Tuesday, August 12, 2014
No one wants to roll their grandmother or mother over and take such photos, but it is simply needed.
As they say, a "picture is worth a thousand words."
Pressure wounds, bed sores, heel sores, blisters, redness, swelling, drainage and odor are all signs that a loved one is being mistreated.
Worse yet, sacral or tailbone sores, are often infected when one is laying in their own waste. Fecal matter is the worst offender.
This often leads to sepsis. When one becomes septic, the blood is actually poisoned.
Early detection prevents worsening. Early documentation prevents dishonesty.
Monday, June 11, 2012
There are annoying lawyer ads on television every waking moment. So, you may think there must be a mighty long line at the Shelby County Courthouse just to get a jury trial.
The most recent report from Shelby Circuit Court indicates quite the opposite. It indicates a total of only thirteen jury trials were tried in the Summer/Fall 2011 Jury Term among the eight divisions.
The other myth is that juries are giving out money like water. “Jackpot justice” is what it is often called. Of those thirteen trials, seven were either “defense verdicts” or “mistrials.” That means that the injured plaintiffs got nothing.
In the remaining six that the Plaintiffs actually won, the figures are unlikely to impress you. One poor guy won his trial but got a zero verdict. Three others received just a few thousand each. Only two were significant verdicts: $68,106.83 and $750,000.00.
To hear people’s talk of out of control juries, you would expect many millions of dollars to be thrown around like beads from so many Mardi Gras floats in the French Quarter.
The truth is that the really severe injuries that result from clear-cut liability generally get settled quietly.
The tough cases go to trial. The results indicate that.
Be aware that there is a real effort to take away your right to a jury trial or at least reduce any major award. Why? It is certainly not due to any jackpot justice. It is so that insurance companies can squeeze more premiums from policyholders while facing less exposure at court.
Jury awards, especially those for punitive damages, constitute the one thing that a company cannot budget for. None of these awards are reported to have included any punitive damages. Indeed, they are difficult to win under Tennessee law. They serve as an important deterrent against reckless corporate behavior.
Verdicts are why cars no longer explode on impact like Pintos did. They are why pool drains cannot turn little kids inside out like some used to. Juries have made our drugs safer, our cars more resilient and our healthcare among the best in the world.
In the end, if you are the victim of a reckless driver, a careless doctor or a profit-driven nursing home, you expect to be able to sue. But, if citizens do not protect this right, it may be going the way of the vinyl record. This may actually happen in our lifetime.
Monday, September 26, 2011
Thursday, September 8, 2011
What to Do After an Accident
You thought they were going to stop.
They pulled right out like you were not there. There was no way you could avoid them.
You may have found yourself in this situation before. After an accident, people are stunned, injured, scared. Massive amounts of adrenaline dull pain in what is known the “fight or flight” response.
Post accident response in a serious collision is one of the things that you need to think through now, because at the time it is unlikely you will be thinking as clearly.
Here are steps you can take:
1. It is usually recommended that you stay in the car unless there is actual fire or burning or someone else is in immediate jeopardy. (The whitish powdery smoke you will see is from the airbags, more than likely, and is not dangerous.) Cars rarely catch on fire, but it can happen. Be careful, as many people are hit as pedestrians by passing motorists after an accident.
2. Dial 911. It is best that an ambulance with trained first responders evaluate everyone involved. Self-diagnosis after such an impact is difficult and even dangerous. Especially in cases of undiagnosed head or spinal trauma, permanent damage can be done by movement.
3. If you or another are able and out of the car, take cell phone photos of the scene. This proves the arrangement in case the cars are moved before police investigate. Do not get into fault discussions with the other parties.
4. Do accept treatment and recommendations from first responders. They are in a much better position to decide what you might require. Transport to a good Emergency Room, not necessary the closest, is desirable.
5. Follow up with general doctors and specialists as you require. The “muscle tightness” after the wreck is likely to be severe pain in the days following.
6. Contact your insurance company; and consult an injury attorney to discuss your right and responsibilities, if you believe you were not at fault.
Much like having a fire drill, these steps should be thought through before it happens. The Department of Transportation's National Highway Traffic Safety Administration estimated that 37,313 people were killed in motor vehicle traffic crashes in 2008. Motor vehicle collisions the leading cause of injury death among children worldwide 10 – 19 years old (260,000 children die a year, 10 million are injured) and the sixth leading preventable cause of death in the United States (45,800 people died and 2.4 million were injured in 2005). Odds are good that you will be in at least one crash during your lifetime.
You will have an idea of what to do if that happens.
David B. Peel is a local injury attorney who assists victims of car and truck accidents. Mr. Peel often speaks to civic clubs, churches, Sunday Schools, and other groups without charge. He may be reached at www.PeelLawFirm.com wherein other article may be found as well.
Thursday, September 16, 2010
Friday, February 12, 2010
Wednesday, February 3, 2010
Article on front page/top fold of the Tennessean…
TN nursing homes rank fifth worst in U.S.
Staffing levels are less than half what Medicare suggests
By Christina E. Sanchez
Poorly staffed http://health.state.tn.us/NursingHomes/index.htm">nursing homes have put Tennessee among the worst in the nation for quality of long-term care for a second year, a federal report shows.
Only four states had worse standings, according to a Tennessean data analysis.
That's because Tennessee has one of the lowest staffing requirements in the country — less than half of what Medicare recommends.
"We don't think the standard is enough," said Traci O'Kelley, assistant administrator at West Meade Place, one of only two nursing homes in the Nashville area to earn top marks in the survey.
But it is unlikely that facilities' staffing will get better anytime soon, in part because state law would have to require higher staffing levels, and funding for nursing homes would have to increase.
60% got low ratings
About 15,000 nursing homes nationwide got ratings of one to five stars, with five being the best, from the U.S. http://www.medicare.gov/NHCompare">Centers for Medicare and Medicaid Services. The ratings are based on inspections, complaint investigations, staffing levels and other nursing home survey data collected in 2008 and 2009.
More than 60 percent of Tennessee's 319 nursing homes got low ratings — one or two stars — for staffing by registered nurses.
Overall, the state ranked in the bottom five. Only West Virginia, Texas, Georgia and Louisiana had lower average scores. However, Tennessee fared better than it did a year ago, when the star ratings earned the state's nursing homes a third-worst designation.
Tennessee's results were better this year in quality of care, which measures such factors as the number of patients developing bedsores and infections. Staffing levels remained the biggest problem.
"We have 319 nursing homes in the state. To have one out of four rated just as one star is a sign we are not doing our job in Tennessee," said Patrick Willard, AARP advocacy director.
Staffing law faulted
Advocates say the staffing level required by state law is not enough to care for nursing home residents, and that carries consequences: ignored bedside calls, medication errors and unanswered questions.
Under Tennessee law, each patient should have at least two hours of direct care each day, including 24 minutes of a licensed nurse's time. Standards in neighboring states vary, with Mississippi requiring 2.8 hours of direct care and Arkansas mandating more than 3.8 hours.
Medicare's standard of staffing is higher: four hours of care for each patient daily, including 55 minutes from a registered nurse.
"If you increase the minimum number of hours, then you are going to be pushing those nursing homes that are trying just to get by, and by doing that, you will improve the quality of care in nursing homes," Willard said.
To get a five-star rating for staffing, a nursing home must meet Medicare's standard. No nursing home in the Nashville area achieved five stars in that category.
West Meade Place earned four stars for staffing by registered nurses and three stars for overall staffing. O'Kelley, its assistant administrator, said the home strives to have more staff than is required. The 120-bed facility, which is usually 86 percent full, adjusts staffing based on patient volume and hires more nurses if needed.
"Because of acute care and patient needs, I don't think the job would be done effectively at that minimum staffing level," O'Kelley said.
Star system has flaws
The star system is useful as a starting point for families but should not be an end in itself, O'Kelley said.
"I am always amazed at how many people show up here just because we are a five-star facility, and had never stepped foot in here," she said. "People should visit, get to know the staff and ask around."
Proponents and critics of the star system say it is a useful tool, but it has flaws. Medicare tries to streamline the standards of all states into a one-size-fits-all scenario, they say.
"You have differences between states, different ideas about what constitutes a deficiency, and a lot of information is provided by the nursing homes themselves," Willard said. "It is a worthwhile measuring stick, but it is not the only tool for finding a facility for a loved one."
'A good first glance'
Medicare officials say a one-star rating does not mean a nursing home is a bad facility. All homes must meet baseline Medicare conditions, which are often higher than state standards.
"It's a good first glance for people," said Lee Millman, spokeswoman for the Centers for Medicare and Medicaid Services' Atlanta region, which includes Tennessee.
The agency even states on its own Web site that the report has limitations, noting that state requirements vary and that some data are self-reported and may reflect only a two-week period.
Medicare "uses a system of ranking for staffing that is based on desired staffing levels, not a required or mandated level," said Ron Taylor, executive director of the Tennessee Health Care Association. "Using that staffing level, a lot of facilities that have good, quality service don't rank really high because they don't meet (Medicare's) standard. But they meet the state standard."
Keith Smith, administrator and CEO of Spring Meadows Health Care Center in Clarksville, said it's good that the government tried to keep the ratings simple, but the program needs serious work.
"The whole system was very prematurely implemented and fundamentally flawed," Smith said. "But we try to work with it."
Spring Meadows received an overall one-star rating. It moved up in the area of quality from one star to three.
The ratings for staffing and surveys focus on regulatory compliance, not quality of care and outcomes, he said.
"I'm all about the public having a good tool to evaluate, but this is not it," he said.