Nashville Tennessee Nursing Home Abuse Lawyer
After spending a lifetime of contributing to the community and making Nashville the wonderful place it is, senior citizens have earned the right to receive the highest quality care. Unfortunately, many nursing home residents are victimized by caregivers who are given the responsibility to ensure their health and well-being. The Nashville nursing home neglect attorneys at Rosenfeld Injury Lawyers LLC have handled many cases where the victim is left only with the severe consequences of mistreatment that might involve physical injury, emotional trauma, mental anxiety, depression and, at times, death.
Nearly 650,000 residents live within the Nashville city limits, where more than 80,000 our senior citizens. The aging population is even higher when accounting for all of the retirees living throughout Davidson County. The number of elders in the community has risen significantly over the last few decades as many individuals in the baby boomer generation have chosen to make Nashville the ideal place to live during their retirement years.
Unfortunately, this increase of seniors has placed a significant burden on nursing homes, assisted living centers and rehabilitation facilities throughout the county. As a result, many nursing homes of become overcrowded and unable to meet the needs and demands of all of their residents. In addition to the overcrowded conditions, many facilities are understaffed by overworked doctors, nurses, nurses aides and employees who often become frustrated in their workplace to the detriment of their residents.Nashville Nursing Home Resident Health Concerns
Even though nursing facilities and assisted-living homes are designed to provide a high level of care to the residents, the reality is often much different. Too many nursing personnel and staff members choose to neglect or abuse the residents under their care in various ways. Some cases of abuse are obvious where the resident suffers broken bones through a deliberate act or unsupervised fall. Other cases are not as obvious where the victim is neglected due to the facility’s conditions, minimal staffing or the uncaring nature of one or more nurses, doctors or employees at the home.
For years, our Nashville elder abuse law firm has guided family members to the complex legal system when their loved one has become a victim of mistreatment. In addition, we routinely evaluate and assess publicly available information from federal and state databases including Medicare.gov that rates every nursing facility across the nation. Our Davidson County nursing home neglect lawyers review nursing home opened investigations, filed complaints, safety hazards, state surveys and health violations involving nursing facilities all throughout Tennessee.Comparing Nashville Nursing Area Facilities
The list below outlines the Nashville nursing area facilities that currently maintain below average ratings compared to other facilities throughout the United States. In addition, our team of elder abuse lawyers have posted primary concerns about the facility and have detailed our concerns about specific cases that directly or indirectly cause the resident harm, injury or death. Many families use this information as an effective tool before placing a loved one in a nursing facility to ensure they receive the highest care available.Information on Tennessee Nursing Home Abuse & Negligence Lawsuits
Our attorneys have compiled data from settlements and jury verdicts across Tennessee to give you an idea as to how cases are valued. Learn more about the cases below:
- Tennessee Nursing Home Bed Sore Case Valuation
- Tennessee Nursing Home Abuse Valuation
- Tennessee Nursing Home Fall Cases
Signature Healthcare Natural Rehabilitation & Wellness Center
832 Wedgewood Avenue
Nashville, Tennessee 37203
A “For-Profit” 119-certified bed Medicaid/Medicare-participating facility
Overall Rating – 2 out of 5 possible stars
Primary Concerns –
Failure to Provide Adequate Nursing Staff to Ensure That the Needs of the Residents Are Met
In a summary statement of deficiencies dated 10/05/2015, a complaint investigation was opened against the facility for its failure to “provide sufficient nursing staff to meet resident’s needs for nursing care in accordance with the resident Care Plan.” This deficient practice by the nursing staff at Signature Healthcare Natural Rehabilitation and Wellness Center affected five residents at the facility.
A state investigator reviewed a resident’s medical records and Quarterly MDS (Minimum Data Set) that revealed that “the resident was moderately cognitively impaired; required extensive assistance for transfers, bed mobility, toilet use and bathing; extensive [one person] assistance for hygiene; and was frequently incontinent of bladder.”
The state investigator reviewed the resident’s 04/17/2015 Care Plan revealing that the resident was self-sufficient for ADL (activities of daily living) and “is at risk for complications related to deficient approach staff to provide only the amount of assistance/supervision to meet the resident’s needs for all ADL (activities of daily living).”
The complaint investigation involved in incident logged in the 09/14/2015 Complaint / Grievance Report that revealed in part: Reports this morning that there is not enough staff. “My people are hearing from your people that there is not enough (staff) and that sometime over the last couple of days the Nurse reported there were no CNAs [Certified Nursing Assistants] available. This is looking like a pattern.”
The state investigator conducted a 9:04 AM 09/21/2015 interview with the resident in the “resident’s room. When asked about the care and staff stated, ‘there isn’t enough staff to meet the needs of the residents. I have to wait hours to get the call light answered’.” The resident was asked “how long she had to wait a long time, the resident stated three times in the past month. I can’t do anything by myself.”
The state investigator then asked, “if she had been incontinent due to the long wait.” The resident replied, “I’ve been wet about three times because they didn’t answer the call light. I feel terrible. Dirty. Raised all your life not to soil yourself.” When asked what time of day she had to wait for assistance the resident stated, ‘More later at night. Second shift’.”
The investigator reviewed the Nurse Staff Schedule and Assignments at the facility between the 7:00 PM and 7:00 AM shifts along with the 09/08/2015 Time Detail for the Nurse Staff listed on the schedule. The information revealed “on the 600 unit with a census of 34 residents, [the facility had] two Licensed Practical Nurses working for a total of 20.5 hours and one CNA [Certified Nursing Assistant] working for a total of 3.5 hours.”
A closer review of a Certified Nursing Assistant’s time detail record revealed that the CNA “clocked out at 10:30 PM leaving the unit with no CNA [on-duty] from 10:30 PM until 7:00 AM.”
The investigator then reviewed the same set of schedules and assignments documented on 09/18/2015 revealing that the same 600 unit with a census of 39 residents in the facility and that unit had only two Licensed Practical Nurses “working a total of 23.7 hours and one [Certified Nursing Assistant] working 10.8 hours.”
An interview was conducted by the state investigator at 4:54 AM on 09/22/2015 with the facility’s Licensed Practical Nurse (LPN) in the 600 unit dining room. The LPN was asked, “if there had been a night with only one CNA or none.” Licensed Practical Nurse answered, “Yes, it has happened. We had a CNA and were not sure what time she left (at 9:30 PM or 10:00 PM) we were looking for her but we couldn’t find her.”
When the state investigator asked the Licensed Practical Nurse why the Certified Nursing Assistant left the facility, the LPN replied, “She was the only one here. Someone called off or someone was a no call/no show. We notified supervisor [but] we didn’t get any help.” During the interview, the LPN also stated that “The other units were working with less staff also and we did not have anyone to send to help on the 600 unit.
An interview was conducted at 1:20 PM on 09/22/2015 with the facility Administrator who was asked: “if there had been a time recently when the unit worked with no CNAs.” The Administrator responded, “No. I can’t recall anything like that happening.” The investigator then asked the Administrator if “it would surprise her to know that it happened and it was recent?” The Administrator replied, “We have a lot of staff and is not something I would want to happen. I find it hard to believe.”
The Administrator reply during the interview that she was not made aware of the staffing problem. The Administrator also said that the residents could receive necessary care to meet their needs because when required, “the nurses pitch in and change people, answer call lights.” The state investigator then asked the Administrator “if it was acceptable to have a unit of 39 residents staffed with one Certified Nursing Assistant.” However, “the Administrator did not respond.”
The following week, the Administrator was interviewed again at 11:15 AM on 09/29/2015 in regards to a 09/08/2015 Call Light Audit and “was asked if the times were acceptable according to the policy [in the amount of time to for the nursing staff to answer the resident’s call light].” The Administrator responded, “No, the times are not acceptable. Should be 3 to 5 minutes.”
Later that day the Administrator was again interviewed at 12:30 PM and was “asked about staffing and while she presented a staff posting, stated “We are way over. We have a lot of staff.” The investigator then asked if the Administrator “had ever broken [the data] out and looked at the night shift only?” The Administrator replied, “No, we are more staff-challenge on that shift.”
The administrator was then asked about “what the expectation of incontinence care for the residents [would be] and the situation expressed by [the resident interviewed by the state investigator].” The Administrator responded, “Even two hours is not acceptable if you’re alert and aware.”
Our national nursing home neglect attorneys recognize the failing to provide adequate staffing to meet the needs of every resident could place a health and well-being of the resident in jeopardy. The deficient practice by the nursing staff failed to follow multiple policies of the facility including their October 2009 facility policy title: Answering the Call Light along with the facility’s policy title: Call Light Response Time and Toileting that both read in part:
“Answer the resident’s call soon as possible. Do what the resident asks of you, if permitted. If you have promised the resident that you will return with an item or information. Do so promptly.”
“Respond to the resident’s call light/needs immediately (3 to 5 minutes). Response time to all residents call light is 3-5 minutes. All nursing staff is responsible for ensuring all residents are toileted in a timely manner.”
CRESTVIEW HEALTH AND REHABILITATION CENTER
2030 25th Ave North
Nashville, Tennessee 37208
A “For-Profit” 111-certified bed Medicaid/Medicare-participating facility
Overall Rating – 2 out of 5 possible stars
Primary Concerns –
Failure to Ensure the Nursing Home Is Free of Accident Hazards and Adequate Supervision Is Provided to Prevent Avoidable Accident from Occurring
In a summary statement of deficiencies dated 10/08/2015, a complaint investigation against the facility was opened for its failure to “conduct and provide a fall investigation and complete neurological (neuro) check for [3 residents at the facility].”
The investigation included a review of a resident’s Admission MDS (Minimum Data Set) revealing that the resident had a Brief Interview for Mental Status (BIMS) score of nine indicating “moderate cognitive impairment. The assessment confirmed [the resident] had fallen last month prior to admission […and that the resident] had a fall 2 to 5 months prior to admission and [that the resident] had a fracture related to a fault in the six months prior to admission to the facility.”
At the investigator reviewed the resident’s Quarterly MDS (Minimum Data Set) confirmed that the resident “had a fall since admission.” The incident reports revealed that the resident had a witnessed no injury fall occurring on 05/10/2014 and an unwitnessed fall on 05/19/2015 causing a left iliac crest, abrasion left elbow, a hematoma to the left ear. The next documented an unwitnessed no injury fall occurred on 07/10/2014 followed by a witnessed, no injury fall on 07/16/2014, followed by an unwitnessed fall on 08/01/2014 and two unwitnessed, no injury falls on 09/30/2014 and 10/03/2014.
The state surveyor noted that there were no investigations conducted by the facility for the fall stated above.
At 10:53 AM 10/06/2015, the state inspector interviewed the facility’s Acting Director of Nursing who was asked “about the investigations for [the resident’s] falls. The acting Director of Nursing stated, ‘I can’t find the investigation for all these falls’.”
The investigator then asked the Acting Director of Nursing at 3:30 PM two days later on 10/08/2015, “What do you expect of your staff when a fall occurs?” The Director of Nursing replied, “I expect them to put interventions in the computer, assess the resident, do a pain assessment, fall assessment, and an SBAR (Situation, Background, Assessment, Recommendation) Change of Condition form.”
The Acting Director of Nursing also stated, “If it is an unwitnessed fall, we do the neuro checks. If we know they hit their head, we send them out for an evaluation. When they come back we should continue them (neuro checks) if they were not admitted to the hospital. We usually review every fall in the morning meetings.”
The acting Director of Nursing stated that during the morning meetings, “we go over the falls, and we go over the investigation reports […and] determine if the intervention is accurate and if they need another intervention. The care plan should be done immediately with the fall, but if a better one (intervention) is determined, we change it.” The Acting Director of Nursing stated that the Director of Nursing, Social Worker and Wound Care Nurse along with the MDS Coordinator and Nurse Educator attend the morning meetings.
Our Nashville nursing home neglect lawyers recognize that failing to follow procedures and protocols when a resident has a single fall could place the health and well-being of the resident in jeopardy. The deficient practices of the nursing staff at Crestview Health and Rehabilitation Center might be considered negligence or mistreatment because no interventions, assessments or evaluations were performed on the resident who had numerous repeated falls between 05/10/2014 and 10/03/2014.
In addition, the actions of the nursing staff failed to follow the facility’s policy title: Procedure Post-Fall that reads in part:
Do neuro checks for all unwitnessed falls any time resident is witnessed or reported hitting their head during the fall. Nursing to complete. Start investigation report process to determine the root cause of the fall.”
NASHVILLE COMMUNITY CARE and REHABILITATION AT BORDE
1414 County Hospital Rd
Nashville, Tennessee 37218
A “For-Profit” 419-certified bed Medicaid/Medicare-participating facility
Overall Rating – 1 out of 5 possible stars
Primary Concerns –
Failure to Assemble an Ongoing Quality Assessment and Assurance Group to Review Quality Deficiencies on a Quarterly Routine to Develop Corrective Plans of Action
In a summary statement of deficiencies dated 03/26/2015, a notation was made by a state investigator during an annual licensure and certification survey concerning the facility’s quality assessment and assurance committee’s failure to “identify and address quality assurance issues to identify and implement plans of actions to correct concerns when nurses failed to complete weekly skin assessments and identify pressure ulcers timely, identify the correct anatomical location of a pressure ulcer […and] obtain a physician’s orders.”
This deficient practice by the nursing staff at Nashville Community Care Rehabilitation at Borden affected nine residents at the facility with pressure ulcers.
The deficient practice was noted by a state investigator who outlined the facility’s “failure of the facility staff to complete weekly assessments on residents who are at risk for developing pressure ulcers and identify pressure ulcers before residents develop an unstated pressure ulcer.” The failure of the nursing staff resulted in actual harm for four residents at the facility.
The state investigator conducted a 4:23 PM 03/26/2015 interview with the facility’s QA (Quality Assurance) Coordinator who “was asked what were the concerns discussed in the January 2015 QA meeting [including] what did you do and was it effective?”
The Quality Assurance Coordinator replied, “we did the in-service [training] for the handwashing from December 2014 meeting and that was effective and we had no other issues.” The investigator then asked “what issues were identified in the February 2015 QA meeting [including] what did you do and wasn’t effective?” The QA Coordinator wasn’t there because a member of the nursing staff returned to school to obtain a Registered Nurse license, the facility “has been losing leads and money, so we hired someone in her place. We did an event manager update and did nurse training, now all the falls go in the event manager and they do not give me any paperwork.” The QA coordinator also stated that the computer program used by the Certified Nursing Assistants “was out of compliance, so we educated staff and put announcements in place.”
Less than two hours later, the state investigator conducted an interview with the facility’s Director of Nursing at 5:48 PM. When the Director of Nursing “was asked if the QA committee had identified a trend in pressure ulcers, the Director replied ‘No’.”
Our Nashville elder abuse attorneys recognize that failing to establish an ongoing Quality Assessment and Assurance Group could place the health and well-being of the residents in jeopardy. In fact, the deficient practice by the administration and nursing staff at Nashville Community Care Rehabilitation at Borde might be considered negligence or mistreatment because their actions resulted in actual harm of four residents who developed pressure sores while residing at the facility.
GREENHILLS HEALTH AND REHABILITATION CENTER
3939 Hillsboro Circle
Nashville, Tennessee 37215
A “For-Profit” 150-certified bed Medicaid/Medicare-participating facility
Overall Rating – 1 out of 5 possible stars
Primary Concerns –
Failure to Follow Procedures, Practices and Protocols When Administering Medications through Gastronomy Tube
In a summary statement of deficiencies dated 09/24/2015, a state surveyor made a notation during an annual licensure and certification survey concerning the facility’s failure to “ensure the acceptable standards of nursing care were followed in administering medication via a [gastronomy tube].”
The state surveyor observed a resident in a resident’s room at 4:00 PM on 08/24/2015 where it was revealed that the third floor Registered Nurse “administered pain medication via [the resident’s gastronomy tube].” During the procedure, the Registered Nurse “used a large syringe and attempted to aspirate stomach contents from the resident but nothing was obtained […and] proceeded to administer the medication without having verified the correct placement of the [gastronomy tube].”
An interview was conducted at 4:10 PM on 09/21/2015 with that Registered Nurse who revealed that “she sometimes listens for placement with a stethoscope but not always […and] the resident only gets meds through the tube and not feedings. It is a brand-new [gastronomy tube]. The resident was having a lot of pain and she went to the hospital and got a new [gastronomy tube] placement and now it’s working much better.”
The following day at 9:30 AM on 09/22/2015 the facility’s Director of Nursing provided the state surveyor “the facility policy on Enteral Nutrition and stated it doesn’t say the nurse has to check placement any certain way.” However, a review of the facility’s revised January 2013 policy for Enteral Nutrition “revealed the nurse checks gastronomy placement prior to flushes or medication administration. The policy did not provide how the nurse was to check for placement.”
The state investigator noted that a review of the standards of nursing care for administering medication via the gastronomy tube reveals in part:
“Step one. Check placement by auscultating [listening to] the resident’s abdomen about three inches below the sternum with a stethoscope; gently insert can CC (cubic centimeter) of air into the two. You should hear the bubble entering the stomach. If you hear the sound, gently draw back on the piston of the syringe. The appearance of gastric content implies the two is patent and in the stomach. If no gastric contents appear, the tube may be against the lining of the stomach or the tube may be obstructed.”
Our Nashville elder abuse lawyers recognize that failing to follow procedures, practices and protocols when administering medication through gastronomy tube could place the health and well-being of the resident an immediate jeopardy. The deficient practices by the nursing staff at Greenhills Health and Rehabilitation Center and their established policies might be considered negligence or mistreatment because it does not follow established procedures and protocols adopted by state and nursing home regulators to ensure the resident is provided the highest quality of care.
CUMBERLAND HEALTH CARE AND REHABILITATION CENTER
4343 Ashland City Hwy
Nashville, Tennessee 37218
A “For-Profit” 124-certified bed Medicaid/Medicare-participating facility
Overall Rating – 2 out of 5 possible stars
Primary Concerns –
Failure to Efficiently Investigate How a Cognitively Impaired Resident Eloped from the Facility without Supervision or Setting off an Alarm
In a summary statement of deficiencies dated12/9/2015 a state surveyor made a notation during an annual licensure and certification survey concerning the facility’s failure to “complete an investigate to determine the root cause of the elopement of [a resident at the facility].”
The deficient practice was noted by state investigator reviewed a resident’s quarterly MDS (Minimum Data Set) revealing that the resident “was severely cognitively impaired […and] ambulatory, wandered daily and his wandering had worsened.”
The failure was revealed in a 5:54 PM 02/05/2015 Nurses Event Note documenting that the resident was “found walking outside the building. At around 2:25 PM, a nurse and a technician saw him walking outside the building. He almost got to the stop sign on the highway.”
The state investigator reviewed the resident’s 02/05/2015 Occurrence Investigation Statement documented by a Licensed Practical Nurse who revealed that the resident “was seen approximately 2:25 PM to 2:30 PM outside the facility walking toward the main street, walking outside on the street beside the facility.” Further review indicated that the Occurrence Investigation form revealed that there was no indicator of the causation or location of the occurrence noted in the form.
A review of the administrator’s 02/05/2015 written statement noted that the resident’s “elopement documented. It is believed [the resident] exited the front door when some visitors left. No one heard the front door alarm that should have been triggered by the Wander Guard. Bracelet intact on [the resident]. The system is tested weekly (without) indication of malfunction.” Further notations were made that the wander guard was in place and functioning from 10/07/2014 until the day that the resident wandered away from the facility.
The state investigator then interviewed the Licensed Practical Nurse at 1:30 PM on 07/01/2015 who witnessed the event by confirming “she observed [the resident] walking on the side of the street on 02/05/2015 at approximately 2:30 PM. The resident was approximately 150 feet from the facility on the side road headed toward the main highway […and] confirmed the wander guard in place on the resident’s ankle and no alarm was sounding prior to [the Licensed Practical Nurse] exiting the facility.”
A 07/01/2015 interview was conducted with the facility’s Maintenance Director and Administrator. The interview was conducted by “the double doors leading to the maintenance area/staff entrance door.” During the interview, it was noted that the “doors were accessible for two minutes after the keypad was punched; then the alarm sounded and the doors were locked.” Later that afternoon, “the surveyor notified the Administrator that the accessibility of two minutes after the pad was punched on the double doors leading to the maintenance area was unacceptable and would have to be changed to accessibility of 30 seconds before the survey team left the facility [at the conclusion of their investigation].”
At the conclusion of the investigation, the state surveyor team concluded that “the facility failed to check every door/alarm after the resident eloped; [and that the] “Occurrence Investigation was incomplete; and the facility failed to determine exactly how the resident was able to elope when the documentation confirmed all doors, alarms and wander guard were functioning.”
Our Nashville nursing home abuse attorneys recognize the failing to follow procedures and protocols before, during and after a cognitively impaired resident elopes from the facility without supervision could place the resident’s life in immediate jeopardy. The deficient practice by the nursing staff, Maintenance Director and Administrator at Cumberland Health Care and Rehabilitation Center might be considered mistreatment or neglect because their actions failed to follow established procedures and protocols enforced by state and federal nursing home regulators.