The largest single cause of injury to nursing home residents is injury due to a preventable fall. A typical 100 bed nursing home reports at least 100 to 200 falls per year. Keep in mind these are only the reported falls. Another danger facing nursing home residents is the development of preventable bed sores. A bed sore or pressure ulcer usually develops over a bony prominence and can range from a small bruise to a gaping hole in the skin which goes all the way down to the bone. The sores can rapidly develop and can cause serious health issues including life-threatening infection. In an effort to protect nursing home residents, the State of New Jersey implemented a law that requires nursing homes to render care so that it’s residents can avoid developing a bed sore and if a bed sore develops, that it is properly treated so that the bed sore is resolved.
Elder abuse, also known as nursing home abuse, involves damages incurred by an elderly individual/patient while under the complete or partial care of a nursing home in\ olved in elderly care.
Types of Injuries:
Medical/Health Injuries include bed sores (pressure ulcers), rashes, malnutrition, dehydration, infectious disease, bacterial infections, fractures and other orthopedic injuries.
United States Code: Title 42, Section 1395i-3:
(a) Skilled nursing facility defined
In this subchapter, the term “skilled nursing facility” means an institution (or a distinct part of an institution) which –
(1) is primarily engaged in providing residents –
And is not primarily for the care and treatment of mental disease^:
(2) has in effect a transfer agreement (meeting the requirements of section 1395x (1) of this title) with one or more hospitals having agreements in effect under section 1395cc of this title; and
(3) meets the requirements for a skilled nursing facility described in subsections (b), ©, and (d) of this section.
They range from a small bruise loa gaping hole in the skin which goes all the way down to the bone. They commonly occur in elderly people who are immobile or have limited mobility. The National Pressure Ulcer Advisory Panel (NPUAP) defines a pressure ulcer as “a localized injury to the skin and/or underlying tissue usually over a bony prominence as a result of pressure, or pressure in combination with shear and/or friction.”
THE LAW IS THAT THE NURSING HOME MUST RENDER CARE SO THAT THE RESIDENT CAN AVOID DEVELOPING A BED SORE AND IF A BED SORE DEVELOPS, THAT IT IS PROPERLY TREATED SO THAT THE SORE IS RESOLVED.
* In other words, the nursing home is responsible unless the bedsore is unavoidable. To be unavoidable, the nursing home must establish that the resident has a clinical condition that makes the resident susceptible to pressure ulcers and that the nursing home took all steps to render necessan treatment and promote healing, prevent infection and prevent new sores from developing.
What is a pressure injury?
A skin breakdown due to pressure.
The common areas of skin breakdown involve:
*Stage 3 and Stage 4 pressure ulcers are the worst types and the most common types that people have to file a lawsuit because of.
*Pressure ulcers are measured by length times width times depth.
Note – A provider must set up a care plan – which is a roadmap of what to do and they must follow it.
*A pressure ulcer can develop despite a provider following all the factors above (numbers 1 through 4 above).
Law Establishes the Standard of Care
42 CFR §483.25(c) states that a facility must:
How are Facilities Supposed to Assess the Risk for the Development of a Pressure Ulcer
The facilities’ own forms can be very helpful for the attorney and are not always easy to get:
Types of Forms:
Wound document sheets:
Care plans – these are fluid and revolving plans
A care plan may include the following:
Look at the Facility’s Clinical records pursuant to §483.75(1)(5) which must contain:
CNA’s write on a flow sheet and generally provide care of repositioning and assisting patients with their activities of daily living. The attorney has to obtain and review all records, not just a shift or two. We ask:
Depositions – We Sit Down with the Nursing Home Representas and Employees and Question them Under Oath
Get Cost Reports
There are various mattresses that can be utilized when a patient is at risk or is beginning to develop pressure ulcers. They vary in effectiveness and cost and include:
The facility is required to make assessments of the patients which will be broken down into 4 groups below. Pressure Ulcers do not heal if the patient lacks proper nutrition.
4 Assessment Groups:
Treatment of Pressure Ulcers
“Based on the comprehensive Assessment of a resident, the facility musi ensure that:
Nursing Home Liability is based on Federal Regulations which are incorporated into the NJ Nursing Home Bill of Rights.
“Every resident of a nursing home shall:
N.J.S.A.30:18-8 creates a private right cause of action on behalf of a resident of a nursing home whose rights have been violated under the New Jersey Home Bill of Righis (above).
Attorney Fees and Costs: This statute entitles a prevailing party to reasonable attorney fees and costs.
Punitive Damages: Punitive Damages are available if there is clear and convincing evidence that the Nursing Home’s violations of the NJ Bill of Rights constitutetl “deliberate acts or omissions with knowledge of a high degree of probability of harm and reckless indifference to the consequences.”