Category: Nursing Home Abuse

This summer was a busy one for the owners of Avante at Boca Raton, Inc., the operators of the skilled nursing home of the same name in central Boca Raton. On four different visits from field office representatives of the Agency for Health Care Administration, or AHCA, the governing regulatory body of all heath care facilities in the state of Florida, dozens of deficiencies were cited between April 2014 and June 2014.

One of the visits, conducted over three days beginning on May 27 th, 2014, generated a Statement of Deficiencies summary report that is 81 pages long. This visit was a standard re-certification visit, which is required of a nursing home on the agency’s “Watch List”. Another report documents 59 pages of violations after agency workers were called to the facility unannounced in mid-May to investigate an official complaint of mistreatment and physical neglect.

Avante certainly isn’t the only poorly-performing Palm Beach County skilled nursing facility, more commonly known as a nursing home. But it is one that stands out among other homes in our area. The facility is currently on the ACHA’s Watch List for three active cases. The agency’s Watch List allows a nursing home to operate under a particular conditional status, allowing the owners the opportunity under direct scrutiny to cure extraordinary deficiencies or violations. In the most recent of the three pending cases, the facility was placed on the Watch List for a conditional timeframe of 103 days, beginning on May 16 th, 2014 – the same date the unannounced ACHA conducted its on-site investigation following the patient complaint described above.

Failure to resolve the deficiencies, or perpetuation of violations of applicable State and Federal law could result in the permanent revocation of Avante’s license to operate this particular facility, forcing a shutdown.

To be fair to Avante and other nursing homes in our area, the mere issuance of a Statement of Deficiencies does not constitute a penalty. It is only the results of an on-site inspection by the ACHA. Any facility cited with deficiencies has the right to appeal the findings. The Statement of Deficiencies requires the facility to create and implement a plan of correction for each deficiency cited. If and when the facility does correct the cited issues, and the agency can verify the correction on a follow-up visit, often there are no further civil or criminal penalties of any sort.

No Gold Stars for Avante

A quick and handy tool for consumers who are considering or comparing nursing homes is the Nursing Home Inspection Ratings ranker, which categorizes inspection and deficiency reports into a sortable data table on an ACHA-run website.

The tool uses graphical stars to depict how well one facility ranks against another based on several customizable inspection components. One easy way to see the “best” and “worst” is to simply rank the results by the “Overall Inspection” column, and then sort the results based on the highest stars (5), or the lowest stars (1). Avante at Boca Raton ranks at the very bottom of only seven facilities in Palm Beach County that have just one star. On the other end of the scale, Willowbrooke Court at St. Andrews Estates in Boca Raton has the highest number of stars across all categories.

Granted, the “one-star” approach doesn’t tell the whole story. The rankings are compiled in relation only to peer facilities in the same county. So for a county or state with a record of relatively high instances of care and scoring, a facility with only one star may still be “better” than a high-ranking facility in another county or state, and vice-versa. How does Florida compare to other states? According to a 2010 Government Accountability Office Report to Congressional Requesters on “poorly performing nursing homes”, Florida is ranked #8 in the nation for the highest scores of Special Focus Facilities, or SFFs, which are nursing homes that have caught the attention of Federal regulators for continually poor performance. (Source: GAO – Special Focus Facilities)

The ranker gives Avante a one-star score for most of its categories, including Overall Inspection, Quality of Care, Quality of Life, Nutrition and Hydration, Restraints and Abuse, and Decline.

The other six Palm Beach County facilities included in the ranker with only one star for Overall Inspection are:

• Coral Bay Heathcare (West Palm Beach)
• Darcy Hall (West Palm Beach)
• North Lake Rehabilitation (Lake Park)
• Signature Healthcare of Palm Beach (Lake Worth)
• Terraces of Lake Worth
• Wood Lake Health and Rehab (West Palm Beach)

Legal Actions Against Avante

Avante at Boca Raton has defended itself against more than half a dozen lawsuits brought by the State of Florida and the AHCA in only the last decade (records prior to 2014 were not immediately available on the FloridaHealthFinder.gov website at the time of publishing.) According to the most recent complaint filed in 2012, with a final order settled in January of 2013, Avante was charged with violating the dignity standards of at least six named patients. Some of these violations mentioned in the complaint, among many others, include:

• Failing to respond or deliberately ignoring resident call bells
• Deliberate restriction of patient access to common area bathrooms
• Staff behaving or responding rudely while fulfilling or performing basic and necessary tasks at the requests and care of patients, or ignoring those requests all together
• At least one instance in which a staff member placed a soiled bed pan among a resident’s personal items

According to available records, Avante has been fined at least $21,125 in the last ten years for various cases, violations, and complaints. In 2009, a complaint was filed by the AHCA alleging serious violations of the Life Safety Code, which are Florida laws that mandate minimum standards for safety precautions. On various occasions, the AHCA cites Avante at Boca Raton for the property’s deficient or improperly configured fire and smoke alarm systems during routine Life Safety Survey visits. The complaint described how management failed to adequately correct the violations, which are documented on multiple follow-up visits, leading to a long and arduous legal case that eventually settled for a $16,500 fine.

According to the research conducted and presented in and for this article, there is no other skilled nursing home facility in Palm Beach County with a record like Avante at Boca Raton’s record. The facility is the lowest-scoring of the bottom 10% of Palm Beach County facilities, according to the Nursing Home Inspection Ratings on the FloridaHealthFinder.gov website, a division of the Florida Agency for Health Care Administration. The facility has had more Statements of Deficiencies and lawsuits filed against it in ten years than its peers. Avante is also the only facility in Palm Beach County to be placed on three separate Watch Lists concurrently, as the result of and pending three separate, active, complaint-driven cases.

We highly suggest that you conduct your own research when comparing available nursing homes in Palm Beach County. If you suspect you or someone you love has been the victim of nursing home neglect or abuse, call the Law Offices of Craig Goldenfarb. There is no up-front cost to hire our firm to represent you or your family.

West Palm Beach, FL area nursing homes can be dangerous places for residents as well as visitors. Falling in a Florida nursing home can lead to massive medical complications, ranging from simple but annoying (e.g., sprained ankle or hip) to catastrophic (e.g., uncontrolled bleeding, traumatic brain injury, spinal damage, etc…).

South Florida is a popular spot for retirees, thanks to the beautiful weather, community spirit and resources for seniors. Unfortunately, many West Palm Beach area nursing homes are poorly managed, understaffed and poorly maintained. Visitors to a property can get hurt in any number of ways: they can slip and fall on wet floors; trip over cords, garbage, or debris; or even suffer an accident when a cane or walker collapses at an inopportune moment.

When Visitors Fall in a Nursing Home, Is the Nursing Home Liable?

Liability in a Florida slip and fall case depends very specifically on the details of the accident. If you acted in a knowingly careless or negligent fashion, the nursing home can essentially argue that you brought the accident upon yourself. Examples of such cases may include:

• You went into an “employee’s only” area without permission.
• You went for a joy ride in a nursing home golf cart and then tipped the cart over.
• You drank alcohol or took massive amounts of prescription painkillers and wandered around the premises.

In other cases, the nursing home clearly bears significant responsibility for what happened. Unfortunately, it’s not always easy to know whether the nursing home was liable or not. Even if you believe the home was in the wrong, you still need to provide compelling evidence and build a powerful case to obtain a settlement or judgment in your favor.

Fortunately, the Florida slip and fall lawyers at the Law Offices of Craig Goldenfarb have powerful processes and procedures to help accident victims like you protect your rights. Connect with our compassionate, thorough, knowledgeable team at the Law Offices of Craig Goldenfarb.

Mistreatment of our elderly loved ones in nursing homes and similar facilities, including assisted living facilities and hospitals, has become an epidemic in our country. Instances of nursing home abuse and neglect are at an all-time high, and we expect the numbers of cases of abuse and neglect to be even higher because so many of these victims are not able to report the abuse and/or neglect. Many nursing home residents do not have the cognitive ability to report the abuse, or they fear that reporting the abuse will only result in further mistreatment. In addition, reductions in payments by Medicare has resulted in companies hiring cheap and poorly trained staff who cannot adequately meet the needs of the patients.

If your elderly loved one has suffered at the hands of a caretaker or has been neglected to the point of developing bed sores, then you need an experienced, compassionate nursing home abuse attorney such as Craig Goldenfarb, P.A. in West Palm Beach, Florida.

Physical Signs of Nursing Home Abuse

There are many signs and symptoms that your loved one is being abused. Bruises may appear, broken bones may occur, and lacerations and even burns may occur. If your loved one is neglected, he or she may appear to be unsanitary or may be wearing dirty clothing. He or she may be malnourished or dehydrated. All of these signs and symptoms are dreadful, and what’s worse is that the victim may not be able to speak for him or herself due to dementia or some other form of cognitive deterioration. Bed sores are an unfortunate, yet common, occurrence in nursing homes whose staff members simply are not doing their jobs properly. Bed sores are almost always preventable by proper nursing care.

Bed sores, medically known as “decubitus ulcers,” are a common symptom of nursing home neglect. If a patient is not moved frequently (to maintain proper circulation) and is forced to lie in the same position day in and day out, then bed sores will develop. Bed sores are very painful and can even lead to death. If left untreated, bed sores can lead to severe pain, gangrene, the need for limb amputation, or death (which would be a wrongful death case). While bed sores may be one of the most common problems amongst nursing home patients, they are also the most avoidable.

Bed Sores Can be Prevented

If proper care is given, bed sores will not occur at all. Bed sores develop when the skin remains in contact with the same surface for a long period of time. If patients are properly exercised and turned, then bed sores will not develop. Nursing homes should have both the staff and equipment to adequately move even the most immobile patients. If a patient cannot move him or herself, then the staff must do it. It is that very care that families pay for and expect when they have to place their loved one in a nursing home or assisted living facility or hospital.

Surgical treatment of bed sores (which involves cutting and scraping the skin, which is called “debridement”), is very painful, so preventing them is the best option. Nursing home employees are trained to know where bed sores may develop on a patient, especially on immobile patients. There are special paddings, mattresses, and cushions specifically designed to protect areas that are vulnerable to developing bed sores.

If your elderly loved one is showing signs of bed sores, then there is a very good chance he or she is being neglected. If you live in West Palm Beach, Florida and need a nursing home abuse attorney, please contact the Law Offices of Craig Goldenfarb, P.A. today to schedule a confidential, no-cost consultation.

When is it time to finally connect with a Florida nursing home attorney?

This is a simple question with serious ramifications. If you suspect that a beloved senior has been victimized at his or her nursing home, what signs would confirm your diagnosis? Fortunately, you need not guess. The symptoms are straightforward, if also disturbing:

Common Symptoms of Florida Nursing Home Neglect

Look for these important warning signs that nursing home patients are being neglected. If you spot these practices, you need to take action. Lives are at stake:

• Medication errors (e.g., a senior is overdosed or under-dosed by a caregiver)
• Multiple instances of “slipping and falling”
• Infections that recur regularly or that persist despite thorough treatment
• Patients wandering off the facility
• Bed sores
• Hygiene problems (e.g., the resident does not appear groomed or clean when you visit)
• Evidence of malnourishment or lack of hydration
• Suffocation or strangulation. A federal government survey estimated that up to 30 deaths happen every year in nursing homes due to suffocation or strangulation in bed
• Rapid weight gain or weight loss
• Nursing home failure to report illnesses or other changes in health to the family promptly

Note that this list of symptoms is neither comprehensive nor definitive. In other words, just because a senior presents some symptoms does not mean she has been victimized. On the other hand, a senior can be suffering from neglect, even if she exhibits none of these signs. Still, this list should help you start to clarify your thinking.

When to Call a Florida Nursing Home Attorney

As noted above, diagnosing neglect is challenging, both emotionally and legally. But there is no need to wait for certainty before getting legal help. Indeed, if you wait too long, the patient may get worse or suffer additional injuries — or even death.

Connect with a Florida nursing home and abuse lawyer at the Law Offices of Craig Goldenfarb, P.A., immediately for a free and confidential consultation.