Chicago Nursing Home Abuse Attorney Blog

When hunting for a place to spend their retirements, people tend to look for a degree of luxury. Consider, for example, The Park at Vernon Hills, a retirement community featuring independent and assisted living. It's not a nursing home, but concerns are similar.

Among the amenities The Park advertises as part of its carefree resort-style senior living is "the largest residential rain forest in the world - larger than a football field and more than six stories tall! It is a beautiful site to behold, maintained at a constant 72 degrees and 50 percent humidity. Residents walk along the winding quarter-mile walking path and see the spa, pool, café and more than 5,000 trees and shrubs."

We have no reason to believe The Park is anything but a responsible, caring facility, but even the best can suffer from the unexpected, reminding us again of the importance of vigilance - and the law of unintended consequences. In this case, the unintended seems to be Legionnaire's Disease.

The disease has a mysterious history but is now generally tied to bacteria that can survive in warm, moist, air-conditioning systems of large buildings, including hospitals - and apparently in artificial rain forests. It is spread by inhaling water mist, not by direct contact between individuals.

The Lake County Health Department and the Illinois Department of Public Health are investigating five cases - including two resulting in death - of the disease at The Park. The departments say that, so far, the outbreak is limited to that community. They have targeted the rain forest atrium as a possible source of the bacteria.

The Park has also hired an independent contractor to investigate - and has shut down the rain forest.

"We're taking every precaution and doing everything we can," Jane Woloson, executive director at The Park told the Lake County News Sun.

Michael Kosner, President
The Kosner Firm Chtd.

The Chicago Tribune's recent articles on the use of mind-altering drugs used unnecessarily to treat nursing home patients reported that even when the homes are cited by regulators, doctors who prescribe the medications get away free. This is despite incidents where the doctors prescribed such psychotropic drugs and increased dosage apparently without regard for the patient's true condition.

The article cites examples taken from Illinois inspection records. In one 2008 case, a woman considered "moderately impaired" by Altzheimer's disease was placed by relatives in Heritage Manor of Mount Zion, a facility southeast of Decatur, Ill. When admitted, this grandmother scored 23 out of 30 on a mental exam. Nurses found her pleasant and talkative.

However, she had crying spells and tried to wander off. Though she was not psychotic, her doctor prescribed two antipsychotic drugs, and later doubled the dosage of one of the drugs at least four times. That put her above its recommended limit.

Her family called in a neurologist who found her to be glassy-eyed and "catatonic," scoring zero on the mental test. The neurologist urged that she be weaned off the drugs. She was and became aware and responsive.

The Tribune said state regulators cited the home in November 2008 for the misuse of psychotropic drugs. Nothing happened to the doctor - the person primarily responsible for her medications. The newspaper found this pattern repeated many times when it reviewed 40,000 state and federal inspection reports filed since 2001 on 742 Illinois nursing homes: homes cited for misusing psychotropics even though the patients' doctors were responsible. Facilities must administer prescribed drugs as long as the orders meet state and federal nursing home regulations.

The Tribune noted many cases of doctors prescribing powerful drugs without sufficient reason and in doses too high. Cases also showed doctors failed to follow-up appropriately. They are required to see nursing home patients only once every 60 days, though some don't turn up that often. Nurses, who may not be trained in the drugs, are stuck monitoring side effects.

Unfortunately, as a former regulator with the Illinois Department of Public Health told the paper, "There's no downside for the physicians" who order inappropriate psychotropics. "Physicians don't have any citations against them." The Department enforces nursing home regulations but cannot discipline doctors, other than by reporting alleged wrongdoing to the Illinois Department of Financial and Professional Regulation.

Individuals can make similar complaints to Financial and Professional Regulation, though the Department can take quite a bit of time to act.

Or family members can enlist the help of an attorney to keep doctors attentive and their loved ones safe.

Michael Kosner, President
The Kosner Firm Chtd.

It happens even at the best of Illinois' nursing homes: misuse of drugs used to treat mental illness. At least that's what reporters from the Chicago Tribune have found.

Looking back through regulatory records from the last eight years, Trib reporters found that half of homes rated four or five stars by the federal government have been cited for situations involving psychotropic drugs - medications that change the way people's brains work. And some of the violations involved injury and death.

This emphasizes how hard it is for potential nursing home residents and their families to evaluate their options; problems are everywhere.

Among the citations the Tribune reported was one in 2003 of Lake Forest Place, a five-star facility, for improperly using or monitoring psychotropic drugs given to six residents. One 95-year-old was given an antipsychotic drug though he had no psychotic symptoms. Three other residents reportedly received psychotropic drugs without justification or consent - and at least one man was given such a medication and sleeping pills in larger than recommended amounts. Inspectors wrote that his private caretaker after one such dosing tried to wake him and couldn't.

Hickory Nursing Pavilion, another five-star home, was cited because a resident had her dosage of a psychotropic doubled after she complained about people smoking on the bus taking her to an outside program. The Tribune said she told inspectors, "The doctor came to see me for one minute, then left. Next thing I know, he was increasing my medication."

Staffs ignorant of the dangers of these drugs were also reported. The paper said nurses at a four-star home near Peoria were unaware of a test that can check residents for tics and tremors, and staff at another four-star facility, a few miles away, knew of the test but not how to give it.

Deaths involving psychotropics included a woman who died at the four-star Wauconda HealthCare and Rehabilitation Centre after having trouble breathing for three hours after being given an anti-anxiety drug. While it was a regular medication for her, the staff failed to recognize the severity of her reaction that day.

Then there was a man on multiple psychotropics at the four-star P.A. Peterson Center for Health in Rockford. He became lethargic and then, when staff withheld the drugs for several days without informing the patient's doctor, he worsened and died. The report said the doctor, after learning the drugs were stopped, said they couldn't do that without throwing a patient into withdrawal. Cited, the facility unsuccessfully appealed and then agreed to train staff and change policies about contacting doctors.

The facilities, which retain top ratings, all explained that things happen.

However, the lesson is that when we choose a home, we need to consider a wide range of things. Though the star ratings of the moment may be accurate, it's worth looking further back and asking questions. If nothing else, it will tell the nursing home you're watching.

Michael Kosner, President
The Kosner Firm Chtd.