Do you have an emergency preparedness plan for your home and family? Do you have an evacuation plan in the event you have to leave the area? Do you keep extra batteries for flashlights… a well-stocked first-aid kit… a supply of bottled water?  Well, the federal government requires that nursing homes have specific plans in place for how they plan to protect their sick, frail residents from natural disasters, such as tornados, hurricanes, floods, and fires. Sadly, inspectors have found that the plans are weak or nonexistent.

According to an article in the News & Observer, the department of Health and Human Services has been investigating emergency plans of of nursing homes ever since Hurricane Katrina seven years ago. Now, their report says that current plans lack relevant information, such as how to coordinate with local authorities, how to notify relatives, and how to keep track of residents’ medications. They recommend that Medicare and Medicaid add mandated specific planning and training steps to the current disaster plan requirements.

While nursing homes can easily pull out written disaster plans, the proof of true preparedness lies in how well the staff respond in an actual emergency. So inspectors dug a little deeper into the records of 24 selected nursing homes in California, Louisiana, Minnesota, North Carolina, North Dakota, Tennessee, and Texas. All 24 facilities had been affected by a disaster, and 14 had evacuated. According to the N&O article:

Of the 24 emergency plans, 23 did not describe how to handle a resident’s illness or death during an evacuation. Also, 15 had no information about specific medical needs of patients, such as feeding tubes and breathing equipment. Seven plans were silent on how to identify residents in an evacuation, such as by attaching wristbands or name tags. Inspectors said 15 made no provision for including medication lists.

None of the nursing homes met a government recommendation for a seven-day supply of drinking water if residents had to shelter in place and their regular source of water was unsafe or unavailable.

Twenty-two had no backup plans to replace staff members unable to report for work during a disaster.

Transportation was an Achilles’ heel. None of the nursing homes had planned to ensure transportation of adequate food and water for evacuated residents, while 19 had no specific plan for transporting wheelchairs and similar equipment. Twenty-two of the plans did not describe how the nursing home would transport medications.

Let’s hope that the results of this investigation lead to some real changes with actual benefits to residents. We’re not going to hold our breath: Medicare chief Marilyn Tavenner agreed that training steps should be added to the current regulations, she offered no timetable for doing so. Will it take another disaster on the level of Hurricane Katrina to have them heed the call to action?

To read the full article in the N&O, click here:  Big gaps found in nursing homes’ disaster plans

Even here in North Carolina, where winter is mild and snow melts almost before it hits the road, influenza is wreaking havoc on everyone of every age. The populations most at risk are the very young and the very old, but even the healthiest people are affected this season.

The latest casualty:  18-year-old Katie Taylor from Cary, NC.  According to an article in the the News & Observer, high school senior Katie was admitted to the hospital on Wednesday, but her heart failed and she died on Thursday.

“It was very fast,” Roy Taylor [Katie's father] said. “I want to make people aware that this is a very serious strain and they shouldn’t take it lightly.” …

State health officials said Tuesday the uptick in cases is likely to continue for another two or three weeks, hitting a high in early March. ”There is still time for vaccination,” said Dr. Zack Moore, state public health epidemiologist, adding that a flu shot takes about two weeks for full protection to kick in. Flu shots are still available at many area pharmacies, plus for free at public health clinics.

Our Most Fragile Citizens

While teenagers are vulnerable to serious flu complications, the elderly are at the mercy of every virus they come into contact with. Today, the Huntington Herald-Dispatch offers tips for visiting nursing homes during flu season:

• If you are sick, don’t visit. As much as nursing home residents enjoy visitors, you may leave behind viruses that linger long after you leave.
• If you must cough or sneeze while in the nursing facility, cover your mouth with a handkerchief…or use the crook of your elbow.
• Wash your hands before entering the facility, and before touching your loved one.
• Use a gloved hand or a cloth to touch common surfaces, such as doorknobs, sign-in pens, or light switches.

For more information about the flu, including prevention and treatment, click here: CDC Seasonal Influenza

To read the full N&O article, click here: http://www.newsobserver.com/2011/02/09/976883/teens-death-points-to-flus-danger.html#ixzz1DThfroIt

To read the full Herald-Dispatch article, click here: Tips offered for visiting nursing homes

In North Carolina, if a restaurant scores below a “C” grade for sanitary reasons during a health inspection, the business must close until it passes inspection.  If property owners allow their homes to fall into disrepair, the state can condemn the residence as unsafe, and in some cases, the building may be demolished.

But if a nursing home “fails” Medicare inspections…or if the facility has a history of unsafe practices, or of hiring workers who bring harm to the feeble and elderly residents, do you know what happens?

There’s a small fine. But that’s more than offset by the money Medicare will continue to pay into the nursing home on behalf of the patients living there.

Case in point: Britthaven of Chapel Hill.  This nursing home also has been rated by Medicare as one of the worst in the country. Britthaven of Chapel Hill has been called out as a “Special Focus Facility,” which means that they have a history of persistent poor quality of care. In February, six Britthaven patients were hospitalized from morphine overdose…one patient died of complications. A nurse has been charged with murder in that case.

And now, this article in Saturday’s News & Observer, and this article in today’s newspaper.

If you have legal questions about nursing home care, feel free to contact the attorneys of HensonFuerst. If you have questions, we have answers.

Message received:  Getting older doesn’t mean giving up on health.

An article in today’s News & Observer reports that more senior living communities and facilities are offering state-of-the-art fitness machines to keep up with the demand by residents. Previously ignored, senior fitness is now a burgeoning business.

“Change came slow; however, now it is happening at a frantic pace,” said Colin Milner, CEO of the International Council on Active Aging. Now, he says, communities have their own fitness facilities with the best equipment money can buy.

In North Carolina, the issue is of particular importance due to our status as an ideal retirement destination. Warmer than the north, but without the relentless heat of Florida, North Carolina is the go-to spot for new retirees… and current residents don’t plan on migrating away. By 2020, our senior population is projected to increase by 88%–from about 70,000 now to about 128,000.

The benefits are obvious:  Greater endurance and strength… prevention of muscle deterioration… and improved balance to prevent falls. According to the Centers for Disease Control and Prevention (CDC), falls are the leading cause of injury deaths and trauma hospital admissions, and each year more than one-third of adults 65 and older fall.

In the newspaper article, Janie Clark, a physical therapist and president of the American Senior Fitness Association, offered these exercise tips for seniors (check with your doctor, first):

• Walk or swim. Taking a walk can get your heart pumping and blood flowing.
• Strength train. Lift dumbbells or tug resistance bands.
• Stretch. Sit up straight and try to bring your shoulder blades together.
• Practice your balance. Hold a chair as a support and stand on one foot.

The National Institute on Aging has “The Age Page” on its website with more health and exercise tips for seniors. You can also order the institute’s free book by going to www.nia.nih.gov and searching for “Exercise and Physical Activity: Getting Fit For Life.” The book will be available later this summer.

To find a senior community that offers exercise and wellness options, visit the International Council on Active Aging website at www.icaa.cc. Scroll over “Consumer Section” and click “Facility/services locator.”

To read the full article: http://www.newsobserver.com/2010/06/22/544555/seniors-want-to-take-gym.html#ixzz0raraELya

One patient from the Alzheimer’s unit of Britthaven of Chapel Hill nursing home died…six more have been hospitalized after opiates were found in their system…three others were hospitalized as a precaution. You know what happened to the staff? According to a report in the Raleigh News & Observer, they were put on paid leave. Paid. Kind of like a vacation.

Managers from Britthaven’s corporate offices were brought in to investigate. We truly hope that some drastic action will be taken, but we’re not holding our collective breath. This nursing home is one of the facilities that failed to show significant improvement after being tagged by Medicare as a “Special Focus Facility,” which is a gentle way of saying that they provide substandard care, and that serious problems persisted for a long time. (See our earlier blog about this rating.)

According to the newspaper, criminal investigation has not been launched.

We’ll keep you posted on further developments.

It’s a case of adding insult to injury–literally.

HensonFuerst, a North Carolina injury law firm, successfully fought on behalf of Marine veteran Joe Cooper, who was severely and permanently injured due to abuse and neglect he suffered at the hands of people who were supposed to care for him. Countryside Villa assisted nursing facility in Cumberland county had been ordered by a judge to pay $1.2 million in damages.

According to an article in Raleigh’s News & Observer, the owners of the abusing facility, John and Janice Weeks, filed for bankruptcy. Meanwhile, Countryside Villa is still open and operating. Business as usual. So it was a case of justice properly served, but with no beneficial outcome for the Cooper family. No peace of mind.  No compensation. No punishment for the abusers.

I wanted to bring attention to the fact that I placed my dad in a facility expecting them to treat him like a human being.

(Victim’s daughter, Barbara Cooper, as quoted in the News & Observer newspaper.)

This was not a minor case of abuse.  In a single January 2003 incident, Joe Cooper suffered a head injury and concussion, respiratory failure that required a breathing tube, and the loss of several upper and lower teeth.

The take-home message for those who need to place their loved ones in a nursing facility:  Ask whether the facility has adequate liability insurance…and ask for proof! At a bare minimum, they should carry $1 million in liability coverage. Good nursing homes carry $10 million or more. If the facility won’t or can’t show proof of coverage, go somewhere else.

(News & Observer article can be read in full here: http://www.newsobserver.com/news/local_state/v-print/story/314783.html)

According to Catherine Goldman, senior practitioner with Wake County Human Services, the home needs sharp regulatory eyes trained on it to protect residents.

“These folks are at risk,” Goldman said Wednesday. Consequently, the home has a no-star rating due to problems like a smoking-related building fire, high rates of medication mistakes, electrical hazards and food described for the record as “nasty,” according to state and county records.

Click to read Tommy Goldsmith’s article in today’s News & Observer.

Various operating entities, wholly or partly owned by Trefzer—a Hickory entrepreneur—manage 20 assisted living centers in North Carolina, with operations divided among a series of limited-liability entities, according to The News & Observer.  Since Trefzger began managing Zebulon House in Wake County last summer, the long-term care center has racked up citations for a four-month infestation of bed bugs, for diverting residents’ funds without permission and for mistakes in dispensing medicine.  The N&O’s Tommy Goldsmith reports, “Trefzger’s homes have accumulated fines of close to $100,000 for 20 top-level or second-rank violations since 2003.”

Click to read Tommy Goldsmith’s entire article.

“In a front page story on Christmas Eve in the Raleigh News & Observer titled: Nursing-Home Records Closed Off; Bush Administration Changes are Sharply Criticized by Patient Advocates” attention was brought to recent changes in federal rules that prevent or severely hinder access to patient information.”

 Click HERE to read the entire News & Observer article, including statements by HensonFuerst’s Anne Duvoisin

The federal Centers for Medicare and Medicaid Services released the ratings for individual homes online this morning.  They included ratings for 32 nursing homes in Wake, Durham, Orange, Chatham and Johnston counties. The ratings were based on health inspections, staffing and various quality measures. The poor ratings reflected such factors as high staff turnover, patients with bedsores, use of restraints and unrelieved pain.

Click HERE to read this Raleigh News & Observer article.