Oklahoma City Personal Injury Lawyer - Nursing Home & Elder Abuse

Debate Over Use of Video Cameras in Nursing Home Residents Rooms

Margaret Embry — Wed, 27 May 2009 16:32:27 GMT

With the number of nursing home abuse claims so high, Oklahoma County District Attorney David Prater believes that families should be allowed to install video cameras in the rooms of state nursing home residents.

In the May 1, 2009 edition of Tulsa World, Prater was quoted during a hearing on nursing homes at the state Capitol as saying,

If they're aboveboard and fully staffed and take care of the residents, what do they have to hide? I would think they would offer that option to the residents.

Executive Director of the Oklahoma Association of Health Care Providers, Becky Moore, explained that there are cameras in the common areas of most nursing homes. While there is no law against putting cameras in residents' rooms, many residents are hesitant to have the cameras installed. She states that this hesitation is due to the fact that most personal care takes place at bedside and many residents do not want their personal care filmed.

Moore went on to say that she believes having cameras in residents' rooms would be an issue for providers because a camera "in more cases than not is used to sue a nursing facility."

Originally posted at InjuryBoard by Margaret Embry

Representative Dr. Cox Kills Mandatory Nursing Home Insurance Bill

Jeremy Thurman — Mon, 07 Apr 2008 17:23:01 GMT

In a classic example of putting one's financial interests ahead of the public good, Representative Dr. Cox killed the mandatory nursing home insurance bill in his committee today. What can really make your belly squirm is that Dr. Cox owns several "uninsured nursing homes." I got ask Dr. Cox, is there such a thing as conflict of interest? Shame on you Dr. Cox for putting your financial interests ahead of elderly Oklahomans. I guess your employees can allow patients to develop bed sores, falls, dehydration and all the while you can rake in your profits and have no real threat of losing any of that money regardless of the type of care these homes provide.

Here is a press release from Oklahoma Center for Consumer and Patient Safety. Great job Mr. Roberts in the release and its factual statements.

HOUSE COMMITTEE KILLS NURSING HOME INSURANCE REQUIREMENT:

REPLACES BILL TO FAVOR COMMITTEE CHAIRMAN

Tulsa, OK – The Public Health Committee in the Oklahoma House of Representatives considered the amended version of the bi-partisan approved Senate Bill 1549 this morning. Just minutes before the committee meeting was scheduled to begin, Representative Cox, the owner of several nursing homes, submitted a committee substitute which stripped out the insurance requirement. The committee members voted 10-9 to consider the committee substitute, falling one vote short of being able to hear the bill in the form already approved by the Senate.

“It is sad that Dr. Cox put his personal financial interest in front of requiring nursing homes be financially responsible,” said Hugh M. Robert, Executive Director of the Oklahoma Center for Consumer and Patient Safety. Robert went on to say “the Oklahoma Senate had overwhelmingly supported the amended bill and Dr. Cox, who purportedly operates his nursing homes without insurance, today showed his personal financial interest is more important to him than protecting his constituents or the citizens of the State of Oklahoma.”

The amended bill would have required nursing home operators to prove they have sufficient assets to cover claims of resident abuse or neglect. If the nursing home operator fails to keep sufficient assets and does not carry liability insurance the officers, directors and shareholders of the nursing home operator would be personally liable to a nursing home resident or their family when someone is abused or neglected.

One reason Dr. Cox as well as the nursing home lobby has cited for not carrying insurance is that the Medicaid reimbursement levels not being high enough to provide the owners with large profits and pay for insurance. However, this does not take into account the private pay residents and if the issue is with reimbursement rates, then Dr. Cox, in his capacity as a representative should work on reimbursement rates, not blocking a resident or family of a resident from holding responsible a nursing home who abuses or neglects a loved one.

If a nursing home resident is neglected or abused they should have a remedy. Robert comments “we require people who drive cars to carry mandatory insurance, why should nursing homes be any different.” “Forcing nursing home operators to show they are financially sound in order to have a license to take care of our elderly citizens just makes common sense, especially with the growing elderly population” Robert says. Most nursing home operators are for profit and carrying liability insurance is a legitimate cost of doing business. A nursing home does not have to choose between providing good care and being financially responsible, they should be required to do both.

About the Oklahoma Center for Consumer and Patient Safety- Please call 800-994-6025 or visit www.okccps.org.

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Originally posted at InjuryBoard by Jeremy Thurman

Tulsa World Oped on Nursing Home Abuse

Jeremy Thurman — Sun, 23 Mar 2008 18:56:32 GMT

I saw this great oped in the Tulsa World this morning. The article is by Hugh M. Robert and below. For those of us who represent injured Oklahomans in nursing home abuse cases, we realize the importance of getting insurance for Oklahoma nursing homes. This will create a greater degree of responsibility and allow injured Oklahomans to hold nursing homes liable for their neglect.

"A growing number of nursing homes in Oklahoma are not financially sound and cannot respond to legitimate claims when one of their residents is seriously injured or killed due to neglect or abuse. Often, the company that operates the nursing home and has the license is a shell corporation and has no assets, while another company owns the building and equipment. These nursing home operators also fail to carry liability insurance.

Most Oklahomans are shocked to hear that it's not a requirement nursing homes carry some kind of insurance. This was the case of Mrs. Cleo Cloud. Her daughter, going through the already stressful decision to place her mother in a nursing home, didn't think to look for financial solvency or insurance. After her mother was placed in a nursing home, she suffered a terribly painful injury due to the negligence of the home that left her with both her legs broken. Cloud, who endured much suffering and multiple surgeries due to the negligence of the nursing staff, was left with no remedy.

There are at least 56 uninsured homes with 6,621 beds, and the number is likely much higher, but since it is not currently required or reported, we have to rely on unofficial methods of collecting the data. This represents around 20 percent of the total beds in Oklahoma being uninsured; a state study last year speculated the number may be as high as 65 percent. We have asked the state Department of Health to conduct a survey and publish the results of homes not carrying insurance.

If nursing home residents are neglected or abused, they should have the ability to hold the home's owners responsible. We require people who drive to carry insurance, why should nursing homes be any different? Forcing nursing home operators to show they are financially sound in order to have a license to take care of our elderly citizens just makes sense, especially with the growing elderly population. Most nursing home operators are for-profit companies; carrying liability insurance is a legitimate cost of doing business.

It's ironic that opponents of the requirement for nursing homes to carry insurance indicate the cost is too prohibitive and they have to choose between providing quality care for their residents or insurance. We believe they can and should do both.

While the same opponents believe the taxpayer should subsidize the cost to carry insurance, it is hard to imagine the taxpayer paying for the increased cost due to negligence or abuse of a nursing home. Nursing homes are generally for-profit and owners enjoy the profits -- if neglect or abuse occurs in their nursing home, they should pay the cost, not the innocent patient or taxpayer.

We suspect there is a direct correlation between nursing homes operating in a financially irresponsible manner and the quality of care delivered to residents. If a nursing home knows it cannot be held responsible for neglect or abuse, what motivation does it have to offer a high standard of care?

Robert is executive director of the Oklahoma Center for Consumer and Patient Safety ( www.okccps.org)."

Originally posted at InjuryBoard by Jeremy Thurman

Mandatory Nursing Home Insurance Bill Passes Oklahoma Senate

Jeremy Thurman — Wed, 19 Mar 2008 09:51:45 GMT

The Tulsa World is reporting that an amendment submitted by Sen. Richard Lerblance, D-Hartshorne, to Senate Bill 1549 would require nursing homes to carry at least $250,000 in liability insurance.

The Senate approved the bill by Sen. Brian Crain, R-Tulsa, 45-0. It now heads to the House.

An example of why this is important was placed in the Tulsa World article. The article talked about "Leah Gann of Tulsa, whose mother endured painful surgeries after suffering a severely broken leg at a nursing home, said she learned that the facility was in bankruptcy after she filed a lawsuit.

Gann said she filed the lawsuit because she couldn't get an answer as to how the injuries occurred. But because the facility was in receivership, it was not going to be financially responsible, she said.

People searching for a nursing home consider safety, cleanliness, location, an attentive staff and how well patients are cared for, she said.

"I never knew to look for financial solvency," she said. "I never knew to look for insurance."

Originally posted at InjuryBoard by Jeremy Thurman

Bed Sores - What to Look For

Jeremy Thurman — Wed, 19 Mar 2008 08:42:21 GMT

You know we use a lot of legal and medical terms as trial lawyers, but I wanted to briefly discuss the basic parameters of what a bed sore is and what to look for. For all those who have loved ones in Oklahoma Nursing Homes, I challenge you to constantly visit and monitor those who are bed ridden or do not change positions for a long period of time. I truly hope you never have to contact a Oklahoma nusring home abuse lawyer, but if you do,take pictures of what I'm about to describe.

Bed sores are also known as decubitus ulcers or pressure sores. When there is continuous pressure on any part of the body and the pressure is not relieved periodically, then the tissues and skin in that particular area break down and this results in a sore. The term bed sore is used because such sores typically occur in people who are bed ridden for long periods of time and do not change their position in bed often.

In the initial stage the sore area turns red, which is an indication of mild bed sores. If the patient is not treated properly, or if left in the same position for longer, then the mild bed sores start to worsen. The reddening of the skin gives way to breaks and tears on the surface of the skin. Severe cases of bed sores have often left the muscles, internal tissue, and sometimes even the bones of the patients open to the naked eye.

Bed sores can occur anywhere on the body, but the areas most prone to bed sores are those where the bones are closer to the surface of the skin. For instance, the hips, elbows, ankles, back, shoulder, and behind the head; these areas are more likely to result in bed sores than other parts of the body.

Originally posted at InjuryBoard by Jeremy Thurman

Oklahoma - Nursing Homes Lack Insurance

Jeremy Thurman — Tue, 18 Mar 2008 15:42:57 GMT

Citing a study by the Oklahoma Center for Consumer & Patient Safety, newsok.com ran a story about Oklahoma nursing homes failure to carry insurance. Don't be confused by the story as the Oklahoman/Newsok.com rarely if ever will run a story that speaks favorable to consumer rights. However, I did find it interesting the comments made by Becky Moore, executive director of the Oklahoma Association of Healthcare Providers, who said her nursing home group opposes mandatory medical liability insurance coverage. She stated taht underfunding from Medicaid and Medicare has forced many nursing home owners to make a choice, either pay for liability insurance or pay for taking care of residents," Moore said. I find this interesting in that most nursing homes owners, after you break through the corporate barriers are making millions of dollars on these operations.

I guess I can never get over the hypocrisy of some "entities" who claim that they put patient rights over profit. Believe me, failure to carry insurance is more about profit than it is about the patient.

Originally posted at InjuryBoard by Jeremy Thurman

National Pressure Ulcer Advisory Panel's Pressure Ulcer Staging System

Jacob Diesselhorst — Thu, 15 Nov 2007 16:58:34 GMT

National Pressure Ulcer Advisory Panel's Updated Pressure Ulcer Staging System

Abstract
The National Pressure Ulcer Advisory Panel has updated the definition of a pressure ulcer and the stages of pressure ulcers based on current research and expert opinion solicited from hundreds of clinicians, educators, and researchers across the country. The amount of anatomical tissue loss described with each stage has not changed. New definitions were drafted to achieve accuracy, clarity, succinctness, clinical utility, and discrimination between and among the definitions of other pressure ulcer stages and other types of wounds. Deep tissue injury was also added as a distinct pressure ulcer in this updated system.
Problems with Staging Systems
Inherent to the accuracy of pressure ulcer staging is: (1) knowledge of the integumentary anatomy and deeper tissue layers including the ability to identify and differentiate between these layers; (2) assessment and differential diagnostic skill (Nix, 2006); (3) and validity (accuracy) and reliability (consistency of results) of the staging system. Illustratively, a 2007 inter-rater reliability study comparing pressure ulcer staging between staff nurses and certified wound, ostomy, continence nurses (CWOCN) in two National Database of Nursing Quality Indicators (NDNQI) prevalence surveys using the NPUAP staging system reported a 65% agreement between raters Kappa = 0.514 across all stages of pressure ulcers (Nickoley, Helvig, Ritter, & Heinsler, 2007). Of the 235 "potential pressure ulcers identified," 16.6% were eliminated from the study as they represented etiologies other than pressure (such as candidiasis, maceration, denudement) (Nickoley et al., 2007).
Comparatively, 44 pressure ulcer experts were asked to classify lesions, using 56 photographs, as normal skin, blanchable erythema, pressure ulcers using the EPUAP grades 1 to 4 or incontinence lesions (Defloor & Schoonhoven, 2004). The percentage of agreement was 94.5% and the multi-rater Kappa was 0.80 (Defloor & Schoonhoven, 2004). Lesions secondary to incontinence were most often misclassified as grade 2 (blisters) or grade 3 pressure ulcers (Defloor & Schoonhoven, 2004).
Staff nurses frequently ex hibit uncertainty in accurately differentiating between Stage II, Stage III, and lesions secondary to moisture and/or friction (Doughty et al., 2006; Defloor et al., 2005; Pieper & Mattern, 1997; Zulkowski & Ratliff, 2006). Given the ulcer's anatomical location, herpetic, fungal, and moisture lesions are of ten misclassified as pressure ulcerations (Defloor et al., 2005). Neuropathic foot ulcers, epidermal stripping from adhesive removal, reactive hy peremia, bruises, radionecrosis, surgical wounds, and ulcers secondary to venous and arterial insufficiency have also been staged incorrectly using the NPUAP system. Diagnostic inaccuracies result in inappropriate prevention and treatment interventions, misappropriated health care expenditures with the potential for punitive regulatory, litigious, and quality implications.
Deep Tissue Injury as an Etiology
In 2001, the concept of another etiology for pressure ulcers was discussed by the NPUAP. These pressure ulcers were known to begin as "purple" or "bruised" looking tissue and many had a propensity to become large Stage IV ulcers quickly (Black & Black, 2003). The term "deep tissue injury" was selected because it was likely that the etiology of these pressure ulcers was high levels of pressure at the bone-muscle interface. Deep tissue injury (DTI) was initially defined as "A pressure related injury to subcutaneous tissues under intact skin. Initially, these lesions have the appearance of a deep bruise and they may herald the development of subsequent development of a Stage III-IV pressure ulcer even with optimal treatment" (NPUAP, 2001).
A task force was formed and a thorough review of the literature was conducted to determine previous documentation on the phenomenon of DTI. Surprisingly, some existed. In 1873, Paget wrote that ulcers could erupt from intact skin and that tissue may be purple or yellow from extravasation of blood. He went on to say, the deeper tissues die, including muscles and bones, where sloughing follows in the skin and fat and the place under the skin ulcer is empty. Groth (1942), a German scientist, created ulcers in an animal model by applying external pressure and described these ulcers that started in muscle as "malignant." Even Shea in 1975, in addition to defining the stages of pressure ulcers, included a "closed pressure ulcer." Through these sentinel pieces of literature it was apparent that the idea of a DTI pressure ulcer was not new, but had been overlooked with the current staging system. A literature review identified many variations in terminology used to describe DTI (Ankrom et al., 2005).
Reexamining and Updating the Definition and Stages
At the 2005 Consensus Confer ence the NPUAP achieved its goal of clarifying the understanding of deep tissue injury, yet soon realized that deep tissue injuries did not neatly fit into the current staging system. Thus began an intensive 2-year examination and revision of the entire staging system. Current research was analyzed. Opinions were actively solicited from researchers, clinicians, educators, and public policymakers at a variety of public meetings and forums. NPUAP alumni were invited to participate. NPUAP board members engaged their colleagues at the EPUAP to discuss their common concern of accurately staging (or grading) pressure ulcers. Based on this ongoing feedback, NPUAP members drafted multiple iterations of a pressure ulcer staging system and sought expert critique and feedback.
Definitions were drafted with the goal of achieving accuracy, clarity, succinctness, clinical utility, and discrimination between and among other definitions for both stages of pressure ulcers and other types of wounds. A key determinant of accuracy was available scientific evidence. Brevity was emphasized in drafting definitions. Each definition includes a "further description" to support educational efforts and refine clinical utility and clarity.
In 2005, the NPUAP posted a draft of the staging definitions on its Web site and solicited public comment. Participants were asked to rate the qualities of clarity, succinctness, accuracy, and discrimination for each definition. Unlimited space was provided for recommendation for revision. Two hundred volunteers participated in the survey, representing 45 of 50 states. The majority of respondents were CWOCNs or nurses with wound care experience. Some physicians, physical therapists, and administrators also responded. Percent agreement for the qualities of clarity, succinctness, accuracy, clinical utility, and discrimination ranged from 56% to 75% for deep tissue injury, 76% to 91% for Stage I, 83% to 95% for Stage II, 83% to 96% for Stage III, 72% to 98% for Stage IV, and 73% to 90% for the definition of unstageable pressure ulcers. While these results were encouraging, the NPUAP examined all comments contained in a 60-page report and made further im provements to the staging definitions. This lengthy validation and refinement process set the stage for the 2007 NPUAP Con sensus Confer ence.
During the 2007 Consensus Conference, attendees were asked to use the updated definitions of pressure ulcers to classify 30 photographs of pressure ulcers and other dermal lesions. Percent of agreement was computed with an average of 60% for all photos. The majority of inaccuracies were due to classification of pressure ulcers on the foot or heel in patients with diabetes or arterial inflow diseases as diabetic foot ulcers or arterial ulcers, rather than pressure ulcers.
Deep Tissue Injury
Deep tissue injury is the newest pressure ulcer in the updated staging system. The definition of DTI was derived from multiple clinical cases as "purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear." The area may be preceded by tissue that is painful, firm, mushy, boggy, warmer or cooler as compared to adjacent tissue. Today, many of the cases of DTI are recognized after the fact and the word "suspected" can be added to the clinical diagnosis. Note that blood blisters have been included in this definition. NPUAP believes that blood blisters represent a deeper level of injury than a serum-filled blister yet the true depth of tissue damage is not known. NPUAP realizes that deep tissue injury may be difficult to detect in individuals with dark skin tones and placed this information in the description of deep tissue injury. Also, from retrospective data review, it is fairly well known that evolution of DTI may in clude a thin blister over a dark wound bed. The wound may further evolve and become covered by thin eschar. It may heal or evolution may be rapid, exposing additional layers of tissue even with optimal treatment.
Stage I
NPUAP continues to view Stage I pressure ulcers as a sign of risk. The updated definition is "intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible blanching; its color may differ from the surrounding area." Further description of a Stage I is "The area may be painful, firm, soft, warmer or cooler as compared to adjacent tissue. Stage I may be difficult to detect in individuals with dark skin tones. May indicate 'at risk' persons (a heralding sign of risk)."
An important component of the revision of the Stage I definition was to remove any reference to deep tissue injury (see later discussion). Stage I pressure ulcers are also considered reversible in that no irreparable tissue damage has occurred. Even though pain is used as a descriptor of Stage I pressure ulcers, pain often does exist in pressure ulcers at all stages. It should not be assumed that just because tissue is missing, pain sensation is not present.
Stage II. Even though the staging system was designed for pressure ulcers only, the Stage II definition lacked clarity to differentiate true Stage II pressure ulcers from other wound etiologies, which pressure redistribution alone would not improve. NPUAP changed the definition of Stage II pressure ulcers to clarify the use of the term Stage II for pressure ulcers only. The updated definition is "Partial thickness loss of dermis presenting as a shallow open ulcer with a red or pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled blister." Blood blisters are thought to be due to damage to tissues deeper than the dermis and are not to be classified as a Stage II. Similarly, the presence of slough on a pressure ulcer bed also indicates damage to deeper tissue and these ulcers should not be classified as a Stage II.
Further descriptions of a Stage II pressure ulcer include that it presents as a shiny or dry shallow ulcer without slough or bruising. Bruising indicates suspected deep tissue injury. This stage should not be used to describe skin tears, tape burns, perineal dermatitis, maceration, or denudement.
Stage III. The NPUAP goal for updating of Stage III pressure ulcers was to address the idea of variations in the appearance of a Stage III ulcer. The updated definition of Stage III pressure ulcers is "Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling." The depth of a Stage III pressure ulcer varies by anatomical location. The bridge of the nose, ear, occiput, and malleolus do not have subcutaneous tissue and Stage III ulcers can be shallow in these locations. In contrast, areas of significant adiposity can develop extremely deep Stage III pressure ulcers. Bone/tendon is not visible or directly palpable.
Another common clinical issue is describing the healing pressure ulcer over time. While staging represents what can be seen, it cannot describe history nor should it be used to describe healing (reversed staging). Healing of pressure ulcers is more accurately monitored through the Pressure Ulcer Scale for Healing (PUSH Tool) (Stotts et al., 2001). There is a continuing need to communicate about the history of the wound, including the past stages of the pressure ulcer to enhance patient care in all settings. Stage IV pressure ulcers may appear to be Stage III ulcers while they are healing, but they should be classified as healing Stage IV ulcers. Stage IV pressure ulcers often require a full year to heal and once healed, the ulcer site remains an area of risk because the scar tissue has only 40% of the original tissue tensile strength.
Stage IV. The Stage IV pressure ulcer definition required the least amount of revision. The updated definition is "Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed. Often includes undermining and tunneling." Further description of a Stage IV is included to help discriminate it from Stage III pressure ulcers and includes "The depth of a Stage IV pressure ulcer varies by anatomical location. The bridge of the nose, ear, occiput, and malleolus do not have subcutaneous tissue and these ulcers can be shallow. Stage IV ulcers can extend into muscle and/or supporting structures (e.g., fascia, tendon or joint capsule) making osteo myelitis possible. Exposed bone/tendon is visible or directly palpable." NPUAP recognizes that palpation of bone is outside the scope of practice for some clinicians.
Unstageable Pressure Ulcers
The goal for revising the definition of unstageable ulcers was to reduce the tendency to classify an ulcer with any necrotic tissue as unstageable, when the depth of the ulcer can be seen. The new definition is "Full thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the wound bed." Note the phrase "the base of the ulcer" is used to denote the inability to determine the depth. If necrotic tissue is present, for example, on the edge of the ulcer, but the base is bone, the ulcer should be staged as a Stage IV. Further description of Stage IV ulcers include these phrases: "Until enough slough and/or eschar is removed to expose the base of the wound, the true depth, and therefore stage, cannot be determined. Stable (dry, adherent, intact without erythema or fluctuance) eschar on the heels serves as 'the body's natural (biological) cover' and should not be removed."
Wounds that are obscured from view by dressings, braces, or casts should not be staged as unstageable. Likewise, do not assume the previous stage persists until the ulcer is visualized. Documentation should denote that the wound was not staged due to these products/devices. It is recommended that upon admission, every attempt be made to see the wound and not rely solely on the history of the wound.
Future Plans
Further basic science and clinical research is needed in order to validate the NPUAP pressure ulcer staging system and evaluate the effectiveness of educational programs aimed at enhancing inter-rater and intra-rater reliability of the staging system. Issues related to public policy, research, and education related to the updated staging definitions were discussed at the Consensus Conference. Atten dees rated the issues in public policy, education, and research and these ratings will guide NPUAP's future plans. Future Consensus Conferences will address this continuing agenda.
As you can see, NPUAP has updated the staging system for pressure ulcers to improve clinical accuracy, clinical utility, and discrimination from other dermal wounds. Accurate staging is critical for care planning and communication. While staging represents what can be seen, it cannot describe history nor should it be used to describe healing (reversed staging). In addition, greater emphasis has been placed on developing DTI as an independent wound classification, which may act as a "double-edged sword" to health care providers. On one hand, the introduction of a new classification category will allow doctors and nurses to better assess and customize a care plan for patients with these types of wounds. However, this new category also places a greater burden on health care professionals to be as accurate as possible both in diagnosing DTI as well as implementing the correct care plan to alleviate the problem before it develops into a more severe injury.

Originally posted at InjuryBoard by Jacob Diesselhorst

LTC reform bill introduced in House

Jacob Diesselhorst — Mon, 12 Nov 2007 16:05:23 GMT

See the following excerpt from a recent article on the quality of care in our country's nursing homes:

LTC reform bill introduced in House

The level of discourse about improving the quality of long-term care rose to a new level Tuesday, when three members of the U.S. House introduced the Long Term Care Quality & Modernization Act of 2007 (H.R. 4082). Although there are no illusions in the provider community about quick passage for the sweeping reform measure, its unveiling had been anxiously anticipated since a companion bill was unveiled in the Senate in early August.

Advocates praised H.R. 4082 for its wide array of provider-friendly provisions. They say it would promote investment in health information technology and capital improvements. It also would encourage collaboration between nursing home providers and surveyors.

In addition, it would ease loan repayment rules for nurses in for-profit settings and mandate annual updates to Medicare consolidated billing rules, according to the American Health Care Association. Another provision would ease requirements about about obtaining physician authorization for diabetes blood-glucose testing.

Introducing the bill yesterday were Reps. Earl Pomeroy (D-ND) and Shelley Moore Capito (R-WV), co-chairs of the House Long-Term Care Caucus, as well as Rep. Tom Allen (D-ME), the caucus' vice chair.

"All across the nation there have been significant improvements in the quality and accessibility of long term care options," Allen said. "Our bill bolsters this progress.... It provides a comprehensive strategy that combines public and private resources to address the challenge that the coming influx of aging baby boomers poses to our health care system."

As you can see, the quality of nursing home care is a national issue getting attention at the highest ranks of our goverment.

Our firm specializes in nursing neglect, abuse and death cases. If you have any questions regarding the care a loved one received in a nursing home, please contact us.

For more information on this subject please refer to the section on Nursing Home and Elder Abuse.

Originally posted at InjuryBoard by Jacob Diesselhorst

Nursing Home Lawsuit in Nebraska

Jeremy Thurman — Wed, 16 May 2007 14:39:35 GMT

A Nebraska nursing home settled a lawsuit claiming that the facility allowed one patient to lie in her own excrement for extended periods following back surgery. The plaintiff alleged that the nursing home, Life Care Center of Elkhorn's, neglect lead to a severe infection that resulted in the removal of most of her colon. The parent company of the facility, Life Care Centers of America, owns and operates over 280 senior citizen homes in 28 states. Terms of the settlement were not disclosed. Josh Funk, Houston Chronicle

Originally posted at InjuryBoard by Jeremy Thurman

Mandatory Arbitration Clauses in NH Admission Contracts

Jacob Diesselhorst — Thu, 15 Mar 2007 10:03:49 GMT

Flores v. Evergreen at San Diego, LLC, No. D048002 (Cal. 4th App. Dist. March 13, 2007)

This case was decided by the 4th District yesterday here in California. It invalidated an arbitration agreement in a SNF admission contract, signed by a husband on behalf of his wife, who was being admitted to the SNF. The husband did not have power of attorney, and they rejected the argument that simply by being spouse he was her "agent" and the argument that waiver of jury trial is a "medical decision".

Flores v. Evergreen at San Diego, LLC, No. D048002 (Cal. 4th App. Dist. March 13, 2007)

In case involving arbitration agreements signed by plaintiff-husband when admitting plaintiff-wife into a skilled nursing facility, denial of the facility's petition to compel arbitration is affirmed as the husband did not have authority to bind his wife to the arbitration agreement.

http://login.findlaw.com/scripts/callaw?dest=ca/caapp4th/slip/2007/d048002.html

Originally posted at InjuryBoard by Jacob Diesselhorst