Provider, help thyself

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Elizabeth Newman, McKnight's Senior Editor
Elizabeth Newman, McKnight's Senior Editor
There is a fair amount of complex legalese that McKnight's aims to decipher for our readers, whether it's the intricacies of this week's Supreme Court arguments, an obscure statute governing some aspect of Medicare that ended up in court or whether a spider bite that killed a nursing home resident is a “healthcare liability.” 

So you might expect attorney Timothy McVey to have a wonky, intricate presentation last week at McKnight's Online Expo about wound care cases. I had thought that these cases were based on wound minutiae, or egregious examples of neglect.

What is closer to the truth, McVey said, is that wound care cases land in court largely due to one bigger truth: Too many providers are relying on verbal agreements or instructions between residents, families and staff. In short, a lack of documentation is what can mean the difference between a provider winning and losing a case.

In one horrific case McVey discussed, a lady with Stage 4 metastatic breast cancer had been very clear: She didn't want to be moved, and she didn't want painkillers because she wanted to be able to talk to her daughter. But when she was transferred to a hospital, and staff saw an enormous wound, there was no amount of talking that was going to keep that case out of court.

That's also a good example, McVey said, of how sometimes a provider can't abide by the wishes of a resident if there is going to be more harm than good. But in other circumstances, measuring, documenting and even photographing a wound is what can protect a provider in court. In fact, a long-term care nurse wrote for McKnight's last year about how wound photography allowed her home health company to win in a suspected Medicare fraud case.

McVey also didn't mince words about the frontline caregivers who may be overseeing a wound. Even if you believe all of your staff are articulate and truthful, with excellent memories and stellar track records, no amount of moral fiber can keep a witness from potentially being destroyed on the stand.

But all hope is not lost, he said. Having a physician or wound expert evaluate the resident's wound, coming up with a care management plan and imputing extensive notes can protect a provider, not to mention it is also the right thing to do.

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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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