Ivy League-educated pediatrician Robert P. Lindeman sat on the stand in a Boston area court this month, defending himself in a malpractice suit involving the death of a 12-year-old patient, when the opposing counsel startled him with a question.
Was he Lindeman Flea?
It appears Dr. Lindeman authored a blog under the assumed name, Lindeman Flea. No problem there. Where the doctor got in trouble was writing in his blog about the proceedings of the medical negligence case against him. In his blog, Flea had ridiculed the plaintiff's case and the plaintiff's lawyer. He had revealed the defense strategy. He had accused members of the jury of dozing.
Read about this doctor’s arrogance and lack of sensitivity in this Boston Globe article.
Thursday, May 31, 2007
47 NURSING HOME RESIDENTS BECOME SICK
The Naples Daily News reports 47 residents of ManorCare Health Services, a 118-bed nursing home in East Naples, Florida became ill late last week from what could be the Norwalk virus with symptoms of vomiting and diarrhea. Read the new article here.
Norwalk virus, from the norovirus class, can cause acute gastroenteritis in humans and is the outbreak that often afflicts cruise ship passengers because of how easy and quickly it spreads among people living in close quarters. The same holds true for nursing homes and other health-care centers.
The virus spreads by people in food preparation, by touching contaminated surfaces or objects and then placing one’s hands in his or her mouth, or having direct contact with someone who is infected. Both stool and vomit are infectious, according to the U.S. Centers for Disease Control and Prevention in Atlanta.
These are the types of problems in nursing homes which can be avoided with proper hygeine, hand washing, and a staff trained to prevent the spread of infectious disease.
Norwalk virus, from the norovirus class, can cause acute gastroenteritis in humans and is the outbreak that often afflicts cruise ship passengers because of how easy and quickly it spreads among people living in close quarters. The same holds true for nursing homes and other health-care centers.
The virus spreads by people in food preparation, by touching contaminated surfaces or objects and then placing one’s hands in his or her mouth, or having direct contact with someone who is infected. Both stool and vomit are infectious, according to the U.S. Centers for Disease Control and Prevention in Atlanta.
These are the types of problems in nursing homes which can be avoided with proper hygeine, hand washing, and a staff trained to prevent the spread of infectious disease.
DRUG RESISTANT TUBERCULOSIS THREAT
I saw in an article today in USA Today, a man with drug-resistant TB decided to take a trip a couple of weeks ago and now at least two countries are scrambling to locate people who might have traveled near him. Health officials want to alert those individuals that they may have come in contact with a drug resistant type of TB, called XDR-TB, which stands for Extensively Drug Resistant Tuberculosis. The man is now in quarantine in a hospital in Atlanta, Georgia, but authorities in the United States and Europe are trying to contact everyone who could have been close enough to be affected by the virus.
What is XDR-TB?
XDR-TB is a type of tuberculosis that is extremely resistant to most effective anti-TB drugs and to some of the second-tier drugs as well. Its resistance makes the bacteria very hard to fight. The World Health Organization says that, even in countries with good TB programs, a cure is possible in only 30% of cases.
How is normal TB treated?
Regular TB is treated with a drug regimen that lasts 18 – 24 months. The patient begins with four antibiotics for eight weeks. If the patient responds well, the treatment is often reduced to two drugs for up to seven more months.
How is TB spread?
TB is a bacterium that can be spread through the air when someone coughs, sneezes, or simply talks. It is not as contagious as the flu but only a small number of germs need to be inhaled for another person to become infected. Most infections remain dormant in a healthy person and may never become the disease unless the immune system becomes weak.
What are the symptoms of TB?
Symptoms include a cough with thick, cloudy mucus for more than two weeks, fever, chills, night sweats, weight loss, fatigue and muscle weakness and shortness of breath.
Another article in USA Today states, “This form of TB is rare. Only 49 cases were reported in the United States between 1993 and 2006; 17 have been diagnosed since 2000. By contrast, the nation reported 13,767 ordinary TB cases last year alone, an all-time low.”
Finally, on MSNBC, Julie Gerberding, Director of the Center for Disease Control and Prevention is quoted as saying “Is the patient himself highly infectious? Fortunately, in this case, he’s probably not. But the other piece is this bacteria is a very deadly bacteria. We just have to err on the side of caution.”
What is XDR-TB?
XDR-TB is a type of tuberculosis that is extremely resistant to most effective anti-TB drugs and to some of the second-tier drugs as well. Its resistance makes the bacteria very hard to fight. The World Health Organization says that, even in countries with good TB programs, a cure is possible in only 30% of cases.
How is normal TB treated?
Regular TB is treated with a drug regimen that lasts 18 – 24 months. The patient begins with four antibiotics for eight weeks. If the patient responds well, the treatment is often reduced to two drugs for up to seven more months.
How is TB spread?
TB is a bacterium that can be spread through the air when someone coughs, sneezes, or simply talks. It is not as contagious as the flu but only a small number of germs need to be inhaled for another person to become infected. Most infections remain dormant in a healthy person and may never become the disease unless the immune system becomes weak.
What are the symptoms of TB?
Symptoms include a cough with thick, cloudy mucus for more than two weeks, fever, chills, night sweats, weight loss, fatigue and muscle weakness and shortness of breath.
Another article in USA Today states, “This form of TB is rare. Only 49 cases were reported in the United States between 1993 and 2006; 17 have been diagnosed since 2000. By contrast, the nation reported 13,767 ordinary TB cases last year alone, an all-time low.”
Finally, on MSNBC, Julie Gerberding, Director of the Center for Disease Control and Prevention is quoted as saying “Is the patient himself highly infectious? Fortunately, in this case, he’s probably not. But the other piece is this bacteria is a very deadly bacteria. We just have to err on the side of caution.”
DEPRESSION LEADS TO BONE LOSS?
This morning I read an abstract in the Journal of the American Geriactrics Society - June 2007 publication. While you cannot access the entire study without a subscription, it seems recent studies reflect older women with depression, have higher bone loss than woman who are not depressed. AND the study concludes that anti-depressents are not the cause. http://www.ingentaconnect.com/content/bsc/jgs/2007/00000055/00000006/art00003;jsessionid=2ssxegrb9v1n5.alice
Very interesting - especially if you have a loved one, experiencing mild depression... better get their bone density checked!
Very interesting - especially if you have a loved one, experiencing mild depression... better get their bone density checked!
Wednesday, May 30, 2007
IS IT DANGEROUS TO BE IN THE HOSPITAL AT NIGHT?
An article in Reader’s Digest suggests that it is!
Lewis, a 15 year old child, was admitted to the Medical University of South Carolina’s Children’s Hospital for a minimally invasive and low risk surgery to correct a sunken chest. That night, after hours of pain and struggling, he suffered cardiopulmonary arrest and died. Throughout the night, the resident on call attended to Lewis but just assumed his stomach complaints were caused by gas from the surgery and never called an attending doctor. Had Lewis experienced these complaints and symptoms during the day, his bleeding ulcer would have been recognized and treated, and he would have lived. The hospital settled the parents’ claim, without a lawsuit, for $950,000.
“A 2005 study of 3.3 million births in California found that babies born late at night were 16 percent more likely to die than those born in the daytime. Other recent research found that patients going into cardiac arrest at night were more likely to die. In a review of pharmacy and patient records, significantly more medication errors were made at night. Daytime deaths can also be attributed to nighttime hospital errors: An analysis of 5 pediatric intensive care units found that children admitted to the units at night were more likely to die within 48 hours.”
What a scary thought! It isn’t because the staff and doctors tending to the patients don’t care, because most of them do. But hospitals keep lower staff numbers at night and most doctors are on a rotation. Workers with the most seniority tend to get first choice of daytime positions, leaving workers who are newer and less experienced to work the nighttime shifts. Hospital staffs also work notoriously long hours; it is common for residents and interns to work 24 hour shifts and 80 hour weeks. Combine that fatigue with the natural fatigue which occurs at night and you have a recipe for disaster.
Lewis’s mother has been working as a patient advocate since the death of her son. She was instrumental in the passage of the Lewis Blackman Hospital Patient Safety Act which requires all physicians in South Carolina to wear identification badges with their rank. Hospital staffs are also required to call attending physicians if requested to do so by the patient or family member.
Medical schools, such as the University of Minnesota, are now working to foster doctors and hospital staff to work as teams, and manage crises better. The University of South Carolina Medical Center has also started a statewide initiative to educate and train medical staff to manage simulated crises. Dr. Jerry Reeves, dean of the college, said “This way, you don’t get out of it until you’ve proven you can actually manage it, even if it takes a hundred times.”
Lewis, a 15 year old child, was admitted to the Medical University of South Carolina’s Children’s Hospital for a minimally invasive and low risk surgery to correct a sunken chest. That night, after hours of pain and struggling, he suffered cardiopulmonary arrest and died. Throughout the night, the resident on call attended to Lewis but just assumed his stomach complaints were caused by gas from the surgery and never called an attending doctor. Had Lewis experienced these complaints and symptoms during the day, his bleeding ulcer would have been recognized and treated, and he would have lived. The hospital settled the parents’ claim, without a lawsuit, for $950,000.
“A 2005 study of 3.3 million births in California found that babies born late at night were 16 percent more likely to die than those born in the daytime. Other recent research found that patients going into cardiac arrest at night were more likely to die. In a review of pharmacy and patient records, significantly more medication errors were made at night. Daytime deaths can also be attributed to nighttime hospital errors: An analysis of 5 pediatric intensive care units found that children admitted to the units at night were more likely to die within 48 hours.”
What a scary thought! It isn’t because the staff and doctors tending to the patients don’t care, because most of them do. But hospitals keep lower staff numbers at night and most doctors are on a rotation. Workers with the most seniority tend to get first choice of daytime positions, leaving workers who are newer and less experienced to work the nighttime shifts. Hospital staffs also work notoriously long hours; it is common for residents and interns to work 24 hour shifts and 80 hour weeks. Combine that fatigue with the natural fatigue which occurs at night and you have a recipe for disaster.
Lewis’s mother has been working as a patient advocate since the death of her son. She was instrumental in the passage of the Lewis Blackman Hospital Patient Safety Act which requires all physicians in South Carolina to wear identification badges with their rank. Hospital staffs are also required to call attending physicians if requested to do so by the patient or family member.
Medical schools, such as the University of Minnesota, are now working to foster doctors and hospital staff to work as teams, and manage crises better. The University of South Carolina Medical Center has also started a statewide initiative to educate and train medical staff to manage simulated crises. Dr. Jerry Reeves, dean of the college, said “This way, you don’t get out of it until you’ve proven you can actually manage it, even if it takes a hundred times.”
WHO'S THE BOSS
Grandma is in the local nursing home for rehab after she broke her hip. A pressure ulcer develops, or she gets a UTI, diabetes is uncontrolled or something else happens. Who is looking after her? WHO IS THE BOSS?
Well, the Medical Director of the nursing home is - right? Maybe. In a nursing home case I recently learned that the facility has form orders they use for almost every ailment - so, if pressure ulcer, nurses don't call the physician, they look at the form. UTI, they don't call the physician, they look at the form. Uncontrolled diabetes - the form will say what to do - look there first!
Why is this a problem? Who wrote the form? What if this patient's symptoms are different? Is the physician aware of new treatments or does she rely on the form? Does the physician make sure the form is followed? If not, do they make sure the form is correct? If the form is treating your loved one, what is the point of the physician on staff? Just a thought - but one I share because it certainly scared me!
Well, the Medical Director of the nursing home is - right? Maybe. In a nursing home case I recently learned that the facility has form orders they use for almost every ailment - so, if pressure ulcer, nurses don't call the physician, they look at the form. UTI, they don't call the physician, they look at the form. Uncontrolled diabetes - the form will say what to do - look there first!
Why is this a problem? Who wrote the form? What if this patient's symptoms are different? Is the physician aware of new treatments or does she rely on the form? Does the physician make sure the form is followed? If not, do they make sure the form is correct? If the form is treating your loved one, what is the point of the physician on staff? Just a thought - but one I share because it certainly scared me!
Tuesday, May 29, 2007
NEW INDICATORS OF BREAST CANCER RISK
Researchers have announced they found six new sites of variation on the genome that increase the risk of breast cancer. The discovery means “a sizable fraction of the overall genetic risk of breast cancer may now have been accounted for, and much of the rest could be captured in a few years.” This announcement is the result of the human genome project which was completed in 2003.
The human genome project was working to understand the genetic basis of common diseases. The project completed in 2003 but has been slow to show tangible results. However, the results are starting to come forth. Last month, researchers announced seven new DNA variations associated with diabetes, and announcements about other diseases are expected soon.
The new findings are possible through new instruments called chips which enable up to 5000,000 points of variation on the human genome to be tested simultaneously for possible association with disease. However, to attain the statistical strength needed for these studies many research groups, which have been otherwise competitive, are working together.
By using the new chips scientists compare breast cancer patients with healthy individuals and look for the differences in the DNA of the human genome. They have expressed confidence that most of the genetic risk of breast cancer can be detected through the whole genome association approach. The researchers believe the sites of variation will, once fully understood, reveal new biology that underlies the progression toward breast cancer.
See the full New York Times article here.
The human genome project was working to understand the genetic basis of common diseases. The project completed in 2003 but has been slow to show tangible results. However, the results are starting to come forth. Last month, researchers announced seven new DNA variations associated with diabetes, and announcements about other diseases are expected soon.
The new findings are possible through new instruments called chips which enable up to 5000,000 points of variation on the human genome to be tested simultaneously for possible association with disease. However, to attain the statistical strength needed for these studies many research groups, which have been otherwise competitive, are working together.
By using the new chips scientists compare breast cancer patients with healthy individuals and look for the differences in the DNA of the human genome. They have expressed confidence that most of the genetic risk of breast cancer can be detected through the whole genome association approach. The researchers believe the sites of variation will, once fully understood, reveal new biology that underlies the progression toward breast cancer.
See the full New York Times article here.
TURNING OFF GENE MAKES MICE SMARTER
According to an article in the New York Times, researchers have found that if they turn off a gene that is associated with Alzheimer’s, mice become smarter in the lab. The researchers said the mice “were far more adept at sensing environmental changes than other mice.”
Dr. James Bibb led the study which used genetic engineering to breed mice and turn off the gene (Cdk5) which controls a brain enzyme linked to diseases. Dr. Bibb believes that Cdk5 may be contributing to the loss of neurons. He states that the mice without the Cdk5 gene are better at tasks based on associated learning and perform better at negotiating a maze.
Dr. Bibb credits the inspiration of his work to the 1999 discovery of Doogie mice at Princeton University (named for the child prodigy on television, Doogie Houser, MD). The mice at Princeton were bred by manipulating NR2B, a gene also associated with memory. Professor Bibb said “It turns out that Cdk5 was controlling the regulation of NR2B. Maybe by finding these new mechanisms we can find new drugs that improve the cognitive performance of people who have deficits.”
Dr. Bibb and his colleagues are working on the development of drugs that would create the same effect without genetic alteration. The long term effects of drugs such as these are unknown at this time.
Dr. James Bibb led the study which used genetic engineering to breed mice and turn off the gene (Cdk5) which controls a brain enzyme linked to diseases. Dr. Bibb believes that Cdk5 may be contributing to the loss of neurons. He states that the mice without the Cdk5 gene are better at tasks based on associated learning and perform better at negotiating a maze.
Dr. Bibb credits the inspiration of his work to the 1999 discovery of Doogie mice at Princeton University (named for the child prodigy on television, Doogie Houser, MD). The mice at Princeton were bred by manipulating NR2B, a gene also associated with memory. Professor Bibb said “It turns out that Cdk5 was controlling the regulation of NR2B. Maybe by finding these new mechanisms we can find new drugs that improve the cognitive performance of people who have deficits.”
Dr. Bibb and his colleagues are working on the development of drugs that would create the same effect without genetic alteration. The long term effects of drugs such as these are unknown at this time.
Monday, May 28, 2007
HOW CONSUMERS CHOOSE NURSING HOMES
A recent report prepared for the U.S. Department of Health and Human Services by the RAND Corporation examines nursing home selection statistics in six states. The purpose of the report was to determine how the million-plus elders headed for senior care every year make their choices. Researchers determined that generally consumers do not take full advantage of the information available to them about the country’s nursing facilities. Many respondents to the research surveys indicated the information they needed or wanted was not readily available, or they were not aware of how to find such useful tools as facility inspection reports. Many also reported that internet resources, such as Nursing Home Compare, were not “user-friendly.”
Research participants were most likely to rely on lists of facilities that provide general information such as location, supplemented by word of mouth and more easily observed characteristics of the facility that reflect a sense of quality of life. In general, consumers based their facility selection on information often not available on internet-based resources, such as information on costs and what activities are available in the facility.
Read the RAND report for yourself.
Research participants were most likely to rely on lists of facilities that provide general information such as location, supplemented by word of mouth and more easily observed characteristics of the facility that reflect a sense of quality of life. In general, consumers based their facility selection on information often not available on internet-based resources, such as information on costs and what activities are available in the facility.
Read the RAND report for yourself.
COMMUNICATION BEFORE SURGERY IS CRITICAL
We have handled many cases through the years where a patient was needlessly injured or killed during surgery due to a lack of communication between the surgeon, anesthesiologist, operating nursing staff and other medical professionals who are present in many surgeries. Operating on the wrong leg or side of the brain are just two examples.
Hospitals should require brief meetings for surgeons, anesthesiologists, and nurses before they operate on a patient. Read an abstract of an article published in the Journal of the American College of Surgeons which reaches the same conclusion.
…and another supportive article.
Hospitals should require brief meetings for surgeons, anesthesiologists, and nurses before they operate on a patient. Read an abstract of an article published in the Journal of the American College of Surgeons which reaches the same conclusion.
…and another supportive article.
NURSING HOME OWNER FACES NEGLECT CHARGES
The owner and manager of a Palmetto, Florida nursing home has been arrested on a charge of neglecting an elderly person in connection with a large lesion found on the face of a resident. According to a report from the Palmetto Police Department, 85-year-old Ronald Larsen began living at the Palmetto Guest House in June, 2005. Jacqueline Dorelien took over the home in July of the following year.
The lesion was present when Dorelien took charge, but grew during the next few months, eventually rupturing into a large open wound. The report says Dorelien failed to get medical help for the man, despite the advice of doctors.
Follow this sad story of neglect in the Bradenton Herald.
The lesion was present when Dorelien took charge, but grew during the next few months, eventually rupturing into a large open wound. The report says Dorelien failed to get medical help for the man, despite the advice of doctors.
Follow this sad story of neglect in the Bradenton Herald.
Friday, May 25, 2007
PENN TREATY LONG TERM CARE INSURANCE
I wrote a short blog article on April 6, 2007 (link to article) about how some long term care insurers are quick to take your premium payment and slow and dilatory in paying benefits. The New York Times published a great article on this problem which is becoming all too common.
I was recently contacted by a reader in California who relayed a very unfortunate story concerning her parents’ purchase of a long term care policy issued by Penn Treaty. The reader told me her parents purchased LTC insurance from Penn Treaty in 1997 with premium waiver benefit for the surviving spouse (i.e. if one spouse dies the surviving spouse does not pay any more premiums for the rest of his/her life). Her mother passed away on May 5, 2007 and Penn Treaty is trying to deny her father the surviving spouse benefit.
Has anyone experienced similar problems with Penn Treaty? If so, please let us hear about your situation.
I was recently contacted by a reader in California who relayed a very unfortunate story concerning her parents’ purchase of a long term care policy issued by Penn Treaty. The reader told me her parents purchased LTC insurance from Penn Treaty in 1997 with premium waiver benefit for the surviving spouse (i.e. if one spouse dies the surviving spouse does not pay any more premiums for the rest of his/her life). Her mother passed away on May 5, 2007 and Penn Treaty is trying to deny her father the surviving spouse benefit.
Has anyone experienced similar problems with Penn Treaty? If so, please let us hear about your situation.
DOCTORS WANT PATIENTS TO SIGN A “NO SUE” CONTRACT
I knew it was coming to this! As consumers of medical care, this should alarm you! A group of New Jersey obstetricians and gynecologists has begun asking prospective patients to sign away their right to a jury trial.
Citing the high cost of medical malpractice insurance, more than a dozen ob-gyns have joined Obstetricians & Gynecologists Risk Retention Group of America (OGRRGA), a new Montana-based company. As part of their participation in the group, these physicians are requiring patients to sign agreements stating that they will pursue any subsequent disputes through binding arbitration. They also must agree that pain-and-suffering awards will be capped at $250,000.
Let’s say your ob-gyn’s negligence in delivering your child causes your baby to suffer such horrendous injuries that, while they will have a normal life expectancy, they will be blind, deaf, and never function above the level of an infant. These doctors believe that $250,000 is enough damages for the pain and suffering of your baby and your family. And by the way…if you fail to pay our doctor’s bill he will sue you in court.
Pretty damn outrageous!
Read the news report for yourself.
Citing the high cost of medical malpractice insurance, more than a dozen ob-gyns have joined Obstetricians & Gynecologists Risk Retention Group of America (OGRRGA), a new Montana-based company. As part of their participation in the group, these physicians are requiring patients to sign agreements stating that they will pursue any subsequent disputes through binding arbitration. They also must agree that pain-and-suffering awards will be capped at $250,000.
Let’s say your ob-gyn’s negligence in delivering your child causes your baby to suffer such horrendous injuries that, while they will have a normal life expectancy, they will be blind, deaf, and never function above the level of an infant. These doctors believe that $250,000 is enough damages for the pain and suffering of your baby and your family. And by the way…if you fail to pay our doctor’s bill he will sue you in court.
Pretty damn outrageous!
Read the news report for yourself.
DIABETES MEDICINE AVANDIA MAY CAUSE HEART ATTACKS
An article published (May 21, 2007) in the New England Journal of Medicine has doctors and diabetes patients scrambling to learn more about the link between Avandia (a drug for Type II diabetes) to a potentially increased risk of heart attacks. The analysis of the drug was conducted by Dr. Steven Nissen, a prominent cardiologist with the Cleveland Clinic, who interestingly was an early critic of Vioxx, a pain killer which has been withdrawn from the market. Read the Journal article here.
The FDA has issued an Alert which says in part: The FDA is aware of a potential safety issue related to Avandia (rosiglitazone). Safety data from controlled clinical trials have shown that there is a potentially significant increase in the risk of heart attack and heart-related deaths in patients taking Avandia. Patients who are taking Avandia, especially those who are known to have underlying heart disease or who are at high risk of heart attack should talk to their doctor about this new information as they evaluate the available treatment options for their type II diabetes. Read the entire FDA alert here.
Read other safety alerts from Dr. Nissen here.
The FDA has issued an Alert which says in part: The FDA is aware of a potential safety issue related to Avandia (rosiglitazone). Safety data from controlled clinical trials have shown that there is a potentially significant increase in the risk of heart attack and heart-related deaths in patients taking Avandia. Patients who are taking Avandia, especially those who are known to have underlying heart disease or who are at high risk of heart attack should talk to their doctor about this new information as they evaluate the available treatment options for their type II diabetes. Read the entire FDA alert here.
Read other safety alerts from Dr. Nissen here.
SECRETS OF THE FOUNTAIN OF YOUTH
A neat article on www.alternativemedicine.com talks about the 15 ways to live longer - so here it is, a little Holiday weekend advice:
FIND HAPPINESS AND PASSION
Some of Dr. Mitch Carroll's patients are still going strong at more than 100 years old. Here are his tips based on observations of his healthiest and happiest patients:
1. Cultivate a support system. Whether it's that gentle nagging by your partner to get your annual physical or it's a concerned friend reminding you to take your blood-pressure medicine, the benefits of a support system are numerous.
2. Find passion for the little things in life. Love for the theater or gardening or art or reading keeps the mind active and can give you joy and a sense of purpose in life.
3. Don't let mental illness go untreated. Depression and other psychological conditions can contribute to poor quality of life, and may compromise the body's ability to recover from injury and illness.
CONTROL BLOOD PRESSURE
Dr. Joseph Ravenell, a hypertension specialist at University of Texas Southwestern Medical Center, says that age 40 is the time people really need to start paying attention to hypertension, because that's the time when you're most vulnerable to type 2 diabetes and high cholesterol. His tips include:
1. Control blood pressure early because as you age, your vascular health can worsen. Controlling hypertension helps slow the aging of your blood vessels.
2. Don't be complacent about high-normal blood pressure because that's increasingly seen as pre-hypertension. Your risk of developing hypertension increases with a blood pressure higher than 115 over 75. Anything you can do to reduce your risk of hypertension can add years to your life.
3. Keep the medications simple. The more medications you add, the more it costs, the more side effects may increase and the more complex it will be to keep track of them. There are more than 100 medications to treat hypertension, but the average number of medications needed for any one patient is 3.5.
---
START AS EARLY AS YOU CAN
Dr. Jack W. Spitzberg, a cardiologist at Presbyterian Hospital of Dallas, says that with heart disease being the No.1 killer of Americans, the earlier you practice good heart health the better.
Not smoking tops his list. His other tips:
1. Establish healthy habits early in life. Exercise and eat a balanced diet when you're young. Overweight children most often become overweight adults-and that carries with it a host of risk factors for heart disease, diabetes and other serious medical conditions.
2. Get your blood pressure and cholesterol checked regularly. They're treatable risk factors for cardiovascular disease, which causes heart attacks, strokes and other deadly conditions. The tests are quick and easy, and medical treatments are effective.
3. Don't ride motorcycles. This actually doesn't affect heart health, but he's noticed over the years that motorcycles send a lot of patients to the emergency room.
---
REMEMBER THE BASICS
Dr. Jeremy Denning, a neurosurgeon at Baylor Regional Medical Center at Plano (Texas), has trained in spinal and cerebrovascular surgery. Here are his tips:
1. Eat healthy. It is important to not only limit the types of food you eat but the amount you eat as well. Obesity is a real problem. Diabetes, heart disease and spine problems are just a few secondary effects of obesity.
2. Exercise regularly. Dr. Denning tries to exercise one to two hours a day. He enjoys it, but he points out that it doesn't require an hour of exercise every day to make a difference. As little as 30 minutes a day can help improve cardiovascular fitness, boost the immune system and also serve as a great stress reducer and mood enhancer.
3. Avoid tobacco. When he sees a patient who is a smoker, a red flag is immediately raised in his mind. Tobacco can lead to poor healing after surgery, a higher chance of infection or wound breakdown and higher risk of medical complications after surgery. Cigarette smoking also increases risk of heart attack, stroke, aneurysm development, deep-vein thrombosis and cancer. Nonsmokers are at a tremendous health advantage.
---
TREAT THE WHOLE PERSON
Dr. Bassem Elsawy, a geriatric specialist at Family Practice Center at Methodist Charlton Medical Center in Dallas, specializes in the diagnosis, treatment and prevention of disease in adults 65 and older.
Dr. Elsawy's goal is to treat the whole person, which means working with social workers as well as resident physicians to assess each senior's medical, mental and social condition. His tips:
1. Continue your social interactions and involvement. Stay physically, mentally, spiritually and emotionally active.
2. Take to the water. The best exercise for the elderly is water aerobics because it is an exercise that does not put a burden on weight-bearing joints such as the knees.
3. A well-balanced diet is crucial. An adequate intake of calcium and vitamin D is important for bone health and to prevent osteoporosis. Folic acid, B6 and B12 can lower homocysteine levels, possibly reducing the risk of coronary artery disease and helping to prevent the decline in the cognitive function associated with aging. Protein and zinc help with immunity. But people should consult with their doctors before spending money on over-the-counter supplements.
Dr. Elsawy's main concern with elderly patients is weight loss. As people age, they tend to lose the senses of taste and smell and have decreased stomach capacity. Keeping well-hydrated is important. Making mealtime a social event and adding herbs and spices may make meals appetizing. Well-fitting dentures and good oral hygiene help, too.
Nancy Churnin - http://www.alternativemedicine.com/common/news/news_results.asp?task=HowTo&id=9163&storeID=02AD61F001A74B5887D3BD11F6C28169
FIND HAPPINESS AND PASSION
Some of Dr. Mitch Carroll's patients are still going strong at more than 100 years old. Here are his tips based on observations of his healthiest and happiest patients:
1. Cultivate a support system. Whether it's that gentle nagging by your partner to get your annual physical or it's a concerned friend reminding you to take your blood-pressure medicine, the benefits of a support system are numerous.
2. Find passion for the little things in life. Love for the theater or gardening or art or reading keeps the mind active and can give you joy and a sense of purpose in life.
3. Don't let mental illness go untreated. Depression and other psychological conditions can contribute to poor quality of life, and may compromise the body's ability to recover from injury and illness.
CONTROL BLOOD PRESSURE
Dr. Joseph Ravenell, a hypertension specialist at University of Texas Southwestern Medical Center, says that age 40 is the time people really need to start paying attention to hypertension, because that's the time when you're most vulnerable to type 2 diabetes and high cholesterol. His tips include:
1. Control blood pressure early because as you age, your vascular health can worsen. Controlling hypertension helps slow the aging of your blood vessels.
2. Don't be complacent about high-normal blood pressure because that's increasingly seen as pre-hypertension. Your risk of developing hypertension increases with a blood pressure higher than 115 over 75. Anything you can do to reduce your risk of hypertension can add years to your life.
3. Keep the medications simple. The more medications you add, the more it costs, the more side effects may increase and the more complex it will be to keep track of them. There are more than 100 medications to treat hypertension, but the average number of medications needed for any one patient is 3.5.
---
START AS EARLY AS YOU CAN
Dr. Jack W. Spitzberg, a cardiologist at Presbyterian Hospital of Dallas, says that with heart disease being the No.1 killer of Americans, the earlier you practice good heart health the better.
Not smoking tops his list. His other tips:
1. Establish healthy habits early in life. Exercise and eat a balanced diet when you're young. Overweight children most often become overweight adults-and that carries with it a host of risk factors for heart disease, diabetes and other serious medical conditions.
2. Get your blood pressure and cholesterol checked regularly. They're treatable risk factors for cardiovascular disease, which causes heart attacks, strokes and other deadly conditions. The tests are quick and easy, and medical treatments are effective.
3. Don't ride motorcycles. This actually doesn't affect heart health, but he's noticed over the years that motorcycles send a lot of patients to the emergency room.
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REMEMBER THE BASICS
Dr. Jeremy Denning, a neurosurgeon at Baylor Regional Medical Center at Plano (Texas), has trained in spinal and cerebrovascular surgery. Here are his tips:
1. Eat healthy. It is important to not only limit the types of food you eat but the amount you eat as well. Obesity is a real problem. Diabetes, heart disease and spine problems are just a few secondary effects of obesity.
2. Exercise regularly. Dr. Denning tries to exercise one to two hours a day. He enjoys it, but he points out that it doesn't require an hour of exercise every day to make a difference. As little as 30 minutes a day can help improve cardiovascular fitness, boost the immune system and also serve as a great stress reducer and mood enhancer.
3. Avoid tobacco. When he sees a patient who is a smoker, a red flag is immediately raised in his mind. Tobacco can lead to poor healing after surgery, a higher chance of infection or wound breakdown and higher risk of medical complications after surgery. Cigarette smoking also increases risk of heart attack, stroke, aneurysm development, deep-vein thrombosis and cancer. Nonsmokers are at a tremendous health advantage.
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TREAT THE WHOLE PERSON
Dr. Bassem Elsawy, a geriatric specialist at Family Practice Center at Methodist Charlton Medical Center in Dallas, specializes in the diagnosis, treatment and prevention of disease in adults 65 and older.
Dr. Elsawy's goal is to treat the whole person, which means working with social workers as well as resident physicians to assess each senior's medical, mental and social condition. His tips:
1. Continue your social interactions and involvement. Stay physically, mentally, spiritually and emotionally active.
2. Take to the water. The best exercise for the elderly is water aerobics because it is an exercise that does not put a burden on weight-bearing joints such as the knees.
3. A well-balanced diet is crucial. An adequate intake of calcium and vitamin D is important for bone health and to prevent osteoporosis. Folic acid, B6 and B12 can lower homocysteine levels, possibly reducing the risk of coronary artery disease and helping to prevent the decline in the cognitive function associated with aging. Protein and zinc help with immunity. But people should consult with their doctors before spending money on over-the-counter supplements.
Dr. Elsawy's main concern with elderly patients is weight loss. As people age, they tend to lose the senses of taste and smell and have decreased stomach capacity. Keeping well-hydrated is important. Making mealtime a social event and adding herbs and spices may make meals appetizing. Well-fitting dentures and good oral hygiene help, too.
Nancy Churnin - http://www.alternativemedicine.com/common/news/news_results.asp?task=HowTo&id=9163&storeID=02AD61F001A74B5887D3BD11F6C28169
Thursday, May 24, 2007
SCARY NEWS FOR DIABETICS
Type II, Type I - there is no good kind of diabetes. Nor is there an easy treatment. Diabetics struggle daily with controlling their sugar, and in order to do so, must watch what they eat - excercise, medication etc.
How do many diabetics control their sugar? With insulin, and others with medications like Avendia.
This week, recent studies reflect that Avandia, which about 1 million Americans take to keep their blood sugar at safe levels, boosts the risk of a heart attack by 43 percent and may increase the risk of dying from a heart attack or stroke by 64 percent, the analysis found. http://www.washingtonpost.com/wp-dyn/content/article/2007/05/21/AR2007052100558.html.
If you have adult on-set diabetes, your weight is likely a struggle - which of course leads to heart problems etc - but now, treating your diabetes medically may be even more dangerous.
The manufacturer, so I have heard, is encouraging patients to speak to their physicians before discontuining the medication - but what will physicians do, with little information from the analysis?
Scary stuff... stay tuned.
How do many diabetics control their sugar? With insulin, and others with medications like Avendia.
This week, recent studies reflect that Avandia, which about 1 million Americans take to keep their blood sugar at safe levels, boosts the risk of a heart attack by 43 percent and may increase the risk of dying from a heart attack or stroke by 64 percent, the analysis found. http://www.washingtonpost.com/wp-dyn/content/article/2007/05/21/AR2007052100558.html.
If you have adult on-set diabetes, your weight is likely a struggle - which of course leads to heart problems etc - but now, treating your diabetes medically may be even more dangerous.
The manufacturer, so I have heard, is encouraging patients to speak to their physicians before discontuining the medication - but what will physicians do, with little information from the analysis?
Scary stuff... stay tuned.
Wednesday, May 23, 2007
HIGH WORKLOADS FOR STAFF ON PATIENT’S ADMISSION DAY MAY WORSEN PATIENT’S OUTCOME
A recent report suggests that higher workloads for hospital staff on a patient’s admission day increase the length of stay, mortality risk (risk of dieing) and total costs. The study was based upon a retrospective study of 5742 adults admitted to an academic (medical school affiliated) hospital. Maybe hospital administrators should make sure there is enough staff on hand in the admissions department to see that all of the paper work and initial patient assessments are performed correctly.
Read an abstract of the study, which was published in the Archives of Internal Medicine
Read an abstract of the study, which was published in the Archives of Internal Medicine
MORE GRUESOME NEWS REGARDING CHICAGO AREA NURSING HOME
I reported last year (11-26-06) on an Illinois nursing home under investigation. The inquiry focused on possible morphine overdoses at the Woodstock Residence Nursing Home. Investigators interviewed a former employee of Woodstock Residence and believe the deaths suspicious but are not calling them homicides.
The Chicago Tribune now reports a third body has been exhumed as part of an Illinois State Police investigation into six suspicious deaths at the nursing home. Efforts to investigate three other suspicious deaths at the Woodstock Residence have been stymied because the bodies were cremated.
Read the Chicago Tribune article on this bizarre story.
The Chicago Tribune now reports a third body has been exhumed as part of an Illinois State Police investigation into six suspicious deaths at the nursing home. Efforts to investigate three other suspicious deaths at the Woodstock Residence have been stymied because the bodies were cremated.
Read the Chicago Tribune article on this bizarre story.
CONTAMINATED TOOTHPASTE FROM CHINA
In a recent article, The New York Times reports that Chinese authorities are investigating whether two companies have exported contaminated toothpaste overseas.
“No tainted toothpaste has been found in the United States, but a spokesman for the Food and Drug Administration” said yesterday that the agency would be taking “a hard look” at whether to issue an import alert. “
Authorities in the Dominican Republic have found about 36,000 tubes of toothpaste which may be contaminated with diethylene glycol, which is an industrial solvent and an ingredient in some antifreeze. Unfortunately, included in this huge amount of toothpaste were tubes of toothpaste marketed for children as “Mr Cool Junior” or “Excel”.
Tubes of toothpaste containing the toxic ingredient were also found in Panama and Australia within the last week. Diethylene Glycol is the same poison that the Panamanian government accidentally mixed into cold medicine last year, killing 100 people. There have been no reports of deaths tied to consumption of this toothpaste so far.
“No tainted toothpaste has been found in the United States, but a spokesman for the Food and Drug Administration” said yesterday that the agency would be taking “a hard look” at whether to issue an import alert. “
Authorities in the Dominican Republic have found about 36,000 tubes of toothpaste which may be contaminated with diethylene glycol, which is an industrial solvent and an ingredient in some antifreeze. Unfortunately, included in this huge amount of toothpaste were tubes of toothpaste marketed for children as “Mr Cool Junior” or “Excel”.
Tubes of toothpaste containing the toxic ingredient were also found in Panama and Australia within the last week. Diethylene Glycol is the same poison that the Panamanian government accidentally mixed into cold medicine last year, killing 100 people. There have been no reports of deaths tied to consumption of this toothpaste so far.
Tuesday, May 22, 2007
TAKING ASPIRIN AND YOUR HEALTH
For as long as I can remember, one of the ways to avoid heart attacks has been to take aspirin on a daily basis. The benefits of taking aspirin both to avoid heart attacks and to avoid colon cancer are now up for debate.
In The Cheerful Oncologist, the author posts the following articles:
From the Boston Globe, “A baby aspirin a day is healthy; but more than that can be dangerous”
From All Headline News, “High doses of aspirin may reduce colon cancer risk”
In these articles, it is stated both that taking more than 81mg of aspirin a day will increase your risk of gastrointestinal bleeding. BUT, in order to prevent colon cancer you should take higher doses of aspirin. With conflicting information like these, how do you know what to do?
This is an issue to think about. As always, consult your doctor to determine what is right for you but be informed when starting a new drug or health regimen. Ask questions and do your own research of benefits and risks. Doctors are specialized in medicine but they cannot always know all of the answers for everything. You may be able to ask a question or bring up a point that would help your doctor treat you the best that he/she can.
In addition, you can view information on the benefits and risks of aspirin therapy on WebMD at http://www.webmd.com/heart-disease/aspirin-therapy
In The Cheerful Oncologist, the author posts the following articles:
From the Boston Globe, “A baby aspirin a day is healthy; but more than that can be dangerous”
From All Headline News, “High doses of aspirin may reduce colon cancer risk”
In these articles, it is stated both that taking more than 81mg of aspirin a day will increase your risk of gastrointestinal bleeding. BUT, in order to prevent colon cancer you should take higher doses of aspirin. With conflicting information like these, how do you know what to do?
This is an issue to think about. As always, consult your doctor to determine what is right for you but be informed when starting a new drug or health regimen. Ask questions and do your own research of benefits and risks. Doctors are specialized in medicine but they cannot always know all of the answers for everything. You may be able to ask a question or bring up a point that would help your doctor treat you the best that he/she can.
In addition, you can view information on the benefits and risks of aspirin therapy on WebMD at http://www.webmd.com/heart-disease/aspirin-therapy
NEGLIGENCE LAW SUITS = LIENS
A new article entitled "Negligence Law Suits = Liens" has been posted by Lauren Ellerman on frithlawfirm.com. This article discusses the impact of a possible lien on a negligence law suit and some of the parties that may claim a lien against a settlement. Please view the article here.
You may also find articles by both Dan Frith and Lauren Ellerman here.
You may also find articles by both Dan Frith and Lauren Ellerman here.
Monday, May 21, 2007
WOULD CARILION HOSPITALS GUARANTEE THEIR WORK?
Impossible! Outrageous! Unreasonable! Those are the types of responses I would expect to hear from administrators of our local hospital (Carilion Roanoke Memorial Hospital) if asked the above question. Well, it appears that at least one hospital is willing to give it a try.
Geisinger Health System in Pennsylvania has overhauled its approach to surgery. And taking a cue from the makers of television sets, washing machines and consumer products, Geisinger essentially guarantees its workmanship, charging a flat fee that includes 90 days of follow-up treatment. Even if a patient suffers complications or has to come back to the hospital, Geisinger promises not to send the insurer another bill. The plan is called “Provencare.”
Geisinger stands out as a group that has transformed the way it delivers care, said Dr. Donald M. Berwick, the chief executive of Institute for Healthcare Improvement, a national nonprofit organization whose goal is better patient care. In almost no other field would consumers tolerate the frequency of error that is common in medicine, Dr. Berwick said, and Geisinger has managed to reduce the rate significantly. “Getting everything right is really, really hard,” he said.
What a great idea!
Read the New York Times article on Provencare.
Geisinger Health System in Pennsylvania has overhauled its approach to surgery. And taking a cue from the makers of television sets, washing machines and consumer products, Geisinger essentially guarantees its workmanship, charging a flat fee that includes 90 days of follow-up treatment. Even if a patient suffers complications or has to come back to the hospital, Geisinger promises not to send the insurer another bill. The plan is called “Provencare.”
Geisinger stands out as a group that has transformed the way it delivers care, said Dr. Donald M. Berwick, the chief executive of Institute for Healthcare Improvement, a national nonprofit organization whose goal is better patient care. In almost no other field would consumers tolerate the frequency of error that is common in medicine, Dr. Berwick said, and Geisinger has managed to reduce the rate significantly. “Getting everything right is really, really hard,” he said.
What a great idea!
Read the New York Times article on Provencare.
FREDERICKSBURG, VIRGINIA NURSING HOME IN BIG TROUBLE!
It takes a lot for a nursing home to lose certification from Medicare and Medicaid but it looks like a nursing home in Fredericksburg, Virginia has done just that.
On May 1, 2007 a resident of Carriage Hill Rehabilitation and Nursing Center in Fredericksburg strangled to death on a nurse call bell cord which had been improperly tied to the resident’s bed. Unbelievably, the nursing home learned nothing from the senseless and preventable tragedy as evidenced by the fact that when a Health Department inspector arrived at the facility one week later the inspector found 20 call bell cords tied to residents’ beds. The facility, owned by MediCorp Health Systems, had been cited 4 times in 5 months for deficiencies by state regulators.
Maybe the loss of the source of payment (Medicaid and Medicare) for 70% of its residents will force the corporate owners to start taking better care of its residents!
Read the newspaper report here.
On May 1, 2007 a resident of Carriage Hill Rehabilitation and Nursing Center in Fredericksburg strangled to death on a nurse call bell cord which had been improperly tied to the resident’s bed. Unbelievably, the nursing home learned nothing from the senseless and preventable tragedy as evidenced by the fact that when a Health Department inspector arrived at the facility one week later the inspector found 20 call bell cords tied to residents’ beds. The facility, owned by MediCorp Health Systems, had been cited 4 times in 5 months for deficiencies by state regulators.
Maybe the loss of the source of payment (Medicaid and Medicare) for 70% of its residents will force the corporate owners to start taking better care of its residents!
Read the newspaper report here.
Friday, May 18, 2007
TRIAL LAWYERS ACCUSE MALPRACTICE INSURER OF ILLEGAL RATES
Yes, you read the title correctly! Doctors have long complained large malpractice lawsuits contribute to climbing insurance rates and rising medical costs. I represent the victims of medical negligence and hear from doctors all the time that my cases are driving their malpractice premiums so high that some doctors are stopping the practice of medicine. First, I do not know of any Virginia doctor who stopped practicing medicine as a result of medical malpractice suits – unless the State Board of Medicine took his/her license away. Second, why don’t doctors take a closer look at their insurance company’s role in the problem? Trial lawyers in North Carolina are doing just that.
The North Carolina Academy of Trial Lawyers is pushing for an investigation into the rates charged by Medical Mutual Insurance Co. of North Carolina. State law bars medical malpractice insurers from charging excessive rates. The company's rates have "crossed the legal threshold," said Dick Taylor, chief executive officer of the trial lawyers’ academy. The group on Tuesday asked state Insurance Commissioner Jim Long to investigate.
Follow the story here.
The North Carolina Academy of Trial Lawyers is pushing for an investigation into the rates charged by Medical Mutual Insurance Co. of North Carolina. State law bars medical malpractice insurers from charging excessive rates. The company's rates have "crossed the legal threshold," said Dick Taylor, chief executive officer of the trial lawyers’ academy. The group on Tuesday asked state Insurance Commissioner Jim Long to investigate.
Follow the story here.
WHO IS READING YOUR X-RAY IN ROANOKE?
The front page of today’s Roanoke Times (5-8-07) contains an excellent article about a serious problem right here in Roanoke. For starters, Carilion Roanoke Memorial Hospital lost most of their radiologists several months ago. That group of doctors, Radiology Associates, moved most of their practice to another hospital, Lewis-Gale Hospital in Salem, Virginia. The reasons for the departure of Radiology Associates are numerous but it is the impact on patient care which concerns me.
Radiologists are specially trained doctors who spend most of their day looking at x-rays and CT films in a darkened room. There work is critical in diagnosing broken bones, collapsed lungs, aneurysms, strokes, cancer, etc. Who is reading Roanoke Memorial Hospital patient’s films? Somebody in Australia or India!
It appears RMH is sending your films, via the Internet, to doctors half way around the world. How well are those doctors in Australia or India trained? How does your doctor (who ordered the radiology study) ask questions the foreign doctor’s interpretation of the film? What happens when the hospital’s Internet connection goes down?
To bad that you, as the patient, have no say in this ticking time bomb of problem!
Radiologists are specially trained doctors who spend most of their day looking at x-rays and CT films in a darkened room. There work is critical in diagnosing broken bones, collapsed lungs, aneurysms, strokes, cancer, etc. Who is reading Roanoke Memorial Hospital patient’s films? Somebody in Australia or India!
It appears RMH is sending your films, via the Internet, to doctors half way around the world. How well are those doctors in Australia or India trained? How does your doctor (who ordered the radiology study) ask questions the foreign doctor’s interpretation of the film? What happens when the hospital’s Internet connection goes down?
To bad that you, as the patient, have no say in this ticking time bomb of problem!
HOSPITAL WARRANTIES
A surgical group in Penn. has received a great deal of press this week - a 90 day post surgery warranty. Yup. Any "repair " work you need post surgery, "corrections" or fixing required, its covered! No additional charges or bills to the insurance company. A guarantee, like your kitchen aid, whirlpool washer or hairdryer. So way to go Geisinger Surgical Group, we applaud your efforts at helping patients and encouraging post op care - not just the discharge because insurance won't pay anymore. Hope it works well for you and your patients!
NEW TRENDS IN RADIOLOGY
Small and large hospitals are using teleradiology. Well, so what - what does that mean and why should you care? It means, between 9pm and 8am, anyone that presents to the emergency room that may be in danger of having cervical fracture, compromises to the spinal chord - ANYTHING that requires an X-Ray or CT Scan, the scans are read by a radiologist far away - communicated and shared through the computer usually.
You can imagine the many reasons this is an attractive options for many hospitals. The process could save money, guarantee a radiologist "on duty" over night - holidays, etc. And that is why hospitals of all sizes are relying on these sometimes local, and sometimes not local radiology services.
Example:
Mike gets into a car accident at 11:00pm Friday night - presents to the emergency room at 11:30 in a soft collar applied by the EMT squad. Possible head trauma, internal bleeding and the ED physician orders complete X-Ray series and CT of head and spine. Thats it. Then the radiology tech takes Mike to the CT X-Ray room, gets the scans and basically emails them to Virginia Beach or wherever the service is located. Radiologist Fred gets the scans on his computer at midnight - reviews, writes a report and faxes it back to the hospital. The new ED physician on duty glances at the reports, sees no fractures and places the reports in the file. At 8am, local radiologist Suzi gets to work - looks at the original CTs and X-Rays, and writes her own report. Does she look at the preliminary one prepared by the tele-radiologist? What if she disagrees, do they discuss it? Which radiologist does the treating physician consult with? These are the possible problems with teleradiology, all of which stem from lack of one on one contact and the possible miscommunication that would naturally occur when you rely on technology.
And we are finding, most hospitals do not have written policies about the process.
So why even write about it if its not a huge concern? Just be aware - maybe ask -"who did the preliminary read?" "Did the local radiologist agree?" "Did they speak about my scans?" Two sets of eyes are no doubt better than one, but its always good to know and find out, whether or not they agree.
My local paper features an article on it this morning - www.roanoke.com
You can imagine the many reasons this is an attractive options for many hospitals. The process could save money, guarantee a radiologist "on duty" over night - holidays, etc. And that is why hospitals of all sizes are relying on these sometimes local, and sometimes not local radiology services.
Example:
Mike gets into a car accident at 11:00pm Friday night - presents to the emergency room at 11:30 in a soft collar applied by the EMT squad. Possible head trauma, internal bleeding and the ED physician orders complete X-Ray series and CT of head and spine. Thats it. Then the radiology tech takes Mike to the CT X-Ray room, gets the scans and basically emails them to Virginia Beach or wherever the service is located. Radiologist Fred gets the scans on his computer at midnight - reviews, writes a report and faxes it back to the hospital. The new ED physician on duty glances at the reports, sees no fractures and places the reports in the file. At 8am, local radiologist Suzi gets to work - looks at the original CTs and X-Rays, and writes her own report. Does she look at the preliminary one prepared by the tele-radiologist? What if she disagrees, do they discuss it? Which radiologist does the treating physician consult with? These are the possible problems with teleradiology, all of which stem from lack of one on one contact and the possible miscommunication that would naturally occur when you rely on technology.
And we are finding, most hospitals do not have written policies about the process.
So why even write about it if its not a huge concern? Just be aware - maybe ask -"who did the preliminary read?" "Did the local radiologist agree?" "Did they speak about my scans?" Two sets of eyes are no doubt better than one, but its always good to know and find out, whether or not they agree.
My local paper features an article on it this morning - www.roanoke.com
Wednesday, May 16, 2007
A ROSE BY ANY OTHER NAME
A black or blue mark on the skin - what is that called? A bruise? An abrasion? A scratch? A pressure ulcer? What does it mean for your loved one in an acute care, hospital or nursing home setting, that he has abrasions, bruises, scratches or pressure ulcers?
Each term means something very different - but sadly, they are often used interchangibly. Pressure ulcers occur when the skin breaks down as a result of pressure. This happens in persons who are not moved frequently, perhaps always in a bed, or chair in the same position. How do you treat these? The federal government has a set of guidelines for pressure Ulcer treatment (see http://www.guideline.gov/summary/summary.aspx?doc_id=7006). Many states have developed their own as well (see Mass. http://www.masspro.org/HS/docs/tools/Pressure%20Ulcer%20Manual.pdf) Where do state and federal organizations get their information about pressure ulcers? From the National Pressure Ulcer Advisory Panel, which just in the last few months, has updated their research and regulations for pressure ulcer identification and treatment. http://www.npuap.org/pr2.htm. Does your loved one's nursing home know about the update system? Ask them - and then ask, is the bruise you see on your loved one's arm, a Bruise, scratch abrasion or worse?
Each term means something very different - but sadly, they are often used interchangibly. Pressure ulcers occur when the skin breaks down as a result of pressure. This happens in persons who are not moved frequently, perhaps always in a bed, or chair in the same position. How do you treat these? The federal government has a set of guidelines for pressure Ulcer treatment (see http://www.guideline.gov/summary/summary.aspx?doc_id=7006). Many states have developed their own as well (see Mass. http://www.masspro.org/HS/docs/tools/Pressure%20Ulcer%20Manual.pdf) Where do state and federal organizations get their information about pressure ulcers? From the National Pressure Ulcer Advisory Panel, which just in the last few months, has updated their research and regulations for pressure ulcer identification and treatment. http://www.npuap.org/pr2.htm. Does your loved one's nursing home know about the update system? Ask them - and then ask, is the bruise you see on your loved one's arm, a Bruise, scratch abrasion or worse?
CASE REPORT: TENNESSEE NURSING HOME SETTLES LAWSUIT
A Cleveland, Tenn., nursing home company has settled a lawsuit that accused it of neglecting its patients and allowing an elderly woman to lie in her own feces for hours at a time after back surgery.
The woman, Betty Mae Hanzel of Hastings, developed an infection in her wound during her stay at the Life Care Center of Elkhorn that required surgery to reopen her incision and drain the infection and fecal matter in the wound, according to the lawsuit. According to the lawsuit, the nursing home staff allowed Hanzel to lie in her own feces and urine for extended periods and, on at least one occasion, told Hanzel to get her own water even though she could not get out of bed. Near the end of her stay at the home, Hanzel discovered a discharge from her surgical incision, but staff did not tell her doctor about the condition for several days, according to the lawsuit. Later, she developed blood clots in the artery leading to her lungs and a "super-infection of the bowel," which led to surgery to remove most of her colon, according to the lawsuit.
Read the Associated Press report here.
The woman, Betty Mae Hanzel of Hastings, developed an infection in her wound during her stay at the Life Care Center of Elkhorn that required surgery to reopen her incision and drain the infection and fecal matter in the wound, according to the lawsuit. According to the lawsuit, the nursing home staff allowed Hanzel to lie in her own feces and urine for extended periods and, on at least one occasion, told Hanzel to get her own water even though she could not get out of bed. Near the end of her stay at the home, Hanzel discovered a discharge from her surgical incision, but staff did not tell her doctor about the condition for several days, according to the lawsuit. Later, she developed blood clots in the artery leading to her lungs and a "super-infection of the bowel," which led to surgery to remove most of her colon, according to the lawsuit.
Read the Associated Press report here.
ELDERLY LESS LIKELY TO ENTER NURSING HOME IN STATES WITH MORE SERVICES
Senior citizens who do not have children to help care for them are less likely to have to go into a nursing home if they live in a state that spends more on home- and community- based services, researchers have found. Researchers at the University of Illinois at Chicago report the finding in the May 11 issue of the Journals of Gerontology: Social Sciences.
Some states spend as little as $35 per person each year on home and community-based services for seniors, while other states spend more than $1,300 per person annually, according to previous research. Regardless of how much was spent on home- and community-based services, the researchers found that doubling states' spending on services would reduce the risk of nursing home admission among childless seniors by 35 percent.
Read about this study in SeniorJournal.com.
Some states spend as little as $35 per person each year on home and community-based services for seniors, while other states spend more than $1,300 per person annually, according to previous research. Regardless of how much was spent on home- and community-based services, the researchers found that doubling states' spending on services would reduce the risk of nursing home admission among childless seniors by 35 percent.
Read about this study in SeniorJournal.com.
Tuesday, May 15, 2007
INVESTORS WILLING TO PAY BILLIONS TO PURCHASE NURSING HOME
I hear it all the time, “we cannot hire more nurses to take care of residents because we just don’t make enough money!” More than one nursing home administrator has testified in depositions that there is “not enough money in the budget to hire more help because 60 – 70 % of the residents are on Medicaid and the reimbursements are too low!”
If true, why are savvy investors and businessmen wiling to pay $1.36 billion for Genesis HealthCare Corporation? Genesis is the nation’s fifth largest nursing home chain. These corporate chains, which operate more than half the nation's nursing homes, are positioning themselves as the cheapest setting to provide rehabilitation rather than as places that house frail, elderly people until they die, industry experts said.
Nursing home owners are making big money and if you don’t believe their philosophy is “profits over people”…you better get your head examined!
Read what the Philadelphia Inquirer reports here.
If true, why are savvy investors and businessmen wiling to pay $1.36 billion for Genesis HealthCare Corporation? Genesis is the nation’s fifth largest nursing home chain. These corporate chains, which operate more than half the nation's nursing homes, are positioning themselves as the cheapest setting to provide rehabilitation rather than as places that house frail, elderly people until they die, industry experts said.
Nursing home owners are making big money and if you don’t believe their philosophy is “profits over people”…you better get your head examined!
Read what the Philadelphia Inquirer reports here.
FRITH LAW FIRM RESOURCES
Our firm’s website, www.frithlawfirm.com has many articles and resources that could be helpful for you. Please visit our articles page at www.frithlawfirm.com/articles.htm or our general Resources page at www.frithlawfirm.com/resources.htm.
Please feel free to contact us if you have any questions.
Monday, May 14, 2007
SENATE OVERWHELMINGLY APPROVES DRUG SAFETY BILL
The Senate recently approved a drug safety bill which will double the number of government scientists assigned to find risky side effects in medicines that are already on the market in the United States. The bill will also create a computerized network to scan medical insurance and pharmacy records for signs of trouble with new drugs, and it will greatly increase the power of the Food and Drug Administration to require drug makers to reduce risks.
This drug safety bill was drafted due to the safety lapses of late, including the withdrawal of Vioxx and Rezulin, as well as the FDA’s late warning regarding suicide risks with antidepressants. It also addresses consumer complaints about misleading marketing of drugs. The FDA will now have a voluntary program which will review television commercials before they are aired.
The House is expected to come up with its own drug safety bill soon. The House bill is likely to be harder on the industry, but senior House lawmakers have praised the Senate’s basic attempt. They are hoping to have a bill to President Bush this summer.
Highlights from the Senate’s bill include:
- A computerized system to monitor potential problems with new drugs.
- Strengthens FDA powers to require follow-up safety studies and stronger warnings for medications already on the market.
- Significant increases in funding and staff for the FDA drug safety office.
- Expanded public disclosure of clinical trials and their results.
- FDA required to release dissenting opinions of agency scientists.
- Stricter conflict-of-interest rules for the FDA's outside advisors.
NURSING HOMES: LOW STAFFING EQUALS POOR CARE
We have written about it before but are regulators and consumers listening? Nursing homes, in an attempt to maximize profit over people, almost uniformly fail to hire a sufficient number of aides and nurses to provide adequate care of its residents. How can one or two nurse aides take care of 15 to 20 residents who need assistance in many of their activities of daily living? The simple answer is they cannot and the resident suffers as a result.
How widespread is the problem? “Ninety-two percent of the nursing homes in the country are not staffed at a level that allows them to provide adequate care," said Alice Hedt, executive director of the National Citizens’ Coalition for Nursing Home Reform (NCCNHR), which is pushing federal legislation that would mandate specific staffing levels in nursing homes.
In our home state of Virginia, we have no minimum requirements for the number of nurses and nurse aides. It is a crime!
Read an article from The Cincinnati Post on this problem.
How widespread is the problem? “Ninety-two percent of the nursing homes in the country are not staffed at a level that allows them to provide adequate care," said Alice Hedt, executive director of the National Citizens’ Coalition for Nursing Home Reform (NCCNHR), which is pushing federal legislation that would mandate specific staffing levels in nursing homes.
In our home state of Virginia, we have no minimum requirements for the number of nurses and nurse aides. It is a crime!
Read an article from The Cincinnati Post on this problem.
CASE REPORT: OHIO NURSING HOME CHARGED WITH NEGLECT IN RESIDENT’S DEATH
The state of Ohio has issued a second Type A citation to Baptist Convalescent Center in Newport after a resident who had become dehydrated at the nursing home died of renal failure on April 8, two days after being hospitalized. The citation, the most serious type the state employs, was issued April 26. It charges that Baptist Convalescent Center put the resident's life in immediate jeopardy when it failed to monitor fluid intake and failed to assure lab tests were conducted in March.
It was the second Type A citation this year for the nursing home. The first was issued on March 16, after a resident went four days without food or water because no one noticed that his feeding tube bottle needed changing.
Read the newspaper article here.
It was the second Type A citation this year for the nursing home. The first was issued on March 16, after a resident went four days without food or water because no one noticed that his feeding tube bottle needed changing.
Read the newspaper article here.
Friday, May 11, 2007
WHAT HAPPENS WHEN PARAMEDICS AND EMT PERSONNEL MAKE MISTAKES?
A Mustang broadsided Kathy Schroeder's Hyundai sports coupe in an intersection, knocking her unconscious. She woke up wedged against the console, covered with an oily film. ‘I just remember my eyes and face burning,’ she said, ‘like bacon sizzling.’ She recalled telling the Los Angeles County Fire Department rescuers at the scene but said they didn't flush her eyes. After being rolled into a private ambulance, she told the attendants too. They didn't flush her eyes, either, explaining that it would get their floor wet, she said.
By the time the hospital did the flushing, the damage was done. Battery acid and other chemicals had burned her corneas, according to her subsequent lawsuit against her rescuers. Even now, after five eye surgeries in five years, life on a good day is a blurry video. Unable to resume her job as an advocate for the disabled, Schroeder, now 47, received a $400,000 settlement from the ambulance company. The people who regulate medical rescuers in Los Angeles County, however, heard nothing about this incident.
Read the Los Angeles Times article.
By the time the hospital did the flushing, the damage was done. Battery acid and other chemicals had burned her corneas, according to her subsequent lawsuit against her rescuers. Even now, after five eye surgeries in five years, life on a good day is a blurry video. Unable to resume her job as an advocate for the disabled, Schroeder, now 47, received a $400,000 settlement from the ambulance company. The people who regulate medical rescuers in Los Angeles County, however, heard nothing about this incident.
Read the Los Angeles Times article.
FDA EXPANDS SUICIDE WARNINGS ON DRUGS
The Food and Drug Administration ordered drug makers yesterday to add warnings to antidepressant medications, saying the drugs increase the risk of suicidal thinking or behavior in some young adults. The drug labels, which have included similar warnings for adolescents and children since 2005, will now apply to people younger than 25.
The expanded warnings, which will appear in a black box displayed prominently on the prescribing information, are the strongest caution that regulators can impose. The drug agency also recommended that the labels remind doctors to balance this risk against the ‘clinical need’ for treatment and to mention that the drugs, which include well-known products like Paxil and Zoloft, are associated with no increased suicide risk in patients older than 25 and appear to reduce the risk in those older than 64.
Read the New York Times article on this news.
The expanded warnings, which will appear in a black box displayed prominently on the prescribing information, are the strongest caution that regulators can impose. The drug agency also recommended that the labels remind doctors to balance this risk against the ‘clinical need’ for treatment and to mention that the drugs, which include well-known products like Paxil and Zoloft, are associated with no increased suicide risk in patients older than 25 and appear to reduce the risk in those older than 64.
Read the New York Times article on this news.
Thursday, May 10, 2007
THERE IS NO EPIDEMIC OF MALPRACTICE LAWSUITS IN AMERICA!
There is no evidence to support the much-publicized notion that the tort system amounts to a lottery for injured plaintiffs, as President Bush and others have long maintained, writes Philip G. Peters Jr. in the May edition of the Michigan Law Review. If anything, the system appears to be biased against them. In Peters’ 42-page analysis, he reports that studies examining closed claims in three states, as well as those involving major insurance companies, found that the current jury system favors defendant doctors.
"The studies reveal that juries treat physicians very favorably, perhaps unfairly so," Peters writes,” and are more likely to defer to the judgment of a physician defendant than other physicians are." Overall, injured patients win only about 27 percent of all cases that go to trial -- the lowest rate of any category of tort litigation, researchers have found.
Read the Washington Post article here.
"The studies reveal that juries treat physicians very favorably, perhaps unfairly so," Peters writes,” and are more likely to defer to the judgment of a physician defendant than other physicians are." Overall, injured patients win only about 27 percent of all cases that go to trial -- the lowest rate of any category of tort litigation, researchers have found.
Read the Washington Post article here.
Wednesday, May 09, 2007
TENNESSEE NURSING HOME OFFICIAL RESIGNS
A top Milan nursing home official has resigned a week after the state Department of Health suspended admissions of new patients at the facility. The Health Department has cited problems, including resident neglect, at Douglas Nursing Home. New admissions were suspended April 27 at the facility
A complaint survey the Health Department conducted April 17 through 24 found conditions at the nursing home "likely to be detrimental to the health, safety and the welfare of the residents." Read the newspaper account here.
Read the Tennessee Health Department's Report on Long Term Care.
A complaint survey the Health Department conducted April 17 through 24 found conditions at the nursing home "likely to be detrimental to the health, safety and the welfare of the residents." Read the newspaper account here.
Read the Tennessee Health Department's Report on Long Term Care.
Tuesday, May 08, 2007
NO INSURANCE MEANS HIGHER PRICE OF HEALTHCARE
A study conducted by a Johns Hopkins University researcher found that uninsured patients often pay much higher prices for hospital care. According to the study, uninsured patients are billed 2.5 times more than their counterparts under healthcare plans. Hospitals have faced criticism and lawsuits for alleged price gouging and aggressive collection procedures. Members of the healthcare community have criticized the study, saying the findings are based on old data. Daniel Yi, LA Times 05/08/2007 -http://www.latimes.com/business/la-fi-overcharge8may08,1,188711.story?ctrack=1&cset=true
This may be news to you - sadly, not us. We have long heard that insurance companies negotiate repayment rates with hospitals, so a bandaid may be $2.50 for someone without insurance, but my insurance company has already contracted with the hospital, that they will only pay $1.00 for the bandaid. The hospital will therefore charge me $1 for the same service or care, that someone uninsured pays 250% as much.
The article cites "that Uninsured patients on average are billed 2 1/2 times more than what the insured are billed through their health plans, and more than three times what is billed to patients through Medicare, according to the study appearing today in the journal Health Affairs. In effect, the uninsured are billed at full price, while health plans and Medicare receive deep discounts. Hospitals might charge $12,500 for an appendectomy, for example, but collect only $5,000 from a health insurance plan. Members of the plan actually pay a lot less, through nominal co-pays or deductibles."
So the moral - is that you need insurance. I know, you have to pay the electric bill too - but at least they charge everyone the same rate!
This may be news to you - sadly, not us. We have long heard that insurance companies negotiate repayment rates with hospitals, so a bandaid may be $2.50 for someone without insurance, but my insurance company has already contracted with the hospital, that they will only pay $1.00 for the bandaid. The hospital will therefore charge me $1 for the same service or care, that someone uninsured pays 250% as much.
The article cites "that Uninsured patients on average are billed 2 1/2 times more than what the insured are billed through their health plans, and more than three times what is billed to patients through Medicare, according to the study appearing today in the journal Health Affairs. In effect, the uninsured are billed at full price, while health plans and Medicare receive deep discounts. Hospitals might charge $12,500 for an appendectomy, for example, but collect only $5,000 from a health insurance plan. Members of the plan actually pay a lot less, through nominal co-pays or deductibles."
So the moral - is that you need insurance. I know, you have to pay the electric bill too - but at least they charge everyone the same rate!
TLC4LTC: TENDER LOVING CARE FOR LONG TERM CARE
I want to make those of you living in Virginia who read our Legal Medicine blog aware of a tremendous advocacy group – TLC4LTC. This charitable organization is committed to achieving quality care for nursing home residents in the Commonwealth of Virginia. Here is a brief summary of this great organization:
Actions:
TLC4LTC has developed minimum staffing legislation that has been sponsored by Virginia legislators for the last six years.
TLC4LTC was successful in defeating a bill that would have allowed felons convicted of domestic abuse to work in nursing homes.
TLC4LTC worked to pass legislation that strengthens the existing adult protective services law, including enhanced reporting and investigation procedures.
Activities:
Educational meetings are held at various times and places throughout the year. They are free and open to the public. Planning meetings of the executive committee are also open to the public. Members testify in Richmond and locally on nursing home issues. Committee members meet regularly with numerous related organizations. Members meet with state officials to discuss our mission. Joint meetings of our chapters are held in Harrisonburg.
Training workshops are held for families who want to start family councils.
Locations: Home Base: Northern Virginia
Chapter: Roanoke, Virginia
Time in Existence: 7 years
Staff: There is no paid staff. This is a grassroots organization run totally by volunteers.
Funding: Donations are the sole source of funding. Donations are not accepted from nursing home owners, management or administration. TLC4LTC is a 501c3 organization; donations are tax deductible.
Expenditures: Donations are used for office and mailing supplies, audio-visual equipment rentals, postage, speaker honorariums, website fees, dues to national and state organizations, conferences, travel costs, and publicity.
Membership: Membership is open to any individual who adheres to the principles of TLC 4 Long Term Care as delineated in our mission statement. Dues are not a requirement for membership.
Contact: Dale Belrose, Chairman for TLC4LTC: www.tlc4ltc.org
Actions:
TLC4LTC has developed minimum staffing legislation that has been sponsored by Virginia legislators for the last six years.
TLC4LTC was successful in defeating a bill that would have allowed felons convicted of domestic abuse to work in nursing homes.
TLC4LTC worked to pass legislation that strengthens the existing adult protective services law, including enhanced reporting and investigation procedures.
Activities:
Educational meetings are held at various times and places throughout the year. They are free and open to the public. Planning meetings of the executive committee are also open to the public. Members testify in Richmond and locally on nursing home issues. Committee members meet regularly with numerous related organizations. Members meet with state officials to discuss our mission. Joint meetings of our chapters are held in Harrisonburg.
Training workshops are held for families who want to start family councils.
Locations: Home Base: Northern Virginia
Chapter: Roanoke, Virginia
Time in Existence: 7 years
Staff: There is no paid staff. This is a grassroots organization run totally by volunteers.
Funding: Donations are the sole source of funding. Donations are not accepted from nursing home owners, management or administration. TLC4LTC is a 501c3 organization; donations are tax deductible.
Expenditures: Donations are used for office and mailing supplies, audio-visual equipment rentals, postage, speaker honorariums, website fees, dues to national and state organizations, conferences, travel costs, and publicity.
Membership: Membership is open to any individual who adheres to the principles of TLC 4 Long Term Care as delineated in our mission statement. Dues are not a requirement for membership.
Contact: Dale Belrose, Chairman for TLC4LTC: www.tlc4ltc.org
NURSING HOME CARE WITHHELD DUE TO RACIAL EPITHETS
In searching the web, I found a post recently on the Illinois Nursing Home Abuse Blog where a man in Louisiana recently filed a lawsuit alleging his mother was neglected during her stay at Heritage Manor in Houma, LA prior to her death on Christmas of 2004. The son alleges his mother received acceptable care there until her Alzheimer’s and dementia made her start verbally lashing out at the staff of the nursing home.
Residents suffering from Alzheimer’s disease and dementia often become verbally abusive due to frustration and confusion. The staff at all nursing homes should be trained in ways to deal with such patients such as redirection, appropriate activities, etc. and withholding proper medical care is never the answer!
Read the blog post here.
Read the newspaper account here.
Residents suffering from Alzheimer’s disease and dementia often become verbally abusive due to frustration and confusion. The staff at all nursing homes should be trained in ways to deal with such patients such as redirection, appropriate activities, etc. and withholding proper medical care is never the answer!
Read the blog post here.
Read the newspaper account here.
SAN FRANCISCO TO BUILD HUGE NURSING HOME
San Francisco plans to spend about $600 million to replace the Laguna Honda Hospital and Rehabilitation Center, an effort that "bucks a tenuous trend across the country" to provide care to seniors in their homes or in assisted living facilities, the Wall Street Journal reported on May 7, 2007. "A debate has long raged over whether it's cheaper to care for the elderly and frail in institutions or at home," and the federal government "now believes it can save Medicaid dollars and improve elderly people's lives by encouraging more home care," the Journal reports. However, nursing homes "still are favored by federal Medicaid payment rules, which in recent years have allowed the elderly and younger disabled to seek alternatives but require them to clear more hurdles to qualify," according to the Journal.
The Journal reports that Laguna Honda "benefits from unusually friendly treatment from Medicaid," under which reimbursements are doubled to $338 per patient daily because the facility is licensed as both a hospital and a nursing home, although the facility has only 20 hospital beds. With additional payments from the city, Laguna Honda receives an average of $431 per patient daily, and the new facility could receive as much as $500 per patient daily because of additional payments from Medicaid and the city related to construction costs.
Sounds like a warehouse for the elderly to me!
The Journal reports that Laguna Honda "benefits from unusually friendly treatment from Medicaid," under which reimbursements are doubled to $338 per patient daily because the facility is licensed as both a hospital and a nursing home, although the facility has only 20 hospital beds. With additional payments from the city, Laguna Honda receives an average of $431 per patient daily, and the new facility could receive as much as $500 per patient daily because of additional payments from Medicaid and the city related to construction costs.
Sounds like a warehouse for the elderly to me!
Monday, May 07, 2007
I WISH THIS WAS A JOKE
Prisoners assigned to a nursing home.... and they escape. What if it was worse? What it they had assaulted residents, taken their things - or left with residents?
http://www.wcax.com/Global/story.asp?S=6466959&nav=menu183_2_4
I am in favor of prison work sites - but would anyone say a nursing home is an appropriate location?
http://www.wcax.com/Global/story.asp?S=6466959&nav=menu183_2_4
I am in favor of prison work sites - but would anyone say a nursing home is an appropriate location?
CASE REPORT: WV NURSING HOME HIT WITH $1.75 MILLION DOLLAR VERDICT
A federal jury awarded $1.75 million last month to a woman who said her sister lost her dignity in the last days of her life because of unhygienic conditions and improper care at a Charleston, West Virginia nursing home. Tammy Rectenwald, 44, was in the late stages of multiple sclerosis and could no longer speak. She lived at Meadowbrook Acres in Charleston, WV from March 1999 until October 2003.
On Oct. 8, 2003, she had chest congestion and other signs of pneumonia, but nursing home staff did not call her family or an ambulance. When the nursing home called Tammy’s family 12 hours later, the family insisted that Tammy be taken to the hospital.
Tammy died a week later at Saint Francis Hospital, where doctors found evidence that she had been neglected, such as an infected catheter site and dirty nails and skin. Read the newspaper report here.
When will nursing homes start providing the care needed by the elderly and infirm?
On Oct. 8, 2003, she had chest congestion and other signs of pneumonia, but nursing home staff did not call her family or an ambulance. When the nursing home called Tammy’s family 12 hours later, the family insisted that Tammy be taken to the hospital.
Tammy died a week later at Saint Francis Hospital, where doctors found evidence that she had been neglected, such as an infected catheter site and dirty nails and skin. Read the newspaper report here.
When will nursing homes start providing the care needed by the elderly and infirm?
Friday, May 04, 2007
TROUBLE ERUPTS AT ILLINOIS NURSING HOME
Conditions at an East Peoria, Illinois nursing home changed dramatically for elderly residents when a number of younger residents with psychiatric problems and/or criminal histories were admitted to the East Peoria Gardens Healthcare Center.
The Chicago Tribune reported the new residents wandered the hallways at night, shouting and pounding the walls with their heads and fists. Law enforcement, fire and rescue officials received nearly 150 calls since January about issues with residents that included burglary, assault and battery, and disorderly conduct. Read the report here.
Will nursing home owners admit anyone just to make a buck?
The Chicago Tribune reported the new residents wandered the hallways at night, shouting and pounding the walls with their heads and fists. Law enforcement, fire and rescue officials received nearly 150 calls since January about issues with residents that included burglary, assault and battery, and disorderly conduct. Read the report here.
Will nursing home owners admit anyone just to make a buck?
NCCNHR TAKES THE FIGHT TO CONGRESS
We have previously written about NCCNHR - the National Citizens' Coalition for Nursing Home Reform (NCCNHR), formed because of public concern about substandard care in nursing homes. This tremendous advocacy organization has been busy this week testifying before the Senate Aging Committee on the need for increased staffing at all of America’s nursing homes.
NCCNHR needs your support. Now is the time to:
NCCNHR needs your support. Now is the time to:
- Write your Congressmen expressing support for the recommendations made by NCCNHR at the May 2 Senate Aging Hearing. This is an opportunity to say you care about residents and about conditions in nursing homes.
- Identify opportunities to highlight your experiences with enforcement and staffing – letters to the editor, local talk shows with callers asking questions, getting the press to focus on nursing home issues, etc.
Visit NCCNHR’s website for a quick link to listen to C-SPAN and the Senate Aging Committee as well as to see the written comments of the Hearing presenters including Executive Director Alice Hedt, researcher Charlene Harrington and Kathryn Allen representing the GAO.
Wednesday, May 02, 2007
JURY AWARDS $750,000 IN NURSING HOME RAPE CASE
Four years ago, a 77 year-old female nursing home resident was sleeping in her room at the Southwood Nursing Center in Jacksonville, Florida, when she was sexually assaulted by an 83 year-old male resident. The nursing home resident offender had been arrested 58 times in his past and convicted twice of sex crimes. The victim’s daughter sued the nursing home for nursing home negligence in not informing residents about the offender’s past. The jury agreed that the nursing home was negligent awarding $750,000.
Why would a nursing home knowingly admit a dangerous and predatory patient? Would it be for the money? The attacker now resides in a mental hospital.
Read the report here.
Why would a nursing home knowingly admit a dangerous and predatory patient? Would it be for the money? The attacker now resides in a mental hospital.
Read the report here.
NURSING HOME EMPLOYEE CHARGED WITH RECKLESS ENDANGERMENT AND NURSING HOME NEGLECT
Police arrested a Pennsylvania nursing home employee who now faces charges of reckless endangerment and nursing home neglect. The former employee, a certified nurses aide, is alleged to have covered up a 96 year-old woman’s fall at a nursing home. The CNA was supposed to be caring for the elderly woman when the patient fell. Police stated that the employee discovered what happened then covered it up, even pretending that she was fainting to get out of the nursing home. They also noted that the employee smelled of alcohol.
This nursing home abuse and neglect incident again stresses the importance of criminal background checks on nursing home employees. During this employee’s arraignment, detectives revealed that she had an extensive criminal background with a RAP sheet of 30 pages. Read the news report here.
Better ask the Administrator and Director of Nursing at your facility if they have completed a criminal background check on all employees.
This nursing home abuse and neglect incident again stresses the importance of criminal background checks on nursing home employees. During this employee’s arraignment, detectives revealed that she had an extensive criminal background with a RAP sheet of 30 pages. Read the news report here.
Better ask the Administrator and Director of Nursing at your facility if they have completed a criminal background check on all employees.
Tuesday, May 01, 2007
GREAT NURSING HOME RESOURCE
We get calls often "I live in Texas, my Mom is in a nursing home in Florida, but my sister knows your firm" "What are the laws in Texas?"
Well, I am neither licensed in any state other than Va and West Va., nor am I able to answer questions on other states. A super new resource however, has just been added to the internet to provide a direct link to state laws on nursing homes and assisted living facilities. Here it is - use it well! http://www.hsr.umn.edu/NHRegsPlus/ and thank you University of Minnesota.
Well, I am neither licensed in any state other than Va and West Va., nor am I able to answer questions on other states. A super new resource however, has just been added to the internet to provide a direct link to state laws on nursing homes and assisted living facilities. Here it is - use it well! http://www.hsr.umn.edu/NHRegsPlus/ and thank you University of Minnesota.
LONG TERM CARE INSURANCE
Many people believe that Medicare will pay their bills for nursing home care, if needed. Not true! Medicare will only pay in certain limited situations (rehabilitation after surgery) and then for a very limited time period (often 100 days). Medicaid will step in and pay but only if you qualify - which means you have few, if any, assets.
The alternative is to purchase long term care insurance. The problem with long term care insurance is that unless you purchase life-time coverage you run the risk of running out of coverage if you live too long in a nursing home. Life-time is very, very expensive! Too expensive for many to afford.
A federal law enacted last year is intended to help solve this problem. The Partnership for Long Term Care, a public-private long term insurance program is now operating in 5 states (California, Connecticut, Idaho, Indiana, and New York) and is soon expected in 25 other states. Under this program, you first purchase a private long term care insurance policy that has received your state’ approval. If those benefits run out, you can then apply for Medicaid to help cover any additional costs. For example, if you bought a policy with $100,000 in benefits, then used them up, you could keep $100,000 in personal assets and still qualify for Medicaid coverage. Without a partnership policy, your state Medicaid department could require you to spend down your assets before you are qualified.
These web sites can help you determine the costs of long-term care in your area:
Longtermcare.gov
Metlife.com
Longtermcare.genworth.com
Notaburden.com (click on “cost by state” calculator)
The alternative is to purchase long term care insurance. The problem with long term care insurance is that unless you purchase life-time coverage you run the risk of running out of coverage if you live too long in a nursing home. Life-time is very, very expensive! Too expensive for many to afford.
A federal law enacted last year is intended to help solve this problem. The Partnership for Long Term Care, a public-private long term insurance program is now operating in 5 states (California, Connecticut, Idaho, Indiana, and New York) and is soon expected in 25 other states. Under this program, you first purchase a private long term care insurance policy that has received your state’ approval. If those benefits run out, you can then apply for Medicaid to help cover any additional costs. For example, if you bought a policy with $100,000 in benefits, then used them up, you could keep $100,000 in personal assets and still qualify for Medicaid coverage. Without a partnership policy, your state Medicaid department could require you to spend down your assets before you are qualified.
These web sites can help you determine the costs of long-term care in your area:
Longtermcare.gov
Metlife.com
Longtermcare.genworth.com
Notaburden.com (click on “cost by state” calculator)
HOSPITAL ACQUIRED INFECTIONS
If it hasn’t happened to you, it probably has happened to someone you know. A patient goes into the hospital for an emergent or elective procedure and contracts an infection that ends up being far worse than the medical problem which sent them to the hospital in the first place. These infections are called “nosocomial” or “hospital-acquired” infections and they can lead to extended periods of hospitalizations and even death.
Virginia has passed a new law which goes into effect in July of 2008 which requires certain hospitals to report hospital-acquired infections in patients with central-line infusion devices (primarily catheters). The reports will go to the Center for Disease Control and will ultimately be available to the public by the Virginia Department of Health upon request.
Dr. Richard Wenzel, president of the International Society for Infectious Diseases, urges hospital administrators to implement a “zero-tolerance” policy for skirting infection control procedures such as hand-washing, sterilizing equipment, and using gloves and masks with infected patients. Carilion Health System in western Virginia, to its credit, has implemented a new policy in which all high-risk patients (intensive care patients or patients admitted from other hospitals or nursing homes) will submit to a simple skin swab test which detects antigens for one of the most difficult to treat infections, MRSA. If the patient tests positive, isolation procedures and special precautions are followed.
As a hospital patient you cannot control whether other patients bring infections into the hospital. However, you can demand that the nurses and doctors who care for you wash their hands and use appropriate safety equipment such as gloves and masks.
Virginia has passed a new law which goes into effect in July of 2008 which requires certain hospitals to report hospital-acquired infections in patients with central-line infusion devices (primarily catheters). The reports will go to the Center for Disease Control and will ultimately be available to the public by the Virginia Department of Health upon request.
Dr. Richard Wenzel, president of the International Society for Infectious Diseases, urges hospital administrators to implement a “zero-tolerance” policy for skirting infection control procedures such as hand-washing, sterilizing equipment, and using gloves and masks with infected patients. Carilion Health System in western Virginia, to its credit, has implemented a new policy in which all high-risk patients (intensive care patients or patients admitted from other hospitals or nursing homes) will submit to a simple skin swab test which detects antigens for one of the most difficult to treat infections, MRSA. If the patient tests positive, isolation procedures and special precautions are followed.
As a hospital patient you cannot control whether other patients bring infections into the hospital. However, you can demand that the nurses and doctors who care for you wash their hands and use appropriate safety equipment such as gloves and masks.
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