5. Nursing Home Abuse: What it is. Who to Report Nursing Home Abuse to?
Deezer In this episode Jonathan Rosenfeld chats with James M. Morgan an Attorney at Lanzone Morgan LLP. Here, they discuss nursing home abuse and how to handle it from a legal perspective.
They discuss into 4 key issues related to nursing home abuse and litigation:
1) What is Nursing Home Abuse? 2) How do You Report Nursing Home Abuse (Who Do You Report Nursing Home Abuse To)? 3) What does an investigation by state agencies do and how does it work? 4) At what point should the family of a resident consider a civil lawsuit against a nursing home?Read the Transcript
Jonathan Rosenfeld:
Hello, everybody. I am Jonathan Rosenfeld and today on the Personal Injury Podcast I have my friend and colleague, Jim Morgan. Jim is an attorney in California and he is a named partner at Lanzone & Morgan, and the bulk of Jim's practice is related to nursing home negligence and elder abuse. Today, I want to talk with Jim about one of the real emerging areas of litigation in the field of personal injury law, and really, this is specific to nursing home care, is nursing home abuse. Jim has been practicing in this area for many, many years, and when it comes to these types of cases, I feel very fortunate to have him with me today to really answer some questions that people and families really come to us continually related to their care of their family member.
Jonathan Rosenfeld:
First up, Jim, I really appreciate you joining me today.
James M. Morgan:
Yeah, thanks for having me.
Jonathan Rosenfeld:
Now, today, we're going to talk about something called nursing home abuse. Nursing home abuse seems to me like the most broad, general term ever. In the field of personal injury law, a lot of times we talk about a surgical error case. We talk about a car accident case. We talk about a truck accident case, but a nursing home abuse case seems like it's the most over, all encompassing term ever. I guess, to begin with, can you just, in your mind's eye, give us an idea of what that term means? What does nursing home abuse mean?
James M. Morgan:
Yeah, well, you're really right on that because all the other stuff you mentioned, those are event cases where there's a car accident and that's an event. Somebody does something to somebody else. That can be within the realm of elder abuse or nursing home abuse, because you can have physical abuse cases where a caregiver is hitting a patient or resident or choking them. We've had those cases, or a sexual assault on a resident, but believe it or not, most of the nursing home abuse cases are neglect cases, which is really a failure to do something, so it's not an event.
James M. Morgan:
It's not a CNA or a nurse or a care provider doing something to the resident physically. It's more what they're not doing for the resident. They're not giving them sufficient water so that they get dehydrated, or they're not turning them and repositioning them to prevent them from getting bed sores, or they're not providing enough supervision or assistance to go to the bathroom so that the resident ends up falling and fracturing their hip. When we say elder abuse or nursing home abuse, most of our clients and callers, they're really talking about neglect and failing to provide proper care to the resident as opposed to actually doing something for the resident.
Jonathan Rosenfeld:
Interesting. In most of these cases, it's really just a systemic breakdown, almost, when it comes to the care of these patients. I've seen these cases. I know you've worked on many, many of these cases, and it seems to me like a lot of these cases, like you mentioned, it's not an isolated episode or event, it's a systemic breakdown where there's maybe not enough staff available to care for these patients or maybe the staff is not trained sufficiently to care for these people. Is that the type of situation that you see?
James M. Morgan:
Absolutely, and in fact, you really hit the nail on the head. Well over 50% of our cases result from lack of staff or insufficient number of staff. It's not that the caregivers are necessarily bad people who are doing bad things. We get that, too, but it's really, they don't have enough time because they have so many patients, so one person can't feed or give a bath to 20 different residents on their shift or two meals and a bath to that many residents, so well over 50% of our cases are a result of just the facility not hiring enough staff to take care of the residents.
James M. Morgan:
Some of it's not necessarily not enough staff, but a lack of training of the staff, so the staff doesn't know how to prevent bed sores or to provide fall prevention or cautions, or they have no training on how you get somebody with Alzheimer's or dementia to eat their whole meal when they say, "Oh, I'm not hungry," or, "I don't want to eat." They don't know what to do. They take their tray away and they say, "They don't want to eat dinner." They really don't have the training, so I'd say the vast majority of our cases come down to either insufficient number of staff or insufficiently trained staff.
Jonathan Rosenfeld:
You mentioned a bunch of episodes involving cases that you see on a fairly regular basis, falls, pressure sores, medication errors, patients who may wander from a facility, patients who may become dehydrated. Now you're sort of going into a new phase, if you will, of COVID, where family members, a lot of times, they may not be able to see their family member for some time over the past year, but now, some of the restrictions in various areas of the country are starting to lighten up a little bit, people are able to actually get in and see their family member, and they may see something where, "Hey, that doesn't look right to me," or, "Hey, man, Grandma Sue has really deteriorated over the past year," if they see that, is there anything that a family member can do? What kind of action can they take?
James M. Morgan:
A couple things. Let me start with the first thing that I tell my clients to do when they're getting back in the nursing homes and seeing mom or dad or grandma, and they don't want to do this, especially the men, but you need to look at them head to toe and assess them yourself. You need to look at their skin. You need to take their socks off and look at their heels and make sure they don't have any redness or bed sores on their heels, and, frankly, the number one place to get bed sores is the coccyx area, right above the butt. Listen, you don't want to go in there and visit mom for the first time in a year and go taking her clothes off and looking at her coccyx area, but if you don't do that, you're not going to know what's there, because most of the time they're not telling you that mom or dad's getting a bed sore.
James M. Morgan:
If, at all possible, I tell them, assess mom or dad or grandma head to toe, especially their skin, because you don't know what kind of bed sores they may have gotten during this COVID lockdown, and by the way, that's important even when there isn't COVID. I can tell you a case in particular where a lady said, "I noticed, every time I went to visit my husband, that they weren't changing his socks and they always told me they would change him, and I'd come back and he always had the same socks on, so finally I changed it," and she pulled off the sock and half of his heel came off with the sock, because nobody ever changed his sock and nobody ever knew he had a horrible bed sore on his heel, so even in normal times, you need to assess the resident's skin.
James M. Morgan:
That's number one. Number two, kind of to answer your question a little more directly, if you notice there's some weight loss, mom doesn't look so good, you need to ask questions and you need to ask questions not just of the caregiver who's coming in, because a lot of times that's a CNA and they don't have a lot of answers. You need to go to the head nurse or the director of nurses or the administrator and say, "Hey, look, when I saw mom or dad 12 months ago, I think they weighed significantly more than they do now. Will you show me their weights from last year and how that's decreased over time?" Because, they should be weighing them on a regular basis, especially if they're losing weight, and by the way, if they lose a certain percentage of weight in a certain amount of time, they're required to report that to the state.
James M. Morgan:
Ask questions and ask questions of the higher ups, not just the CNAs who are providing the hands on care.
Jonathan Rosenfeld:
Jim, we were talking a little bit about situations where a family member may see their loved one with a situation where it may not be an acute injury. They may not have that broken bone and they may have gone to the staff at the nursing home, they may have had a meeting with them, but they still don't feel like they're really making any headway in terms of remedying the situation. In that context, what,...