Results from the 2017 AAJ STAC National Finals in Cleveland

After five grueling days of competition, we’re crowned the National Champion for law school trial teams!

Find Out Who You Judged

First, recall what day / rounds you judged.

  • Round 1 was Thursday
  • Round 2 was Friday
  • Round 3 was Saturday a.m.
  • Round 4 / Quarter Finals was Saturday p.m.
  • Round 5 / Semi-Finals was Sunday a.m.
  • Round 6 / Finals was Sunday p.m.

Then, either recall the team’s letter or the courtroom you were in.  This chart will “decode” the teams you saw, by Team letter:

And this is the list of schools based on team letter:

And the Winner Is…

The final round was Wake Forest (Team H as Plaintiff) versus Belmont (Team N as Defendant).

They swept the round, taking all tree judges, but won by just 5 points. It was a tight round!

The 2017 National Champion is Wake Forest!

Check out tons of photos and more information at the Eadie Hill Trial Lawyers Facebook Page.

 


The Corporate Understaffing Game in For-Profit Nursing Homes

Earlier we reviewed the Plain Dealer article on Park East nursing home in Beachwood, Ohio, and it’s poor ratings, big fines, and deadly care from understaffing.

I thought I’d take a second to point out a familiar and disturbing part of how nursing homes are run: the corporate understaffing game.

Silhouette of three business people in suits

It’s the “corporate” folks who are understaffing most for-profit nursing homes.

When I’m investigating a nursing home on behalf of a family whose loved one was killed in the nursing home, the common defense is that the person was old, sick, and dying.  Nursing home dehydration, for example, is easy to blame on a person’s medical conditions. Dehydration can be caused by vomiting or diarrhea associated with infection, “third-spacing” fluids, or sepsis.  But dehydration from inadequate intake can cause illness and death itself–and quickly.  Or dehydration can cause otherwise stable medical conditions to become emergencies.

What is one major reason people do not get enough fluid?  There aren’t enough nursing staff members available to help them eat and drink, or to monitor and make sure they’re eating or drinking enough.  (source)

That’s called understaffing.  (Learn more about Nursing Home Dehydration negligence.)

Now, you might think there’s a decision at the nursing home to under-staff.  Or a decision to staff a certain amount, but the amount of nursing staff is too, low.  Whether on purpose (to make more money) or because of carelessness, the nursing home in-building leadership should be to blame, right?

Not in my experience.

Most nursing homes are for-profit (source).  As Leading Age reported, there are some major differences–mostly bad–between for-profit and non-profit nursing homes, such as more hospitalizations, more deficiencies, and lower staffing levels.

When those for-profit nursing homes are part of a chain, it is almost always the “corporate” level decision makers who control the money.  And it takes money to budget and staff a nursing home.

Profiting from understaffing is a simple formula.  Profit = income – expenses.  The number one source of income in a nursing home is residents–the needier, the better.  The number one expense in a nursing home is nursing staff. So for the corporate folks, Profit = (residents) – (staff).  More residents and less staff means more profit.

A lot more.

In one nursing home case we took to trial, our expert discovered over $4 million in understaffing in just three years.  From one nursing home that was one of dozens the for-profit company owned.

That’s a lot of extra profit.

I never blame the nurses or aides themselves, unless there’s direct physical abuse.  Most of the nurses and aides I’ve dealt with–when suing their nursing home employer for killing a resident they cared for–are well-meaning, caring people.  That’s good.  But it is simply impossible to care for 20 people at one, alone, as a nurse.  or 10-15 as an aide.  There’s just too much to do for each person.  Something will have to give.

So even after the nurses and aides run around, high-stress, burning themselves out, staying late (sometimes off the clock), there’s still things that have not been done.

Sometimes that means someone does not get turned enough, and develops a bedsore skin wound.  Or they’re not fed enough and develop dehydration or malnutrition.  Maybe they recover.  Sometimes they die.

So a nursing home corporation can make a few extra bucks.

What have you seen in nursing homes that shows too few nurses or aides were working?  Post a comment below, or contact us if you think a loved one has been injured or killed as the result of nursing home understaffing, abuse, or neglect.


One of the Worst Nursing Homes in Cleveland?

Most people understand—in a general way—that nursing homes can be a scary place.  But most people do not know the specifics.  How and why a nursing home can kill someone.

I see that all too often.

A Plain Dealer report by John Caniglia & Jo Ellen Corrigan this week included an article on a nursing home in Cleveland, Ohio that has earned the lowest possible rating on Medicare’s 5 star rating system.

With over 200 beds, this is a large facility.  And it is located in a well-to-do suburb, Beachwood.  And it has been fined hundreds of thousands of dollars for substandard care the killed people.

Park East Care and Rehab Center is a facility I’ve become familiar with from calls from the public.  And with this new report, some of the serious concerns from state investigations have been highlighted.

Image of large brick building with blue sky.

A marketing image of Park East nursing home in Beachwood, Ohio (source: http://www.genesishcc.com/)

One of the terrifying things I’ve found with nursing homes is how vulnerable you are.  The more care you need, the more vulnerable you are.  And the more dangerous it can be if the nursing home is understaffed or has poorly trained or monitored employees.  You could need help moving in bed to prevent bedsores, or help eating and drinking to avoid dehydration.

That’s what makes the story the Plain Dealer reported so terrifying.

A man who had a tube inserted into his windpipe so he could breathe, called a tracheotomy.  Those tubes, like our throats, can become filled with fluids.

But unlike our throats, you can’t just clear the tube yourself.  You need someone to do it for you.  Or you can’t breathe.

Overnight shifts are some of the worst-staffed shifts in nursing homes I’ve seen.  But that doesn’t mean people do not need care.

As Caniglia & Corrigan report, things did not go well for this man overnight:

On Sept. 18, 2015, a 39-year-old male resident was admitted to the nursing home with severe respiratory issues. Records show he had a tracheostomy, a procedure in which a tube was inserted into his windpipe to allow him to breathe.

A doctor’s order required the nursing staff to suction the tubing every four hours. But state and federal reports regarding his treatments say there was no written indication that suctioning had been done at 12 a.m. or 4 a.m. on Sept. 21. At 6:30 a.m., he was found to be unresponsive. He later died.

According to a state report, the nursing home’s manager of clinical operations did an internal investigation and interviewed the registered nurse who cared for the resident. The nurse, according to the report, said the resident’s tracheostomy tube had become disconnected at 11:30 p.m., 30 minutes before the tubing was to be suctioned.

“He (the registered nurse) said that he did not think the resident required suctioning during his observations of him throughout the night,” according to a report by the Ohio Department of Health, which investigates complaints at nursing homes.

Terrible care.

What’s worse?  First, it’s only coming to light because the staff did not simply fill in the treatment sheets pretending they’d provided the care.  That’s easy to do, especially when a facility is understaffed.

Second, no jury will ever hear about Ohio’s investigation.  Why?

Because the Ohio General Assembly decided to protect dangerous nursing homes over keeping resident’s safe.

I’m glad the Plain Dealer is spending so much time and energy to help the public understand the crisis we find in nursing home care.  Park East is one of many for-profit nursing homes making money from government funding while providing substandard care.   Maybe if people have a better understanding of these issues, they’ll demand change at the statehouse.

It could not come soon enough.

What do you think of this care?  What has you experience been with nursing homes?  Have you experienced nursing home abuse, or been involved in nursing home lawsuits? Comment below.


New Research: Headaches Much More Common in Pediatric Strokes than Adult Strokes

New research presented at the 2017 International Stroke Conference taking place in Houston, Texas confirms childhood strokes may be linked to headaches, much more often than in adults.

As reported by MedPage Today:

For children 3 to 18 years of age, 46% of acute arterial ischemic strokes presented with headache, Lori L. Billinghurst, MD, of the University of Pennsylvania in Philadelphia, and colleagues reported here at the International Stroke Conference.

While the rate was 6% in those younger than 3 years, limited communication capability may have limited reporting, Billinghurst noted at a press conference.

She contrasted the high rate of headache in the older children with the rate of no more than 25% among adults in a prior prospective hospital-based registry.

That’s almost two times the rate of headaches reported for children at or near the time of an ischemic stroke.  Given this new and critical finding, doctors need to pay attention.

Pediatricians and in particular emergency room doctors need to understand the difference in importance of headaches for children.  Otherwise, they may not recognize the emergency.  That will lead to more pediatric stroke malpractice for failure to diagnose.

“This study shows that headache at the time of stroke onset is more common in children than adults — in about 50% of cases,” Dr Saba told Medscape Medical News. “Stroke is much less common in children but still does occur; when it does occur, it is more likely to be attributed to an abnormality of the blood vessels.”

How should doctors react?  As reported in EMS World, this requires doctors to take action:

“Stroke should be considered as a possible diagnosis in any child with a headache and additional symptoms of weakness or numbness (in the face, arm or leg) or changes in walking, talking or vision,” said Lori L. Billinghurst, M.D., M.Sc., clinical assistant professor of neurology at the University of Pennsylvania in Philadelphia. “Urgent brain imaging may be required to distinguish a migraine with aura from a stroke.”

That is not to say headache alone is enough to diagnose stroke in children.  It is just a factor to consider in a differential diagnosis.

Why do children suffering from stroke have (or report) more headaches than adults?  According to one of the study’s lead authors, the issue may related to the differences in juvenile brain blood vessels, or the role of inflammation:

“It is possible that younger brains have blood vessels that are more easily distended and more likely to activate pain sensors that trigger headache. It is also possible that inflammation – a powerful activator of pain sensors – may be more important in the processes underlying stroke in children than in adults,” Billinghurst said. “The VIPS study has already shown that inflammation plays a key role in the vascular injury pathway in children with stroke. We will be doing further work to see if there are differences in blood markers of inflammation in those with and without headache at time of stroke.”

Although headache was most common in stroke related to blood vessel tears or narrowing, the numbers in this study were too small to suggest that doctors use the presence of headache to determine the stroke cause, according to the researchers.

“We would like to conduct a study of children who enter hospital emergency rooms with headache and suspected stroke to see whether there are characteristics of the headache or other neurologic symptoms that predict whether a stroke will be confirmed on imaging. We would like to develop a predictive formula that can help physicians diagnose stroke more rapidly and enable earlier, perhaps life-saving, stroke treatments,” Billinghurst said.

See the American Heart Association’s press release for more information on the report.

Have you experienced stroke or had a child suffer a stroke?  Learn more at our sister site, Ohio Stroke Lawyer (www.ohiostrokelawyer.com) or leave a comment below.


New Infographic Helps People Understand Pediatric Stroke

The American Stroke Foundation published an infographic to help people understand, identify, and react to strokes in children:

Available for download in English and Spanish.

Learn more about pediatric stroke malpractice at our Ohio Stroke Lawyer site.


Nursing Home Staffing Tricks: Inspection Bump

If you’re looking for a nursing home for yourself or a loved one, the federal agency that oversees nursing homes–the Centers for Medicare and Medicaid Services, or “CMS”–has a great resource to look up and evaluate nursing homes.  It’s called “Nursing Home Compare,” and you can find it here.

But wait!

As I’ve sued more nursing homes and gotten into the weeds on their staffing, I’ve found a disturbing trend.  There can be a “bump” in staffing around the time of the nursing home’s annual “surprise” inspection.  (I say “surprise” because they are not supposed to know when it is happening.)

Why does this matter?

The Nursing Home Compare’s 5-Star rating system evaluates things including staffing.  We know better nurse staffing leads to better resident outcomes.  So it is kind of important to be accurate about staffing.

As it turns out, the staffing picture isn’t based on the staffing data the nursing home submits to Medicare throughout the year.  It’s based on just a 2-week snapshot from just before the inspection.

Now, if nursing homes were really “surprised” by the inspection, that shouldn’t matter, right?  Except, we see the bump, which means something is going on.

Besides the possibility they are tipped off or find out when the inspection is coming, another possible explanation is that the two-week data is submitted on a different form than normal staffing data.  That gives the nursing home the opportunity to inflate the numbers.  not honest, not fair, but a possibility.

So when using the resource, take the rating with a grain of salt.


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