. Lankford required a second surgery to close the wound.  Afterward, he was returned to Life Care Center where he was subsequently diagnosed with having C. difficile infection. Lankford later died of unrelated causes.

The Lankford family and estate filed a lawsuit against the nursing home and a related corporate entity claiming liability for its nurse’s blatant mistake of removing the staples and for the nursing home’s choosing not to adequately have in place infection control resources. The Lankford family maintained that had the nursing home been equipped properly, the infection could have been controlled, saving Lankford’s life.

The jury’s verdict was $303,300. The attorney representing the Lankford family was Clay Mitchell.

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Martha Pierce, 83, suffered a stroke and became partially paralyzed and weak on her right side. She required additional assistance from her nursing facility, the Allenbrooke Nursing & Rehabilitation Center.  One of the nursing home’s staff members identified Stage IV pressure ulcers on Pierce’s right foot. Even in view of that serious condition, the ulcers were allowed to worsen and Pierce developed sepsis. As a result, she required an above-the-knee amputation of her right leg and died four months later.

Pierce’s estate and family sued the nursing home and several corporate entities, claiming negligence in violation of the state’s Nursing Home Protection Act. The jury entered a verdict of $30 million, which included $28 million in punitive damages.

The attorneys representing Martha Pierce’s family were Kenneth L. Connor, Carey Acerra and Cameron Jehl.

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The plaintiff, August Bosman, who was the special administrator of the Estate of Joan Bosman, appealed from the denial of his motion for a new trial. The plaintiff argued that the court was in error in replacing a holdout juror with an alternative juror during jury deliberations.

The lawsuit was filed in June 2011 against Riverside Health System, d/b/a  Miller Healthcare Center and Riverside Senior Living Center where it was alleged that Joan Bosman suffered multiple necrotic pressure ulcers while she was a resident of the long-term care facility operated by the defendant Riverside Health System.

During jury selection, one juror was questioned about whether she had been personally involved in or knew someone who was involved in an incident that resulted in personal injuries or damages and if the incident resulted in a lawsuit. This juror said her friend had filed a lawsuit against a nursing home after her friend’s mother died from injuries sustained while she resided at the facility. The juror assured the court that her prior experiences would not affect her ability to sit as a juror. In addition, defense counsel asked this juror whether she personally had any experience receiving rehabilitative care or knew someone who had received care. The juror said she had no experience receiving rehabilitative care and that she could set aside her friend’s experience with the nursing home and decide the case on the evidence presented.

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An Ohio Appellate Court has held that an arbitration agreement signed by the son of a resident at the time of the father’s admission to a nursing home did not justify compelled arbitration. Marcus Vickers signed an arbitration agreement when his father, Jack Johnson, was admitted to the Canal Pointe Nursing & Rehabilitation Center.

After Johnson’s death, his son, Marcus Vickers, filed suit against the nursing home for negligence and wrongful death.  The lawsuit alleged survivorship as well as wrongful death claims.

The defendant nursing home filed a motion to stay the proceedings and compel arbitration.  The trial judge granted the nursing home’s motion and Vickers appealed.

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