nursing home negligence | Dinizulu Law Group, Ltd

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Sepsis Complications: How Nursing Homes Should Prevent & Treat

July 15, 2020/in Blog/by Yao Dinizulu

CHICAGO, IL – Infections are one of the leading causes of death in nursing homes throughout the country. Unfortunately, nursing homes can be inattentive to the conditions that give rise to infections and then leave the infections untreated, putting nursing home residents at risk.

An infection that is left untreated can turn into a very dangerous condition called sepsis. When someone develops septic shock, this is how an infection can kill. Sepsis happens when an infection you already have – in your skin, lungs, urinary tract, or somewhere else – triggers a chain reaction throughout your body. A toxic agent is introduced into the bloodstream because of the infection and will begin to result in organ failure. If you do not seek medical treatment in a timely manner, sepsis can rapidly lead to tissue damage, organ failure, and death.

There are numerous symptoms that may occur, with some of the more severe ones including:

Abnormal heart function including a very rapid heart rate
Significant pain and discomfort
Difficulty breathing
Disorientation or delirium
Unconsciousness

The Stages of Sepsis

Stage One: Systemic Inflammatory Response Syndrome (SIRS)

Sepsis can be difficult to identify but is typically denoted by a very high or low body temperature, high heart rate, high respiratory rate, high or low white blood cell count and a known or suspected infection. For sepsis, two of the mentioned SIR signs, as well as an infection, must be present.

Stage Two: Severe Sepsis

Severe sepsis is diagnosed when acute organ dysfunction begins. Severe sepsis can be diagnosed when sepsis is present along with hypotension, or low blood pressure, or hypoperfusion, the decreased blood flow through an organ.

Organ dysfunction can be characterized by symptoms such as a sudden change in mental state, decreased urine output, decreased blood platelet count, difficulty breathing, abnormal heart pumping function and abdominal pain.

Stage Three: Septic Shock

Septic shock is the most severe stage of sepsis. Septic shock is defined as the presence of hypotension, induced by sepsis, despite fluid resuscitation. Septic shock has the highest chance of mortality, with estimates that range from 30% to 50%.

Symptoms of Septic Shock

Septic shock is accompanied by the following symptoms:

Little to no urination
Blood clots throughout the body that can lead to organ failure
Very low or high temperature
Extremely low blood pressure
Palpitations

Even if the nursing home resident is about to survive septic shock, it will have long-term ramifications on their health and they likely will not make a full recovery.

Early detection of sepsis is necessary in order for a nursing home resident to have a better chance at survival; however, when a resident is a victim of nursing home neglect, they likely are not receiving the care that they need to notice the signs of sepsis and begin prompt treatment. This becomes more of a problem at understaffed nursing homes that are prone to neglect.

Medical Treatment for Patients with Sepsis

When a nursing home does diagnose and treat sepsis, the course of treatment begins with antibiotics. Some patients may need to have procedures to remove dead skin or tissue depending on the severity of the infection. Patients may also need oxygen or other intravenous fluids to maintain the level of oxygen and blood going to the organ so organ failure can be prevented. Patients can recover from mild sepsis in about three to ten days; however, more severe cases can take longer to recover if the patient is able to survive at all. Severe sepsis requires critical care for a month or more.

Sepsis and Pressure Ulcers

Sepsis is also how pressure ulcers can become fatal. There are four stages of a pressure ulcer: Stage I and II is the first discoloration of the skin and a small ulcer. Stage III is when a small crater in the skin begins to degenerate to a Stage IV pressure ulcer where the hole in the skin gets deeper and can reach the muscle. When the hole in the skin becomes large enough and is untreated, the resident can develop sepsis from the infection. A pressure ulcer can become septic, though the ones that are more advanced have a higher change of becoming infected. The wounds can leak puss and give off a foul smell. There can also be an increased in pain in the area and a fever.

Pressure ulcers should not form in the first place, but if they do, they should not reach the level of sepsis. If your loved one has developed sepsis, there is a high chance that the nursing home did not provide the level of care that it was legally obligated to, causing your family member to develop a life-threatening infection.

Nearly 25,000 residents in nursing homes will die from sepsis, and most of these deaths are preventable. Thousands of nursing homes each year are cited by the federal government for their failure to prevent and treat pressure ulcers.

Has Your Loved One Been Injured by a Nursing Home’s Failure to Treat an Infection? Get Legal Help Now

The experienced attorneys at the Dinizulu Law Group have handled numerous cases over the years where nursing home residents have died from infected pressure ulcers and other severe infections due to nursing home negligence. If your loved one has been injured or died from neglect at a nursing home, call us today at (312) 384-1920 to set up your free consultation. Please visit our website for additional information.

How to Find a Quality Nursing Home During a Pandemic

June 11, 2020/in Blog/by Yao Dinizulu

CHICAGO, IL – The novel coronavirus is uprooting many areas of life for people across the world. For families that considering nursing home care for their loved one, it’s causing people to rethink such a move. Nursing homes have been the epicenter of coronavirus outbreaks, which certainly can lead to concern; however, this doesn’t mean you should stop looking into nursing homes.

While COVID-19 is certainly a risk factor that one should consider, families should also consider nursing home abuse and illness outbreaks happen daily in nursing home settings. No matter what the concerns are, there are some things that families can do to research and find a quality nursing home facility for their loved one – even during a pandemic.

Determine a Budget

One of the first steps while choosing a nursing home is determining what your family can afford. First, start by determining how much care your loved one needs. Does he or she require daily medical care and supervision? Does he or she need limited care, such as assistance with meals or medication reminders? These are things that will factor into the cost.

Determining the amount of care your loved one needs will help determine if you need assisted living or nursing home care. This will also help you narrow down your budget which will narrow down your field of choices.

Nursing homes can be more expensive because they require more specialized staff, nursing staff, and medical care. Nursing homes tend to have much stricter regulations, such as regulations for staffing, services, and food safety. On the other hand, assisted living facilities have less restricted regulations because there is less involvement in the daily needs of their residents.

Use Online Resources for Your Search

There are several legitimate online resources and tools you can use to help identify and review nursing homes you may be considering. If you are considering a facility that accepts Medicaid or Medicare, the best place to start your search is utilizing Medicare’s Nursing Home Compare tool. This tool is excellent to use because they have data on staffing, data on incidents, and can tell you the number of residents that have suffered from bedsores.

You can also find information through your state’s long-term care Ombudsman office. The Long-Term Care Ombudsman Program offers important information about nursing homes and assisted living facilities.

Visit the Facility

Before deciding on a nursing home, it’s important to visit the facility first. Don’t just settle for an informal meeting with the administrator – talk to the staff members who will potentially be caring for your loved one. Ask to meet with the nursing director and nursing assistants (CNAs). These are the people who will be interacting and caring for your loved one the most. It’s important to take note of what they’re saying and what their attitudes are like. Do they have a mean demeanor? Do they seem to enjoy their work? Do they seem tired or overwhelmed? Notice how they come across now and imagine how they will respond to your loved ones needs during a difficult shift.

Do More than a Guided Tour

Most nursing homes offer a guided tour of the facility and show where your loved one will be sleeping, the activity area, and the dining room. This is a great way to see an overview of the facility and what they have to offer, but this should not be the only way to assess the facility. When visiting, be mindful of a few things:

Residents – Do residents seem to be well-groomed? Do they seem to be happy? Are they actively moving around?
Food Service – Take note of what meals look like and how residents are reacting. Do they seem to enjoy it? Are residents complaining about the food quality?
Smells – Do you notice a smell or urine or strong cleaning products?
Sounds – Does it sound pleasant? Is there music playing? Do you hear upset residents that are crying or grumbling?

When visiting a nursing home, these are important factors to consider. If anything seems off to you, it’s likely a sign that this isn’t the best nursing home suited for your loved one.

Discuss Important Issues Before Signing Paperwork

Once you’ve narrowed down your list on possible nursing homes, it’s important to discuss certain issues before you sign any paperwork. It’s important to discuss your loved ones medical records since you can’t assume you will have access to their medical records once they are living at the facility. Ask the facility what they require to make sure you have all relevant medical information to help make medical decisions.

You should also discuss the plan for your loved one’s care. Ask the nursing home facility how they establish a care plan for residents. Most facilities will have a meeting with nursing staff to discuss the resident’s needs where families should be present.

Do You Have Concerns about Your Loved Ones Care in a Nursing Home?

If you have questions or concerns about the care your loved one is receiving in a nursing home, contact the attorneys at the Dinizulu Law Group. We help families understand their legal rights and options to ensure their loved ones are safe. To request a free consultation, please call (312) 384-1920 or visit our website for more information.

Effects of Understaffing in Nursing Homes

May 19, 2020/in Blog/by Yao Dinizulu

Nursing home facilities across the nation are facing an understaffing crisis. Research has shown nearly 95 percent of nursing facilities in the United States are understaffed. Understaffing can lead to serious injuries, or in some cases death among residents. Some states, such as New York, don’t have a legal mandate on the ratio of nursing home staff to senior residents, which means problems can often go unnoticed.

Understanding the Issue of Understaffing
Understaffing in nursing homes is a serious, prevalent problem that often goes underreported. There is often pressure for nursing facilities to cut costs. This can result in facilities taking in more residents than what they’re staff can effectively and adequately handle. Understaffing can mean that a single nurse must care for dozens of residents at one time.

Nursing facilities may find that they have having problems holding onto enough adequately trained nurses and certified nursing assistants who can provide care to residents. High turnover rates can result in the over-scheduling of available staff members, who then in turn become overwhelmed by their duties.

Understaffing in nursing facilities can also lead to nursing home abuse. Staff are overwhelmed while being underpaid, which can lead staff members or caregivers to be more abusive towards their residents. Forms of abuse can include physical or sexual injuries, financial exploitation, and psychological trauma. Staff members can also neglect the needs of vulnerable residents by not giving out the proper dosage of medication or the proper medication, for example.

Consequences of Nursing Home Understaffing
There can be negative consequences of understaffing in nursing homes which can affect residents’ basic needs. Staff members may be suffering from extensive stress, which increases the likelihood of nursing home abuse and neglect. Abuse and neglect become a bigger issue as the resident to staff member ratio increases.

Neglect and abuse from nursing home staff can cause long term issues, such as psychological problems, physical illnesses, and even death in some circumstances. Understaffing can attribute to already present psychological issues or physical illnesses among residents.

Consequences of Immobile Patients
Many residents suffer from limited ability to ambulate on their own and are dependent on caregivers for all of their movement needs, as well as their physiological needs. When a nursing facility is understaffed, it can be impossible for staff members to turn the patients in bed enough times or to move residents around as they need to be moved in order to prevent bedsores. This can lead to further skin conditions or infections.

Neglecting Residents Needs
Residents may be dependent on caregivers and nursing home staff for their bathing, eating, grooming, and medication administration needs. If a resident is not bathed or groomed on a regular basis, they may develop sores and infections. Facilities that are understaffed may have problems with feeding and administering medication to residents on a routine schedule. This may lead to malnutrition, nutrition deficiencies, and other complications from not receiving medications on schedule.

The Abuse of Residents
Understaffing in nursing homes can also lead to the neglect and abuse of residents in the facility. Abusive nurses have indicated stress from understaffing is the primary cause of their being abusive to residents. Having limited time to care for each resident can result in caregivers or nursing home staff to become impatient and frustrated, resulting in abuse towards a resident.

Prevalence of Understaffing in Nursing Homes in U.S.
Each state has a different definition of what constitutes as adequate staffing levels for nursing homes; however, research indicates nearly 95 percent of nursing facilities in the United States are significantly understaffed. In 2001, 20 states introduced a total of more than 50 Bills on nursing staff standards in nursing homes.

For example, Illinois requires that a nursing home have enough staff to give each resident that needs skilled care at least 3.4 hours of nursing care, including at least 51 minutes of licensed nurse care. At least 21 minutes of the licensed nurse time bust be care by a registered nurse (R.N). For residents who are in need of intermediate care, the numbers include 2.3 hours of total nursing care, including 34 minutes by a licensed nurse and 14 minutes of registered nurse time (Illinois Citizens for Better Care).

Eleven states, including Florida, Massachusetts, Michigan, Minnesota, New Jersey, New York, Ohio, Pennsylvania, Tennessee, Texas, and West Virginia have proposed staffing increases that were not passed.

Four states (Hawaii, Minnesota, Montana, and Wyoming) have not changed their staffing standards since the 1970-1980s. Furthermore, eighteen sates made changes to their staffing standards in the 1990s.

Preventing Understaffing in Nursing Homes
Many nursing homes have been held accountable for issues related to understaffing in recent years through lawsuits. While this may be a temporary fix to the problem, there is much more work to be done in order to combat this issue. Because of understaffing, nursing homes nationwide have had to pay out millions of dollars to patients who have suffered from wrongful death and illnesses that are related to the understaffing in nursing facilities.

If a nursing home facility fails to provide adequate staff and supervision, it can have a serious impact on residents who depend on nurses, caregivers, and other staff members for care.

If you or a loved one has experienced abuse or neglect at the hands of a caregiver, we recommend you contact an experienced nursing home neglect and abuse attorney right away. Our team has proven success in nursing home cases and we will use our extensive legal experience to help you navigate the process to get you full and fair compensation for our loved ones injuries. To receive a free consultation, please call (312) 384-1920 or visit our website for more information.

Awareness of Elder Abuse Increases While One Form is Often Overlooked

April 7, 2020/in Blog/by Yao Dinizulu

In recent decades, the media has exposed a crime that is often overlooked – abuse against the elderly. Often times the violation comes from a caregiver or a relative. Extensive research has shown adults 65 and older will often experience violence or neglect that was brought on by a caregiver or family member. Experts have recently been studying patients that suffer from dementia or Alzheimer’s disease; however, there is one form of abuse that is often overlooked.

Resident-to-Resident Harassment
Resident-to-resident mistreatment (R-REM) is the “negative and aggressive physical, sexual, or verbal interactions between long-term care residents that (as in a community setting) would like be construed as unwelcome and have high potential to cause physical or psychological distress in the recipient,” according to the National Long-Term Care Ombudsman Resource Center (LTCOP) Reference Guide.

Nearly 20% of nursing home residents experience a negative or aggressive encounter with another patent in just a four-week period. Encounters include:

Verbal abuse
Physical abuse
Invasion of privacy
Inappropriate sexual behavior

Types of Abuse
According to research by the National Consumer Voice, there are many forms of R-REM that include the following:

Verbal abuse
- Cursing
- Screaming
- Verbally threatening
- Controlling
- Racial or ethnic slurs
Physical abuse
- Hitting
- Kicking
- Grabbing
- Pushing
- Biting
- Scratching
- Spitting
Sexual abuse
- Unwelcome verbal sexual advances
- Exposing self or inappropriate body parts
- Touching/kissing/trying to get in another resident’s bed

These are the most common forms; however, other forms include throwing items, destroying others property, threatening gestures, wandering, or rummaging.

Case Studies Show Staff Negligence of Issue
In one case study, a researcher found over a one-year period 294 cases of resident-to-resident abuse. Common injuries included lacerations, bruises, and fractures. Nurse aides reported extensive verbal, physical, material, psychological and sexual abuses, with the most common being verbal and physical.

Victims of R-REM are more likely to be male, with cognitive impairment, moderate functional dependency and behavioral disturbances. Perpetrators are normally individuals who have suffered with alcoholism, psychiatric illness and substance abuse.

Research has also shown that the actions of staff members may cause aggressive tendencies by resident. Another study found that a crowded environment was correlated with violent episodes. For example, in a nursing home setting where older people who may have lived alone for years are exposed interactions with residents and staff in crowded spaces. Any hostile or aggressive environment puts victims at an increased risk of being abused.

Consequences of Resident-to-Resident Mistreatment
There can be minor or severe consequences to R-REM such as a victim falling, fracturing a bone(s), lacerations, and/or abrasions. Victims also experience a decreased quality of life, depression and anxiety.

The SEARCH approach to managing R-REM. The SEARCH approach (Support, Evaluate, Act, Report, Care plan & Help to avoid) provides the guidelines for nurses and care staff on how to prevent R-REM in long-term care settings. According to research, the steps include:

Support	Support the injured resident until help arrives Listen to all involved residents’ perspectives on the situation or any witnesses Validate residents’ fears and frustrations
Evaluate	Evaluate what actions are needed Evaluate and support all residents involved in, or who have witnessed an act of abuse Monitor residents’ behavior
Act	Seek medical treatment when indicated Try to stop the incident verbally before interfering Call for other staff or security to help Separate residents who do not get along In the case of missing personal items, assure the resident that a room-by-room inspection will be conducted promptly Follow-up with involved residents Acknowledge resident’s concerns
Report	Initiate an investigation of serious incidents when warranted Contact families, if appropriate Notify a supervisor or administrator Document the incident Initiate facility protocol and procedure for reporting RREM
Care Plan	Plan for the victim and the initiator Talk with the care team about the best ways of intervening and avoiding RREM Document all threatening behaviors Monitor residents to potentially avoid future incidents
Help to Avoid	Have adequate staff Avoid crowding people and equipment into small spaces Reinforce resident’s safety is a nursing homes priority Educate residents about dementia-specific behaviors Take inventories of personal belongings Recognize risk factors or RREM

Filing a Lawsuit
While resident-to-resident mistreatment is often overlooked, it is still a form of abuse that needs to be reported immediately. To prove negligence or abuse has happened to a resident, you will need an experienced nursing home neglect and abuse attorney. Our team has proven success in nursing home cases and will use our extensive legal experience to help you navigate the process and to get you full and fair compensation for you or your loved one’s injuries. To receive a free consultation, please call (312) 384-1920 or visit our website.

Neglected Nursing Home Residents Often Develop Bed Sores

April 3, 2020/in Blog/by Yao Dinizulu

Most residents in nursing facilities can’t move around on their own. They may be confined to their bed or a wheelchair, and it can be difficult for them to shift their weight of their body. When a body part is experiences persistent pressure, bed sores can develop. Staff members must take extra precaution to prevent the development of bed sores, such as flipping the resident over.

What are bedsores?

According to John Hopkins, bedsores can form when a person is, “bedridden or otherwise immobile, unconscious, or unable to sense pain.” Bedsores happen on areas of the skin that are under pressure from lying in bed or wheelchair for an extended period of time.

If an immobile or bedridden resident is not turned or positioned properly, given proper nutrition and skin care, bedsores can develop into one of four stages.

What causes bedsores?
Bedsores develop when blood supply to a person’s skin is cut off for more than 2 to 3 hours. Depending on the severity of the bed sore, the person’s physical condition and depending on if they have any underlying diseases, bedsores can take days, months, or years to heal.

What are the symptoms of bedsores?
Bedsores have 4 stages, ranging from least severe to most severe:

Stage 1. The area is red and warm to touch. On darker skin, the area may have a blue or purple tint. During this stage, a person may complain that it hurts, itches, or burns.
Stage 2. The area begins to look more damaged and have an open sore, scrape or blister.
Stage 3. The area has a crater-like appearance because of the damage below the skin’s surface.
Stage 4. The area is severely damaged, and a large wound is present. Infection is a significant risk at this stage.

How are bedsores diagnosed?
A healthcare provider or physician can diagnose bedsores by inspecting the person’s skin. According to their appearance is what stage the person is at.

How do you treat bedsores?
A healthcare provider will discuss specific treatment options based on the severity of the person’s condition. Healthcare professionals are supposed to monitor the bedsore closely and document the size, depth, and response to treatment. Treatment can include:

Keeping the wound clean
Ensuring good nutrition
Removing pressure on the affected area
Protecting the wound with gauze
Medication, such as antibiotics

How can bedsores be prevented?
By examining the skin closely and looking for areas of redness, aparticularly in bony areas. Other methods include:

Turning and repositioning a resident every 2 hours
Sitting up-right in a wheelchair, repositioning roughly every 15 minutes
Provide good skin care
Provide good nutrition

What to do if I’ve found bed sores on myself or a loved one?
To prove negligence or abuse has happened to a resident, you will need an experienced nursing home neglect and abuse attorney. Our team has proven success in nursing home cases and will use our extensive legal experience to help you navigate the process and to get you full and fair compensation for you or your loved one’s injuries. To get a free consultation, please call (312) 384-1920 or contact us via our website at www.dinizululawgroup.com.

Illinois Nursing Home Abuse & How to Report

March 26, 2020/in Blog/by Yao Dinizulu

Nursing home neglect happens more often than you think. An estimated 5 million adults 65 and older are abused and neglected each year in the U.S. Neglect is an form of elder abuse committed against an older adult in a nursing home that breaches the duty that may harm a resident.

You’re more than likely going to experience a family member or someone you know being in a long-term care facility. Nearly 1.5 million people live in a nursing home in the U.S., according to the Centers for Disease Control and Prevention (CDC). When someone else is taking care of your loved one, it’s important to do research on the facility you ultimately choose.

Illinois has one of the highest rates of nursing home abuse in the nation. It’s important to be aware of the signs and symptoms to look out for when suspecting abuse and know how to report a case.

Anyone can commit elder abuse; in fact, in almost 60% of elder abuse and neglect incidents, the perpetrator is a family member and two thirds are adult children or spouses according to the National Council of Aging (NCOA). However, perpetrators are not limited to just family members and may include caretakers or other residents.

What is elder abuse?

Elder abuse or neglect “refers to the mistreatment of a person 60 years of age or older who lives in the community,” according to the Illinois Department of Human Services (IDHS).

IDHS states abuse and neglect includes any of the following:

Abuse – physical, sexual, or emotional mistreatment and/or willful confinement.
Neglect – the failure of a caregiver to provide the older person with the necessities of life, including but not limited to food, clothing, shelter, and medical care.
Financial exploitation – the misuse or withholding of the older person’s resources by another to the disadvantage of the older person and/or the profit of another.

What makes an older adult vulnerable to abuse?

Older adults who are in nursing homes are socially isolated and those who have mental impairments such as dementia or Alzheimer’s disease makes them more susceptible to being abused or neglected. Studies have shown that those with dementia have experienced a form of abuse or neglect.

Most common types of abuse:

According to the Illinois Department of Aging (IDOA) victims often experience more than one form of abuse. 67 percent of victims are female, while 33 percent are male; however, 51% of abusers are females, while 49% of abusers are male.

Based on the 2017 annual report, the most common forms of abuse in Illinois were:

Financial exploitation, (8,604)
Emotional abuse (6,476)
Passive neglect (6,679)
Physical abuse (3,782)
Willful deprivation (2,268)
Confinement (1,381)
Sexual abuse (765)

What to do if you suspect abuse:

If you suspect your loved one is experiencing abuse in their nursing home, talk to the staff immediately. If the problem isn’t resolved, you can talk to one of the following:

Call 911, especially if they are in life threatening danger
Supervisor
Social worker
Director of nursing
Administrator
Doctor

Families should document signs of nursing home abuse and indicate any change in their loved ones behavior, take pictures of the injuries and note if injuries worsen, and write or record any witnesses that has seen the abuse or from the victim themself.

How to report nursing home abuse:

There are several ways you can report nursing home abuse. In case of emergencies, please dial 911. You can also contact:

Long-term care ombudsman
- You can find your local ombudsman here.
Professional medical experts like doctors or nurses
Nursing home administrator

To confidentially report abuse:

A 2019 report by GAO states, “nursing home abuse often goes unreported mainly because residents are afraid of what will happen if they speak out.” Residents fear that staff may treat them worse, or abuse will continue and worsen.

A nursing home report can often remain confidential when complaints are filed with a long-term care ombudsman, unless consent is given otherwise. Confidentiality eases the concern of addressing a problem.

File a Lawsuit

If you suspect your family member or loved one is the victim of nursing home abuse or neglect, it’s important to take legal action right away to protect their rights. In Illinois, the statute of limitations limits the amount of time you have to file a lawsuit which is 2 years from the injury date.

Throughout the litigation process, the attorney’s at Dinizulu Law Group collect evidence to build your case against the nursing home and staff and inform you of the steps we take along the way. Please call our firm today for a free consultation at (312) 384-1920 to learn how you can obtain justice for your loved one.

Coronavirus Outbreak in Illinois Nursing Home Facility

March 24, 2020/in Blog/by Yao Dinizulu

CHICAGO, IL – Officials of the Illinois Department of Public Health (IDPH) have reported at least 46 people, including residents and staff members, have tested positive for coronavirus at a DuPage county nursing home. This outbreak is the first in a long-term care facility in Illinois. Chicago’s WGN9 reported the first confirmed test of a Willowbrook resident by state health officials.

Within a matter of days, the virus spread to other members at Chateau Nursing and Rehabilitation Center of Willowbrook, a southwestern suburb of Chicago. Forty-six people, thirty-three residents and 13 staff members – have all tested positive for the virus. Other residents are now isolated in another area of the facility as officials expect additional positive tests to come back within the near future.

Mayor Frank Trilla, said, “this could have happened anywhere.”

There haven’t been any unusual incidents at this nursing home before the outbreak, though the mayor noted that nursing homes are regulated by the state and not local government.

Centers for Medicare & Medicaid Services (CMS) established a new set of rules for nursing home facilities beginning on March 13. The critical new measures were designed to reduce the spread of COVID-19. The new set of rules directs facilities to to significantly restrict visitors and nonessential personnel, as well as restrict communal activities inside nursing homes, with exceptions for compassionate care, such as an end-of-life situation. All group activities and communal dining are canceled and be implementing active screening of residents and health care personnel for fever and respiratory symptoms. The only exception is for certain care situations, such as end-of-life situations. The new measures are CMS’s latest action to protect America’s seniors, who are especially vulnerable to contracting COVID-19.

The First Outbreak at a Nursing Home Facility

According to the CDC, seniors with multiple health conditions are at the highest risk for complications. There have been reports of large numbers of cases spreading rapidly through nursing homes, such as the Life Care Center in Kirkland, Washington. The New York Times reported two thirds of residents, 55 employees, and 14 visitors have tested positive for COVID-19. Thirty five people have died, claiming 12 percent of staff and residents lives. These death totals make up nearly half of the coronavirus death toll in Washington. These numbers are expected to increase as tests become more available.

The Life Care Center stated, “Current residents and associates are being monitored closely, specifically for an elevated temperature, cough and/or shortness of breath.”

It’s not clear how the virus reached the facility; however, according to the New York Times the first reported case of coronavirus in the United States was from a man in nearby Snohomish County.

Officials of the Life Care Center, which operates more than 200 facilities in 28 states, are monitoring residents and workers closely.

The Outbreak Continues to Spread

Other than the outbreak in Kirkland, at least 15 others have died and dozens more have been infected at long-term care facilities across the nation. Major outbreaks include Willowbrook, Illinois with 46 infections, four deaths in at least two facilities in New Jersey, 13 infected in Little Rock Arkansas, and 11 infected in Troy, Ohio, with at least 30 more showing symptoms.

“Nursing homes would always have been ground zero, but given we already have a huge staff shortage, this will be magnified,” said, David Grabowski, a Harvard Medical School professor who has studied staffing storages in nursing homes. “It could be worse for today’s nursing home facilities than ever.”

The spread of COVID-19 in a nursing home can amplify when patients are transferred and when staff and visitors come and go. The CDC has said visitors and healthcare personnel are the most likely sources of introduction into long-term care facilities. In a recent report by CDC, the agency went on to say, “Limitations in effective infection control and prevention and staff members working in multiple facilities,” can contribute to an outbreak.

How to Keep Residents Safe

The CDC has made additional recommendations for nursing homes as they work to keep residents safe, including:

Nursing homes should put alcohol-based hand sanitizer with 60-95 percent alcohol in every resident room – both inside and outside the room if possible – and in every common area
Sinks should be well-stocked with soap and paper towels for hand washing
Tissues and facemasks must be available for people who are coughing
Hospital grade disinfectants must be available to allow for frequent cleaning of high-touch surfaces and shared resident equipment

More information on a full list of CDC’s guidance for nursing homes safety can be found here.

Counties in Illinois with Confirmed COVID-19 Cases:

Adams
Christian
Champaign
Clinton
Cook
Cumberland
DeKalb
DuPage
Kane
Kankakee
Kendall
Lake
LaSalle
Madison
McHenry
McLean
Peoria
Sangamon
St. Clair
Washington
Whiteside
Will
Williamson
Winnebago
Woodford

Any nursing home with residents suspected of having COVID-19 should contact their local health department immediately. To remain updated on long-term care and nursing home updates, please visit the CMS website.

Negligence Related to Coronavirus

If a loved one has sustained a serious infectious disease complication or missed a medical treatment provided by a nursing home or the understaffing in facility, we can help you. Please reach out to Dinizulu Law Group, a Chicago-based law firm with extensive experience in nursing home negligence. For a free consultation, please call (312) 384-1920.

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

Report Claims Nursing Home Kitchen’s “Horrible,” Endangering Residents Nationwide

October 10, 2019/in Blog/by Yao Dinizulu

CHICAGO, IL – Nursing home facilities are now being investigated nationwide after an extensive investigation on nursing home kitchen’s are in “horrible” condition, leaving residents endangered. You may hear horror stories of elder abuse and neglect in facilities such as bedsores, bed bugs, or over-medicating residents, but food handling remains a consistent and overlooked hazard.

A five month extensive study was conducted by FairWarning, a non-profit organization that focuses on the public’s health, consumer, and environmental issues. FairWarning’s investigation is based on inspection reports, federal data, and interviews with residents and caretakers showed that residents nationwide are at-risk for foodborne illnesses due to unsafe and unsanitary kitchens.

Foodborne illnesses are a threat to any age group; however, people over 65 are especially susceptible due to weaker immune systems, chronic diseases, immobility, and any age-related changes in their digestive system. The most common incident’s that were not logged in any restaurant inspector’s notebook include: flies buzzing around food, cockroaches in the kitchen, moldy ice cream machines, debris stuck to food handling items, and mouse droppings across the top of the stove.

From 1998 to 2017, 230 foodborne illness outbreaks were reported by the Centers for Disease Control and Prevention. The outbreaks caused 54 deaths and 532 hospitalizations, and further sickening 7,648 people.

Not all cases were brought on by poor sanitation – some outbreaks were the result of contaminated food brought into facilities from the outside. Investigators reported that in one facility, the kitchen staff failed to check the sanitizer levels in the dishwasher and didn’t realize the injector was clogged. The facility’s administrator had no comment.

“There’s a huge under-reporting of food issues,” said Charlene Harrington, a nurse and professor at University of California, a researcher of nursing home quality.

Dangerous and Unsafe Food Handling

In Illinois, all workers in a restaurant and non-restaurant food establishment is required to have a Food Handler’s Safety Card, a certification that shows you know how to prepare, store or serve food, handle food equipment and utensils, or food-contact surfaces. All employees are required to obtain their Food Handler’s Card within the first 30 days of hire.

Food handling is the third most frequently cited violation in America’s estimated 15,700 nursing homes, behind infection control and accidents, according to the Centers for Medicare & Medicaid Services. These figures do not include assisted living, who create their own standards and have nearly no data collection nationwide.

Feds Propose Rollback

Thirty-three percent of nursing homes were cited for violating federal requirements to safely store, prepare and serve food. Genesis HealthCare, the nation’s largest for-profit nursing home chain with 400 facilities in 27 states, has more than 43 percent of nursing homes cited for food safety lapses last year.

A CDC spokesperson stated that the agency relies on voluntary reporting of foodborne illness from state, local, and territorial health departments, some of which have limited to no resources or training. Many illnesses go under-reported due to sick individuals not seeking medical care or a diagnosis.

In July, the Trump Administration proposed lower qualifications for directors of food and nutrition services, weakening the standards of an already broken system.

“They’re clearly weakening the standards regarding food service and the safety of food handling,” said Richard Mollot, executive director of New York’s Long Term Care Community Coalition.

Reoccurrences

Many of the same nursing homes are breaking standards of food repeatedly by skimping on resident’s dietary needs to increase profit. Since January 2016, nearly a third of nursing homes that were cited two or more times had the same food safety violation, according to the FairWarning report.

The report claims one Arkansas facility was written up seven times in the last three years, including “unsealed foods in storage, grimy kitchen appliances and staff with unwashed hands touching residents’ food,” inspection reports show. When the nursing home was cited the sixth time in July 2018, a government inspector asked the nursing director if she would eat the food that was being prepared in the facilities kitchen.

“No,” the nurse responded, according to the report.

Lack of Assisted Living Supervision

Assisted living facilities lack federal oversight, which food safety experts stated it could be a much worse living situation for residents. Audrey Kelly of Los Angeles said she quickly moved her 98-year-old mother out of a six-person assisted living facility this year after finding cockroaches in the kitchen.

“It’s not right. It’s really, really disgusting,” Kelly said.

Her mother, Sally, uses a wheelchair after suffering from multiple strokes, became ill after her stay at Toluca Lake Manor Senior Assisted Living in Sherman Oaks, California. She was suffering from stomach cramps and diarrhea.

In another assisted living facility, a Georgia woman who pays thousands of dollars a month, stated she has experience several food- related illnesses that confined her to her bed. She mentions the moldy cheese and lettuce that was being served at the salad bar.

Contact an Experience Nursing Home Abuse and Neglect Attorney

Within the coming weeks, we are sure to hear more information regarding food safety and standards in nursing homes and more people will speak out on their experience now that light is being shed on this. It’s important to contact an experienced nursing home abuse and neglect attorney as soon as possible rather than wait to see what the facility will do to change the problem – if they ever do.

Our attorney’s work diligently towards getting your loved one out of harm’s way and getting the justice they deserve. Due to the statue of limitations, we will need to begin to work on your case right away due to the time sensitive manner.

Please contact our office at (312) 384-1920 for a free consultation, or by visiting our website.

Contact:

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