title: Where to declare poor nursing home care.
abstract: You have been called to the emergency room to evaluate an elderly nursing home patient sent for consultation who has ischemic gangrene of the right foot. The patient has vasculopathy, has diabetes, and suffers from moderately advanced dementia. The leg ischemia has been severe and the patient had complained repeatedly but was largely ignored. Both heels have ulcerations. A primary care physician usually visits monthly and charged Medicare for a comprehensive visit 2 weeks ago. The facility nurse sent the patient for medical evaluation after his moaning kept other residents from sleeping. He is known only to have an elderly distant cousin. This type of situation has been seen repeatedly from this particular nursing home. What should you do? A. Report the physician to the state medical board. B. Do nothing. You will waste your time and accomplish nothing. C. Encourage the cousin to sue. D. Report the nursing home to the appropriate state agency. E. Call the local newspaper.
authors.affiliation: The Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA. jwjones@bcm.tmc.edu
authors.forename: James W
authors.initials: JW
authors.lastname: Jones
authors.forename: Laurence B
authors.initials: LB
authors.lastname: McCullough
mesh_terms: D000368:Aged; D004552:Elder Abuse; D004636:Emergency Service, Hospital; D019538:Health Care Surveys; D006707:Homes for the Aged; D006801:Humans; D007871:Leg Ulcer / Q000503:physiopathology / Q000628:therapy*; D020380:Needs Assessment; D009735:Nursing Homes / Q000592:standards* / Q000639:trends; D011787:Quality of Health Care; D014481:United States