I live in Virginia and our state does a fairly good job investigating complaints of neglect and abuse in Virginia nursing homes. I do believe the office which investigates these complaints is under-staffed and over-worked but acknowledge they do the best they can.
While Virginia may get a passing grade for taking complaints seriously and looking into the allegations…many states do a poor job of protecting the elderly and U.S. Senator Charles Grassley (R- Iowa) wants to know why. Senator Grassley has called for a national investigation into the way states handle complaints of poor nursing care. He acted after receiving a serious complaint regarding a nursing/rehab center from a constituent.
Senator Grassley is asking the Government Accountability Office to look at all state agencies to determine how they respond to nursing home related complaints. He also is asking the Centers for Medicare & Medicaid Services to give him four years of reports dealing with state inspections.
Kudos Senator Grassley!
Thursday, January 31, 2008
Wednesday, January 30, 2008
HAND WASHING STILL A MUST
We had a series of cases last year, regarding infection and handwashing. The argument was - "we couldn't have spread the infection to the patients, we use anti-bacteria hand sanitizer after every patient contact." My response was - "yah - right."
Well, this morning, my response can be "So what?"
Hand gels alone may not curb infections, By TIMBERLY ROSS Associated Press Writer
OMAHA, Neb. (AP) -- Doctors and nurses on the go often skip soap and water in favor of an alcohol-based hand gel, thinking the quick-acting goo will kill bacteria on their hands and curb the spread of infection. It turns out that's not enough.
In a Nebraska hospital, medical workers nearly doubled their use of the alcohol-based gel, but their generally cleaner hands had no bearing on the rate of infections among patients.
The doctor who studied the problem pointed to many villains: Rings and fingernails that are too long and hard to clean, poor handling of catheters and treatment areas that aren't sanitized.
"Hand hygiene is still important, but it's not a panacea," said Dr. Mark Rupp, an infectious disease specialist at the University of Nebraska Medical Center. He led the study at the adjoining Nebraska Medical Center.
The results of his study appear to contradict hospital guidelines from the Centers for Disease Control and Prevention that say better hand hygiene - through frequent washing or use of hand gels - has been shown to cut the spread of hospital infections.
The spread of infection-causing germs in U.S. hospitals is a huge health problem, accounting for an estimated 1.7 million infections and 99,000 deaths each year, according to the CDC. These include drug-resistant staph, urinary tract infections and ventilator-associated pneumonia, among others.
The study appears in the January issue of Infection Control and Hospital Epidemiology.
The findings of the new study were based on 300 hours of hand hygiene observations of nurses and doctors in two comparable intensive care units over a two-year period.
Good to know - by the way, doesn't mean not to use the Gels - it just means, wash, clean, use the Gel, take off rings, etc!
Well, this morning, my response can be "So what?"
Hand gels alone may not curb infections, By TIMBERLY ROSS Associated Press Writer
OMAHA, Neb. (AP) -- Doctors and nurses on the go often skip soap and water in favor of an alcohol-based hand gel, thinking the quick-acting goo will kill bacteria on their hands and curb the spread of infection. It turns out that's not enough.
In a Nebraska hospital, medical workers nearly doubled their use of the alcohol-based gel, but their generally cleaner hands had no bearing on the rate of infections among patients.
The doctor who studied the problem pointed to many villains: Rings and fingernails that are too long and hard to clean, poor handling of catheters and treatment areas that aren't sanitized.
"Hand hygiene is still important, but it's not a panacea," said Dr. Mark Rupp, an infectious disease specialist at the University of Nebraska Medical Center. He led the study at the adjoining Nebraska Medical Center.
The results of his study appear to contradict hospital guidelines from the Centers for Disease Control and Prevention that say better hand hygiene - through frequent washing or use of hand gels - has been shown to cut the spread of hospital infections.
The spread of infection-causing germs in U.S. hospitals is a huge health problem, accounting for an estimated 1.7 million infections and 99,000 deaths each year, according to the CDC. These include drug-resistant staph, urinary tract infections and ventilator-associated pneumonia, among others.
The study appears in the January issue of Infection Control and Hospital Epidemiology.
The findings of the new study were based on 300 hours of hand hygiene observations of nurses and doctors in two comparable intensive care units over a two-year period.
Good to know - by the way, doesn't mean not to use the Gels - it just means, wash, clean, use the Gel, take off rings, etc!
Tuesday, January 29, 2008
ANOTHER RECALL
Told you - recalls everywhere!
Syringe Recall:
FDA has announced a nationwide recall of all lots of heparin and saline pre-filled flush syringes manufactured by AM2 PAT, Inc. under the brand names Sierra Pre-filled, Inc. and B. Braun. Two lots have been found to be contaminated with Serratia marcescens, a bacterium that can cause serious injury or death. The syringes are sold in fill sizes of 3mL, 5mL and 10mL and syringe sizes of 6mL and 12mL.
http://www.fda.gov/bbs/topics/NEWS/2008/NEW01785.html
Syringe Recall:
FDA has announced a nationwide recall of all lots of heparin and saline pre-filled flush syringes manufactured by AM2 PAT, Inc. under the brand names Sierra Pre-filled, Inc. and B. Braun. Two lots have been found to be contaminated with Serratia marcescens, a bacterium that can cause serious injury or death. The syringes are sold in fill sizes of 3mL, 5mL and 10mL and syringe sizes of 6mL and 12mL.
http://www.fda.gov/bbs/topics/NEWS/2008/NEW01785.html
RECALLS EVERYWHERE
One glance at the Wall Street Journal yesterday - recalls, recalls, recalls.
Johnson & Johnson recalls a catheter; Baxter, drug company, recalls their anti-coagulation shot, Heparin over allergic reactions; Merck is denied application to sell their new "Mevacor" over the counter....
There is a lesson here. Medicine is not exact. Drugs are not perfect. Medications are not predictable. Health care providers use products they probably shouldn't use - and know little about.
Please do the research on medications, products you use... you won't be shocked to hear they may have been recalled!
Johnson & Johnson recalls a catheter; Baxter, drug company, recalls their anti-coagulation shot, Heparin over allergic reactions; Merck is denied application to sell their new "Mevacor" over the counter....
There is a lesson here. Medicine is not exact. Drugs are not perfect. Medications are not predictable. Health care providers use products they probably shouldn't use - and know little about.
Please do the research on medications, products you use... you won't be shocked to hear they may have been recalled!
Our friend, Tom Farrell
Yesterday we were deeply saddened when we learned our friend Tom Farrell, was killed. Dan and I are plaintiff lawyers, Tom is a defense lawyer - this combination in Roanoke guarantees you will have cases against one-another, and we did. Tom was always kind, maintained a good sense of humor - and was always thankful when attorney interactions were civil, and thoughtful. My calender has a two hour block on it for tomorrow, for a phone conference with Tom. He will be missed, we will be praying for his family... and are so sorry for the loss.
Sunday, January 27, 2008
WEST VIRGINIA MAN SUFFERS MULTIPLE INJURIES IN NURSING HOME
Clarence Brown was a resident of Marmet Health Care Center from April 27of 1996 to May of 2007. Clayton Brown claims that while in the care of the facility Clarence Brown suffered several personal injuries and damages. Brown was admitted to Marmet Health Care Center in 1996 at the age of 46 because he suffered from dementia and his cognitive and physical skills were impaired.
A lawsuit was filed on Brown’s behalf against the owner of the nursing home, Genesis Healthcare Corporation, in the in the Kanawha Circuit Court. The suit alleges that Brown suffered from multiple pressure sores, dehydration, malnutrition, contractures, aspiration pneumonia and infections.
We will keep an eye on the progress of this suit!
A lawsuit was filed on Brown’s behalf against the owner of the nursing home, Genesis Healthcare Corporation, in the in the Kanawha Circuit Court. The suit alleges that Brown suffered from multiple pressure sores, dehydration, malnutrition, contractures, aspiration pneumonia and infections.
We will keep an eye on the progress of this suit!
Thursday, January 24, 2008
WALL STREET JOURNAL BLOG - GOOD POINT!
The WallStreet Journal Health Blog has a great point
"The presidential candidates are fighting over who would do the most to increase the number of Americans with health insurance and expand access to care, BUT "their plans don’t ensure that there will be enough doctors and nurses will treat all those new patients, argues a report expected to be released later today."
What are they going to do about nursing shortage?
"Clinton would spend $300 million on nursing programs; Edwards would try to recruit 50,000 new nurses, keep another 50,000 from leaving ther profession, and increase seats at nursing schools; and Obama would offer tuition assistance for nursing students and funding to nursing schools.
The health plans of the leading Republican candidates don’t discuss the nurse supply. None of the top candidates in either party discuss the physician supply in their plans. And, AMN argues, the Democrats’ nurse supply plans don’t go far enough."
I am very scared - we see negligence because of nursing shortage, all the time... more patients, you need more nurses!
"The presidential candidates are fighting over who would do the most to increase the number of Americans with health insurance and expand access to care, BUT "their plans don’t ensure that there will be enough doctors and nurses will treat all those new patients, argues a report expected to be released later today."
What are they going to do about nursing shortage?
"Clinton would spend $300 million on nursing programs; Edwards would try to recruit 50,000 new nurses, keep another 50,000 from leaving ther profession, and increase seats at nursing schools; and Obama would offer tuition assistance for nursing students and funding to nursing schools.
The health plans of the leading Republican candidates don’t discuss the nurse supply. None of the top candidates in either party discuss the physician supply in their plans. And, AMN argues, the Democrats’ nurse supply plans don’t go far enough."
I am very scared - we see negligence because of nursing shortage, all the time... more patients, you need more nurses!
SAD NURSING HOME STORIES CAPTURED BY BLOGGERS
As our readers are aware, at this blog we post comments and articles on issues and topics of interest to American consumers of health care. We also spend a great deal of time reading other blogs which focus on the state of health care in America.
Recently, we ran across two blog posts on appalling cases of problems in nursing homes. First, Ed Normand has posted on a story of a nursing home patient who developed maggots in his eyes. Not to be outdone, Ray Mullman at the South Carolina Nursing Home Blog posts on a nursing home that hired a serial rapist as a nurse. Not surprisingly, the nurse ended up raping one of the residents.
Come on Congress – Do Something to Help the Elderly!
Recently, we ran across two blog posts on appalling cases of problems in nursing homes. First, Ed Normand has posted on a story of a nursing home patient who developed maggots in his eyes. Not to be outdone, Ray Mullman at the South Carolina Nursing Home Blog posts on a nursing home that hired a serial rapist as a nurse. Not surprisingly, the nurse ended up raping one of the residents.
Come on Congress – Do Something to Help the Elderly!
Tuesday, January 22, 2008
PRESSURE ULCERS
Sadly, we review more than a few pressure ulcer cases each year. A pressure ulcer is essentially a bedsore that can develop because too much pressure is placed on the skin. Often pressure ulcers form on heels, sacrums (buttocks) and other areas that non-walking long term care residents sit for hours. Family by law - SHOULD BE NOTIFIED if their loved one develops a pressure ulcer. They should also be notified if the ulcer gets worse - or a change in the condition occurs. We find however, that this rarely occurs. Often family members are told "there is a pressure ulcer but nothing to worry about - it is getting better." Not until the hospital finds the wound is the size of a softball, and bone is exposed, does a family learn what happened.
So if a nurse says - " I can't show you the wound because it has to be covered to heal" - tell them "take it off anyway," then request the attending physician to explain the wound and ask if a wound care consult out of the facility is a good idea. We have learned "wound care" nurses may be someone with less than 48 hours of special training - and that doctors don't even look at the wound.. So that tells me - you need a second opinion!
So if a nurse says - " I can't show you the wound because it has to be covered to heal" - tell them "take it off anyway," then request the attending physician to explain the wound and ask if a wound care consult out of the facility is a good idea. We have learned "wound care" nurses may be someone with less than 48 hours of special training - and that doctors don't even look at the wound.. So that tells me - you need a second opinion!
Monday, January 21, 2008
RETAIL HEALTH CLINICS: A NECESSITY IN TODAY’S WORLD
There was a letter to the editor in the Roanoke Times newspaper several days ago about “retail health clinics.” For those readers unfamiliar with the term, it basically means a nurse or physician’s assistant working in a retail store and seeing/treating patients with minor medical problems. The author of that letter, Dr. Mark Schleupner, correctly recognized there is a place for these retail health clinics in providing care to those Americans without insurance or a regular doctor.
It is not an ideal situation but…what is the alternative for the uninsured and poor? Wait in an already overcrowded Emergency Room at the local hospital? That just doesn’t make sense to me! Some Roanoke Valley doctors are not taking new patients – what are these people supposed to do when they need a doctor?
Unfortunately, today’s edition of the Roanoke Times contains a letter to the editor from Dr. Mark Watts, President-elect of the Virginia Academy of Family Physicians. Dr. Watts enjoys a fine reputation in our community but I take issue with his position on retail health clinics. Dr. Watts’ criticizes retail health clinics as “catering to “consumer’s desire for instant service.” He also mentions the “significant limitations” of retail health clinics – although he fails to tell us what those limitations are.
I have a question for Dr. Watts. What are the limitations imposed by Carilion on its primary care providers when they are told to spend no more that 10 minutes with each patient?
It is not an ideal situation but…what is the alternative for the uninsured and poor? Wait in an already overcrowded Emergency Room at the local hospital? That just doesn’t make sense to me! Some Roanoke Valley doctors are not taking new patients – what are these people supposed to do when they need a doctor?
Unfortunately, today’s edition of the Roanoke Times contains a letter to the editor from Dr. Mark Watts, President-elect of the Virginia Academy of Family Physicians. Dr. Watts enjoys a fine reputation in our community but I take issue with his position on retail health clinics. Dr. Watts’ criticizes retail health clinics as “catering to “consumer’s desire for instant service.” He also mentions the “significant limitations” of retail health clinics – although he fails to tell us what those limitations are.
I have a question for Dr. Watts. What are the limitations imposed by Carilion on its primary care providers when they are told to spend no more that 10 minutes with each patient?
VA LAW MAKERS - WOW, THE IDEAS JUST GET WORSE!
Here are additional laws I think stink.... Time I write my representatives to tell them so!
HB 221/ SB 232 – Kilgore/McDougle - Landlord and managing agent immunity for mold claims. Provides immunity for landlords and managing agents if they are in compliance with the Virginia Residential Landlord and Tenant Act. Managing agents can be held liable for affirmative acts of negligence. Any party who pleads a defense pursuant to this immunity shall be entitled to a hearing on the merits after limited discovery and before adjudication of the underlying claim.
HB501/SB 602 – Watts/Norment - Medical malpractice; professional services. Defines the term "professional services" in the context of medical malpractice actions as services provided to a patient by a health care provider pursuant to federal or state statutes or regulations. The bill also provides that the definition of "health care" includes professional services provided during a patient's residency at a nursing home. This bill is in response to the Supreme Court decision in Alcoy v. Valley Nursing Homes, Inc., 272 Va. 37, 630 S.E.2d 301 (2006). Issue Paper Available
HB382 – O’Bannon - Medical advisory committees and consultants; privileged communications. Clarifies that information created by and shared with medical review or advisory committees is privileged and inadmissible in legal proceedings. This bill seeks to effectively overturn the Supreme Court decision in Riverside v. Johnson. Issue Paper Available
HB 1282 – Athey- Medical Malpractice Settlement Offer and Recovery Act. Provides that a defendant in a medical malpractice case may make an irrevocable settlement offer within 180 days after responsive pleadings were filed. The offer shall provide for the payment of the plaintiff's net compensatory damages and attorney fees in an amount equal to 10 percent of these damages, however it shall not provide for punitive or exemplary damages. The plaintiff has 30 days to accept or reject the offer. If the offer is rejected, the plaintiff's case proceeds with the increased burden that he prove by clear and convincing evidence that his injuries resulted from the defendant's gross negligence or wanton and willful misconduct. Issue Paper Available
NICE - OFFER PEANUTS and if you don't want to take their peanuts, you have to prove the doctor almost INTENTIONALLY committed the malpractice, or that he showed NO CARE.
HB403/SB657 – Hamilton/Newman - Health care provider liability protections. Provides that, in the absence of gross negligence or willful misconduct, health care providers who respond to a disaster are immune from civil liability for any injury or wrongful death arising from the delivery or withholding of health care. This immunity only applies if a state or local emergency has been or is subsequently declared in response to such a disaster.
WOW - these are some pretty bad laws.
HB 221/ SB 232 – Kilgore/McDougle - Landlord and managing agent immunity for mold claims. Provides immunity for landlords and managing agents if they are in compliance with the Virginia Residential Landlord and Tenant Act. Managing agents can be held liable for affirmative acts of negligence. Any party who pleads a defense pursuant to this immunity shall be entitled to a hearing on the merits after limited discovery and before adjudication of the underlying claim.
HB501/SB 602 – Watts/Norment - Medical malpractice; professional services. Defines the term "professional services" in the context of medical malpractice actions as services provided to a patient by a health care provider pursuant to federal or state statutes or regulations. The bill also provides that the definition of "health care" includes professional services provided during a patient's residency at a nursing home. This bill is in response to the Supreme Court decision in Alcoy v. Valley Nursing Homes, Inc., 272 Va. 37, 630 S.E.2d 301 (2006). Issue Paper Available
HB382 – O’Bannon - Medical advisory committees and consultants; privileged communications. Clarifies that information created by and shared with medical review or advisory committees is privileged and inadmissible in legal proceedings. This bill seeks to effectively overturn the Supreme Court decision in Riverside v. Johnson. Issue Paper Available
HB 1282 – Athey- Medical Malpractice Settlement Offer and Recovery Act. Provides that a defendant in a medical malpractice case may make an irrevocable settlement offer within 180 days after responsive pleadings were filed. The offer shall provide for the payment of the plaintiff's net compensatory damages and attorney fees in an amount equal to 10 percent of these damages, however it shall not provide for punitive or exemplary damages. The plaintiff has 30 days to accept or reject the offer. If the offer is rejected, the plaintiff's case proceeds with the increased burden that he prove by clear and convincing evidence that his injuries resulted from the defendant's gross negligence or wanton and willful misconduct. Issue Paper Available
NICE - OFFER PEANUTS and if you don't want to take their peanuts, you have to prove the doctor almost INTENTIONALLY committed the malpractice, or that he showed NO CARE.
HB403/SB657 – Hamilton/Newman - Health care provider liability protections. Provides that, in the absence of gross negligence or willful misconduct, health care providers who respond to a disaster are immune from civil liability for any injury or wrongful death arising from the delivery or withholding of health care. This immunity only applies if a state or local emergency has been or is subsequently declared in response to such a disaster.
WOW - these are some pretty bad laws.
Sunday, January 20, 2008
WEST VIRGINIA DENIES LICENSE TO VETERANS NURSING HOME
State regulators have refused to issue a license for the West Virginia Veterans Nursing Home because of a host of problems, including failure to meet requirements for accident prevention and infection control. Problems cited in the report include failure to meet requirements for therapeutic diets, care of pressure sores, vision and hearing, activities of daily living, menus and nutrition, quality of life, staffing and general maintenance.
The nursing home originally was expected to be completed in 2005. Its opening was pushed back several times for various reasons, including problems with its communications and air control systems. The citizens of West Virginia should be proud that their state regulators are holding the facility’s “feet to the fire” before granting the license to operate.
Our veterans deserve good care!
The nursing home originally was expected to be completed in 2005. Its opening was pushed back several times for various reasons, including problems with its communications and air control systems. The citizens of West Virginia should be proud that their state regulators are holding the facility’s “feet to the fire” before granting the license to operate.
Our veterans deserve good care!
Friday, January 18, 2008
VA GEN ASSEMBLY 2008 - Are you kidding me?
Just for fun, I like to see what laws are being presented / rejected / passed in Virginia's General Assembly Session. Here are some proposed laws, some good, some bad - some AWFUL!
HB 22 - Amendment requriing methicillin-resistant staphylococcus aureus (MRSA) be addede to the list of diseases required to be reported to the Department of Health.
REJECTED " Stricken from docket by Health, Welfare and Institutions by voice vote"
HJ 101 (not a Bill) *Study; "Directs the Joint Commission on Health Care to study the use of disclosure, apologies, alternative dispute resolution, and other measures in the case of medical errors and adverse medical outcomes and the impact of such measures on the cost and quality of care, patient confidence, and the medical malpractice system."
Great idea Delegate O'Bannon - we hear families say often - "If only the doctor / facility apologized, and admitted they were wrong, we wouldn't have filed the lawsuit." There is a high price to pay for peace of mind!
HB 89 - Removes requirement that girls receive the human papillomavirus vaccine. (Been Tabled in Health, Welfare and Institutions by voice vote)
HB 364 - Hospital-Emergency Treatment Reimbursement Fund. Requires employers to withhold from wages payable to employees who are not covered by a health insurance policy an amount equal to two percent of their wages. The withheld moneys are to be remitted to the State Corporation Commission, which will allocate the funds among the licensed hospitals that have provided emergency care for which they have not been paid, based on the ratio of each hospital's unpaid costs to the statewide total. The Health Commissioner is required to collect information from licensed hospitals regarding the amount of their unpaid emergency care. Only hospitals that provide the requested data are eligible to receive distributions from the Fund.
WHAT - that is basically MEDICAID for ER Facilities. This law smells for a bunch of reasons.
Please - actually get involved with your state laws - http://leg1.state.va.usate.va.us
HB 22 - Amendment requriing methicillin-resistant staphylococcus aureus (MRSA) be addede to the list of diseases required to be reported to the Department of Health.
REJECTED " Stricken from docket by Health, Welfare and Institutions by voice vote"
HJ 101 (not a Bill) *Study; "Directs the Joint Commission on Health Care to study the use of disclosure, apologies, alternative dispute resolution, and other measures in the case of medical errors and adverse medical outcomes and the impact of such measures on the cost and quality of care, patient confidence, and the medical malpractice system."
Great idea Delegate O'Bannon - we hear families say often - "If only the doctor / facility apologized, and admitted they were wrong, we wouldn't have filed the lawsuit." There is a high price to pay for peace of mind!
HB 89 - Removes requirement that girls receive the human papillomavirus vaccine. (Been Tabled in Health, Welfare and Institutions by voice vote)
HB 364 - Hospital-Emergency Treatment Reimbursement Fund. Requires employers to withhold from wages payable to employees who are not covered by a health insurance policy an amount equal to two percent of their wages. The withheld moneys are to be remitted to the State Corporation Commission, which will allocate the funds among the licensed hospitals that have provided emergency care for which they have not been paid, based on the ratio of each hospital's unpaid costs to the statewide total. The Health Commissioner is required to collect information from licensed hospitals regarding the amount of their unpaid emergency care. Only hospitals that provide the requested data are eligible to receive distributions from the Fund.
WHAT - that is basically MEDICAID for ER Facilities. This law smells for a bunch of reasons.
Please - actually get involved with your state laws - http://leg1.state.va.usate.va.us
Thursday, January 17, 2008
VIRGINIA OBSTETRICIANS SANCTIONED
The Virginia Board of Medicine has taken a rare step in reprimanding two Fairfax, Virginia doctors for their failure to provide appropriate care during the delivery of a new born. The Board found that Dr. Evelyn Anna Ruelaz and Dr. Regina Burton failed to adequately assess a pregnant patient with a history of excessive bleeding during childbirth.
The patient, Lee Ann Hershberger, told a medical board panel that she labored alone at Inova Fair Oaks Hospital as her baby’s heart rate slowed and oxygen to him in utero was shut off. The doctor’s negligence resulted in catastrophic and life-long injuries to the baby.
Unfortunately, the doctors could not be sued for their medical negligence due to a law enacted by the Virginia General Assembly over 15 years ago called the Virginia Birth-Related Neurological Injury Compensation Act. A bad law which has two negative components. First, the law prevents holding the negligent doctors responsible as civil lawsuits against those physicians are barred. Secondly, the “compensation” permitted for a claim accepted into the program is woeful…clearly inadequate to recognize the devastating injuries suffered by the infant!
The patient, Lee Ann Hershberger, told a medical board panel that she labored alone at Inova Fair Oaks Hospital as her baby’s heart rate slowed and oxygen to him in utero was shut off. The doctor’s negligence resulted in catastrophic and life-long injuries to the baby.
Unfortunately, the doctors could not be sued for their medical negligence due to a law enacted by the Virginia General Assembly over 15 years ago called the Virginia Birth-Related Neurological Injury Compensation Act. A bad law which has two negative components. First, the law prevents holding the negligent doctors responsible as civil lawsuits against those physicians are barred. Secondly, the “compensation” permitted for a claim accepted into the program is woeful…clearly inadequate to recognize the devastating injuries suffered by the infant!
Wednesday, January 16, 2008
NURSING HOMES: BLACKS TREATED WORSE THAN WHITES
Here is a disturbing report: Black nursing home residents in Maryland and Virginia are more likely than white residents to be sent to hospitals for dehydration, poor nutrition, bedsores and other ailments because of a gap in the quality of in-house medical care, according to a new study.
Researchers affiliated with Brown University's medical school found that 23 percent of black nursing home residents in Maryland were hospitalized in 2000, compared with 17 percent of white residents. In Virginia in 2000, researchers found 20 percent of black nursing home residents were hospitalized, compared with 18 percent of white residents.
Researchers said the findings in the two states reflected a national trend. The study is scheduled to be published in the June issue of the journal Health Services Research.
Why? My guess is that economic factors play a significant role. Nursing homes which rely heavily on Medicaid have lower employee-to-patient ratios and often operate without a nurse practitioner or a medical director, which results in more residents needing to be hospitalized. Whatever the reason….its is a sad commentary on how we care for our elderly!
Researchers affiliated with Brown University's medical school found that 23 percent of black nursing home residents in Maryland were hospitalized in 2000, compared with 17 percent of white residents. In Virginia in 2000, researchers found 20 percent of black nursing home residents were hospitalized, compared with 18 percent of white residents.
Researchers said the findings in the two states reflected a national trend. The study is scheduled to be published in the June issue of the journal Health Services Research.
Why? My guess is that economic factors play a significant role. Nursing homes which rely heavily on Medicaid have lower employee-to-patient ratios and often operate without a nurse practitioner or a medical director, which results in more residents needing to be hospitalized. Whatever the reason….its is a sad commentary on how we care for our elderly!
Tuesday, January 15, 2008
WAIT TIMES GETTING LONGER IN EMERGENCY ROOMS
Patients are waiting longer and longer to be seen in America’s emergency rooms…and some are dying while they wait! A recent report from the journal Health Affairs confirms what we all have experienced. Emergency rooms are crowded, under-staffed, and the time from arrival to examination by a physician is too long.
The report concludes that 50% of all emergency rooms patients waited an average of 30 minutes or longer before seeing a doctor. Even patients suffering from chest pain and potential heart attacks are not seen in a timely fashion, half of these patients are not seen within 20 minutes of arrival at the emergency room. Sadly, the wait times are even longer for blacks and Hispanics according to the report.
I know this blog is read by our area hospital administrators. How about it Carilion Roanoke Memorial Hospital, Memorial Hospital of Martinsville and Henry County, Danville Regional Medical Center, Stonewall Jackson Hospital, Carilion New River Valley Hospital, Montgomery Regional Hospital, Wellmont Bristol Regional Hospital, Carilion Giles Memorial Hospital, Alleghany Regional Hospital, Carilion Franklin Memorial Hospital , Tazewell Community Hospital….
What is the wait time in your hospital’s emergency room?
The report concludes that 50% of all emergency rooms patients waited an average of 30 minutes or longer before seeing a doctor. Even patients suffering from chest pain and potential heart attacks are not seen in a timely fashion, half of these patients are not seen within 20 minutes of arrival at the emergency room. Sadly, the wait times are even longer for blacks and Hispanics according to the report.
I know this blog is read by our area hospital administrators. How about it Carilion Roanoke Memorial Hospital, Memorial Hospital of Martinsville and Henry County, Danville Regional Medical Center, Stonewall Jackson Hospital, Carilion New River Valley Hospital, Montgomery Regional Hospital, Wellmont Bristol Regional Hospital, Carilion Giles Memorial Hospital, Alleghany Regional Hospital, Carilion Franklin Memorial Hospital , Tazewell Community Hospital….
What is the wait time in your hospital’s emergency room?
Monday, January 14, 2008
PRICELESS
If I had money to burn, I would create a public service announcement, based on the Visa "Priceless" adds..It would have some interesting statistics, like these:
Cost of maintaining an elderly person in a nursing home - $7,000 a month
Money the nursing home spends on care givers - $8.00 an hour
Money the nursing home spends on meals - $4.00 a day
Money that shareholders of the nursing home
earned in 2007 in cash dividends - $2,000,000.00
Cost of taking care of your loved one: $$$ PRICELESS $$$
Cost of maintaining an elderly person in a nursing home - $7,000 a month
Money the nursing home spends on care givers - $8.00 an hour
Money the nursing home spends on meals - $4.00 a day
Money that shareholders of the nursing home
earned in 2007 in cash dividends - $2,000,000.00
Cost of taking care of your loved one: $$$ PRICELESS $$$
RESIDENT MISSING FROM NURSING HOME FOR OVER 5 YEARS!
This case report comes to us from Idaho but could, and does, occur everywhere.
The family of a man who wandered away from a Gooding nursing home five years ago has sued the facility's parent company. In the lawsuit, stepsons of former Magic Valley Manor resident John Henry Davis allege the home and Northwest Bec-Corp didn't do enough to keep their 81-year-old stepfather safe. Wendell, who suffered from Alzheimer's disease, disappeared in July 2002.
These facts describe what is called an “elopement” or unauthorized departure from a nursing home. They should not occur and cannot occur if exit door have alarms and patients are closely supervised.
The family of a man who wandered away from a Gooding nursing home five years ago has sued the facility's parent company. In the lawsuit, stepsons of former Magic Valley Manor resident John Henry Davis allege the home and Northwest Bec-Corp didn't do enough to keep their 81-year-old stepfather safe. Wendell, who suffered from Alzheimer's disease, disappeared in July 2002.
These facts describe what is called an “elopement” or unauthorized departure from a nursing home. They should not occur and cannot occur if exit door have alarms and patients are closely supervised.
Sunday, January 13, 2008
CONGRESS SEEKS MORE INFORMATIONON BAD NURSING HOMES
We reported here several weeks ago the Centers for Medicare and Medicaid Services (CMS) disclosure of the 54 worst nursing homes in the United States. That list my friends is just the “tip of the iceberg.”
Democratic lawmakers are pressing the Bush administration to disclose the identity of more troubled nursing homes, saying earlier efforts to alert consumers did not go far enough. Senators Hillary Clinton and Tom Harkin (D-Iowa) introduced a bill last month that would require CMS to reveal the names of all nursing homes that are substandard. Nine senators, including Harkin, also urged Health and Human Services Secretary Mike Leavitt to immediately release the full list. The full list contains the names of 128 nursing homes.
Wouldn’t you want to know if the nursing home you are considering for father is on the list?
Democratic lawmakers are pressing the Bush administration to disclose the identity of more troubled nursing homes, saying earlier efforts to alert consumers did not go far enough. Senators Hillary Clinton and Tom Harkin (D-Iowa) introduced a bill last month that would require CMS to reveal the names of all nursing homes that are substandard. Nine senators, including Harkin, also urged Health and Human Services Secretary Mike Leavitt to immediately release the full list. The full list contains the names of 128 nursing homes.
Wouldn’t you want to know if the nursing home you are considering for father is on the list?
Friday, January 11, 2008
NURSING HOMES UNDERSTAFFED? - NO!
A few years ago in Virginia, a law was proposed to require certain number of staff in nursing home, per number of residents. GREAT IDEA I thought. Well, those for-profit healthcare providers didn't agree, and so there is no law.
An attorney in California filed a lawsuit this week, Sun Mar Healthcare Inc., alleging that the skilled nursing company scrimps on staffing and training and misrepresented staffing levels to elderly residents. Accpording to the San Jose News - the lawsuit alleges it was Sun Mar's corporate strategy to impose budget guidelines that forced supervisors to understaff facilities and skimp on employee training, all while representing high staffing and training levels to new customers.
"There is a direct correlation between the conduct that leads to abuse of an elder and insufficient staffing levels in these long-term facilities," attorney Stephen Garcia, a Long Beach attorney, said in a printed statement.
We see that all the time - too few staff + too many residents = poor care, and why? To make a few more bucks..
An attorney in California filed a lawsuit this week, Sun Mar Healthcare Inc., alleging that the skilled nursing company scrimps on staffing and training and misrepresented staffing levels to elderly residents. Accpording to the San Jose News - the lawsuit alleges it was Sun Mar's corporate strategy to impose budget guidelines that forced supervisors to understaff facilities and skimp on employee training, all while representing high staffing and training levels to new customers.
"There is a direct correlation between the conduct that leads to abuse of an elder and insufficient staffing levels in these long-term facilities," attorney Stephen Garcia, a Long Beach attorney, said in a printed statement.
We see that all the time - too few staff + too many residents = poor care, and why? To make a few more bucks..
TORT REFORM: NO LAWYERS NO JUSTICE
I hear from my friends all the time about the need for tort reform. They say that good companies and good doctors and hospitals are going out of business as a result of “frivolous lawsuits.” I will not turn my back on my friends but…they are as “green as grass”!
Want to hear about how tort reform is working in California? Dave Stewart's 72-year-old mother went to Stanford University Medical Center for double knee-replacement surgery in April. Four days later, she was dead. To Stewart, an anesthesiologist, it seemed a clear case of medical malpractice. After the operation, his mother developed sharp abdominal pain that she described as "10 on a scale of 1 to 10," according to her medical records. The hospital failed to diagnose the cause of her pain and continued to treat her with narcotics. Her vital signs became unstable and she was moved to the intensive care unit, but she died of complications from an untreated bowel obstruction.
The problem: no lawyer would take the case! Dr. Stewart approached two dozen lawyers. One after another declined to take the case, always for the same reason: It wasn't worth the money. Why? In 1975, California enacted legislation capping malpractice payments after an outcry from doctors and insurers that oversized awards and skyrocketing insurance rates were driving physicians out of the state.
The law limited the amount of money for "pain and suffering" -- usually the physical and emotional stress caused from an injury -- to $250,000. There is no limit on what patients can collect for loss of future wages or other expenses. The result is that when an elderly, retired person dies due to medical negligence the recoverable damages are too small to justify the thousands of dollars in litigation expense required to prosecute the case over an average of two years.
Think about situations like this the next time you hear folks talking about the need to limit damages and enact tort reform. The elderly person who dies could be someone in your family!
Want to hear about how tort reform is working in California? Dave Stewart's 72-year-old mother went to Stanford University Medical Center for double knee-replacement surgery in April. Four days later, she was dead. To Stewart, an anesthesiologist, it seemed a clear case of medical malpractice. After the operation, his mother developed sharp abdominal pain that she described as "10 on a scale of 1 to 10," according to her medical records. The hospital failed to diagnose the cause of her pain and continued to treat her with narcotics. Her vital signs became unstable and she was moved to the intensive care unit, but she died of complications from an untreated bowel obstruction.
The problem: no lawyer would take the case! Dr. Stewart approached two dozen lawyers. One after another declined to take the case, always for the same reason: It wasn't worth the money. Why? In 1975, California enacted legislation capping malpractice payments after an outcry from doctors and insurers that oversized awards and skyrocketing insurance rates were driving physicians out of the state.
The law limited the amount of money for "pain and suffering" -- usually the physical and emotional stress caused from an injury -- to $250,000. There is no limit on what patients can collect for loss of future wages or other expenses. The result is that when an elderly, retired person dies due to medical negligence the recoverable damages are too small to justify the thousands of dollars in litigation expense required to prosecute the case over an average of two years.
Think about situations like this the next time you hear folks talking about the need to limit damages and enact tort reform. The elderly person who dies could be someone in your family!
Thursday, January 10, 2008
FREDERICKSBURG, VIRGINIA NURSING HOME REMAINS UNDER SUSPENSION
The Carriage Hill Nursing Home in Spotsylvania County, Virginia was dropped from the Medicare and Medicaid programs in June of 2007 after state surveyors found a host of problems, from unsafe conditions to poor record-keeping. A resident died in May when he was strangled by his nurse-call cord.
The facility, owned by MediCorp Health System, is still awaiting the inspections needed to restore the nursing home to the Medicaid and Medicare programs. Officials requested the first of two required inspections in early December, six months after the nursing home was dropped from the government health insurance programs.
MediCorp officials decided to keep the home open after losing government funding. Residents were told they could stay if they wanted to and would not have to pay the costs normally covered by Medicare or Medicaid. The majority of its residents receive reimbursement from one of the two insurance programs.
The facility, owned by MediCorp Health System, is still awaiting the inspections needed to restore the nursing home to the Medicaid and Medicare programs. Officials requested the first of two required inspections in early December, six months after the nursing home was dropped from the government health insurance programs.
MediCorp officials decided to keep the home open after losing government funding. Residents were told they could stay if they wanted to and would not have to pay the costs normally covered by Medicare or Medicaid. The majority of its residents receive reimbursement from one of the two insurance programs.
Wednesday, January 09, 2008
LONGER LIFE
Rumor, or a study in the UK rather, has it that the secret to a longer life is exercise, eating better, moderate drinking and NO SMOKING. Really? Not at all surprised to read that - but the interesting part of the study was that someone doing all of those things, lived on average 14 years longer! So if these are important factors to quality and quantity of life, how are long term care facilities incorporating exercise, healthy food etc into the lives of their residents? Anyone know of any examples, I would love to learn about them. Sadly, the facilities I see don't often take the time or the money to treat a "resident" as I wish they could!
BEDS ALLOCATED TO RICHMOND NURSING HOME PURCHASED BY NORTH CAROLINA COMPANY
We have previously discussed the goings on with Seven Hills Health Care Center in Richmond, Virginia. A facility operated by the Hospital Authority of Richmond and located in Henrico County. The same facility which announced last month it was closing after losing eligibility for Medicaid and Medicare dollars. The funding was withdrawn after repeated inspections turned up quality and safety violations.
Now, an official with North Carolina-based Autumn Corporation says the company is acquiring rights to the 169 nursing-home beds at Seven Hills Health Care Center. The company plans to relocate the beds to a new facility in suburban Richmond.
Let’s hope the Autumn Corporation also plans to improve the care provided to its residents!
Now, an official with North Carolina-based Autumn Corporation says the company is acquiring rights to the 169 nursing-home beds at Seven Hills Health Care Center. The company plans to relocate the beds to a new facility in suburban Richmond.
Let’s hope the Autumn Corporation also plans to improve the care provided to its residents!
2008 GENERAL ASSEMBLY SESSION
Well - I am excited to report, as the Gen. Assembly Session opens today in Richmond, some members of the House are off to a good start!
HJ 79 - PROPOSED FOR 2008 by Phillip Hamilton, addresses the issue of pharmaceutical sales:
Barring physicians or other health care practitioners from prescribing an alternative brand of medication because of financial incentives. Requests the Governor and the Secretary of Health and Human Resources to develop a policy barring physicians or other health care practitioners from prescribing an alternative brand of medication because of financial incentives without first disclosing the incentives to the patient or the patient's parent, legal guardian, or other authorized representative.
Here is another one, Kenneth Plum (HJ 69) wants to study alternative solutions to long-term care needs in the Commonwealth; report. Directs the Joint Commission on Health Care to study alternative solutions to long-term care needs, including intentional communities of clustered homes.
And last but not least, I like this one that didn't make it last year - thank you delegate Kilgore:
"Copies of medical bills and charges; no cost. Provides that a patient, patient's attorney, or insurance provider may obtain a list of charges or an account balance pertaining to that patient at no cost. "
This is a great idea - if you want us to help our clients pay your bills, don't charge us for a copy of the bill!
Stay tuned, see what happens this session!
HJ 79 - PROPOSED FOR 2008 by Phillip Hamilton, addresses the issue of pharmaceutical sales:
Barring physicians or other health care practitioners from prescribing an alternative brand of medication because of financial incentives. Requests the Governor and the Secretary of Health and Human Resources to develop a policy barring physicians or other health care practitioners from prescribing an alternative brand of medication because of financial incentives without first disclosing the incentives to the patient or the patient's parent, legal guardian, or other authorized representative.
Here is another one, Kenneth Plum (HJ 69) wants to study alternative solutions to long-term care needs in the Commonwealth; report. Directs the Joint Commission on Health Care to study alternative solutions to long-term care needs, including intentional communities of clustered homes.
And last but not least, I like this one that didn't make it last year - thank you delegate Kilgore:
"Copies of medical bills and charges; no cost. Provides that a patient, patient's attorney, or insurance provider may obtain a list of charges or an account balance pertaining to that patient at no cost. "
This is a great idea - if you want us to help our clients pay your bills, don't charge us for a copy of the bill!
Stay tuned, see what happens this session!
Monday, January 07, 2008
MEDICATION ALLERGIES - VERY SERIOUS STUFF!
I have preached and preached on this topic. If you have a medical allergy - tell the doctor, tell the nurse, tell the pharmacist - tell everyone. YES, it is their job to write it down, record it and act accordingly. It is also their job not to give you a medication you have a known allergy to, but I have news for everyone, it happens all the time.
Just this weekend I learned a friend, with a known allergy to penicillin, was given a penicillin based medication - and had serious problems as a result. Serious problems mean lost wages, hospital bills, and could mean far worse. When her mother asked the physician why she had such a bad reaction the physician said "must have been the combination of drugs." It wasn't even until later, my friend's Mom called the pharmacist and asked if the medication was a penicillin base drug... so, the doctor messed up, somehow the pharmacy didn't catch it (or they didn't know of the allergy and should have), and then the doctor didn't tell the family the true problem.
Second time I know of this happening in our little town - so it must be much worse than we even realize. Moral of the story - SHOUT YOUR ALLERGIES from the rooftop. Well, actually the Moral is for physicians and pharmacists to pay better attention, but if we can't rely on them, we will need to do more ourselves.
Just this weekend I learned a friend, with a known allergy to penicillin, was given a penicillin based medication - and had serious problems as a result. Serious problems mean lost wages, hospital bills, and could mean far worse. When her mother asked the physician why she had such a bad reaction the physician said "must have been the combination of drugs." It wasn't even until later, my friend's Mom called the pharmacist and asked if the medication was a penicillin base drug... so, the doctor messed up, somehow the pharmacy didn't catch it (or they didn't know of the allergy and should have), and then the doctor didn't tell the family the true problem.
Second time I know of this happening in our little town - so it must be much worse than we even realize. Moral of the story - SHOUT YOUR ALLERGIES from the rooftop. Well, actually the Moral is for physicians and pharmacists to pay better attention, but if we can't rely on them, we will need to do more ourselves.
NURSING HOME ADMINISTRATOR WRITES HELPFUL BOOK
Which nursing home is right for my father? Will my mother be happy and get good care at this facility? These are questions we all will face at one time or another and here is a book which provides some good guidance and needed answers.
Nurse and nursing home administrator V.K. Lynn (a pseudonym) stresses in her slim book, “Finding a Nursing Home (And What You Find When You Get There),” being old is not a dysfunction; it is a progression of life. Her common-sense manual provides lists of questions to ask (how often are residents' nails trimmed?) and what to look for on visits.
After choosing a nursing home, families will want Lynn's advice for what to expect. Residents may have to adapt to less privacy, though they may not realize that they are allowed to bring some of their own favorite, familiar items, like furniture, with them. Lynn cautions that residents often mislay eyeglasses and hearing aids, prompting them to pick up the nearest similar item.
Finding a Nursing Home is only 24 pages, but at $7.99, it could allay a lot of anxieties. The book is available at http://www.booksurge.com.
Nurse and nursing home administrator V.K. Lynn (a pseudonym) stresses in her slim book, “Finding a Nursing Home (And What You Find When You Get There),” being old is not a dysfunction; it is a progression of life. Her common-sense manual provides lists of questions to ask (how often are residents' nails trimmed?) and what to look for on visits.
After choosing a nursing home, families will want Lynn's advice for what to expect. Residents may have to adapt to less privacy, though they may not realize that they are allowed to bring some of their own favorite, familiar items, like furniture, with them. Lynn cautions that residents often mislay eyeglasses and hearing aids, prompting them to pick up the nearest similar item.
Finding a Nursing Home is only 24 pages, but at $7.99, it could allay a lot of anxieties. The book is available at http://www.booksurge.com.
Sunday, January 06, 2008
CASE REPORT: NURSING HOME EMPLOYEE RAPES ALZHEIMER’S PATIENT
This sad story comes to us from Texas but could be from anywhere in the U.S. A state investigation revealed a laundry worker was caught raping an Alzheimer's patient at the Village Creek Nursing Home in Fort Worth.
Charles Schealy, 67, told police the sex was consensual. However, he was arrested and charged with one count of sexual assault in June. He was immediately fired from the facility. Shealey committed suicide on November 16. Police say he waited on tracks for an oncoming train to run him over.
These types of sexual attacks are more common than you might think. We recently successfully concluded a rape case against a nursing home in West Virginia. All nursing homes should conduct extensive criminal background checks on all employees and provide appropriate supervision and training to avoid these tragedies!
Charles Schealy, 67, told police the sex was consensual. However, he was arrested and charged with one count of sexual assault in June. He was immediately fired from the facility. Shealey committed suicide on November 16. Police say he waited on tracks for an oncoming train to run him over.
These types of sexual attacks are more common than you might think. We recently successfully concluded a rape case against a nursing home in West Virginia. All nursing homes should conduct extensive criminal background checks on all employees and provide appropriate supervision and training to avoid these tragedies!
Friday, January 04, 2008
BIG PHARMA
I had the misfortune of having to go to the doctor yesterday. A slight case of bronchitis.
The woman in line in front of me, was a drug rep. When I was taken back to the exam room, I passed two more drug reps in the hall. One doctor joked "Hey Bob - which drug company do you work for these days?" The same drug rep teased the nursing staff about feeling unloved, taken advantage of.
When I entered the exam room - I realized the mouse pad used by my treating physician was advertising a Merck product. The Clock in the Exam room was advertising a drug I was not familiar with. Pamphlets, articles - the room was almost covered by drug ads.
Was my treating doctor swayed by these ads? The presence of the familiar drug reps? I doubt it as she didn't feel medication would really help my URI - but it made me wonder. Does it sway the patients? Worse yet, is the goal to make money at any cost, causing problems for the medical community that has a duty to examine and analyze each case individually? Or, does the time the drug reps take away from the physicians during the day, effect the time they can spend with each patient?
No matter what the actual effect of this intense one on one advertising, it was made clear to me, that as a patient, I was not the priority of the drug reps.
The woman in line in front of me, was a drug rep. When I was taken back to the exam room, I passed two more drug reps in the hall. One doctor joked "Hey Bob - which drug company do you work for these days?" The same drug rep teased the nursing staff about feeling unloved, taken advantage of.
When I entered the exam room - I realized the mouse pad used by my treating physician was advertising a Merck product. The Clock in the Exam room was advertising a drug I was not familiar with. Pamphlets, articles - the room was almost covered by drug ads.
Was my treating doctor swayed by these ads? The presence of the familiar drug reps? I doubt it as she didn't feel medication would really help my URI - but it made me wonder. Does it sway the patients? Worse yet, is the goal to make money at any cost, causing problems for the medical community that has a duty to examine and analyze each case individually? Or, does the time the drug reps take away from the physicians during the day, effect the time they can spend with each patient?
No matter what the actual effect of this intense one on one advertising, it was made clear to me, that as a patient, I was not the priority of the drug reps.
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