Nursing Home Abuse Blog - Page 19 of 35 - The Law Offices of Barry G. Doyle, P.C.

Failure to use gait belt during transfer at Jacksonville Skilled Nursing & Rehab

July 28, 2019 By Barry G. Doyle

IDPH has cited and fined Jacksonville Skilled Nursing & Rehab after a resident was injured due to an aide attempting to transfer her without a gait belt.

The resident at issue was receiving both physical and occuptional therapy. She required stand-by or contact guard assist with ambulation and minimal to moderate assist rising from a seated position to standing. Stand by assist means being close enough to get support the resident in the event of a loss of balance; contact guard is having hands on the resident but not providing any support unless there is a loss of balance. This kind of assistance, as well as minimal to moderate assist in rising requires the use of a gait belt, if done properly.

A gait belt is a canvas strap which is applied around the torso of the resident. It is an essential piece of equipment for CNA’s. It is a fall prevention device and assists in safe transfers and ambulation of residents, and actually reduces the risk of injury to both the aide and the resident. The alternative is to hold onto the resident’s clothing which is at risk of tearing, or the resident’s body – which can cause injury to the resident.

In this case, the CNA attempted to assist the resident from a seated position by pulling her arm instead of using the gait belt as the resident actually requested (and failing to do so in these circumstances is truly a form of nursing home abuse). When the aide did so, the resident experienced pain in the chest, severe enough to make her scream. She told the state surveyor that it hurt so much it took her breath away.

Over the next few days, the staff noted significant complaints of pain, a decline in the ability to participate in physical therapy, and use of pain medication. She complained that it hurt to cough and was no longer able to get her shoes on independently. The resident told the surveyor that she thought she was going backwards.

These injuries were not necessarily life-changing, but very easily could have been. Our firm handled a case a number of years ago where the aide chose to not use the gait belt, and as a result, a nursing home fall occurred with a hip fracture that led to the development of bed sores and osteomyelitis and the wrongful death of the nursing home resident. Even this situation, where the resident suffered a chest wall injury, could very easily have led to the resident developing pneumonia. Failing to use the gait belt was utterly inexcusable.

One of our core beliefs is that nursing homes are built to fail due to the business model they follow and that unnecessary accidental injuries and wrongful deaths of residents are the inevitable result. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.

Other blog posts of interest:

Brain bleed from fall at Gibson Community Hospital Annex

Improper use of gait belt at Manorcare of Palos West

Unsafe transfer at Robings Manor

Failure to train staff leads to broken hip and death and Heritage Health in Jacksonville

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Resident suffers broken hip in unsafe transfer at Pearl of Rolling Meadows

July 27, 2019 By Barry G. Doyle

IDPH has cited and fined the Pearl of Rolling Meadows nursing home after a resident suffered a broken hip as a result of an unsafe transfer while being transferred to the toilet.

The resident at issue had weakness and limitations in range of motion such that she could not fully bear weight on her lower extremities. She was assessed as requiring the assist of two for transfers between surfaces. As part of her care plan, the staff was to use a sit-to-stand lift to move her to the toilet. The resident care plan called for the use of two aides to make a safe transfer using the sit to stand lift, as did the nursing home’s own internal policies and procedures. The facility policy and the manufacturer’s specifications both called for the use of two buckles to adequately support the resident in the sling while being transported.

On the day of the accident, the resident was being transferred to the toilet by an aide. The resident told the aide that transfers were normally done with one person. The aide placed the resident in the lift, but was only able to secure one of the two buckles to the sling. The aide brought the resident to the bathroom, but due to the small size of the bathroom, had difficulty positioning the resident over the toilet. The resident believed that she was over the toilet and let go of the lift. She was not actually over the toilet and crashed to the floor, suffering a broken hip.

This was a highly preventable accident with serious consequences for this resident. There were multiple failures on the part of the aide which led to this nursing home fall: failing to follow the care plan, failing to follow facility policies and procedures, failing to secure the resident in the lift properly, and failing to properly position the lift over the toilet. Curing any one of these failures probably would have avoided this injury, but would not have cured the fact that this was substandard nursing home care all the way through. One of the things that we believe in our law firm is that bad care is often provided in nursing homes, and the fact that nothing bad happens is often the result of being lucky. Being lucky is not a substitute for good care because you never know when the gamble you take with a resident’s safety is going to come back to bite you.

A hip fracture is a serious injury for a person who is in the typical age range for nursing home residents. Many have significant pre-existing health issues which make undergoing surgery for repair of a hip fracture a risky proposition indeed. Assuming that they survive the surgery and immediate post-operative period, many do poorly following surgery for repair of a hip fracture, both in terms of quality of life and in terms of life expectancy. Any death that is caused in whole or in part by a nursing home fall which results in hip fracture can be the basis for a wrongful death lawsuit.

An additional issue came to my attention while reading this citation, and that was this: the resident said that the transfer was normally done with only one person. The aide then went ahead and did the transfer with only one. Even though the care plan and facility policies called for two persons to assist in this kind of transfer, the aide proceeded with one. Why did the resident think that only one person was needed? Why did the aide proceed with the transfer one her own with only one person in the face of flashing red lights that said that two people were needed? The likely answer to that is that both the resident and the aide both knew that there really wasn’t enough help on hand to use two people, and that speaks to an issue of understaffing at this nursing home home.

Other blog posts of interest:

Fall from shower chair leads to fall and death at Manorcare of Arlington Heights

Moorings staff fails to notify doctor of symptoms of GI bleed

Unsafe transfer at Alden Town Manor results in broken hip

Fall from failure to follow care plan at Tower Hill Healthcare

Brain bleed from fall at Landmark in Des Plaines

Failure to use gait belt leads to fall and fractured knee at Friendship Village in Schaumburg

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Resident rolled from bed at South Holland Manor

July 25, 2019 By Barry G. Doyle

IDPH has cited and fined South Holland Manor after a resident there suffered a fractured femur due to being rolled out of bed by a staff member.

The resident at issue suffered from multiple health conditions, was morbidly obese, and was largely bed-bound. Her assessment showed that she required the extensive assist of two with bed mobility, meaning that she required the assistance of two aides to be turned and repositioned in bed. This was incorporated into the resident care plan, which was communicated to aides using a tool known as the Kardex, which was a summary of what care had to be provided to the resident.

On the day of the accident, an aide was in the resident’s room providing incontinent care to the resident. She called for another aide to help her, but that aide was slow in responding, so the aide decided to proceed to try to finish rolling the resident onto her side on her own. As she did so, the resident rolled off the edge of the bed, landing on the floor. She had a laceration to her head and was complaining of pain in the leg, so she was sent to the emergency room where x-rays showed that she had a comminuted fracture of the femur.

The aide here was doing a truly crucial task – providing incontinent care for this resident is a key measure for preventing bed sores. The facility had a care plan in place for doing it safely, one which called for the help of two aides with this task. There was a specific safety concern for the resident that motivated this item to be in the care plan: the risk that the resident would be rolled out of bed in the process if there wasn’t another aide on the other side of the bed. A reasonable care plan, communicated to the staff, not carried out – it seems like a simple enough scenario to result in this nursing home fall.

Look the next level deeper, and ask the question “why” – why did this aide proceed to try to turn this debilitated resident on her side without any help. The citation describes the aide involved waiting for a prolonged period of time for the other aide to arrive to help her, and then deciding to go it alone. It is not hard to imagine the aide waiting, hearing additional call lights going off, knowing all of the other scheduled tasks she had to complete … and then taking the risk, a risk that sadly came back to haunt the resident. But why take risk? The answer is likely understaffing of the nursing home – there just weren’t enough hands on deck to meet the care needs of the resident, and that came back to bite one of the residents.

Other blog posts of interest:

Prairie Manor resident suffers brain bleed after being rolled from bed

Resident rolled from bed at South Suburban Rehab

Resident breaks in leg in failed mechanical lift transfer at South Holland Manor

Understaffing results in fall at Manorcare of Libertyville

Lack of footrests on wheelchair leads to broken ankle at South Holland Manor

Brain bleed from being rolled out of bed at Bria of Palos Hills

Staff rolls resident out of bed at Generations of Applewood

Brain bleed from fall at Landmark in Des Plaines

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Resident burned by hot pack at University Nursing & Rehab

July 18, 2019 By Barry G. Doyle

IDPH has cited and fined University Nursing & Rehab in Edwardsville after a resident was burned by a hot pack applied by a CNA.

The resident at issue suffered from multiple medical conditions including Parkinson’s, fibromyalgia, and lower back pain. There was an order entered to administer hot packs to her lower back three times per day. There was a problem with that order: the facility didn’t use hot packs and didn’t have any in the facility. A CNA obtained a hot pack (the citation doesn’t say from where), placed it in a pillow case, and applied it to the resident’s back. As a result of the application of the hot pack, the resident sustained second degree burns.

There are a few issues that come immediately to mind with this. First, the nurse should have known and told the doctor that the facility doesn’t have and/or use hot packs. This is a simple issue of proper communication between the nurse and the doctor. If the doctor really wanted the hot packs administered, he could have ordered that the treatment be adminsitered elsewhere of found other alternatives to a hot pack. The failure of the nurse to have that conversation indicates that she did not know what kinds of modalities could be used properly in the facility.

Second, the hot pack was administered by the CNA who was not trained in its use. A hot pack seems like a simple thing to use, but with a geriatric patient population, it can be a tricky thing. As people age, their skin thins, which is part of the reason that seniors are so vulnerable to the development of bed sores.

Instead of acknowledging that the order could not be implemented, the staff here did something that they were not trained to do, and injury to the resident resulted.

Other blog posts of interest:

University Rehab resident breaks leg due to lift failure

DuPage Care Center resident burned by hot packs during therapy

Resident burned by hot pack at Miller Health Center

Third degree from burns from fall at Sauk Valley Senior Living

Resident burned at Walnut Manor

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Resident’s third fall at Bria of Chicago Heights nets brain bleed

July 17, 2019 By Barry G. Doyle

IDPH has cited and fined Bria of Chicago Heights nursing home after a resident suffered her third fall in eight days, the last one causing a brain bleed.

The first of these occurred on July 7. The resident was discovered laying on the floor by a nurse who did not treat the incident as a fall because the resident, who suffered from Alzheimer’s, told him that she just wanted to lay on the floor.

The guidance to federal regulations pertaining to nursing home falls provides that any unwitnessed incident where a resident is found on the floor should be treated as a fall. The history of having a fall is significant for at least two reasons. First is that the occurrence of a single fall is often a precursor to having additional falls. Second is that the occurrence of a fall starts the process of revising a resident fall prevention care plan and serial follow-up checks for injury. Calling a fall as something other than was it is places the health and well-being of the resident at risk.

The second fall happened on July 9. The resident was once again found on the floor by staff. The fall report completed by the nursing home documented that the resident’s roommate stated that she rolled out of bed while sleeping. However, when the roommate was interviewed by a state surveyor, she denied having said that. Further, when staff was later interviewed by the state surveyor, they told the surveyor that the fall happened when she stumbled coming back from the bathroom.

As we stated earlier, the occurrence a single fall is often the precursor to having additional falls, and this resident experienced a third fall on July 15, eight days after being found on the floor. This was another unwitnessed fall where she was discovered on the floor shortly before 8 am. By 3 pm that day she was sent to the hospital where a CT scan showed a brain bleed with a 10 mm shift of midline, indicating significant pressure on the brain from the bleeding.

After the second fall, she was care planned as being at risk for falls, with a care plan which included regular rounds, staff assistance, safety cues, call light placement.

A few impressions come immediately to mind regarding this nursing home fall:

First, the initial fall on July 7 was not documented as a fall and it is unclear whether the care planning that preceded the third catastrophic fall assumed that there had been only one fall in the preceding days or two. If the assumption was that there was a single fall, the interesting question to pose to the care plan coordinator would be whether that would have changed her approach.

Second, of the interventions that were listed, two of the four required the cooperation and participation of the resident who was suffering from Alzheimer’s. These are interventions that had no more than a hope of actually working, and hope is not a substitute for good care.

Third, the other two interventions: staff assistance and regular rounding were pretty meaningless – How frequently? What sort of assistance? The point of having a care plan is to ensure that the residents receive the care needed on a day to day, shift to shift basis and isn’t left to random chance. This care plan screams “random chance”.

Fourth, when the resident was brought to the emergency room, the CT scan showed a 10 mm shift, which means that there was significant bleeding which would have caused neuro changes much earler than when the staff acted on it. If the staff was properly doing a 72-hour fall watch, the transfer to the hospital should have occurred much earlier resulting in detection and treatment of the brain injury much sooner.

Other blog posts of interest:

Violation of care plan leads to fall and broken arm at Bria of Palos Hills

Resident rolled from bed at South Suburban Rehab

Unsafe transfer results in fractured femur at Woodbridge Nursing Pavilion

Fall and fractured hip at Villa of South Holland

Brain injury from being rolled from bed at Bria of Palos Hills

Two serious falls at Holy Family Villa

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Third degree burns from fall at Sauk Valley Senior Living

July 13, 2019 By Barry G. Doyle

IDPH has cited and fined Sauk Valley Senior Living in Rock Falls after a resident there fell and suffered third-degree burns after landing against a heater.

The resident at issue lived in a room which did not get heated adequately by the boiler for the building, so the facility bought a series of electric baseboard heating units to make up for it. The temperature setting on the heating units could be adjusted, but were supposed to be set for comfort, although anyone could adjust the heating levels and there was no policy in place regarding the use of the heating units.

The resident at issue lived in one of the rooms where the heating unit was in place, and his bed was placed about a foot away from the heating unit. He woke up in the middle of the night to go to the bathroom, slipped and fell, and landed with his back against the heating unit. He was discovered a short time later by staff who saw that the skin was blistered. He was sent to the emergency room where he was diagnosed as suffering from third-degree burns. When the state surveyor came in to inspect the facility, the surface of the heating unit was measured at 145 degrees.

There are two basic federal regulations which cover accidents in nursing homes including nursing home falls. One is 42 CFR Part 483.25(d)(1) which requires that the facility be as free of accident hazards as possible and 42 CFR part 483.25(d)(2) which provides in essence that resident receives supervision and assistive devices necessary to prevent accidents.

The issue of whether the nursing home was at fault for the fall to begin with was not a focus of this citation, although as a nursing home lawyer, that would certainly be a part of my investigation. The more pertinent issue was the use of the electric heating unit and the temperature it was set to as well as the placement of the bed so close to the heating unit. 145 degrees is hot for anyone; however, our skin thins as we age (which is part of why bed sores are such a major issue in nursing homes) which made the use of that heater in that manner something that was particularly hazardous.

Obviously, the real solution to the problem of cold rooms would have been to make the repairs required to the boiler so that all of the rooms would be adequately heated without the use of the baseboard heaters. However, that would have been the more expensive solution, and as might be expected in the long-term care industry the cheaper solution was adopted.

Other blog posts of interest:

Newman Rehab resident suffers burns to leg from hot radiator

Shower room scalding at Westchester Health & Rehab

Resident burned by hot pack at Miller Health Center

Waverly Place of Stockton resident fractures hip in unsafe transfer

Sauk Valley Senior Living fails to provide proper tracheostomy care

Spinal fracture from fall from bed at Pine Acres

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Call lights not being answered at Aperion of Mascoutah

July 11, 2019 By Barry G. Doyle

IDPH has cited and fined Aperion Care of Mascoutah for repeatedly not answering call lights.

The issue raised in the complaint at first blush seems like it may be a trivial one. A resident who needed help getting on a bed pan to go to the bathroom was not getting a response when she sounded the call light for staff to help her. As a result, she had multiple episodes of being incontinent of bowel and was humiliated and embarrassed about it. She reported waiting 30-60 minutes for a response to the call light. When queried about it by the state surveyor, the administrator acknowledged that the DON had reviewed video and seen that call light response times were in need of improvement.

One thing that every member of a nursing home staff agrees to is that residents have a right to be treated in a way that assures their dignity. Failing to answer a call light so that residents are left to soil themselves is a form of nursing home abuse. On a surface level, this may not seem to be a big issue, but it is a sign of what is happening at that nursing home. The fact that call lights are not being answered is an indicator that there is understaffing at that nursing home, which has multiple negative impacts on the delivery of care. Past that, failing to answer call lights trains the residents that no one is coming to help, so they are more likely to get up without necessary assistance, setting the stage for nursing home falls. Understaffing leads staff members to try to use a Hoyer lift with only one person instead of two, setting the stage for residents being dropped while being transferred. Failing to answer call lights to help residents go to the bathroom and instead suffer episodes of incontinence sets the stage for residents to develop bed sores.

There is a saying that little hinges swing big doors, and little things like not answering call lights sets the stage for much worse things to happen. This citation only called out the loss of dignity, but it could just as easily been a much more serious issue. When call lights are not being answered, avoiding catastrophe is the result of good luck, not good care. Relying on good luck is not a strategy for caring for nursing home residents.

Other blog posts of interest:

Failure to recognize infection at Helia of Belleville

Brain bleed from fall at Good Samaritan Home in Quincy

Failure to answer call light leads to fall at Pekin Manor

Broken ankle from fall at Aperion of Mascoutah

Resident develops pressure ulcers at Eastside Nursing & Rehab

Bed sore caused by leaving resident sitting on bed pan at Mar Ka Nursing Home in Mascoutah

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Fall results in fractured hip at Villa of South Holland

July 6, 2019 By Barry G. Doyle

IDPH has cited and fined the Villa at South Holland nursing home after a resident sustained a fractured hip as a result of a fall.

When we review potential nursing home cases, especially those that involve the kinds of events that happen frequently in a nursing home setting such as nursing home falls, bed sores, or injuries resulting from elopement or wandering, the first parts of the chart we look at are the resident assessments and care plan. When a resident is admitted to a nursing home, the staff performs a comprehensive assessment which is intended to identify the risks to the health and well-being of the resident. Based on the results of that assessment, the care plan is developed which sets forth a series of steps that should be taken on a day-to-day, shift-to-shift basis to address the risks identified during the assessment.

There are a number of ways that we look at the assessment and care plan. First: were reasonable assessments done? If the assessments are the basis of the care plan, bad assessments yield bad care plans. Second: was the care plan adequate? We will address that in a moment, as that was an issue in this situation. Third: was the care plan actually implemented? Having a great care plan is useless if it is not being carried out, and that has been the issue in other situations, such as here, here, and here. Finally, was the care plan revised and updated in light of experience and/or changes in the resident’s condition? If the care plan proves inadequate in practice (as might be shown by the occurrence of falls or the development of new bed sores, assuming that those areas had been targeted in the care plan) or the resident has changed care needs after the care plan is developed, it needs to be changed.

Getting back to the situation at hand – this was a situation where the care plan itself was not adequate, and in many ways, this care plan was typical of many that I see. Many of the care plans I see consist of a set of check boxes which are marked. Frequently, there is not a lot of thought given to including specific steps which needs to be taken top meet the care needs of the resident – care plans are supposed to be individualized to meet the care needs of the resident. You also see things included in the care plan which are so general that it does not create any real accountability on the part of the staff to accomplish these things.

This resident was a classic high fall risk resident. She had significant musculoskeletal issues, but also had poor insight into her own condition and made poor judgments regarding her own safety. Before the fall at issue here, her fall prevention care plan included the following steps: 1) make sure that she uses appropriate footwear, 2) place call light in reach, encourage her to use it, and respond promptly, 3) follow facility fall protocol, and 4) PT to evaluate and treat as ordered or needed. After experiencing two falls before the one at issue, a bed alarm and chair alarm were added as interventions.

During the course of the survey, the staff agreed that for a resident with that kind of profile, frequent rounding or monitoring should have been a part of the care plan. The “facility fall protocol” referred to the facility’s own policies and procedures, which listed frequent rounding and monitoring as a fall prevention measure. Federal regulations relating to nursing home falls require that nursing homes provide supervision and assistive devices necessary to prevent accidents. Despite all of this, providing frequent monitoring and rounding and keeping the resident under observation was not a part of the care plan.

At the time of the accident, the resident was unattended in the dining room. The nurse was passing medications, and the assigned CNA was in another resident’s room. The resident apparently got up from her wheelchair to walk somewhere on her own and fell, as she was found just inches from her wheelchair. After she complained of leg pain, she was brought to the hospital where x-rays showed that she had a broken hip.

This was a resident who had a new for close supervision. She was properly assessed as a high fall risk, and one of the key factors for this was her own poor judgment for her own safety. When this is present, this requires close supervision by the nursing staff. However, this was not a part of her care plan, and was clearly not a part of the care that was in fact being delivered to this resident. A poor care plan led to a poor outcome – a broken hip for this resident.

This is situation where no real critical thought was given to the care plan, and as a result this nursing home was dodging bullets for weeks leading up to this fall, especially in light of the two falls that led up to this. One of our core beliefs is that nursing homes are built to fail due to the business model they follow and that unnecessary accidental injuries and wrongful deaths of residents are the inevitable result. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.

Other blog posts of interest:

Resident breaks in leg in failed mechanical lift transfer at South Holland Manor

Resident rolled from bed at South Holland Manor

No fall prevention care planning at South Suburban Rehab

Lack of footrests on wheelchair leads to broken ankle at South Holland Manor

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Niles Nursing & Rehab resident wanders, suffers fractures

July 3, 2019 By Barry G. Doyle

Niles Nursing & Rehabilitation Center was cited and fined by IDPH after a resident wandered from the facility. He fell while he was gone sustaining multiple facial fractures.

The resident was 90 years old and suffered from dementia. He had multiple orthopaedic issues but walked well. The incident happened on the first day that the resident was admitted to the nursing home. After the admission assessments were completed, the resident was seen wandering on the first floor, going out onto the patio. There was a security door which was connected to an alarm which sounded at the reception desk.

While the receptionist was seated at her desk speaking with a CNA who was checkinghis schedule, alarm went off at the reception desk. The receptionist turned off the alarm. After not being able to see the resident for a few minutes, she asked the CNA to go outside and look for him. When the CNA returned saying that he could not find the resident, the receptionist called a Code Purple (resident missing) instead of a Code Green(resident out of the building). Because of the choice she made, staff did not start looking outside the building for 30-40 minutes after.

The staff never found the resident. Instead the received a call from the hospital, saying that he was in the emergency roon there. He had fallen while out of the facility and suffered multiple facial fractures.

The technical term for a resident wandering from a nursing home unattended like this is elopement. It is a major risk to the well-being of the resident, as they can have falls, as happened here, or have any number of other mishaps such as suffering injury/illness due to adverse weather conditions, can be hit by a car, made the victim of a criminal assault, among other things.

One of the basic assessments that is completed when a resident is admitted to a nursing home is an elopement assessment. This measures the resident’s risk of leaving the facility. In this case, the resident spoke primarily Korean which could have been a barrier to doing a good assessment. One simple measure that can be taken and probably should have been taken in this situation is to apply a wangerguard. This is a device which is applied to the resident and when the resident leaves an area (a wing, the building, etc.), an alarm sounds. Since the resident suffered from dementia and was able to walk well, this would have been a reasonable step especially since the resident was new to the facility and likely to be disoriented.

Past that, there were systems in place to address the risk of this resident wandering and being out of the facility on his own. The facility had an alarm which had the ability to heard throughout the facility, but was set to sound only at the receptionist’s desk. Once the alarm sounded there, it was up to the receptionist to call the appropriate code to get a search underway for the resident before he wandered too far from the facility. This was not done either, as the code that was called only started a search within the building and not in the community where the greater danger was.

Multiple failures, all leading to serious injury for the resident. One of our core beliefs is that nursing homes are built to fail due to the business model they follow and that unnecessary accidental injuries and wrongful deaths of residents are the inevitable result. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.

Other blog posts of interest:

Resident wanders from Claridge Healthcare Center

Resident wanders from Alden Long Grove

Wandering Alden Town Manor resident suffers fatal injuries

Niles Nursing & Rehab resident suffers fatal brain bleed in fall

Symphony of Midway resident suffers fatal fall from window

Resident from Chalet Living & Rehab leaves facility, fall and suffers broken leg

Generations Oakton Pavilion resident falls and fractures hip

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Resident sexually assaulted by fellow resident at Dixon Rehab

June 29, 2019 By Barry G. Doyle

IDPH has cited and fined Dixon Rehabilitation & Healthcare Center after a resident there was sexually assaulted by a fellow resident.

Nursing homes in Illinois serve residents with a variety of issues. Some are in for short term rehab after a surgery; some have chronic long term medical issues which leave them too frail to live at home safely.

Still others have few physical limitations but instead have mental/psychiatric conditions which require long-term care. Sometimes their issues manifest themselves in ways which are physically aggressive toward other residents. When that happens the nursing home has an obligation to keep all of its residents safe.

One of the residents that Dixon Rehab admitted had a host of psychiatric diagnoses: frontal lobe dementia, delusional disorders, generalized anxiety disorder, pseudobulbar affect, restlessness and agitation, and a series of other diagnoses. What he did not have was any significant physical/musculoskeletal disorder, which meant that he was physically capable of acting out on his impulses.

The resident was admitted in June, but was sent out of the facility for a psychiatric admission after a resident-to-resident altercation. When he was readmitted to the facility in mid-September, a care plan was put into place to monitor for and record inappropriate behaviors, including those directed at other residents. His location was supposed to be checked every 15 minutes and supervised when he was wandering the halls to prevent entry into the rooms of other residents.

About a month after this resident was readmitted to the facility, his behavior began to decline rapidly and become more sexually aggressive. The citation describes multiple episodes where he maded sexually inappropriate comments to female staff members and guests of the nursing home. He began to express a desire to kiss other residents, to have sex with them, and a nurse was told that he said with regard to another resident, “I want her, can I have her?”

Besides the verbal expression of sexual aggressiveness, there was an incident October 27 where he sat next to a female resident on a resident on a couch and touched her side, waist, and legs. The staff was made aware of this incident and the began to seat the resident in between other male residents in the dining room so as to prevent further incidents of touching or kissing but the care plan was not formally updated to include this. More importantly the psychiatric nurse practitioner was not notified of the incident by the nursing staff, as she told the state surveyor she would have sent the resident to the hospital had she been notified of the incident. She had been notified of escalating sexual behaviors and was attempting to bring these under control through medication. The staff had begun to have conversations with the resident’s wife about having him placed in a different facility where men and women were housed separately.

In general, the resident spent most of his time in his room, and checks were supposed to be done every 15 minutes, but his wife reported that there were time where she would be in his room for hours without interruption by the staff. On November 22, he left his room and was seen walking in the hallway by two CNA’s who were moving a chair to the dining room. After returning to the hall to get a pad for the chair from the linen cart, she recognized that resident was not in the hallway. She then heard a female resident in her room saying, “That hurts.” The aide entered the room and saw him standing over the female resident pulling a blanket back over her waist. Asked what he was doing, the resident replied, “I was fingerf***ing her.”

This is the kind of event that anyone who admits a parent to a nursing home fears most – that their parent will end up being victimized in some way. In this instance, the person who committed this horrific act of nursing home abuse was not a staff member, but a fellow resident. However, this does not relieve the nursing home of responsibility for what occurred because the nursing home failed in at least three aspects:

It continued to keep this resident in the facility when the staff clearly recognized that he required care beyond their ability to deliver. The sexual behaviors had been escalating rapidly, and the staff recognized that they were in over their heads when they began to discuss alternative placements with the resident’s wife. One of the basic truisms in the nursing home industry is that you should not accept as a resident and should not keep as a resident anyone whose care needs cannot be met. They recognized that the resident’s behaviors were escalating beyond their ability to address it, but chose to keep him in the facility. When the discussions were being had with the resident’s wife, actin had to be taken also because each day they kept him in the facility after that was a day where they ran a risk that this kind of incident would take place. That was not a gamble that families of other residents signed up to take. They looked to the staff to keep their mother safe.
They failed to notify the nurse practitioner of the October incident. The escalating verbal expressions of sexual aggression were significant enough, but when the resident acted on those expressed desires, this was something that required physician notification, similar to the occurrence of a nursing home fall or the development of a bed sore. The nurse practitioner inidcated to the state surveyor that this would have resulted in an in-patient psychiatric admission, and if that had happened, this likely never would have happened.
They failed to supervise the resident while he was out of his room. This is what the care plan called for, but instead of executing the plan, the aides moved the chair into the dining room. Obviously, this was not a task that took a long time, but that was all that it took for this resident to act out on a woman who was sinmply laying in bed in her room. There should be zero argument that keeping residents safe is infinitely more important that moving furniture.

Besides this being an unspeakable vioaltion of this female resident’s body and dignity, it is also important to keep in mind that this is something that took place in her room. Many residents in nursing homes feel like they are at the mercy of the staff and feel vulnerable to begin with. This kind of incident occurring in someone’s room – their home at the nursing home – only serves to exacerbate the undelrying feelings of vulnerability that many nursing home residents feel to begin with.

Other blog posts of interest:

Resident sexually abused at Countryside Nursing & Rehab

Multiple residents victimized by fellow resident at Winning Wheels

Resident assaulted by roommate at Countryside Nursing & Rehab

Forest City resident pushed to the ground, fractures hip

Nurse violently attacked by resident at Parker Nursing & Rehab in Streator

Broken hip from assault at Stephenson Nursing Center

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Fall from edge of bed at Integrity of Alton

June 27, 2019 By Barry G. Doyle

IDPH has cited and fined Integrity Healthcare of Alton after a resident was injured in a fall from the edge of her bed.

The resident at issue had severely impaired cognition, had poor balance, and required extensive assist from the staff with her activities of daily living. She was known to have musculoskeletal weakness and poor balance and often leaned to one side while sitting.

On the day of the accident, an aide had her seated on the edge of the bed. The aide left her seated by herself while she went to get the resident’s bra. While she stepped away from the resident, the fell forward, suffering a broken nose. When interviewed by the state surveyor, the aide told the surveyor that the resident had good days and bad days and “I guess she was having a bad day” on the day of that fall. A member of the physical therapy staff stated that the resident required extensive assist 75% of the time and required contact guard assist (meaning actually having hands on the resident, but providing no other physical support) the balance of the time.

The aide’s observation that this resident had good days and bad days and was apparently having a bad day on the day that she was injured is an interesting one. Nursing home residents have good days and bad days and which will be which is inherently unpredictable. This is why when fall prevention care planning is done, it should be based on the what is needed to keep the resident from harm on the bad days, and that level of care should be delivered day to day, shift to shift. Operating on the basis that the resident will be having a good day is doing nothing more than gambling with the safety and well-being of the resident.

The resident here was brought to the emergency room where x-rays showed that she had a broken nose. While this may not be a catastrophic injury from this nursing home fall, it does not minimize the safety principles that were being violated. The extent of the injury is not a reflection of skill or good care on the part of the nursing home staff, as this kind of fall could have just as easily resulted in a fractured hip, a brain bleed, or worse.

Other blog posts of interest:

Fall from edge of bed leads to broken leg at Jerseyville Manor

Failure to use gait belt during transfer at Jacksonville Skilled Nurisng & Rehab

Pittsfield Manor resident suffers fatal fall

Improper transfer at Southgate

Fall from edge of bed yields broken leg at Eunice C. Smith Nursing Home in Alton

Failure to recognize infection at Helia of Belleville

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Failure to notify doctor of abnormal labs at Champaign Urbana Nursing & Rehab

June 23, 2019 By Barry G. Doyle

IDPH has cited and fined Champaign Urbana Nursing & Rehabilitation located in Savoy after the nursing staff failed to notify the doctor of abnormal lab results leading to the hospitalization of the resident for hyperosmolar hyperglycemia coma due to diabetes mellitus.

This long-term resident was a diabetic but had never been on diabetes medications while a resident at the facility. In September, 2017, her doctor ordered a set of labs on her since there were no lab results in the chart for her since 2016. Between September 7, 2017 and October 30, 2017, the following lab tests were done with the following results:

9/9/17 – glucose level was 120 (H) (normal fasting level is 65-99)
1/29/18 – glucose level was 168 (H) (normal fasting level is 65-99)
5/25/18 – glucose level was 200(H) (normal fasting level is 65-99)
10/3/18 – glucose level was 240 (H) (normal fasting level is 65-99)
10/30/18 – glucose level was 794 (critically high); hemoglobin A1C 14.2% (critically high)(normal is 4.1 – 6.1%)

On October 30, 2018, the resident’s grandaughter came to the facility and saw that her grandmother was having difficulty talking and was not her usual self. She was seen by an Advance Practice Nurse who obtained the labs that day and ordered her sent to the hospital. On arrival at the hospital her glucose level was 909 and other labs were showing signs of dehydration. She was admitted to the hospital with a diagnosis of Hyperosmolar Hyperglycemia Coma due to Diabetes Mellitus.

There were no lab reports in the resident’s chart, and when the state surveyor arrived, they had to be obtained from the laboratory. One of the basic tasks of nurses in a nursing home setting is to serve as the eyes and ears of the doctor. When a doctor orders lab work to be performed, it is the role of the nursing staff to see that it is done and that the results are forwarded to the doctor. Nurses are also responsible for notifying a doctor about abnormal labs results, as all of these were.

This has not been done in this case, and the attending doctor was clear about the consequences of this: that the resident’s diabetes went untreated for over a year. Had he been notified of the abnormal labs in September, 2017, she would have been started on medications to treat the diabetes. Failing to notify the doctor of the abnormal labs was a form of nursing home abuse and neglect.

Past the immediate serious medical conseuqences of failing to treat this resident’s diabetes, there are the longer-term implications of having diabetes untreated for that length of time. It can help complicate wound healing in residents who suffer from bed sores. Diabetes can have adverse effects on a resident’s vision which can increase the risk of a nursing home falls.

This is a case which speaks to a significant systems failure at this nursing home. Obtaining labs and reporting back on the results of them are one of the very basic things that are done on a day to day basis at a nursing home. Here, there were multiple tests which “slipped through the cracks” to the point that there were not even reports in the resident’s chart. It also brings into focus the role of the lab, an outside vendor – what proof do they have of the delivery of the lab reports?

Other blog posts of interest:

Resident given wrong medication at Villa Health Care East

Diabetes care mismanaged at Aperion Care Capitol

Failure to notify doctor of changes in condition leads to death of resident at Alden Estates of Barrington

Diabetes medication not given at Alden Estates of Orland Park

Dehydration leads to hospital admission for resident at Mattoon Rehab

Medication error at Palm Terrace in Mattoon

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Injury from catheter placement at Marigold Rehab

June 20, 2019 By Barry G. Doyle

IDPH has cited and fined Marigold Rehabilitation & Healthcare Center in Galesburg after a resident suffered a urinary tract injury due to improper insertion of an indwelling urinary catheter.

The resident at issue had an indwelling catheter. An indwelling catheter is a tube which goes up the urethra to the bladder. Once the tip reaches the bladder, urine should begin to pass down the catheter tube. The passage of urine through the catheter is the signature that the catheter has reached the bladder. At that point a balloon at the tip of the catheter should be inflated which holds the opening to the bladder open and allow urine to continue to drain through catheter.

The male resident at issue had a catheter which needed to be replaced. He apparently suffered from significant dementia and struggled with the staff during catheter changes. This time, he was held down by the staff while a nurse inserted the catheter. She encountered some resistance in passing the catheter, but did not have urine draining from the catheter. Thinking she had reached the bladder, she inflated the balloon and attempted to remove the port for blowing up the balloon. When they did so, the catheter came out of the penis as did large amounts of blood.

The resident was sent to the emergency room to get the bleeding under control which was made more difficult due to the fact that he was taking blood thinners (which is part of why nursing home falls are such a serious issue for residents who are on blood thinners – internal bleeding can progress much further than would otherwise be the case).

The fundamental issue in this case is an issue of poor nursing technique. The nurse who was responsible for replacing the catheter did not use proper technique in placing the new catheter. Instead of inflating the balloon after the catheter had entered the bladder, she inflated the balloon while the catheter tip was still within the urethra – in other words, she inflated the balloon too early. The signature of a proper placed catheter is a flow of urine from the bladder into the bag. The nurse saw that there was no urine entering the bag but nonetheless inflated the balloon on the catheter. When nurses fail to follow proper technique, this is a form of nursing home abuse and neglect and can be the basis for a civil lawsuit.

Other blog posts of interest:

Heartland of Galesburg resident dies due to untreated urinary tract infection

Diabetes care mismanaged at Aperion Care Capitol

Urinary catheter injury at Friendship Manor

Wheelchair accident at Galesburg Rehab

Unsafe transfer at Heartland of Galesburg results in dislocated hip

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Brain bleed from fall at Gibson Community Hospital Annex

June 16, 2019 By Barry G. Doyle

IDPH has cited and fined the Gibson Community Hospital Annex nursing home after a resident of that nursing home suffered a brain bleed in a fall. The Annex is a separate wing of the hospital which is licensed as a nursing home.

The resident at issue suffered from Parkinson’s Disease and dementia. She also suffered from atrial fibrillation (an episodic irregular contraction of the heart which can result in stroke-causing blood clots) for which she was receving Eliquis, a blood thinning medication, to prevent the formation of blood clots. Unfortunately blood thinning medications like Coumadin, Xarelto, or Eliquis can also result in internal bleeding after a nursing home fall.

The resident was assessed as being a moderate risk for falls and her fall prevention care plan required the assist of one staff to stabilize her balance. The facility had a policy in place requring the use of a gait belt for all residents who required assistance with walking or transfers and that the staff member have a hand on the gait belt while it was in use.

On the day of the accident, the resident was being assisted by a nurse who was a “floater” who normally worked in the hospital obstetrics unit. She was unfamiliar with the resident, with her care plan, and with the facility policy requiring the use of a gait belt. The nurse assisted the resident to the bathroom and was bringing her back to her recliner when the resident fell over backwards, hitting her head on the door frame. The nurse did not have the gait belt on and was simply walking alongside the resident.

After the fall, a post-fall monitoring process was initiated with frequent neuro checks. After the resident began to complain of feeling tired and off, her doctor was notified of the change in condition and ordered her sent to the emergency room. A scan revealed a brain bleed and she was transferred to another hospital for more definitve treatment.

This was a very preventable kind of nursing home fall. The resident had been properly assessed as a fall risk and there was a reasonable care plan with good facility policies in place to address this fall risk. They just weren’t being carried out – under the circumstances, the nurse helping this resident back from the bathroom should have had a gait belt on her and been holding onto the gait belt. Had that been done, the nurse would have been able to prevent the resident from hitting her head against the door frame.

While much of the focus will be on the nurse who was in the room when the fall occurred, there is also a significant amount of fault to be assessed against the facility itself. Federal regulations require the nursing home to have sufficient numbers of nurses on hand on a 24/7 basis to meet the care needs of the residents, with the appropriate skills and competencies. When the nursing home accepted a nurse on board to provide care to the its residents, it had an obligation to make sure that the nurse knew what had to be done to deliver appropriate care to the residents. Failing to do that was setting everyone up for disaster.

One of our core beliefs is that nursing homes are built to fail due to the business model they follow and that unnecessary accidental injuries and wrongful deaths of residents are the inevitable results. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.

Other blog posts of interest:

Failure to follow care plan result in fall with broken arm for resident at Heritage of Hoopeston

Resident suffers brain bleed in fall from bed at Meadowbrook Manor in Bolingbrook

Fall with head injury at University Rehab

Fall results in fractured kneecap at Country Health in Gifford

Wheelchair accident at Generations of Lincoln

Fall in shower at Champsign County Nursing Home

Improper use of lift at Danville Care Center

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Rosewood of Elgin resident dies due to fall from wheelchair

June 14, 2019 By Barry G. Doyle

IDPH has cited and fined Rosewood of Elgin nursing home after a resident there suffered fatal injuries in a fall from his wheelchair.

The resident at issue suffered from dementia and required extensive assistance with his activities of daily living and required the assistance of two staff members for transfers with a mechanical lift. He was wheeclchair bound and had been assessed as a fall risk by the staff due to balance deficits and inadequate safety awareness. He also had a history of prior falls.

As is a recent trend, the nursing home had elected to stop using bed alarms and mobility alarms as tool to help prevent nursing home falls, instead relying upon supervision of residents by the staff as a means of preventing falls. The practice at that facility had been to place residents who were fall risks at the nurse’s station for observation by the staff while they were charting.

Typically, the residents at risk for falling would be placed behind the nurse’s station and in view of the nurses so that the staff could assist them while doing work at the nurse’s station. That morning, this resident was placed on the far side of the nurse’s station because the staff was all behind the nurse’s station having their morning meeting. Another nurse was walking down the hallway and saw that the resident was sitting in his wheelchair with a bowl filled with cereal in his lap. She noticed that he had spilled some of the cereal and that he had had an episode of incontinence. She instructed an aide to clean him up and proceeded to her meeting.

A few minutes later, a visitor to the facility saw the resident leaning forward and shouted “He’s going to fall!” The staff at the meeting tried to reach him, but he fell forward out of his wheelchair, striking his forehead on the floor.

He was brought to the hospital, where a CT scan showed that he suffered a burst fracture at the C6 level. A neurosurgeon was brought in, but he determined that surgery could not be done. The resident died the next day due to respiratory compromise brought on by the spinal fracture.

Many nursing homes are doing away with bed alarms and mobility alarms as a fall prevention measure. Alarms were – and in my opinion, are – a good tool to alert staff that a resident who is at risk for falling is getting up unattended. It is was a part of the focused, systematic effort at fall prevention that was at the heart of many fall prevention care plans.

Federal regulations were updated and changes took effect in late November, 2017, but the basic federal regulations pertaining to falls in nursing homes have not changed – nursing homes are required to provide supervision and assistive devices necessary to prevent falls. However, without alarms, nursing homes must have a systematic, routinized way of providing supervision to residents on a 24/7 basis without having the information that the alarms provided as to what residents needed it at a particular moment.

If nursing homes are going to discharge their obliagtion to provide supervision necessary to prevent resident falls, in practice that means that they are going to have to get more eyes on the residents …. and that means more staff. I believe that if a nursing home has given up using alarms as fall prevention measure and don’t have more staff on the floor, they are truly understaffed in terms of meeting the requirements of the federal regulations which require them to have sufficient staff on hand to meet the care needs of residents on a 24/7 basis and to provide adequate supervision to prevent falls.

Indeed, review of the citation relating to this nursing home wrongful death reveals that at least some of the staff feel that same way, as they describe having reported to management that they needed additional staff once the alarms were removed from the facility.

One of our core beliefs is that nursing homes are built to fail due to the business model they follow and that unnecessary accidental injuries and wrongful deaths of residents are the inevitable results. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.

Other blog posts of interest:

Fall from shower chair leads to fall and death at Manorcare of Arlington Heights

Resident suffers broken hip in unsafe transfer at Pearl of Rolling Meadows

Wheelchair accident at Avanti Wellness in Niles

Failure to follow care plan at Tower Hill in Elgin

Resident suffers fractures in fall at Chateau Nursing & Rehab

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Wandering Alden Town Manor resident falls down stairs, suffers fatal injuries

June 13, 2019 By Barry G. Doyle

IDPH has cited and fined Alden Town Manor nursing home in Cicero after a resident wandered out the front door in a wheelchair and rolled down the front stairs, suffering multiple injuries which resulted in the wrongful death of this nursing home resident.

The resident at issue was wheelchair-bound due to hemiplegia (paralysis on one side, often associated with the residuals of a stroke) and had been assessed as having significant cognitive issues related to dementia. He was recognized as being a fall risk. He had family that visited often and there was an order in place that permitted him to go out on pass in the company of family. The family often visited and would take him out on the front porch which was just outside the front door.

As a matter of practice, the facility often kept the front door propped open to allow residents to easily access the front porch and tasked the front desk receptionist with watching for residents who were elopement risks.

On the day of the incident, the residentat issue headed to the front door at about the same time that a resident who was a known elopement risk entered the front lobby. The receptionist left the front desk area to get a piece of candy to divert the other resident, not pyaing much attention to the resident at issue who she had seen out on the front porch frequently with family.

With the receptionist away from the front desk, the resident pushed himself out the front door and down the five front steps to the facility, crashing to the sidewalk below. As a result of this nursing home fall, the resident suffered multiple brain bleeds and multiple fractures, all of which resulted in his wrongful death five days later.

There are a number of issues that come immediately to mind with regard to this accident.

First, federal regulations require the nursing home to provide supervision and assistive devices necessary to prevent accidents. Falls and elopement fall under the category of “accidents” under the federal regulations, and leaving this cognitively impaired resident unobserved and unattended by staff or family near the stairs in a wheelchair is not adequate supervision.

Second, leaving the front door propped open so that residents can freely go in and out the front door is a hazard of the nursing home’s own making. Stairwells in nursing homes pose a safety hazard, which is why they are routinely locked as a fall prevention measure. The front exterior stairs are no less of a hazard to residents, not to mention the fact that is a literal open door for a resident who wants to elope (or leave the facility and wander in the surrounding community). Keeping watch on the front door is something that needed to be done, but leaving it in the hands of a receptionist to handle full time was an invitation to disaster.

Third, the citation indicates that the resident had not been assessed as an elopment risk for approximately two years prior to this accident. This speaks to a breakdown in the care planning process as the risk of elopement is one area which is routinely assessed and care planned for when necessary. Failing to consider this risk is a failure to follow the care planning process.

These failures are a form of nursing home abuse and neglect which in this case would be the basis for a wrongful death lawsuit.

One of our core beliefs is that nursing homes are built to fail due to the business model they follow and that unnecessary accidental injuries and wrongful deaths of residents are the inevitable results. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.

Other blog posts of interest:

Resident wanders from Niles Nursing & Rehab, suffers fractures

Resident wanders from Aperion of Forest Park, falls into river and drowns

Diabetes medication not provided at Alden Estates of Orland Park

Resident wanders from Good Samaritan Society in Mount Carroll

Resident suffers fractures in fall at Chateau Nursing & Rehab

Resident wanders from Alden Long Grove

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

St. Anthony’s fails to treat resident’s pain during wound care

June 11, 2019 By Barry G. Doyle

IDPH has cited and fined St. Anthony’s Nursing & Rehabilitation Center in Rock Island for failing to treat a resident for pain during wound care. Click the link in the prior sentence to check out the actual citation issued by IDPH. It is really disturbing reading.

The resident at issue was suffering from cellulitis of both lower legs. As a result there were open, weeping blisters on both legs. He was sent to the hospital for treatment and when he was discharged, he received a prescription for Norco, a pain medication. He ripped it up believing that this was the same order that he had before he went to the hospital. When he came back from the hospital, the pain medication was discontinued. Despite the fact that the discharge instructions included continuing pain medication for supportive care, no one from the nursing home called the doctor or the hospital to resolve the discrepancy. As a result he did not receive the pain medication that was ordered for him.

The citation graphically describes the results of what happened when he began to receive wound care without the pain medication:

Before wound care began he described a pain level of 10+ like getting your finger on a hot stove all over his calf and that he had not been able to sleep the night before due to pain;
When the nurse began unwrapping the dressings, he jumped with each touch, furrowed his brow, and grabbed the arm rests of his wheelchair, and said, “I wish I had a leather belt I could bite on so I don’t scream.”
When he was offered lunch he declined it saying that he couldn’t eat because he was so nauseous from the pain.
When they began to work on the other leg, he said, ‘Oh my f***ing God, this hurts.” When asked if he was okay, he replied, “No, I am not okay. This hurts like holy hell.” While the nurse continued to dress the leg, he writhed in pain and moaned.

Many nursing home residents experince severe pain as a result of wounds like bed sores due to the exposure of nerves under the skin. Failing to take steps to control the resident’s pain is a form of nursing home abuse.

This resident had been assessed as being at risk for severe pain, but the care plan did not properly address his pain control needs. Moreover, when the resident arrived back at the nursing home following his hospital admission without an order for pain medication, this is something that should have been resolved immediately by the nursing staff with the doctor and/or hospital. Past that, when the resident was experiencing the kind of severe pain described in the citation, it was the nurse’s responsibility to notify the doctor that the resident was having that kind of pain and to obtain an order for pain medication. Allowing this resident to suffer in the way that he did was inhumane.

One of our core beliefs is that nursing homes are built to fail due to the business model they follow and that unnecessary accidental injuries and wrongful deaths of residents are the inevitable results. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.

Other blog posts of interest:

Failure to notify doctor of pressure ulcer at Aperion of Moline

Urinary catheter injury at Marigold Rehab

Assault by fellow resident results in hip fracture at Stephenson County Nursing Home

Sauk Valley fails to provide proper tracheostomy care

Generations at Rock Island fails to treat bed sores

Spinal fracture from fall from bed at Pine Acres

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Resident suffers fractures in fall at Chateau Nursing & Rehab

June 8, 2019 By Barry G. Doyle

IDPH has cited and fined Chateau Nursing & Rehabilitation in Willowbrook after a resident suffered multiple fractures in a nursing home fall.

The resident at issue had signiifcant cognitive impairments and needed extensive assitance with locomotion throughout the unit. Her physician told the state inspector that she did not have a concept of danger for herself. That is a classic example of a resident who is at high risk for falls – they have musculoskeletal issues and cognitive deficits that make it difficult for them to make good judgments about their own safety.

On the day of the injury, she was unattended in the dining room and got up from her chair, took a few steps forward hitting her face on the floor. While the Director of Nursing claimed that a nurse was present when the fall occurred, he denied being in the dining room but was at the nurse’s station from where he saw the fall occur. No other staff members were described as being in the dining room at the time.

As a result of the fall, the resident sustained multiple injuries including extensive bruising to her whole face, lacerations to her face and lips, a broken nose, and a fracture to her orbital floor.

During the course of the inspection by the state, multiple staff members agreed that this resident was a high fall risk and residents who are high fall risks should not be left unattended in the dining room. This is something that would be consistent with the requirements of federal regulations related to nursing home falls: they require that nursing homes provide residents with supervision and assistive devices necessary to prevent falls. In practice, in this facility, that meant not leaving high fall risk residents unattended in the dining room. Unfortunately, that was what happened and this injury was the result.

Falls are a serious issue in the long term care industry. In this patient population, the occurrence of one fall is often the precursor for additional falls (indeed, this resident had one fall before and one fall after this fall). Nursing home residents are at risk for serious injury such as hip fractures or brain bleeds (especially for residents who are on blood thinner medications), all of which can lead to the wrongful death of the nursing home resident.

One of our core beliefs is that nursing homes are built to fail due to the business model they follow and that unnecessary accidental injuries and wrongful deaths of residents are the inevitable results. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.

Other blog posts of interest:

Resident trips over towel, breaks hip at Oak Brook Care

Three falls lead to brain bleed at Bria of Chicago Heights

Communication breakdown leads to fractured hip at Chateau

Fall from wheelchair at Meadowbrook Manor

Head injury in fall at Holy Family Villa

Inadequate care plan leads for fall and fractured hip at Villa of South Holland

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Sandwich Rehab fails to obtain test ordered by doctor

June 7, 2019 By Barry G. Doyle

IDPH has cited and fined Sandwich Rehab after it took 8 days to get test results s for a resident showing signs and symptoms of a urinary tract infection.

The resident at issue suffered from urinary retention, a condition where the bladder does not empty completely. To help the bladder empty, she was provided with an indwelling catheter. One of the risks associated with the use of a catheter is the development of a urinary tract infection.

Nurses are required to be able to identify signs and symptoms of a urinary tract infection. Some of the signs of a urinary tract infection in a resident with a catheter include cloudy or blood-tinged urine, strong smelling urine, burning at the catheter site, fevers, lower back pain, and generalized malaise. When a resident demonstrates signs and symptoms of urinary tract infection, they are required to notify the doctor.

In this case, on September 12, the resident complained of burning at the catheter site and lower body pain. The nurse caring for her did the right thing: she notified the doctor and obtained an order for a urinalysis with culture and sensitivity. This is a test which would confirm the the presence of the urinary tract infection and let the doctor know which antibiotics would be most effective in combatting the infection.

The nurse drew the urine sample that day, but the lab failed to pick the sample up. On September 15, another order was obtained from the doctor for a urinalysis with culture and sensitivity. It wasn’t until September 20 — 8 days after the test was ordered — that the results came back, and the doctor then ordered keflex (an antibiotic). During the interim, the infection progressed with the resident demonstrating additional symptoms of the urinary tract infection with sediment and blood in the urine, fevers, and chills. On September 22, she was admitted to the hospital with sepsis.

When IDPH came to investigate this incident, the facility’s Director of Nursing turned on the lab, telling the inspector, “Our lab is horrible, horrible!” (exclamatino point in the original), relating to the surveyor that the urine sample was taken on the 12th, but no one came that day to pick it up. A follow-up call was made on the 13th, but no one came. On the 15th, the Director of Nursing said she “threw a fit” and was promised that someone would be out that day but no one came until the 17th when a new urine sample was taken to the lab.

Obviously, a significant part of the blame here rests on the lab – it is their job to get the sample in a timely way. However, when the sample was not being picked up, more action than was taken was required; after all there was a resident with a serious illness.

Past that, this is a good example of how the decisions made by people at the business end of the nursing home industry impact the care that residents receive. Most often this is seen in nursing homes being understaffed. In this case, the people delivering the care are stuck working with a vendor (the lab) that isn’t getting the job done. The DON’s description of the lab (“horrible, horrible!”) tells me that this is probably not the first time that they have had problems with the work being done by the lab.

One of our core beliefs is that nursing homes are built to fail due to the business model they follow and that unnecessary accidental injuries and wrongful deaths of residents are the inevitable results. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.

Other blog posts of interest:

Resident abuse at Sandwich Rehab

Crossroad Care Center fined for neglect

Pine Acres resident breaks neck in fall

Fall during transfer results in broken ankle at Sandwich Rehab

Failures in care lead to bed sores at Park Place of Belvidere

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Sauk Valley Senior Living fails to provide proper tracheostomy care

June 5, 2019 By Barry G. Doyle

IDPH has cited and fined Sauk Valley Senior Living in Rock Falls after a resident was admitted to the hospital in respiratory distress due the failure of the nurisng staff provide proper care for a resident with a tracheostomy.

The resident at issue was 31 years old who suffered a severe brain injury after choking on food. As a result of this incident she was nonverbal, unable to care for herself of participate in her care, and had a tracheostomy.

A tracheostomy is a surgical hole in a person’s throat which helps a person breathe. After the surgical incision is made, there is a tub called a cannula which is placed down the person’s airway. The cannula actually has two components: an inner cannula and an outer cannula. The outer cannula hold open the site of the tracheostomy, while the inner cannula is inserted into the windipipe and can be removed for cleaning.

The cannula can become obstructed with fluids or other items. Obstruction of the cannula can result in a loss of oxygen to the patient and ultimately result in the wrongful death of the nursing home resident. One way of resolving an obstruction is by suctioning.

The orders for tracheostomy care called for the resident to receive trach care daily and as needed, to be suctioned as needed, and to have the inner cannula changed daily. This was doubtless part of her care plan.

On the night of the incident, an aide recognized that the resident was struggling to breathe, so she brought the nurse in. The nurse gave oxygen and listened to the resident’s lungs and recognized that the resident had minimal lung sounds. She admitted to the state surveyor that she did not attempt to suction the resident because she did not have much experience working with tracheostomies. She notified the doctor and obtained an order for the resident to be sent to the hospital.

When the paramedics arrived, they recognized that resident was in respiratory distress and was told by the nurse that had been going on for up to an hour. When they arrived at the hospital, the nursing staff found that the tracheostomy cannula was clogged with blood tinged sputum and hair. It was very dirty and it was obvious to the nursing staff that the cannula had not been cleaned or suctioned. They cleaned out the cannula and replaced it and the resident began breathing normally.

The obvious issue here is that the resident was not receiving the care that she needed to maintain her airway. When she was brought to the hospital, the inner cannula was clogged with hair and fluids and was very dirty. This indicates that the resident was not receiving the care that she needed and which is actually required under federal regulations.

Nursing homes are also required by federal regulations to have sufficient staff with the skills needed to assure resident safety and meet the care needs of residents. The nurse on duty at the time of this incident demonstrated that she did not have necessary skills to care for this resident as she either did not know to suction the resident or did not believe that she had the skills to do so. Either way, the most immediate step to care for the resident was not taken.

Violations of federal regulations like this are a form of nursing home abuse and neglect.

If the nursing home did not have the staff available to properly care for this resident – and it appears from the description of the cannula in the IDPH citation that this resident was not the only nurse uncomfortable caring for the tracheostomy – then the only proper course for this nursing home would have been to deline the admission. However, this is the kind of medically compromised, complex patient that tends to bring higher levels of revenue for the nursing home, so the profit model says that this resident will be accepted for admission when the wisest course action may have been to decline the admission.

One of our core beliefs is that nursing homes are built to fail due to the for-profit business model they follow and that unnecessary accidental injuries and wrongful deaths of residents are the inevitable results. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.

Other blog posts of interest:

Resident wanders from Good Samaritan Society in Mt. Carroll

California Gardens fails to obtain respiratory equipment

Urinary catheter injury at Marigold Rehab

Resident dies after yanking out own tracheostomy

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Resident fall at Walker Nursing Home

June 3, 2019 By Barry G. Doyle

IDPH has cited and fined Walker Nursing Home in Virginia, Illinois after a resident suffer a broken tibia and fibula in a fall which required surgical repair. The amount of the fine was $25,000 which is one of the highest that can be imposed against a nursing home.

The details of the citation are scarce, but the resident was assessed as being at high risk for falls due to severe cognitive impairments, poor impulse control, musculoskeletal weakness, and a history of falls. There was a fall prevention care plan which included making sure that the resident had proper-fitting footwear. The resident experienced a nursing home fall on July 12. Following this fall, the nursing home conducted an investigation and concluded that poorly fitting shoes was one of the causes of the fall.

The resident had a second fall on August 29. This is the fall which resulted in the fractured tibia and fibula. The nursing home investigated the cause of this nursing home fall and concluded that there were two causes. One was unlocked wheels to a bed. The other was ill-fitting footwear.

This fall shows a couple of areas where there is a breakdown in the delivery of care to this resident.

First, there are a few federal regulations relating to nursing home falls. 42 CFR Part 483.25 has two separate requirements which likely came into play in this factual scenario. The first is that the resident environment be kept as free from accident hazards as possible. Residents with poor balance frequently on furniture, railings, and so forth as aids to help them maintain their balance. When the wheels to a piece of furniture are unlocked and starts to move, elderly residents with musculoskeletal weakness and balance issues are not likely to recover their balance and a fall is the likely result. The second regulatory requirement is section 483.25 is that resident be provided with adequate supervision and assistive devices to prevent accidents. If the resident was wearing improper footwear leading up to the second fall, that raises serious issues about whether proper supervision was being provided.

Second, there is an issue with the care planning process. One of the steps in the care planning process is evaluating a care plan for effectiveness and revising it if it isn’t working. When it comes to fall prevention, the occurrence of a fall is something that should trigger the process of evaluating and revising the care plan. Having resident in proper footwear is a basic step in a fall prevention care plan. When a fall occurs and improper footwear is shown to be the culprit, specific steps to ensure the use of proper footwear is required, but it does not appear that this was the case. This is a simple measure which if taken would have helped assure the safety and well-being of this resident.

One of our core beliefs is that nursing homes are built to fail due to the business model they follow and that unnecessary accidental injuries and wrongful deaths of residents are the inevitable results. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.

Other blog posts of interest:

Broken ankle from fall at Aperion of Mascoutah

Failure to use gait belt during transfer at Jacksonville Skilled Nursing & Rehab

Auburn Rehab resident suffers fractured hip in fall

Improper transfer at Alden of Shorewood

Pittsfield Manor resident suffers fatal fall

Shower room fall at Champaign County Nursing Home

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Unsupervised resident falls on smoking deck at Uptown Health Center

June 1, 2019 By Barry G. Doyle

IDPH has cited and fined Uptown Health Center in Chicago after an unsupervised resident fell on the smoking deck.

Federal regulations require that residents receive supervision and assistive devices necessary to prevent accidents. When there are smoking accidents at nursing homes or nursing home falls, this is often one of the regulations which has been violated.

The resident at issue had been assessed as being a fall risk in part due to generalized weakness, but also a history on nine – yes, nine – prior falls. He had a fall prevention care plan which included as one of the steps wearing proper footwear. He was a smoker, and part of his care plan addressed the risks associated with smoking by providing that he would not smoke without supervision. There was also a facility-wide policy that essentially provided for the same thing.

The resident was injured in a fall occurring on January 14. When the fall occurred he was on the smoking deck unsupervised, wearing only a pair of nonskid socks – no shoes. As a result of the fall, he suffered a laceration to his head which required stitches. Residents advised the state inspector that there frequently was no staff present when residents were out on the smoking deck and that some of the residents who suffered from psychiatric issues would “pee and poop” on the smoking deck.

The injury that this resident suffered was not severe, but that was a matter of luck, not good care, as nursing home falls can just as easily and often do end in devastating injuries such as brain bleeds or fractured hips. Getting lucky is not a substitute for providing proper care.

Past the fact that this particular incident demonstrates rampant violations of care plans and facility policies, the fact the residents are often left unsupervised on the smoking deck leaves open the potential for a smoking accident due to mishandling of smoking materials or use of smoking materials near compressed oxygen. This is something that has the potential for serious injuries which can lead to the wrongful death of one of the nursing home residents.

One of our core beliefs is that nursing homes are built to fail due to the business model they follow and that unnecessary accidental injuries and wrongful deaths of residents are the inevitable results. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.

Other blog posts of interest:

Multiple injuries in fall at Symphony of Midway

Resident burns to death at Lake Shore

Continuing falls at Claremont Rehab

Hip fracture from fall at St. Joseph Village

Unsafe transfer results in femur fracture at Woodbridge Nursing Pavilion

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Resident suffers from pressure ulcers at Parker Rehab

May 30, 2019 By Barry G. Doyle

IDPH has cited and fined Parker Nursing & Rehabilitation Center in Streator regarding the pressure ulcers or bed sores one resident developed while a resident there.

There are two basic federal regulations relating to bed sores. The first of these provide that a resident entering a nursing home without a bed sore should receive care to prevent pressure ulcers and should not develop them unless the resident’s clinical condition demonstrates that they were unavoidable. The second of these provides that in essence that after a resident develops a bed sore, they should receive care, treatment, and services necessary to promote healing, prevent infection, and prevent the development of new bed sores. This is a reason that bed sores are a focal point of emphasis in the assessment (including the use of the Braden scale) and care planning process.

It appears from this citation that the staff at Parker failed on both counts.

The resident at issue had developed bed sores on his gluteal folds and on his coccyx. There were orders in place for use of a duoderm, a type of dressing which is intended to prevent contamination of the wound. When the IDPH surveyor was doing her inspection, the dressing which had been ordered were not on the resident. This amounts to a violation of the regulations which require the nursing home to provide the necessary care, treatment, and services to promote healing and prevent infection.

Beyond that, the resident also had deep tissue injuries present on his heel which had not been documented in the chart.

In practice, much of the detection of new skin breakdowns is done by CNA’s. It is part of the responsibility of CNA’s to inspect the skin of the residents when getting them dressed, changing them after an episode of incontinence, or getting them dressed. Often in their early stages bed sores may appear as a reddish discolored area. It isn’t the job of the CNA to decide what it is – that is the role of the nurse. And if a nurse determine that a new bed sore is present, then it is her job to notify the doctor about the presence of a new bed sore or a decline in an existing wound. At that point, the doctor can issue orders for care and the resident’s care plan for bed sores can be updated.

When the IDPH inspector was in the nursing home, she also discovered that this resident had dark burgundy/purple fluid filled blister. This is a near-classic description of a deep tissue injury, which is a type of pressure ulcer. Typically, deep tissue injuries are caused by a combination of pressure and shear. Shear is one of the specific risk factors for developing a bed sore under the Braden scale, and it is the role of the nursing staff to eliminate or reduce the resident’s exposure to shear. Either way, the doctor had not been notified of the presence of the new pressure ulcers to the residents heel even though reddening of the heels had been recorded inthe resident chart several weeks earlier. This appears to be the onset of a new bed sore which was never reported to the doctor, which delayed the start of care and changes to the resident’s care plan.

Other blog posts of interest:

Untreated pressure ulcer at Aperion Care of Bradley

Failure to notify doctor of pressure ulcer at Aperion of Moline

Resident burned by hot pack at Miller Health Center

Failure to follow feeding tube orders leads to hospice admission for Parker Rehab resident

Multiple residents develop bed sores at Elmwood Terrace in Aurora

Six residents suffer bed sores at Lakewood Nursing & Rehab

Failure to obtain urinalysis at Sandwich Rehab

Failures in care lead to bed sores at Park Place of Belvidere

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Fall from shower chair at Charleston Rehab

May 29, 2019 By Barry G. Doyle

IDPH has cited and fined Charleston Rehab and Health Care Center in Charleston after a resident suffered a fractured arm in a fall from a shower chair.

The resident at issue was completely dependent on the staff for all activities and care, had significant cognitive deficits, and had poor trunk control. Poor trunk control is a contributor to fall risk for residents when they are placed in chairs. This is because they may tilt forward or to the sides and have weight of their torso carry them forward out of the chair or over the sides of the chair. One way of addressing that risk is through the use of a tilt-back wheelchair, a recliner, and ensuring that anything where the resident will be seated has arms. Making sure that this kind of equipment is available for seating the resident is an essential step for preventing nursing home falls in residents with poor trunk control.

On the day of the accident, the resident was brought to the shower and placed in the shower chair using a mechanical lift. The resident began to slide forward out of the chair and to the left. As she did so her arm got caught in the arm rest. She began to demonstrate pain in the arm with some swelling. She was sent to the hospital where x-rays showed that she had a fracture of the humeral head.

This is a resident who had the issues with poor trunk control, cognitive deficits, and had been dependent on staff for everything for a significant period of time. She used a tilt back wheelchair, but the chair that she would be placed did not tilt backwards, did not have a gripping seat, and did not have foot rests which would have helped prevent her from slipping forward out of her seat. Federal regulations require the nursing home to provide supervision and assistive devices necessary to prevent accidents, and for residents such as this one, that would have included a tilting shower chair with the added features intended to prevent falls from the chair.

The nursing home had addressed the deficits that the resident had in her care plan for a well over a year before this injury occurred. At a minimum, this would have included review of the care plan by the care planning team at least four times per year. Despite the fact that the issues of poor trunk control had been present for several reviews of the care plan, the staff failed to consider the need for a chair that would keep her safe while being showered.

Other blog posts of interest:

Fractured hip in fall at Heartland of Casey

Fall in shower at Champaign County Nursing Home

Taylorville Skilled resident suffers fractured hip after multiple falls

Wheelchair fall at Hillcrest Retirement Village

Fall with head injury at University Rehab

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Assault by fellow resident results in broken hip at Stephenson Nursing Center

May 27, 2019 By Barry G. Doyle

IDPH has cited and fined Stephenson Nursing Center in Freeport after a resident suffered a broken hip due to being pushed down by a fellow resident.

The assailant was well-known to staff and fellow residents as being physically aggressive who did not enjoy interacting with fellow residents and did not allow other residents to touch her. There were multiple documented events of her being aggressive toward other residents and staff members, including another incident where she pushed another resident to the floor. The staff was aware of her aggressive behaviors and knew that she had to be watched closely, but the Director of Nursing was apparently unaware of the incident where she pushed another resident to the floor until IDPH came in to investigate this incident. The facility social services assistant told the state inspector that when residents have aggressive behaviors, they are supposed to be put on 1:1 supervision, but there was no evidence that this was done.

The victim suffered from dementia and musculoskeletal weakness. She had a known set of behaviors that included wandering through the facility in way that disrupts care and intrudes on the privacy of others. She had been assessed as a fall risk, and there was a fall prevention care plan in place which called for the use of a gait belt and assist of one with walking.

On the day of the incident, the victim was walking down the hall unassisted. She reached out to the assailant to touch her on the shoulder. When she did so, the assailant turned around and pushed her down. The victim fell to the floor, in obvious pain with her leg rotated. She was taken to the hospital where she was diagnosed with a broken hip. During the hospital admission to treat the broken hip, she developed pneumonia which is a common consequence of a hip fracture.

This is a regrettably common scenario in nursing home resident-on-resident assault cases. You have a resident who is known to wander and intrude on other’s private space and another resident who is known to be physically aggressive. It is a combustible mix that has predictably sad results.

On one level, this nursing home assault was very simple to prevent. The victim was supposed to be 1:1 assist with walking and a gait belt in use, which meant that she should not have been up walking around by herself which was what happened. Had she been accompanied by an aide, she could have been steered away from the assailant or at least had her fall broken by the use of the gait belt.

Past that, there needed to be a more focused approach to the assailant’s known aggressive behavior. The facility did not have policies which addressed resident-on-resident aggression, and there was no care planning in place which specifically addressed this resident’s aggressive behavior. The staff was all well aware of the behavior and that she was someone who needed to have “an eye kept on her” but there was no specific care planning done as to how that would be implemented on a day-to-day, shift-to-shift basis or what specific steps should be taken to lessen the aggressive outburst. It was simply catch-as-catch-can, which is a horrible way to address known issues of resident safety.

Other blog posts of interest:

Head injury from fall from lift at Presence St. Joseph Center in Freeport

Resident sexually abused at Countryside Nursing & Rehab

Multiple residents victimized by fellow resident at Winning Wheels

Sexual assault at Swansea Rehab

Residents terrorized by fellow resident at Carmi Manor

Forest City resident pushed to the ground, fractures hip

Choking death at Ridge Terrace

Click here to file a complaint about a nursing home with the Illinois Department of Public Health.

Failure to use gait belt during transfer at Jacksonville Skilled Nursing & Rehab

Resident suffers broken hip in unsafe transfer at Pearl of Rolling Meadows

Resident rolled from bed at South Holland Manor

Resident burned by hot pack at University Nursing & Rehab

Resident’s third fall at Bria of Chicago Heights nets brain bleed

Third degree burns from fall at Sauk Valley Senior Living

Call lights not being answered at Aperion of Mascoutah

Fall results in fractured hip at Villa of South Holland

Niles Nursing & Rehab resident wanders, suffers fractures

Resident sexually assaulted by fellow resident at Dixon Rehab

Fall from edge of bed at Integrity of Alton

Failure to notify doctor of abnormal labs at Champaign Urbana Nursing & Rehab

Injury from catheter placement at Marigold Rehab

Brain bleed from fall at Gibson Community Hospital Annex

Rosewood of Elgin resident dies due to fall from wheelchair

Wandering Alden Town Manor resident falls down stairs, suffers fatal injuries

St. Anthony’s fails to treat resident’s pain during wound care

Resident suffers fractures in fall at Chateau Nursing & Rehab

Sandwich Rehab fails to obtain test ordered by doctor

Sauk Valley Senior Living fails to provide proper tracheostomy care

Resident fall at Walker Nursing Home

Unsupervised resident falls on smoking deck at Uptown Health Center

Resident suffers from pressure ulcers at Parker Rehab

Fall from shower chair at Charleston Rehab

Assault by fellow resident results in broken hip at Stephenson Nursing Center

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