This episode addresses cases involving nursing home patients breaking their hips in my view as a medical malpractice lawyer.
Transcript[00:00:07] Good morning, and welcome to Ask Andy, a daily podcast about personal injury practice in Philadelphia, Pennsylvania. I’m Andrew Neuwirth. You can reach me at 215-2598-3687 or on the Web at Neuwirthlaw.com. These podcasts are archived on SoundCloud. So I wanted to talk to you today about nursing homes and nursing home staffing. So if you’re in my business and personal injury practice or in medical malpractice, it is well known that nursing homes are poorly staffed. There was a recent, you know, National Institute of Health study saying exactly what practitioners in the field know, which is that nursing homes are poorly staffed. This is not surprising to us. However, you know, the nursing homes are largely for profit institutions. A lot of them are owned by hedge funds. They try and run them in a lean fashion, meaning, you know, the fewest employees possible to draw out the most profit. And you know, if you’re a business person, you know that. Employees are the largest cost in any business. So what are you trying to do if you’re a nursing home operator to try and reduce the number of employee hours? How does that affect you as the consumer or you as the patient? Or more likely you as the parent or the child of a parent who’s got into a nursing home? It means there’s less care for you. It means there’s less supervision of your loved one. What’s the reason you put someone into the nursing home in the first place? It’s because they weren’t safe at home, usually whether they were physically unable to walk upstairs or they were declining cognitively or mentally. [00:02:07] And they, you know, couldn’t remember how to pay their bills or take their pills or, you know, so on and so forth. Any number of things that happen as we get older. So the parent, you know, the family couldn’t care for the parent anymore, and we want them to be cared for. And they were, you know, we found, you know, you worked hard to find a nursing home that you thought was good and safe and boom, you know, within six months, you realize that there is not enough care for your mom or that your mom’s not getting, you know, a full range of her services or this or that. Or maybe, you know, you’re very happy with the place. And, you know, mom or dad has one incident that devastates them, like they fall and they break a hip, or they have two falls and they break two hips. A lot of the nursing home cases we see are ones where, you know, people are unhappy with the care their parent has received. And that’s, you know, to a great extent, upsetting and unfortunate, but doesn’t make truly doesn’t make a case that’s worth pursuing in court. So a lot of people come to me and say, Well, can you just write a letter? You know, I don’t write letters in that situation. I will essentially decline the case or turn the client away because in my experience, I’ve never written a letter that got much in the way of any effect in a in a medical malpractice or nursing home negligence case. [00:03:40] They’re just there cases that are fought out and examined and and inspected with great care, and they’re usually high value cases. So we don’t mess around with ones where it’s a close call. And frankly, you know, I’m a spouse of a physician. I’ve dealt with a lot of physicians on both sides of of plaintiff and defense work. You know, physician judgment, nurse judgment is is something that is serious. Like, you know, patient care is not easy. It’s challenging. And most physicians can tell you there have been situations where, you know, they weren’t thrilled with their own care or they made tremendous saves and tremendous, you know, benefits for the patient. So we don’t mess around too much in cases where the judgment of someone is at issue. But in cases where there is a clear breakdown in what the nursing home is supposed to be doing, those are cases we pursue when there is a clear breakdown of policies, procedures or clear negligence. So, you know, what does that mean? For example, someone comes in they’re a fall risk because they have, you know, a bunch of medications and they’re a little demented. Does the nursing home do a bunch of things to make sure that they’re OK? Yeah, sure. Maybe they put a bed alarm. Maybe they put it this. Maybe they put a mattress on the floor. [00:05:08] Eventually, maybe that person has a fall. Ok, then they need extra precautions now. But when that second fall comes around, they break a hip at the second fall. You know, that’s the sort of thing that we’ll start getting. You know me interested or my ears perked up because, you know, the first fall is maybe a signal to the nursing home that something’s not right in how this person is being monitored. But the second fall that injures the patient or breaks their hip and causes further decline is really a problem because it’s going to set the person back physically. It takes rehab and rehab for demented people is very challenging, and ethically, the doctors don’t really like to, you know, force demented people through physical therapy. So, you know, usually it’s not the first one that that causes the lawsuit. It’s the second one that’s sort of on the fall aspect. But you can see that if there were more staff taking care of patients, it would be more expensive for the nursing home. But the patients might get better care. There might be a one to one, meaning someone supervising your family member at all time. Or there may just be more nurses. And if they see the person wandering down the hall when they’re not supposed to be wandering, they do something about it. I like to believe that, you know, 90 percent of the population are well-intentioned people. And, you know, I’d like to believe that similarly, 90 percent of the nursing home seniors or friends are all well-intentioned and. [00:06:46] trying to do their best, but there just aren’t enough of them to watch, you know, 40 people on a ward. So, you know, it’s not that the nurse or the R.N. or the CNA is doing a bad job, it’s just that they’re, you know, they can’t possibly do a good job given the limitations of how many there are versus how many patients there are. And this, you know, acuity of the patients, meaning how severely impaired or how severely sick they are in a nursing home situation, you know, can be pretty concerning. You know, if you have a lot of demented people, you need to be extra careful that they’re not wandering off or acting, you know, acting inappropriately. So, you know, that’s how most nursing home negligence cases come to me to be evaluated is that there’s some clear break from protocol. You know, Mom had two broken hips in the course of six months or someone was assaulted by an out-of-control resident or someone, you know, one of the nursing homes sometimes will pop up with having, you know, unfortunately, a oftentimes a male aide has been sexually abusing demented patients. There are a bunch of situations that are just clear negligence and never under any circumstances acceptable conduct. And frankly, like, you know, what I’m here for is to hold those places accountable when they can’t uphold even their own standards of care. So that’s enough for today on nursing homes and negligence. Again, this is Ask Andy and I hold people accountable.