The arm of the federal government tasked with providing health care coverage to seniors and the disabled is taking aim at “boomerang hospitalizations” of nursing home residents. Medicare officials have begun taking steps to address high hospital readmission rates, especially for patients who already require skilled nursing care and will reportedly increase those efforts on the nursing home side by this fall.

What Is a Boomerang Hospitalization?

Many nursing home patients require acute medical attention in a hospital at some point during the stay at a nursing home. This is understandable, considering those in nursing homes are there because they are already dealing with fairly serious injuries, illnesses, and other conditions. The problem, however, seems to be beginning when patients are released from the hospital and sent back to their nursing homes. According to reports, 20 percent of Medicare patients who are discharged from a hospital to a nursing home are readmitted to the hospital within 30 days. This number is 27 percent higher for Medicare nursing home patients than for Medicare patients who do not require nursing home care.

The phenomenon of a quick readmission is called a “boomerang hospitalization” as a reference to the thrown hunting tool that returns to the thrower in midair. Experts suggest that government payment policies have inadvertently led to a pattern of back-and-forth transfers between hospitals and nursing homes for far too many patients.

You have probably heard many news stories of nursing home abuse and neglect. Individuals staying in nursing homes generally need a higher level of care than those at other types of facilities and are therefore more vulnerable to abuse and neglect. However, mistreatment does still happen at assisted living facilities, and it is just as unacceptable as mistreatment at nursing homes. If you or a loved one has suffered due to negligence or abuse while living in an assisted living facility, you may be able to sue for damages.

Residents May Be Afraid to Come Forward

Residents of an assisted living facility are usually slightly more independent than residents at a nursing home. They may only need limited assistance with daily living activities and are less likely to suffer from serious dementia or other memory or cognition issues. Even though they are more self-sufficient than nursing home residents, those living at an assisted living facility can still be taken advantage of and mistreated. Sometimes assisted living abuse and neglect goes unreported because the victim is afraid to speak up. Other times, residents fear that an abusive staff member will retaliate if they report the mistreatment. Other residents are simply unaware of what their rights are at an assisted living facility or put up with bad care because they do not realize they deserve better.

Examples of Assisted Living Abuse and Neglect

Assisted living abuse can occur not only between staff and residents, but also among residents themselves. In cases in which a resident is being abused by another resident, the assisted living staff have a responsibility to implement interventions to prevent future abuse incidents. Assisted living abuse can involve:

Did you know that laws exist to define and protect the rights guaranteed to people in a nursing home? The Illinois Nursing Home Care Act was created with the explicit purpose of protecting the sick and elderly from receiving less than adequate care while living in a skilled nursing facility. The statute confirms that nursing home residents have every right that all Illinois citizens have and cannot be denied any of those rights while staying in a nursing home. The Act also establishes more specific guidelines and boundaries to which Illinois nursing homes must adhere.

If you have a loved one who is currently residing in a nursing home, it is important to know and understand the rights that he or she has.

Residents Have the Right to Be Free from Neglect and Abuse

In general, nursing home residents have the right to be free from abuse or neglect. Additionally, nursing home residents have the right to:

Data shows that about 1.5 million individuals are living in nursing homes across the United States. As the “Baby Boomer” generation ages, more and more people will need the intensive care that nursing homes and assisted living facilities offer. It has never been more important for those with loved ones in nursing homes to hold the facility and staff within it responsible for their actions. Many nursing homes are understaffed or have staff members who have not been adequately trained. This can result in the residents receiving poor care and consequently worsened medical conditions. One way inadequate staff put residents at risk is through medication errors.

Fragile Health Means Medication Mistakes Can Be Deadly

Those who live in a nursing home are usually there because they have numerous medical conditions, are functionally impaired, have cognitive deficits such as dementia, and are currently on medication which requires supervision. For some residents, their health issues are purely physical, but approximately 70% of residents experience cognitive impairment which makes them unable to understand and remember everything which happens to them. The combination of serious medical issues and cognitive impairment can leave nursing home residents extremely vulnerable to mismanaged medication. In fact, needing help taking their required medications is one of the main reasons some individuals end up in nursing homes. Unfortunately, nursing home staff sometimes make errors with resident’s medication which can put them at risk of injury, illness, or even death.

Examples of Medication Errors That Put Residents at Risk

There are countless ways that nursing home staff can make mistakes when administering medication to residents. MEdciation errors which most frequently occur include:

Inadequate hygiene in nursing homes can be deadly to vulnerable residents. Poor hygiene is often the consequence of ineffectively trained staff members or facilities that have too high a resident to staff ratio. Other times, poor hygiene can be the result of staff who are not properly educated about safe health care practices.

Not Using Proper Hygiene Is Neglect

Elderly individuals or those with physical or mental disabilities in a nursing home deserve to be kept safe and clean. Some residents are not physically capable of doing hygiene tasks on their own while others have cognitive impairments which makes it hard for them to remember hygiene. Sadly, reports of nursing home residents left in soiled clothes, diapers, or beds are not uncommon. Nursing home residents deserve to be treated with dignity and respect and this includes cleanliness. Unsanitary conditions can increase the risk of infection, illness, and other medical conditions.

Staff May Take Unsafe Shortcuts When It Comes to Their Own Hygiene

When nursing home staff are not properly educated about caretaker hygiene, the results can be deadly. A staff member who does not wash his or her hands after helping a resident with bathroom-related tasks and then interacts with another resident can spread dangerous bacteria to the second resident. Most residents have compromised immune systems due to illness, injury, or old age and are especially susceptible to germs. When staff are not regularly cleaning common areas, kitchens, or bathrooms, the facility becomes a breeding ground for dangerous bacteria and viruses. This places residents in further unnecessary risk.

Although they may also have other health issues, many residents require the constant supervision a nursing home offers because they have a mental deficit such as dementia or Alzheimer’s disease. Those with cognitive disabilities often have trouble understanding what is going on around them. They may not be fully aware of their physical limitations and can take unnecessary risks when not supervised by nursing home staff. Sadly, many nursing home residents have been seriously hurt or killed because they ventured into unsafe territory while the staff’s backs are turned.

Wandering and Elopement Defined

Wandering refers to instances when a nursing home resident walks around a nursing home facility unsupervised. Nursing home staff should know the whereabouts of their residents at all times. Those residents with cognitive impairments should be closely monitored. Sometimes wandering residents slip and fall out of staff’s sight and are left suffering in pain for hours. Other times, residents wander into an unsafe area such as the kitchen or storage area and harm themselves on the equipment there.

Elopement occurs when a resident wanders off of the nursing home campus. While some nursing home residents may be able to take walks outside of the facility safely, nursing home staff have an obligation to monitor and supervise these trips. When a resident who does not understand where he or she is due to a disease like dementia leaves the facility, the results can often be fatal. Residents may wander into traffic, trip and fall, be exposed to the elements, or even be attacked by another person.

There are many different reasons a person may bring a lawsuit against a nursing home or medical staff member. Sometimes a nursing home harms a resident not by what they did but by what they failed to do. Residents in a nursing home are often elderly, suffering from age-related illnesses, or recovering from surgery. They therefore require a much higher level of care than a healthy person would. When nursing homes are understaffed or for other reasons cannot adequately care for their residents, the residents’ health may suffer as a result. One of the most common ailments caused by nursing home neglect is dehydration. 

The Sick and Elderly Are Especially Vulnerable

While a human can survive without food for an impressive three weeks or more, water is a different story. Our bodies crave water, and without it, they start to shut down. Most individuals would die without water within a mere three days. When nursing home residents do not get enough to drink, they can suffer from considerable health consequences and physical discomfort.

Dehydration is sadly quite common among elderly residents staying in nursing homes. There are a few reasons for this. Some residents have physical disabilities which make it difficult to sit up or swallow water. Other residents have trouble speaking and cannot tell staff when they are thirsty. Those residents with dementia, Alzheimer’s disease, or other cognitive impairments may not be able to recognize when they are dehydrated, let alone express this to nursing home staff. Because many residents cannot do so themselves, nursing home staff have a duty to monitor residents’ hydration and make sure they are getting enough to drink. When nursing home staff fail to uphold this serious responsibility, they and the organization they work for can be held legally liable for residents’ suffering and harm.

A woman who lived what her family called the “American dream” died in a manner that is only fitting of the worst nightmares, according to a recent lawsuit. An autopsy reported indicated that the 93-year-old passed away in a Georgia nursing home in 2015 as the result of “septicemia due to crusted scabies.” For those who may be unfamiliar, scabies is a contagious infestation of the skin caused by burrowing, parasitic mites—a wholly unacceptable condition for a patient contract, let alone die of, while under the care of a nursing home.

A Storied Life and Tragic Death

The woman was a small-town girl from North Carolina who moved to Virginia during World War II to work in a naval yard in Norfolk. She went on to do some modeling in New York City and later worked for a television station in Chicago. As the woman got older, she began to show symptoms of dementia, and her daughter moved her into a nursing home in LaFayette, Georgia in 2010.

Records obtained from the Georgia Department of Public Health show that officials received reports of scabies outbreaks at the LaFayette facility in 2013 and prior to her death in 2015. The nursing home’s own records show additional scabies cases in 2014 as well, according to court documents.

Sometimes, a nursing home resident needs to be retrained in some way. In some cases, confusion or aggression related to a mental illness or dementia can make a nursing home resident act out in ways that could hurt another resident, a staff member, or themselves. In other situations, patients must be secured so that they do not hurt themselves while waking up from surgery or when recovering from certain medical procedures. It is understandable that doctors, nurses, and other staff have means to control residents who are acting dangerously, but too often, unfortunately, restraints do more damage than they prevent.

Physical Restraints Which Inhibit Movement

It is often necessary for nursing home staff to limit a resident’s movement. In order to do this, they may use physical restraints such as straps, belts, vests, limb ties, wheelchair brakes, and bedside rails. The misuse or overuse of restraints such as these can cause nursing home residents to suffer injuries such as:

• Diminished muscle strength and balance;
• Bruises and cuts;
• Urinary incontinence;
• Constipation;
• Decubitus ulcers, also called bedsores;
• Respiratory complications;
• Malnutrition;
• Reduced cardiovascular endurance; and
• Feelings of agitation, depression, anxiety, and helplessness.

If you a loved one has suffered one of these injuries after being restrained by nursing home employees, you may have a valid personal injury case.

The Centers for Disease Control and Prevention (CDC) reports that, in any given year, almost three-quarters of all nursing home residents suffer a fall. Furthermore, many of these patients fall more than once per year. While a slip and fall may not be injury-causing to a young, healthy person, seemingly minor falls can have serious consequences for someone whose body is weakened by illness, injury, or old age. Sadly, falls cause around 1,800 nursing home resident deaths each year.

What Causes Falls?

People staying in nursing homes generally are there because they are at least partially unable to care for themselves. For some residents, this is due to a mental incapacitation such as dementia or Alzheimer’s disease. Other residents are recovering from major surgery or other invasive medical procedures. Many nursing home residents experience muscle weakness or gait problems. These factors can make a person much more likely to slip and fall. Sometimes, hazards such wet floors, incorrect bed height, poor lighting, and inadequate equipment further increase risks of falls.

CDC Says Many Falls Go Unreported

Approximately 36 percent of preventable emergency room visits by nursing home patients are caused by falls. An average-sized nursing home—one containing about 100 beds—generally reports about 100 to 200 falls a year. Unfortunately, the CDC says that this information may not accurately reflect the number of falls actually happening in nursing homes across the country. Realistically, many falls are never reported, so the real number is likely to be much higher.

When you place a loved one under the care of a nursing home, you expect that they will be treated with the care and dignity they deserve. You probably understand that a nursing facility may be more institutional than “homey,” but such facilities are designed to give patients around the clock access to medical care and personalized attention. Unfortunately, nursing home residents face a variety of dangers—some related to their own health conditions and some that may be caused by negligence on the part of the staff. For residents who are bedridden or wheelchair bound, bed sores are among the most common nursing home injuries, and many are the result of substandard care.

What Are Bed Sores?

Bed sores are also known as pressure ulcers or decubitus ulcers. These injuries are areas of skin that become inflamed due to pressure on the skin that prevents normal blood flow. If not addressed, the inflammation can transform into blisters and eventually open sores. In the most serious cases, the ulcers can continue to worsen and expose underlying muscle and bone.

Pressure ulcers are especially common among patients who are confined to bed or a chair and unable to move themselves easily. Friction caused by contact with clothing or bedsheets and moisture from sweat or urine can accelerate the development of bed sores. Patients with more fragile skin and those with circulatory problems are at a particularly high risk. Bed sores can form on any part of the body, but they are most frequently found on the parts of the body that remain in contact with a bed, including heels, elbows, shoulders, hips, and tailbones.

Nursing home abuse and neglect can sometimes occur not because of what caretakers do, but because of what they fail to do. Whether it is due to being an understaffed facility, inadequate staff training, or lack of oversight, nursing home negligence is sadly common. There are certain standards of care which nursing home staff must meet to ensure the safety of their residents. Unfortunately, when these standards are not met, the result can be devastating to residents as well as their families.

Elderly Woman Denied Essential Medication

A Bartlett, IL  nursing home may be forced to pay millions to a family of a former resident. In February of 2011, the 89-year-old resident was admitted to the facility after suffering a hip fracture. She was meant to stay in the nursing home while undergoing physical therapy to help her recover from her injury. As part of her treatment, the elderly woman was prescribed a medication called Coumadin which thins the blood and can help prevent clotting and strokes. Unfortunately, the woman did not receive this medication on a timely and consistent schedule. Records show that the woman did not receive her stroke-preventing medication for a period of two weeks.

Stroke Causes Significant Decrease in Quality of Life

 In March of 2011, just a month after being admitted to the facility, the woman suffered a stroke with left her almost completely incapacitated. According to family, the woman lost the ability to speak and walk on her own after the stroke. The attorney for the family explains that the stroke left the woman unable to “enjoy life in any realistic manner.” The woman passed away four years after the stroke. Her family believes that her final years would have been much more pleasant had she been given her medication on a consistent schedule.

The people who call nursing homes their residence are generally unable to care for themselves. Caused by either physical disability or mental, nursing home residents often have trouble expressing when they are being mistreated. Sometimes, residents do not have the memory to report times they have been neglected by staff and other times they are afraid to report abuse or neglect because they fear retaliation. If you have a loved one in a nursing home, be on the lookout for the following signs of mistreatment.

Major Changes in Mood or Behavior

If your loved one has become much more withdrawn or unhappy, this can be a sign that something is not right at their nursing home. While these symptoms alone are not enough to accuse the staff of abuse, patterns of sadness or irritability which coincide with certain staff members or activities could be an indication that something is not right. If a nursing home resident is hesitant or outright afraid to go to certain areas or be around certain people, more investigation is needed as to the cause of the apprehension.

Unexplained Bruises or Injuries

It can be very difficult to find signs of physical abuse on a nursing home resident. Many medications and illnesses can cause individuals to easily bruise and sometimes residents have accidents where they simply bump into something. However, if you are noticing a pattern of unexplained injuries or staff cannot account for when the injury occurred, this may be a sign your loved one is being physically abused. If your loved one experiences unexplained weight loss, this could be a warning that he or she is not getting enough to eat and drink. Sadly, short-staffed nursing homes can sometimes skip basic duties like feeding and hydrating residents.

Nursing home staff have one of the most important responsibilities in our society: caring for our elders. Tragically, some nursing home staff do not take this responsibility seriously. Nursing home resident neglect and abuse are serious issues. More than two million cases of elder abuse are reported every year. It is estimated that one out of every ten elderly individuals in nursing home facilities will experience some type of abuse. While efforts are being made by regulatory agencies and advocacy groups to prevent nursing home abuse and neglect, the current state of many nursing homes is unacceptable.

Shocking Camera Footage from Inside Michigan Nursing Home

The family of an 89-year-old Lebanese man is suing a Michigan nursing home after footage surfaced of caretakers abusing the elderly man. The resident was admitted to the facility in 2015 after undergoing a bowel obstruction surgery. His son was the first to grow concerned about his father’s safety. The son noticed his father was often covered in cuts and bruises. The octogenarian was also rapidly losing weight.

Family Claims Man Was Physically and Psychologically Abused

The elderly resident’s cuts and bruises, according to nursing home staff, were a result of the man falling eleven times throughout five months. In order to get to the bottom of his father’s injuries, the man’s adult son hid a camera in an alarm clock next to his father’s bed. The family of the man claims that the hidden camera captured over 100 clips of the staff’s neglectful behavior. Additionally, the footage is claimed to include instances of physical abuse and even ethnic slurs directed at the 89-year-old.

Many nursing home residents are prescribed opioid medication to manage severe pain. These opioid drugs have been controversial recently because of their extreme addictive properties. They are also dangerous in that an overdose of an opioid medication such as OxyContin, morphine, codeine, Fentanyl, or hydrocodone is often fatal. While these drugs offer relief for patients in severe pain, the presence of opioids in a nursing home often leads to trouble.

Illinois Nurse Caught Stealing Fentanyl Patches

A nurse from Bloomington has been accused of removing pain-relieving opioid patches from the bodies of nursing home residents. The man allegedly visited both the nursing home he worked at as well as a second nursing home in order to steal the patches off of terminally ill patients. He was recently charged with burglary and theft after co-workers noticed that he had come into work on his day off. He was found to also have stolen fentanyl patches from a resident with dementia. Assistant State’s Attorney Jeff Horve requested a $50,000 bond because of what he called “the egregious nature of the offenses.”

Overdose of Oxycodone Kills Minnesota Resident

Another dangerous element to opioids being prescribed in nursing homes is the risk of overdose. When medical staff are not properly trained or the nursing home facility is understaffed, deadly mistakes can be made with regard to opioid medication. For example, in January, a resident recovering from cancer was given over 20 times the prescribed dose of oxycodone. The resident was later found unresponsive on the floor of their room and eventually passed away. When asked about her gross mistake, the nurse who administered the deadly drug claimed she was "busy with multiple patients."

Imagine you are a resident in a nursing home. Perhaps you are recovering from an invasive surgery, have had limbs amputated, or are elderly and suffering from other ailments. Now imagine that the place you have called home during your recovery no longer welcomes you and you are forced to pack your things and leave. This is the reality for many nursing home residents who are evicted from nursing homes every year. Unfortunately, many nursing home residents and their families are unaware of the rights which residents have.

Changes in Insurance Leave Some Residents Unable to Pay Nursing Home Costs

About 14 million people are currently living in nursing homes across the country. Many of these residents are ill or injured and others have mental incapacities such as dementia with disallow them to care for themselves. These individuals require round-the-clock care and supervision. Unfortunately, nursing homes often evict residents for unjustified reasons. Sometimes, it is because a change in insurance, such as switching from Medicare to Medicaid, means that the resident can no longer afford to stay at the nursing home. Discharges and evictions have been the top-ranking category of grievances brought to state long-term care regulators programs in recent years. Unfortunately, many nursing home residents are unaware of their rights and leave without challenging an eviction or discharge.

Tony Chicotel, a lawyer at California Advocates for Nursing Home Reform, explains “The nursing homes, they know the system and they really game it to where they maximize their advantage.” Federal regulators are now looking for ways to enforce federal laws which protect nursing home residents. Evictions or discharges can greatly damage a resident’s well-being. Because nursing home residents are already ill or elderly, moving them against their will can be dangerous to their physical health as well as their psychological health.

When a family decides to place a parent or other loved one in a nursing home, they expect a certain level of care. Residents of nursing homes require a significant amount of assistance doing everyday tasks such as eating and bathing. Furthermore, most nursing home residents have serious health issues which make them unable to care for themselves. Nursing home staff have a responsibility to keep individuals in their care safe and comfortable to the best of their ability. When staff are negligent and do not provide the expected level of care to their patients, they can be held liable.

Elderly Woman Dies After Fall

A $50,000 lawsuit filed recently in the Kane County Circuit Court claims that a North Aurora nursing home failed to properly monitor an elderly woman and that this negligence led to her death. The 86-year-old woman passed away in February of 2016. A year prior to her death, she was admitted to the North Aurora nursing home. The wrongful death lawsuit claims that the elderly woman was a high risk for falls, and that the nursing home staff should have taken certain precautions to prevent this.

The plaintiffs claim that the nursing home had a responsibility to evaluate the woman’s risk of falling and then provide adequate supervision and assistance in order to prevent her from hurting herself. Unfortunately, within the same month as her arrival, the woman did fall and suffered serious injuries. In addition to needing ten stitches, the 86 year-old suffered cervical, nasal and orbital fractures. The suit claims that this fall led to the woman’s physical and mental decline and, eventually, her death. The complaint also alleges that the Illinois nursing home failed to appropriately train staff and follow its own policies and procedures for supervising residents.

Staff at a nursing home have a responsibility to keep the residents of a nursing home safe and as comfortable as possible. When families place a loved one in a nursing home, they are assuming that the medical staff there will treat the new resident with appropriate medical care. Tragically, this is not always the case. Some nursing homes are understaffed or their staff is not adequately trained, which can result in medicine being given superfluously or necessary medicine being withheld.

Alarming Study Results 

According to a recent study conducted by the Human Rights Watch, approximately 179,000 nursing home residents are being given medicine which is not intended to treat the illness they have. Antipsychotic drugs such as aripiprazole, olanzapine, and quetiapine are used to manage psychosis. Individuals suffering from delusions, hallucinations, paranoia or a disconnection from reality are generally given these medications as a treatment for schizophrenia and bipolar disorder. The problem is that about 179,000 nursing home residents being given this medicine do not have schizophrenia, bipolar disorder, or other mental illnesses that those drugs are designed to treat.

Many of the residents being given these medications have Alzheimer's disease or another form of dementia which antipsychotics are not approved to treat. Even more disturbing, antipsychotic drugs come with a "black box warning" from the FDA.  Black box warnings are the strictest labeling requirements that the FDA can mandate. These warnings are used to call attention to serious or life-threatening risks associated with the medication. The black box warning on antipsychotics states that they increase the risk of death in older people with dementia. The study also found that antipsychotic drugs were administered to residents without their informed consent. The purpose of using antipsychotic medications for residents who do not require them is often to make dementia patients “easier to handle” in understaffed facilities.

Residents in a nursing home are often those we should respect the most. Grandparents, great-grandparents, veterans, and other venerable elderly people live in homes like these. Unfortunately, sometimes the elders of our society are not treated justly. Because many residents of nursing homes lack the ability to communicate well, nursing home abuse and neglect often goes unreported. When evidence of abuse or neglect arises, it is critically important that it be investigated thoroughly and that guilty parties are held accountable.

Extreme Heat and Dehydration

A Florida nursing home is under severe scrutiny after a horrific series of events led to 12 residents dying. The residents who passed away did so in the days and weeks following Hurricane Irma in the fall of last year. The hurricane caused the air conditioning to go out at the facility, and residents were forced to endure dangerous heat and disgusting conditions. Many of them were simply not well enough to handle the extreme conditions and lost their lives as a result.

Although federal regulations state that temperatures should not be above 81 degrees, Florida regulators report that temperatures rose to 99 degrees in the sweltering nursing home. Some patients' body temperatures were up to 107.5 degrees. Residents were found in horrible conditions, covered in sweat and excrement. The heat was so unmanageable that four out of every five residents on particular floor suffered dehydration and other heat-related symptoms. Almost half of the residents living on another floor also suffered these heat-related symptoms.

Those who stay in a nursing home are usually there because they cannot physically or mentally care for themselves anymore. Families place their loved ones in nursing homes with the expectation that the staff will treat their family member with the same compassion and dignity that they do. When a resident at a nursing home is injured or killed due to the negligence of the nursing home staff, the injured person or the estate of the individual who passed away may be eligible for compensation. Such was the situation in a recent case involving a Georgia nursing home.

Lacking Medical Staff Can Result in Inadequate Care

The case in question was a lawsuit that stemmed from the 2012 death of a 71-year-old resident in a Lowndes County, GA, nursing home. According to court documents, the problems began the elderly man began complaining of vomiting and a distended abdomen. An alleged lack of appropriate medical staff at the facility meant that there was not a registered nurse (RN) or a doctor who could provide prompt medical attention. The only available medical staff member was a licensed practical nurse (LPN) who examined the man and called an off-site physician’s assistant (PA) for a second opinion, the lawsuit allged.

The suit claimed that the LPN contemplated sending the man to an emergency room based on his presenting symptoms, but the PA did not agree that emergency room treatment was necessary. The man’s condition reportedly worsened, and he was finally taken to a hospital. He only survived for another 12 hours, and he died from complications due to a bowel obstruction.