Articles Posted in Long-Term Care Facilities

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Meadowbrook Manor Nursing Home invoked the Quality Assurance Act in a case i which Jannie Lindsey, as plenary guardian for 88-year-old Laura Lindsey, alleged that Lindsey was injured by a fall while she was a resident at Meadowbrook’s Naperville Nursing Home.

The Illinois Appellate Court was presented with a case of first impression under the Quality Assurance Act (Long-Term Care Peer Review and Quality Assessment and Assurance Protection Act; 745 ILCS 55/1 et seq.)

In this case, Meadowbrook Manor used a contempt sanction to question the validity of a discovery order that commanded it to handle (1) an internal report it prepared after Lindsey fell and (2) written statements from six witnesses.

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In an Illinois Senate bill sponsored by Sen. Tom Cullerton, D-Villa Park, the law would create a “resident’s representative” for Illinois nursing home residents.  The law would amend the Nursing Home Care Act, changing Section 1-123 (210 ILCS 45/1).

This law — should it be enacted — would allow a nursing home resident to choose someone to support the resident in decision-making, access medical, social, or other personal information of the resident, manage financial matters or receive notifications.

The law would also include the following:  (1) an individual chosen by the resident to act on behalf of the resident in order to support the resident in decision-making; access medical, social or other personal information of the resident; manage financial matters; or receive notifications; (2) a person authorized by state or federal law, including, but not limited to, agents under power of attorney, representative payees, and other fiduciaries, to act on behalf of the resident in order to support the resident in decision-making; access medical, social, or other personal information of the resident; manage financial matters; or receive notifications.  (3) a legal representative, as used in Section 712 of the federal Older Americans Act (42 U.S.C. 3058g); or (4) the court-appointed guardian or conservator of a resident. Nothing in this definition is intended to expand the scope of authority of any resident’s representative beyond that authority specifically authorized by the resident, state or federal law, or a court of competent jurisdiction.

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Julio Reyes Concepcion, a 73-year-old nursing home resident of the Royal Suites Health Care & Rehabilitation facility, had a number of different medical and health problems after he suffered a stroke.  He required tube feeding at the nursing home. After a feeding, a nursing staff worker noted that he had vomited.  The nursing home staff did not notify his treating physician.  About five hours later, he was transferred to a hospital suffering from respiratory distress and aspiration pneumonia. Unfortunately, Reyes Concepcion died two days later.

His family sued the nursing home, claiming that its nursing staff negligently chose not to elevate his bed 45 degrees before or after the feeding and chose not to timely respond to signs of respiratory distress.

The jury in this case concluded that the nursing home had been negligent but determined there had been no pain and suffering. The jury’s verdict was for $250,000, which the trial judge later vacated for “excessiveness.”  The case is being retried on damages only.

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A state appellate court had held that a nursing home’s alleged failure to prevent a nursing home resident’s injuries by raising bedrails was a triable issue of fact. The case centered on whether this choice — made by the nursing home  — was a departure from the standard of care.

Rosalia Petralia, 88, suffered from dementia. She lived at the Glengariff Health Care Center. She was a fall risk and formal fall precautions were noted in her chart. She fell out of bed and suffered serious injuries.  Later, she  sued the nursing home, and her son was substituted as the plaintiff when his mother passed away.

The lawsuit maintained that Glengariff Health Care Center was negligent and also alleged medical malpractice for the nursing home’s choosing not to have Petralia’s bedrails raised before her fall. The nursing home moved for summary judgment. The trial court granted the motion, holding that the nursing home had shown it had not departed from the acceptable nursing and professional practice standard.

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Doris Green was 79 years old when she was discharged to HealthSouth Rehabilitation Hospital of Gadsden for a two-week stay following her hospitalization for gastroenteritis. About a week after her admission, a nurse discovered that she was in an unresponsive mental state; the physician ordered that she be transferred to a nearby hospital.

At the hospital, she underwent a CT scan of her brain and it was negative. She was then rehydrated and returned to HealthSouth.

Three days later, Green became unresponsive again with an oxygen saturation level of just 70%.  She was returned to the hospital in a coma. Doctors believe she had been given opiates. The doctors ordered two urinalyses, which were positive for opiates.  The hospital staff administered Narcan and Green responded favorably over the next few days. Although her condition stabilized, she did suffer brain damage resulting from lack of oxygen or hypoxia to the brain. She died several months later.  She was survived by her adult daughter.

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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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Violet Moseson, a 97-year-old resident of an assisted living facility, was mandated to be checked on every morning. The facility was to perform safety checks each morning for this resident and others. At the time of this occurrence, the electronic system through which the facility was supposed to communicate with Moseson was not turned on in her apartment when she moved in.

A week later, Moseson fell in her apartment at night. It was alleged that she spent the next 2-3 days trying to get help. There was a trail of blood and excrement in her apartment when a family member found her lying on the floor. Because of the severity of the fall, Moseson suffered spinal fractures, contusions as well as progressive dementia. Moseson died several months later and is survived by her two adult sons.

The decedent’s estate and family brought a claim that was arbitrated against the assisted living facility. It was maintained that the facility chose not to check on Moseson every 24 hours and chose not to activate the call system in her apartment. The defendant facility disputed the length of time that Moseson had been left in the apartment after her fall and countered that she was at fault for failing to purchase an emergency pendant. Many elderly people wear a pendant around their necks for emergencies. The pendant has a call button that alerts a switch board that then contacts family members.

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Sophia Alcon, 77, was admitted to Life Care Center of Pueblo, a skilled nursing facility. During the 7 months that she remained there, she suffered various injuries and illnesses, including urinary tract infections, bed sores, dehydration, malnutrition, pain, renal failure and aspiration pneumonia. She was brought to a nearby hospital where a staff medical provider noticed that her vagina was packed with dried feces. She died as a result of her medical conditions and is survived by her 10 adult children.

One of her sons, on her behalf and for the family, sued the nursing home and its corporate affiliates maintaining that they were responsible for her death. In the complaint it was alleged that the nursing home was negligent, was responsible for her wrongful death and was guilty of numerous consumer protection violations. Among other things, the Alcon family alleged that the defendants chose not to properly assess Sophia’s medical needs, formulate an appropriate care plan, provide adequate staffing and properly trained personnel at this skilled nursing facility.

The jury’s verdict of $5.56 million, included $5 million in punitive damages, which are designed to punish the defendants for the abusive treatment to Sophia Alcon.

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In an April/May CBA Record article written by attorney Dmitry N. Feofanov, the options for agreeing to confidentiality clauses in settlement agreements were explained. Too often confidentiality agreements seem to show up in settlement agreements or release documents when no negotiations have been previously entertained. At the very least, if a confidentiality clause is insisted upon by any party to a settled case, the inclusion should be negotiated as part of the consideration.

Mr. Feofanov’s focus was on the ethics rules of professional conduct. What Mr. Feofanov wrote was that confidentiality clauses should be avoided whenever possible and even with the risk that refusal to include confidentiality clauses to the agreement may undo a settled case.

Mr. Feofanov says he refuses to compromise on confidentiality clauses in any way and would not enter into settlement agreements that contain confidentiality clauses.

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The Illinois Nursing Home Care Act has been amended. The new law changes the requirements of nursing home facilities when they transfer residents. The amendment allows for exceptions to the requirement that nursing home facilities shall request a criminal background check on people admitted to a facility within 24 hours of admission when the transferring resident is either (i) immobile or (ii) moving into hospice.

These exceptions are applicable only if a background check was completed by the resident’s prior facility and the resident was transferred to the current facility with no time passing in which the resident was not institutionalized.

If either exception is applicable, the prior facility shall provide the facility to which the resident is being transferred with a copy of its background check of the resident and all supporting documentation, including, when applicable, the criminal history report and the security assessment.

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