Boca Raton Nursing Home Neglect: A Lawyer's Perspective

Good to see you again, Joe. How are you doing today?

I'm doing good. Thanks for having me, Renee.

Okay. Without any further ado, we're going to go into our second episode of nursing home neglect and abuse. What advice would you give someone who suspects their loved one might be experiencing neglect in a nursing home?

If you suspect that your loved one is experiencing neglect in a nursing home, it's imperative to contact a lawyer right away. The first thing is, it's all about preservation of evidence and documentation. In a nursing home, it's a lot of different aides and nurses and personnel can be involved in a loved one's care, and the documentation in terms of either what didn't happen or did happen becomes important in the case. So you want to get a lawyer involved right away because there are rights that a patient has that need to be protected and preserved. The other thing is, is if a family member sees that a loved one has received poor care in a nursing home, they need to go up the chain of command, meaning that nurses and aides have charge nurses and other personnel. that oversee how they care for patients. So be sure if something is happening that you report it up the chain of command to as many superiors as possible to document, you know, for later on that poor care has been provided. And then if neglect is happening and you feel like something is not right, your gut will tell you that, or that you can observe something physically wrong with your loved one. Immediately request a transfer to the hospital. Nursing homes will often comply with those requests, especially if there are situations, certainly from a medical standpoint— malnourishment, dehydration, whatever it may be. They'll honor those requests and they'll get your loved one to a hospital where greater attention and oftentimes better care will be provided.

I don't know if it's how important or why it's important to have legal representation when dealing with suspected nursing home negligence.

Oh, it's extremely important because oftentimes, and people don't realize this because they just often are signing forms to get their loved one admitted, but one of the things nursing homes have tried to do more recently is include in the incoming paperwork something called an arbitration agreement. Where the family and the patient are waiving their rights to file a case for a violation of Chapter 400, the residents' rights statute, and agreeing upfront that if something goes wrong, they'll just go into an arbitration proceeding, which oftentimes is a venue or a proceeding that is really run by the industry and run by the nursing homes. And oftentimes when we look at cases, we see patients sign the arbitration agreements before they got there and then received terrible care. We have been successful in overcoming those arbitration agreements and getting them thrown out of court for lack of meeting of the minds or informed consent and other reasons that then allow us to bring a case where the outcome was less than optimal when a patient went into a nursing home. So it's, it's, it's imperative to, to make sure you get legal representation so that the family has an understanding of what the arbitration agreement is, what it means, and how to overcome it. And then navigating Chapter 400 is something that we do all day, every day. And in certain— by looking at the medical records, we're going to be able to tell what rights have been violated, where the neglect came from. And how, how often a loved one may have received poor care. And then the third issue is, which is just as important, being able to identify where records were falsified, either where records were not completely accurate because information was left out in a purposeful way, or even where someone has gone into the records after the fact and either scribbled things out. Changed things or created documentation that was untrue. And through our experience and our experts, we're able to figure those things out.

Are these arbitration agreements signed at the admittance stage, or are they signed afterwards? When do people sign these?

Sorry, they are at the admittance stage. So when you fill out all the initial paperwork, you may get a stack of documents that's 10 or 15 pages long and say, sign here, sign here. One of those documents is the arbitration agreement, and many times it's signed by the patient themselves depending upon their medical and cognitive condition. And if that happens to be bad, it's signed by a family member. So depending upon the circumstances of the situation, it can be signed by either or. They have real legal consequences, but we have great, great experience and great success in terms of getting them tossed out and being able to proceed with our cases.

Should they refuse to sign it? Is it possible, or does it mean if they refuse to sign it that they're refusing to be admitted into this particular facility?

That's actually a great question. The nursing homes have gotten smarter in terms of trying to make them more enforceable, and they actually put in the arbitration agreement that this is not a condition of admission. Meaning that if you refuse to sign it, we can still admit— we'll still admit, um, you know, your loved one. So it's something that if you get one of those and you're, you're familiar with this issue, uh, read it, go over it, and if that provision is in there, meaning it says this is not a condition of admission, then refuse to sign it, and then it doesn't create an issue later.

Oh, that's great to know.

Yep.

How about any measures family members can take, uh, for an elderly parent, uh, that they can implement so they can avoid neglect and ensure proper care?

Well, uh, there's a few things you can do. Physical presence is always paramount, meaning visit your loved one, go see them, talk to the nurses, you know, become familiar with who is caring for your mom or dad or grandmother or grandfather. Oftentimes having a physical presence in the facility, it's just human nature. We've seen, you know, we've seen situations where it's created an atmosphere where people tend to get the best care and the best attention, as opposed to someone who's there in the facility and someone never comes and sees them, and they're in the room by themselves all the time. Communication in these facilities becomes very, very, very important. And then one of the things we also recommend is you can actually bring in a third-party auditor, an RN who will come in depending upon how often you want to do this. You know, once every couple weeks. We'll review your loved one's chart, look at the medications he or she may be receiving. It's not uncommon in nursing homes to see patients sometimes be overmedicated or be receiving a combination of medications that can be, you know, can be affecting their ability to function on a daily basis. So you'll get a third party to look at that and, you know, can help in terms of just making sure monitors and bed rails and safety measures are in place to make sure that your loved one doesn't get hurt. And then, you know, one thing that is really important too is, in addition to the arbitration agreements that we talked about, is when you're, when you're going into a facility or selecting a facility, many of these nursing homes no longer carry insurance or underinsured. Many of them still have great coverage or great insurance such that if something goes wrong, you have the ability to seek compensation if a problem is created by the nursing home. So you can ask for a certificate of insurance. You can ask about, you know, what protective measures are in place by the insurance company to protect you and your family in case something doesn't go— doesn't go the way you want or bad and unfortunately ends up in an injury.

Well, if I understand what you're saying, if you're a daughter or a son, you need to be proactive and ask for the certificate to see if they have proper insurance.

Yeah, and don't be shy about bringing in a third-party auditor. Medical providers who do the right thing and really care about patients, they often welcome that. It's not uncommon to see doctors and nurses collaborate about patients and listen to different ideas. So we've seen situations where RNs have come in and really helped. And because many of these nurses and aides in the nursing homes are overworked, Or taking care of too many patients, as opposed to being defensive about it, they actually appreciate the help and the extra eyes and ears.

Well, it sounds like the good facilities would be open to that care, that type of extra care for their patients and clients. I don't know if you have any views, but what impact do you hope your work has on the standards of elder care in nursing homes nationally?

Oh, it's a great question. I think what we do, and as the watchdogs, you know, we just lend, um, our efforts to make the facility safer, um, so that when, you know, loved ones go into a nursing home, you know, we hope, we hope that they are there getting the best care within a safe environment. And I think with safety comes, um, comes, you know, compassion. compassionate care. Oftentimes, when loved ones get to the point they have to be in a nursing home, they obviously have other medical issues going on and they are in later stages of life. So it's about being safe on a day-to-day basis, but it's also about making sure they're receiving compassion along with The loved ones being there and helping them in terms of, you know, getting through probably some rough times and hopefully stabilizing through some medical situations. But, you know, overall, I think providing them dignity and compassion in a safe environment is really, I think, and hopefully the best we can do and what we should be doing for our elderly population.

Lastly, maybe you can share a case study or story where your firm successfully Sure.

We unfortunately represented a family where a woman in her early 70s had to go into a nursing home because she developed some memory problems and some cognitive problems. And when she went into the facility, she was a great fall risk and a wandering risk because of her cognitive issues. Uh, and when someone like that goes into a nursing home, it's routine and the standard of care for bed rails to always be up and alarms to be placed such that, such that if a patient like that tries to get out of bed, either to go to the bathroom or stand up, the bed rails are there to prevent that. And even worse, if she tries to get up or he tries to get up and wander out of the room, then the alarms go off. Well, in this unfortunate situation, despite the risk factors, the bed rails were not in place, the alarms had not been placed, and a family showed up to see their loved one on like a random Tuesday in the facility around dinnertime. And when they got to the room, their loved one wasn't there. She was missing. She was gone. Which the whole facility went into a panic and started looking for her. No one could find her. Approximately 15 minutes later, they found her outside slumped against a chain-link fence and unfortunately had been attacked by hundreds and hundreds and hundreds of red ants, given where she was sitting. And they rushed her to the hospital, but she did not— given her underlying condition, she did not survive the red ant attacks and she died. And it was, it was a situation where, you know, the neglect and not instituting the right safety measures led to a horrible, horrible outcome for that family.

That's such a, that's such a sad story. I can't imagine something like that happening to, you know, one of my parents.

Absolutely.

Well, Joe, it's always insightful to have you on the show. And I look forward to seeing you in the very near future. Thanks for coming on.

Thank you, Renee. Always a pleasure.