Illinois Nursing Home Hid Fall of Resident

In a sad story, Ruston Health Care in Williamsburg, Illinois has been sued for trauma to one of its residents. The mentally disabled man was supposed to have his bed guard rails raised. The rails are there for a very specific reason, to keep the resident from falling out of bed.

Tragically, the staff at the nursing home failed to follow the instructions for the man's care, leaving the rail down. The man fell out of bed, striking his head hard enough to cause swelling the size of an orange. He also had blood in his urine. Visible blood in the urine (gross or acute hematoria, depending on the amount of blood -- acute being more severe) after trauma, such as a fall, can be a sign of damage to the upper or lower urinary tract. This can mean trouble with the kidneys, bladder, or urethra. 

Basically, this was no small fall.

The sad part is, the nursing home failed to act in the best interests of the patient by not disclosing the fall to hospital staff after blood was in his urine. Its bad enough that they put him in danger in the first place. But by failing to disclose the fall, they put him in danger of wasted time in trying to diagnosis the cause of the blood in his urine, as it can be caused by many non-trauma related issues. 

Its these simple things that the homes know they should do, but don't, that make me the most frustrated. How do you get a nursing home to stop understaffing? How do you get them to hire people qualified enough to follow the patient's care plan? Simple, you make them pay. Everything in a for profit business comes down to money. If it costs less to break the rules than to follow them, the for profit company will usually break the rules. But by making it hurt every time they endanger a patients life, these companies will start to realize that their bottom line is better off if they follow the rules. 

Of course, this can't be the only tactic used to reform this deplorable behavior, this putting of profit over people.

Its important that each of us, whether in the legal or medical community, get involved with other avenues that can help with reform. There are boards and commissions that deal with nursing homes, you can stay in contact with your local Health and Human Services Department to see what you can do to help.

Residents and their families can help to, by staying involved with the Resident and Family Councils at these places, documenting what they see and working with DSHS to improve the conditions for our loved ones.

I know I often sound like a broken record, but this is how we fix things -- by working together.

Many thanks to Levin and Perconti for bringing this story to my attention. 

Family Councils Improve Quality of Care

California seems to be on the forefront of legislation aimed at improving the lives of nursing home residents. The legislature recently approved AB 1457, which provides transparency in the shell game of nursing home ownership and operation. 

California also has legislation in place which improves on the idea of Resident Councils by creating Family Councils. Resident Councils can have any number of residents as members, and are usually facilitated by the facility. The downside of a Resident Council is that there is no check on the accountability of the system. A problem may get reported to a Resident Council but not acted on. A Family Council allows two extra prongs of accountability. First, the Family Council involves not just residents, but family members external to the nursing home. These family members can push back without worry of the inherent power dynamic that is involved in an elder care relationship. Second, the concerns of the Family Council must be addressed by law. According to Walton Barber, the law in California provides improved protections not available in other states:

California law allows the creation of "family councils" by relative of a nursing home resident to help influence the quality of care given to a resident. Not merely gripe sessions, these councils can facilitate communications between families and residents with the nursing home staff and caregivers, and also offer peer support for friends and relatives of the resident, and help prevent substandard care.

A nursing home may not prohibit the formation of a family council, and must allow the council to meet on the grounds of the facility at least once a month. In addition the home must designate a staff member who is responsible for assisting the council, and to respond to all written requests made by the council.

Maybe its time to look at these types of protections in Washington. Below is a short video on Family Councils.