Source: https://www.pennsylvanianursinghomeabuseattorneyblog.com/category/pennsylvania-nursing-home-news/
Timestamp: 2019-04-26 13:11:28+00:00

Document:
The American Thoracic Society met for their annual conference where findings from a recent sepsis study was presented. Sepsis infections also known as blood infections can cause whole body inflammation, organ decay, and in some severe cases death. Sepsis is particularly fatal among the elderly and those with weakened immune system such as infants and those with HIV/AIDS. At the annual conference the researchers of a recently published study in the Journal of American Medical Association discussed the deadly effects of sepsis and the increased rate at which emergency departments are seeing patients present with sepsis along other infections. The occurrence of sepsis has been steadily rising with about one of out every 10 patients being treated for sepsis in U.S. hospitals. Even more telling the study found that 52 percent of those who died in a hospital were diagnosed even if sepsis was not the direct cause of the patient’s death. Dr. Vincent Liu, the lead study author indicated that the researchers were surprised at the number of deaths in which sepsis was present. Approximately as many as “1 in 2 patients dying in the US hospitals had sepsis.” Further stating the need for improved care for sepsis patients in order to save many more lives.
Sepsis deaths have been on the rise according to the U.S. Centers for Disease Control and Prevention. During a ten-year span from 2000 to 2010, the rate of deaths associated with sepsis infections increased 17 percent equating to a death toll of 135,000, an increase from 45,000 deaths. The Mayo Clinic defines sepsis as a “potentially life-threatening complication of an infection.” Sepsis, which is the body’s response to fighting a severe infection often caused by pneumonia, abdominal infection, kidney infection or a bloodstream infection such as bacteremia, can trigger inflammation throughout the body. The inflammation can prove deadly as damage to multiple organ systems can occur, if left to progress sepsis can also cause blood pressure to severely drop which may also lead to death. The longer a patient goes untreated with sepsis the lower the chances of survival. Early treatment is particularly important for those with advanced aging.
It has even been suggested that for those over the age of 65 who contract sepsis the long-term effects may include being susceptible to cognitive impairment. A 2010 study in the Journal of the American Medical Association authored by the lead researcher Theodore J. Iwashyna, MD, PhD, of the University of Michigan Medical School, found that sepsis may have a direct link to 20,000 new cases of dementia among those 65 years or older who contract sepsis each year in the U.S. While there have been advances in the treatment of sepsis prevention among the elderly is vital to their survival and overall quality of life. Vaccinating those with compromised immune systems against the flu and pneumonia is still one of the best practices available.
When a family makes the decision to transition a loved one into a nursing home it can be an overwhelming and understandably emotional experience. The daily care, safety, and overall wellbeing of your loved one are being placed in the hands of another. It is a duty that many nursing home staffs and facilities pride themselves in excelling in. U.S. News & World Report has released their sixth annual data and ratings results of nearly every nursing home in the United States. The search tools and valuable information within the detailed U.S. News database can help make choosing a nursing home a better, quicker, safer, more informed experience. The user-friendly search tools gives a multi-layer approach in finding a suitable nursing home that meets the needs for you or a loved one. It is estimated that over 3 million Americans live in approximately 16,000 nursing homes throughout the United States. That number is expected to only increase as the nation’s older adult population continues to steadily climb. Much of the raw data relied on by U.S. News in rating nursing homes comes from Nursing Home Compare, the federal database detailing every Medicare and Medicaid certified nursing home in the country. You can search by state, region, city, or zip code, or by a numerical star rating of 1 to 5. The 2014, ratings of 1,893 nursing homes in Pennsylvania indicate that 702 nursing homes, about 25 percent, earned a five-star rating, while less than 5 percent of Pennsylvania nursing homes earned a one-star rating.
There are three key areas that the overall ratings correlate to, the nursing home’s individual ratings of their (1) state-conducted health inspections, (2) sufficient nursing staff and, (3) the quality medical care measures. As a nursing home injury specialist with practices in both Pennsylvania and New Jersey, when looking at a nursing home’s overall rating, I place particular importance on a nursing home’s nursing staff rating. The nurse staff rating relates to the average number of hours per day of care received per resident from nurses and physical therapists. A nursing home with a low rating for nursing staff raises concerns as understaffing is the leading cause of neglect and abuse in nursing homes and long care facilities. When a nursing home is inadequately staffed the required daily care to stave off fatal infections, pressure sores, devastating falls, and to meet the minimal quality of care required by both federal and state regulation, is often found lacking. Sufficient staffing is a critical component in running a safe, clean, well managed nursing home, so much so that all nursing homes participating in Medicare are required to meet specified requirements of the Federal Nursing Home Reform Act, part of the Omnibus Budget Reconciliation Act of 1987. Specifically facilities are legally required to have “sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident.” Therefore, when narrowing down the choices of a nursing home facility remember to pay close attention to the nursing home’s staff rating, as this singular component can have life-altering effects.
I have spoken extensively about nursing home arbitration clauses often placed within nursing home admission papers. An arbitration clause has the power to dictate which causes of action can go before a jury and which must go through arbitration, a more discrete out of public view dispute resolution option. Arbitration agreements are construed according to contract law, requiring a valid offer, acceptance, and consideration. The recent case brought before the Pennsylvania Court of Common Pleas, Tyler v. Kindred Healthcare Operating, the court overturned the defendant’s preliminary objections to plaintiff’s wrongful death and survival complaint. The court held that the meeting of the minds could not be established when the decedent signed her admission papers for admittance into Kindred Healthcare nursing home. Further finding that the decedent’s daughter was also unable to act as the decedent’s power of attorney as the decedent had not given away any rights nor did the decedent authorize any family member to make any legal decisions on her behalf.
In Tyler v. Kindred Healthcare Operating, plaintiff Avenia Tyler brought a wrongful death and survival action against two nursing homes, Kindred Healthcare Operating, Inc. (“Kindred”), and St. Francis County House (“St. Francis”). Plaintiff alleged that decedent Ruth McNear, had developed necrosis, advanced pressure sores on her right lower extremity, and a second fracture to her right femur which required surgery. Plaintiff further stated that Ruth McNear had passed away due to complications from the second leg fracture and subsequent surgery. At the time decedent’s death, McNear was in complete control and care of defendants. When proper care is taken bedsores should not be present in residents of nursing homes. Part of care plans for residents that have limited mobility is a reposition of the resident approximately every 2 hours. If repositioning continues to be overlooked or ignored, often as a means to save limited time in understaffed facilities, a resident can suffer bedsores, urinary tract infection, and even a wrongful death. As part of the Federal Nursing Home Reform Act of 1987, all nursing homes that receive federal funding are required to have “sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident.” Bedsores are the most common form of negligent care given in nursing homes. It takes time and pressure for a bedsore to begin to form and even more time for the pressure wound to become infected.
Ultimately the court held that the arbitration clause could not be enforced as the decedent was not competent at the time of signing and therefore there was no meeting of the minds when the contract was executed. Medical records note at the time of signature decedent was disoriented and her thoughts were cloudy. While a resident at the nursing homes, nurses noted that decedent was both confused and impaired. St. Francis the second nursing home for the deceased Ruth McNear wanted to enforce the arbitration clause despite the late McNear state of confusion. The court held that the decedent’s daughter could not act as her mother’s agent simply because there is a familial relationship. Instead, the court held that the decedent would have had to given Lynette, her daughter power of attorney or at the very least the authority to make legal decisions on her late mother’s behalf. Accordingly, the court held in favor for the plaintiff finding that the survival action could not be severed from the wrongful death action.
A recent ruling by the Court of Common Pleas in Philadelphia, upheld the federal and state public policy that favors promoting arbitration agreements. There are definite plus and minus to arbitration. Especially true with nursing home arbitration agreements, where the publics’ knowledge of a nursing homes’ safety record is greatly limited. Before placing a loved one into a facility checking their safety record of known allegation of serious abuse and neglect is of great importance. However, when a party is bound by contractual principles, which upholds arbitration agreements, instead of being able to file a lawsuit that is public record, these legal disputes are processed in a more private manner. It has long been touted as an efficient, and less costly alternative to trial litigation, enabling the courts to free up limited resources and time. Often, nursing home companies’ favor, and accordingly place an arbitration agreement clause into their contracts, a contract which is required to be signed prior to admission into their facility. As was the case in Lipshutz v. St. Monica Manor, the Philadelphia Court of Common Pleas found that the survivorship action related to a wrongful-death case was bound by the arbitration agreement and further upheld by federal law.
In Lipshutz v. St. Monica Manor, the plaintiffs brought a wrongful death and survival claims on behalf of their deceased mother and her estate under Pennsylvania’s Wrongful Death Act and Survival Act. Decedent suffered a stroke on November 4, 2011 at which time she was taken to Jefferson University Hospital. The decedent was discharged with an “impaired mental status” unable to care for herself. On November 11, 2011, decedent’s daughter, plaintiff Elizabeth Lipshutz, acting as her mother’s power of attorney, signed an admission agreement which contained within a mandatory arbitration clause. On May 16, 2013, plaintiffs alleged that the substandard care at St. Monica Manor was the direct cause of the decedent’s untimely death.
Because the decedent’s daughter acted with the authority and in a representative capacity, the court held that the survival claims had to be remanded to arbitration. At the time of the signing there was a valid contract supported by fundamental contract principles, such as a valid offer, acceptance, and consideration and that no traditional defenses to formation were available. The court held that the Federal Arbitration Act (“FAA”) pre-empts Pennsylvania civil procedure rules, Pa.R.Civ.P. 213(e), which requires wrongful-death claims and survival claims to be litigated together.
In determining who was bound by the arbitration clause, the court looked to Pisanco v. Extendicare Homes, Inc., which determined that “one who is not a party to a contract cannot be bound by it, and that arbitration agreements are not binding on non-signatory beneficiaries.” Here, her four children, three of whom did not sign an arbitration agreement with St. Monica Manor, survived the late Mrs. Lipshutz. Therefore, Elizabeth Lipshutz signing of the agreement in her capacity of power of attorney bound her late mother’s decedent’s survival claims to arbitration, but did not affect her own right or the rights of other surviving beneficiaries to bring wrongful death claims. While the Court of Common Pleas is not the highest court in Pennsylvania, if higher courts uphold the ruling, it can soon become precedent in the state.
Earlier this month, in a devastating and gruesome parking lot accident, a group of pedestrians were run over after leaving church in Bradenton, Florida. At approximately 11:20 a.m. Sunday, February 2nd, 2014, 79-year-old Doreen Landstra, of Palmetto FL., was seen backing out from a handicapped space at the Sugar Creek Country Club. 1 pedestrian was declared dead at the scene, while 2 more were pronounced shortly after arriving at local area hospitals. Another 4 pedestrians were transported in critical condition; no word has been released at this time on their current condition. According to the Bradenton Herald, Florida Highway Patrol sighted Doreen Landstra the driver of the white Chevrolet SUV with “improper backing.” If found guilt of this non-criminal moving violation, Florida’s mandatory punishment imposed where there is a fatality involved, is a fine of $1,000 and suspension of one’s license for six months. This week’s earlier church parking lot accident was not the first for Landstra. Only two and a half years earlier, on July 28, 2011, Landstra accidentally drove her 2009 Chevrolet Tahoe into a McDonald’s restaurant as she tried to pull into a parking lot space. The Centers for Disease Control and Prevention (“CDC”) finds that as drivers age, their risk of being severely injured or killed in a motor vehicle crash increases. The most recent CDC statistics finds that nearly 500 older adults are injured daily due to motor vehicle accidents.
As a personal injury lawyer, practicing in both Pennsylvania and New Jersey, I understand the complexities and life-altering events a parking lot accident can have especially on our older population. Many older Americans can quickly have their freedom and quality of life greatly impacted if they are involved in a motor vehicle accident, both as a driver and as a pedestrian. In this case, 8 such lives were greatly affected by Sunday’s parking lot accident. A tragedy such as being struck and run over by a car can require expensive medical bills, a long stay in a hospital, extensive physical therapy, and in some rare cases it may require that the injured party check into a long-term care facility, while they heal from the injuries sustained.
Nationwide, according to the June 2008 National Highway Traffic Safety Administration (“NHTSA”) study, pedestrians are more likely to be fatally injured between the hours of 3 a.m. and 6 a.m. and especially during the weekend days of Saturday and Sunday. Parking lots in particular can seem like a mind field for drivers and pedestrians alike. As one ages their eyesight also degrades making it more difficult to see at dusk, and at night. On average, a vehicle fatally injures 13 pedestrians every day. While many do not consider parking lots a place to drive with added caution, such as in a school zone, in parking lots pedestrians and other vehicles can act unpredictability. Unpredictability when driving can increase the likelihood of being involved in a parking lot accident.
In Pennsylvania, if you are a driver over the age of 55, you are eligible to receive a 5 percent discount on your vehicle insurance, if you complete a Pennsylvania Department of Transportation approved Basic Mature Driver Improvement Course. In order to maintain the discount the driver would have to take a supplemental Refresher Mature Driver Improvement Course, every three years. The courses are offered through AAA, AARP, or Seniors for Safe Driving.
Courts and Not Arbitrators Have Jurisdiction Over Pennsylvania Nursing Home Lawsuit – Pisano v. Extendicare Homes, Inc.
I’ve written a lot here about the trouble with arbitration agreements in nursing home negligence lawsuits. Arbitration is a form of “private judging” that allows disputes to be resolved out of court. It’s often touted as quicker and less expensive than going to court, and thus advantageous to both sides of the dispute. But for nursing home companies, arbitration is often the preferred solution because it allows them to hide allegations of serious abuse or neglect, away from public records. In some cases, arbitration companies have even been known to decide cases in a way that’s most favorable to their customers–the nursing home companies, who send them the cases and sometimes pay all of the bill. That’s why I was pleased to see Pisano v. Extendicare Homes, Inc., a Pennsylvania Superior Court case denying an attempt to take the dispute to arbitration.
Vincent Pisano was admitted to Belair Health and Rehabilitation Center in April of 2010. His daughter, Jamie Pisano, had his power of attorney at the time and executed an agreement saying any dispute would be resolved by mandatory binding arbitration. Some time later, Vincent Pisano died at the facility. His family alleges negligence by Extendicare (doing business as Belair) in a wrongful death lawsuit filed by son Michael Pisano, individually and as administrator of his father’s estate. Jamie Pisano executed a disclaimer and renunciation in October of 2011, giving up all proceeds in a recovery for wrongful death, and is thus not a party to the case. In trial court, Extendicare objected to the court’s jurisdiction, citing the arbitration agreement. The trial court refused to compel arbitration, however. The parties agree that the agreement is valid and binding, the court said, but the wrongful death action was outside its scope.
Extendicare appealed, but the Pennsylvania Superior Court affirmed. In Pennsylvania, wrongful death actions by the estate of the deceased are separate from survival actions by the deceased person’s immediate family. In this case, the agreement in dispute is broad enough to cover tort claims as well as contract claims. In relevant part, it says the parties agree to arbitration of “all disputes arising out of or relating in any way to this Agreement or to the Resident’s stay at the center [including] …wrongful death.” Thus, the case turns on whether a Pennsylvania wrongful death lawsuit is derived from Vincent Pisano’s rights. The Superior Court ruled that it is not. Pennsylvania courts have consistently ruled that wrongful death and survival actions are two separate rights of action deriving from a single death, the court said, but not from the decedent’s rights. Thus, because Extendicare’s agreement is between it and Vincent Pisano, it does not bind his family, the court found.
This is good news for Pennsylvania families that suffered a wrongful death because of nursing home abuse or neglect. The Superior Court is not the highest court in Pennsylvania, but if its reasoning is adopted by higher courts, it will be settled law in our state that arbitration agreements don’t bind family members who never signed them. And that’s important, because as I mentioned, arbitration is often not friendly to families hurt by nursing home abuse in Pennsylvania. It takes away their right to settle disputes in open court, file appeals and more. If this case is appealed further, I will be interested to watch its progress.
Because I practice nursing home abuse law in Pennsylvania, I was interested to see that publicly owned nursing homes are rapidly dwindling in our state. According to the Pocono Record, Monroe County’s government is considering selling its publicly owned Pleasant Valley Manor, in part because it’s running at a loss. To the west, Franklin County is already in the process of selling its nursing home, Falling Spring Nursing and Rehabilitation Center. One Monroe County Commissioner, Charlie Garris, noted that the trend in Pennsylvania counties is increasingly toward selling county-owned homes. But residents of both counties expressed concerns about the quality of care in the homes as they transitioned from public, nonprofit ownership to private, for-profit ownership. The news comes on the heels of an announcement from the Catholic Archdiocese of Philadelphia that it will sell several nursing homes in greater Philadelphia.
In Monroe County, the commissioners are considering a sale because the home is losing money. Pleasant Valley Manor lost $940,000 in 2012 and had already lost the same amount in the first six months of 2013. Garris noted that a supplier of food to the home once withheld its deliveries until it got paid, suggesting that the home’s administrators were behind on payment. The only commissioner to publicly oppose a sale is Suzanne McCool, who said the county has a moral obligation to take care of elderly and infirm residents. The article said “there’s a fear” that a for-profit home might not take indigent residents.
In Franklin County, Commissioner Robert Ziobrowski said county-run homes are no longer needed for indigent Pennsylvanians, because Americans can now rely on Medicare and Medicaid as well as private insurance. They have chosen two finalists from among the 10 private companies that offered to buy Falling Spring. But according to the local newspaper, Franklin County residents are concerned that private ownership will result in a drop in quality of care.
I share that concern. In my experience pursuing nursing home neglect lawsuits in eastern Pennsylvania, there is genuine cause for concern when nonprofit homes are sold to for-profit companies. As I noted in my blog post about the Catholic Church’s sale of homes, studies show that nonprofit homes do better on multiple measures of care, including staffing ratios, number of bedsores, citations from government regulators and more. Indeed, one study concluded that statistically, for-profit ownership leads to an additional 7,000 pressure sores a year. The difference may be attributed to things like attempting to get along with fewer employees or employees who are not well trained, both of which can lead to overwhelmed employees who cut corners or forget important tasks. Nursing home abuse is devastating and sometimes fatal; Pennsylvanians should think very carefully before doing anything that could lead to more of it.
Based in Philadelphia, Rosenbaum & Associates represents clients across eastern Pennsylvania who have suffered serious injuries from abuse or neglect at a nursing home.
As a Pennsylvania nursing home lawyer, I was interested to see reports that the Catholic Archdiocese of Philadelphia plans to sell six nursing homes in greater Philadelphia. According to the Philadelphia Daily News, the archdiocese is selling six nursing homes and one assisted-living facility in order to address financial problems. Three of the homes are in Philadelphia: Immaculate Mary Home, St. John Neumann Home and St. Monica Manor. St. Martha Manor and Villa St. Martha are in Chester County, St. Francis Country House is in Delaware County, and St. Mary Manor is in Montgomery County. The announcement comes after several years of financial problems for the archdiocese. The National Catholic Reporter said the homes ran a deficit of $1.4 million at the end of fiscal year 2012.
In all, 1,400 residents will be affected by the proposed sales, as well as more than 2,000 employees. The archbishop for Philadelphia, Charles Chaput, said it will be a condition of the sale that no residents will be evicted, and “every effort will be made” to retain employees. As a Philadelphia injury lawyer, I am concerned for these residents and employees, because a sale is likely to mean a change to for-profit status. Studies show that nonprofit nursing homes generally deliver higher-quality care than for-profit homes, as measured by factors like citations by government regulators, use of restraints, number of bedsores the residents sustain, and staffing ratios. A 2009 meta-study published in the British Medical Journal drew that conclusion, echoing 2002 and 1991 studies. Among other things, it said, there are 7,000 pressure sores per year that can be attributed to for-profit care, statistically speaking.
It’s not a given that for-profit status inevitably leads to Pennsylvania nursing home abuse, but if I had a loved one in one of these Catholic facilities, I would watch the sales closely. In my experience as a Philadelphia medical malpractice lawyer, for-profit status can lead to neglect when profit-motivated owners choose to understaff their homes or hire cheaper, unskilled workers. Overworked employees may skip or simply forget needed care, leading to problems like bedsores, missed medications or lack of attention to basic nutrition and hydration. In more serious cases, nursing home employees have been known to steal residents’ drugs, physically abuse them or overuse psychiatric drugs as “chemical restraints” against unruly dementia patients. All of these are forms of abuse and neglect in nursing homes, which no Philadelphia family should have to experience.

References: v. 
 v. 
 v. 
 v. 
 v. 
 v. 
 v.