nursing home neglect Chicago | Dinizulu Law Group, Ltd

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Better Oversight in Needed in Nursing Homes to Protect Residents

December 16, 2019/in Blog/by Yao Dinizulu

CHICAGO, IL – The Centers for Medicare and Medicaid Services (CMS) is responsible for ensuring nursing homes nationwide meet the federal quality standard of care, including residents be free from abuse. CMS has a contract with state agencies that allow citations on nursing homes for any incidents of abuse.

What GAO Found

In June 2019, the U.S. Government Accountability Office (GAO) report found that from 2013 to 2017, nursing home abuse citations more than doubled, increasing from 430 reports in 2013 to 875 in 2017 and the largest increase in severe cases. There are gaps in the oversight that make it difficult to protect residents from the abuse occurring within nursing home facilities.

Specifically, the main concerns by GAO include:

Information on abuse and perpetrator types is not readily available. CMS’s database does not allow the type of abuse or perpetrator to be identified by the agency. Specifically, CMS does not require state agencies to record abuse or perpetrator type, and even when recorded, it cannot be easily analyzed by CMS. GAO suggested that CMS require state agencies to submit data on abuse, perpetrator types, and HHS concurred.
Facility reported incidents lack key information. Federal law requires nursing homes to self-report allegations of abuse and covered individuals to report reasonable suspicions of crimes against residents. CMS has not provided any guidance to nursing homes on what information should be included in facility-reported incidents, which contributes a lack of information to state agencies and delays in on-going investigations.
Gaps exist in the CMS process for state agency referrals to law enforcement. There are gaps in CMS’s process for reporting incidents to law enforcement officials. These gaps may limit or delay CMS’s ability to ensure that nursing homes meet federal requirements to ensure residents are free from abuse. GAO identified issues relating to:
1. Referring abuse to law enforcement in a timely manner,
2. Tracking abuse referrals,
3. Defining what it means to substantiate an allegation of abuse,
4. And sharing information with law enforcement.

Recommendations by GAO for Executive Action

The administrator of CMS should require that abuse and perpetrator type be submitted in CMS’s databases for deficiency, complaint, and facility-reported incident data where CMS can systematically assess trends in these data.
The administrator of CMS should develop and guide – using a standardized form – to all state agencies on the information nursing homes and covered individuals should include on facility-reported incidents.
The administrator of CMS should require state agencies to immediately refer complaints to law enforcement if they have reasonable suspicion that a crime against a resident has been committed when the complaint was received.
The administrator of CMS should conduct oversight of state agencies to ensure referrals of complaints, survey’s, and incidents within a reasonable suspicion be referred to law enforcement in a timely manner.
The administrator of CMS should develop guidance for state agencies clarifying allegations verified by evidence should be substantiated and reported to law enforcement and state registries in cases where federal deficiency may not be appropriate.
The administrator of CMS should provide guidance on what information needs to be contained in the referral of abuse allegations to law enforcement.

Why GAO Conducted this Study

Nationwide, nearly 1.4 million elderly or disabled individuals receive care in more than 15,500 nursing homes. CMS, an agency within the Department of Health and Human Services (HHS), defines the standards nursing homes must meet to participate in the Medicare and Medicaid program.

Often times, nursing home residents have physical or cognitive limitations that can leave them vulnerable to abuse. Abuse of nursing home residents can occur in many forms – including physical, mental, verbal, and sexual – and can be committed by staff, residents, or others in the nursing home. Any incident of abuse is serious and can result in potentially devastating consequences for residents such as mental anguish, serious injury, and even death.

What to do if You Suspect Abuse

You should contact an attorney immediately who is knowledgeable and experienced in nursing home abuse to ensure your loved one’s rights are fully protected. A lawyer may serve as the liaison between your family, the nursing home, and IDPH during the investigation, or can conduct an independent investigation.

An attorney will help assess your options to seek relief through a lawsuit, which can include compensation for any physical, emotional, or financial harm your loved one has endured.

To schedule a free consultation, please contact our office at (312) 384-1920 or (800) 693-1LAW. Please visit our website for any additional information including previous verdicts and settlements.

How do I report nursing home abuse in Illinois?

December 3, 2019/in Blog/by Yao Dinizulu

CHICAGO, IL – Making the decision to place a loved one in a nursing home facility can be very stressful for the person, as well as the family. You can do all the research for your loved one and where you think may be best suited for their needs. You can even talk to the facility, staff members, and tour the facility to make sure it is their best option.

But even then, the facility may not turn out to be as great as you thought it was. What if you visit your loved one, and notice something may be off? Nursing home abuse is more common than you think, and often is not reported. You may be confused and not know what’s going on, and sometimes your loved one can’t verbalized what they’re experiencing. According to the Nursing Home Abuse Center, these are the steps you should take if you suspect your loved one is being abused:

Evaluate the situation

Before reporting abuse, you should assess why you want to report suspected abuse or neglect. It’s a good idea to write a summary of what has happened so you don’t miss anything when reporting a nursing home facility. Some questions to ask yourself include:

Did my loved one complain about treatment that he or she is receiving in the nursing home? Have other residents voiced similar complaints?
Have I seen signs of abuse and neglect such as bed sores, cuts, or bruises?
Did I personally witness abuse or neglect of my loved one?
Who has inflicted the harm my loved one has suffered?
When did the harm occur?

The more you understand your concerns, the better you will be able to communicate these concerns to authorities. Please assess whether your loved one may be facing immediate harm. If so, you should take steps to immediately remove him or her from the facility.

File a complaint with local Illinois Long-Term Care Ombudsman or Senior Helpline

Once you understand the situation at hand, contact your local Illinois Long-Term Ombudsman Program. This program provides nursing home residents with their own advocates that will help them with any complaints they may have, as well as enhance their overall quality of life. This program is normally free of charge. The Ombudsmen are able to:

Listen to the concerns of the patient and their family members
Inform residents of their rights and possible legal action
Provide information on different nursing home options
Work with the current nursing home staff to make changes
Get law enforcement involved, if necessary.

You can find contact information for your local Ombudsman by visiting the Department of Aging website, or by calling the toll-free number (866) 800-1409 or (888) 206-1327 (TTY).

The Ombudsman may attempt to work directly with the nursing home facility to address the issue raised by your complaint. If that doesn’t resolve the issue, the Ombudsman will assist you in a complaint with the Illinois Department of Public Health (IDPH).

You can also report suspected abuse or neglect by contacting the Senior HelpLine. The Senior HelpLine is available Monday through Friday from 8:30 a.m. to 5 p.m. You can call their toll-free number at (800) 252-8966 or (888) 206-1327 (TTY) or by e-mail at aging.ilsenior@illinois.gov.

File a complaint with IDPH

The next step is to file a complaint with the IDPH. You can download the IDPH Complaint Form and send it to IDPH by fax or mail, or you can use the form to guide you if you’d like to report by phone.

Be prepared to answer the following questions:

Who was the resident that was abused or neglected? Be prepared to give the name and age of your loved one. Please provide the names of staff members or administrators you believe to be involved.
What happened to the nursing home resident? Be prepared to describe specific acts of abuse or neglect that you believe to have occurred. For example, was your loved one assaulted by a staff member? Are staff members administering medications without authorization? Have you found bedsores on your loved one from nursing home staff failing to re-position them?
When did the abuse or neglect occur? Provide specific dates or time periods in which the abuse or neglect occurred.
Where is the facility located? You will need to provide the name of the nursing home and where the facility is located. You can verify this information by visiting the IDPH’s nursing home directory. Please provide the room number and floor number the mistreatment occurred on.
How was the resident harmed or potentially harmed? Keeping a journal to note the harm your loved one has endured is important so you are able to relay this information to IDPH and potentially the authorities. Being able to describe specific instances of harm your loved one has experienced is critical.

You can contact IDPH at:

Phone: (800) 252-4343 or (800) 547-0466 (TTY)
The hotline is open from Monday through Friday 8:30 a.m. to 4:30 p.m.

Fax: (217) 525-8885

Mail: Illinois Department of Public Health
Office of Health Care Regulation
525 W. Jefferson Street, Ground Floor
Springfield, IL 62761-0001

If you would prefer to stay anonymous, you can do so; however, if you would like to receive a written confirmation that your complaint has been received and to be informed of the results of IDPH’s investigation, you must give your name, address, and phone number. IDPH will not reveal your identity as the one who filed the complaint unless:

You give written permission.
Your identity is essential to the investigation.
A court case is filed by IDPH against the nursing home.

It’s important to know the facility cannot retaliate against your loved one which includes harassment, discharge or transferring the resident, simply because you filed a complaint. The IDPH is legally obligated to investigate your complaint. If you report abuse or neglect, IDPH must complete an investigation within seven days. All other investigations must be completed within 30 days.

Keep an eye out

Although you reported abuse or neglect, it’s important to still keep an eye out for your loved one until the issue is resolved. Whenever your visit your loved one, make sure to take a look around and check for anything that may be out of order. It’s also important to make sure your loved one is happy and healthy. If you ever find yourself suspecting abuse occurring in your loved ones facility, report it immediately. Time is crucial, especially in a circumstance like this.

Contact a lawyer

It’s important to contact an experienced and knowledgeable nursing home abuse lawyer to ensure your loved ones rights are fully protected. A lawyer can serve as a liaison between your family, the nursing home, and IDPH during the investigation, or can conduct an independent investigation.

A lawyer will help your assess your options for seeking relief through a lawsuit which can include compensation for any physical, emotional, or financial harm your loved one has endured.

To schedule a free, no obligation consultation, you can contact our office at (312) 384-1920 or (800) 693-1LAW (toll-free). Please visit our website for any additional information including verdicts and settlements.

The Severity of Medication Errors

November 20, 2019/in Blog/by Yao Dinizulu

CHICAGO, IL – Medication errors are one of the most prevalent problems in the healthcare industry. Experts estimate that more than 7 million Americans experience a medication error each year. In the study, it stated mistakes have cost more than $21 billion – which are all preventable. Some individuals are able to handle the unintentional consequences of improper medication administration, but for seniors and young children, this can be life threatening.

Medication errors are particularly found in nursing homes due to under-staffing. Many say that errors are common and not life-threatening; however, there are errors that are likely to be under-reported which the medical coding system makes easy to cover up error-related deaths. The Centers for Disease Control and Prevention (CDC) argues medication errors are the third most common cause of death among nursing home patients.

So what does this say about nursing homes? Extensive investigations have taken place and research has shown as many as 95 percent of nursing homes in the United States are understaffed, causing neglect to most patients. Nursing home staff is expected to work longer hours and care for double, or even triple, the amount of residents they are normally expected to care for.

Types of Errors

The Nursing Home Law Center requires skilled nursing facilities to keep errors within a 5 percent margin. Although this margin is broadly defined, it includes errors such as not mixing medication as directed, giving medications at improper times, or not dosing the last small portion of medication.

Errors within this 5 percent margin do not impact licensing because these types of administration errors are likely to be made at home when self-administering, as well. More serious errors can lead to tremor, coma, or even death – resulting in legal action against nursing facilities.

Prevention Process

Nursing homes must begin to increase staffing levels exponentially and invest in better prevention practices to help prevent nursing home abuse. Nursing facilities are chronically understaffed due to the notorious low-paid and poor management resulting in high turnover rates. High turnover rates cause staff to be unfamiliar with patients needs and care regiments, and are more likely to make mistakes.

Nursing homes need to implement a medication reconciliation program that evaluates a complete list of medications used by each patient. These programs are critical as many patients will not be able to independently which is used to verify their course of treatment.

Finally, nursing homes need to minimize high-risk behaviors, such as disposing of discontinued medications or medications from discharged patients, improperly transporting medications, or administering medications without a full review of the label directions.

As a society, we must come together to protect nursing home residents who are some of the most vulnerable members of our society. They deserve to be treated fairly and just with careful and appropriate treatment. This is critical on management as they will need to be client-focused and to implement changes immediately by taking responsibilities more serious.

The Alarming Reality

For one family, their loss of a loved one was tragic and very much preventable. A recently widowed 71-year-old female was hospitalized for uncontrolled hypertension and acute kidney injury. Her past medical history was significant for coronary heart disease with hypertension, persevered ejection fraction, and type 2 diabetes. The patient had a history of being a cigarette smoker and was under significant stress due to the death of her husband.

During her stay of hospitalization, she clinically improved after receiving temporary hemodialysis and her anti-hypertensive medications were adjusted. At the time of discharge, her prescription medications included amlodipine (Norvasc) 10mg twice daily with two refills allowed, metoprolol 50mg twice daily, doxazosin 2mg daily, and torsemide 10mg daily.

Over the course of 3 months, she experienced worsening fatigue, personality changes, became lethargic, and slower movements – all of which was noted in medical records. Her blood pressure was no longer controlled, and she was re-hospitalized for chest pain and underwent angioplasty. When admitted to the hospital, she saw multiple specialists and ancillary staff. As an outpatient, she was seen by her family physician twice. After several weeks had passed, she was eventually diagnosed with anxiety and depression, and prescribed citalopram and alprazolam.

The patient then entered the emergency room for a third time after a fall. She demonstrated several side effects of the multiple medications she was prescribed to take. Lab work was conducted and was noted for elevated creatinine and a CT of the head and brain revealed no acute abnormalities. Admission medication reconciliation (MED REC) revealed she was taking metoprolol, doxazosin, alprazolam, citalopram, and thiothixene (Navane) 10 mg twice daily.

Upon review of her pill bottles, it was found that her outpatient pharmacy accidentally dispensed Navane, an anti-psychotic, instead of Norvasc, and she took this medication religiously for 3 months. A diagnosis of thiothixene-related drug-induced Parkinsonism was made.

Errors were made at a multitude of care levels, including prescribing, initial pharmacy dispensation hospitalization, and subsequent outpatient follow-up. Adverse drug events account for more than 3.5 million physician office visits and nearly 1 million emergency department visits per year that affects patients, providers, and the economy.

Despite the countless opportunities for intervention, multiple health care providers overlooked her symptoms. Our population is continually growing with a longer life-expectancy, the frequent occurrence of medication errors and polypharamacy will likely increase. Efforts must be made to improve overall physician communication and transition of care to decrease preventable errors.

What to do if Your Loved One has been Neglected or Abused in a Nursing Home

It’s important to reach out to an experienced nursing home abuse attorney immediately to begin reviewing the facts of your case. In the case discussed, the woman is entitled to legal action against the hospital, providers, and specific staff members who neglected her, among others. Due to the statue of limitations, an attorney must begin to work on your case immediately.

Do not wait to hear what the facility is going to do going forward to address this issue – contact an attorney right away. The attorney’s at Dinizulu Law Group specialize in nursing home abuse and neglect and use their experience with a dynamic and honest approach so appropriate parties are held accountable for the abuse your loved one has endured. Please call our office to schedule a free consultation. For additional information, please visit our website.

Contact Information:

(312) 384-1920

221 N. LaSalle St., Suite 1100
Chicago, IL 60601