Bedsores Reference Guide: Lawsuit, Medical, and Treatment information

Have bedsores reached epidemic proportions yet? To many it seems so — especially in elders that are in hospitals and nursing homes — and they do not have to be incapacitated or totally immobile to be at risk.

Whether or not you or an elder in your family has unfortunately become a victim of a bedsore, pressure ulcer, or decubitus ulcer keep this handy reference guide available. Download it to you computer, cell phone or bookmark it. Because bedsores can happen extremely fast and catch you off guard. They can progress rapidly, even within hours if proper care and medical attention are not given.

Anyone with an elder family member entering a hospital, nursing home or even a skilled nursing facility for a short term stay should read and help prevent these potential life treating wounds from happening to a loved one. They can occur at even the best hospitals with the best doctors. You may not expect malpractice, but it happens. You may not expect neglect but it happens. It happens to tens of thousands of innocent patients.

Lawsuits can yield millions of dollars to the victim and their family.

Understaffing, inadequate training, changes in shifts, or simply a scenario where your loved one in a nursing home may need care but that care is given to others with a more acute immediate need. It’s at these times that the elder is at extreme risk.

You can read more about risk factors, treatment, and lawsuits to be compensated for pain, suffering or loss of life here. Reference Guide>

Screen Shot 2018-01-13 at 12.17.17 PM

Additional information on bedsores from Medical News Today>

More Facts About Your Legal Rights>

Advertisements

Pressure sores: Causes, treatment, and prevention

Informative medical information: 

Via MEDICAL NEWS TODAY, By Christian Nordqvist

Pressure sores can affect people who spend a long time in one position, for example, because of paralysis, illness, old age, or frailty.

Also known as pressure ulcers and bedsores, pressure sores can happen when there is friction or unrelieved pressure on one part of the body.

People who cannot make even small movements are at risk of pressure sores.

The sores can affect any part of the body, but the bony areas around the elbows, knees, heels, coccyx, and ankles are more susceptible.

Bedsores are treatable, but, if treatment comes too late, they can lead to fatal complications.

The prevalence of pressure sores in intensive care units in the United States (U.S.) is estimated to range from 16.6 percent to 20.7 percent.

Fast facts on pressure soresHere are some key points about pressure sores. More detail and supporting information is in the main article.

  • Pressure sores, pressure ulcers, or bedsores commonly affect people who cannot move easily.
  • They are more likely to affect the bony parts of the body.
  • The sores develop in stages. Identifying them in the early stage enables treatment and reduces the risk of complications.
  • Moving patients frequently is key to preventing pressure sores.

Symptoms

[Pressure sores]There are varying stages of severity of pressure sore.

Pressure ulcers can affect patients who are unable to move because of paralysis, illness, or old age.

Bed-bound patients are most at risk of developing bedsores on the bony parts of their body, such as the ankles, heels, shoulders, coccyx or tailbone, elbows, and the back of the head.

Patients who use a wheelchair have a higher risk of developing pressure sores on their:

  • buttocks and tailbone
  • spine
  • shoulder blades
  • back of arms or legs

Pressure sores develop in four stages.

  1. The skin will look red and feel warm to the touch. It may be itchy.
  2. There may be a painful open sore or a blister, with discolored skin around it.
  3. A crater-like appearance develops, due to tissue damage below the skin’s surface.
  4. Severe damage to skin and tissue, possibly with infection. Muscles, bones, and tendons may be visible.

An infected sore takes longer to heal, and the infection can spread elsewhere in the body.

Causes and risk factors

Anyone who stays in one place for a long time and who cannot change position without help is at risk of developing pressure sores. The ulcers can develop and progress rapidly, and they can be difficult to heal.

Sustained pressure can cut off circulation to vulnerable parts of the body. Without an adequate supply of blood, body tissues can die.

According to Johns Hopkins Medicine, a sore can develop if blood supply is cut off for more than 2 to 3 hours.

Pressure ulcers are usually caused by:

Continuous pressure: if there is pressure on the skin on one side, and bone on the other, the skin and underlying tissue may not receive an adequate blood supply.

Friction: For some patients, especially those with thin, frail skin and poor circulation, turning and moving may damage the skin, raising the risk of bedsores.

Shear: If the skin moves one way while the underlying bone moves in the opposite direction, there is a risk of shearing. Cell walls and minute blood vessels may stretch and tear.

This can happen if a patient slides down a bed or a chair, or if the top half of the bed is raised too high.

Injured tissue can develop an infection. This can spread, leading to serious illness.

Risk factors

[Pressure sores immobility]Pressure sores mainly affect those who are less mobile, or restricted to one position, such as older people or those with mobility impairments.

Pressure ulcers are more common among those who:

  • are immobilized because of injury, illness, or sedation
  • have long-term spinal cord injuries

Patients with long-term spinal cord injuries or neuropathic conditions, including diabetes, have reduced sensation.

They may not feel a bedsore developing, so they continue to lie on it, making it worse.

Patients who cannot move specific parts of their body unaided have a greater risk of developing pressure ulcers.

Factors that increase the risk include:

  • Older age as skin gets thinner and more vulnerable with age
  • Reduced pain perception, due, for example, to a spinal cord or other injury, as they may not notice the sore
  • Poor blood circulation, due to diabetes, vascular diseases, smoking, and compression
  • Poor diet, especially with a lack of protein, vitamin C, and zinc
  • Reduced mental awareness, due to a disease, injury, or medication, can reduce the patient’s ability to take preventive action
  • Incontinence of urine or feces can cause areas of permanently moist skin, increasing the risk of skin breakdown and damage

A low or high body mass index (BMI) increases the risk.

A person with a low body weight will have less padding around their bones, while those with obesity can develop sores in unusual places. Studies show that people with a BMI of 30 to 39.9 have a 1.5 times higher rate of developing pressure ulcers.

Diagnosis, treatment, and management

[Pressure sores relief]Placing a pillow under the affected area can help to alleviate pressure and symptoms.

A doctor will diagnose a pressure ulcer through a visual examination.

The physician will ask about recent medical history and they will check the size and shape of the sore, and if there is any oozing or weeping.

If the patient is not in residential care, a doctor may teach them how to carry out regular daily checks on themselves.

People should report any sign of a pressure sore to the doctor.

Treatment

Treating pressure ulcers is not easy.

An open wound is unlikely to heal rapidly. Even when healing does take place, it may be inconsistent, because of the damage to skin and other tissues.

Less severe pressure ulcers often heal within a few weeks with proper treatment, but serious wounds may need surgery.

The following steps should be taken:

  • Remove the pressure from the sore by moving the patient or using foam pads or pillows to prop up parts of the body.
  • Clean the wound: Minor wounds may be gently washed with water and a mild soap. Open sores need to be cleaned with a saline solution each time the dressing is changed.
  • Control incontinence as far as possible.
  • Remove dead tissue: A wound does not heal well if dead or infected tissue is present, so debridement is necessary.
  • Apply dressings: These protect the wound and accelerate healing. Some dressings help prevent infection by dissolving dead tissue.
  • Use oral antibiotics or antibiotic cream: These will can help treat an infection.

In the early stages, people may treat ulcers at home, but more severe ulcers will need dressing by a health care professional.

Negative pressure wound therapy

Also known as vacuum-assisted therapy, this procedure involves the attachment of a suction tube to the bedsore. The tube draws moisture from the ulcer, drastically improving the healing time and reducing the risk of infection.

Wounds heal within around 6 weeks at half the cost of surgery.

Surgery

Some bedsores may become so severe that surgical intervention is necessary.

Surgery aims to clean the sore, treat or prevent infection, reduce fluid loss, and lower the risk of further complications.

A pad of muscle, skin, or other tissue from the patient’s body is used to cover the wound and cushion the affected bone. This is known as flap reconstruction.

Prevention

Even with excellent medical and nursing care, bedsores can be hard to prevent, especially among vulnerable patients.

Preventing bedsores is easier than treating them, but this too can be challenging.

Tips to reduce the risk of a bed sore developing include:

  • moving the patient at least every 15 minutes for wheelchair users and at every 2 hours for people in bed
  • daily skin inspections
  • keeping the skin healthy and dry
  • maintaining good nutrition, to enhance overall health and wound healing
  • quitting smoking
  • exercises, even if they must be carried out in bed, with assistance, as they improve circulation.

Patients should mention any possible bed sores to their health care worker or doctor.

A physical therapist can advise on the most appropriate positions to avoid pressure sores.

Complications

[Pressure sores cellulitis]Cellulitis is a possible complication of bed sores.

Without treatment, bed sores can lead to serious complications.

Cellulitis is a potentially life-threatening bacterial infection of the skin, from the surface to the deepest layer of skin. Cellulitis can result in septicemia, or blood poisoning, and the infection can spread to other parts of the body.

Bone and joint infections can arise if a pressure ulcer spreads to the joints or bones. This can result in damage to cartilage and tissue, and a reduction in limb and joint function.

Sepsis, in which bacteria can enter through sores, especially advanced ones, and infect the bloodstream. This can lead to shock and organ failure, a life-threatening condition.

There is a higher risk of developing an aggressive Cancer in the skin’s squamous cells if the patient has bedsores.

Outlook

Stage 2 bedsores can heal within 1 to 6 weeks, but ulcers that reach stage 3 or 4 may take several months, or they may never heal, especially in people with ongoing health problems.

With the appropriate measures, patients and medical staff can significantly reduce the risk of developing pressure ulcers.

_____________________________________________________________________________________

Download: Bedsore Legal and Medical Facts Booklet>

_____________________________________________________________________________________

 

A Brothers’ Dispute Over Mother’s Nursing Home Placement Is Not Domestic Violence

nu

A New Jersey appeals court rules that an ugly dispute between two brothers over their mother’s placement in a nursing home did not amount to domestic violence. R.G. v. R.G.(N.J. Super. Ct., App. Div., No. A-0945-15T3, March 14, 2017).

R.G was the attorney-in-fact and primary caregiver for his parents. After R.G.’s mother fell ill, R.G. wanted to place his mother in a nursing home. R.G’s brother objected to this plan, but R.G. went ahead and had his mother admitted to a nursing home without his brother’s consent. R.G.’s brother sent angry and threatening texts and emails to R.G. as well as emails expressing his desire to find a way to care for their parents in their home. Eventually the men got into a physical altercation in which R.G.’s brother shoved R.G.

R.G. filed for a restraining order against his brother under the Prevention of Domestic Violence Act. The trial judge ruled that R.G. was harassed and assaulted and issued the restraining order. R.G.’s brother appealed, arguing that R.G. did not meet the definition of a victim of domestic violence.

The New Jersey Superior Court, Appellate Division, reverses, holding that R.G.’s brother’s actions did not amount to domestic violence. The court finds that there was insufficient evidence that R.G.’s brother purposely acted to harass R.G., ruling that “a mere expression of anger between persons in a requisite relationship is not an act of harassment.”

For the full text of this decision, go to: http://www.judiciary.state.nj.us/opinions/a0945-15.pdf

 

Elder Abuse is a National Epidemic

Via Huffington Post…

When Helping Hurts

Screen Shot 2017-03-21 at 12.17.01 PM

Elder abuse is a national epidemic. Each year in the United States, an estimated 10 percent of older Americans are injured physically, debilitated emotionally, exploited financially and/or neglected — often by an adult child, spouse, other relative or caregiver. Elder abuse victims have a three-fold risk of death compared to their non-abused counterparts. Frequently, an elder is isolated, their mistreatment hidden.

In 2006, newspapers around the country headlined the story that Brooke Astor, the legendary New York City philanthropist and socialite, was financially exploited and neglected by her son and attorney. The case attracted national attention as her grandson, with the help of others, sought elder justice – first, by petitioning for guardianship to help his grandmother and those who were (also) helping her, and second, to help bring some of her perpetrators (his father included) to justice. The Elder Abuse Unit of the New York County’s District Attorney’s Office indicted and convicted Brooke Astor’s son and attorney. Elder justice was realized.

That is rare. Most of the millions of elder abuse victims, their suffering shrouded in silence, do not receive justice. Only one in 24 elder abuse cases are reported to authorities. What is not rare is that, despite an almost total lack of support or resources, family, friends and neighbors step up to help. Yet helping hurts, as confirmed by new findings of our research.

 

Staggering Number Know About Elder Mistreatment, Assist Victims, and Feel Distress

Along with colleagues at Cornell University, University of Toronto and Purdue University, we utilized Cornell University’s Survey Research Institute’s omnibus survey to learn about these concerned persons who step up for elder abuse victims — a population that had never been assessed. The survey results were recently released in The Gerontologist. They show that when findings are extended to the general population (U.S. Census Bureau, 2016), approximately 73 million adult Americans have had personal knowledge of a victim of elder mistreatment. Further, approximately 44 million adult Americans have become involved in helping an elder abuse victim. And for over 32 million adult Americans, just knowing about an elder abuse situation is generally highly stressful. Actually providing help to the victim tends to intensify this personal distress.

We need more research to understand what specific aspects cause this distress. We do know from conversations with concerned persons that the path to assisting elder abuse victims is often fraught with challenges. Concerned persons may witness the decline in the victim’s health and seek to obtain medical care, or provide what care they can themselves. They might feverishly focus efforts on trying to stop a financial exploiter from completely emptying bank accounts. They may try to lessen the victim’s despair. Often, they are often the only ones standing between the victim and the abuser, preventing the victim from slipping into total isolation.

Yet they are usually wholly unprepared for how this intervention might take a toll on they themselves. Relationships with friends they confide in and family may become strained, sometimes to the breaking point. They may suffer financial consequences. And seeing or confronting an abuser can be dangerous, so they personally risk becoming the target of abuse. Intervening can take real courage, and even more to remain involved. And it requires time, as elder abuse cases tend not to resolve quickly. It is not surprising that concerned persons can experience anguish, frustration and trauma. Yet like the victims they help, they are largely invisible: their deeds often not recognized, their needs unacknowledged.

 

Communities Can Help

What can communities do? A new program to be launched this spring in New York City is a beginning. The New York City Elder Abuse Center is launching a pilot helpline for concerned persons assisting elder mistreatment victims residing in New York City. Funded in part by the Fan Fox & Leslie R. Samuels Foundation, it will provide information, referrals and support. This is an important first step, but the need is great. Programs must be developed for concerned persons — and elder abuse victims — in every community. This will require support from foundations, private philanthropists, businesses and government. Brooke Astor fervently believed in a collectively expressed philanthropy, a

Elder abuse is a national epidemic. Each year in the United States, an estimated 10 percent of older Americans are injured physically, debilitated emotionally, exploited financially and/or neglected — often by an adult child, spouse, other relative or caregiver. Elder abuse victims have a three-fold risk of death compared to their non-abused counterparts. Frequently, an elder is isolated, their mistreatment hidden.

In 2006, newspapers around the country headlined the story that Brooke Astor, the legendary New York City philanthropist and socialite, was financially exploited and neglected by her son and attorney. The case attracted national attention as her grandson, with the help of others, sought elder justice – first, by petitioning for guardianship to help his grandmother and those who were (also) helping her, and second, to help bring some of her perpetrators (his father included) to justice. The Elder Abuse Unit of the New York County’s District Attorney’s Office indicted and convicted Brooke Astor’s son and attorney. Elder justice was realized.

That is rare. Most of the millions of elder abuse victims, their suffering shrouded in silence, do not receive justice. Only one in 24 elder abuse cases are reported to authorities. What is not rare is that, despite an almost total lack of support or resources, family, friends and neighbors step up to help. Yet helping hurts, as confirmed by new findings of our research.

 

“My mom is in a nursing home and I noticed some bruises and sores. I think they are bedsores—what should I do?”

Bedsores are often a sign of neglect and sometimes a sign of abuse. The first thing you should do is speak to a nurse on duty and begin to remedy the situation. Be aware that the nurse may not have a full understanding of these injuries and you will likely need the attention of a wound care specialist and medical doctor. If you have a cell phone take some pictures of the wound for documentation. Bedsores and Pressure Sores, also known as Decubitus Ulcers can progress quickly and can be deadly. They occur when someone is immobile and there is not adequate blood flow. Then the affected tissue dies and an ulcerated sore develops. In a nursing home, hospital or other care facility it is their responsibility to check and turn the patient regularly. There are laws in place that protect patients and you should know that these injuries are not the fault of the patient. The patient is the victim. If a loved one you know is suffering they may have a significant, financially rewarding lawsuit. Read more about this on our website, http://www.RaphanLaw.com.

As an Elder Law firm we see these cases often. Whether malpractice, abuse or neglect it is simply unjust for it to happen to an innocent victim. Do not put off addressing the issue. Call me for a free consultation (212-268-8200, 800-278-2960) or even to just guide you through the process of getting the proper medical and legal attention.

Visual Stages of Bedsores:

Image

Read our Frequently Asked Bedsore Lawsuit Questions here>

By Brian A. Raphan, Esq.

Jury awards family $1 million in lawsuit against Beachwood nursing home

Mandatory sentencing laws keep U.S. judges' hands tied
The family of a former resident of Beachwood Pointe Care Center has won a $1 million lawsuit against the nursing home. (Eli Saslow, Washington Post)
By Bob Sandrick, special to cleveland.com 

BEACHWOOD, Ohio — A jury has awarded the family of a former Beachwood nursing home resident $1 million in a lawsuit filed more than two and a half years ago.

The resident, 71-year-old Mary L. Stevens, died in May 2012 at Beachwood Pointe Care Center on Chagrin Boulevard. She suffered infected pressure wounds, or bedsores, caused by “negligence and recklessness” of the nursing home staff, according to the lawsuit, filed in March 2013 by The Dickson Firm LLC in Beachwood.

The verdict came Wednesday in Cuyahoga County Common Pleas Court. The jury awarded David P. Lang, on behalf of Stevens, $560,000 in punitive damages and $440,000 in compensatory damages, according to the electronic court docket.

In addition to suffering from bedsores , Stevens also sustained “severe” and “fatal” injuries while at Beachwood Pointe, according to the lawsuit. Nursing home staff allowed her to become “very ill” and her condition deteriorated.

Beachwood Pointe did not tell Stevens’ family about her condition. Decisions about her medical care were made by non-medical staff, the lawsuit says, adding that the nursing home’s staffing levels and supervision were inadequate, and it failed to give Stevens palatable food.

Officials from Beachwood Pointe did not return calls Tuesday. Its attorney could not be reached about whether the nursing home would appeal the verdict.

More FAQs on Bedsore Lawsuits>

You may be signing away your right to sue the nursing home

By Michelle Andrews, Kaiser Health News

When Paul Ormond signed John Mitchell into a nursing home in Dennis, Mass., in June, he was handed a few dozen pages of admission papers. Ormond, Mitchell’s legal guardian and an old friend, signed wherever the director of admissions told him to.

He didn’t realize that one of those documents was an agreement that required Mitchell and his family to take disputes to a professional arbitrator rather than to court.

bedsore lawyer

Mitchell had been institutionalized since suffering a stroke in 1999. During a hospital stay early this summer, Mitchell, then 69, had received a tracheotomy and needed to switch to a nursing home that could accommodate him.

A few weeks after Mitchell arrived at the new nursing home, staff members dropped him while using a lift device to move him from his bed to his chair. Later that night Ormond, 63, got a call from the nursing home that Mitchell was unresponsive. Mitchell was rushed to the hospital, and doctors found that the fall had caused extensive bleeding on his brain. He died a few days later.

Mitchell’s sons hired a lawyer to look into the circumstances surrounding their father’s death. That was when Ormond learned that amid all the admissions papers he had signed was an arbitration agreement.

“I thought it was deceptive, and I was pretty angry that I’d been tricked into signing something that I didn’t know what it was,” says Ormond.

A mandatory arbitration agreement is an often overlooked document in the package of admissions papers at many nursing homes these days. It can have an outsize impact if something goes wrong. But anxious seniors or their caregivers often sign every document that’s put in front of them, perhaps only glancing at the content.

Signing an arbitration agreement means that in the event of a problem that is not amicably resolved — Mom slips on a wet floor and breaks her hip, say, or Dad wanders off the premises and gets hit by a car — you agree to bring the dispute before a professional arbitrator rather than file a lawsuit for negligence or wrongful death, for example.

Agreeing to arbitrate is generally not in families’ best interests, say consumer advocates. For one thing, it can be pricey. In addition to hiring a lawyer, the patient or family generally has to pay its share of the arbitrator’s fee, which may come to hundreds of dollars an hour, says Paul Bland, a senior attorney at Public Justice, a public interest law firm based in Washington.

“In court, you don’t have to pay the judge,” he says. “Our taxes pay for that.”

Court proceedings are also conducted in a public courtroom and leave a detailed public record that can inform industry practice and help develop case law, say experts. Not so with arbitration hearings, which are conducted in private and whose proceedings and materials are often protected by confidentiality rules.

The amount awarded — if any — may also be less if an arbitrator hears the case than it would be if a case went to trial, say experts.

Aon Global Risk Consulting analyzed 1,449 closed claims involving long-term-care providers between 2003 and 2011 and found that there was no money awarded in 30 percent of claims where a valid arbitration agreement was in place, compared with 19 percent of claims in which there was no arbitration agreement or the agreement was determined to be unenforceable.

Likewise, nearly 12 percent of claims without arbitration agreements resulted in awards of $250,000 or more, compared with 8.5 percent of claims with arbitration agreements.

The study was conducted with the American Health Care Association, which represents 11,000 long-term-care facilities. According to the report, “loss rates” — reflecting the dollar value of liability claims paid — are increasing 4 percent annually.

“Liability costs for providing care have grown and escalated” in recent years, says Greg Crist, a spokesman for the association. Arbitration agreements help keep a lid on those costs, he says.

That may explain why arbitration agreements have become much more common in nursing homes, experts say. The agreements are increasingly used in assisted living facilities as well.

Arbitration can also benefit patients and their families, Crist says. Claims are typically resolved more quickly than court cases, he says, so attorney costs are lower and patients can retain a larger portion of any financial settlement.

The Federal Arbitration Act, enacted in 1925, allows for two sides in a dispute to agree to binding arbitration to resolve their differences. If a dispute arises and an arbitration agreement is in place, the arbitrators are jointly selected by the patient and the nursing home.

Although consumers usually don’t realize it, there’s a simple way to avoid being forced into arbitration, say experts: Don’t sign the arbitration agreement.

What happens if you don’t sign? Nothing, Crist says. “It’s not a condition of admission to the facility,” he says. The American Health Care Association doesn’t support requiring people to sign an arbitration agreement as a condition of admission, he says, although practices may vary at individual nursing homes.

If you do sign and then wish you hadn’t, arbitration agreements typically have a 30-day “opt-out” provision that allows you to change your mind and retain your rights to sue.

The judge in John Mitchell’s wrongful death case threw out the agreement on the grounds that it was “unconscionable,”  a legal term used to describe contracts that are unfair or unjust.

“The judge agreed it was too much to expect me to digest all of this information at once, and that the arbitration clause hadn’t been explained thoroughly,” says Ormond. A trial date hasn’t yet been set.

Arguing that an agreement is unconscionable is one of the few ways people can extricate themselves from arbitration agreements once a dispute arises, says David Hoey, a North Reading, Mass., lawyer representing the Mitchell family. Another possibility is to prove that the person wasn’t competent to sign an agreement or that the family member who signed wasn’t legally qualified to do so.

Better yet, experts agree, is not to sign in the first place.

Related article: Should you sign that nursing home agreement:

The Rights of Nursing Home Residents

While residents of nursing homes have no fewer rights than anyone else, the combination of an institutional setting and the disability that put the person in the facility in the first place often results in a loss of dignity and the absence of proper care.

As a result, in 1987 Congress enacted the Nursing Home Reform Law that has since been incorporated into the Medicare and Medicaid regulations. In its broadest terms, it requires that every nursing home resident be given whatever services are necessary to function at the highest level possible. The law gives residents a number of specific rights:

  • Residents have the right to be free of unnecessary physical or chemical restraints. Vests, hand mitts, seat belts and other physical restraints, and antipsychotic drugs, sedatives, and other chemical restraints are impermissible, except when authorized by a physician, in writing, for a specified and limited period of time. 
  • To assist residents, facilities must inform them of the name, specialty, and means of contacting the physician responsible for the resident’s care. Residents have the right to participate in care planning meetings. 
  • When a resident experiences any deterioration in health, or when a physician wishes to change the resident’s treatment, the facility must inform the resident, and the resident’s physician, legal representative or interested family member. 
  • The resident has the right to gain access to all his or her records within one business day, and a right to copies of those records at a cost that is reasonable in that community. The facility must explain how to examine these records, or how to transfer the authority to obtain records to another person. 
  • The facility must provide a written description of legal rights, explaining state laws regarding living wills, durable powers of attorney for health care and other advance directives, along with the facility’s policy on carrying out these directives. 
  • At the time of admission and during the stay, nursing homes must fully inform residents of the services available in the facility, and of related charges. Nursing homes may charge for services and items in addition to the basic daily rate, but only if they already have disclosed which services and items will incur an additional charge, and how much that charge will be. 
  • The resident has a right to privacy, which is a right that extends to all aspects of care, including care for personal needs, visits with family and friends, and communication with others through telephone and mail. Residents thus must have areas for receiving private calls or visitors so that no one may intrude and to preserve the privacy of their roommates 
  • Residents have the right to share a room with a spouse, gather with other residents without staff present, and meet state and local nursing home ombudspersons or any other agency representatives. They may leave the nursing home, or belong to any church or social group. Within the home, residents have a right to manage their own financial affairs, free of any requirement that they deposit personal funds with the facility. 
  • Residents also can get up and go to bed when they choose, eat a variety of snacks outside of meal times, decide what to wear, choose activities, and decide how to spend their time. The nursing home must offer a choice at main meals, because individual tastes and needs vary. Residents, not staff, determine their hours of sleep and visits to the bathroom. Residents may self-administer medication. 
  • Residents may bring personal possessions to the nursing home such as clothing, furnishings and jewelry. Residents may expect staff to take responsibility for assisting in the protection of items or locating lost items, and should inquire about facility policies for replacing missing items. Residents should expect kind, courteous, and professional behavior from staff. Staff should treat residents like adults. 
  • Nursing home residents may not be moved to a different room, a different nursing home, a hospital, back home or anywhere else without advance notice, an opportunity for appeal and a showing that such a move is in the best interest of the resident or necessary for the health of other nursing home residents. 
  • The resident has a right to be free of interference, coercion, discrimination, and reprisal in exercising his or her rights. Being assertive and identifying problems usually brings good results, and nursing homes have a responsibility not only to assist residents in raising individual concerns, but also to respond promptly to those concerns.

Nursing Home Myths and Realities

Myth

Reality

Medicaid does not pay for the service you want.

Medicaid residents are entitled to the same service as other residents.

Only staff can determine the care you receive.

Residents and family have the right to participate in developing a care plan.

Staff cannot accommodate individual schedules.

A nursing home must make reasonable adjustments to honor residents’ needs and preferences.

You need to hire private help.

A nursing home must provide all necessary care.

Restraints are required to prevent the resident from wandering away.

Restraints cannot be used for the nursing home’s convenience or as a form of discipline.

Family visiting hours are restricted.

Family members can visit at any time of day or night.

Therapy must be discontinued because the resident is not progressing.

Therapy may be appropriate even if resident is not progressing; Medicare may pay even without current progress.

You must pay any amount set by the nursing home for extra charges.

A nursing home may only require extra charges authorized in the admission agreement.

The nursing home has no available space for residents or family members to meet.

A nursing home must provide a private space for resident or family councils.

The resident can be evicted because he or she is difficult or is refusing medical treatment.

Being difficult or refusing treatment does not justify eviction.

Court Ruling: Transfers Made Years Before Needing Care Were Not Made in Order to Qualify for Medicaid

Doing Medicaid Planning for clients, I often get asked the question: “How does medicaid determine if my gifts were made to qualify for medicaid or not?” Saavy clients have a long history of gifting to show a pattern meant for gifting not medicaid spend down. This recent decision should be of interest.

medicaid planning, appeal
http://www.raphanlaw.com

A New York appeals court holds that a Medicaid applicant who transferred funds several years before needing long-term care and kept enough resources to care for herself rebutted the presumption that the transfers were made in order to qualify for Medicaid. Safran v. Shah (N.Y. Sup. Ct., App. Div., 2nd. Dept., 2013-04373, 20166/12, July 2, 2014).

While she was living independently and didn’t require long-term care, Louise Kornhaber transferred funds to her family as gifts. Several years later, Ms. Kornhaber entered a nursing home. Due to the unexpected theft of her remaining resources, Ms. Kornhaber applied for Medicaid. The state assessed a penalty period based on the uncompensated transfers.

Ms. Kornhaber appealed, arguing that the transfers were made for a reason other than to qualify for Medicaid. The state affirmed the penalty period, and Ms. Kornhaber appealed to court.

The New York Supreme Court, Appellate Division, orders the state to provide Ms. Kornhaber with Medicaid benefits, holding that the penalty period was not appropriate. The court rules that because Ms. Kornhaber still had enough resources to maintain herself for years after she made the transfers, she rebutted the presumption that the transfer was made in order to qualify for Medicaid.

Medicaid Planning takes the experience and legal expertise of a qualified attorney. The detailed process of medicaid planning needs to avoid errors and mistakes that can make you ineligible of cost you possibly tens of thousands of dollars in delays or penalties. Click here to read: 8  Medicaid Mistakes to Avoid,

For the full text of this decision, go to: https://www.nycourts.gov/reporter/3dseries/2014/2014_04943.htm

Any questions? Send me an email: info@raphanlaw.com or call 212-268-8200 during the day for a free consultation.

Regards, Brian

Can you sue a hospital if you develop bedsores?

Bedsores are often a sign of neglect and can be the result of hospital malpractice, nurse malpractice or nursing home negligence. It is simply not acceptable that they should happen while a person is at a facility in the care of professionals. Sadly, bedsores are the underlying cause of death for several thousand Americans each year. They are not the fault of the patient. The patient is a victim. A bedsore lawsuit is a way to seek justice for the pain and suffering and also a get a financial award for the victim or family of a deceased victim.

Image

Click for online Bedsore Lawsuit Evaluation.

Bedsores can develop quickly, progress rapidly and are often difficult to heal. Caring for them can cost into the tens of thousand of dollars. Often, due to the lower staffing in nursing homes, patients are forced to wait longer for care, such as simply being turned in a bed, or the changing of soiled linens and clothes. One example of how they can happen is if a patient cannot change themselves then they are forced to sit or lay in their own urine until a caregiver arrives. While the patient waits, their skin is being weakened by the moisture making them susceptible to bedsores. Health experts agree that bedsores do not have to occur. Preventive measures from a nursing home, hospital or health care provider are your legal right. It is the duty of a nursing home or hospital to follow proper procedures to prevent them.

Click here for information on treatment.

Click here for BedsoreHotline.com…Your hotline to legal information, treatment information, and to see if you have a lawsuit. Learn the importance of a dedicated bedsore legal team.

If you want further information on this subject, feel free to email or call me. bedsores@RaphanLaw.com. All conversations are confidential.

Regards,

Brian

212-268-8200