New Jersey Looks to Improve Staffing Ratios

Often, many of the problems that occur in nursing homes are a direct result of terribly insufficient staffing. This knowledge is born out in studies that show a direct correlation between staffing ratios and quality of care.

Despite all of this clear evidence, many facilities only meet the bare minimum hours required under state regulation. Some aides have told me the ratio on their day shift at a nursing home was as high as 1 aide to 14 residents. For those unaware, aides are the people who feed, bathe, and transfer residents, and they are also responsible turning and repositioning any residents who are at risk for developing bed sores. Having only 1 person in charge of caring for 14 patients at the same time is a catastrophe waiting to happen.

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Misrepresenting Their Qualifications, Inexperienced Contractors are Liable for Consumer Fraud

When finding and hiring contractors to perform construction work, property owners rely on information provided by the contractor, especially relating to the experience, skill and specialized knowledge they possess to perform the requested job. But, what happens when the contractor does not have the adequate experience and knowledge to perform the work properly? According to the New Jersey Supreme Court Appellate Division, such a contractor may be liable to the owner for consumer fraud, which provides for triple damages as well as recovery of attorneys’ fees and costs of suit.

Wanting an outdoor tennis court, the Hudson Harbour Condominium Association hired Oval Tennis, Inc. to install an open-celled Premier Court (specific brand of tennis court) on an existing concrete slab. Oval, an “experienced” tennis court installer, represented to the Association that it was a certified Premier Court installer, was familiar with the requirements of the job, possessed sufficient experience to properly install the court and employed trained technicians to perform the work. Despite the contract calling for an open-cell court and Oval’s representations, Oval installed a closed-cell, non-breathable court, which was unsuitable for the concrete surface it was installed upon.

Immediately after installation, the Association started noticing problems with the new court, which included blisters near the net, holes, ripples, bubbling and delaminating of the court surface. These conditions were a direct result of Oval’s failure to install the court with the contracted open-cell surface material, which would allow vapor to push through the breathable court surface. Instead, the closed-cell surface did not allow vapor to pass through, ultimately resulting in a buildup of vapor and moisture trapped underneath the court which caused the problems on the surface.

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The True Cost of Anti-Psychotics and Tort “Reform”

A recent series of disturbing stories by NPR report finding with objective data what many of us practitioners know already – that in many substandard facilities residents are over medicated with sometimes dangerous medications just to keep them quiet.  This is disturbing because these medications are sometimes powerful, dangerous, and ineffective.  Some even get “black box” warnings from the FDA.  It is a subject I’ve written about before and you can find the full article here.

The most recent NPR article points out that Texas ranks the highest in the United States for residents receiving anti-psychotic medications.  Interestingly, Texas also has caps on non-economic damages of $250,000 – i.e., no matter how negligent a company is and how much pain and suffering they cause, they are capped at $250K in non-economic damages.  Is this a coincidence?

With caps on damages, nursing home companies can more easily factor in lawsuits as a “cost of doing business” as opposed to spending more money to do right by people.  With no caps on damages, juries are free to award what they believe are just damages based on the facts.  The uncertainty of a jury verdict often forces companies to spend the money to do the right thing.  With caps, they know exactly what they’re facing.  It’s yet another reason caps do nothing but hurt people.

Knowing your resident’s medications and the side effects is important.  Don’t be afraid to ask about them in care conferences.

Non-Disparagement Clauses: Buying the Silence of Guardians

I’ve noticed in my practice a dangerous and burgeoning phenomenon. That is, the emergence of non-disparagement clauses for people who know the dangerous secrets of the worst of the worst long-term care facilities. I am finding that the vast majority of these clauses are found in assisted living facilities. These organizations appear to have very organized corporate structures and, upon the termination, retirement or resignation of high-level personnel, they sign legal separation agreements, which also include aggressively enforced non-disparagement language within them.

I first began to notice this phenomenon when I would take depositions and find that people who were fired under very questionable circumstances absolutely afraid to say anything negative about their former employer. It became apparent to me that they feared corporate retribution if they still worked in the healthcare facility and even worse with regard to whatever amounts of money they were paid upon their termination.

Finally, as I began to look more deeply into this, I got witnesses to agree that upon leaving either assisted living facilities, or at times, nursing homes, they would sign legal separation agreements which would not permit them to say anything at all negative about their former employer. With the exposure of these stifling contracts, the truth became self-evident.

Still, these are people are the guardians of our most frail and vulnerable citizens. These are people who know the secrets of poor facilities that could be remedied. These are people who can help folks like me who advocate for nursing home residents to hold wrong-doers accountable. It is a corporate philosophy that through the use of payoffs, chills the speech of the most important people who can shed light on the growing problem of corporate greed being placed over the welfare of nursing home residents.

As we have said in prior blogs, we have uncovered false employees in nursing homes being paid by taxpayer dollars. We have found exorbitant rent being paid by  nursing home owners to themselves for the property they own, while complaining that Medicare and Medicaid dollars are not enough to take care of residents. They do this while paying off in full their investment properties multiple times over.  Now, with this new corporate philosophy, the only people who can truly tell the truth are being silenced.

Former employees should know that there are laws in place to protect them from retribution for being honest.  Also, there are powerful whistleblower laws empower people to get the truth out about fraud and abuse of our most vulnerable citizens.  If in doubt about such agreements, people should obtain representation before signing and think long and hard before allowing their silence to be bought. Contact the Nursing Home Attorneys at Stark & Stark with any questions.

 

Lack of Nurses in Nursing Homes Exposed

When I began working in this field, I was astonished to realize that very few nursing homes and no assisted living facilities have a full-time doctor working there.  I found that facilities at times may be staffed almost entirely with nurse aides and Licensed Practical Nurses (LPN) as opposed to Registered Nurses (RN).  RNs received far more training and education than LPNs and are able to do far more.  LPNs are supposed to do most activities under the direction of a RN and their duties are limited to collecting data.  For example, LPNs cannot assess residents for injury after a fall.

This problem was recently highlighted in an article in the New York Times.  It reports a study that shows that 11.4 percent of nursing homes did not have an around the clock RN.  This is significant because, as the article states, “With higher registered-nurse staffing, patients have fewer pressure ulcers (aka bedsores) and urinary tract infections and catheterizations. They stay out of hospitals longer. Their homes get fewer serious deficiencies from state inspectors. Their care improves, but it costs less.”

As a result, legislation entitled Put A Registered Nurse in the Nursing Home Act, or House Vote 5373, was proposed by Jan Schakowsky (D-Illinois) and six other democrats.  You can read the full article here.

I’ve personally encountered facilities that staff with LPNs and then have them conduct activities they should not do, such as assessing injuries and pain.  In some cases they are not competent to do these activities and serious and sometimes mortal injuries go undiagnosed leading to amputation and death.

Why aren’t there more RNs?  In short, cost.  RNs cost more than LPNs, and if the nursing home company does not offer good enough pay, RNs choose higher paying jobs in hospitals.

Hopefully, the legislation will pass and resident will all see the benefits of properly staffed facilities.

Fate and Fortune: Unauthorized Acts of the Board Cannot Be Challenged by Non-Owner Third Parties but Can Be Retroactively Cured by the Membership

In a decision that has renewed the faith of condominium law practitioners in our state’s judicial system, the New Jersey Appellate Division recently issued a strongly worded opinion in Port Liberte II Condo. Ass’n v. New Liberty Residential Urban Renewal Co. et. al., 2014 N.J. Super. LEXIS 19 (App. Div. Jan. 21, 2014) (approved for publication on January 31, 2014), that has prevented a grave injustice and allowed unit owners to control their own fates by having the power to validate unauthorized decisions of the board.

Cracking the Paradox: Complying with the Statute of Limitations in Construction Defect Cases

In early April, a Bergen County judge dismissed a construction defect complaint filed by a mammoth 40-story condominium complex known as the Palisades, located along the Hudson River in Fort Lee, based on the statute of limitations. While dismissal for filing suit outside the statute of limitations is nothing new or surprising, the way in which the judge reached that conclusion and applied the “law” is. According to Judge Robert C. Wilson, the six-year statute of limitations begins to run upon “substantial completion,” is not subject to the discovery rule, and is not tolled until the association is created and subsequently controlled by the homeowners. Not only does this decision render the ten-year statute of repose meaningless, it unduly prejudices the rights of condominium associations whose legislatively granted six-year window to file suit can seemingly be judicially dwindled down to two years or one year or less.
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Class Recourse for Individual Home Owners Suffering from Construction Defects

Until now, owners of single-family homes were left to their own devices and resources in seeking redress for construction defects. Class suits were thought to be unavailable to homeowners despite their homes having been built by the same builder and suffering from the same general defects. The differences in subcontractors used, methods of construction, location of defects, time built and nature of resulting damages defeated class certification and deterred law firms from bringing class action lawsuits alleging construction defects. The economics of bringing an individual construction defect suit weighed heavily against litigation and, as a result, homeowners ended up either living with the defects or paying for repairs out of pocket.

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