Kentucky nursing homes are some of the worst in the United States. This is partly because Kentucky imposes few regulations to ensure that nursing homes provide adequate staffing to care for residents. The result is that some of the companies that own nursing homes reduce staff as much as possible in order to maximize their profits. Our firm recently resolved a case that was a direct result of such a reduction in nursing home staffing. 

The family of a woman who had recently passed away called us to investigate the circumstances of their mother’s death. Their mother had been a resident for two years at a Kentucky nursing home. She was admitted by her family doctor after she began having difficulty caring for herself due to increased symptoms of dementia.

Our Clients Were Happy With the Care Their Mother Received for Nearly Two Years

Her children had been taking turns keeping an eye on her and helping out at her house, but her dementia had progressed to the point where she required more help than they could safely give her with eating and bathing. The family visited a few nursing homes but were impressed with the Administrator and Director of Nursing (DON) at this particular home, so they chose to have her admitted. She was a Medicaid recipient, and the home had just recently had a bed open up. For almost two years, the family had no complaints concerning her care. They visited her several days each week, and she always seemed happy and well cared for.

The Family Noticed a Significant Decline in Care After the Nursing Home Changed Ownership

Then, the nursing home was sold to an out-of-state company. When the new company took over, they immediately replaced the Administrator and DON. They also replaced some of the more experienced nurses—those who had worked at the home for several years—with agency nurses.

The family was concerned, but the new company held a meeting with the families of the residents to inform them and answer questions concerning the change in ownership. They made several statements indicating that there was no need to be concerned. The new administration stated that the care wouldn’t be negatively impacted—and it might actually improve in some areas.

It only took two weeks before the family noticed a change in their mother. She didn’t seem as happy when they visited. They expressed their concerns to the nurses but were reassured that she was probably just having a bad day. Her mood didn’t seem to improve, and they became increasingly concerned. The family also noticed a change in the demeanor of the staff in general and also a reduction in their numbers. The nursing home had changed. Their mom didn’t appear as well bathed and groomed as she had in the past, and the family had to help clean her whenever they visited.

The Woman Died Despite Nursing Home Staff Assurances They Could Properly Care for Her

A meeting was held, at the family’s request, with the Administrator and new DON. They assured the family that they would increase their oversight to ensure their mother was receiving what she needed in terms of care.  Despite their promises, the problems persisted, and their mother began to further decline. Her swallowing difficulties (dysphagia) increased to the point that she had to have a feeding tube—known as a PEG tube—to ensure she was receiving enough calories and nutrients.

The nursing home assured the family that they were capable of caring for the feeding tube. The family was concerned, given the recent trend of events. Only nine days after receiving her PEG tube, the family was called by a nurse aid to inform them that their mother was transferred to the hospital due to an issue with her feeding tube. The family arrived at the hospital and learned that she had aspirated due to a blockage in the PEG tube line. Luckily, she did not develop aspiration pneumonia and was discharged back to the nursing home within a few days.

The family began contacting other nursing homes in an effort to move her to a different facility.  Unfortunately, this was one of only three homes within the area, and they were full. They then started to contact homes further away in Louisville. Tragically, during these few days of trying to move her out of the nursing home, they received a call that she had passed away. This was when they contacted our firm to help them find out what happened.

We Got to Work to Find Out What Really Happened

Immediately after meeting with the family, our firm delivered litigation hold letters to the nursing home, demanding they preserve all evidence concerning our clients’ mother. This included medical records, financial records, witness statements, internal investigations, electronic data, surveillance data, staffing logs, meeting minutes, and all department logs. We also had our private investigators look into the background of the company that had recently purchased the nursing home as well as the new Administrator, DON, and the agency nurses that had taken over the resident’s care.

This is what we discovered after reviewing the evidence gathered:

  • The company that purchased the nursing home had been cited over 37 times for resident care violations in less than 3 years.
  • The Administrator had been involved in over 5 homes in the past 10 years and appeared to be the company’s hatchet man for newly purchased homes.
  • There had been 2 resident deaths since the nursing home had changed ownership, and the state office of inspector general was conducting an investigation into those incidents.
  • Two of the agency nurses had past criminal charges.
  • The nursing home staff had been reduced by approximately 17% since the new owners took over.

We then turned our attention to the medical records. After reviewing in house with our staff nurse, we sent the records out to several nursing home care experts, including a former nursing home administrator, a DON that teaches nursing home care and regulatory compliance, and a geriatrics doctor with years of clinical experience in caring for patients with PEG tubes. After discussing the case with our experts, we were confident that our clients had a solid case of nursing home abuse and neglect.

The evidence showed that their mother did, in fact, experience a clinical decline almost immediately following the change in ownership at the nursing home.  According to the nursing notes, her social time (when she was taken to the common areas to be near and interact with other residents and staff) decreased by over 50% after the nursing home changed ownership. In addition, the nursing notes contained large charting gaps in her bathing schedule, indicating that she was not receiving proper bathing care.

The most alarming discovery involved her PEG tube. The charting concerning the PEG tube was a tale of inadequate training and a lack of administrative oversight. There were two nurses primarily involved in caring for the PEG tube. Both nurses had notations in their personnel file, indicating that they had to be re-educated several times concerning PEG tube care. In addition, the charting indicated that on several occasions, including the day our clients’ mother aspirated, the nurses placed too much Ensure into the PEG tube. This excessive amount is what led to the aspiration.

Feeding Tube Displacement Led to the Woman’s Death—and the Staff Ignored All of the Signs

We then discovered what had caused her death. The nurses had ignored several clinical signs of PEG tube displacement. When our clients’ mom returned from the hospital following her admission for aspirating, she began complaining of abdominal discomfort later that evening. In addition, she was noted to feel “hot” and appeared “flush,” although the nurses did not check her temperature.

The next day, she continued to have these same clinical signs with the additional sign of a slightly distended abdomen (swollen stomach). Incredibly, the nurses did not notify a physician of these signs and symptoms, nor did they investigate them further. In fact, there was no mention of even considering that there might be a problem with her feeding tube.

The PEG tube had become dislodged and was spilling the total parenteral nutrition into her abdominal cavity. This caused her to develop peritonitis, a very serious medical condition in which the body can quickly become septic. She died because the nursing home staff neglected to investigate obvious signs of infection and inflammation in a resident with a PEG tube—a clear case of nursing home abuse and neglect.

We Uncovered Evidence of Negligence and Sent a Large Settlement Demand to the Nursing Home

Once we discovered the cause of her death and uncovered evidence of negligence, we discussed our plan of action with the family. Given our strong expert opinions and clear evidence, we sent a demand for settlement package to the defendant nursing home, giving them 30 days to pay our demand, or we would file the lawsuit. We also stated that if they accepted our demand, we would require proof of their insurance coverage limits before any offer was formally accepted. We didn’t want to leave any money on the table, especially given their reckless conduct.

Within 15 days, we received a letter accepting our demand. We also received verified proof of two insurance policies for amounts that were less than what we had demanded. Not only had the nursing home’s insurance companies paid their insurance policy limits, but the nursing home contributed their own money to settle the case.

Our Hard Work Paid Off for the Family and Sent a Message to the Nursing Home

While this is not a typical scenario to achieve such a large settlement pre-lawsuit, it is proof that our diligence, hard work, and aggressive litigation lets the defendants know we are ready, willing, and able to take our cases to a jury. We are proud of our work for the family in this case and confident that we sent a wake-up call to the nursing home to take better care of its Kentucky residents.

If you believe your loved one is a victim of neglect or abuse in a Kentucky nursing home, contact our office today to learn more about your rights and legal options during a complimentary, no-obligation consultation.

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Matthew L. White
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Founder & Partner of Louisville Personal Injury Law Firm Gray & White Law

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