• Differentiate Yourself from Hospice and Other Care Providers
  • July 15, 2011 | Author: David S. Barmak
  • Law Firm: Law Offices Of David S. Barmak, LLC - Princeton Junction Office
  • I defended a nursing home against a lawsuit here my client provided great care and adequate documentation but still settled for a lot of money because hospice did not documentation properly.

    A woman in her 50’s was admitted to nursing home client with severely compromised circulation. Within a few months everyone except the resident herself acknowledged that her right leg needed to be amputated. The resident insisted that “I came into this world with two legs and I’m gonna leave this world with two legs”. Her daughter was in terrible conflict. Her choices were very grim: either follow her mother’s demand which meant certain death OR transfer her mother, against her wishes, to the hospital for an amputation which might save her mother’s life but probably with great suffering.  She decided to follow her mother’s wishes. Hospice was called in to provide care for her mother.  The right leg was gangrenous. A small sacral ulcer developed. No one was surprised considering the resident’s terrible condition. Georgette, as our expert witness, believed the ulcer was as Kennedy ulcer. Unfortunately, hospice did not document the development of the ulcer. Just as her mother was about to die, the daughter changed her mind and rushed her mother to the hospital where the leg was amputated. Miraculously the mother survived but suffered for months as the sacral ulcer developed into a stage 4 and was finally addressed with a skin flap. Georgette was right -- it turned out to be a Kennedy ulcer.

    The family sued our client, the nursing home. They did not sue the hospice. We ultimately settled for many thousands of dollars.  I told the insurance company the same thing I’m sure you are thinking right now -- that the nursing home did not do anything wrong.

    Unfortunately, the family could not differentiate between the care provided by the nursing home and the hospice. There was no clear bright line between the two organizations. The family claimed that the ulcer developed before the hospice was called in. They were wrong but the nursing home could not disprove their claim.

    My point with this story is that you are ultimately responsible for the care of your residents. If you call in hospice -- you are still responsible. If you call in a wound care company -- you are still responsible. If you call in an incontinence company -- you are still responsible. If you call in a therapy company -- you are still responsible. You must make sure that your residents and their families know that they are dealing with different companies and you must supervise the documentation and the care that these contractors provide. In our nursing homes, there’s no such thing as handing off responsibility to another party.