Counties are only liable for poor nursing home care caused by municipal policies, judge rules

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Even if county nursing home workers provide poor care, the county is not liable unless the employees are executing an official policy, a federal judge in Pennsylvania recently ruled, providing a victory for county-operated nursing homes.

The case involved a Bucks County-operated nursing home, Neshaminy Manor Inc. and Neshaminy Long Term Care. Lauretta Notwick, the daughter of a Neshaminy resident who died in June 2010, sued the county, saying her mother had been deprived her civil rights to adequate care under the Federal Nursing Home Reform Amendments.

Notwick's mother, Almira Will, was admitted to Neshaminy in August 2008 after breaking her hip. She required continuous oxygen due to end-stage chronic obstructive pulmonary disease. Notwick alleged that she frequently found her mother's oxygen tank empty or turned off. She also said her mother repeatedly fell while at Neshaminy due to staff negligence, and this led to a second hip fracture in April 2010.

An oxygen policy created by Bucks County led to the inadequate care her mother received, Notwick argued in her suit. Specifically, Notwick cited policy language that staff “may” replace oxygen cylinders with needles halfway in the red, or refill, zone. Judge Lynne A. Sitarski ruled that nursing staff may have provided poor care for Will by not providing enough continuous oxygen, but the discretionary language in the county's policy was not to blame for this. Similarly, Notwick provided no evidence that Will's falls were caused because workers were carrying out a county policy, the judge wrote. She granted a Motion for Summary Judgment in favor of the county.

Precedent for the decision came from a 1983 U.S. Supreme Court Case, Monell v. New York Dept. of Social Services.

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