In my practice as a Houston, Texas medical malpractice lawyer, I have handled many lawsuits involving patients who were seriously injured or died because of poor nursing home care.
A recent case shed some light on the type of practices that may occur and nursing home or skilled nursing facilities.
In October 2017, the U.S. Department of Justice announced that Health Services Management Inc., which operates a Huntsville, Texas nursing home, paid $5 million to settle claims that it billed Medicare and Medicaid for services that did not meet basic standards.
The investigation and settlement came about because of complaints by a former employee of Huntsville Health Care Center, a skilled nursing facility, that patients were being abused and neglected.
According to the whistleblower lawsuit, the former employee personally witnessed healthcare providers at the facility abusing and neglecting patients, failing to provide basic care to patients, including things like baths, changing clothes, helping them to the bathroom, and getting treatment for infections.
The whistleblower also alleged that administrators at Huntsville Health Care Center orchestrated a cover up by changing grievance reports about mistreatment and hiding patient complaints.
I respect the courage of this former employee and whistleblower, and wish that more healthcare providers would take their duty to advocate for patients and their safety more seriously.
The standard of care and Texas Board of Nursing regulations require nurses, for example, to advocate for the care of their patients need. In some situations, this includes going up the chain of command, to supervisors and administrators. Although the whistleblower in this case was not a nurse—she worked in the marketing department—she took the reasonable first step of bringing up concerns about patient treatment to executives at Health Services Management Inc. Instead of acting on her complaints, she said that she was rewarded by mistreatment on the job and eventually being fired.
Texas law creates incentives for poor nursing home care
Over the years, after investigating many nursing home cases, I formed an opinion that few facilities in Texas provide adequate, compassionate care to patients. Unfortunately, this is not surprising because of the one-sided system created by Texas tort reform laws.
For many facilities, I believe it all gets down to money. Let me explain why.
Generally speaking, there two categories of damages that can be recovered in a medical negligence lawsuit. The first is economic damages, which include things like medical bills and lost wages resulting from the negligence. These damages are not capped by the tort reform law.
The second category of damages is noneconomic damages, which include things like pain and suffering, mental anguish, disfigurement, and other types of damages where is more difficult to decide on a specific dollar amount. Under current Texas law, these damages are capped at $250,000 total for all physicians involved in the negligence. If all the negligence occurred at one hospital or nursing home facility, the noneconomic damages as to the hospital or facility are capped at $250,000.
This draconian law is designed to help healthcare providers, at the expense of patient safety. It is particularly harmful, though, when it comes to elderly people or others who are not working and earning money.
In other words, if a patient is unemployed or retired and a resident of a nursing home, the potential financial risk to the facility from medical malpractice is often limited to $250,000. This is because most nursing home residents are patients are not working, thus, the only available damages in a Texas lawsuit would be noneconomic and capped.
Based on these financial realities, I believe that it creates an economic incentive that allows nursing homes to have inadequate staffing. In other words, it may be cheaper for them to settle an occasional medical malpractice lawsuit, rather than paying to have enough staff members to take care of their patients.
Types of care concerns at skilled nursing facilities
While there are many ways that a nursing home can provide subpar care, in my experience, I see two areas, in particular, over and over.
The first is the development of bedsores, also called pressure sores or decubitus ulcers. Anytime the patient spends a lot of time in bed, there is a risk for compromised skin integrity. The standard of care requires nursing homes to implement skin protection measures, including assisting patients with turning and repositioning, performing regular skin checks, and quickly addressing any problems. Unfortunately, many nursing homes fail on each and every one of these requirements.
The second common problem area is medication management. In many nursing facilities, physicians or hospitalists come by only once a week to see patients. That means that most of the care is provided by nursing staff. Errors occur when patients are overmedicated with painkillers, which can lead to oversedation, respiratory distress, and death. In addition, there is often a breakdown in a process called medication reconciliation. The standard care requires this to be done upon admission, and includes obtaining a complete history of medications that the patient took at home for the prior facility. This is done to prevent adverse interactions of new prescriptions with old ones.
We are here to help
The attorneys at Painter Law Firm, in Houston, Texas, are experienced in handling nursing home, skilled nursing facility, and hospital medical malpractice cases. For a free consultation about your potential case, call us at 281-580-8800.
Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC, in Houston, Texas. He brings a unique perspective to his cases as a former hospital administrator. He focuses law practice on representing patients and their families in medical malpractice lawsuits against nursing homes, skilled nursing home facilities, hospitals, doctors, surgeons, and other healthcare providers.