I think the state of medical care provided by nursing homes is abysmal! There are too many bed sores, too many falls, too many malnourished and dehydrated residents.
The federal Centers for Medicare and Medicaid Services (CMS) is trying something new to encourage better care. CMS announced last week a new demonstration project to test whether cash incentives will help improve quality and efficiency in nursing homes. Its called the Nursing Home Value-Based Purchasing Project. Points will be awarded to facilities based on nurse staffing levels, avoidable hospitalizations, resident outcomes and citations received during inspections. Performance payments will be granted based on points earned. Officials say that money saved through quality and efficiency improvements will fund the performance payments.
The trial project will take place in nursing homes in Arizona, Mississippi, New York and Wisconsin. The demonstration program will run from July 2009 until June 2010.
My Take: Nursing Home owners love to make money...a lot of money...so lets use that incentive to see if we can get them to provide good medical care to the elderly.
Monday, March 30, 2009
Friday, March 27, 2009
FOOT HEALTH AND AMPUTATIONS IN NURSING HOMES
It happens way too frequently. An elderly nursing home resident with poor circulation and diabetes receives poor care at the nursing home and ends up losing a foot...or worse a leg. Why does it happen?
It happens because "at risk" patients don't receive a thorough assessment and an individualized preventive care plan. Foot health and amputation prevention programs for geriatric patients with diabetes are crucial to allowing the elderly to remain functional and independent. Patients with healthy feet can continue to walk and exercise.
Geriatric and long-term care residents with diabetes have a greater risk for foot ulcers, infections and amputations due to diabetic neuropathy. Usually first observed as a tingling sensation, diabetic neuropathy often results in loss of sensation in the feet. This makes residents especially vulnerable to silent or painless trauma.
My Take: If your loved one has risk factors for amputation, make certain they receive daily or weekly assessments and that there is a care plan in place which is strictly followed and revised if ineffective.
It happens because "at risk" patients don't receive a thorough assessment and an individualized preventive care plan. Foot health and amputation prevention programs for geriatric patients with diabetes are crucial to allowing the elderly to remain functional and independent. Patients with healthy feet can continue to walk and exercise.
Geriatric and long-term care residents with diabetes have a greater risk for foot ulcers, infections and amputations due to diabetic neuropathy. Usually first observed as a tingling sensation, diabetic neuropathy often results in loss of sensation in the feet. This makes residents especially vulnerable to silent or painless trauma.
My Take: If your loved one has risk factors for amputation, make certain they receive daily or weekly assessments and that there is a care plan in place which is strictly followed and revised if ineffective.
Thursday, March 26, 2009
WHAT'S THE BIG DEAL? IT'S ONLY A BED SORE!
First, bed sores, decubitus uclers, or pressure ulcers.....are all the same thing and they can be horrible and painful. Pressure sores can range from red areas on the surface of the skin (Stage I) to severe tissue damage that goes deep into muscle and bone (Stage IV). These sores are hard to treat and slow to heal. Other problems, such as bone, blood, and skin infections, can develop when pressure sores do not heal properly.
I've heard nursing home administrators try to play down the significance of bed sore...making it sound like it is no big deal. Well, those administrators are wrong and it is a big deal...a big painful and sometimes life-threatening deal!
Having a pressure ulcer, particularly a Stage IV ulcer, impacts an individual's life in many ways. A concern whether the pressure ulcer would heal, concomitant with an expectation that it would heal, has been mentioned in studies as a patient concern. Individuals need hope that the ulcer will heal, the pain, odor, and treatments will end, and that they will eventually regain their former lives.
My Take: Pressure sores (or whatever you want to call them) are painful, debilitating, and can be life-threatening. If your loved one is suffering from a pressure sore, get prompt medical attention.
I've heard nursing home administrators try to play down the significance of bed sore...making it sound like it is no big deal. Well, those administrators are wrong and it is a big deal...a big painful and sometimes life-threatening deal!
Having a pressure ulcer, particularly a Stage IV ulcer, impacts an individual's life in many ways. A concern whether the pressure ulcer would heal, concomitant with an expectation that it would heal, has been mentioned in studies as a patient concern. Individuals need hope that the ulcer will heal, the pain, odor, and treatments will end, and that they will eventually regain their former lives.
My Take: Pressure sores (or whatever you want to call them) are painful, debilitating, and can be life-threatening. If your loved one is suffering from a pressure sore, get prompt medical attention.
Tuesday, March 24, 2009
MAY I SEE THOSE RECORDS PLEASE?
I thankfully, am in good health and don't have many physician visits. I do however, have a loved one who spends hundreds of hours a year under direct physician care.
Do her doctors communicate? Do you assume they share information?
When my loved one goes to the doctor, I encourage her to ask the physician what records he or she has? Do they know about consultant Smith and the treatment recommended by Dr. Thomas? Keep a list of all your physicians and make a copy for every health care provider.
They won't take the time to request records or review them, unless you ask them to. So ask if you can see their records. If part of your health picture is missing, fill them in.
Do her doctors communicate? Do you assume they share information?
When my loved one goes to the doctor, I encourage her to ask the physician what records he or she has? Do they know about consultant Smith and the treatment recommended by Dr. Thomas? Keep a list of all your physicians and make a copy for every health care provider.
They won't take the time to request records or review them, unless you ask them to. So ask if you can see their records. If part of your health picture is missing, fill them in.
HOW GOOD IS THE MEDICAL CARE IN AMERICA?
A couple of weeks ago I got into a little discussion with a friend over the state of medical care in the United States. My friend knows I represent individuals who are injured or killed as a result of medical negligence. While my friend acknowledged that medical mistakes can and do injure many patients, he kept stressing how, overall, the provision of medical care in the United States is the best in the world.
I beg to disagree and can point to at least one publication which agrees with me. In a publication entitled, "Health Affairs," Cathy Shoen shines some light on what chronically ill patients think of the provision of medical care in the U.S. Her article, "In Chronic Condition: Experiences of Patients with Complex Health Care Needs in Eight Countries," does not paint a pretty picture! One-third of chronically ill patients in the U.S. have experienced faulty prescriptions, incorrect test results, medical errors, or delays in receiving abnormal test results. Almost one-half of the patients surveyed reported they felt poorly organized health care had wasted their time or was of little or no value.
My Take: My high school science teacher would not give the American health care system a passing grade.
I beg to disagree and can point to at least one publication which agrees with me. In a publication entitled, "Health Affairs," Cathy Shoen shines some light on what chronically ill patients think of the provision of medical care in the U.S. Her article, "In Chronic Condition: Experiences of Patients with Complex Health Care Needs in Eight Countries," does not paint a pretty picture! One-third of chronically ill patients in the U.S. have experienced faulty prescriptions, incorrect test results, medical errors, or delays in receiving abnormal test results. Almost one-half of the patients surveyed reported they felt poorly organized health care had wasted their time or was of little or no value.
My Take: My high school science teacher would not give the American health care system a passing grade.
Monday, March 23, 2009
WHY IT IS DIFFICULT FOR PATIENTS TO PREVAIL IN MEDICAL MALPRACTICE CASES
I tell prospective clients all the time that medical malpractice cases are very difficult for the patient/plaintiff. They are long, drawn out, and very expensive. Additionally, call it want you want but there is a "conspiracy of silence" when it comes to one doctor pointing a finger at another member of the "white coat profession."
I recently experienced yet another example of how far some members of the medical profession will go to protect themselves. The case involved a young mother who gave birth to a baby who was severely injured during delivery. The baby's shoulder became caught on the mother's pubic bone (shoulder dystocia) and, as the doctor continued to pull on the baby's head in an attempt to deliver, the infant's brachial plexus nerves were stretched and permanently injured. You may have seen adults with this injury...one of their arms is often smaller and shorter than the healthy arm and they have limited use of the affected arm and hand.
In this case, the cause of the injury was fairly clear. The delivering obstetrician exerted too much force on the baby's head in attempting to deliver. The entire delivery was captured on video tape by one of patient's family members.
How does the doctor/defendant defend his medical care. His insurer hires a doctor who travels the state of Virginia, and elsewhere, to arrive in court and testify, with the deepest of sincerity, "the doctor did nothing wrong....this is just an unfortunate outcome." This "hired gun" defense expert doctor makes between $80,000 and $109,000 per year testifying on behalf of other doctors who have been sued for malpractice. Of course, that is in addition to his salary as a practicing obstetrician/gynecologist.
Just another hurdle to overcome for the patient who is the victim of poor medical care.
I recently experienced yet another example of how far some members of the medical profession will go to protect themselves. The case involved a young mother who gave birth to a baby who was severely injured during delivery. The baby's shoulder became caught on the mother's pubic bone (shoulder dystocia) and, as the doctor continued to pull on the baby's head in an attempt to deliver, the infant's brachial plexus nerves were stretched and permanently injured. You may have seen adults with this injury...one of their arms is often smaller and shorter than the healthy arm and they have limited use of the affected arm and hand.
In this case, the cause of the injury was fairly clear. The delivering obstetrician exerted too much force on the baby's head in attempting to deliver. The entire delivery was captured on video tape by one of patient's family members.
How does the doctor/defendant defend his medical care. His insurer hires a doctor who travels the state of Virginia, and elsewhere, to arrive in court and testify, with the deepest of sincerity, "the doctor did nothing wrong....this is just an unfortunate outcome." This "hired gun" defense expert doctor makes between $80,000 and $109,000 per year testifying on behalf of other doctors who have been sued for malpractice. Of course, that is in addition to his salary as a practicing obstetrician/gynecologist.
Just another hurdle to overcome for the patient who is the victim of poor medical care.
Tuesday, March 17, 2009
DEALING WITH DANGEROUS DOCTORS IN VIRGINIA
Last week the Roanoke Times published an excellent editorial on the lack of disciplinary action taken by the Board of Medicine against Virginia doctors. Some of the more interesting observations included:
* A 1999 report faulted the Board of Medicine for allowing physicians to practice in situations where license revocation or suspension was warranted.
* Public Citizen, a non-profit public advocacy group, reports that Virginia has fallen from 30th to 39th in the nation in the number of serious disciplinary actions taken against physicians.
* The Virginia Board of Medicine receives about 2,000 complaints against physicians each year....yet disciplines only about 5 physicians per year.
Does this mean we have great doctors? Maybe, or does it mean the Board of Medicine is not doing its job of policing incompetent doctors and protecting the safety and well being of Virginia citizens.
What do you think?
* A 1999 report faulted the Board of Medicine for allowing physicians to practice in situations where license revocation or suspension was warranted.
* Public Citizen, a non-profit public advocacy group, reports that Virginia has fallen from 30th to 39th in the nation in the number of serious disciplinary actions taken against physicians.
* The Virginia Board of Medicine receives about 2,000 complaints against physicians each year....yet disciplines only about 5 physicians per year.
Does this mean we have great doctors? Maybe, or does it mean the Board of Medicine is not doing its job of policing incompetent doctors and protecting the safety and well being of Virginia citizens.
What do you think?
End of life can be scary for both patient, family
This is a question / answer column in our local paper, the Roanoke Times.
Dear Dr. Camardi: I'm in a panic, I'm really scared and I just don't know what to say or how to act.
My mother is dying because of cancer and she has little time left and she wants me to be with her all the time. She cries when I leave -- she really screams out "don't leave me" when I have to work or go to the store or something, and it just kills me.
I have her at home with my sister and me, and I got time off from work when her doctor filled out some papers telling my boss what was happening. Now I wish I didn't listen to her and left her in the hospital to die. I hate myself for saying that because she wanted to die at home and I thought I could deal with it, but I can't.
From what the doctor says, she's going to die any day. What in God's name do I have to do, what do I say, I'm so confused.
-- Roanoke
I'm so sorry for you and your mother that you are going through this ordeal, but let's take a deep breath and think about it.
I commend you for not "running away" -- as many people do and when you think about it, who can blame them? But you've decided not to and as difficult and painful as this time is, you've made the commitment in getting you and Mom through this natural process.
It may be helpful if you think that it's always been you and Mom anyway: as a mother helping her child at the start of life and now as a daughter helping her mother at the end of life; it's always been about the two of you. Now let's work through this.
First thing is that Mom does not sound too comfortable, so have her medications been recently reviewed and optimized for her condition? And have you and your doctor thought about a referral to a hospice care center?
I have been involved with the hospice movement from the 1980s, ranging from medical directorship of a hospice service to being an avid utilizer and advocate. In short, I can't say enough about hospice, and I urge you to explore the key services they provide.
Understand that Mom will soon probably start to refuse to eat or drink. Do not force food or fluids but try to keep the mouth and lips moist for comfort. At some point, Mom will be sleeping more and more, become restless and may start to hallucinate. She may have skin color changes, become very congested and have labored breathing. Be prepared, as this is all part of the process.
The next key consideration is the spiritual factor, which gives great comfort to all concerned and cannot be underestimated.
Arranging for pastoral visits can be very helpful during this time. I have seen it ease deep emotional suffering and allow some understanding of this sorrowful mystery of life. Even if you do not consider yourselves to be religious people, I strongly encourage you to be open to spiritual counseling as your loved one -- and I have seen this many time over the years -- may feel the need but may not be able to or know how to ask. Do it for them.
I'd ask you to consider, if need be, that certain aspects of the past be brought to a close with "I'm sorry" or "I forgive you" and "I love you" and "Thank you." Now is not the time to revisit what can't be undone. We are all imperfect people and tend to make mistakes, big and small, and those judgments of the past can wait. This time, this moment with Mom must be one of peace.
Next, please make the necessary arrangements with your funeral director of choice as soon as possible. This also means getting in touch with family and friends who should know that somebody important to them is not doing well. This is not being overly morbid, this is being prepared because when Mom does pass away, things will move quickly and some things tend to be overlooked.
Finally, what do you do during that time of dying as death approaches?
This may sound strange but please listen closely: Silence is possibly the greatest thing you can do. Simply being there to let Mom emote as she deems fit with a cool washcloth, a tissue to wipe away a tear, a soft hug when needed without a lot of words that the dying person has to struggle to process.
It may not seem like it to you, but the dying person even through the disease and the medication is a bundle of emotions struggling to reason with what is happening to them. Just hold her hand and when the time comes -- and if you're quiet enough, you'll "hear" that whisper of a voice move inside you -- you'll know when to say: "It's OK Mom, just let go."
Dr. Michael Camardi is a geriatrician at the Carilion Center for Healthy Aging. His columns run on the third Tuesday of each month in Extra.
If you have questions for Camardi, please mail them to him at Center for Healthy Aging, 2118 Rosalind Ave., Roanoke, VA 24014 or e-mail them to extra@roanoke.com with "Age Matters" in the subject line.
GREAT ADVICE DOC - thats why I wanted to share it!
Dear Dr. Camardi: I'm in a panic, I'm really scared and I just don't know what to say or how to act.
My mother is dying because of cancer and she has little time left and she wants me to be with her all the time. She cries when I leave -- she really screams out "don't leave me" when I have to work or go to the store or something, and it just kills me.
I have her at home with my sister and me, and I got time off from work when her doctor filled out some papers telling my boss what was happening. Now I wish I didn't listen to her and left her in the hospital to die. I hate myself for saying that because she wanted to die at home and I thought I could deal with it, but I can't.
From what the doctor says, she's going to die any day. What in God's name do I have to do, what do I say, I'm so confused.
-- Roanoke
I'm so sorry for you and your mother that you are going through this ordeal, but let's take a deep breath and think about it.
I commend you for not "running away" -- as many people do and when you think about it, who can blame them? But you've decided not to and as difficult and painful as this time is, you've made the commitment in getting you and Mom through this natural process.
It may be helpful if you think that it's always been you and Mom anyway: as a mother helping her child at the start of life and now as a daughter helping her mother at the end of life; it's always been about the two of you. Now let's work through this.
First thing is that Mom does not sound too comfortable, so have her medications been recently reviewed and optimized for her condition? And have you and your doctor thought about a referral to a hospice care center?
I have been involved with the hospice movement from the 1980s, ranging from medical directorship of a hospice service to being an avid utilizer and advocate. In short, I can't say enough about hospice, and I urge you to explore the key services they provide.
Understand that Mom will soon probably start to refuse to eat or drink. Do not force food or fluids but try to keep the mouth and lips moist for comfort. At some point, Mom will be sleeping more and more, become restless and may start to hallucinate. She may have skin color changes, become very congested and have labored breathing. Be prepared, as this is all part of the process.
The next key consideration is the spiritual factor, which gives great comfort to all concerned and cannot be underestimated.
Arranging for pastoral visits can be very helpful during this time. I have seen it ease deep emotional suffering and allow some understanding of this sorrowful mystery of life. Even if you do not consider yourselves to be religious people, I strongly encourage you to be open to spiritual counseling as your loved one -- and I have seen this many time over the years -- may feel the need but may not be able to or know how to ask. Do it for them.
I'd ask you to consider, if need be, that certain aspects of the past be brought to a close with "I'm sorry" or "I forgive you" and "I love you" and "Thank you." Now is not the time to revisit what can't be undone. We are all imperfect people and tend to make mistakes, big and small, and those judgments of the past can wait. This time, this moment with Mom must be one of peace.
Next, please make the necessary arrangements with your funeral director of choice as soon as possible. This also means getting in touch with family and friends who should know that somebody important to them is not doing well. This is not being overly morbid, this is being prepared because when Mom does pass away, things will move quickly and some things tend to be overlooked.
Finally, what do you do during that time of dying as death approaches?
This may sound strange but please listen closely: Silence is possibly the greatest thing you can do. Simply being there to let Mom emote as she deems fit with a cool washcloth, a tissue to wipe away a tear, a soft hug when needed without a lot of words that the dying person has to struggle to process.
It may not seem like it to you, but the dying person even through the disease and the medication is a bundle of emotions struggling to reason with what is happening to them. Just hold her hand and when the time comes -- and if you're quiet enough, you'll "hear" that whisper of a voice move inside you -- you'll know when to say: "It's OK Mom, just let go."
Dr. Michael Camardi is a geriatrician at the Carilion Center for Healthy Aging. His columns run on the third Tuesday of each month in Extra.
If you have questions for Camardi, please mail them to him at Center for Healthy Aging, 2118 Rosalind Ave., Roanoke, VA 24014 or e-mail them to extra@roanoke.com with "Age Matters" in the subject line.
GREAT ADVICE DOC - thats why I wanted to share it!
Thursday, March 12, 2009
AGITATION = UTI, NOT EXCUSE FOR MORE ATIVAN
I want a dollar for every case I have reviewed, wherein an ambulatory (walking) nursing home resident is over-medicated so they won't bother the nursing staff any more.
No, that is clearly not in the records, but you will see:
Nurses Note:
- pt. ambulating up and down hall. Redirected to room. .25 mg of Ativan, sleeping soundly.
Wait? Since when is walking a sign of aggitation, anxiety or aggression? Ativan after all is an anti-psychotic.
Or I will see
Nurses Note:
pt aggitated. Did not eat breakfast. .50 mg of Ativan resting soundly.
Wait? She probably has a UTI - why did you drug her?
Families, please do not agree to overmedication of your loved one because the nursing home staff sees it fit. Find out what the real problem is, and I bet it is number of nurses, not your loved one.
No, that is clearly not in the records, but you will see:
Nurses Note:
- pt. ambulating up and down hall. Redirected to room. .25 mg of Ativan, sleeping soundly.
Wait? Since when is walking a sign of aggitation, anxiety or aggression? Ativan after all is an anti-psychotic.
Or I will see
Nurses Note:
pt aggitated. Did not eat breakfast. .50 mg of Ativan resting soundly.
Wait? She probably has a UTI - why did you drug her?
Families, please do not agree to overmedication of your loved one because the nursing home staff sees it fit. Find out what the real problem is, and I bet it is number of nurses, not your loved one.
Tuesday, March 10, 2009
FUNERAL HOME NEGLIGENCE
A few years ago, we handled a funeral home negligence case. Apparently, negligence occurs more than you would think in funeral homes.
What is funeral home negligence?
Well, if the facility mis-treats your loved ones' body, fails to care for it in the way you contracted, and it causes you emotional distress, that would be a funeral home negligence case.
Examples:
- dropping body
- failing to bury body in right plot
- cremating body when family requested burial
Remember the funeral home in Georgia that was in hot water a few years back? The owner was telling families their loved one had been cremated and then they found bodies buried outside?
It can be a very emotional experience, in addition to the loss of your loved one - so if you have such a case, don't hesitate to call our office.
What is funeral home negligence?
Well, if the facility mis-treats your loved ones' body, fails to care for it in the way you contracted, and it causes you emotional distress, that would be a funeral home negligence case.
Examples:
- dropping body
- failing to bury body in right plot
- cremating body when family requested burial
Remember the funeral home in Georgia that was in hot water a few years back? The owner was telling families their loved one had been cremated and then they found bodies buried outside?
It can be a very emotional experience, in addition to the loss of your loved one - so if you have such a case, don't hesitate to call our office.
Thursday, March 05, 2009
WOMAN ESCAPES FROM NH AND DIES IN THE COLD
I hate to read this - but again, elderly person with cognitive problems elopes from Nursing Home and dies.
According to the Chicago Tribune, however, the employee that ignored the alarm indicating the resident had eloped, has been charged:
According to the Chicago Tribune, however, the employee that ignored the alarm indicating the resident had eloped, has been charged:
An Itasca nursing home employee watched three straight episodes of "Dog The Bounty Hunter" and "shrugged off " an alarm that indicated an 89-year-old woman with Alzheimer's disease had wandered outside into near-zero conditions early one morning last month, prosecutors said Tuesday.
The woman's lifeless, frozen body later was found in the facility's courtyard after she had been outside for as many as five hours, prosecutors said, and now the employee, a nursing assistant, has been charged in connection with her death.
Heidi Leon, 23, of Bensenville was charged Tuesday with criminal neglect of a long-term-care facility resident, criminal neglect of an elderly person and obstruction of justice. If convicted, she faces up to 7 years in prison.
"She was expected to do her job. She was expected to make bed checks every two hours, and she didn't," DuPage County State's Atty. Joseph Birkett said.
Leon is charged in connection with the Feb. 5 death of Sarah Wentworth, a two-year resident of The Arbor of Itasca nursing home. Leon had been an employee since last March. She has no previous criminal record, Birkett said.
"The death of Sarah Wentworth was not an accident, but a pattern of neglect," Birkett said. "She was known by staff to be a wanderer and wore an ankle bracelet that reminded the staff."
Birkett said nursing home protocol called for checks every two hours, and Leon is accused of lying about a 3 a.m. check she claimed she made on Wentworth.
Although an alarm sounded at a secure door during the middle of the night when Wentworth left the building, no nursing home employee checked on her, Birkett said, adding the outside temperature that morning was about 1 degree.
"Leon shrugged off the alarm and went back to watching TV," he said.
Birkett said staff members at The Arbor were cooperative during the investigation, and he expected no criminal charges against others.
Wentworth's family has filed a civil lawsuit alleging neglect and abuse on the part of The Arbor of Itasca.
"The family is pleased the state's attorney has taken this matter seriously," said Louis Cairo, the attorney representing the Wentworth family. "Because of [Leon's] action and inaction, their mother lost her life."
A federal rating system gives The Arbor of Itasca one star out of a possible five.
The facility's most recent annual inspection was in April, when state investigators found 22 violations—more than twice the number at the average Illinois nursing home. But most were relatively minor and a majority were corrected by August, records show.
abarnum@tribune.com
25 MINUTES TO HELP YOUR FAMILY
Want to help your loved one who is in a nursing home? Take 25 minutes to learn about elder abuse and neglect.
Don't wait - you may learn enough to be helpful.
Don't wait - you may learn enough to be helpful.
Wednesday, March 04, 2009
SUPREME COURT RULES AGAINST DRUG COMPANIES
March 4, 2009
The Supreme Court ruled 6-3 that a Vermont woman can sue Wyeth for injuries she suffered after receiving one of the drug maker's medicines. The ruling affirms an opinion by the Vermont Supreme Court, which upheld a $6.7 million verdict in favor of Diana Levine, who lost an arm to gangrene after Wyeth's antinausea drug Phenergan was inadvertently injected into one of her arteries during a push IV injection.
Wyeth argued the suit, based on Vermont law, should be pre-empted by federal drug regulations. Justice John Paul Stevens, in the majority opinion, said FDA oversight of drug labeling doesn't prevent the filing of state-level consumer liability lawsuits against drug companies.
http://online.wsj.com/article/SB123618148123830541.html?mod=djemalertNEWS
This is great news for consumers... Now the FDA is not the judge as to whether or not a medication is "safe."
If you have been following many cases against drug and medical device manufacturers were removed from court upon finding that the FDA had approved them as safe. Again, we know how safe the FDA can be - come to my house and we will celebrate, peanutbutter anyone?
The Supreme Court ruled 6-3 that a Vermont woman can sue Wyeth for injuries she suffered after receiving one of the drug maker's medicines. The ruling affirms an opinion by the Vermont Supreme Court, which upheld a $6.7 million verdict in favor of Diana Levine, who lost an arm to gangrene after Wyeth's antinausea drug Phenergan was inadvertently injected into one of her arteries during a push IV injection.
Wyeth argued the suit, based on Vermont law, should be pre-empted by federal drug regulations. Justice John Paul Stevens, in the majority opinion, said FDA oversight of drug labeling doesn't prevent the filing of state-level consumer liability lawsuits against drug companies.
http://online.wsj.com/article/SB123618148123830541.html?mod=djemalertNEWS
This is great news for consumers... Now the FDA is not the judge as to whether or not a medication is "safe."
If you have been following many cases against drug and medical device manufacturers were removed from court upon finding that the FDA had approved them as safe. Again, we know how safe the FDA can be - come to my house and we will celebrate, peanutbutter anyone?
NURSING HOMES FOR VETERANS IN SOUTHWEST VIRGINIA
The Lynchburg daily newspaper (The News and Advance) ran an article today about nursing home resources and options for military veterans. It is a good article. It describes how the Veteran’s Health Administration (VHA) provides nursing home services to veterans through three national programs: VA owned and operated nursing homes, state veterans homes owned and operated by states and community nursing programs.
The article then becomes a little misleading...as it starts to speak glowingly about the Virginia Veterans Care Center (VVCC) in Salem, Virginia. For example, it describes the VVCC as "a state-of-the-art model for long-term health care. Maybe true but isn't the fact that the facility only received a 2 star rating (out of 5) from the Center for Medicare and Medicaid Services more important?
My Take: Thoroughly check out any nursing home before making a decision to place a loved one.
The article then becomes a little misleading...as it starts to speak glowingly about the Virginia Veterans Care Center (VVCC) in Salem, Virginia. For example, it describes the VVCC as "a state-of-the-art model for long-term health care. Maybe true but isn't the fact that the facility only received a 2 star rating (out of 5) from the Center for Medicare and Medicaid Services more important?
My Take: Thoroughly check out any nursing home before making a decision to place a loved one.
Tuesday, March 03, 2009
CONGRESS HELP US ON ARBITRATION
There is an article in McKnight's today: Another bill that would prohibit pre-admission arbitration clauses panned by nursing home operators
March 02 2009
U.S. Rep. Linda Sanchez (D-CA) on Friday re-introduced a bill that would prohibit nursing home and assisted living operators from including pre-dispute arbitration clauses in their admissions contracts. Providers wasted no time attacking the bill, just as they have similar legislation in the past.
Providers contend that pre-dispute agreements compel “more timely, less adversarial settlements” by averting lengthy, potentially higher-costing lawsuits. One top nursing home lobbyist said the new bill, the Fairness in Nursing Home Arbitration Act (HR 1237) “needlessly discriminates” against both providers and those in their care.
“Arbitration settlements are quicker and less adversarial than traditional litigation, and many courts throughout America have determined the process to be both fair and appropriate,” stated Dave Kyllo, executive director of the National Center for Assisted Living. “We believe that fair and timely resolution to any legal concerns is in the best interest of the patients, residents, taxpayers and the nation's entire health care sector.”
Kyllo also called HR 1237 “a misguided attempt to restrict and weaken the Federal Arbitration Act.” Similar anti-arbitration clause bills have been introduced in the House and Senate previously but have never come close to becoming law.
WANT MY TAKE? No one knows they are signing an agreement that they will WAIVE their right to a jury trial. Plus, to file a claim in arbitration may cost $3000 when to file one in your local court will only cost $300.... So is that "avoiding higher costing litigation?"
YES for the nursing home. No for the family.
And if arbitration is so wonderful nursing home industry, why do you often reserve the right to sue for non-payment in local court?
March 02 2009
U.S. Rep. Linda Sanchez (D-CA) on Friday re-introduced a bill that would prohibit nursing home and assisted living operators from including pre-dispute arbitration clauses in their admissions contracts. Providers wasted no time attacking the bill, just as they have similar legislation in the past.
Providers contend that pre-dispute agreements compel “more timely, less adversarial settlements” by averting lengthy, potentially higher-costing lawsuits. One top nursing home lobbyist said the new bill, the Fairness in Nursing Home Arbitration Act (HR 1237) “needlessly discriminates” against both providers and those in their care.
“Arbitration settlements are quicker and less adversarial than traditional litigation, and many courts throughout America have determined the process to be both fair and appropriate,” stated Dave Kyllo, executive director of the National Center for Assisted Living. “We believe that fair and timely resolution to any legal concerns is in the best interest of the patients, residents, taxpayers and the nation's entire health care sector.”
Kyllo also called HR 1237 “a misguided attempt to restrict and weaken the Federal Arbitration Act.” Similar anti-arbitration clause bills have been introduced in the House and Senate previously but have never come close to becoming law.
WANT MY TAKE? No one knows they are signing an agreement that they will WAIVE their right to a jury trial. Plus, to file a claim in arbitration may cost $3000 when to file one in your local court will only cost $300.... So is that "avoiding higher costing litigation?"
YES for the nursing home. No for the family.
And if arbitration is so wonderful nursing home industry, why do you often reserve the right to sue for non-payment in local court?
Monday, March 02, 2009
WHAT TO ASK BEFORE YOU PLACE A LOVED ONE IN A NURSING HOME
These are some good questions to ask before choosing a nursing home.
1. Non-profit, or for-profit?
2. If for profit, locally owned?
3. If for profit, how many nursing home owned by the one corporate owner?
4. How many residents are there now?
5. How long have the Administrator and DON been there?
So why do these questions matter? In my humble opinion, non-profit facilities can often afford to hire more nurses because they don't care to make a profit at the end of the day. More nurses, means more and better care.
Is there proof to support my theory? Not much - but I will tell you in 2008, only 2or 3 of the over 100 calls I received for SW Va nursing home complaints of abuse or neglect, were about non-profit facilities.
If you have to chose for-profit, ask how many locations and where corporate is. If corporate is in California, do you really think they will pay extra special attention to your loved one, or will she be a line on a spreadsheet?
1. Non-profit, or for-profit?
2. If for profit, locally owned?
3. If for profit, how many nursing home owned by the one corporate owner?
4. How many residents are there now?
5. How long have the Administrator and DON been there?
So why do these questions matter? In my humble opinion, non-profit facilities can often afford to hire more nurses because they don't care to make a profit at the end of the day. More nurses, means more and better care.
Is there proof to support my theory? Not much - but I will tell you in 2008, only 2or 3 of the over 100 calls I received for SW Va nursing home complaints of abuse or neglect, were about non-profit facilities.
If you have to chose for-profit, ask how many locations and where corporate is. If corporate is in California, do you really think they will pay extra special attention to your loved one, or will she be a line on a spreadsheet?
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