Assignment: For this week assignment, write a 1500-word essay addressing each of the following points/questions. Read the case study presented at the end of Chapter 10, which begins “The elderly patient resided at the nursing home for almost a year before she died at the hospital.”

Assignment: For this week assignment, write a 1500-word essay addressing each of the following points/questions. Read the case study presented at the end of Chapter 10, which begins “The elderly patient resided at the nursing home for almost a year before she died at the hospital.”

Assignment: For this week assignment, write a 1500-word essay addressing each of the following points/questions. Read the case study presented at the end of Chapter 10, which begins “The elderly patient resided at the nursing home for almost a year before she died at the hospital.”

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Assignment Description:

For this week assignment, write a 1500-word essay addressing each of the following points/questions.

Read the case study presented at the end of Chapter 10, which begins “The elderly patient resided at the nursing home for almost a year before she died at the hospital.”

You be the Judge

The elderly patient resided in a nursing home for almost a year before she died at the hospital. She had been hospitalized for six days, with admitting diagnoses of gram negative septicemia, gram negative sepsis, and acute myeloid leukemia. Also, discovered on admission to the hospital was a necrotic Stage III pressure ulcer on her coccyx, which was nowhere documented in the clinical records from the nursing home. A review of the nursing progress notes was silent regarding any specialized mattress or other comfort devices used for this patient.

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The family sued on behalf of the patient, alleging that the patient’s demise from leukemia was linked to the negligence of the care that the patient had received in the nursing facility. The defense lawyer for the facility denied any negligence in the cause of the patient’s death.

Did the lack of documentation in the admitting nurse’s assessment and notes affect the ultimate outcome of this case?

Was there negligence on the part of the nursing staff in the care of this patient?

What could the nurse have done differently to facilitate a different outcome in this case?

How would you decide this case?

Using the sample professional liability insurance policy (Chapter 11 p. 191-192 Figure 11-1) locate the various provisions:

Limits of liability

Declarations

Deductibles

Exclusions

Reservation of rights

Covered injuries

Defense costs

Coverage conditions and supplementary payments

Did you have difficulty finding some of the sections? Would this be a policy that you would consider purchasing for your own liability coverage? Why or why not?

Figure 11–1 Sample Professional Liability Insurance Policy
Description

The figure lists the following:

DECLARATIONS

Policyholder’s Name: Judy Doe

Covered Professional Occupation: Registered Nurse; Staff position, Acute care institution or community health/home health

Coverage Period: May 1, 2008 through April 30, 2009

Duties in Event of a Claim: If there is a claim, you must do the following:

notify us and our program administrator, in writing, as soon as possible;

specify the names and addresses of the injured party(s) and any witnesses, information on the time and place of the event;

verbally discuss the nature of the event with our claims representative;

immediately forward all documents that you receive in connection with the claim to us:

fully cooperate with us, or our designee, in the consummation of settlements, the defense of suits or other proceedings, enforcing any right of contribution or indemnity against another who may be liable to you because of injury or damage. You shall attend hearings and trials, assist in securing and giving evidence, and obtaining the attendance of witnesses;

refuse, except at your own cost, to voluntarily make any payment, assume any obligation, or incur any expense.

Limits of the policy: 1,000.000 dollars per claim per 3,000,000 dollar aggregate

In consideration of payment of the premium, in reliance upon the statements in the declarations and subject to all of the terms of this policy, agrees with the named insured as follows:

Read the case study presented at the end of Chapter 11, You Be the Judge, which begins, “During an unexpected heat wave,…” (Guido, p. 195):

You be the Judge

During an unexpected heat wave, the administrator of a nursing home decided against turning on the air conditioner, which resulted in the death of four of the residents of the home. One of the deceased residents’ daughters brought a lawsuit against the home for a wrongful death suit. She was awarded a judgment of $275,000. She then filed a second lawsuit against the nursing home’s insurance company to collect payment on the judgment.

The insurance company refused to pay, stating that the judgment underlying the lawsuit was professional liability and the insurance company did not cover the nursing home for professional judgment. The nursing home then filed a lawsuit against the insurance company for payment of this judgment.

What provisions of an insurance policy would you consult to determine if an insurance company should pay such a claim, and what would the limits of the liability be?

Is the nursing home insurance company correct in saying that this is a professional judgment issue?

Which insurance company (the nursing home’s or that of the administrator of the nursing home, assuming she has coverage) should pay the court-ordered judgment?

How would you decide the case?