The Geneva Suites Failure to Respond to Stroke Symptoms

Failure to Respond to Client Having Stroke at The Geneva Suites
Failure to Respond to Client Having Stroke at The Geneva Suites

Delayed Response to Change in Condition at The Geneva Suites

In a report from the MDH, it was alleged that a client at The Geneva Suites was neglected when the facility did not respond appropriately to reports of a client with a significant change in condition. The client was sent to the emergency room with signs and symptoms of a stroke. Additionally, it was alleged that the client was not receiving meal preparation services that were a part of the client’s care plan.

Neglect Substantiated Due to Care Issues

Neglect was substantiated. The facility was responsible for the maltreatment. Facility staff did not initiate a timely and appropriate response when the client had a significant change in condition. The direct care staff did not call 911 even after concluding the client needed emergency medical services. In addition, the nurse did not ask the unlicensed personnel detailed questions to assess the client’s condition, and did not arrive at the home during the shift to assess the client. 911 was called at the end of the shift, at which time the client was sent to the hospital with signs and symptoms of a stroke.

For a Free Consultation with an experienced elder abuse and neglect attorney call Kenneth LaBore at 612-743-9048.

A common form of neglect in elder care facilities involves medication management and administration or injuries from fall and fractures. Most forms of elder abuse are preventable with proper care and supervision.

Report Suspected Elder Abuse

Click Here For Link To Report Abuse To Adult Protection
Click Here For Link To Report Abuse To Adult Protection

If you have concerns about care provided to a resident in a nursing home, assisted living or any other type of elder care provider contact Attorney Kenneth LaBore for a Free Consultation to discuss your legal rights and options.

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Saint Therese of Woodbury Resident Falls with Injuries

In a report from the MDH, St. Therese / Saint Therese of Woodbury was alleged to neglect a resident when the facility failed to follow the client’s service plan for toileting, resulting in a fall with injuries.

Fall Injury at Saint Therese Woodbury

Neglect is substantiated. The alleged perpetrator (AP) was responsible for neglect. The AP failed to toilet the client during the night shift and the client had a fall with injuries when the client toileted herself. The AP could not sign into the computer to access to client service plan, and therefore did not complete or document any scheduled client services. The AP did not contact the on-call nurse for assistance.

The investigation included interviews with facility staff, including nursing staff, unlicensed staff and family member. The investigator conducted observation of staff/client interactions toured the facility, spoke with additional clients, and reviewed documents, including policies related to implementation of service plans, nursing assessments, and falls prevention.

For a Free Consultation with an experienced elder abuse and neglect attorney call Kenneth LaBore at 612-743-9048.

A common form of neglect in elder care facilities involves medication management and administration or injuries from fall and fractures. Most forms of elder abuse are preventable with proper care and supervision.

Report Suspected Elder Abuse

Click Here For Link To Report Abuse To Adult Protection
Click Here For Link To Report Abuse To Adult Protection

If you have concerns about care provided to a resident in a nursing home, assisted living or any other type of elder care provider contact Attorney Kenneth LaBore for a Free Consultation to discuss your legal rights and options.

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MS-AC Mankato AG Senior Living Fall with Fractures

Client at MS-AC Mankato AG Senior Living Falls and Suffers Leg Fracture
Client at MS-AC Mankato AG Senior Living Falls and Suffers Leg Fracture

Unsafe Transfer Leads to Fractured Leg at MS-AC Mankato AG Senior Living

In a report from MDH, it was alleged that a client at MS-AC Mankato AG Senior Living was neglected by the facility (AP) when the AP failed to transfer the client in a safe manner resulting in a fall with fractures.

Substantiated Neglect Against MS-AC Mankato – Improper Transfer

Neglect was substantiated. The facility for maltreatment. The client’s plan of care did not clearly specify how to transfer the client so it was left to the discretion of the unlicensed personnel which led to an unsafe transfer resulting in the client’s leg fractures.

The investigation included interviews with the family, facility staff members, and therapy staff. In addition, the investigator reviewed the client’s medical records, the AP’s personnel file, facility internal investigation notes, and facility policies. The investigator also observed transfers of the clients at the facility.

For a Free Consultation with an experienced elder abuse and neglect attorney call Kenneth LaBore at 612-743-9048.

A common form of neglect in elder care facilities involves medication management and administration or injuries from fall and fractures. Most forms of elder abuse are preventable with proper care and supervision.

Report Suspected Elder Abuse

Click Here For Link To Report Abuse To Adult Protection
Click Here For Link To Report Abuse To Adult Protection

If you have concerns about care provided to a resident in a nursing home, assisted living or any other type of elder care provider contact Attorney Kenneth LaBore for a Free Consultation to discuss your legal rights and options.

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Maple Hill Senior Living – Multiple Falls

Resident at Heritage of Edina Suffers Shoulder Fracture in Fall
Resident at Maple Hill Senior Living Sustained Shoulder Fracture in Fall

Fracture to Shoulder of Resident at Maple Hill Senior Living

In a report from the MDH it is alleged that the Maple Hill Senior Living (AP) neglected the client, on two separate occasions, when the AP did not answer the call light for several hours. The first time, the client attempted to get out of bed, fell and laid on the floor for several hours. The client sustained a shoulder fracture.

Neglect was substantiated. The facility and the AP were responsible for the maltreatment. The AP neglected to provide the client a scheduled safety check and neglected to answer the client’s call pendant for approximately five hours. The client fell after attempting to transfer herself from the bathroom and laid on the floor for several hours. The client sustained a shoulder fracture.

Maple Hill Senior Living Resident – Fall Incident

In another MDH report it was alleged that Maple Hill Senior Living (AP) neglected to supervise a client who had multiple falls. It is also alleged that the facility neglected to provide the client with clean sheets or correct medications.

Neglect was substantiated. The facility was responsible for the neglect. The client had a fall that resulted in a broken facial bone and required hospitalization. When the client returned from the hospital, a nurse assessed the client to be a high fall risk, but failed to implement fall prevention interventions because the client was on the memory care unit and received hourly checks.

For a Free Consultation with an experienced elder abuse and neglect attorney call Kenneth LaBore at 612-743-9048.

A common form of neglect in elder care facilities involves medication management and administration or injuries from fall and fractures. Most forms of elder abuse are preventable with proper care and supervision.

Report Suspected Elder Abuse

Click Here For Link To Report Abuse To Adult Protection
Click Here For Link To Report Abuse To Adult Protection

If you have concerns about care provided to a resident in a nursing home, assisted living or any other type of elder care provider contact Attorney Kenneth LaBore for a Free Consultation to discuss your legal rights and options.

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Vulnerable Client at Butterfly Bound Care Sexual Abuse Allegations

In a MDH report it was alleged that a client at Butterfly Bound Care was sexually abused when the alleged perpetrator (AP) abused a client when he had sex with the client, gave the client $100.00, and then told the client would get kicked out if she told anyone.

Report that Client abused, then paid, the threatened at Care Facility

According the MDH abuse was substantiated against Butterfly Bound Care and the AP were responsible for the maltreatment. The facility failed to ensure that the AP completed training on staff/client boundaries. The AP told the client that if she had sex with him, he would make sure that she was not kicked out of the home. The AP gave the client $100 and then told her that is she told anyone about the incident she would be kicked out of the home.

On the evening of the incident, the AP gave the client a back massage. The AP then asked the client to have sex with him. The AP told the client he would give her $100 for sex. The AP took the client in his car to the bank and to Walgreens. The AP left the other clients alone in the facility.

The AP brought the client back to the Butterfly Bound Care facility where they engaged in sex. Afterward, the AP told the client not to tell anyone or he would make sure she was kicked out of the facility. The client moved out of the facility about two weeks later.

Police Contacted Concerning Assault / Abuse at Butterfly Bound Care

During an interview, the client said she reported the incident to a county worker, who contacted the police.

The investigation with the Minnesota Department of Health resulted in the conclusion that abuse was substantiated.

For a Free Consultation with an experienced elder abuse and neglect attorney call Kenneth LaBore at 612-743-9048.

A common form of neglect in elder care facilities involves medication management and administration or injuries from fall and fractures. Most forms of elder abuse are preventable with proper care and supervision.

Report Suspected Elder Abuse

Click Here For Link To Report Abuse To Adult Protection
Click Here For Link To Report Abuse To Adult Protection

If you have concerns about care provided to a resident in a nursing home, assisted living or any other type of elder care provider contact Attorney Kenneth LaBore for a Free Consultation to discuss your legal rights and options.

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Corona Virus Information For Elder Advocates


Corona Virus COVID-19 Information
Corona Virus COVID-19 Information

The recent novel corona virus, COVID-19 has taken the world by literal storm. The virus has had an effect on society not seen in generations the risk of death to vulnerable adults has lead to the closing of most businesses and a lock down on travel and forced social distancing.

Minnesota Department of Health Information about Corona Virus COVID-19

According to the MDH:

  • COVID-19 is a viral respiratory illness caused by a coronavirus that has not been found in people before.
  • Because this is a new virus, there are still things we do not know, such as how severe the illness can be, how well it is transmitted between people, and other features of the virus. More information will be provided when it is available.

Severity

  • Many cases have mild or moderate illness and do not require a clinic visit and most do not require hospitalization.
  • Those at highest risk for severe illness include older people or those that have certain underlying health conditions. These include such high risk conditions as a blood disorder, chronic kidney disease, chronic liver disease, compromised immune system, late term or recent pregnancy, endocrine disorders, metabolic disorders, heart disease, lung disease, neurological conditions. Check with your health care provider to see if you are considered high risk.

Symptoms of COVID-19

  • According to CDC, patients with confirmed COVID-19 have had mild to severe respiratory illness with symptoms of:
    • fever
    • cough
    • shortness of breath
  • Some patients have had other symptoms including muscle aches, headache, sore throat, or diarrhea.
  • These symptoms may appear 2-14 days after exposure.

How it spreads

  • The virus is thought to spread mainly from person-to-person through respiratory droplets produced when an infected person coughs or sneezes.
    • It spreads between people who are in close contact with one another (within about 6 feet).
    • These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
  • It is also possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes. Washing your hands and cleaning frequently touched surfaces often is a good way to prevent you from getting COVID-19 from touching surfaces.
  • Some spread might be possible before people show symptoms (when they are asymptomatic); there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads.
    • The virus spreads most easily when a person has symptoms and is coughing or sneezing.

Testing for COVID-19

  • People who do not have symptoms should not be tested for COVID-19. Due to national shortages of lab testing supplies, we do not have an unlimited capacity for testing.
  • We are currently prioritizing most testing for people who are hospitalized, health care workers, and people living or working in congregate living settings, such as nursing homes and others.

Corona Virus Impact on Elders

Aside from the direct impact to seniors and vulnerable adults themselves under lockdown and unable to see their family and friends, they are also the highest risk of serious complications or death from exposure.

According to CMS, it directs nursing homes to significantly restrict visitors and nonessential personnel, as well as restrict communal activities inside nursing homes. The new measures are CMS’s latest action to protect America’s seniors, who are at highest risk for complications from COVID-19. While visitor restrictions may be difficult for residents and families, it is an important temporary measure for their protection.

The Guidelines Have Exceptions for Compassionate Care Reasons

The guidelines do make an exception for compassionate care reasons, such as end-of-life situations, which will be handled on a case-by-case basis. Visitors and essential health care providers should be actively screened prior to any visit. Essential health care workers include, but are not limited to, facility staff, therapists, home health, hospice providers, dialysis staff, physicians, necessary lab/X-ray staff, clergy, mobility drivers for transport to essential appointments, local public health, the ombudsman, state agency survey staff, and Minnesota Department of Human Services (DHS) staff. Any essential health care provider exhibiting acute respiratory symptoms will be prohibited from entering the building.

Minnesota Has Corona Virus Situation MDH Website Updated Daily

This MDH site provides information on the totals of persons, testing for the virus, those testing positive and deaths related to COVID-19.

MINNESOTA DEPARTMENT OF HEALTH, MDH – PROVIDES DAILY UPDATES ON THE CORONA VIRUS COVID-19

Elder Care Facilities Must Ensure Proper Infectious Disease Control to Protect Residents and Staff

Nursing homes always have a duty to implement proper disease control to prevent or reduce the spread of infectious disease. The need for personal protective equipment, PPE, compliance with infectious disease control protocols and sanitation is essential to protect vulnerable residents.

CENTER FOR MEDICARE MEDICAID SERVICES GUIDANCE FOR HEALTH CARE WORKERS

CMS COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers

The Trump Administration is taking aggressive actions and exercising regulatory flexibilities to help healthcare providers contain the spread of 2019 Novel Coronavirus Disease (COVID-19). CMS is empowered to take proactive steps through 1135 waivers as well as, where applicable, authority granted under section 1812(f) of the Social Security Act (the Act) and rapidly expand the Administration’s aggressive efforts against COVID-19. As a result, the following blanket waivers are in effect, with a retroactive effective date of March 1, 2020 through the end of the emergency declaration

Hospital Patient Rights. CMS is waiving requirements under 42 CFR §482.13 only for hospitals that are considered to be impacted by a widespread outbreak of COVID-19. Hospitals that are located in a state which has widespread confirmed cases (i.e., 51 or more confirmed cases*) as updated on the CDC website, CDC States Reporting Cases of COVID-19, at https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html, would not be required to meet the following requirements:

• §482.13(d)(2) – With respect to timeframes in providing a copy of a medical record.

• §482.13(h) – Related to patient visitation, including the requirement to have written policies and procedures on visitation of patients who are in COVID-19 isolation and quarantine processes.

• §482.13(e)(1)(ii) – Regarding seclusion.

*The waiver flexibility is based on the number of confirmed cases as reported by CDC and will be assessed accordingly when corona virus COVID-19 confirmed cases decrease.

Long-Term Care Facilities and Skilled Nursing Facilities (SNFs) and/or Nursing Facilities (NFs)

• 3-Day Prior Hospitalization. Using the authority under Section 1812(f) of the Act, CMS is waiving the requirement for a 3-day prior hospitalization for coverage of a SNF stay, which provides temporary emergency coverage of SNF services without a qualifying hospital stay, for those people who experience dislocations, or are otherwise affected by COVID-19. In addition, for certain beneficiaries who recently exhausted their SNF benefits, it authorizes renewed SNF coverage without first having to start a new benefit period (this waiver will apply only for those beneficiaries who have been delayed or prevented by the emergency itself from commencing or completing the process of ending their current benefit period and renewing their SNF benefits that would have occurred under normal circumstances).

• Reporting Minimum Data Set. CMS is waiving 42 CFR 483.20 to provide relief to SNFs on the timeframe requirements for Minimum Data Set assessments and transmission.

• Staffing Data Submission. CMS is waiving 42 CFR 483.70(q) to provide relief to long-term care facilities on the requirements for submitting staffing data through the Payroll-Based Journal system.

• Waive Pre-Admission Screening and Annual Resident Review (PASARR). CMS is waiving 42 CFR 483.20(k) allowing states and nursing homes to suspend these assessments for new residents for 30 days. After 30 days, new patients admitted to nursing homes with a mental illness (MI) or intellectual disability (ID) should receive the assessment as soon as resources become available.

• Physical Environment. CMS is waiving requirements related at 42 CFR 483.90, specifically the following:

• Provided that the state has approved the location as one that sufficiently addresses safety and comfort for patients and staff, CMS is waiving requirements under § 483.90 to allow for a non-SNF building to be temporarily certified and available for use by a SNF in the event there are needs for isolation processes for COVID-19 positive residents, which may not be feasible in the existing SNF structure to ensure care and services during treatment for COVID-19 are available while protecting other vulnerable adults. CMS believes this will also provide another measure that will free up inpatient care beds at hospitals for the most acute patients while providing beds for those still in need of care. CMS will waive certain conditions of participation and certification requirements for opening a NF if the state determines there is a need to quickly stand up a temporary COVID-19 isolation and treatment location.

• CMS is also waiving requirements under 42 CFR 483.90 to temporarily allow for rooms in a long-term care facility not normally used as a resident’s room, to be used to accommodate beds and residents for resident care in emergencies and situations needed to help with surge capacity. Rooms that may be used for this purpose include activity rooms, meeting/conference rooms, dining rooms, or other rooms, as long as residents can be kept safe, comfortable, and other applicable requirements for participation are met. This can be done so long as it is not inconsistent with a state’s emergency preparedness or pandemic plan, or as directed by the local or state health department.

• Resident Groups. CMS is waiving the requirements at 42 CFR 483.10(f)(5), which ensure residents can participate in-person in resident groups. This waiver would only permit the facility to restrict in-person meetings during the national emergency given the recommendations of social distancing and limiting gatherings of more than ten people. Refraining from in-person gatherings will help prevent the spread of COVID-19.

•Training and Certification of Nurse Aides. CMS is waiving the requirements at 42 CFR 483.35(d) (with the exception of 42 CFR 483.35(d)(1)(i)), which require that a SNF and NF may not employ anyone for longer than four months unless they met the training and certification requirements under § 483.35(d). CMS is waiving these requirements to assist in potential staffing shortages seen with the COVID-19 pandemic. To ensure the health and safety of nursing home residents, CMS is not waiving 42 CFR § 483.35(d)(1)(i), which requires facilities to not use any individual working as a nurse aide for more than four months, on a full-time basis, unless that individual is competent to provide nursing and nursing related services. We further note that we are not waiving § 483.35(c), which requires facilities to ensure that nurse aides are able to demonstrate competency in skills and techniques necessary to care for residents’ needs, as identified through resident assessments, and described in the plan of care.


• Physician Visits in Skilled Nursing Facilities/Nursing Facilities. CMS is waiving the requirement in 42 CFR 483.30 for physicians and non-physician practitioners to perform in person visits for nursing home residents and allow visits to be conducted, as appropriate, via telehealth options.

• Resident roommates and grouping. CMS is waiving the requirements in 42 CFR 483.10(e) (5), (6), and (7) solely for the purposes of grouping or cohorting residents with respiratory illness symptoms and/or residents with a confirmed diagnosis of COVID-19, and separating them from residents who are asymptomatic or tested negative for COVID-19. This action waives a facility’s requirements, under 42 CFR 483.10, to provide for a resident to share a room with his or her roommate of choice in certain circumstances, to provide notice and rationale for changing a resident’s room, and to provide for a resident’s refusal a transfer to another room in the facility. This aligns with CDC guidance to preferably place residents in locations designed to care for COVID-19 residents, to prevent the transmission of COVID-19 to other residents.

• Resident Transfer and Discharge. CMS is waiving requirements in 42 CFR 483.10(c)(5); 483.15(c)(3), (c)(4)(ii), (c)(5)(i) and (iv), (c)(9), and (d); and § 483.21(a)(1)(i), (a)(2)(i), and (b) (2)(i) (with some exceptions) to allow a long term care (LTC) facility to transfer or discharge residents to another LTC facility solely for the following cohortingpurposes: 1. Transferring residents with symptoms of a respiratory infection or confirmed diagnosis of COVID-19 to another facility that agrees to accept each specific resident, and is dedicated to the care of such residents; 2. Transferring residents without symptoms of a respiratory infection or confirmed to not have COVID-19 to another facility that agrees to accept each specific resident, and is dedicated to the care of such residents to prevent them from acquiring COVID-19; or 3. Transferring residents without symptoms of a respiratory infection to another facility that agrees to accept each specific resident to observe for any signs or symptoms of a respiratory infection over 14 days.

Federal Law Mandates Infectious Disease Control in Nursing Homes

Pursuant to 42 CFR § 483.80 Infection control.

The facility must establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections.

(a) Infection prevention and control program. The facility must establish an infection prevention and control program (IPCP) that must include, at a minimum, the following elements:

(1) A system for preventing, identifying, reporting, investigating, and controlling infections and communicable diseases for all residents, staff, volunteers, visitors, and other individuals providing services under a contractual arrangement based upon the facility assessment conducted according to § 483.70(e) and following accepted national standards;

(2) Written standards, policies, and procedures for the program, which must include, but are not limited to:

(i) A system of surveillance designed to identify possible communicable diseases or infections before they can spread to other persons in the facility;

(ii) When and to whom possible incidents of communicable disease or infections should be reported;

(iii) Standard and transmission-based precautions to be followed to prevent spread of infections;

(iv) When and how isolation should be used for a resident; including but not limited to:

(A) The type and duration of the isolation, depending upon the infectious agent or organism involved, and

(B) A requirement that the isolation should be the least restrictive possible for the resident under the circumstances.

(v) The circumstances under which the facility must prohibit employees with a communicable disease or infected skin lesions from direct contact with residents or their food, if direct contact will transmit the disease; and

(vi) The hand hygiene procedures to be followed by staff involved in direct resident contact.

(3) An antibiotic stewardship program that includes antibiotic use protocols and a system to monitor antibiotic use.

(4) A system for recording incidents identified under the facility’s IPCP and the corrective actions taken by the facility.

(b) Infection preventionist. The facility must designate one or more individual(s) as the infection preventionist(s) (IPs) who are responsible for the facility’s IPCP. The IP must:

(1) Have primary professional training in nursing, medical technology, microbiology, epidemiology, or other related field;

(2) Be qualified by education, training, experience or certification;

(3) Work at least part-time at the facility; and

(4) Have completed specialized training in infection prevention and control.

(c) IP participation on quality assessment and assurance committee. The individual designated as the IP, or at least one of the individuals if there is more than one IP, must be a member of the facility’s quality assessment and assurance committee and report to the committee on the IPCP on a regular basis.

(d) Influenza and pneumococcal immunizations

(1) Influenza. The facility must develop policies and procedures to ensure that –

(i) Before offering the influenza immunization, each resident or the resident’s representative receives education regarding the benefits and potential side effects of the immunization;

(ii) Each resident is offered an influenza immunization October 1 through March 31 annually, unless the immunization is medically contraindicated or the resident has already been immunized during this time period;

(iii) The resident or the resident’s representative has the opportunity to refuse immunization; and

(iv) The resident’s medical record includes documentation that indicates, at a minimum, the following:

(A) That the resident or resident’s representative was provided education regarding the benefits and potential side effects of influenza immunization; and

(B) That the resident either received the influenza immunization or did not receive the influenza immunization due to medical contraindications or refusal.

(2) Pneumococcal disease. The facility must develop policies and procedures to ensure that –

(i) Before offering the pneumococcal immunization, each resident or the resident’s representative receives education regarding the benefits and potential side effects of the immunization;

(ii) Each resident is offered a pneumococcal immunization, unless the immunization is medically contraindicated or the resident has already been immunized;

(iii) The resident or the resident’s representative has the opportunity to refuse immunization; and

(iv) The resident’s medical record includes documentation that indicates, at a minimum, the following:

(A) That the resident or resident’s representative was provided education regarding the benefits and potential side effects of pneumococcal immunization; and

(B) That the resident either received the pneumococcal immunization or did not receive the pneumococcal immunization due to medical contraindication or refusal.

(e) Linens. Personnel must handle, store, process, and transport linens so as to prevent the spread of infection.

(f) Annual review. The facility will conduct an annual review of its IPCP and update their program, as necessary. [81 FR 68868, Oct. 4, 2016]

For a Free Consultation with an experienced elder abuse and neglect attorney call Kenneth LaBore at 612-743-9048.

Due to the lack of staffing and concerns about health care workers the residents are not only at risk of the virus and its complications, but also the ongoing common form of neglect in elder care facilities including for example medication management and administration or injuries from fall and fractures. Most forms of elder abuse are preventable with proper care and supervision.

Report Suspected Elder Abuse

Click Here For Link To Report Abuse To Adult Protection
Click Here For Link To Report Abuse To Adult Protection

If you have concerns about care provided to a resident in a nursing home, assisted living or any other type of elder care provider contact Attorney Kenneth LaBore for a Free Consultation to discuss your legal rights and options.

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Pressure Injuries Sores Decubitus

Decubitus Pressure Injuries Sores are Avoid Unless Underlying Clinical Reason for Sores

NPUAP Stage 3 Pressure Injury

Avoiding Nursing Home Pressure Ulcer Injury

Nursing homes are established to provide the elderly with the assistance and care they need. In many instances, your loved one may become sick or bed ridden due to an accident or disease, or suffer from a pressure injuries sores or other neglect.

If your loved one is currently on bed rest or disabled, it is critical that they are receiving the adequate nursing care, including sufficient food and hydration as well as personal attention from the nursing home staff, to ensure they have adequate movement to shift the weight bearing locations on their bodies.

A lack of mobility leading to prolonged periods of time of increased pressure on a resident’s heels, lower back and shoulders can lead to ulcerations, often called decubitus ulcer, pressure ulcer or bed sores.

Pressure Injuries Sores / Ulcers are often a sign that the nursing home staff is not assisting the residents to move freely or not turning them as they are meant to. This is a serious form of nursing home abuse that should be dealt with right away. Contacting a nursing home abuse lawyer is your first step against this type of mistreatment.

The Federal Code which regulation governs nursing homes considers pressure ulcers to Be “AVOIDABLE” and therefore preventable: Pressure ulcers / sores. Based on the comprehensive assessment of a resident, the facility must ensure that—

(1) A resident who enters the facility without pressure sores does not develop pressure sores unless the individual’s clinical condition demonstrates that they were unavoidable; and
(2) A resident having pressure sores receives necessary treatment and services to promote healing, prevent infection and prevent new sores from developing. (42 CFR § 483.25(c)).

Understanding Pressure Injuries Ulcers – Bed Sores

Bed sores also referred to as decubitus ulcers and pressure sores, are areas of damaged skin and tissue that develop due to a reduction in circulation often accompanied by excessive periods of unrelieved pressure on the affected area. In order to properly track the care provide for a pressure sore, it is essential that the staff understand the correct way to identify and chart the stages of pressure wounds.

The National Pressure Ulcer Advisory Panel (NPUAP) serves as the authoritative voice for improved patient outcomes in pressure ulcer prevention and treatment through public policy, education and research.

Pressure Ulcer Stages Revised by NPUAP

NPUAP Stage 1 Pressure Ulcer Injury: Non-blanchable erythema of intact skin Intact skin with a localized area of non-blanchable erythema, which may appear differently in darkly pigmented skin. Presence of blanchable erythema or changes in sensation, temperature, or firmness may precede visual changes. Color changes do not include purple or maroon discoloration; these may indicate deep tissue pressure injury.

Stage 2 Pressure Injury: Partial-thickness skin loss with exposed dermis Partial-thickness loss of skin with exposed dermis. The wound bed is viable, pink or red, moist, and may also present as an intact or ruptured serum-filled blister. Adipose (fat) is not visible and deeper tissues are not visible. Granulation tissue, slough and eschar are not present. These injuries commonly result from adverse microclimate and shear in the skin over the pelvis and shear in the heel. This stage should not be used to describe moisture associated skin damage (MASD) including incontinence associated dermatitis (IAD), intertriginous dermatitis (ITD), medical adhesive related skin injury (MARSI), or traumatic wounds (skin tears, burns, abrasions).

Stage 3 Pressure Injury: Full-thickness skin loss Full-thickness loss of skin, in which adipose (fat) is visible in the ulcer and granulation tissue and epibole (rolled wound edges) are often present. Slough and/or eschar may be visible. The depth of tissue damage varies by anatomical location; areas of significant adiposity can develop deep wounds. Undermining and tunneling may occur. Fascia, muscle, tendon, ligament, cartilage and/or bone are not exposed. If slough or eschar obscures the extent of tissue loss this is an Unstageable Pressure Injury.

Stage 4 Pressure Injury: Full-thickness skin and tissue loss Full-thickness skin and tissue loss with exposed or directly palpable fascia, muscle, tendon, ligament, cartilage or bone in the ulcer. Slough and/or eschar may be visible. Epibole (rolled edges), undermining and/or tunneling often occur. Depth varies by anatomical location. If slough or eschar obscures the extent of tissue loss this is an Unstageable Pressure Injury.

Unstageable Pressure Injury: Obscured full-thickness skin and tissue loss Full-thickness skin and tissue loss in which the extent of tissue damage within the ulcer cannot be confirmed because it is obscured by slough or eschar. If slough or eschar is removed, a Stage 3 or Stage 4 pressure injury will be revealed. Stable eschar (i.e. dry, adherent, intact without erythema or fluctuance) on the heel or ischemic limb should not be softened or removed.

For a free consultation with an experienced nursing home neglect attorney concerning pressure injuries, injury from mechanical patient lift, assault or other neglect contact Kenneth LaBore at 1-888-452-6589.

Nursing Home Abuse and Neglect Lawyer Kenneth LaBore Offers Free Consultations and Serves Clients Throughout the State of Minnesota Call Toll Free at 1-888-452-6589
Nursing Home Abuse and Neglect Lawyer Kenneth LaBore Offers Free Consultations and Serves Clients Throughout the State of Minnesota Call Toll Free at 1-888-452-6589
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Hoyer Mechanical Patient Lift Fall Injuries

Hoyer Type Lift Neglect Fall From Patient Lift
Hoyer Type Lift
Neglect Fall From Patient Lift

How to Avoid Injury From Mechanical Patient Lifts

Nursing Homes have a legal duty to ensure that all the patient lifts also known as Hoyer Lifts and other medical equipment, including the staff training, is up to the standards. It is important that all medical equipment be checked and serviced by professionals and that all staff are properly trained and qualified for their positions. In fact, nursing home law mandates they should be “as free of accidents as possible”. Patient lift injuries are some of the most common injuries in nursing homes since the residents often require assist with transfers many time a day. Often patient lifts called by generic terms such as: “hoyer lift”, “inva-lift”, “pro-lift”, “valero” and others – this can or cannot be the actual manufacturer of the lift.

Federal Regulation Mandates Concerning Falls – Patients Lifts

42 CFR 483.25(h) (h) Accidents. The facility must ensure that—

(1) The resident environment remains as free of accident hazards as is possible; and

(2) Each resident receives adequate supervision and assistance devices to prevent accidents.

Improper Patient Lift and Other Medical Equipment Concerns

There are a number of different problems surrounding the improper use of mechanical patient lift and other medical equipment in nursing home and other care facilities. Some of the cases we handle include the following:

  • Hazardous equipment – this includes patient lifts, beds, bathroom facilities and common room facilities
  • Lack of safety devices – bed rails, wheelchairs, etc.
  • Inadequate bedding – unclean sheets and linen, rickety beds, missing bed rails
  • Lack of hygiene and cleanliness
  • Lack of proper specialized care medical equipment including bariatric patient lifts, oxygen carts, tracheal suctioning equipment, etc.
  • Inadequate training and supervision of staff

Inadequate Medical Equipment Training

In addition to hazardous medical equipment concerns, you also need to be sure that the nurses, the doctors and the caregivers in the facility are properly qualified and trained. Because of the rise in the aging population, more and more nursing facilities are hiring people off the street that do not have the education, the qualifications or the background to work in this environment. For more information see: patient lift injuries. If a nursing home is not providing an adequate level of health care and support including the use of proper patient lifts and other medical equipment then it is important that the authorities be notified right away and that the nursing home neglect stops immediately. It is also important to have an attorney experienced with handling nursing home and patient lift injury cases to hold the facility accountable. If you or someone you love has suffered an injury from a patient lift or any abuse or neglect in a nursing home, then contact Attorney Kenneth LaBore locally at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com or fill out the form on this page. Disclaimer

Patient Lift Injuries are Preventable

Many falls and the serious injuries that can occur from mechanical patient lifts are preventable using the medical lift as outlined in the manual including the proper number of aides required for the transfer.

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UTI Complications Infections

Complications Can Be Serious

As a result of UTI complications many residents can require hospitalization and can die from blood poisoning known as sepsis.

Bladder and Urinary Infection Information

Urinary Tract Infection, UTI complications, Infectious Disease
Urinary Tract Infection, UTI complications, Infectious Disease

According to the Mayo Clinic in an article concerning urinary infections, UTI complications, the most common urinary infection occur mainly in women and affect the bladder and urethra. Urinary tract infections UTI are unfortunately common in nursing home and other elder care settings. UTIs can be very serious and if left untreated can result in sepsis leading to death. Infection of the bladder (cystitis) is usually caused by Escherichia coli (E. coli), a species of bacteria commonly found in the gastrointestinal tract. Sexual intercourse may lead to cystitis, but you don’t have to be sexually active to develop it. All women are susceptible to cystitis because of their anatomy — specifically, the close proximity of the urethra to the anus and the short distance from the urethral opening to the bladder. Infection of the urethra (urethritis) can occur when the gastrointestinal bacteria make the short trip from the anus to the urethra. In addition, because of the female urethra’s proximity to the vagina, sexually transmitted diseases (STDs), such as herpes simplex virus, gonorrhea and chlamydia, also are possible causes of urethritis. Often the use of a catheter without proper care can lead to a serious bladder or urinary infection. The infection can spread to the blood and cause the person to become septic. The Mayo Clinic defines sepsis as a potentially life-threatening complication of an infection. Sepsis occurs when chemicals released into the bloodstream to fight the infection trigger inflammation throughout the body. This inflammation can trigger a cascade of changes that can damage multiple organ systems, causing them to fail. If sepsis progresses to septic shock, blood pressure drops dramatically, which may lead to death. Anyone can develop sepsis, but it’s most common and most dangerous in elderly people or those with weakened immune systems. Early treatment of sepsis, usually with antibiotics and large amounts of intravenous fluids, improves chances for survival.

Male and Female Urinary Systems from Mayo Clinic

Female Urinary System Male Urinary System

Risk factors for Urinary Infection

Some people appear to be more likely than are others to develop urinary infections. Risk factors include:

• Being female. Half of all women will develop a urinary tract infection at some point during their lives, and many will experience more than one. A key reason is their anatomy. Women have a shorter urethra, which cuts down on the distance bacteria must travel to reach the bladder.

• Aging. After menopause, urinary tract infections may become more common because tissues of the vagina, urethra and the base of the bladder become thinner and more fragile due to loss of estrogen.

• Kidney stones or any other urinary obstruction.

• Diabetes and other chronic illnesses that may impair the immune system.

• Prolonged use of tubes (catheters) in the bladder.

Recommendations for Prevention of Urinary Infection

These steps may reduce your risk of urinary tract infections:

• Drink plenty of liquids, especially water. Cranberry juice may have infection-fighting properties. However, don’t drink cranberry juice if you’re taking the blood-thinning medication warfarin. Possible interactions between cranberry juice and warfarin may lead to bleeding.

• Wipe from front to back. Doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra.

• Avoid potentially irritating feminine products. Using deodorant sprays or other feminine products, such as douches and powders, in the genital area can irritate the urethra.

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Bacteria Infection Culture
Federal Regulations Concerning Urinary Infection

42 CFR §483.25 (d) Urinary Incontinence. Based on the resident’s comprehensive assessment, the facility must ensure that—

(1) A resident who enters the facility without an indwelling catheter is not catheterized unless the resident’s clinical condition demonstrates that cathertization was necessary; and

(2) A resident who is incontinent of bladder receives appropriate treatment and services to prevent urinary tract infections and to restore as much normal bladder function as possible.

If you or a loved one has suffered an injury from bladder or urinary infection or other neglect or abuse in a nursing home or other care facility that serves the elderly in Minnesota, Kenneth LaBore provides a free consultation and information regarding the obligations of the facility and your rights as a resident or concerned family member. To contact Attorney Kenneth L. LaBore, directly please send an email to KLaBore@mnnursinghomeneglect.com, or call Ken at 612-743-9048 or call him at his direct toll free number 1-888-452-6589. This website is not intended to provide legal advice as each situation is different and specific factual information must be obtained before an attorney is able to assess the legal questions relevant to your situation.

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Elder Physical Abuse

Physical Abuse to Nursing Home Residents or Vulnerable Adults
Physical Abuse to Nursing Home Residents or Vulnerable Adults

Physical Abuse in Nursing Homes by Staff and Fellow Residents is a Real Problem

Nursing home physical abuse happens more often than anyone wants to admit. This is often because the nursing home staff is not properly checked during the hiring process. Many nursing home residents who are victims of nursing home physical abuse will hide this abuse from others. They may feel ashamed or feel like it is their fault. Nursing home abuse can be hard to identify the signs of nursing home abuse and neglect. They may believe that they deserve the treatment or that there is nothing they can do about it. They might think staying silent is the best way to make the abuse stop or they may not even realize that their mistreatment is considered abuse. It is important that if you, or someone you love, is showing signs of physical abuse, that you consult a nursing home abuse lawyer immediately.

Nursing Homes Have a Duty to Reduce or Prevent Physical Abuse

All patients have the right to be free of all forms of abuse, including: violation of Minnesota Nursing Home Bills of Rights physical, sexually and verbal abuse. However, what goes on behind closed doors will often include all forms of abuse. Physical abuse comes in many forms including:

  • Seclusion/ Restriction of visitors/ Restriction of access to facilities and to go outdoors
  • Over medication
  • Physical harm from rough handling or hitting
  • Unnecessary use of restraints
  • Lack of proper care
  • Fellow Resident Left Unsupervised

If you suspect any form of physical abuse is occurring in a nursing home, it is important to take a stand and contact a nursing home abuse lawyer. The welfare of all residents should not be compromised by physical abuse and there are laws in place to protect residents and keep them safe. Physical Abuse Symptoms and Complications One of the most How to identify elder abuse and neglect of physical abuse is in a nursing home is bed sores or pressure sores on the body. However, this is not the only sign of physical abuse, additional signs can include:

In some instances, a resident may not display any signs of physical abuse. However, it is important to always be on the lookout for these signs and to speak with your loved one about the treatment he/she is receiving. Any type of abuse in a nursing home environment is wrong and a crime. Under the Minnesota Nursing Homes Residents Bill of Rights, all residents have the right to “be free from harm, including abuse, neglect and financial exploitation.” Physical abuse is the most common type of abuse in nursing homes but sexual abuse also occurs behind closed doors. No one wants to think that this could be happening to a family member.

Psychological and Physical Abuse of Nursing Home Residents

Sometimes it is difficult to determine if there was an incident of abuse or neglect suffered by a nursing home resident. Due to the complex nature of the care needs of many residents it is not always immediately evident if a person’s condition is the result of declining health or a disease process or due to either physical abuse or more subtly neglect.

Federal Regulations Prohibit Physical Abuse and Neglect of Nursing Home Residents

According to 42 CFR § 483.10 Resident rights, the resident has a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility. A facility must protect and promote the Minnesota Nursing Home Bills of Rights, including each of the following rights: (a) Exercise of rights. (1) The resident has the right to exercise his or her rights as a resident of the facility and as a citizen or resident of the United States. (2) The resident has the right to be free of interference, coercion, discrimination, and reprisal from the facility in exercising his or her rights. (3) In the case of a resident adjudged incompetent under the laws of a State by a court of competent jurisdiction, the rights of the resident are exercised by the person appointed under State law to act on the resident’s behalf. (4) In the case of a resident who has not been adjudged incompetent by the State court, any legal-surrogate designated in accordance with State law may exercise the resident’s rights to the extent provided by State law.

Definitions of Physical Abuse and Neglect

Nursing Home Abuse

Nursing Home Neglect

Reporting Nursing Home Abuse and Neglect

Nursing Home Resident Rights

If You Suspect Physical Abuse Contact Attorney Kenneth LaBore

If you or a loved one has suffered an injury from physical abuse or neglect in a nursing home or other care facility that serves the elderly in Minnesota, Kenneth LaBore provides a free consultation and information regarding the obligations of the facility and your rights as a resident or concerned family member. To contact Attorney Kenneth L. LaBore directly please send an email to: KLaBore@MNnursinghomeneglect.com, or call Ken at 612-743-9048 or toll free at 1-888-452-6589. Disclaimer

Free Consultation on Issues of Elder Abuse and Neglect Serving all of Minnesota Toll Free 1-888-452-6589
Free Consultation on Issues of Elder Abuse and Neglect Serving all of Minnesota Toll Free 1-888-452-6589
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