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Over-Drugging Nursing Home Residents Still Prevalent

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Medication Errors

Medication Errors

Over-Drugging Nursing Home Residents Still Prevalent

By Kosieradzki Smith Law Firm

December 1, 2013

Forbes magazine reports in its article entitled “Dementia Patients Still Getting Dangerous Antipsychotic Drugs In Nursing Homes,” that more “than one out of every five nursing home residents is still being given powerful antipsychotic drugs despite a growing consensus that they are inappropriate and often dangerous. These drugs frequently are given to “calm” dementia patients even though many are approved only for the treatment of diseases such as schizophrenia.”

Forbes reports that “[d]espite a federal initiative, a $2.2 billion legal settlement by [Johnson & Johnson] earlier this month, and the support of many nursing home and consumer organizations, it has been extremely difficult to reduce the overuse of these drugs.”

Forbes reports that the federal Centers for Medicare and Medicaid Services (Medicare) kicked off an effort in March, 2012 “aimed at reducing nursing home use of antipsychotic drugs from nearly 24 percent to about 20 percent by the end of that year.” (CMS pushed back the goal to the end of 2013.)  Forbes reports that CMS that more than 21 percent of long-stay nursing home residents are still getting these drugs and that a “coalition of patient advocates estimates that represents more than 300,000 residents.”

Forbes reports that “the root problem may be with nursing homes themselves. Many find it easy to manage anxiety, confusion, or behavioral issues of their residents with drugs. It is, for too many facilities, a convenient solution even though most research shows few benefits for residents and many risks.”

The Forbes article explains that “there are alternatives. Residents are often agitated because  they are in pain or discomfort. Facilities need to make the effort to identify those causes and address them.”

The Kosieradzki • Smith Law Firm represents clients in cases involving catastrophic injury caused by nursing homes and other care facilities that fail to provide proper care. If you believe you or your loved one has suffered medication errors because the nursing home failed to do its job, take action and contact the Kosieradzki • Smith Law Firm online or call us toll-free at (877) 552-2873 to set up a no-cost, no-obligation consultation.

Good Samaritan’s Nursing Home in Waconia Neglects Its Resident

By Kosieradzki Smith Law Firm

November 25, 2013

The Minnesota Department of Health (MDH) has completed its investigation of neglect concerns at Good Samaritan’s nursing home in Waconia, Minnesota.  A complaint was filed with the Department alleging that the nursing home failed to administer Coumadin for 10 days.  The resident developed a clot in the left femoral artery.

The Department investigated the matter and found that allegation was substantiated.  The resident did not receive Coumadin (an anti-coagulant) for ten days as a result of Good Samaritan’s medication error in transcribing the doctor’s order.  The MDH found that due to Good Samaritan’s error, “the resident’s Coumadin order disappeared from the [nursing home’s] electronic medical record.”   The MDH determined that Good Samaritan is responsible for neglect of the facility’s resident.  [Case no. H5234012]

The Kosieradzki • Smith Law Firm represents clients in cases involving catastrophic injury caused by nursing homes and other care facilities that fail to provide proper care. If you believe your loved one has been harmed due neglect or abuse in a nursing home, take action and contact the Kosieradzki • Smith Law Firm online or call us toll-free at (877) 552-2873 to set up a no-cost, no-obligation consultation.

Addicted Nurses Keep Licenses in Minnesota

By Kosieradzki Smith Law Firm

November 8, 2013

According to an investigative report by the Minneapolis Star Tribune, there are nurses who continue to steal narcotics or practice while impaired under monitoring by the state that’s supposed to stop them.

Base on its examination of more than 1,000 Minnesota Board of Nursing disciplinary records, there are 112 Minnesota nurses since 2010 who are licensed to practice despite having either stolen narcotics on the job, fraudulently obtained prescriptions, or practiced while impaired by drugs or alcohol.

The report states, “Nearly all of those nurses have kept their licenses by taking part in a state program created to protect the public from health professionals who are alcoholics or drug addicts. To avoid further board action, they have to prove they are sober and getting treatment. Yet records show that nurses have been able to keep practicing while abusing drugs or alcohol, raising questions about whether the program actually works.”

The investigation further reveal that for “at least 67 currently licensed nurses, the state monitoring agency, which is called the Health Professionals Services Program (HPSP), has become a revolving door, Nursing Board records show. They have failed out of the program, only to be sent back by the Nursing Board and allowed to keep practicing.”

The Star Tribune revealed its finding to Minnesota Governor Mark Dayton, who responded that system sounded “very wrong.”  According to the report, the governor said that “There should be consequences. Somebody who’s using illegal drugs or abusing alcohol or engaging in misconduct or malpractice should understand there’s no place for them in the health care professions.”

Click here to read to full article.

The Kosieradzki • Smith Law Firm represents clients in cases involving catastrophic injury caused by nursing homes and other care facilities that fail to provide proper care. If you believe your loved one has been harmed due neglect or abuse in a nursing home, take action and contact the Kosieradzki • Smith Law Firm online or call us toll-free at (877) 552-2873 to set up a no-cost, no-obligation consultation.

TOPICS:   Medication Errors

Norris Square Employee Takes Resident’s Drugs

By Kosieradzki Smith Law Firm

October 22, 2013

The Minnesota Department of Health (MDH) has completed its investigation of financial exploitation concerns at Norris Square, an assisted living facility in Cottage Grove, Minnesota. A complaint was filed alleging that an employee took a resident’s narcotic medications without permission. The Department investigation substantiated the allegation. The resident had physician orders for Oxycodone. The medication was kept in a locked box in the resident’s room, and only employees had access to the box. A pill count on the date of incident found that 30 pills were missing. The resident’s family had installed a camera in the resident’s room, and upon reviewing the film, it was determined that the suspected employee had stolen the medication. [Case no. HL27946002]

The Kosieradzki • Smith Law Firm represents clients in cases involving catastrophic injury caused by nursing homes and other care facilities that fail to provide proper care. If you believe your loved one has been harmed due neglect or abuse in a nursing home, take action and contact the Kosieradzki • Smith Law Firm online or call us toll-free at (877) 552-2873 to set up a no-cost, no-obligation consultation.

Medicare’s New Data on Mismedication of Nursing Home Residents

By Kosieradzki Smith Law Firm

September 9, 2013

Many nursing home residents need several medications as part of their treatment plan. Some nursing homes have used medications to sedate residents more for the convenience of the nursing home staff than for the welfare of patients. CMS data show that in 2010, more than 17 percent of residents received daily doses of antipsychotic drugs exceeding recommended levels. The CMS goal is to get the offending number under 15 percent.

Mismedication is a common problem, but new data show that the use of antipsychotic drugs is down across the United States. In July, Nursing Home Compare revealed the new numbers from a CMS study:

  • The national prevalence of antipsychotic use in long stay nursing home residents has been reduced by 9.1 percent by the first quarter of 2013, compared to the last quarter of 2011.
  • There are approximately 30,000 fewer nursing home residents on these medications now than if the prevalence had remained at the pre-National Partnership level.
  • At least 11 states have hit or exceeded a 15 percent target and others are quickly approaching that goal. The states that have met or exceeded the target are: Alabama, Delaware, Georgia, Kentucky, Maine, North Carolina, Oklahoma, Rhode Island, South Carolina, Tennessee and Vermont.

CMS created the National Partnership to Improve Dementia Care in 2012. The Partnership plans to keep decreasing mismedication in the following ways:

  • Enhanced training for nursing home providers and state surveyor
  • Increased transparency by making antipsychotic use data available online at Nursing Home Compare
  • Highlighting alternate strategies to improve dementia care

The Partnership is not a perfect solution, but it is a step toward solving this nationwide problem. Risks of mismedication continue to plague nursing home residents.

The Kosieradzki • Smith Law Firm represents clients in cases involving catastrophic injury caused by nursing homes and other care facilities that fail to provide proper care. If you believe your loved one has been harmed due neglect or abuse in a nursing home, take action and contact the Kosieradzki • Smith Law Firm online or call us toll-free at (877) 552-2873 to set up a no-cost, no-obligation consultation.

TOPICS:   Medication Errors

Details about the Faribault Care Center Nursing Home in Minnesota

By Kosieradzki Smith Law Firm

September 7, 2013

Medicare rates nursing homes, including this 55-bed nursing home facility.  Medicare has assigned an overall rating to the Faribault Care Center as a “much below average” facility.  In addition, Medicare has assigned a “much below average” rating to the nursing home based on the government’s health inspections of the facility.

In its recent inspection in February 2013, Faribault Care Center was cited with 16 health deficiencies (compared to the state average of 6.2). These include the facility’s:

  • Failure to hire only people with no legal history of abusing, neglecting or mistreating residents; or report and investigate any acts or reports of abuse, neglect or mistreatment of residents.
  • Failure to develop policies that prevent mistreatment, neglect, or abuse of residents or theft of resident property.
  • Failure to make sure services provided by the nursing facility meet professional standards of quality.
  • Failure to provide care by qualified persons according to each resident’s written plan of care.
  • Failure to provide necessary care and services to maintain the highest well being of each resident.
  • Failure to assist those residents who need total help with eating/drinking, grooming and personal and oral hygiene.
  • Failure to develop a complete care plan that meets all of a resident’s needs, with timetables and actions that can be measured.
  • Failure to make sure that each resident’s drug regimen is free from unnecessary drugs and that each resident’s entire drug/medication is managed and monitored to achieve highest well being.
  • Failure to keep accurate, complete and organized clinical records on each resident that meet professional standards.

In addition, the Minnesota Department of Health has substantiated several instances of nursing home neglect and abuse, including the following:

  • Faribault Care Center improperly discharged the resident.  The facility failed to have a post-discharge plan for the administration of the resident’s medication and the facility had not determined a competent means for administration of the resident’s insulin. It was necessary to involve the police to locate the resident.  The resident was located 60 miles from the nursing home. Emergency placement was required for the resident’s safety and well-being. [H5097057]
  • Faribault Care Center’s nurse diverted narcotic pain medication from a resident for her own use, but documented that she had administered the narcotic medication to the resident. [H5097056]
  • Although the resident’s care plan required two assistants to transfer him, Faribault Care Center’s nursing aide repeatedly chose to transfer the resident alone. The resident lost his balance and fell to the floor.  His ribs were fractured. [H5097045]
  • Faribault Care Center failed to have adequate supervision for a resident who frequently attempted to elope from the building.  The resident was found walking on a road away from the nursing home.  The nursing home staff was not aware that the resident had left the facility. [H5097043]

The Kosieradzki • Smith Law Firm represents clients in cases involving catastrophic injury caused by nursing homes and other care facilities that fail to provide proper care. If you believe your loved one has been harmed due neglect or abuse in a nursing home, take action and contact the Kosieradzki • Smith Law Firm online or call us toll-free at (877) 552-2873 to set up a no-cost, no-obligation consultation.

Nervanas Caring Hands Inc. Neglect Causes Death of Resident

By Kosieradzki Smith Law Firm

August 6, 2013

The Minnesota Department of Health (MDH) has completed its investigation of neglect concerns at the Nervanas Caring Hands Inc. in Bloomington, Minnesota.  A complaint was filed with the Department alleging that neglect occurred when a client was given an overdose of narcotics by staff. The Department investigated the matter and found that the resident was given morphine in excess of the prescribed amount, causing her death. [Case no. HL26052001]

The client resided at the facility for about two years prior to the incident. The client was hospitalized for pneumonia. About one week following the client’s return to the facility, during the evening hours, the resident was weak, not taking in nourishment and experienced some shortness of breath. The facility nurse initiated the used of medication morphine, prescribed to C1 for pain and shortness of breath. The nurse made an error when calculating the dosage of morphine, resulting in the client receiving at least two doses that were in excess of the prescribed amount. The client was sedated by the medication overdose and did not regain consciousness. The client died in the early afternoon following initiation of the morphine the prior evening. According to the death certificate, the cause of death was acute morphine toxicity. The MDH determined that the caregiver is responsible for neglect of the facility’s resident.

The Kosieradzki • Smith Law Firm represents clients in cases involving catastrophic injury caused by nursing homes and other care facilities that fail to provide proper care. If you believe your loved one has been harmed due neglect or abuse in a nursing home, take action and contact the Kosieradzki • Smith Law Firm online or call us toll-free at (877) 552-2873 to set up a no-cost, no-obligation consultation.

Anoka Rehab and Living Center Neglects Resident

By Kosieradzki Smith Law Firm

August 6, 2013

The Minnesota Department of Health (MDH) has completed its investigation of neglect concerns at the Anoka Rehab and Living Center in Anoka, Minnesota.  A complaint was filed with the Department alleging that neglect occurred when a resident was not provided an ordered medication for approximately three weeks resulting in adverse effects. [Case no. H5205031]

The Department investigated the matter and found that the resident did not receive Coumadin, as ordered by a physician for 17 days. The resident developed discoloration in the left leg and confusion. The resident required hospitalization, was diagnosed with a clot in the left leg, and required three surgeries to increase circulation to the left leg. The MDH determined that the Anoka Rehab and Living Center is responsible for neglect of the facility’s resident.

The resident was admitted to the facility, from the hospital and had orders for the medication Coumadin. The order directed to staff was to hold the Coumadin dose on the day of discharge from the hospital, then give Coumadin 2.5 mg for two days, and then complete an INR lab draw. The order directed staff to update the physician with the lab results for further Coumadin orders. Staff did not ensure that the lab was drawn, or that the results were obtained or called to the physician. Therefore, the resident did not receive a dose of Coumadin for 17 days.

The Kosieradzki • Smith Law Firm represents clients in cases involving catastrophic injury caused by nursing homes and other care facilities that fail to provide proper care. If you believe your loved one has been harmed due neglect or abuse in a nursing home, take action and contact the Kosieradzki • Smith Law Firm online or call us toll-free at (877) 552-2873 to set up a no-cost, no-obligation consultation.

Yet Another Finding of Neglect at the Red Wing Health Center

By Kosieradzki Smith Law Firm

July 19, 2013

On January 3, 2011 the Minnesota Department of Health revised an investigative report on a substantiated claim of neglect on the part of Red Wing Health Center.  [Report no H5223045]

The neglect occurred when the facility failed to respond to one of its resident’s decline in health.  From the middle of June 2010 to the time the resident was hospitalized on July 10th, the Red Wing Health Center staff collected and documented information pertaining to the resident’s decline in health. This information included data on “Food and Fluid Records”, “24 Hour Nursing/Change of Condition” reports, and in facility “Progress Notes.”

All of the information revealed an on going significant decreased nutritious intake and severe decline in the resident’s physical health. However, the facility failed to respond and address the change in the resident’s health. Red Wing Health Center did not attempt any sort of intervention to decrease the resident’s decline in health. Additionally, neither the resident’s physician nor the clinical dietician was notified of the resident’s change in health.

As a result of the facility’s inaction, the resident’s opportunity for nutritional and medical evaluation and treatment were delayed.  On July 10, 2010, the resident was admitted to the hospital and diagnosed with Wegner’s granulomatosis (an uncommon disorder which causes inflammation of the blood vessels, which in turn restricts blood flow to various organs).

The MDH found that the Red Wing Health Center’s staff were aware of the resident’s on-going decline and failed to respond or address the patient’s decline in condition, failed to offer on-going interventions to decrease the resident’s risk of further decline, and failed to notify the dietician and the physician of the on-going decline.

This is not the first investigation of the Red Wing Health Center by the MDH.  Here are three other investigations in which the MDH substantiated a finding of neglect:

  • In April 2012, the MDH found that the facility’s resident was neglected when he sustained a fall after being placed in a wheelchair that did not have a pressure alarm or a self-release seat belt. The resident had dementia and required total assistance from the Red Wing Health Center staff.  The MDH found that the facility failed to have a system in place to mark or identify resident specific wheelchairs. [Case no. H5223057]
  • In March 2012, the MDH investigated an allegation that a resident with pneumonia did not receive her antibiodics prescribed by her physician because the nursing home’s staff failed to transcribe the medication order properly. The resident died.  The Medical Examiner determined that the cause of her death bronchopneumonia and COPD.  The MDH found that Red Wing Health Center’s policies and procedures did not provide an effective system related to transcribing orders into the computer with stop dates, notifying appropriate persons when a medication is not available, reviewing new orders for compliance/implementation and completing audits of all antibiodic orders/stop dates and that the antibiodics are being ordered. [Case no. H5223060]
  • In September 2011, the MDH investigated an allegation that the facility’s resident fell and suffered a traumatic femur fracture when being transferred from her wheelchair into bed by the care staff.  The care staff, however, failed to use the mechanical lift that was required by the resident’s care plan. [Case no. H5223052]

The Kosieradzki • Smith Law Firm represents clients in cases involving catastrophic injury caused by nursing homes that fail to provide proper care. If you believe that you or your loved one has suffered serious harm because the nursing home failed to do its job, take action and contact the Kosieradzki • Smith Law Firm online or call us toll-free at (877) 552-2873 to set up a no-cost, no-obligation consultation.

 

 

Fairview Nursing Home Resident Neglected

By Kosieradzki Smith Law Firm

July 12, 2013

Fairview University Transitional Services is a nursing home in Minneapolis.  The Minnesota Department of Health (MDH) just released a report, no. H5170018, finding that the nursing home failed to ensure that anticoagulant medication was administered to its resident.  This medication is used to protect patients from blood clots.  The resident subsequently went into cardiac arrest in mid-January and died from blood clots in his lungs, according to the state’s investigation report.

The state concluded that “[b]ased on a preponderance of the evidence, neglect is substantiated when a resident did not receive heparin during the fourteen days that he was at the facility.”  The investigation found that the “nursing staff at the nursing home failed to review the medical information pertaining to the resident.”  The MDH found that “the facility’s policies and procedures did not provide an effective system of reviewing all medical information pertaining to treatment of the resident.”

The MDH investigation revealed that the resident had a cardiopulmonary arrest while at the nursing home and the resident was transferred to the hospital for further care; the resident died at the hospital; a chest CT revealed that the resident had large bilateral pulmonary embody (blood clots); and the resident’s death certificate declared that the immediate cause of death was massive pulmonary emboli.

According to the Star Tribune, the  Fairview nursing home disputes the state investigation findings: “Officials from the home called the incident an ‘isolated event’ that does not support a finding of neglect, according to the report. They also argued that ‘it is unlikely’ that the lapse led to the blood clots.

The Kosieradzki • Smith Law Firm represents clients in cases involving catastrophic injury caused by nursing homes and other care facilities that fail to provide proper care.  Nursing homes commonly deny any wrongdoing when confronted.  For the experienced personal injury lawyer representing a neglected nursing home resident, a thorough understanding of a nursing home’s medication policies and procedures—and a meticulous level of inquiry to determine whether they were followed—is the resident and his or her family’s best tools in evaluating and proving medication mismanagement.

To learn more, please check out our recent series of blogs discussing medication errors in nursing homes:

Mismanaged Medications in Nursing Homes: An Overview (Part 1 of 6)

Mismanaged Medications in Nursing Homes: Proper Medication Management (Part 2 of 6)

Mismanaged Medications in Nursing Homes: A Resident’s Medical Records and Medication History (Part 3 of 6)

Mismanaged Medications in Nursing Homes: Maintaining Adequate Staffing and Staffing Procedures (Part 4 of 6)

Mismanaged Medications in Nursing Homes: A Nursing Home and Its Pharmaceutical and Laboratory Services (Part 5 of 6)

Mismanaged Medications in Nursing Homes: Conclusion (Part 6 of 6)

If you believe you or your loved one has suffered medication errors because the nursing home failed to do its job, take action and contact the Kosieradzki • Smith Law Firm online or call us toll-free at (877) 552-2873 to set up a no-cost, no-obligation consultation.