Anatomy Of The Elder Abuse Case

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  • Jim Wilkes discusses the distinct nature of for-profit nursing homes and offers advice on bringing suit against them
  • Understanding the Medicine
    Medical Malpractice Cases
    Are about a failure that occurred during a moment in time usually as a result of a botched procedure or a misdiagnosis
  • Nursing Home Cases
    Ongoing benign neglect and failure to deliver custodial care
    Deterioration of an already vulnerable person
    Conscious indifference to the pain and suffering
  • Comb through literally dozens of time sheets and payroll records
    Former employees, especially CNAs, must be located and interviewed
  • Encourage management to cut staff and supplies to meet revenue and profit expectations
  • Accounting documents: Use a CPA to review and show that operators cut staff to make budget targets and maximize profits.
    Rewards: Management is often rewarded for meeting these budgetary goals
  • Especially certified nursing assistants for:
    direct accounts of widespread and chronic short staffing
    that management did little or nothing to fix that problem
  • "Medicare: Tighter Rules Needed to Curtail Overcharges for Therapy in Nursing Homes," U.S. General Accounting Office, March 1995;
    "Nursing Home Bankruptcies: What Caused Them?" U.S. Senate Special Committee on Aging, September 2000
    "Appropriateness of Minimum Staffing Ratios in Nursing Homes," Health Care Financing Administration, August 2000
    "Abuse of Residents Is a Major Problem in U.S. Nursing Homes," U.S. Congress Committee on Government Reform, July 2001.
    Government Surveys
  • August 2000 report shows that 54% of the homes in America were dangerously short of staff placing residents in jeopardy. For‑profit homes are the worst offenders.
  • May not require experts to explain
  • May not require experts to explain
  • Leads to adverse medical consequences that are not the central focus of your theme
  • Anatomy Of The Elder Abuse Case

    1. 1. Anatomy of the Elder Abuse Case
    2. 2. Nursing Home Cases AreNursing Home Cases Are Not About The MedicineNot About The Medicine
    3. 3. Nursing Home Cases ongoing benign neglect failure to deliver custodial care conscious indifference deterioration of the vulnerable
    4. 4. Investing Time and Resources “…“…a good plaintiff lawyer must be willing to investa good plaintiff lawyer must be willing to invest serious time and resources to gather of all of the data”serious time and resources to gather of all of the data”
    5. 5. not recreating a moment in time but an ongoing course of conduct monthsmonths yearsyears several corporate entitiesseveral corporate entities
    6. 6. Documenting and Demonstrating Staffing Cuts
    7. 7. Corporate memoranda Profit expectationsProfit expectations Staffing cutsStaffing cuts
    8. 8. Accounting documents Management Rewards
    9. 9.  Annual inspections/surveys  Complaint or adverse - incident inspections  Corporate schemes designed to maximize revenues while minimizing expenses
    10. 10. Former Employees widespread and chronic short staffing management’s efforts to fix problem
    11. 11. General Accounting Office (GAO) Department of Justice (DOJ) Health Care Financing Administration Congressional Hearings The “template” upon which to build an effective case theme
    12. 12. 54% of the homes in America were dangerously short of staff
    13. 13. "A number of highflying nursing home chains appear to have incorporated defrauding Medicare as part of their business strategy."
    14. 14. Plaintiff’s Opening Statement
    15. 15. “…died a needlessly painful death because the company chose to under- staff.”
    16. 16. YOU ARE GOING TO HEAR THAT THEY DON'T HAVE ENOUGH STAFF, THAT THEY WERE WOEFULLY UNDER-STAFFEDWOEFULLY UNDER-STAFFED ON THE DAY OF MARCH 30 AND 31ST. YOU ARE GOING TO HEAR EVIDENCE THAT FOR THE YEAR PRIORYEAR PRIOR, THEY WERE BELOW THE MANDATED MINIMUM ON ANBELOW THE MANDATED MINIMUM ON AN AVERAGE.AVERAGE.
    17. 17. No experts needed?No experts needed? failure to feedfailure to feed failure to give waterfailure to give water failure to turnfailure to turn failure to bathefailure to bathe
    18. 18. Weight loss Malnutrition Dehydration Bedsores
    19. 19. ULCERS
    20. 20. Common Locations for the Development of DecubitusCommon Locations for the Development of Decubitus Ulcers or "Bedsores" or "Pressure-Sores"Ulcers or "Bedsores" or "Pressure-Sores"
    21. 21. Common Locations for the Development ofCommon Locations for the Development of Decubitus Ulcers or "Bedsores" or "Pressure-Sores"Decubitus Ulcers or "Bedsores" or "Pressure-Sores"
    22. 22. Common Locations for the Development ofCommon Locations for the Development of Decubitus Ulcers or "Bedsores" or "Pressure-Sores"Decubitus Ulcers or "Bedsores" or "Pressure-Sores"
    23. 23. 3-D Scanner
    24. 24. X-Ray Scanner
    25. 25. X-Ray Scanner
    26. 26. X-Ray Scanner
    27. 27. X-Ray Scanner
    28. 28. Nursing Homes: A Different Kind of Defendant--Different Kind of Class

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