Archive for the ‘Wound Care’ Category


Stage IV Pressure Sore Suffered by Resident at the Estates at Bloomington

Written By: Kenneth LaBore | Published On: 19th March 2017 | Category: Pressure Ulcers, Wound Care | RSS Feed
NPUAP Stage 4 Pressure Injury with Epibole - Neglect at Golden Living Center Bloomington AKA the Estates at Bloomington

NPUAP Stage 4 Pressure Injury with Epibole – Neglect at Golden Living Center Bloomington AKA the Estates at Bloomington

Substantiated Neglect After Serious Pressure Sores at the Estates at Bloomington

In a report dated August 25, 2017, the Minnesota Department of Health cited Golden LivingCenter in Bloomington now know as the Estates at Bloomington with neglect after a resident developed a stage IV pressure ulcer at the facility.

Pressure Ulcer Wounds Develop for Resident at the Estates at Bloomington

Based on a preponderance of the evidence, neglect occurred when the facility failed to adequately assess, monitor, and implement interventions to prevent and heal pressure ulcers.  The resident re-developed coccyx/buttocks pressure ulcers, which worsened.

The resident was admitted to the facility with a sacral pressure ulcer.  Staff implemented interventions to prevent the development of additional pressure ulcers.  Over the next several months, the sacral pressure ulcer healed, re-developed, and healed again.  New interventions were implemented; however, the resident’s care plan, and direct care staff aside sheet were not kept up to date with instructions for direct staff on how frequently to turn and reposition the resident.

Approximately two months after the last pressure ulcer healed, the resident developed two stage two pressure ulcers to her/his coccyx/buttocks.  Staff did not notify or obtain orders for treatment from the physician until 28 days later, when the ulcers had worsened and resident had four open areas to her/his buttocks.  One week later, the resident went to the hospital due to a decrease in responsiveness and a temperature of 101.6 degrees Fahrenheit.

According to the records, the hospital admitted the resident with a diagnosis of sepsis as well as a catheter associated urinary tract infection.  Upon admission into the hospital, the resident’s pressure ulcers had necrotic tissue with surrounding skin cellulitis.  The sacral bone was exposed.

When interviewed, the nurse practitioner stated s/he had never previously examined the resident’s pressure ulcers due to resident refusals.  The nurse practitioner was not informed of the pressure ulcers redevelopment until approximately one month after staff observed the new pressure ulcers.  The nurse practitioner indicated the facility’s lack of monitoring, and delay in treatment contributed to the worsening of the resident’s pressure ulcers.

The resident did not return to the facility.

Report Suspected Neglect Pressure Ulcers and Wounds – the Estates at Bloomington

Click Here For Link To Report Abuse To Adult Protection

Click Here For Link To Report Abuse To Adult Protection

For more information from the Minnesota Department of Health, Office of Health Facility Complaints concerning nursing homes, assisted living and other elder care providers view resolved complaints at the MDH website.

If you have concerns about pressure ulcers or any other form of elder abuse or neglect contact Minnesota Elder Abuse Attorney Kenneth LaBore toll free at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

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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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KSMS Our House Austin Neglect Substantiated

Written By: Kenneth LaBore | Published On: 18th March 2017 | Category: Bed Sores and Pressure Ulcers, Failure to Resond to Change in Condition, Pressure Ulcers, Wound Care | RSS Feed
Failure to Provide Proper Wound Care and Assessment - Pressure Sores - Ulcers - KSMS Our House in Austin Minnesota

Failure to Provide Proper Wound Care and Assessment – Pressure Sores – Ulcers – KSMS Our House in Austin Minnesota

KSMS Our House Austin Cited with Neglect After Serious Wounds

In a report from the Minnesota Department of Health dated, February 13, 2017, it is alleged that a client at KSMS Our House in Austin Minnesota was neglected when s/he presented to the hospital with an elevated temperature, a leg severely bruised with blisters, and a large ulcerated sore on his/her tailbone that was infected.

Negligence Supported Against KSMS Our House After Ulcerated Sore

Based on the report a preponderance of evidence, neglect occurred when the facility failed to provide proper care and treatment of the client’s coccyx, buttock, and heel wounds.  The client had recurrent problems with wound healing for over two years .  The facility Registered Nurse (RN) failed to provide adequate wound assessment and monitoring of the client’s wounds, and failed to provide direction and training to direct care staff who were to performing the delegated nursing task of wound care.

The client was cognitively impaired and was completely reliant on caregivers for all activities of daily living.  The client could not walk and was transferred by two staff with a mechanical lift. The client was incontinent of bowel and bladder and staff performed the client’s incontinence care.  The client had pressure sores on the coccyx and left heel for over two years.  Direct care staff performed the client’s daily wound treatments, without any written instructions or training by the RN.

The client’s only wound assessment by the facility RN was completed in 2014.  At that time, the client had a stage II pressure ulcer on the inside of the right buttock measuring 2 centimeters (cm) x 1.5 cm.  There was no evidence of further RN oversight of the client’s wound.  The client’s medical record was void of any wound assessments, pertaining to the client’s heel ulcer.

In March 2016, a hospital record indicated that the client still had the stage II pressure ulcer on the right buttock and had also developing stage II pressure ulcer on the sacrum.  Discharge orders to the facility including instructions for dressing changes and instructions to frequently change the client’s position.

In May 2016, direct care staff documented that the client had a “big open sore on her bottom” and the client’s family member took the client to the hospital for evaluation.  A culture of the wound drainage was taken.  Hospital discharge orders provided to the facility included instructions for dressing changes, including the application of antibiotic ointment for ten days.

In July 2016, a hospital record indicated that the client had multiple areas of dermis loss on the buttocks and inner groin, including a 4.5 cm x 0.7 cm open lesion on the left inner groin, a 3.5 x 2.0 cm open ulceration on the right lower buttock, a 4.5 cm x 2.0 cm open ulceration on the right buttock, a 0.3 cm x 5.0 cm open ulceration on the gluteal fold, and two open areas on the left buttock measuring 0.5. cm x 0.5 cm and 0.5 cm x 0.8 cm.  All areas were macerated.  Hospital discharge orders were provided to the facility including instructions for wound care, perineal care, and to document the client’s wound healing each day.

In August 2016, a hospital record indicated that the client had an unstageable ulcer on the left heel and the client was admitted for hospitalization due to osteomyelitis of the heel wound with culture results positive for MRSA and Strep.  The client underwent a surgical limb salvage procedure for the left heel.  The client’s buttock and groin wounds were also evaluated during hospitalization.  Hospital discharge orders provided to the facility included instructions for wound treatment and care of the surgical incision, which entailed application of an ace wrap to the client’s left leg.

In September 2016, a hospital record indicated that the client was emergently hospitalized due to a change in condition.  On hospital arrival, the client was unresponsive, had a fever of 101 degrees, oxygen saturations not above 87% on six liters of oxygen, bilateral blue feet, and a left lower leg that was red and swollen with fluid-filled blisters.  The client was admitted to the ICU with polymicrobial infections of the left leg, sacrum and urinary tract, along with pneumonia.  The client’s condition did not improve with volume resuscitation and broad-spectrum antibiotics.  Comfort measures were elected and the client was discharged to a skilled care facility on hospice care.

All of the client’s hospital visits from March 2016 to September 2016 were facilitated by the client’s family member, based on reports direct care staff gave the family member about the deteriorating condition of the client’s wounds.  During the same time period from March 2016 to September 2016, multiple direct care staff had informed the RN that the client’s wounds were worsening, looked infected, and had drainage that soaked through the dressings.  There was no evidence that the RN ever addressed the client’s wound, monitored the status of the client’s wounds for healing, or followed up on the culture results.  The client’s medical record was void of any wound assessments from March 2016 to September 2016 and void of any progress notes or evidence of follow-up about the client’s wound culture.  During the period March 2016 to September 2016, direct care staff performed the client’s wound dressings, without any evidence of training by the RN including the safe handling of contaminated materials.  The client’s care plan completed by the RN did not contain any information about the client’s wounds.

After the client had the left heel surgical procedure in August 2016, hospital discharge instructions included application of an ace wrap to the client’s left leg following incision care.  Only the RN applied the client’s ace wrap.  There was no evidence that the RN monitored the client’s left leg for circulation, motor ability, or sensation.  When the client was re-hospitalized in September 2016, the hospital record noted that the client’s left lower leg had an “an ace wrap that was bound too tightly” causing the appearance of “rug-burns”, in addition to an obvious cellulitis of the lower extremity which was red and swollen with fluid blisters.

When interviewed, the facility RN had no explanation regarding the inadequate nurse oversight of the client’s wounds.

__________________________

Tibia Fracture - Allegation of Neglect - Fractured Tibia - KSMS Our House in Austin

Tibia Fracture – Allegation of Neglect – Fractured Tibia – KSMS Our House in Austin

Tibia Fracture to Client Leads to MDH Complaint of Neglect Against KSMS Our House

In a report from the Minnesota Department of Health, dated February 13, 2017, it was alleged that a client at KSMS Our House in Austin Minnesota was neglected when s/he had a fall.  The client had progressively worse pain after the fall and it was discovered ten days later that the client had a tibia fracture.

Substantiated Neglect Complaint After Client Fractures Tibia in Fall

Based on the report a preponderance of evidence, neglect occurred when the facility failed to thoroughly assess the client after a fall, monitor the client’s change in condition, and intervene with proper nursing care that addressed the client’s acute needs.  Ten days after the fall, it was discovered that the client had a broken leg.

The client used a wheelchair propelled with his/her feet.  Due to unsteadiness when standing, balance problems, and history of falls, the client needed the assistance of one staff to stand and pivot for transfers.  The client needed the assistance of one staff for all activities of daily living.  The client could verbally express his/her needs and desires.  The client lived alone in an apartment and wore a pendant that s/he could push to alert staff when s/he needed help.

During a night in July 2016, the client paged staff at 3:45 a.m. because s/he had fallen in his/her apartment.  Direct care staff responded and found the client sitting on the floor.  The client told staff that his/her knees hurt.  After the client fell, the client was not thoroughly assessed by a nurse at any time for ten days, even though multiple direct care staff repeatedly reported to the RN the client’s symptoms of leg pain, leg swelling, bruising, difficulty with transfers, and inability to propel the wheelchair independently.  Ten days after the fall, the client’s family member took the client to the hospital due to the client’s complaints of ongoing severe leg pain.

The client’s hospital record indicated that the client had severe pain with movement and positive changes of the right leg and decreased range of motion in the right knee.  The client’s right and left anterior knees had diffuse bruising with greater bruising on the right lateral tibia, and right upper arm.  The client’s right calf was red, swollen, and warm to touch and was suspicious for cellulitis.  X-rays confirmed the client had a right tibial plateau fracture.  Conservative management of the fracture was elected.  The client was hospitalized to treat the cellulitis with intravenous antibiotics.  During hospitalization, the client declined with acute kidney injury and altered mental status.  After being hospitalized for seven days, the client was discharged to a skilled care facility.

The facility has a full-time Registered Nursing (RN) and nurses on-call at all times, when the facility’s RN is not onsite.  There was no evidence that a nurse thoroughly assessed the client’s status at any time during the ten days the client exhibited symptoms of fracture.  The facility’s RN made only two brief progress notes (a note two days after the fall and another note the day before the client went to the hospital) which did not include any detailed assessment information or address changes in the client’s condition that had been reported by direct care staff.  The facility’s medical record was void of any nursing progress notes prior to the client’s fall.

Statements by the facility’s RN concerning the client’s post-fall status were contradictory to multiple interviews of the direct care staff who provided care to the client after the client fell.

__________________________

 

Failure to Assess Change in Condition Fractured Leg

Failure to Assess Change in Condition Fractured Leg, KSMS Our House Austin

KSMS Our House Austin Complaint Findings for Neglect – Failure to Assess

In a report concluded on November 13, 2014, the Minnesota Department of Health cites KSMS Our House Austin for neglect of health care failure to assess change in condition.

It is alleged that neglect of health care occurred when the alleged perpetrator (AP) failed to assess a client #1’s pain.  The client had a broken leg.  In addition; the AP failed to send another client #2 to the hospital in a timely manner after a change in health status.

Substantiated Neglect Against KSMS Our House Austin

Based on preponderance of evidence neglect did occur when a client’s change in condition was not assessed by the AP to ensure timely medical intervention.

The client had diagnoses that included diabetes mellitus, chronic obstructive pulmonary disease (COPD), Coronary Artery Disease (CAD) and Asthma.  The client received assistance of one staff with activities of daily living (ADL) skills that included walking, medication administration, and daily accuceheck (blood sugar monitoring).  The client was independent with administration of his/her insulin injections.  The client’s medication regimen included pain control of Oxycodone (narcotic) 30 milligrams (mg) extended release tablets take one tablet by mouth every 12 hours. Oxycodone/APAP (narcotic) 5-325 mg tablet; take one or two tablets by mouth every 4 -6 hours as needed for pain.

On the morning of the client’s change in condition at 8:00 a.m., the staff identified, the client was “pretty out of it”.  The client had oxygen levels of 86% to 93%, required assistance to put medications in his/her mouth, and was unable to self-administer the insulin.  The staff notified the AP of the client’s change in condition.  The AP instructed staff to administer the client’s insulin, but did not assess the client’s condition in relation to the altered mental status and inability to self-administer medications.  The AP did not provide the staff with any parameters for monitoring the client or when to call the AP back.  In addition, the AP informed the staff not to call 911 unless the client was unconscious.  Later the same day, on the evening shift of work, the client was not able to stand up.  The staff notified the AP of the client’s inability to stand.  The AP instructed staff to use a mechanical lift for transfers without an assessment of the client’s status or provide the staff with any parameters for monitoring the client or when to call the AP back.  Eleven hours after the first reported change in condition had not improved and staff identified the client had an oxygen level of 86%, and a temperature of 101.5.  Staff did not call the AP for direction instead called 911 and the client was transported to the hospital and admitted to the hospital intensive care with a diagnosis of Toxic/metabolic Oxycodone, intermittent myoclonic jerks, acute delirium and pneumonia – likely from aspiration.  The client returned to the facility after a five-day hospital stay.

For more information from the Minnesota Department of Health, Office of Health Facility Complaints concerning nursing homes, assisted living and other elder care providers view resolved complaints at the MDH website.

If you have concerns about a failure to assess a change in condition, falls, fractures or any other form of elder abuse or neglect contact Elder Abuse and Neglect Attorney Kenneth LaBore at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

Disclaimer

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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Nursing Home Bedsore Lawyer

Written By: Kenneth LaBore | Published On: 31st January 2017 | Category: Inadequate Staffing/Training, Nursing Home Abuse and Neglect, Pressure Ulcers, Wound Care | RSS Feed

Minnesota Nursing Home Bedsore Lawyer

Minnesota Nursing Home Bedsore Lawyer

Minnesota Nursing Home Bedsore Lawyer

Elder care nursing home bedsore lawyer cases usually involve a pressure sore or ulcer also known as bedsore which started or worsened due to a lack of care.  Disabled residents require assistance with many activities of daily living including in many situations turning and repositioning themselves in bed.  Many pressure sores can be prevented or diminished if there is pressure relief from areas likely to develop wounds such as the back, rear-end/coccyx, and heels.

Often times pressure sores and ulcers occur due to a lack of well trained staff, particularly nursing aides.  According to federal regulations, the facility must have sufficient nursing staff with the appropriate competencies and skills sets to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident, as determined by resident assessments and individual plans of care and considering the number, acuity and diagnoses of the facility’s resident population in accordance with the facility assessment required at §483.70(e).

(a) Sufficient staff. (1) The facility must provide services by sufficient numbers of each of the following types of personnel on a 24-hour basis to provide nursing care to all residents in accordance with resident care plans.

Federal and State Regulations Summary From Nursing Home Bedsore Lawyer

Federal regulations mandate that based on the comprehensive assessment of a resident, the facility must ensure that—

(i) A resident receives care, consistent with professional standards of practice, to prevent pressure ulcers and does not develop pressure ulcers unless the individual’s clinical condition demonstrates that they were unavoidable; and

(ii) A resident with pressure ulcers receives necessary treatment and services, consistent with professional standards of practice, to promote healing, prevent infection and prevent new ulcers from developing.

Minnesota regulation in Statute 144.7065,requires reporting [by the facility to the Commissioner of the Department of Health] of Stage 3 or 4 or Unstageable ulcers acquired after admission to a facility, excluding progression from Stage 2 to Stage 3 if Stage 2 was recognized upon admission.

Nursing Home Bedsore Lawyer Kenneth LaBore

If you have questions about nursing home abuse and neglect and want accountability for preventable bed sores contact Kenneth LaBore for a free consultation.  There is no fee unless there is a verdict or settlement offer from the wrongdoer.  Mr. LaBore can be reached directly at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

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Keystone Highland Park Cited with Neglect Concerning Wound Care

Written By: Kenneth LaBore | Published On: 30th August 2016 | Category: Wound Care | RSS Feed
Keystone Highland Park Cited With Inadequate Wound Care of Resident

Keystone Highland Park Cited With Inadequate Wound Care of Resident

Wound Care Issues Lead to MDH Complaint at Keystone Highland Park in St. Paul

In a report dated June 24, 2016, it is alleged that a client was neglected at Keystone Highland Park when the facility failed to follow the physician’s orders regarding wound care and also did not provide adequate personal cares for the client.  The facility was not tracking the treatment of wound care.  The client’s wound has worsened.

Keystone Highland Park Cited Concerning Wound Care Problems

Based on the preponderance of evidence, neglect of health care occurred when the facility failed to provide the necessary care and treatment for the client’s sacral wound on a consistent basis, which contributed to the client’s wound worsening and requiring the client to be hospitalized.

The client was admitted to the facility with a sacral ulcer that measured 2 cm by 1 cm.  The client was incontinent of urine and required assistance with toileting and stand-by-assist with ambulation.

The client had physician’s orders on admission for daily wound care that included applying a wound product and covering the wound with a dressing.  An outside home care agency was also involved in providing the wound care three times a week.  There was no evidence the licensee coordinated the treatment of the client’s wound with the outside home care agency to ensure that the wound treatment was done a daily basis.  There was no evidence that the licensee completed the client’s wound treatment for the first seven days the client was at the facility.  The outside home care agency two times during the first seven days.

The client’s care plan on admission identified the client had an open area to the left of the midline, but lacked direction to staff to assist/remind the client to keep off the open area to relieve pressure to the area.

For more information from the Minnesota Department of Health, Office of Health Facility Complaints concerning nursing homes, assisted living and other elder care providers view resolved complaints at the MDH website.

If you have concerns about inadequate wound care, medication errors, improper use of medical equipment, falls or any other form of elder abuse or neglect contact Minnesota Elder Abuse Attorney Kenneth LaBore at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

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Valleyview Owatonna Neglect Substantiated

Written By: Kenneth LaBore | Published On: 15th April 2015 | Category: Wound Care | RSS Feed
Surgical Wound Care

Valleyview Owatonna Complaint for Failing to Respond to Change in Wound Condition

Valleyview Owatonna Complaint Findings for Neglect

In a report concluded on January 10, 2013, the Minnesota Department of Health cites Valleyview Owatonna for neglect of health care – wound.

Based on the preponderance of evidence neglect is substantiated.  Neglect occurred when the facility failed to assess, monitor and implement physician’s orders related to post-operative follow-up care of the client’s left ankle incision after the sutures were removed.  The client required two surgeries for irrigation and debridement of the incision due to infection.

Substantiated Neglect Valleyview Owatonna – Failure to Assess and Monitor

State and federal regulations require that a nursing home facility monitor residents for changes in condition and take action to intervene on their behalf.  When providing wound care, the wound must be carefully monitored by qualified nursing or medical professionals to see if the wound is healing or expanding, getting infected or some other change which would require a change in the treatment plan and care being provided to the resident.  The assessment of the skin condition including wounds is part of the admissions and regular care plan review for the resident.

According to 42 CFR 483.20(2) the assessment including a skin assessment must be performed subject to the timeframes prescribed in § 413.343(b) of this chapter, a facility must conduct a comprehensive assessment of a resident in accordance with the timeframes specified in paragraphs (b)(2) (i) through (iii) of this section. The timeframes prescribed in § 413.343(b) of this chapter do not apply to CAHs.

(i) Within 14 calendar days after admission, excluding readmissions in which there is no significant change in the resident’s physical or mental condition. (For purposes of this section, “readmission” means a return to the facility following a temporary absence for hospitalization or for therapeutic leave.)

(ii) Within 14 calendar days after the facility determines, or should have determined, that there has been a significant change in the resident’s physical or mental condition. (For purposes of this section, a “significant change” means a major decline or improvement in the resident’s status that will not normally resolve itself without further intervention by staff or by implementing standard disease-related clinical interventions, that has an impact on more than one area of the resident’s health status, and requires interdisciplinary review or revision of the care plan, or both.)

(iii) Not less often than once every 12 months

For more information from the Minnesota Department of Health, Office of Health Facility Complaints concerning nursing homes, assisted living and other elder care providers view resolved complaints at the MDH website.

If you have concerns about pressure sore, wounds or any other form of elder abuse or neglect contact Elder Abuse and Neglect Attorney Kenneth LaBore at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

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Chosen Valley Care Center Chatfield Neglect Substantiated

Written By: Kenneth LaBore | Published On: 8th March 2015 | Category: Nursing Home Abuse and Neglect, Pressure Ulcers, Wound Care | RSS Feed
Neglect Failure to Provide Adequate Wound Care, Sepsis

Neglect Failure to Provide Adequate Wound Care, Sepsis, Chosen Valley Care Center Chatfield

Chosen Valley Care Center Chatfield – Neglect – Improper Wound Care

In a report concluded on January 15, 2015, the Minnesota Department of Health cites Chosen Valley Care Center Chatfield for neglect – health care.

It is alleged that neglect occurred when staff failed to adequately care for resident’s wound.  The resident was taken to the hospital and had sepsis.

Substantiated Neglect Wound Care at Chosen Valley Care Center Chatfield Minnesota – Pressure Ulcer

Based on a preponderance of evidence, neglect of care did occur when the facility staff did not monitor and provide the necessary care when the resident developed a right heel pressure ulcer.  The facility failed to ensure the resident’s physician was informed of changes in the resident’s condition.  The resident was admitted to the hospital with a diagnosis that included right necrotic heel lesion and right hallux (great toe) early gangrene.

Information – Pressure Wounds – Nursing Home Injuries

Here are some summaries on various topics related to nursing home falls and fractures, pressure sores and other nursing home injuries:

Bedsore Stages

Pressure Injury Stages

Pressure Sore Injury

Pressure Injuries

For more information from the Minnesota Department of Health, Office of Health Facility Complaints concerning nursing homes, assisted living and other elder care providers view resolved complaints at the MDH website.

If you have concerns about neglect of health care, wound care, pressure sore injuries, or any other form of elder abuse or neglect contact Minnesota Nursing Home Neglect Attorney Kenneth LaBore at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

Disclaimer

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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