This should raise the level of awareness of just how GrannyCams are being used with legal issues in nursing homes. The nurses and aide AND owner, in this article should be punished with the full weight of the law. It’s just strange to know they are charged based on a video…which doesn’t lie.

The Cortland County nurse has been found guilty of violating health laws and falsifying records.

Steven Nadeau worked at the Northwoods Rehabilitation and Extended Care Facility in Cortland from 2001 to 2006. He now faces up to two years in prison and a fine up to $2,000.

Nadeau was convicted of failing to provide necessary care to a 59-year-old patient in a chronic vegetative state and then falsifying documents by indicating he had provided the care.

Steven Nadeau has been found guilty of violating health laws and falsifying records while working at Northwoods Rehabilitation and Extended Care Facility.

The Attorney General’s Medicaid Fraud Control Unit used an undercover camera in the resident’s room to monitor Nadeau’s actions.

This was the first case to go to trial in New York State using video surveillance in a resident’s room as evidence. It’s led to pending prosecution of three other nurses, a certified nurse’s aide and the owner of the Northwoods facility.

So there we have it. Don’t do the care just because a camera is watching you. Do it because it’s your job. Remember: the cameras are there to bear witness to what you do…so do it good, as ordered. Be proud of the care you give and don’t be nervous because of the camera. It can also come back to prove you did everything you were supposed do.

The other day I posted about a nursing home that got sued for DOING TOO much to save a life…for not following the DNR of a resident; who ended up going to a local ER and was subjected to the usual array of life saving tools…Today we see just the opposite in this article:

Albany County has paid a $75,050 fine, levied by the federal government, after its nursing home was cited for jeopardizing the health and safety of residents last year, officials said.

The state Health Department, after an inspection late last year, notified the federal government that the Albany County Nursing Home was not in compliance with requirements for nursing homes participating in the Medicare/Medicaid programs.

Around the same time, the state placed the facility in “immediate jeopardy” status after two people died when the staff failed to resuscitate them.

Question:
What does your facility do to ensure ALL staff KNOW the DNR status of residents? Even non staff, such as agency, must know these things- what exact orders are in place, where these documents are located and facility policy and protocol for such events.

Back at the end of February Kim wrote about a nursing home that was being sued for doing everything possible to keep alive a woman who became nonresponse. The woman had a living will stating she did not want any life saving action taken upon her. Both sides claimed very different scenes and thought processes that went into what happened.

The jury found the nursing home and the doctor guilty on Friday.

WEST PALM BEACH - A Palm Beach County jury ruled a nursing home failed to honor the living will of a 92-year-old Alzheimer’s patient who didn’t want to be kept alive by artificial means.

The Friday decision marked the end of the state’s first prolongation-of-life trial. The jury found that the Joseph L. Morse Geriatric Center in West Palm Beach failed to follow the end-of-life directives of Madeline Neumann and that it should pay $150,000 in damages. The panel declined to find Morse’s former medical director, Dr. Jaimy Bensimon, negligent.

As Neumann lay dying in 1995, rescue workers arrived and began reviving her. She was rushed to a hospital, where she died six days later after various lifesaving measures.

Neumann’s granddaughter, Linda Scheible, said she wanted her grandmother’s “unnecessary suffering” to send a message to nursing homes everywhere.

Lesson: KNOW every resident’s directives. And follow them. To a T. If the T isn’t clear, call a lawyer and be prepared to get sued. No matter how the case is handled.

Seriously, all nursing homes have to have on record the advance directives of residents. The murkiness comes when a resident is really sick vs. really dying. THERE is a difference. Sometimes, when they’re very sick BUT not dying, and a dose of antibiotics will take care of them, it’s considered a medical intervention of life saving proportions. And we all know how quickly very sick turns into REALLY dying…it happens in a matter of hours and even minutes. Should nursing homes have to seek out directives for the many common scenarios we see? No matter what, it’s sad that this happened- for all parties involved. I hope it doesn’t lead to more regulation and stupidness but I suspect it will.

The Nursing Home Guy, Matt, has a list of things that raise suspicion when it comes to worker comp claims. It’s spot on…

1. Monday Morning: The alleged injury occurs either “first thing Monday morning” or late on a Friday afternoon but not reported until Monday.

2. Employment Change: The reported accident occurs immediately before or after a strike, a layoff, the end of a big project, or at the conclusion of seasonal work.

3. Job Termination: If an employee files a post-termination claim:

· Was the alleged injury reported by the employee prior to termination?

· Did the employee exhaust their unemployment benefits prior to claiming workers’ compensation benefits?

4. History of Changes: The claimant has a history of frequently changing physicians, addresses, and places of employment.

Read the rest.

A jury in Allegheny County Common Pleas Court will try to decide today which portrayal of Martha F. Bell to accept.

Was she a caring nursing home administrator who, since the 1970s, worked long hours to increase awareness, raise funds and improve care for people affected by the ravages of Alzheimer’s disease, as her attorney says.

Or was she was a greedy nursing home administrator who enriched herself at the expense of residents and recklessly exposed them to risks of serious injury or death, as the prosecutor claims.

Jury deliberations resume in the trial of Mrs. Bell and the nursing home she operated in the death of resident Mabel Taylor. Prosecution and defense attorneys presented conflicting portraits of Mrs. Bell in closing arguments yesterday.

One thing seems certain: A resident died due to poor staffing and management at this nursing home. Ms. Bell allegedly told staff to cover this death up. We’ll see what the jury thinks.

Previous Posts:

Nursing Home Owner Trial Begins

Nurse testifies in cover up of nursing home resident’s death

Jurors Visit Scene of Death

Families Testify

A Tough Woman to work for

Here’s an interesting article from the Concord (NH) Monitor. This is about nursing home staff who allow others to make health care decisions for able-minded nursing home residents. Does any of this ring a bell for anyone?

Nursing home residents throughout the state are medicated without their knowledge, barred from receiving visitors and ignored when they request changes to their medical care, according to the state agencies that monitor their welfare.

Although most of New Hampshire’s 231 nursing homes and assisted living centers try to include residents in decision-making, recent inspections and reports to the state’s long-term care ombudsman reveal that elders’ rights are often overlooked.

In one case, a woman was placed in a locked ward and barred from seeing her attorney. In another, nurses reinserted a feeding tube after a man repeatedly tore it out, tied it in knots and asked to have it removed. Others seniors found pills tucked into their food or were forced into painful physical therapy.

I’ve seen all of these things happen, on a daily basis. Residents who aren’t “allowed” to attend their own care plan meetings; residents who refuse treatment, care, meds…nurses who dump meds into drinks and eggs at breakfast…and yes, residents are forced to go to PT sessions they would rather not be at. And have said so. I’ve also seen residents forced out of bed at certain times; showered vs. a requested bath- at a time of staff’s choosing; who hasn’t seen staff tell residents they HAVE to eat at predetermined times or go without? Happens every day.

Much of what this article is about though is the family connection…the resident’s family makes choices and decisions they really have no right to do.

Most problems, he said, stem from misunderstandings about one document: the durable power of attorney for health care, which allows a person to designate someone to make health care decisions in case he or she is unable to do so. The power of attorney must be activated by a doctor or, under a law that went into effect this year, a nurse practitioner who determines that a person is unable to make an informed choice. Even when the power is in effect, the patient almost always retains ultimate authority. Health-care providers must review treatment options and, in most cases, heed a person’s verbal orders. Should someone regain decision-making skills, the power of attorney can be deactivated.

When a family member roars, we run and do whatever they say. It’s not always right though.

But Rabun says many families and health professionals view the document as carte blanche to decide nonmedical details of a senior’s life, such as where he or she lives or who he or she socializes with. In one recent case, Rabun received a call from a lawyer who had been barred by nursing home staff from seeing her client. The home, Rabun said, had been ordered by the woman’s son, who held her health care power of attorney, to keep her in a locked ward without visitors.

“This person was literally incarcerated,” he said. “In many ways, this is worse than prison. At least in prison, you can see your attorney.”

When someone holds DPOA over another person, it does not mean the holder has the right to control every aspect of life the person lives…or in some of these situations, doesn’t live in the way they want. I often hear nurses say things about “We have to ask the guardian first”– before a resident is “allowed” to go to a dance with another resident; before a resident is “allowed” to dine at the same table with certain others…it’s all really silly when we look at it. But we look at the wrong things sometimes. We try to limit the small things and overlook the bigger ones.

And with the medical stuff, we overstep our bounds:

Even in a medical context, the forms are often misused. Last year, state health inspectors found numerous instances of nursing homes bypassing seniors to seek permission from family members to administer drugs or other treatments.

Last spring, inspectors determined that Haven Health Center of Derry ignored a man’s repeated requests to remove his feeding tube. According to the report, the man had left written instructions that he didn’t want the tube and granted his wife power of attorney for health care.

He arrived at Haven Health in May 2005 with a feeding tube in place, the report said. Throughout the next year, he removed it five times, tied it in knots and told staff members to remove it. Each time, the report said, it was reinserted at the family’s request. The report included nurses’ notes from April 2006 that said: “I asked resident if resident realized that without the tube (he) would die. Resident said resident did not care. I explained to resident that wife does not want (him) to die and that she is the one with legal control.”

Mark McKerley, the home’s administrator, said the situation was resolved soon after the inspection. Staff members, he said, helped the family create a treatment plan that met the resident’s wishes and the family’s emotional needs. Now, the home keeps closer tabs on its 62 residents’ wishes and calls the ombudsman for advice when a tricky situation arises.

I don’t think most who work in LTC know that the resident ALWAYS has the final say. Period. No matter what family wants. No matter what the papers say. So long as the resident is not demented, they should have the last word. And we should respect this. But we don’t.

Though his office handles dozens of complaints each month, Rabun suspects that he hears from just a fraction of frustrated elders. Nursing homes are required to post contact information for his office and furnish residents with a bill of rights, but he says people often fear retribution for making a complaint. (Rabun’s office also serves as a clearinghouse of information for families and long-term care facilities curious about residents’ rights.)

When seniors do call, they’re often confused and emotional. Recently, Darlene Cray, a member of Rabun’s staff, visited a man and woman living in the same long-term care center. The two had formed a close bond: She called him her boyfriend and, as his health declined, he asked to see her often. But the man’s family ordered the staff to keep them apart.

“There was one evening he was very ill and said, ‘Don’t leave me, don’t leave me,’ ” Cray said. “The staff tried to physically remove her from the room.”

It’s sad but who hasn’t seen this scene before? I have, many times. Nurses direct aides to do this work, and it really tugs at our hearts…but the family doesn’t agree to the relationship, is what we’re told. For a long time we believed families and guardians had the right to separate their loved ones from other residents. They do not. No one does.

A good place to turn to is your state ombudsman’s office. They are trained to deal with ALL of these situations and help ALL involved come to a reasonable agreement…while keeping the residents’ right first in mind. The next time you find yourself in a situation similar to these, STOP AND THINK. Is the resident able minded? If so, consider how YOU would feel if someone tried to stop you, or force you, into something you didn’t agree with, want, need or understand. I recommend those who read this article to print it up, bring it to work and share with your DON and Administrator. This is a great in service topic.

Family and others testify at trial of nursing home owner, where Mabel Taylor died.

One daughter of a former patient testified yesterday that Ronald Reagan Atrium I Nursing, Research and Rehabilitation Center was a deplorable, understaffed place where her mother was injured and neglected.

A daughter-in-law of another patient told jurors the nursing home in Robinson was a loving, clean environment with a caring staff, including its administrator.

It’s strange how different people have different opinions of these things. On any given day, a facility can be clean and appear to be running quite smoothly…and the next day a totally different scene.

Defense attorneys were permitted prematurely to call one witness, Perla Sanchez of Mexico City, because she needed to fly home today before the defense case begins. She said her mother-in-law, a Pittsburgh resident with Alzheimer’s disease, received quality care at the facility from 1996 to 2002.

“They had these nurses helping — they really loved their work,” Ms. Sanchez said. “In case I get that disease, I would like to be in a place like that.”

A series of prosecution witnesses continued finding fault with Atrium’s staffing levels, patient care, management, regulatory compliance, executive compensation and other matters.

Linda Margaret Lasher of Robinson said that she became so concerned by her mother’s falls in 2001 that, after five years there, she moved her to Marian Manor in Green Tree. “There was 180 degrees difference” in attentive care her mother received in the new place, she said.

Dr. William Bader, a geriatrician who stopped serving as an attending physician at the facility in 1998, said Atrium had more state Department of Health violations than other facilities where he tended patients. Mrs. Bell, who headed the nonprofit organization that developed Atrium, became administrator after parting ways with others she had hired for the position.

“I thought if [Mrs. Bell] were the administrator always there wouldn’t be any way to seek correction of the problems,” Dr. Bader said.

Another prosecution witness, a medical staffing contractor, testified that he stopped sending nurses and nurses’ aides to Atrium because Mrs. Bell failed to pay $34,000 he was owed.

Jurors visit the scene of death at the PA nursing home- the owner is on trial for this:

Jurors on Monday will visit a building in Robinson that once housed the nursing home where resident Mabel Taylor died after she was trapped overnight in a fenced outdoor courtyard in 2001.

Allegheny County Common Pleas Judge David R. Cashman yesterday told jurors they will visit the site of the defunct Ronald Reagan Atrium I Nursing, Research and Rehabilitation Center off Campbells Run Road.

The visit is part of the ongoing trial of Atrium and its former administrator, Martha F. Bell, 60, of West Mifflin.

Mrs. Bell and Atrium are charged with neglect of a care-dependent person, involuntary manslaughter and reckless endangerment in the death of Mrs. Taylor, 88.

Mrs. Bell also is charged with conspiring to cover up the circumstances of Mrs. Taylor’s death, and theft of payroll.

Atrium was closed by the state in January 2004 and the building was sold. It now is operated by The Bradley Center as a residential treatment facility for children with disabilities.