Tag: care plan

Nursing Home Abuse Prevention: Good Communication is Key

new jersey philadelphia nursing home abuse attorneys good communication negligence injuryI have spoken with hundreds of families to discuss whether they can sue for nursing home abuse. Bad, negligent, and abusive care at a nursing home can lead to a number of injuries, including – preventable falls and fractures, bedsores, medication errors, unfulfilled doctor’s orders, and sexual and physical assaults by staff and other residents.
The biggest complaint I hear from these families is that the nursing home does not properly communicate with them or their loved one’s physician. This is troubling for many reasons:

  1. Families expect good communication, and often operate under the assumption that no communication from the staff means no issues for their loved one.
  2. A nursing home resident’s primary care physician is usually limited to one visit to the nursing home per month. Your loved one’s doctor counts on the trained, professional staff at a nursing homes to be their eyes and ears, promptly identifying and communicating potential issues before they get worse.
  3. Nursing homes complain about the cost of many different preventative measures – but good communication does not cost them any extra money.
  4. Nursing homes are required to communicate with family members and physicians by state law.
  5. Good communication between the resident’s good care circle – the nursing home staff / the resident’s family / and the resident’s physician – is the simplest way to prevent the worst nursing home injuries abuse.

New Jersey State law REQUIRES:
(c) The facility shall notify any family promptly of an emergency affecting the health or safety of a resident.
(d) The facility shall notify the attending physician or advanced practice nurse promptly of significant changes in the resident’s medical condition.
[N.J.A.C. 8:39-13.1.]

Why don’t nursing homes always follow this law?

That is a question for which I never seem to get a straight answer whenever I depose a nursing home employee in a nursing home abuse case. I think the answer can be as simple as: they forget, they are lazy, or they are overworked. It could also be as complicated as: they are trying to hide the problem and fix it before anyone knows.
A good nursing home will demand timely communications between their staff and the resident’s families and physicians, and will recognize that communication is a cornerstone of providing good care and preventing nursing home abuse. A bad nursing home will not be vigilant about communication, and will often shock families and physicians when they tell them for the first time about dangerous problems that have clearly been going on for some time.

How do we know / how do we prevent this?

A resident’s primary care physician often responds to news of the resident’s medical problems with something like, “Why didn’t the staff at the nursing home tell me about my patient’s problems sooner?” A resident or their family member often learns about a bedsore by asking the staff, “What is that foul smell?” You will never hear these questions being asked to a nursing home that takes their duty of communication seriously.

Here are some tips to help prevent nursing home abuse injuries to your loved one when they are the resident of a nursing home:

  • Ask the staff a lot of questions about what could go wrong and how they prevent it.
  • Ask to be present for all care plan meetings with the Administrator.
  • Inspect your loved one’s skin for blemishes, bruising, broken skin, puss, and oozing.
  • Ask the staff to remove bandages so you can see what they are “covering up” (literally and figuratively).
  • Do not visit your loved one at the nursing home at the same time everyday.
  • Quickly go up the chain of command to nursing supervisors, the Director of Nursing, and the Nursing Home Administrator if your concerns are not being adequately addressed.
  • Put your concerns in writing to the Administrator.
  • Take photographs of anything that looks suspicious, especially problems with your loved one’s skin.

Despite the promises made by the nursing home when your loved one is admitted, you cannot think of a nursing home as a safe haven where your loved one is safe and protected. The better course of action is to think of the nursing home as a babysitter. You can leave your loved one alone at the nursing home – you just need to visit often, ask questions, and inspect your loved one and their surroundings.

NJ and PA Nursing Home Abuse Attorneys at the Mininno Law Office

If you or a loved one are the victim of nursing home abuse and injury, contact a nursing home abuse attorney at the Mininno Law Office. Let our hardworking NJ and PA nursing home abuse attorneys fight to get you the compensation you deserve.
Contact the Mininno Law Office for a free case evaluation, or call for a free consultation at (856) 833-0600 in New Jersey, or (215) 567-2380 in Philadelphia.

What is a Nursing Home Care Plan?

A care plan is a document specific to each nursing home resident that identifies all of their medical issues, the treatments the staff is supposed to provide to treat those issues, and a list of goals to reflect the expected improvement their medical condition.
A federal law known as OBRA requires nursing homes to provide a multi-disciplinary team of care givers who are charged with ensuring that the nursing home resident receives the care and services needed to ensure that the resident reaches and maintains “the highest practicable degree of physical, mental, and psychosocial well-being.”

This team is primarily made up of physicians, nurses, physical therapists, social workers, and dieticians (and essentially any other discipline involved in the resident’s care).
To deliver on the quality of care the resident and their family were promised by the nursing home, the team must develop a comprehensive care plan which provides a framework for the staff who are treating the resident on a day-to-day basis. To be effective and comprehensive, the care planning process must include the input of all caregivers that are involved in the care of the resident.

Care planning is an essential part of properly caring for a nursing home resident. A good care plan provides a ‘road map’ of sorts, to guide all who are involved with a resident’s care. A caregiver that was just hired, or is coming back to work from a vacation, can look at the care plan developed for a resident and know exactly what needs to be done to care for that resident.
A care plan is not a stagnant or stationary document. The care plan changes just as the resident’s condition changes. The care plan needs to be reviewed and updated by the caregivers, especially when there is a change in the resident’s condition.

What is a Care Plan Conference?

Care plans should be created at a care plan conference held at the nursing home. The resident, and their family members, should be involved in the conference. The nursing home should invite the resident, and their family members to attend the conference. If they don’t, the resident, and their family members should tell the nursing home Administrator that they would like to be present at the conference.
At the care plan conference, the resident’s medical issues are identified and the treatments that the staff is supposed to execute to care for the resident are set forth. Goals for improvement are set. Whether the resident’s health improves, or declines, the care plan needs to be adjusted to reflect the best way to treat the resident at that time.

It is important for the family to attend the care plan conferences because they can discuss what they know about the resident to ensure that the resident’s medical issues are properly identified. It is also important for the family to discuss and understand treatment strategies and goals with the caregivers.
Understanding a resident’s care plan will help the family understand what should be happening at the nursing home, and to bring it to the attention of the Administrator and resident’s physician if the family feels the care plan is not being followed. Not following the care plan can often lead to nursing home abuse, debilitating falls, and pressure ulcers for the resident.

Relevant Federal Statute concerning Care Plans

$483.20(d) (A facility must…) use the results of the assessment to develop, review and revise the resident’s comprehensive plan of care.

$483.20(k) Comprehensive Care Plans

The facility must develop a comprehensive care plan for each resident that includes measurable objectives and timetables to meet a resident’s medical, nursing, and mental and psychosocial needs that are identified in the comprehensive assessment. The care plan must describe the following:

(i) The services that are to be furnished to attain or maintain the resident’s highest practicable physical, mental, and psychosocial well-being as required under $483.25; and

(ii) Any services that would otherwise be required under $483.25 but are not provided due to the resident’s exercise of rights under $483.10, including the right to refuse treatment under $483.10.

Nursing Home Neglect: Mininno Law Office

If you or a loved one have been the victim of nursing home neglect or abuse, contact the Mininno Law Office immediately and get a free case evaluation. You could also call us toll-free at (856) 833-0600 in New Jersey, or (215) 567-2380 in Philadelphia.
Let us work to get you the compensation you deserve.