I have heard from more than one potential nursing home or medical malpractice client, that they called an attorney because a treating physician told them to.
Or, I have heard clients say "Dr. Smith said that if he had gotten treatment earlier," or "had his dermatologist seen the spot" or "if only the nurse hadn't missed X" - your loved one would still be alive.
Now, do I believe that physicians say these things? YES. Most are wonderfully caring and end up providing health care as well as emotional care for patients and their families. So explaining to a family member where something went wrong, happens often.
The issue however, is often that these comments, or impressions are NOT reflected in the medical records. Nor is the communication between physicians and families on these issues without complication.
Dr. Smith may tell you your wife could have been saved if only she had been brought in last week, but Dr. Smith's records say that your wife had a history of problems including probable inoperable cancer.
So if a physician shares with you or implies that someone else along the way may have made a mistake, ask the following questions.
1. What was the mistake?
2. Was it an easy one to miss?
3. Did the mistake have any long term consequences?
4. Is that in your record?
I know that sounds silly and maybe pushy - but I have found many clients may misunderstand a physician's empathy, to be an opinion that another health care provider committed malpractice.
Then we they come to my office and say "This is a slam dunk case Dr. Smith said so," and Dr. Smith doesn't hold that opinion, their emotional pain and loss only grows.
It is therefore my hope, that with better communication we will see clear medical records, and fewer hurt feelings.
Wednesday, April 29, 2009
Tuesday, April 28, 2009
GOOD NEWS - NURSING HOMES STILL MAKING A PROFIT
Ok, so I don't think it is good news that nursing homes are making a profit... but even in this rough economy, some are flourishing.
According to a report published in McKnights longterm care publication yesterday,
Nursing home stocks weathering economy OK, but reimbursement concerns loom
April 27, 2009
"At least a handful of for-profit nursing home companies' stock values are holding strong, despite an overall shaky economy, a new Dow Jones report notes. The key has been relatively stable Medicare and Medicaid payments, though there is concern about payment levels for fiscal 2010 that are expected to be announced around the end of the month, report authors note.
Kindred Healthcare, Skilled Healthcare Group, and Sun Healthcare Group have all seen their share values fall by more than in half from 52-week highs. But each also has been holding steady in 2009. The recently signed economic stimulus bill will provide about $87 billion in Medicaid funding, which is helping company values, observers say.
But with healthcare reform on every lawmaker's mind this year, nursing homes could fall victim to the payment axe they have luckily not seen in recent years. Many observers are very interested in what the Centers for Medicare & Medicaid Services might do to counterbalance providers receiving $770 million more than anticipated in Medicare payments for nine higher-acuity reimbursement groups that were added in 2006.Most insiders expect proposed Medicare cuts, or at least a proposed freeze, but almost all acknowledge it is unknown whether lawmakers will have the resolve to act on any such proposals."
OK - lets get to basics. Nursing Homes make money when (1) they make more money (2) then the spend. Simple math.
So what does this mean? (1) They are being paid / reimbursed too much? If so, please note these are your tax dollars. or (2) They are not paying enough for your loved one's care in the form of food, nurses, staff etc.
Either way - the fact they are making a profit, means someone is losing - either those being cared for, or the residents.
According to a report published in McKnights longterm care publication yesterday,
Nursing home stocks weathering economy OK, but reimbursement concerns loom
April 27, 2009
"At least a handful of for-profit nursing home companies' stock values are holding strong, despite an overall shaky economy, a new Dow Jones report notes. The key has been relatively stable Medicare and Medicaid payments, though there is concern about payment levels for fiscal 2010 that are expected to be announced around the end of the month, report authors note.
Kindred Healthcare, Skilled Healthcare Group, and Sun Healthcare Group have all seen their share values fall by more than in half from 52-week highs. But each also has been holding steady in 2009. The recently signed economic stimulus bill will provide about $87 billion in Medicaid funding, which is helping company values, observers say.
But with healthcare reform on every lawmaker's mind this year, nursing homes could fall victim to the payment axe they have luckily not seen in recent years. Many observers are very interested in what the Centers for Medicare & Medicaid Services might do to counterbalance providers receiving $770 million more than anticipated in Medicare payments for nine higher-acuity reimbursement groups that were added in 2006.Most insiders expect proposed Medicare cuts, or at least a proposed freeze, but almost all acknowledge it is unknown whether lawmakers will have the resolve to act on any such proposals."
OK - lets get to basics. Nursing Homes make money when (1) they make more money (2) then the spend. Simple math.
So what does this mean? (1) They are being paid / reimbursed too much? If so, please note these are your tax dollars. or (2) They are not paying enough for your loved one's care in the form of food, nurses, staff etc.
Either way - the fact they are making a profit, means someone is losing - either those being cared for, or the residents.
Monday, April 27, 2009
NURSING HOMES AND SWINE FLU
We have all heard by now about the threat of the swine flu. According to the Centers for Disease Control over 40 cases have been reported in the United States. Swine flu can be deadly for the elderly...especially those with multiple medical conditions who reside in nursing homes or other long term care facilities.
The National Citizens' Coalition for Nursing Home Reform
(NCCNHR), which provides information and leadership on federal and state regulatory and legislative strategies to improve care and life for residents of nursing homes and other long term care facilities, has provided the attached warning and notice to all individuals concerned about the effects of swine flu and nursing home residents.
The National Citizens' Coalition for Nursing Home Reform
(NCCNHR), which provides information and leadership on federal and state regulatory and legislative strategies to improve care and life for residents of nursing homes and other long term care facilities, has provided the attached warning and notice to all individuals concerned about the effects of swine flu and nursing home residents.
SEX OFFENDERS IN VIRGINIA'S NURSING HOMES
Now that I've got your attention with the title...let me share with you a recent discovery.
We found a nursing home (large multi-state chain of "for-profit" nursing homes) which requires its residents (or the resident's representative) to sign the attached notice. In sum, the notice advises all who read it that "sex offenders may be living and/or working in" the area of the nursing home. The notice further advises the resident to "exercise whatever due diligence" the resident feels is necessary.
What about sex offenders living in the facility? What about sex offenders working in the facility?
My Question: Just what the H#@* is the facility's responsibility of "due diligence" to protect its residents?
Friday, April 24, 2009
WOODHAVEN NURSING HOME IN ROANOKE, VA IN THE NEWS
I ran across this little news story about a nursing home in my home town of Roanoke, Virginia. It seems that this private pay facility charged residents and their families for days they were not living in the nursing home....how about charging for days they were not even alive!
Outrageous conduct if you ask me and just another example of abuse.
Follow the story on Woodhaven Nursing Home...and tell me what you think of its billing practices.
Outrageous conduct if you ask me and just another example of abuse.
Follow the story on Woodhaven Nursing Home...and tell me what you think of its billing practices.
Thursday, April 23, 2009
WHAT IS A MEDICAL MALPRACTICE CASE and HOW DO YOU FILE ONE?
Medical Malpractice Frequently Asked Questions
What is a medical malpractice claim?
A medical malpractice claim is a claim filed against a corporation or individual which provided negligent or substandard medical care.
What is involved in the investigation of a medical malpractice claim?
First, we start with a thorough review and analysis of your medical records.
Secon, we will orchestrate a review of your records by qualified medical experts who can testify at trial that your treating doctors were negligent and that his/her negligence is a direct cause of injury or death.
How much will a medical malpractice claim cost?
No case is the same. Most of the expense in pursuing a medical malpractice case arises from the use of experts. Experts charge by the hour for their work on the file and total expert charges can range from a several thousand dollars to $30,000 or more.
How long will my medical malpractice lawsuit take?
Most medical malpractice claims take approximately 18 months from the date the complaint is filed until the case is resolved, by settlement or trial.
WANT TO LEARN MORE ABOUT MED MAL CASES? WANT TO GET A FREE EVALUATION OF YOUR CASE?
What is a medical malpractice claim?
A medical malpractice claim is a claim filed against a corporation or individual which provided negligent or substandard medical care.
What is involved in the investigation of a medical malpractice claim?
First, we start with a thorough review and analysis of your medical records.
Secon, we will orchestrate a review of your records by qualified medical experts who can testify at trial that your treating doctors were negligent and that his/her negligence is a direct cause of injury or death.
How much will a medical malpractice claim cost?
No case is the same. Most of the expense in pursuing a medical malpractice case arises from the use of experts. Experts charge by the hour for their work on the file and total expert charges can range from a several thousand dollars to $30,000 or more.
How long will my medical malpractice lawsuit take?
Most medical malpractice claims take approximately 18 months from the date the complaint is filed until the case is resolved, by settlement or trial.
WANT TO LEARN MORE ABOUT MED MAL CASES? WANT TO GET A FREE EVALUATION OF YOUR CASE?
QUICK CT SCANS ARE CRITICAL WHEN CARING FOR THE STROKE PATIENT
Approximately 750,000 Americans suffer a stroke every year. 83% of those strokes are ischemic, or caused by a blockage of blood flow to the brain. The remainder of the strokes are called hemorrhagic strokes which are caused by bleeding in the brain itself. The treatment for ischemic strokes is the quick administration (within 3 hours of onset) of a clot-dissolving drug called tPA. However, to give tPA to a patient suffering from a hemorrhagic stroke would likely increase the bleeding in the brain and increase the likelihood of death.
How do doctors determine whether the stroke is ischemic or hemorrhagic? They take a picture (CT) of the brain and have that picture interpreted by a radiologist who can then determine what type of stroke the patient is suffering and plan the appropriate treatment.
In a major article published in the Journal of the American Medical Association in 2000, a group of leading neurologists recommended that hospitals be able to perform a CT or MRI scan within 25 minutes of the doctor's order for the test and that radiologists be available to read and interpret the studies within 20 minutes.
The obvious question is, "why don't all stroke patients receive an immediate head CT upon arriving at the hospital with complaints consistent with a stroke"? I don't believe this 9 year old recommendation by America's leading medical association is being followed by the hospitals in southwest Virginia including:
How do doctors determine whether the stroke is ischemic or hemorrhagic? They take a picture (CT) of the brain and have that picture interpreted by a radiologist who can then determine what type of stroke the patient is suffering and plan the appropriate treatment.
In a major article published in the Journal of the American Medical Association in 2000, a group of leading neurologists recommended that hospitals be able to perform a CT or MRI scan within 25 minutes of the doctor's order for the test and that radiologists be available to read and interpret the studies within 20 minutes.
The obvious question is, "why don't all stroke patients receive an immediate head CT upon arriving at the hospital with complaints consistent with a stroke"? I don't believe this 9 year old recommendation by America's leading medical association is being followed by the hospitals in southwest Virginia including:
Carilion Roanoke Memorial Hospital, Lewis-Gale 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, and Tazewell Community Hospital
Tuesday, April 21, 2009
EVERY STATE IS DIFFERENT
If you have a Medical Malpractice question or possible claim, you need to speak to an attorney that is licensed in the state where the negligence occurred.
YES, even if grandmom died in a Virginia nursing home but you live in Florida, call a Virginia lawyer.
Every state is different. I have received two cases recently from attorneys in other states. The attorney will say "this is a great case and we already have a nursing expert."
1. The attorneys in the other states did NOT know about special arbitration law regarding Medical contracts.
2. They did NOT know the active clinical practice requirements of Virginia experts.
So while it may be a great case (1) we are now stuck in arbitration, arguably, and
(2)we have to hire another nurse.
Had that client called a Virginia attorney, he or she would have advised them on specific Virginia laws from the start (hopefully).
We love referrals from other attorneys. We especially love telling people about Virginia law where we are licensed and practice every day.
So - we can help you find an attorney in another state, but we will do that ASAP before any special deadlines or laws are missed. Likewise, if you want to send us a case, please do it as soon as possible so we can help guide the case investigation under Virginia law!
YES, even if grandmom died in a Virginia nursing home but you live in Florida, call a Virginia lawyer.
Every state is different. I have received two cases recently from attorneys in other states. The attorney will say "this is a great case and we already have a nursing expert."
1. The attorneys in the other states did NOT know about special arbitration law regarding Medical contracts.
2. They did NOT know the active clinical practice requirements of Virginia experts.
So while it may be a great case (1) we are now stuck in arbitration, arguably, and
(2)we have to hire another nurse.
Had that client called a Virginia attorney, he or she would have advised them on specific Virginia laws from the start (hopefully).
We love referrals from other attorneys. We especially love telling people about Virginia law where we are licensed and practice every day.
So - we can help you find an attorney in another state, but we will do that ASAP before any special deadlines or laws are missed. Likewise, if you want to send us a case, please do it as soon as possible so we can help guide the case investigation under Virginia law!
Monday, April 20, 2009
FAILURE TO DIAGNOSE BREAST CANCER IN VIRGINIA CASE RESULTS IN AWARD
This a sad story. A 55 year Spotsylvania County (VA) woman noted a lump in her breast during self- examination. Wisely, she went to her family doctor who ordered a mammogram, which was reported as negative.
The patient returned to her family doctor 7 months later to report the lump had grown from the size of a peach pit to that of a lemon. The family doctor referred the patient to a specialist who diagnosed the lump as cancerous. The patient underwent a bilateral mastectomy, chemotherapy, and radiation treatment, but died two years later due to the spread of the breast cancer to her stomach, pancreas, and brain.
The lawsuit (Estate of Eleanor Browder v. Dr. Donna Gamache) alleged that the family doctor should have referred the patient to a specialist for appropriate care and treatment at the time the mammogram was ordered. The failure to make that referral delayed the appropriate diagnosis and treatment by 7 months.
After 5 days of testimony, the jury awarded the patient's husband of 27 years and two adult children $212,000 for medical bills, $785,000 for economic losses (the patient worked as a nurse), and $6.5 million for loss of companionship and solace.
My Take: Family practitioners are an important part of America's health care system. However, when cancer (breast or otherwise) is suspected...get to a specialist for accurate diagnosis and treatment.
The patient returned to her family doctor 7 months later to report the lump had grown from the size of a peach pit to that of a lemon. The family doctor referred the patient to a specialist who diagnosed the lump as cancerous. The patient underwent a bilateral mastectomy, chemotherapy, and radiation treatment, but died two years later due to the spread of the breast cancer to her stomach, pancreas, and brain.
The lawsuit (Estate of Eleanor Browder v. Dr. Donna Gamache) alleged that the family doctor should have referred the patient to a specialist for appropriate care and treatment at the time the mammogram was ordered. The failure to make that referral delayed the appropriate diagnosis and treatment by 7 months.
After 5 days of testimony, the jury awarded the patient's husband of 27 years and two adult children $212,000 for medical bills, $785,000 for economic losses (the patient worked as a nurse), and $6.5 million for loss of companionship and solace.
My Take: Family practitioners are an important part of America's health care system. However, when cancer (breast or otherwise) is suspected...get to a specialist for accurate diagnosis and treatment.
Wednesday, April 15, 2009
WHAT ARE THE BEST NURSING HOMES WITHIN 50 MILES OF MARION, VIRGINIA?
The answer is provided by a new "5 Star Rating System" provided by Medicare. When using the Medicare site...select "Find and Compare Nursing Homes"....then select "Find Nursing Homes within certain distance" of a zip code or identified city. The nursing homes receiving the highest ratings include:
* SW Virginia Mental Health Institute and Geriatric Treatment Center - Marion, VA
* Clinch Valley Medical Center - Richlands, VA
* Westwood Center - Bluefield, VA
* Waddell Nursing and Rehab Center - Galax, VA
The nursing homes receiving some of the worst ratings include:
* Francis Marion Manor - Marion, VA
* Valley Health Care Center - Chilhowie, VA
* Heritage Hall - Tazewell, VA
* Grace Healthcare of Abingdon - Abingdon, VA
* Edgemont Center - Wytheville, VA
* Grayson Nursing and Rehab - Independence, VA
* Carrington Place at Wytheville/Birdmont Center - Wytheville, VA
* Bland County Nursing and Rehabilitation Center - Bastian, VA
* McDowell Nursing and Rehabilitation Center - Gary, WV
* Maples Nursing Home - Bluefield, WV
* Golden Living Center/Blueridge - Galax, VA
* Mercer Nursing and Rehabilitation Center - Bluefield, WV
My Take: Be an informed consumer of health care and do your loved one a favor....check out the nursing home BEFORE you decide what is best for a family member.
* SW Virginia Mental Health Institute and Geriatric Treatment Center - Marion, VA
* Clinch Valley Medical Center - Richlands, VA
* Westwood Center - Bluefield, VA
* Waddell Nursing and Rehab Center - Galax, VA
The nursing homes receiving some of the worst ratings include:
* Francis Marion Manor - Marion, VA
* Valley Health Care Center - Chilhowie, VA
* Heritage Hall - Tazewell, VA
* Grace Healthcare of Abingdon - Abingdon, VA
* Edgemont Center - Wytheville, VA
* Grayson Nursing and Rehab - Independence, VA
* Carrington Place at Wytheville/Birdmont Center - Wytheville, VA
* Bland County Nursing and Rehabilitation Center - Bastian, VA
* McDowell Nursing and Rehabilitation Center - Gary, WV
* Maples Nursing Home - Bluefield, WV
* Golden Living Center/Blueridge - Galax, VA
* Mercer Nursing and Rehabilitation Center - Bluefield, WV
My Take: Be an informed consumer of health care and do your loved one a favor....check out the nursing home BEFORE you decide what is best for a family member.
Tuesday, April 14, 2009
WHAT ARE THE BEST NURSING HOMES WITHIN 50 MILES OF HILLSVILLE, VIRGINIA?
The answer is provided by a new "5 Star Rating System" provided by Medicare. When using the Medicare site...select "Find and Compare Nursing Homes"....then select "Find Nursing Homes within certain distance" of a zip code or identified city.
The nursing homes receiving the highest ratings include:
* Trinity Mission Health and Rehab - Hillsville, VA
* Wytheville Community Hospital ECU - Wytheville, VA
The nursing homes receiving some of the worst scores include:
* Golden Livingcenter - Galax, VA
* Carrington Place at Wytheville/Birdmont Center - Wytheville, VA
* Edgemont Center - Wytheville, VA
* Grayson Nursing and Rehab Center - Independence, VA
* Heritage Hall - Blacksburg, VA
* Bland County Nursing & Rehabilitation Center - Bastian, VA
My Take: Be an informed consumer of health care and do your loved one a favor....check out the nursing home BEFORE you decide what is best for a family member.
The nursing homes receiving the highest ratings include:
* Trinity Mission Health and Rehab - Hillsville, VA
* Wytheville Community Hospital ECU - Wytheville, VA
The nursing homes receiving some of the worst scores include:
* Golden Livingcenter - Galax, VA
* Carrington Place at Wytheville/Birdmont Center - Wytheville, VA
* Edgemont Center - Wytheville, VA
* Grayson Nursing and Rehab Center - Independence, VA
* Heritage Hall - Blacksburg, VA
* Bland County Nursing & Rehabilitation Center - Bastian, VA
My Take: Be an informed consumer of health care and do your loved one a favor....check out the nursing home BEFORE you decide what is best for a family member.
Sunday, April 12, 2009
WHAT IS AN ASSISTED LIVING FACILITY?
The short answer is a residential facility that provides personal and health care services, 24-
hour supervision, and assistance for the maintenance or care of four or more adults who are aged, infirm, or disabled and who are cared for in a primarily residential setting. Facilities may be licensed to provide two levels of care: residential living care and assisted living care, or just residential living care.
Want to know more about Assisted Living Facilities (ALFs) in Virginia? If so, check out the compilation of state laws and regulations published by the National Center for Assisted Living.
The section on Virginia laws and regulations is located on pages 203 -207.
hour supervision, and assistance for the maintenance or care of four or more adults who are aged, infirm, or disabled and who are cared for in a primarily residential setting. Facilities may be licensed to provide two levels of care: residential living care and assisted living care, or just residential living care.
Want to know more about Assisted Living Facilities (ALFs) in Virginia? If so, check out the compilation of state laws and regulations published by the National Center for Assisted Living.
The section on Virginia laws and regulations is located on pages 203 -207.
Saturday, April 11, 2009
WANT TO SURVIVE YOUR TRIP TO THE HOSPITAL? BUY THIS BOOK
I've just read a great book and want to share it with the readers of this blog. At the outset let me state that I do not know the author Martine Ehrenclou, never met her, and have no financial stake in the sale of her book.
The book is entitled, "Critical Conditions: The Essential Hospital Guide to Get Your Loved One Out Alive." The book is a step-by-step guide and workbook that leads you from Admitting through to Discharge and offers concrete advice and tips gathered from over 150 interviews with doctors, nurses, hospital social workers, psychologists, family members, and other medical staff.
The book will teach you how to:
1. Prevent deadly medical errors, medication mistakes,
and the spread of infectious diseases.
2. Reach doctors when you need them—every time.
3. Prevent fatal falls.
4. Create a "Family Advocate Team."
5. Manage your loved one's care if you live out of town.
6. Gather support for yourself and the patient.
7. Research your loved one's illness or injury.
8. Monitor medications, diet, procedures, labs, and treatment.
9. Navigate and manage the hospital system with confidence.
10. Communicate with nurses and doctors to maximize medical attention for the patient.
The book may be purchased at your local book store or through Amazon or Barnes & Noble.
The book is entitled, "Critical Conditions: The Essential Hospital Guide to Get Your Loved One Out Alive." The book is a step-by-step guide and workbook that leads you from Admitting through to Discharge and offers concrete advice and tips gathered from over 150 interviews with doctors, nurses, hospital social workers, psychologists, family members, and other medical staff.
The book will teach you how to:
1. Prevent deadly medical errors, medication mistakes,
and the spread of infectious diseases.
2. Reach doctors when you need them—every time.
3. Prevent fatal falls.
4. Create a "Family Advocate Team."
5. Manage your loved one's care if you live out of town.
6. Gather support for yourself and the patient.
7. Research your loved one's illness or injury.
8. Monitor medications, diet, procedures, labs, and treatment.
9. Navigate and manage the hospital system with confidence.
10. Communicate with nurses and doctors to maximize medical attention for the patient.
The book may be purchased at your local book store or through Amazon or Barnes & Noble.
Friday, April 10, 2009
WHEN TO FIND A NEW DOCTOR
We often receive telephone calls from clients, prospective clients, and friends who ask, "When Should I Change Doctors?" Over the many years of my law practice I've come up with the Top Five Reasons to Find a New Doctor:
1. Lack Of Confidence In Doctor's Ability - for whatever reason.
2. Lack Of Continuity Between Visits - she can't remember why you were here 3 weeks ago and hasn't taken the time to look at your chart.
3. You Doctor is Not Forthcoming and doesn't appreciate (or fully answer) your questions.
4. Excessively Long Wait To Get An Appointment - permanent injury or death can result if the wait is too long.
5. Your Doctor Is Always Rushed - we have a clinic in my area of Virginia which reportedly wants its doctors to spend 8 minutes or less with each patient!
1. Lack Of Confidence In Doctor's Ability - for whatever reason.
2. Lack Of Continuity Between Visits - she can't remember why you were here 3 weeks ago and hasn't taken the time to look at your chart.
3. You Doctor is Not Forthcoming and doesn't appreciate (or fully answer) your questions.
4. Excessively Long Wait To Get An Appointment - permanent injury or death can result if the wait is too long.
5. Your Doctor Is Always Rushed - we have a clinic in my area of Virginia which reportedly wants its doctors to spend 8 minutes or less with each patient!
Thursday, April 09, 2009
DO YOU HAVE ACCESS TO A TOP 50 HOSPITAL?
Healthgrades is the leading healthcare ratings organization, providing ratings and profiles of hospitals, nursing homes and physicians to consumers, corporations, health plans and hospitals. This organization recently published a list of the "Top 50 hospitals in America". These hospitals have been recognized for their consistent clinical excellence and represent the highest scoring of the nation's full-service hospitals for the most consecutive years. Guess what? Only two hospitals from my home state of Virginia made the list... Henrico Doctor's Hospital in Richmond, Virginia and Inova Fairfax Hospital in Fairfax, Virginia. Congrats to both!
Where are the following hospitals which serve the western half of Virginia?
Carilion Roanoke Memorial Hospital, Lewis-Gale 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, and Tazewell Community Hospital
Where are the following hospitals which serve the western half of Virginia?
Carilion Roanoke Memorial Hospital, Lewis-Gale 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, and Tazewell Community Hospital
Tuesday, April 07, 2009
SUSPECT ELDER ABUSE? TAKE ACTION NOW
We hear from families all of the time that they suspected their loved one was being neglected or abused in a nursing home...but they failed to take action until it was too late.
Do you have a loved one living in a Virginia nursing home and suspect they are getting poor or substandard care? If so, take advantage of these resources immediately:
State Government Agencies:
Virginia Adult Protective Services
Virginia Department of Health, Center for Quality Health Care Services, Long Term Care Division
Virginia Department of Social Services Domestic Violence Program
Virginia Long Term Care Ombudsman
Virginia Office of Attorney General
Laws and Regulations:
Va. Code Ann. §§ 63.2-1604-12 Adult Protective Services
Sources for Statistics:
Virginia Department of Social Services: Information Resource Book 2003Virginia Department of Social Services: Who Are Mandatory Reporters for APS?
Help Line and Hotlines
Elder Abuse Hotline: 1-888-83-ADULT or 1-888-832-3858
Family Violence/Sexual Assault Hotline: 1-888-838-8238
Monday, April 06, 2009
VIOLENCE IN NURSING HOMES ON THE RISE
Sad...but true! Criminal offenders and mentally ill residents are fueling an increase in patient-to-patient assaults at nursing homes.
In a recent survey, Wes Bledsoe, founder of A Perfect Cause, a nonprofit nursing home residents’ advocacy group in Oklahoma, found 1,600 registered sex offenders in nursing homes.
The organization has also documented more than 60 rapes, murders and assaults committed by criminal offenders in nursing homes. A recent report by the Associated Press estimated that nearly 125,000 young and middle-aged adults with serious mental illnesses lived in U.S. nursing homes last year.
Nursing homes that are having trouble filling their beds sometimes start looking for residents, and get those residents from bad sources. Often, the staff are not aware of a resident’s violent past. And because of health care privacy laws, the facility is not allowed to disclose information about a resident to other residents, Bledsoe noted. Families often become aware that another resident has a history of violent behavior after their loved one is assaulted, he said.
“People are being raped, physically assaulted and murdered,” he said.
My Take: Ask your nursing home if you, or your loved one, is at risk due to the criminal or psychiatric records of other residents. Also, let the Administrator know that you will hold him/her and the nursing home accountable for any preventable incidents or attacks.
In a recent survey, Wes Bledsoe, founder of A Perfect Cause, a nonprofit nursing home residents’ advocacy group in Oklahoma, found 1,600 registered sex offenders in nursing homes.
The organization has also documented more than 60 rapes, murders and assaults committed by criminal offenders in nursing homes. A recent report by the Associated Press estimated that nearly 125,000 young and middle-aged adults with serious mental illnesses lived in U.S. nursing homes last year.
Nursing homes that are having trouble filling their beds sometimes start looking for residents, and get those residents from bad sources. Often, the staff are not aware of a resident’s violent past. And because of health care privacy laws, the facility is not allowed to disclose information about a resident to other residents, Bledsoe noted. Families often become aware that another resident has a history of violent behavior after their loved one is assaulted, he said.
“People are being raped, physically assaulted and murdered,” he said.
My Take: Ask your nursing home if you, or your loved one, is at risk due to the criminal or psychiatric records of other residents. Also, let the Administrator know that you will hold him/her and the nursing home accountable for any preventable incidents or attacks.
Friday, April 03, 2009
ARE YOU AT RISK FOR BLOOD CLOTS?
Yesterday, I wrote a blog on the dangers of blood clots and what good hospitals are doing to reduce the risk of death for surgical patients who encounter blood clots. Today, I provide a list of factors which may place a surgical patient at risk for developing blood clots. The risks include:
1. Recent elective hip or knee replacement surgery
2. Family history of blood clotting disorders.
3. Recent major surgery (lasting more than 45 minutes).
4. Recent laparoscopic surgery (lasting more than 45 minutest).
5. Age 41 - 60.
6. Varicose veins.
7. Recently confined to bed rest for more than 72 hours.
8. Pregnant or delivered a baby in the last month.
My Take: You better have a discussion about your risk of developing blood clots with your doctor if any of these factors are present.
1. Recent elective hip or knee replacement surgery
2. Family history of blood clotting disorders.
3. Recent major surgery (lasting more than 45 minutes).
4. Recent laparoscopic surgery (lasting more than 45 minutest).
5. Age 41 - 60.
6. Varicose veins.
7. Recently confined to bed rest for more than 72 hours.
8. Pregnant or delivered a baby in the last month.
My Take: You better have a discussion about your risk of developing blood clots with your doctor if any of these factors are present.
Thursday, April 02, 2009
KILLER BLOOD CLOTS
Blood clots...deep vein thrombosis (dvt)...pulmonary embolism....whatever you call them...they are life-threatening...especially if you are in the hospital recovering from surgery. Clots kill some 200,000 hospital patients per year.
The hospitals which provide the best care are taking steps to reduce the risk of dying from blood clots. Steps which include:
1. Screening patients for potential risk factors such as obesity, smoking, and a family history of clotting problems.
2. Closely following guidelines for prevention of blood clots such as putting certain patients on blood-thinning medications, including anti-clotting drugs like heparin or warfarin.
3. Using special compression stockings for a patient's legs, after surgery, which improve circulation.
Wonder what the following hospitals in western Virginia are doing to reduce the risk of blood clots?
Carilion Roanoke Memorial Hospital, Lewis-Gale 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, and Tazewell Community Hospital
The hospitals which provide the best care are taking steps to reduce the risk of dying from blood clots. Steps which include:
1. Screening patients for potential risk factors such as obesity, smoking, and a family history of clotting problems.
2. Closely following guidelines for prevention of blood clots such as putting certain patients on blood-thinning medications, including anti-clotting drugs like heparin or warfarin.
3. Using special compression stockings for a patient's legs, after surgery, which improve circulation.
Wonder what the following hospitals in western Virginia are doing to reduce the risk of blood clots?
Carilion Roanoke Memorial Hospital, Lewis-Gale 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, and Tazewell Community Hospital
DISCHARGE TOO SOON
Our local paper is writing less articles themselves, and printing more AP articles. Bad news is we read very little about local issues, good news is we are more plugged in to national issues.
Like this one - 1 in 5 Medicare patients rehospitalized in a month; study says patients get too little advice
Associated Press Writer Stephanie Nano writes "that one in five Medicare patients end up back in the hospital within a month of discharge, a large study found, and that practice costs billions of dollars a year. The findings suggest patients aren't told enough about how to take care of themselves and stay healthy before they go home, the researchers said. A few simple things - like making a doctor's appointment for departing patients - can help, they said.
The study found that a surprising half of the non-surgery patients who returned within a month hadn't even seen a doctor between hospital stays.
"Hospitals put more effort into the admission process than they do into the discharge process," said Dr. Eric Coleman, one of the study's authors from the University of Colorado in Denver.
Coleman, who runs a program to improve "hand-offs" between health care systems, said patients often have a honeymoon notion about how things will be once they're home. Then when they become confused about how to take their medicine or run into other problems, they head back to the hospital because they don't know where to turn, he said.
The issue of hospital readmissions and their cost has come under scrutiny in recent years. And it's getting attention now because President Barack Obama's budget calls for reducing spending on Medicare readmissions to pay for health care reform.
For their study, reported in Thursday's New England Journal of Medicine, the researchers looked at Medicare records from late 2003 through 2004. They found that about 20 percent of 11.9 million patients were readmitted to the hospital within a month of discharge; about a third were back in the hospital within three months.
About half of the patients hospitalized for ailments didn't see a doctor before they landed back in the hospital within a month.
Patients with heart failure and pneumonia had the most readmissions overall; among surgical procedures, heart stents and major hip and knee surgery had the highest returns.
About 10 percent of all readmissions were probably planned, such as putting in a stent, the researchers said. They estimated that the cost of unplanned return visits in 2004 was $17.4 billion."
17. BILLION.
The article calls attention to a major concern. I have had very ill (cancer) family members who have tried to get two treating physicians to talk to one another about the family member's care. When this person asked the doctors to engage in a quick call, one refused.
WHY? My guess is he couldn't bill her for the call - only a visit.
What if doctors could charge Insurance / Medicare etc - for a call? Would this help alleviate some of the return issues?
Apparently, the study agrees with my phone call idea:
"Besides making follow-up doctor appointments, Jencks said hospitals should give patients a list of all their medications, explain what to do at home and where to call if they run into problems. He said the hospitals should also call the patient within two days and make sure that the patient's doctor knows they were in the hospital.
He said the goal is to keep patients from getting really sick again, not to keep them out of the hospital if they do."
AMEN. And in the meanwhile, lets try to figure out how we can put care above billing. Maybe allow for docs to bill for advice that is not only hands on care.
Like this one - 1 in 5 Medicare patients rehospitalized in a month; study says patients get too little advice
Associated Press Writer Stephanie Nano writes "that one in five Medicare patients end up back in the hospital within a month of discharge, a large study found, and that practice costs billions of dollars a year. The findings suggest patients aren't told enough about how to take care of themselves and stay healthy before they go home, the researchers said. A few simple things - like making a doctor's appointment for departing patients - can help, they said.
The study found that a surprising half of the non-surgery patients who returned within a month hadn't even seen a doctor between hospital stays.
"Hospitals put more effort into the admission process than they do into the discharge process," said Dr. Eric Coleman, one of the study's authors from the University of Colorado in Denver.
Coleman, who runs a program to improve "hand-offs" between health care systems, said patients often have a honeymoon notion about how things will be once they're home. Then when they become confused about how to take their medicine or run into other problems, they head back to the hospital because they don't know where to turn, he said.
The issue of hospital readmissions and their cost has come under scrutiny in recent years. And it's getting attention now because President Barack Obama's budget calls for reducing spending on Medicare readmissions to pay for health care reform.
For their study, reported in Thursday's New England Journal of Medicine, the researchers looked at Medicare records from late 2003 through 2004. They found that about 20 percent of 11.9 million patients were readmitted to the hospital within a month of discharge; about a third were back in the hospital within three months.
About half of the patients hospitalized for ailments didn't see a doctor before they landed back in the hospital within a month.
Patients with heart failure and pneumonia had the most readmissions overall; among surgical procedures, heart stents and major hip and knee surgery had the highest returns.
About 10 percent of all readmissions were probably planned, such as putting in a stent, the researchers said. They estimated that the cost of unplanned return visits in 2004 was $17.4 billion."
17. BILLION.
The article calls attention to a major concern. I have had very ill (cancer) family members who have tried to get two treating physicians to talk to one another about the family member's care. When this person asked the doctors to engage in a quick call, one refused.
WHY? My guess is he couldn't bill her for the call - only a visit.
What if doctors could charge Insurance / Medicare etc - for a call? Would this help alleviate some of the return issues?
Apparently, the study agrees with my phone call idea:
"Besides making follow-up doctor appointments, Jencks said hospitals should give patients a list of all their medications, explain what to do at home and where to call if they run into problems. He said the hospitals should also call the patient within two days and make sure that the patient's doctor knows they were in the hospital.
He said the goal is to keep patients from getting really sick again, not to keep them out of the hospital if they do."
AMEN. And in the meanwhile, lets try to figure out how we can put care above billing. Maybe allow for docs to bill for advice that is not only hands on care.
Wednesday, April 01, 2009
SAFETY CHECKLIST FOR SURGERY
It has been estimated that 234 million surgeries are performed (globally) every year. Unfortunately, preventable surgical complications are way too common for those procedures.
A report published by the New England Journal of Medicine (NEJM), found the death rate from preventable surgical complications to be 1.5 patients out of every 100. The non-fatal, inpatient surgical complication rate is about 11 patients for every 100. What happens when a simply safety checklist is used? The death rate dropped almost in half to .8 patients out of every 100. The non-fatal complication rate dropped to 7 patients out of every 100. Pretty significant don't you think! Here are the elements of the Surgical Safety Checklist:
BEFORE INDUCTION OF ANESTHESIA:
Members of the team (at least the nurse and an anesthesia professional) orally confirm that:
The patient has verified his or her identity, the surgical site and procedure, and consent.
The surgical site is marked or site marking is not applicable.
The pulse oximeter is on the patient and functioning.
All members of the team are aware of whether the patient has a known allergy.
The patient’s airway and risk of aspiration have been evaluated and appropriate equipment and assistance are available.
If there is a risk of blood loss of at least 500 ml (or 7 ml/kg of body weight, in children), appropriate access and fluids are available.
BEFORE SKIN INCISION:
The entire team (nurses, surgeons, anesthesia professionals, and any others participating in the care of the patient) orally:
Confirms that all team members have been introduced by name and role.
Confirms the patient’s identity, surgical site, and procedure.
Reviews the anticipated critical events.
Surgeon reviews critical and unexpected steps, operative duration, and anticipated blood loss.
Anesthesia staff review concerns specific to the patient.
Nursing staff review confirmation of sterility, equipment availability, and other concerns.
Confirms that prophylactic antibiotics have been administered ≤0 min before incision is made or that antibiotics are not indicated.
Confirms that all essential imaging results for the correct patient are displayed in the operating room.
BEFORE PATIENT LEAVE THE OPERATING ROOM:
Nurse reviews items aloud with the team.
Name of the procedure as recorded.
That the needle, sponge, and instrument counts are complete (or not applicable).
That the specimen (if any) is correctly labeled, including with the patient’s name.
Whether there are any issues with equipment to be addressed.
The surgeon, nurse, and anesthesia professional review aloud the key concerns for the recovery and care of the patient.
A report published by the New England Journal of Medicine (NEJM), found the death rate from preventable surgical complications to be 1.5 patients out of every 100. The non-fatal, inpatient surgical complication rate is about 11 patients for every 100. What happens when a simply safety checklist is used? The death rate dropped almost in half to .8 patients out of every 100. The non-fatal complication rate dropped to 7 patients out of every 100. Pretty significant don't you think! Here are the elements of the Surgical Safety Checklist:
BEFORE INDUCTION OF ANESTHESIA:
Members of the team (at least the nurse and an anesthesia professional) orally confirm that:
The patient has verified his or her identity, the surgical site and procedure, and consent.
The surgical site is marked or site marking is not applicable.
The pulse oximeter is on the patient and functioning.
All members of the team are aware of whether the patient has a known allergy.
The patient’s airway and risk of aspiration have been evaluated and appropriate equipment and assistance are available.
If there is a risk of blood loss of at least 500 ml (or 7 ml/kg of body weight, in children), appropriate access and fluids are available.
BEFORE SKIN INCISION:
The entire team (nurses, surgeons, anesthesia professionals, and any others participating in the care of the patient) orally:
Confirms that all team members have been introduced by name and role.
Confirms the patient’s identity, surgical site, and procedure.
Reviews the anticipated critical events.
Surgeon reviews critical and unexpected steps, operative duration, and anticipated blood loss.
Anesthesia staff review concerns specific to the patient.
Nursing staff review confirmation of sterility, equipment availability, and other concerns.
Confirms that prophylactic antibiotics have been administered ≤0 min before incision is made or that antibiotics are not indicated.
Confirms that all essential imaging results for the correct patient are displayed in the operating room.
BEFORE PATIENT LEAVE THE OPERATING ROOM:
Nurse reviews items aloud with the team.
Name of the procedure as recorded.
That the needle, sponge, and instrument counts are complete (or not applicable).
That the specimen (if any) is correctly labeled, including with the patient’s name.
Whether there are any issues with equipment to be addressed.
The surgeon, nurse, and anesthesia professional review aloud the key concerns for the recovery and care of the patient.
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