Nursing Home Abuse

One of the most unsettling thoughts with respect to placing our loved ones in a nursing home is the concern that someone might physically abuse them. Most states have laws that are designed to protect the elderly from abuse and neglect. Despite these laws, the sad reality is that many elderly people continue to be abused. This situation came to light recently in a Montgomery, Alabama, nursing home. Authorities found that a certified nursing assistant (CNA) and former nursing home employee punched a 93-year-old nursing home patient. The report indicated that the elderly patient continued to spit her medicine out when the CNA attempted to administer the medications. The CNA was arrested and charged with abuse or neglect of a protected person.

In 2013, CBS News reported an event where two CNAs physically abused patients in Dallas, Texas. The events were caught on camera. In that report, CBS reported that an elder/nursing home advocacy group, Families for Better Care, researched reports from every state and concluded that 11 states received a failing grade for failing to protect elders from abuse and neglect. For the southeastern states, Florida and South Carolina received a score of “B.” Georgia and all other southeastern states, except Louisiana, received a score of “D.” Louisiana was one of the 11 states that received a failing score of “F.” The states with a “superior” grade of A” were Alaska, Rhode Island and New Hampshire. According to the group’s findings, one in five nursing homes abused, neglected or mistreated residents in about half of the states. The advocacy group determined that the nursing homes that staffed at higher levels received a higher ranking, while those who had fewer staff or who were understaffed received lower rankings. As late as September 2014, the group updated its findings. The updated report can be found at

While the examples of abuse such as those reported in Alabama and Texas are presumably an exception and not the rule in nursing homes, if you suspect your loved one is being abused, the best course of action is to report the abuse to the facility administrator, the facility ombudsman, and the Alabama Department of Public Health (ADPH). For information related to the ADPH, you can go to www.adph. org. The ADPH also maintains a complaint line, and you may call them at 800-356-9596 or 800-873-0366. Of course, you may also need to report the event to the local law enforcement agency as well.

Hopefully, nursing homes will do a thorough job of performing background checks and detailed interviews in order to minimize the possibility of hiring a person who would abuse elderly patients. If you need more information, contact Boyd Newton, who handles Nursing Home litigation, and who can be reached at 404-593-2630 or by email at

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Great Advice From Consumer Reports

February 18, 2015 6:00 am • From the editors of Consumer Reports

In an ideal world, respectful treatment from health care providers would be the norm. In the real world, you may have to insist on it. Consumer Reports suggests increasing the odds of a good hospital experience with these strategies:
•Choose the right hospital. A study published in the New England Journal of Medicine linked low patient satisfaction with less-than-stellar hospital performance in areas such as pain control, discharge instructions and communicating about medication. And research in the American Journal of Managed Care showed that people who were satisfied with their care after a heart attack, heart failure or pneumonia were less likely to be readmitted to the hospital within 30 days.
•Help providers see you as a person. Once you get to the hospital, chances are you won’t know many of the folks taking care of you. Reminding people that you are more than a diagnosis can change that. Bring in pictures, maybe one showing you playing golf or tennis. Add a personal detail when you describe your medical problems to a doctor.
•Invite your doctor to have a seat. In a recent study, Norwegian researchers created simulations in a hospital setting, using real doctors and actors as patients and comparing electronic devices with paper medical records. The patient actors thought the doctors were so busy with their devices that they shouldn’t interrupt to ask questions. If you experience that dynamic, you can change it and make it easier to communicate by inviting your doctor to sit down and have a conversation.
•Have your people with you. An advocate can help in a number of ways — for instance, making sure you are comfortable, getting information from the doctor or nurse, helping you make decisions about treatment and speaking for you if you aren’t able to speak for yourself.
•Know when errors tend to occur. In a new national Consumer Reports survey of 1,200 recently hospitalized people, patients who thought there weren’t enough nurses available were twice as likely to experience some kind of a medical error and 14 percent less likely to think they were always treated with dignity and respect. Shift changes can also create safety hazards, as can care transitions, such as moving from an intensive care unit to a hospital floor. If you know when and where errors are most likely to occur, you can make a special effort to have your advocate be present then.
•Find a “troubleshooter.” Navigating the hospital is much easier with an “insider” ally. You or a family member should introduce yourself to the head nurse on duty or seek out the nursing supervisor, attending physician or even a physical therapist or aide with whom you feel comfortable. Then, if something goes wrong, you will have already established a personal connection with someone who knows the system and can help.
•Be assertive and prepared, but always be courteous. Think about what you want to ask your doctors when they rush in for that early morning visit, and say it out loud a few times so that you get what you want from the encounter.
•Write things down. With doctors, nurses, technicians, medical students and social workers in and out of your hospital room, it can be very difficult to keep track of what is being done, especially when you are ill. Consumer Reports recommends listening to what they have to say, asking questions and taking notes.
•If you don’t understand something, ask again. Medicine is complicated stuff, and sometimes doctors forget you haven’t studied it. “This is so much a part of their lives and their vocabulary. Sometimes they rush through an explanation without realizing that the person in front of them has no clue how to interpret what they just said,” says communications specialist Carolyn Thomas. “I simply raise a hand in the ‘stop’ position, and politely remind them that I haven’t been to medical school, so please slow down and translate.”


The Department of Justice Is Investigating LifePoint Hospitals

Modern Healthcare (2/13, Schencker, Subscription Publication, 246K) is reporting that in a Feb. 12 filing with the Securities and Exchange Commission, Tennessee-based LifePoint Hospitals “revealed” that it is “the target of federal investigations, more than twelve individual lawsuits and two class action suits alleging the performance of improper interventional heart procedures.” After conducting “an internal review,” LifePoint “identified two cardiologists who ‘independently elected to place cardiac stents that may not have been clinically appropriate,’ according to a LifePoint statement released” yesterday. LifePoint “then self-reported the matter to the Department of Justice.” The two physicians no longer practice at any facilities affiliated with LifePoint, according to a company statement. Currently, the only LifePoint Hospital in Georgia is Rockdale Medical Center.


FDA Releases Draft Guidance For Risks Included On Medicine Advertisements

The Wall Street Journal (2/6, Silverman, 5.67M) blog “Pharmalot” is reporting that the FDA has issued new draft guidance requesting that drugmakers refrain from including long lists of risks and concerns associated with drugs in favor of a mild summary in print ads and promotional materials. The summary would not have to include information about all side-effect or contraindication. In the draft guidance, the agency explained that not many consumers have the technical background needed to understand some of the information described in the warnings as they exist now. The intention of the summary is to focus on the broader risks and important information instead of an exhaustive list of every possible issue.


Senators Request FDA Investigate Dietary Supplements

According to The Hill (2/5, Wheeler, 224K) Senators are encouraging the FDA to launch a “nationwide investigation after four major retailers were accused of selling mislabeled and tainted dietary supplements in their New York stores” by the state’s Attorney General Eric Schneiderman. Sen. Dick Durbin (D-IL) said in a statement, “Today, Sen. [Richard] Blumenthal [D-CT] and I are calling on the FDA to…take steps to protect all American consumers from an industry shown to be selling products they know are at best, ineffective, and at worst, truly harmful.” Sen. Blumenthal said in a statement, “The apparent widespread sale of fraudulently-labeled dietary supplements by four major national retailers should be a major wake-up call that the industry is in desperate need of additional oversight.”
The need for increased oversight over dietary substances is substantiated by the fact that US consumers “are nuts” for products they believe help them “boost their health and lose weight,” despite a “series of studies and investigations that have cast serious doubt on the safety and reliability of” dietary supplements, the Washington Post (2/5, Millman, 5.17M) “Wonkblog” reported. The popularity of dietary supplements is maintained by the “common public misperception that these products face the same rigorous oversight that pharmaceuticals receive from the FDA.” A report from the HHS Inspector General in 2012 “found that 20 percent of the weight loss and immune system support supplements they purchased made illegal claims about their ability to treat and cure disease,” and just a year later, researchers from Harvard “found that between 2004 and 2012, there were 237 recalls of dietary supplements — accounting for more than half of FDA recalls of Class 1 drugs,” which signifies that “the products contain substances that can cause death or serious health problems.”


The FDA’s Adverse Reporting System Includes Numerous Incomplete Reports

The New York Times (2/3, B3, Thomas, Subscription Publication, 9.97M) is reporting that “the main system for keeping track of the dangerous side effects of prescription drugs is deeply flawed, primarily because drug makers are submitting incomplete information about the problems to the” FDA, “according to a new study by” the Institute for Safe Medicine Practices (ISMP), “a nonprofit group that tracks drug safety issues.” An FDA spokesman “acknowledged that adverse-event reports were often incomplete, and said improving the system was ‘of great interest’ to the agency.” But, “doing so ‘is challenging because of the voluntary nature of the reporting.’”
Similarly, The Wall Street Journal (2/2, Silverman, 5.67M) “Pharmalot” blog reports that although the ISMP says reports can only be considered reasonably complete when they include patient age, gender and event date, only 49% of reports contained that information. Additionally, the analysis found that 67% of death reports were of limited value due to incomplete information about the cause of death and the possible role of a medicine. Thomas Moore, an ISMP senior scientist, attributes the lack of completeness in reporting in part to the fact that the FDA’s adverse-alert system has not been updated since 2001 despite the fact that the pharmaceutical market has evolved immensely, yielding new interactions between drugmakers, patient, and consumers.


Large Pharmaceutical Companies Are Outsourcing Drug Safety Monitoring Overseas

According to The Wall Street Journal (2/2, Mclain, Subscription Publication, 5.67M) more and more pharmaceutical companies are outsourcing their drug-monitoring operations to foreign countries like India. Outsourcing companies like Accenture are benefiting as major drug companies like AstraZeneca, Novartis, and Bristol-Myers Squibb contract out safety checks in order to lower costs and focus on R&D and marketing. The Journal goes on to explore in great depth the issues surrounding the practice, observing that some opponents of this type of work say that drug monitoring is hard to do, requiring significant experience, natural talent, and sufficient knowledge of biochemistry and pharmacology, and that the outsourcing trend brings greater risk that harmful side effects of drugs will be overlooked.


Another Example of VA Neglect

The Los Angeles Times (1/28, Holland, 3.49M) is reporting that the U.S. government “has agreed to settle a lawsuit accusing the Department of Veterans Affairs of misusing its sprawling West Los Angeles health campus while veterans with brain injuries and mental impairment slept in the streets, people familiar with the agreement said Tuesday.” The settlement will require the VA “will develop a master land-use plan for the campus that identifies sites for housing homeless veterans.” The ACLU of Southern California brought the lawsuit contending “that the VA should develop housing for veterans on the 387-acre campus.” The ACLU of Southern California “accused the agency of illegally leasing land to UCLA for its baseball stadium, a television studio for set storage, a hotel laundry and a parking service.” In 2013 a Federal Judge “struck down the leases, saying they were ‘totally divorced from the provision of healthcare.’” More recently, US District Judge S. James Otero “halted construction of an amphitheater on the property.”


Senator Charles Grassley: Nonprofit Hospitals Who Sue Poor Patients Over Unpaid Bills Could Be Breaking The Law

Fox News (1/25, 8.25M) reports that “Sen. Charles Grassley [R-IA] is calling out nonprofit hospitals who are suing poor patients over unpaid bills and says they could be breaking the law, according to a report by ProPublica and NPR.” Senator Grassley “sent a letter, dated January 16, 2015, to Heartland Regional Medical Center, a nonprofit hospital in St. Joseph, Mo., that has garnished the wages of low-income patients who were unable to pay their medical bills.” Sen. Grassley, “citing the ProPublica (1/26, 7K) and NPR (1/22, 1.58M) report…said the hospital, which recently changed its name to Mosaic Life Care, had stretched the law to the breaking point,” writing that the hospital, “may not be meeting the requirements to be a nonprofit, tax-exempt hospital.”


NHTSA Investigates Jeep Cherokee Vehicles After Reports Of Fires

Bloomberg News (1/17, Plungis, 2.94M) reports that NHTSA has begun “a defect investigation into the latest model of the Jeep Cherokee sport-utility vehicle after an owner reported 20-foot flames shot out of its engine compartment after being parked,” which spreads across 50,415 vehicles built for the 2015 model year. The article states that NHTSA routinely starts investigations “based on a single complaint” when the agency “believes the alleged defect is especially dangerous.”
Reuters (1/17) reports that Fiat Chrysler spokesperson Eric Mayne stated the company plans to cooperate to the fullest with NHTSA.
The Auto World News (1/16, 1K) reported that NHTSA Deputy Administrator David Friedman told the press back in November that Jeep has “to get their act in gear,” adding that “They’ve got to make sure that they are getting those parts in the hands of consumers.”