Pennsylvania Nursing Home Abuse Lawyer Blog

U.S. Sen. Herb Kohl, Chairman of the Senate Special Committee on Aging, introduced legislation last month addressing the consequences of the U.S. Drug Enforcement Administration's scrutiny of pain medication prescribing practices in nursing homes across the county.
According to the website aging.sen.gov, the increased probe has left some patients in pain as nursing home staff try to adhere to the Controlled Substance Act.
Under the Nursing Home Resident Pain Relief Act of 2011, a physician may authorize the nursing home administrator to designate nurses or other licensed health professionals who on a physician's instruction may administer pain-relieving controlled substances whose medical condition warrant immediate pain relief. The bill requires written documentation of the procedure.
Before the CSA, nurses could call urgently needed prescriptions into pharmacies upon a doctor's telephoned order. The doctor would follow up with written confirmation. The CSA now requires doctors to directly prescribe in writing all pain medication before they can be dispensed, even in an emergency.

Officials from the Centers for Disease Control (CDC) and Prevention are recommending the long-term care facilities beef up infection prevention measures to guard against group A streptococcus (GAS).

According to the CDC's website, GAS is a bacterium often found in the throat and on the skin. Some people may carry group A streptococci and have no symptoms of illness. The bacteria is spread through direct contact with mucus from the nose or throat of persons who are infected or through contact with infected wounds or sores on the skin.

A recent report printed in the CDC's Morbidity and Mortality Weekly Report said that in September 2010, the Pennsylvania Department of Health was notified of a cluster of invasive GAS infections among residents of a skilled nursing facility specializing in neurologic and pulmonary care.

In an article on UPI.com, the CDC's report said, "The investigators determined that, during Oct. 12, 2009 to Sept. 22, 2010, at the facility, 10 residents had non-invasive Group A Streptococcus infection and 13 had invasive Group A Streptococcus infection; two residents with invasive infection died." The report continued by saying, "The investigation identified infection prevention lapses and an association between two or more wounds and Group A Streptococcus infection."

According to the CDC's website, those most at risk to develop invasive GAS disease are people with chronic illnesses like cancer, diabetes, and chronic heart or lung disease, persons with skin lesions, and the elderly.

To combat GAS, the CDC recommends good hand washing habits, especially after coughing and sneezing and before preparing foods or eating. All wounds should be kept clean and watched for possible signs of infection such as redness, swelling, drainage, and pain at the wound site.

The article on UPI.com noted that nursing facilities should have strong infection prevention programs to prevent healthcare-associated outbreaks of GAS, with an emphasis on hand hygiene and wound care.

According to the Pennsylvania Health Care Association, state nursing homes will see a $200 million cut in annual Medicare payments under a new rule announced by the Centers for Medicare and Medicaid Services. The new rule means an 11 percent cut in basic Medicare rates beginning Oct. 1 according to phca.org.

PHCA said two-thirds of nursing home residents are on Medicaid and because nursing homes lose money caring for residents on Medicaid, they depend on private insurance and Medicare to make up the difference.

"We recognize that there are limited state dollars in Pennsylvania, and appreciate that Governor Corbett and state legislators made the care of the frail and elderly in nursing homes a priority while negotiating the recent state budget," Dr. Stuart H. Shapiro, MD, President and CEO of the PA Health Care Association, said in a news release.

"These draconian cuts in Medicare now threaten this care and the jobs of those who care for the frail and elderly in Pennsylvania. Any future cuts in Medicaid or Medicare may collapse an already fragile system of care - with unthinkable and tragic results."

Earlier this year, we wrote about an incident of alleged abuse by three workers against an elderly dementia patient at The Quadrangle in Haverford Township. Last week the woman's daughter announced in a press conference that she was filing a civil complaint against the home, its parent companies, Sunrise Senior Living Inc. and Sunrise Continuing Care LLC, and the three employees involved in the incident.

According to DelcoTimes.com, the elderly woman is still suffering from the memories of the abuse. In the article, the woman's mother is quoted as saying, "Our mother has never been the same since the abuse. She entered the Quadrangle a happy, hopeful person, and now she is totally demoralized."

When her granddaughters or other family members tuck her into bed at night, the elderly woman often begs them not to hurt her.

The family placed a hidden camera in the woman's room at the Quadrangle after the home's officials didn't take immediate action when they expressed initial concerns that the woman was being abuse.

The three employees of the Quadrangle have been charged with harassment, neglect, simple assault, conspiracy and recklessly endangering another person. Their trial is scheduled for Nov. 14.

We'll continue to keep you updated on the developments in this story.