Manor

Manor care: nursing home lawsuits

Discussion of Nursing Home Lawsuits and Settlements with Manor Care

Background

HCR ManorCare provides healthcare through nursing homes, assisted living facilities, rehabilitation centers, hospice and home health care.  It operates under three names—ManorCare, Heartland and Arden Court.  Though based out of Toledo, Ohio, it has 500 locations in 32 states, with a total of 60,000 employees. 

Manor Care in Maryland

ManorCare was an independent company before it merged with HCR in 1998.  Before the merger, ManorCare was based out of Gaithersburg, Maryland and had an acute care hospital (which it later sold), 42 assisted living facilities and 171 nursing centers.   Right now, there are 31 ManorCare facilities in Maryland (in cities such as Silver Spring, Potomac, Towson, Catonsville, Bethesda, Chevy Chase, Upper Marlboro, Baltimore, Rosedale, Pikesville, Hagerstown, Ellicott City, Derwood, Beltsville, Adelphi, Hyattsville and Chestertown).  There are about 11 Arden Courts facilities in Maryland, and four Heartland facilities. 

HCR ManorCare’s Services

HCR ManorCare wears a number of hats.  They provide long-term nursing care, short-term care (for example, for patients requiring rehabilitation after surgery), alzheimers care and hospice care.  Whether because of a shift in ManorCare’s focus or hospital overcrowding, ManorCare has assumed the role of caregiver for patients who have serious medical conditions.  ManorCare’s 2011 Quality Report states that “[w]e are able to admit many patients who are clinically and medically complex….”  The company is clearly focused on preventing rehospitalizations. 

Ideally, that goal will be supplemented with properly trained staff, competent and caring doctors, and adequate staff-to-patient ratios.  Too often, however, our medical negligence lawyers and nursing home malpractice lawyers find that these grandmanorcareiose goals are undercut by companies that care more about their bottom line than the care they provide their patients.  To put it mildly, many times nursing homes and health care centers like these “cheap out”—they have too few staff, they don’t properly educate and retrain the staff, and they hold on too long to patients who should be sent to the hospital. 

ManorCare’s Ratings

The federal government evaluates, rates and compares nursing homes.  The results for Maryland ManorCare facilities are less than impressive.  Grouped together and averaged, these are the results:

  • Overall Rating: 20/45 stars (44%)
  • Health Inspections: 16/45 stars (36%)
  • Nursing Home Staffing: 26/45 stars (58%)
  • Quality Measures: 34/45 stars (76%)
Nursing Home Injuries:  Bedsores

By far, the largest percentage of nursing home injuries we see are skin ulcers, also called pressure sores and bedsores.  These are holes that start in the skin, oftentimes because bed-ridden patients (particularly those with alzheimers, dementia or significant physical impairments) are not moved frequently enough.  Lying in one position for long periods of time cuts off blood flow to some areas of the body.  Deprived of oxygen, those skin cells begin to die.  Then the tissue underneath begins to die.  Before long, patients acquire deep and oftentimes untreatable ulcers that are black, necrotic and penetrate to the bone.    These ulcers can be tough to look at—you can see the four stages of bedsores  here (courtesy Michael D. Havranek, Amicus Visual Solutions). 

Bedsores are a normal part of nursing homes, and minor Stage-1 bedsores do not necessarily imply negligence.  Even if they are a result of negligence, there is usually limited injury for this type of bedsore.  Significant nursing home malpractice happens when staff (1) fails to recognize the presence of pressure sores; and (2) fails to treat existing pressure sores.  Caught early, further injury is preventable.  Ignored for too long, and damage may be long-lasting or permanent.  It is not uncommon for patients to die because of infection caused by bedsores. 

Nursing Home Injuries:  Falls

Falls are a second common nursing home injury.  People admitted to nursing homes and other long- or short-term care facilities often have physical limitations, whether because of a recent surgery, advanced age, or disease.  Patients must be cared for based on these limitations.  Some patients should have beds with side rails to prevent them from falling out.  Many falls happen because the patient-to-staff ratio is so high that patients do not have help going to the bathroom.  When they attempt it on their own, which they know they shouldn’t do (but are left with no choice), injuries happen.  It can be difficult for the elderly or people who already have significant injuries to recover from new bone fractures. 

ManorCare Lawsuits

Our firm has faced down HCR ManorCare on a number of occasions.  Anecdotally, it appears to have a large “market share” of nursing home malpractice lawsuits.  One lawsuit in particular, against a facility in West Virginia, left jurors so angry that they awarded over $90 million to the family of a woman with dementia who died after the facility’s failure to treat her decubitus ulcers and dehydration.  Post-trial motions show ManorCare’s lawyers arguing that the state’s medical negligence noneconomic damage cap should apply; and plaintiffs’ lawyers arguing that the medical malpractice cap shouldn’t apply because the failures alleged were basic services—failure to provide water, food and other basic care that required no physician involvement.  Evidence in that case showed a profit motive for the company—plaintiffs argued that the company took home over $4 billion in profit every year (though, ManorCare later argued that its actual profits were closer to $75 million). 

Importantly, every state has specific rules on punitive damages.  In Maryland nursing home neglect cases, punitive damages are not available.  However, that fact should not deter patients and family members from bringing a claim to hold negligent nursing homes responsible for their conduct and to force them to pay compensatory and non-economic damages. 

Sample Lawsuits and Expert Reports

The majority of meritorious nursing home lawsuits against Manor Care in Maryland do reach a settlement. Not many good cases are going to trial. Here are some sample legal documents we have filed in nursing home lawsuits against Manor Care and a sample idea of their defenses:

Contacting a Nursing Home Lawyer

     If someone you love was cared for by Manor Care and has injuries or unknown origin, bed sores, a broken hip or frequent falls and you are suspicions of elder abuse or nursing home negligence, a personal injury/malpractice lawsuit may be filed on their behalf. If you believe that you or someone you love has suffered a serious injury as the result of nursing home abuse or nursing home neglect, call our nursing home attorneys at 800-553-8082 for a free Internet consultation to discuss a potential lawsuit. There are no fees or expenses unless a recovery is obtained.

Finding a Nursing Home in Maryland: More Information
Nursing Home Lawsuits in Maryland: Samples and Explanation of Maryland Law