California Nursing Home Abuse Lawyer Blog

RCFE Reform Act of 2014 Proposes a Dozen New Bills Aimed At Increasing Care and Regulation

January 22, 2014 | by Law Offices of Ben Yeroushalmi

In California, twelve new bills were recently proposed in support of increasing the care, health, and safety of elderly individuals staying at residential care facilities for the elderly (RCFEs). The purpose of these bills was also to enhance state enforcement and regulation, and came in light of numerous reports and occurrences involving elder abuse, injuries, and deaths occurring within such facilities. Many of these bills are sponsored by the advocacy group CANHR and cover a breadth of aspects within RCFEs.

Report Reveals Impact of CMS Initiative Aimed at Reducing Use of Antipsychotic Medications

January 13, 2014 | by Law Offices of Ben Yeroushalmi

The Centers for Medicare and Medicaid Services (CMS) launched the initiative Partnership to Improve Dementia Care in Nursing Homes to lower the use of antipsychotic medication in nursing home facilities. The aim of this initiative was to reduce the inappropriate use of antipsychotic drugs by 15%. However, this goal was not met, and as of 2013, the rate of antipsychotic drug use for long-stay residents was reported to be about 21%, which was approximately a 9% reduction. This meant that more than 1-in-5 residents, or about 300,000 individuals, are still being administered antipsychotic medications.

The Center for Medicare Advocacy recently issued a report analyzing antipsychotic medication use in nursing home facilities. One aspect of the report delved into the perspectives of state surveyors and their process of citing facilities for antipsychotic drug deficiencies. Specifically, the report revealed whether or not the surveyors found any changes in the practices of nursing home facilities after CMS launched its antipsychotic medication initiative.

Study Exposes Nursing Home Staff’s Lack of Knowledge Regarding Antipsychotic Medication

January 7, 2014 | by Law Offices of Ben Yeroushalmi

A recent study published by the Journal of American Medical Directors Association (JAMDA) provided insight as to the knowledge nursing home staff possessed regarding antipsychotic drugs, along with the beliefs they held regarding the appropriateness and effectiveness of such drugs. Antipsychotic medications are generally administered to dementia patients to address behavioral issues. However, administration of these drugs has raised significant patient safety issues. There has been evidence of increased mortality, morbidity, along with risks of serious side effects such as strokes and death. Furthermore, evidence revealed such drugs have limited efficacy in older adults who suffer from dementia. The Food and Drug Administration (FDA) even issued black box warnings to emphasize these risks. Despite such evidence, the use of antipsychotic medications is still high within such facilities.

The study’s survey revealed gaps in knowledge and awareness across all levels of nursing home staff regarding the negative effects of antipsychotic medication. Many believed these drugs were effective in managing the behaviors of dementia patients, and that managing the challenging behavior of such patients was not possible without these drugs. Specifically, only 37% of direct care staff felt they could handle difficult residents without the use of medications. An even more alarming finding exposed the lack of knowledge amongst prescribers such as medical directors, directors of nursing, and RNs/LPNs concerning the significant adverse effects of such medications. The study revealed that only 24% of nursing home leaders were able to identify at least 1 severe adverse effect of antipsychotics, while only 12% of RNs were able to list at least one adverse effect.

States Move toward Implementing Surveillance in Nursing Homes

December 16, 2013 | by Law Offices of Ben Yeroushalmi

Due to the prevalence of nursing home abuse arising across the nation, some states have begun moving towards implementing legislation to explicitly allow surveillance cameras in the rooms of patients residing in nursing homes and long-term care facilities. These surveillance cameras will be used to record evidence of instances of elder neglect and abuse. Some states have taken such steps as a response to nursing home abuse and neglect, with hopes of reducing the incidence of abuse against the elderly. There are currently three states that have passed such laws, with Oklahoma being the most recent state. This new Oklahoma law will allow residents to have cameras in their rooms as long as they sign consent forms which notify the facility. The resident will then have exclusive rights to the footage for use in court. The recorded footage was found to have an impact in Oklahoma, where an aide pleaded guilty to abuse and neglect after being caught on camera.

Both Texas and New Mexico also legalized the use of surveillance cameras in nursing homes in an attempt to catch instances of elder abuse and neglect. Oklahoma passed their surveillance law after an outcry arose over recorded evidence of nursing home aides abusing an elderly resident in the facility. Surveillance footage showed Eryetha Mayberry, a 96-year-old woman, subject to various acts of abuse. For example, the nursing home aides were recorded shoving latex gloves into the resident’s mouth. Other recordings showed nursing home staff taunting Mrs. Mayberry, tapping her head, flinging the elderly woman onto her bed from her wheelchair, and performing heavy handed chest compressions thereafter.

Las Vegas Hospital Sued for Negligence in a Tuberculosis Case

December 13, 2013 | by Law Offices of Ben Yeroushalmi

Summerlin Hospital, located in Las Vegas, is currently being sued by former patients, visitors, and employees for negligence. Those bringing suit are claiming that the hospital failed to take precautionary measures, endangering the health and lives of staff, patients, and others by exposing them to a woman and at least one baby infected with tuberculosis. Tuberculosis is a common, yet potentially lethal disease which generally attacks the lungs and other parts of the body. It is contagious and may be spread through the air when someone with a tuberculosis infection transmits respiratory fluids into the air by sneezing, speaking, singing, or coughing. Due to its contagious nature, those who are in close or frequent contact with an individual with tuberculosis will be at a high risk of contracting the infection themselves.

In this case, the infected woman gave birth to twin daughters at the hospital. Despite exhibiting symptoms of tuberculosis, the woman was allowed continued visitation after being discharged in order to see her babies. The woman and both babies have since passed away from the disease, and the woman was diagnosed with tuberculosis in an autopsy. This lawsuit follows another lawsuit filed by the woman’s family, which alleges that the hospital failed to see and address signs that could have saved the woman’s life. Those bringing this claim are alleging that the hospital was negligent in its failure not only recognize and diagnose the woman’s tuberculosis, but in its failure to take basic precautionary measures. The lawsuit alleges that the hospital not only failed to warn people of a potential exposure to the infection, but also failed to follow isolation procedures.

Medication Error Dangers in the Nursing Home

November 20, 2013 | by Law Offices of Ben Yeroushalmi

A recent investigation in Michigan exposed the number of nursing home facilities in the state that were cited for significant medication errors. The resulting data from the investigation demonstrated that patients within nursing homes either failed to receive enough medication, were administered too much medication, or were administered incorrect medication. The Food and Drug Administration (FDA) reported that medication errors were responsible for injuring approximately 1.3 million people in the United States annually. Given the fact that many elderly individuals commonly take many prescription medications to treat various ailments and conditions, it is imperative that these individuals are provided with correct medication and dosages. The medications that are prescribed to these patients may be critical and vital to their well-being, and may make the difference between life and death.

The investigation noted several examples of medication errors taking place within these facilities. For example, one elderly man entered a nursing home facility for rehabilitation after receiving treatment for his abnormal heartbeat. However, he entered a diabetic coma and passed away after the nursing home failed to treat his diabetes, even though the nursing home knew the elderly resident was a diabetic. Another example involved an elderly woman who died from hypoglycemic brain failure after the nurse accidentally administered her roommate’s medication to her. Furthermore, while one elderly resident was prescribed eleven prescription medications to treat her medical conditions, she failed to receive any of these medications for over a week. The nursing home facility had come to realize their mistake only when the resident’s daughter brought this oversight to their attention. Other tragic cases that have resulted in resident death involved administering residents medication to which they were allergic, or failing to administer prescribed medication.

Johnson & Johnson Agrees to Pay $2.2 Billion in Health Care Fraud Settlement

November 18, 2013 | by Law Offices of Ben Yeroushalmi

According to a news release by the United States Department of Justice (US DOJ), pharmaceutical and health care giant Johnson & Johnson has agreed to pay more than $2.2 billion in a settlement to resolve criminal and civil liability to resolve accusations of health care fraud. Johnson & Johnson faced charges and allegations stating that the company had improperly promoted the use of prescription drugs such as Risperdal, an antipsychotic medication, and Invega, a newer antipsychotic medication, for uses that were not approved by the Food and Drug Administration (FDA) as safe and effective. Additionally, Johnson & Johnson was further charged with paying physicians and nursing homes kickbacks. Attorney General Eric Holder stated that the company’s conduct jeopardized the safety and health of vulnerable patients; as such drugs were marketed to control the conduct of elderly nursing home residents, children, and individuals suffering from developmental disabilities.

Janssen Pharmaceuticals, a Johnson & Johnson subsidiary, had been promoting Risperdal to treat symptoms such as depression, hostility, anxiety, and confusion. The company admitted to promoting the drug to treat psychotic and other behavioral symptoms to those elderly patients who were non-schizophrenic, but suffering from dementia. However, Risperdal had been approved by the FDA to treat schizophrenia only. Furthermore, the government alleged that both Johnson & Johnson and Janssen were aware of the adverse health effects of taking such medications, such as the increased risk of strokes and diabetes, but had downplayed these risks when marketing them to the public. In addition, the company added incentives for the sales representatives who promoted the drug’s off-label use.

Use of Sleep Medication Associated with Increased Risk of Injurious Falls

November 7, 2013 | by Law Offices of Ben Yeroushalmi

A study published in the Journal of the American Medical Association found a correlation between an increased risk of hip fractures and injuries from falls and the use of nonbenzodiazepine hypnotic drugs. Such drugs are a class of sleep medication prescribed prevalently by health care providers in nursing home settings to help elderly residents cope with insomnia and other sleeping issues. Nursing homes are environments that generally do not prioritize residents’ quality of sleep. Therefore, nursing home residents often experience poor sleep and insomnia because they frequently take daytime naps, are subject to nighttime awakenings, or may be suffering from sleep disorders such as sleep apnea.

Many elderly nursing home residents suffer from falls in nursing homes, and these falls can lead to fractures, complications, and even death. Many of these injurious falls may take place at night due to risk factors such as toileting, urinary continence or incontinence. Initially, nonbenzodiazepine sleep medications were thought to be safer than benzodiazepines, in relation to fall risks. As such, the study found there was an increase in the use of nonbenzodiazepine hypnotic drugs in nursing homes. However, the results of the study showed that there was actually a two-fold increased risk for hip fractures when nonbenzodiazepine hypnotic drugs were used. The study was conducted using a sample of 15,528 long-stay nursing home residents who were 50 years or older. This population exhibited a 66% increase in their risk for hip fracture after 30 days of using such sleep medication.

Lawsuit Seeks to Increase Nursing Home Resident Protections in California

November 4, 2013 | by Law Offices of Ben Yeroushalmi

The non-profit nursing home advocacy group, California Advocates for Nursing Home Reform, has filed a lawsuit against the California Department of Public Health, challenging the constitutionality of a 1992 California law, Health and Safety Code § 1418.8. Under this law, if a physician deems a patient to be mentally incapacitated, the resident is found to lack sufficient mental capacity to deny medical treatments and administration of such treatments. As such, in certain instances, these residents were denied life sustaining treatment, subjected to the use of physical restraints, and administered psychotropic medications if they did not have a surrogate such as a relative, conservator, or guardian to deny such medical treatment decisions on their behalf. This is because the Department of Public Health has construed the law to allow facilities to administer intrusive treatments, along with forcing residents to take anti-psychotic medication.

The complaint cited several appalling instances of such elder abuse made against nursing home residents as a result of actions taken under this law. For example, one nursing home resident deemed mentally incompetent was restrained to his bed and fed through a feeding tube, in spite of his medical chart containing a statement that he was not incompetent. When staff later asked him if he wanted to live or die, the resident did not answer, and staff withdrew his feeding tube, revoked a life-sustaining care order, and sent him to a hospice where he died. This occurred because some facilities have interpreted the statute to allow them to end residents’ lives by denying them life-sustaining treatment via ‘do not resuscitate’ orders. Another shocking occurrence involved a nursing home resident who was administered antipsychotic medication without staff informing or checking with her family members who could advise the resident as to the treatment. The woman was later found to be competent.

Nursing Homes Required to Obtain Informed Consent When Administering Psychotropic Drugs

October 28, 2013 | by Law Offices of Ben Yeroushalmi

Many nursing homes often substitute individualized care with the use of psychotropic drugs to make up for the lack of adequate staffing in their facilities. As a result, nursing homes often misuse psychotropic drugs by administering them to residents in order to sedate or control them. This has the tragic result of reducing a resident’s quality of life, because many hazardous side effects accompany the use of these drugs, including death. There are several major classes of psychotropic drugs: antipsychotics such as Risperdal and Haldol, anti-depressants, and anti-anxiety medications. Due to the dangers associated with their use, the FDA issued a black-box warning for anti-psychotics, warning consumers of the increased risk of death for those with dementia, as such drugs have not been approved for this use. Dangerous side effects include, but are not limited to, excessive sedation, weight loss, heart attack, stroke, delirium, agitation, and increased risk of pneumonia.

Despite knowing and understanding the dangers such drugs pose to residents, they are still administered to sedate residents, particularly in facilities that are understaffed or those that have caregivers who are not qualified or trained. Advocacy group CANHR compiled a database of the nursing homes located in California, and each facility’s rates of psychotropic drug use. Therefore, consumers and their loved ones may find such information particularly useful when conducting a search for nursing homes, as this data may help consumers find a facility without a drugging issue.