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Are nursing homes merely 'warehousing' patients?

CASE ON POINT: Estate of Williams v. Tandem Health Care of FL, 2005 WL 700953 So.2d--FL

ISSUE: Are some nursing homes merely warehousing patients? Time and time again, we are confronted with cases involving patients who fall in nursing homes only, to assessed by nurses and returned to bed. These patients fall again and again. In this extraordinary, Florida case, one patient whom nurses erroneously assessed as having sustained no serious injuries after a fall, was placed back in bed. The nurses wrong! The patient suffered an intracranial bleed and died! Although some of the issues in the case involved monetary damages to which the decedent's nine surviving children claimed they were entitled, the gravamen of the case far transcended economic interests. The question remains: are some nursing homes merely warehousing patients?

CASE FACTS: Lucille Williams, then 74 years old, died from a fall suffered while she was a resident in the care of Tandem Health Care of Florida, Inc. She had been hospitalized for congestive heart failure, pulmonary embolism, and renal failure. She was discharged to Tandem's supervision on February 23, 2000. Tandem's staff knew that the patient was at risk for falling. Her care plan included interventions to prevent falls. Notwithstanding Tandem's knowledge, the patient fell while unattended only three days after her admission. However, she sustained no injury. Thereafter, on February 29, at approximately 3:15 am, the patient called for assistance to go to the bathroom. A Licensed Practical Nurse (LPN), Beatrice Haynes, escorted the patient to the bathroom and supposedly instructed her to use the call light when she was finished. Instead, the patient attempted to return to her bed without calling. When Nurse Haynes returned, she found the patient lying on the bathroom floor, complaining of pain in her sacrum. Another LPN assessed the patient, performed neurological checks, and considered her normal. Later that morning, when the patient could not be aroused, she was transported to a hospital. An intracranial bleed was discovered. The patient had a do-not-resuscitate order. She was allowed to expire. The decedent's estate brought suit against the nursing home alleging, inter alia, (1) deprivation or infringement of the nursing home resident's rights under Florida law. The plaintiffs sought recovery for pain and suffering from the time of injury to the time of death. The jury returned verdicts finding that the nursing home had deprived the patient of her rights. As to the wrongful death claim, the jury found that the nursing home's negligence was 95 percent the cause of the patient's death, and the patient's negligence the remaining five percent. As a result of those findings, the jury awarded $220,000 in non-economic damages to each of the decedent's nine children, and approximately $10,000 in medical, including funeral expenses. The total amount of the judgment was approximately $2 million. However, the court refused to award punitive damages. The nursing home appealed.

COURT'S OPINION: The District Court of Appeal of Florida affirmed the judgment for the defendant nursing home as to punitive damages.

LEGAL COMMENTARY: Regardless of whether the nursing home or the defendant prevailed in this case, the case reflects the recurrent pattern of elderly patients being warehoused in nursing homes only to await death whether in weeks, months, years, or decades. Realistically, little or no attention is given to long-term nursing home patients even under the best of circumstances. Ordinarily, primary care physicians do not go to the nursing homes. Generally, a nursing home will have a physician or group of physicians attend to its patients. In most, if not the overwhelming majority of cases, the patient's attending physician is someone virtually unknown to the patient's family. Again, in the overwhelming majority of cases, family members seldom, if ever, get to meet or dialogue with the patient's "attending physician." All too often, it appears that those attending physicians who are "house physicians" at nursing homes do not take complaints of patients as seriously as they might if they were private patients who have family members present during visits with whom the physicians could dialogue. The number of cases in which nursing home patients report that they rarely, and sometimes never, meet their attending physicians is significant. Often, physicians maintain that they come in after hours at which time, most patients are asleep and oblivious to the "visit" of the "attending physician."
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Title Annotation:Nursing Law Case of the Month
Publication:Nursing Law's Regan Report
Geographic Code:1U5FL
Date:Apr 1, 2005
Words:724
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Next Article:AR: 12-hour-shift RN falls on trip to cafeteria: workers' compensation benefits warded to nurse.
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