Resources needed for assisted living negligence.

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Resources needed for assisted living negligence.

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Hello,

I am looking for resources regarding my father who recently passed due to neglect at an A.L. facility in Frisco, TX. I have contacted many legal forums and it seems like no one wants to take on this case of nursing home abuse. I need to not only have legal representation, I need to have as many resources on a national level as possible. My father is dead because due to bedsores and malnutrition and I am destroyed. Thank you for your help.

Assisted Living Elder Abuse Elder Law

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l read your response to me. I think you should have had an autopsy. That would have definitely told you Dad was neglected. I agree that the AL should never had excepted your father. As I said, they are not skilled Nursing. Not all Nurses are wound care Nurses. They are trained to do their jobs. My daughter is one and has been a Unit Manager and paid very well. She has been an admitting Nurse too in NHs and is the one who documents bed sores or even pressure points when a resident is admitted. The first thing that is done that resident gets an air mattress.

You need to find out if those bedsores were there when the AL admitted him and any pressure points. If so, the problem is where he was before being admitted to the AL. If Hospice was involved at the get go and there were sores, their responsbility was to dress them not the ALs. Hospice dresses them but they don't have to cure them? Just keep the client comfortable and pain free. I doubt if a dying body will heal anyway. Being on Hospice he was not allowed to go to the Hospital. If he was sent, Hospice would stop. And, are you sure they were not Kennedy ulcers that form during the dying process. The malnutrition caused by his body shutting down and him not being able to swallow? You cannot feed someone who's body is shutting down, the body no longer digests.

My daughter was in a lawsuit because a family was suing the SNF for bedsores. My daughter was called in to prove that the sores were there when the patient was admitted to the SNF. So, the family was suing the wrong facility, they should have sued the hospital where he got the sores.

"It stated the death was due to Sepsis, Bacteria and Unstageable Wounds." Alva is a Nurse so knows lots more than I do but what I read about Unstageable wounds it means that under the eschar the wound was healing. Bed sores happen especially in bedridden people. Some times though with the best care they may not heal completely. Especially if a person is diabetic which seems ur Dad was with a lot of health problems. My friend lost the lower part of her leg because of a sore on her foot that would not heal because she was a juvenile diabetic. I just lost a friend who blacked out and hit his head on concrete. It caused swelling and bleeding on the brain. His wife was told his age was against him...he was 73 and eventually passed.

I am so sorry for your loss. I can see though why a lawyer won't take this on. Too many things were involved. Where did the bedsores originate? Once hospice is involved, no extreme measures are taken. Could Dad had gone to the Hospital and the sepsis be taken care of? Just too many variables.

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Exactly correct on all points. The main thing here is less about figuring out who was responsible, but whether his health conditions were such that his demise was unlikely. From what OP has said herself, his had myriad issues including heart problems, cancer, and especially diabetes.

I don't see how anyone could definitively put the blame for his death on anything but his own health issues, and of course juries are extremely fickle so barring a cut-and-dried case, I would be too optimistic about the outcome

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The first person you should contact is the state ombudsman overseeing that facility.

Second, there are lawyers who take on such cases, not often for contingency but sometimes. As in this case. https://www.nbcbayarea.com/investigations/third-atria-park-death-lawsuit-san-mateo/3079543/

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PeggySue, since Texas passed Tort Reform (which severely limits medimal damages,) there are few lawyers who will take these cases under any circumstances.

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Thanks for all your thorough responses, MadScientist. We so seldom get responses, and certainly none this detailed.
You have, I see now, been to some attorneys.
Sad to say their advice is solid.
No attorney will take this case on contingency.

The law measures blame in terms of MONEY. It's the American way. So in the case of a YOUNG person badly injured but still ALIVE, a young person who was making a solid 7 figure salary and is now disabled, in need of care over a lifetime, a person who clearly/measurably would never have got what he got had people clearly in charge done their job?
There's a case there. And the award under the law will be weighted by the amount allowable for ongoing care of the injured patient.

The limits you describe for recovery under the law are fact. And that's why so few malpractice cases now go forward. They are costly for the attorney in terms of research, disclosure, expert witnesses. There are limits as you enumerated them in your response for recovery, and without need for ongoing lifetime care it is's simply not worth the time/expense of the case. There will not be enough in damages to refill the coffers.

If a malpractice attorney says he cannot take your case on contingency, then, in the words of Handel on the Law "You've got no case".

People often learn this the hard way, so thanks for explaining it so well in your responses.

I am, again, so terribly sorry for your loss. No amount of money can ever comfort you for such a loss, but the time may have come to make a choice as to whether it is best for you now to move on with your life, or not.

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I agree with Alva . There is no case because there will not be enough money awarded if any to make this worth the lawyers time .
Being negligent doesn’t always turn into justice for the victim, unfortunately . We learned that with my husband’s accident case. It cost us money and my husband permanent pain and moderate loss of function in his hand and did not get reimbursed for any medical costs, nor get any award for pain .

Like Alva said if it was a young person losing earning potential , there is money to be gotten . My husband is older and is able to do his job still after his accident , although it takes longer and is more difficult for him . A lawyer took my husbands case and still lost .
It certainly is your prerogative to try to pursue a case. Let us know what happens . Maybe you will be lucky and win.
I’m so sorry this happened to your Dad. It’s devastating to you . I would go to grief counseling to come to peace with it . Your Dad is in a better place now.

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"the fact my father died unnecessarily and without a shred of dignity".

No lawsuit will fix that hurt.

You mentioned your Father had many illessss & had been circling in the health system for 3.5 years. It was not possible to bring him home.

"died unnecessarily" or he just wore out?

I relatives that left this life twisted in pain, bloated with cancer, wasted or faded by disease. I don't consider it was undignified at all. It was life.

What would a "dignified" death look like to you?

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Do you have an autopsy report for your dad that states his cause of death or is that your belief? You'd have to have an autopsy at the very least to proceed.

If attorneys aren't biting, then they likely don't see a case here that will bring in enough money to make it worth their while. It's heartbreaking, but it's a fact. Lawyers will run you about $400/hour and up, plus even if they take it on contingency, you'll be paying out of pocket up front for all the administrative costs, filing costs, expert witnesses ($1,000/hour), court reporters to take depositions, copies -- you name it -- not to mention the cost of the private autopsy. You're talking tens of thousands of dollars before you see a courtroom in three years or so.

Losing a parent unexpectedly is devastating, I'm sure, but don't go too deep down this rabbit hole instead of addressing your real grief. If you can't prove your case to the satisfaction of an attorney, find a therapist to help you let that go and to process your grief.

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MJ1929, thanks for your reply. An autopsy report was not necessary as the Medical Examiner and physicians stated what the cause of death was on the Death Certificate. This isn't a mystery. It stated the death was due to Sepsis, Bacteria and Unstageable Wounds. I also have medical records and photographs to substantiate this, along with an investigation from HHS citing them for multiple infractions.

With regards to attorney fees, yes they can be quite exorbitant, and I have already consulted a few that didn't tell me they weren't going to take my case because I would be going down a rabbit hole. They stated that the Governor put a cap on medical malpractice lawsuits so that the max recovery amount is $250k and it's not worth their time or resources.

My grief has and continues to be worked through by a support system that consists of concerned friends, church and my fiancé...all while I plan a wedding. I planned the Memorial Service, wrote the Obituary and gave the Eulogy. However, there is no amount of time that will take away the fact my father died unnecessarily and without a shred of dignity.

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Condolences on your loss. Have you taken your concern to the State agency that oversees facilities? Why not start with the Health and Human Services Commission's Complaint and Incidence Hotline - 1-800-458-9858, Option 5 - ASAP.

A few years ago, I read that doctors are rethinking bed sores, that they could develop as a reflection of what's going on inside the body. Unless you can demonstrate that Dad wasn't properly cared for, there may not be anything for DHHC to work with.

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Thank you for your condolences. Yes, HHS has been contacted and two separate investigators went out and cited them for multiple infractions. Plain and simple, bed sores fall under wound care, and they have to be tended to. If the workers are not turning the patient often or even cleaning the patient, the skin will continue to break down to the point of death.

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The AL that my FIL is in requires the resident or POA to sign an arbitration agreement . You can’t sue. Disputes are settled by an arbitrator .
This AL also will not take care of a stage 3 or 4 decubitus . It is stated in the lease . The resident has to go live at rehab or SNF .

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Well I can't comment on an AL that your Father in Law is in, but I can tell you that every facility is different and there is no cookie cutter lease agreement. There is no such clause (no sue) in the lease agreement I signed. Further, before any AL or SNF takes a patient, they have to do a full examination of the patient and the DON request to see medical records. They did both and accepted him along with our $7,000 check. At the time they accepted him, he was bedridden for almost a year and had only Stage 2 wounds. He was under a Hospice Program that was also to provide wound care. Both the AL and the hospice company was found liable for negligence. His bed sores tunneled to his anus which tells me incontinence care was not done either. The director of the facility was subsequently fired, and citations were issued.

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JoAnn makes an excellent point. ALF aren't held accountable for a person's health care necessarily. My own brother died after a small non healing sore on his shin went septic. He hasn't mentioned it to anyone. He wasn't getting any shower assistance and didn't need any. No one was doing nursing checks on him whatsoever. He ignored it, slathering on a little triple antibiotic ointment here and there, and whoops--it did do him in. Not due to any negligence on the part of the ALF. It was my brother's own lack of knowledge as to what could happen with this tiny non-healing sore that did him in. And the fact that the bacteria that invaded was not susceptible to the best antibiotics we currently have available.

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Sorry to hear about your brother's passing but I respectfully disagree with you that the AL is NOT held accountable for their resident's health. Most ALF's also have memory care which means many residents don't even have the mental capacity to know that a "tiny sore" could cause Sepsis. The point of having your loved one in a facility like this is so that can have their ADL's and memory care issues like Dementia addressed. Sounds like your brother was more independent than the patients that need help bathing, grooming, eating, incontinence care, etc. If the employees do not know how to handle wound care, whether it is a tiny sore or not, then they have a legal obligation to inform the MPOA or Caregiver that they need outside help such as Home Health Care or a hospital but to sit on that information and not tell anyone while continuing to take $5,000 is illegal, which explains why they were cited.

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Do you mean a private Assisted Living facility? Or are you calling a Long-term facility/Skilled Nursing an assisted living?

Assisted Living is for people who need assistance with one or more of their ADLs. Usually they are competent or are showing early signs of Dementia. These are manned by an RN, maybe an LPN and certified aides. Aides have no medical training. They just bathe and dress. Not allowed to give out medication. Those people with full blown Dementia usually are transferred to Memory care. But with both, when the resident goes beyond the facilities abilities to care for the resident, its usually suggested they transfer to a Skilled Nursing facility. So if Dad was in this type of facility with bedsores, he should not have been. Bedsores need to be looked after by a Woundcare nurse who knows what to look for. My daughter is one.

If you are talking about a Skilled Nursing facility, yes they were negligent because they can care for bedsores and deal with the malnutrition. (Actually the an AL should have a nutritionist they can call)

In either instance, you should have been informed that there were problems. IMO in both instances, Dad could have been sent to the hospital.

So who do you contact, the State oversees both. You could Start with the State Ombudsman. But you are going to need documentation. Did u have an autopsy so you have proof of neglect. Did the funeral director or you take pictures. Was he seen by a doctor at anytime who documented the sores. Was a nutritionist called in when he continued to lose weight.

Was Hospice involved?

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Thank you for your reply. Dad was in both AL's and SNF's for the last 3.5 years prior to his death. Most recently, he was in an AL that accepted him AFTER doing a physical examination with their nurse and reviewing his medical records. He was in the hospital for 2 months before they accepted him. I was told the Director was later fired for doing this as they are not allowed to take bed bound people.

Yes I agree that patient techs have no medical training but these people were administering his medication as well as supposed to be feeding him, bathing him, changing him, etc. Yes he did have early signs of Dementia but because he knew who the president was, they said he was competent. When I asked for them to write me a letter stated he was competent, they refused to produce it.

I supplied dad with Ensure and other food as I noticed they were giving small bowls of salad to everyone calling it dinner. Other times they would actually cook and have chopped up meatloaf or something.

Yes, he was under Hospice Care which stated during a care meeting that the AL was not doing enough to keep my father safe. This is when they insisted I switch Hospice companies or he "couldn't come back" to the facility after being in the hospital. One of the staffers screamed obscenities to him when he asked about Morphine and another staffer told him "I can't take a s*** for you!"

I agree that I should have been informed of his situation. I came to visit every other day and would constantly ask how he was doing. It was literally a week before he died that someone finally told me dad was hemorrhaging from his back. It looked like a Pitbull was chewing on his back. Yes, I have pictures and yes, the Death Certificate states the cause of death was Sepsis from Unstageable Wounds.

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My mother's AL Memory Care said right up front that they cannot handle bedsores after a certain point. Patients would need to be moved to a Skilled Nursing Facility.

Was your father properly placed, for his many conditions?

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The AL did a physical exam of my father while he was still hospitalized and was under the care of a Palliative Care doctor. They also reviewed his medical records and said that they were capable of taking care of him while he is bedridden. I later found out the person who admitted him was fired because they were not supposed to accept a bed bound patient. He had been to several SNF's in the last 3 years where he contracted Covid, MRSA, several UTI's, etc.

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Go to YELP Look up the Nursing home / AL Facility and next to it should Be a Propublica website where you can report abuse and neglect to medicare . There are Lawyers That do elder abuse and basically work as Personal Injury attorneys . I dont Know what Texas is like But in California and Massachusetts there are such elder abuse attorneys That go after neglect and abuse . Sorry this Happened to your Dad . Unfortunately we live in a cold world where no One seems to care about the elderly . You Can also contact the Ombudsman for the AL or state and Make a complaint .

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Thank you for the advice! I did contact the Ombudsman for HHS Texas and they were cited for multiple infractions. You are correct, no one seems to care about the elderly until it affects them directly. 71 is young to die. He was 69 when he first got to an A.L.

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I am so deeply sorry to hear of the loss of your father - sending you my heartfelt condolences. Regarding your question, it's not an area of expertise for me, but you may want to clarify if your father was in an Assisted Living facility or a nursing home because your post mentions both of them - and I would assume that the responsibilities of a regular nursing home are much more extensive than that of an Assisted Living facility- so that would be a start in which to clarify. And then to describe and substantiate how the neglect took place - and what level of care the facility ensured that your father was going to receive.

I'm sure the appropriate lawyer who handles litigation for nursing homes would ask the right questions and provide proper insight. Also doing some research online can provide more knowledge. You can also go on legal sites that provide specific lawyer's contact information that specialize in this (some sites that I know of are justia.com, lawyers.com, etc - from time to time, I've also gone on "ask a lawyer.com" when I've had specific questions, and the site has lawyers online who can provide some direction and advise.)

I hope you find the answers you need and, again, I am very sorry for your loss. Wishing you my very best for strength, clarity, and inner-peace.

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Thank you for your condolences. He most recently lived in an AL but has lived in SNF's previously. Apologies for the confusion. The negligence included: not getting his medication in a timely manner or just no meds at all. Not feeding him properly (he was living off of Pimento cheese and soda), not changing him properly (letting him sit in his own feces for hours), screaming obscenities to him whenever he asked questions, not brushing his teeth or even putting chapstick on his lips, etc. The list goes on and on and on.

Thank you for the tips on the legal sites. I will try some of those. :)

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I am sorry for the loss of your Father.

You cared for him at home? Were you very close? Did you feel OK with the transition to AL?

Have you explored grief councelling at all? Or someone else trained in to listen?

Your profile lists Dad's many ailements, including Alzheimer's Disease. That is progressive. People lose ability to swallow, chew, walk & move. Many/most will become malnutritioned & bedbound by avanced stage (unless they die earlier from other reasons).

Unfortiunately neglect can happen. I don't discount your personal situation. Very very sad.

However, I'd like to share this in case you see anything of yourself:
I have met many family members that had not been educated on the progression of Alzeimer's, other dementias or life limiting progressive diseases. Their language included phrases like "He was fine! Then he died", "He was so healthy & strong. I don't understand how this happened".

The reality of their ill, frail loved one was very different to their thoughts.

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This is so true. Denial, denial, denial! It’s a coping mechanism that we all use, but it seems especially rampant in folks whose loved ones are sick and dying. My friend, an RN, kept her very sick husband alive with a feeding tube for 2.5 years. He repeatedly aspirated, fell, got pneumonia, you name it. He finally died. She insists to this day that doctors killed him.

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AL may not have been the right place for him. Bedsores come from staying in one place and not turning. Malnutrition can come for refusing to to eat. But that takes months. Did you not notice? An AL is totally the most inappropriate place for him to be and get this far. A resident can refuse to eat and AL does not hand feed, usually without an increase in caregiver fees. A resident will not be pushed to get out of bed or a chair. The resident can choose to stay in bed and refuse all assisted care. This is not a SNF and is not regulated. You do not say how involved you were
On this we site you can get an opinion but not a legal judgement. Seek legal services and do your homework in collecting evidence, not heresay

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I agree the AL was not the right place for him but they are the ones that insisted on having him stay there after doing a physical exam at the hospital. Yes, dad would refuse to eat what they would cook sometimes but he sure gobbled up things I would feed him. They hardly cooked for the residents, not just my father.

No, I didn't notice that his back was completely chewed up like 3rd degree burns. He was laying on his back and I would visit him every other day and ask him what that odor was. He was on a lot of heavy pain meds, so he never complained about it until it was too late. His toe also needed to be amputated but wound care and the hospital just put iodine to dry it out.
Dad insisted he didn't want his toe amputated, but once again, everyone stated he was competent enough to make his own medical decisions.

Your reply is a bit harsh and based on an assumption. What I posted was NOT hearsay. I encourage you to read the replies for everyone who responded. The death certificate stated the cause of death which was Sepsis and Unstageable Wounds. That is NOT hearsay. Likewise, I DID do my research before posting my question which is why I posted my question. Just because I stated I needed some guidance or resources does not mean I did not do my homework. I've already contacted the TX HHS and they were cited. Again, not hearsay. This actually happened.

Finally, if a resident refuses to get out of bed that is their choice, but the AL does have an obligation to let the family and/or doctor know. This AL and the others did have people that would hand feed them. My father had a very shaky hand which would cause him to get more food on his shirt than his mouth. Before being admitted to the AL the DON determines what level of caregiving he needs based on HIPPA released medical records and an in person examination. The AL's are regulated, which again explains why they were cited. They are licensed by the state. Not sure why you said that.

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Have you actually contacted law firms that specialize in elder care issues which often includes cases of negligence and can continue after death? It would be best if you could chronicle to a degree a timeline of when the bedsores appeared and what care if any was done to treat them. The more accurate information and knowledge you can relay the better a possible case would be. A lawyer who specializes in this could tell you the likliness of whether there is a case. If proceeding then all the information is up to firm and facility to gather the facts.

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Yes I have. Similar to what BarbBrooklyn stated below in this thread, most attorneys in Texas do not want to take on medical malpractice cases. The ones who do practice Elder Law focus on Wills and Probates, Trusts, etc.

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i wish you to win your case!

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Thank you for the support!

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AL or NH? You mentioned both. Big difference. Was he really only 71?

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He lived in both AL's and SNF's but when he passed, he was living at an AL under Hospice Care. He died in the ICU at the hospital. Yes, he was only 71. He was born in 1951.

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I believe that since Tort Reform passed in Texas, there are fewer MedMal firms willing to bring cases. Good luck.

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You are correct. This is also what I was told.

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A forum such as this one is just a bunch of folks either with a history of caregiving, or perhaps aging and thinking of care issues. We are here trying to help others facing issues we are also facing, did face, or may face in the future, but we are far from being experts in medicine or legal issues.

I hope you will take your case to an attorney along with all evidence you may have. I wish you the very best of luck. I am so very sorry for your loss.

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Appreciate the support! I know no one here can give legal advice. I was looking for resources of where to find them, which I got. :)

Also here to warn people of the dangers of being at the wrong facility.

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