When you become aware of mistreatment of a nursing facility it is important to get your loved one the medical treatment they need and then get into ‘fact collection mode’.  In fact collection mode, you are beginning to collect information about the incident, acts of the nursing home staff and medical condition of your loved one. Doing some preliminary work before you meet with a lawyer will prove for a more effective meeting.

Don’t assume you won’t forget information regarding the incident. As time goes on, your memory will begin to fade. The following steps will help you organize your thoughts during a stressful time and to give an attorney the information he needs to work best on your behalf.

Despite the urge to block out the unpleasant facts and circumstances leading to an injury, much of the information listed below should be obtained as soon after an incident as feasible.  The following information will prove to be valuable in both assessing the facilities responsibility and potentially as evidence to be used at trial.

Photographs– Take pictures of the physical injuries themselves, the area where the incident took place and if possible, the people involved.  In cases involving particularly gruesome medical conditions (pressure sores, amputations, surgical wounds) no medical record can do justice to what your loved one experienced.  Use a real camera as opposed to a camera-phone as the photos will be better quality.

Start Writing– Write down as much information about the incident or events as you can remember. Write some more. Details can be particularly helpful in the course of litigation as many nursing homes have high rates of employee turnover that can make obtaining information difficult.  Concentrate on: names, dates, room numbers, names of facilities and medication dosages (if relevant).

Medical Chart– The medical chart from a nursing home and / or hospital is crucial to determining what a facility may have done or failed to do that resulted in injury or death.  If your loved one sustained an injury that resulted in subsequent medical care at a hospital, these records will be important as well.

Chronology– This does not need to be one’s life story.  However, if a condition developed over time or there are multiple facilities that may responsible for the injury or condition, it is important get the correct names and general dates of admission at health care facilities.  The names of doctors who provided medical can be helpful as well.

Other Relevant documents: Healthcare Power of Attorney, wills, death certificates, pre-injury photographs, autopsy reports and nursing home inspection reports all can be helpful when meeting with an attorney.  Bring them with.

There really is no such thing as providing a lawyer with too much information.  An experienced nursing home lawyer will be able to sort through the materials and determine what information is relevant to your case.  Further, a law office that regularly handles nursing home matters should be able to access much of the above information with the use of properly executed medical authorizations. 

The bottom line is that you should not let your inability to access certain information delay from meeting your meeting with an attorney as soon as you are comfortable.  Meeting with an attorney soon after an incident will provide the best opportunity to secure information relevant to your case.

Jonathan Rosenfeld represents individuals and families in cases against nursing homes and long-term care facilities.  Jonathan is the author of the Nursing Homes Abuse Blog

Admin Note: Thank You Jonathan for your great Guest post. To all my readers, if you have soemthing you would like to say or something you would like to see, please feel free to e-mail me!


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You Suspect Mistreatment. What To Do Next?

Our legal system is based on proving a case through the use of evidence.  A mere suspicion of mistreatment in a nursing home or long-term care setting, is really just the beginning point in determining why your loved one suffered an injury or died.

Signs of possible physical abuse or neglect include: 

 Once you become aware of the physical signs of abuse, you may want to contact an attorney to help you learn more about the potential cause of the injury.  If a facility caused or contributed to the injury, an attorney can advise you as to your legal rights with respect to recovering damages.

Probable causes of nursing home injuries

Most situations involving nursing home abuse and neglect are the consequence of staffing problems at the facility.  Many nursing homes are chronically under-staffed by employees who may be under-trained and not equipped to handle residents who require high levels of care.  Moreover, high staff turnover is a common problem facing the nursing home industry.  Errors may result from the fact that employees may be unfamiliar with the individuals they are responsible for caring for and what their medical needs are.

What to look for what hiring a lawyer

Once the decision to hire an attorney is made, it is important to distinguish the lawyers who regularly handle nursing home cases from lawyers who may have a generalized law practice.  The field of nursing home litigation is very complex it is imperative that you work with a lawyer who regularly handles nursing home matters. 

Don’t shy away from asking attorneys about their experience with nursing home litigation.  An experienced attorney should never shy away from answering questions related to their practice and all aspects of nursing home litigation.  A good attorney should also be able to answer your questions in a way you can understand.  If you don’t understand them, how will a jury be able to follow them?

Given the fact that many nursing home negligence cases require years of work, it is important that you are comfortable with your attorney and feel like you can work with them.  If you don’t feel comfortable with the individual– you should look for another attorney.

The fee arrangement

Once an attorney is hired, he has an incentive in helping you learn the cause of your loved ones injury or abuse, as most nursing home attorneys work on a contingency fee basis.  Under a contingency fee arrangement, an attorney will only get paid if there is a recovery for your behalf. 

Time requirements for bringing a cause of action against a nursing home

All jurisdictions have time constraints, better known as statutes of limitations, for filing a lawsuit against the nursing home or parties responsible for the injury to your loved one.  If you fail to name the correct parties within the time limits set by each jurisdiction, your claim will be forever barred. 

Given the fact that some nursing home residents suffer from cognitive impairments and are unable to communicate what may have occurred during an incident, time must be allotted to conduct a thorough record review and an investigation to determine the merits of the case with respect to each party.  Consequently, it is in your best interest to contact a lawyer as soon as you are comfortable after an incident.

The decision to hire an attorney is very much a personal decision.  However once an attorney is hired, it should give you some relief that you have someone looking out for your best interest. Your decision to prosecute the harmful acts of nursing homes may lead to safety improvements for future nursing home residents-even yourself.  Over the last decade, improvements in patient care have been made by the nursing home industry in response to issues raised in the course of litigation.

Jonathan Rosenfeld represents individuals and families in cases against nursing homes and long-term care facilities.  Jonathan is the author of the Nursing Homes Abuse Blog

Admin Note: Thank You, Jonathan, for your blog post. I hope to get more opportunities to post informatiion from you.

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A patient in a North Carolina nursing home was allowed to fall by a nurse aide. The aide and her friends/coworkers covered it up and for two weeks the patient was untreated for a hip fracture. She was eventually taken to a hospital and there it was found she had a broken hip. Shocked by the news, the family eventually was able to find out what happened. The resident’s family learned what happened only by reviewing follow-up reports from state inspectors.

As we know, rules and regulations get through “channels” and many times they do so without anyone noticing. That has happened again. A recent change in federal rules on nursing home inspections makes it nearly impossible for families to get the information they need to protect their loved ones.

According to the associated press, the changes were put into effect in October 2008 with little notice and without a public comment period. The change is getting sharp criticism for closing off critically important information. Under the new rules, the state inspector follow-up reports can’t be released without specific approval from the chief of CMS.

“It’s an extremely troubling development – it puts a lot of information related to nursing-home inspections off-limits,” said Eric Carlson, director of the Long-Term Care Project of the National Senior Citizens Law Center, a California-based nonprofit group funded in part by the federal Administration on Aging. “I think it’s certainly bad for consumers and the folks who represent them.”

The change bars nursing home surveyors from releasing privileged information to the public without approval from the Director of the Centers for Medicare and Medicaid Services. State employees (the nursing home and hospital surveyors) who perform inspections for the federal government have been reclassified as federal employees as part of the revision. This reclassification is only for this purpose, and not for wages/benefits or other purposes. The surveyors are still state employees. They contract to the Federal government to perform the surey and certification work and as such are required to follow federal standards and procedures, and in this case, are required to follow the federal procedures for the release or non-release of privileged resident/patient information.

Officials at the Department of Health and Human Services said employees have been too burdened by requests for information. Under the rule change, state employees who inspect nursing homes for the federal government are reclassified as federal employees who aren’t allowed to provide “privileged” information or documents to the public without approval from the head of the Centers for Medicare and Medicaid Services.

Requests were diverting employees from certification responsibilities, Michael Leavitt, secretary of the Department of Health and Human Services, said in announcing the change.

Lawyers are now finding out that the new rule has already slowed efforts to represent their clients. It is slowing down the process to get the information they need.

How does this affect you, the consumer? – You can see, it is putting a wall in your path to ensuring your loved ones are getting safe care.

What about those of you who are administrators and staff of nursing homes – now is it affecting you? You might think at first, that it is a good thing, but really, getting information out to the public about both GOOD and BAD state inspections is beneficial to the facility and to those who are wanting to look at where to place their loved ones.  I would think even those who administer nursing homes find the change in rules, without a public comment period, to be a poor decision.

Then look at who has to give the permission – the head of CMS – the head of a federal agency is going to review and provide permission for the hundreds of requests in every state? That sounds like an impossible task, the permission is either going to be given or withheld willy-nilly. What determines who gets permission to see the documents and who doesn’t? Will there be criteria? Who is developing that criteria? What patient rights are being stepped on here?



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