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Ventilator Patient Neglect in Nursing Homes

Medical advancements have led to increased survival rates for critically ill patients, meaning that the number of patients who need a ventilator (also known as a respirator) to breathe continues to increase every year. Many of these ventilator patients end up in nursing homes or long-term care facilities with ventilator units and teams of doctors, nurses, aides, and respiratory therapists working around the clock to support their care. It is important to ensure that ventilator patients are protected from ventilator patient neglect in nursing homes. It can be very distressing when a loved one needs a ventilator to breathe, and this situation is made even worse if your loved one is a victim of ventilator patient neglect in nursing homes. Read on to learn more about ventilators, the nursing homes that accept ventilator patients, and what to do if your loved one suffers ventilator patient neglect in a nursing home.

Recent cases in the news illustrate the sad reality that ventilator patients can and do suffer neglect in nursing homes, sometimes leading to devastating consequences. As we previously reported, at Palm Gardens Center for Nursing and Rehabilitation in Brooklyn,  two ventilator-dependent patients died after nursing home staff allegedly failed to turn their ventilators back on following a cleaning. Nursing staff at the facility don’t know how to operate the ventilators; only respiratory therapists do, and this lack of communication allegedly led to a staggering tragedy. Palm Gardens, a 240-bed facility run by a for-profit corporation, was cited for seven deficiencies from 2015 to 2019, according to government inspectors.

This was not the only case of a ventilator patient dying because of alleged nursing home neglect. At A. Holly Patterson Extended Care Facility in Uniondale, New York, a resident of the facility’s special respiratory unit died after staff allegedly failed to respond to ventilator alarms. Two registered nurses and one nurses’ aide—initially charged with felonies—were ultimately convicted of Willful Violation of Health Laws, a misdemeanor. The nursing home, A. Holly Patterson Extended Care Facility, a 589-bed facility run by the state, was cited for eight deficiencies from 2016 to 2018. On A. Holly Patterson Extended Care Facility’s Yelp page accessed on February 17, 2020, one Yelp reviewer wrote “Think ‘One Flew Over the Cuckoo’s Nest’ and you’ll have a good picture in your mind” of conditions at A. Holly Patterson Extended Care Facility, also noting that it is “run more like a jail than a care facility.” Another Yelp reviewer referred to the facility as “a horror.”

How might these tragedies have been prevented? In addition to always responding to ventilator alarms, nursing home staff should also be aware of the multifaceted care needs of ventilator-dependent patients.  Proper care while on a ventilator in a nursing home involves many components, such as:

  • Infection prevention
  • Skin irritation prevention
  • Maintaining the hygiene of the equipment
  • Mouth care
  • Bedsore prevention

It is important to prevent infection and skin irritation when a patient is on a ventilator. The equipment must be cleaned and positioned correctly.  A piece of tape or a strap is typically used to keep the endotracheal tube in place. When it gets dirty, the tape or strap must be cleaned. The tube must also be regularly moved from one side of the mouth to the other to prevent it from rubbing against the tissues of the mouth and causing an irritation.

Mouth care is another important part of caring for a ventilator patient in a nursing home. When patients are on a ventilator, their mouths are often dry. Nursing staff must clean the mouth and moisten it to protect the patient’s teeth and reduce any bacteria that could make its way into the lungs, leading to pneumonia. Similarly, nursing staff must use a suction device to remove oral secretions from the mouth, as these could drain into the lungs and cause infection. Lung secretions are also suctioned since ventilator patients cannot cough these up.

It is also important to prevent bedsores in ventilator patients. Ventilator patients are often very sick and weak, so they may not be able to reposition themselves on their own. Nursing staff must reposition them at least every two hours to prevent bedsores. For more information about bedsores, see our article “Bedsores: A Telltale Sign of Nursing Home Abuse.”

Because ventilator patients in nursing homes are often very weak or immobile, these responsibilities fall to nursing home staff. When nursing home staff fail to take the proper steps to prevent infection in a ventilator patient, the patient’s family should consider contacting a nursing home abuse attorney to pursue a claim for nursing home abuse and neglect.

While it is important to understand how nursing staff care for ventilator patients and how to prevent the neglect of ventilator patients in nursing homes, it is also important to recognize that the goal is to eventually get patients to breathe on their own. This process is known as ventilator weaning. It involves helping the patient do breathing exercises in the hopes of eventually removing the ventilator. Unfortunately, this is not always possible, and nursing home staff should know how to care for long-term ventilator-dependent nursing home residents. Since wearing an endotracheal tube can damage the vocal cords and other delicate structures in the mouth and throat, patients who require long-term ventilator care (such as those in nursing home respiratory pavilions) may receive a tracheostomy. If nursing home staff failed to try to wean your loved one from the ventilator, or if the endotracheal tube damaged your loved one’s vocal cords, your loved one may have been a victim of nursing home abuse or neglect.

Which long-term care facilities accept ventilator patients? Many nursing homes accept ventilator patients, but some nursing homes have special “respiratory pavilions” or other specialized support for patients on ventilators. If you are considering nursing home care for a ventilator patient, it’s important to learn about the different facilities that cater to the unique needs of ventilator-dependent residents. In New York and New Jersey, the following facilities have been identified as providing specialized support for ventilator-dependent patients:

New Jersey:

  • Eastern Pines Convalescent Center, a 10-bed facility in Atlantic City, New Jersey
  • The Wanaque Center for Nursing and Rehabilitation, a facility focusing on ventilator-dependent children in Haskell, New Jersey
  • Voorhees Pediatric Facility, a 68-bed facility in Voorhees, New Jersey
  • Linwood Care Center, a 21-bed facility in Linwood, New Jersey
  • Bergen Regional LTC in Paramus, New Jersey
  • Chateau, a 10-bed facility in Rochelle Park, New Jersey
  • Silver Care Center, a 13-bed facility in Cherry Hill, New Jersey
  • Pope John Paul Pavillion, a 30-bed facility in Orange, New Jersey
  • Windsor Gardens in East Orange, New Jersey
  • Meadowview, a 31-bed facility in Williamstown, New Jersey
  • Harborage, a 14-bed facility in North Bergen, New Jersey
  • Hartwyck at Oak Tree, a 16-bed facility in Edison, New Jersey
  • Bayshore Healthcare Center, an 11-bed facility in Holmdel, New Jersey
  • Victoria Healthcare in Matawan, New Jersey
  • Respiratory Rehab Center, a 25-bed facility in Dover, New Jersey
  • Lakeview Subacute, a 16-bed facility in Wayne, New Jersey
  • Clark Nursing, a 10-bed facility in Clark, New Jersey
  • Westfield Center (Genesis), an 8-bed facility in Westfield, New Jersey

New York:

  • Avalon Gardens Rehabilitation & Health Care Center, a facility with 14 pediatric beds in Smithtown, New York
  • Daughters of Jacob – Triboro Center in The Bronx, New York
  • Monroe Community Hospital in Rochester, New York has 20 beds for ventilator patients
  • New Vanderbilt Rehabilitation & Care Center in Staten Island, New York with a 40-bed ventilator unit and a 40-bed stepdown unit for trach users
  • Pathways Nursing & Rehabilitation Center in Niskayuna, New York
  • REMEO Pediatric Ventilation & Weaning Center, an 18-bed unit in Albany, New York
  • St. Barnabas Nursing Home in The Bronx, New York
  • Splitrock Nursing Home in The Bronx, New York
  • Palm Gardens Center for Nursing and Rehabilitation in Brooklyn, New York
  • Angela’s House, a home for medically-fragile children in Hauppauge, New York
  • Gurwin Jewish Nursing & Rehabilitation Center (Weinberg Pavillion) in Commack, New York
  • A. Holly Patterson Extended Care Facility in Uniondale, New York

(This list comes from the International Ventilator Users Network.) If you fear that your loved one may have been abused or neglected in a nursing home, don’t hesitate to contact a nursing home abuse attorney. Call (877) 238-4175 or email info@fkesq.com for your free case consultation