A good DUI lawyer will get copy of both the video and 911 call in order to defend a person accused of DUI when they are available.  There are certain legal requests that must be done in order to obtain copies of this evidence.  A copy of the video can be seen here:

http://tbo.com/news/crime/polk-man-driving-wrong-way-on-i-4-faces-dui-charge-20150817/?utm_content=bufferfe45e&utm_medium=Social&utm_source=Facebook&utm_campaign=buffer

In addition to the DUI charge, the driver was also arrested for Reckless Driving for allegedly endangering other vehicles on the road.  Both of these charges are misdemeanors.  The driver allegedly refused the breath test which is his right under the law, but will result in an administrative suspension of his license for one (1) year.  This suspension can be fought by filing a request for a Formal Review or the driver may be eligible for a hardship permit for the entire year of suspension depending on his previous driving history.

If you have been arrested for DUI, you need an experienced and aggressive DUI attorney that knows how to obtain the evidence against you and has the experience to defend you in court.

DON‘T HESITATE!!!   PROTECT YOUR RIGHTS!!! 

 CALL DUI ATTORNEY THOMAS GRAJEK NOW!!!

 863-838-5549 cell

 You only have 10 days to request a Formal Review!

NCDD

The driver refused the breath test.  In Florida, the police are not allowed to request a breath test until after someone is arrested for DUI.  The driver is not allowed to contact an attorney and is not given any information on the reliability of the breath test machine.  A driver does not have to submit to a breath test.  It can be a crime if this is a 2nd time refusing the breath test and the administrative suspension for the 1st breath test refusal was upheld.  Why would you help the police a breath test sample when the police do not give you ANY INFORMATION about the breath test machine including the software that calculates your breath test result???

With Halloween approaching, DUI units will be out on the roads discouraging drunk driving so please drink and drive responsibly!

If you have been arrested for DUI , call me IMMEDIATELY!!!  TIME MATTERS IN A DUI CASE!!!

call an experienced DUI lawyer that is a member of both the DUI Defense Lawyers Association (DUIDLA) and the National College for DUI Defense (NCDD).

DON‘T HESITATE!!!   PROTECT YOUR RIGHTS!!! 

CALL POLK COUNTY DUI ATTORNEY THOMAS C. GRAJEK NOW !!!

863-838-5549 cell

Because you only have 10 days to request a Formal Review or get a hardship license!

NCDD

Florida Rule of Criminal Procedure 3.220 (d) requires the defendant to also provide:

• A written list of the names and addresses of all witnesses whom the defendant expects to call as witnesses at the trial or hearing,
• Any witness statement (other than the person arrested),
• Reports or statements of defense experts (including results of physical or mental examinations and of scientific tests, experiments, or comparisons),
• any tangible papers or objects that the defendant intends to use in the hearing or trial.

The prosecutor is also allowed to inspect, copy, test, and photograph the above information and material that is in the defendant‘s possession or control.

That is why it is very important that you start collecting evidence in your case IMMEDIATELY.  This may include text messages, voice mails, pictures of the alleged scene, witness names and phone numbers, letters, or anything else that may help in the defense of your case.  If you wait until the day of trial, the judge could rule that you committed a DISCOVERY VIOLATION for not timely revealing the information and the court may EXCLUDE it from evidence!  That means the evidence would be inadmissible and the jury would never hear your evidence!

If you have been arrested, collect this evidence right away and get it to your defense attorney!  Otherwise the evidence may be destroyed (such as a gas station video, evidence may have to be subpoenaed to obtain it, and it could be excluded if not timely disclosed to the prosecutor.

If you have been arrested, retain an experienced criminal defense attorney that knows Florida’s Rules of Criminal Procedure!

I handle ALL CRIMINAL CHARGES!

DON‘T HESITATE!!!   PROTECT YOUR RIGHTS!!! 

CALL POLK COUNTY CRIMINAL DEFENSE LAWYER THOMAS C. GRAJEK NOW !!!

863-838-5549 cell

NCDD

•  You have 10 DAYS, from the date of your arrest, to request a Formal Review or, for 1st time DUI offenders, waive the Formal Review and obtain a hardship license for the entire administrative suspension time,
• The National Highway Traffic Safety Administration (NHTSA) publishes a manual on how the Field Sobriety Exercises are to be performed and graded by the arresting officer?
• Many police officers do not know what the NHTSA manual requires for a proper investigation,
• Many DUI lawyers do NOT own a copy of the manual!  I have a copy of every NHTSA manual ever published,
• The police do not have to videotape a DUI investigation unless there is a specific department policy,
• Refusing the breath test can be a crime!  Call and learn why a Formal Review is important to protect you in the future,
• You may be eligible to drive the ENTIRE DUI suspension period by obtaining hardship licenses!
• Some DUI attorneys have never tried a DUI case as a criminal defense attorney!
• There are national organizations for DUI lawyers to share information, ideas, and educate each other,
• There are DUI officers and Drug Recognition Officers (DRE),
• Even though you have a valid prescription for the medication you are taking, you can be arrested and convicted for DUI while taking that medication,
• The prosecutor is required to prove that a driver was impaired “at the time of driving”, however many breath tests do not occur until hours after an arrest.
• A person can be charged with Driving Under the Influence of Drugs even if the drug was legally prescribed medication from a doctor,
• A felony DUI can be very serious and result in a substantial period of imprisonment.
• There are many ways a driver can end up charged with a felony DUI,
• The majority of DUI penalties are mandated by statute,
• A DUI conviction stays with you for your entire lifetime!
• A DUI conviction will prevent you from sealing or expunging your criminal record!
• Some insurance companies immediately cancel your insurance upon arrest!
• A driver must be “in custody” before the police have to read the driver their Miranda rights,
• A Motion to Suppress requests the judge to throw out evidence in your case and some Motions to Suppress can result in your DUI charge being dismissed,
• Many police departments have policies that must be followed by the DUI officer when making a DUI arrest, I have copies of these polices!

If you have been arrested for DUI, retain a DUI attorney that is part of the National College for DUI Defense (NCDD) and the DUI Defense Lawyers Association (DUIDLA).

Retain an DUI attorney who is experienced and knowledge about DUI’s in order to get the best defense and the best result to your Driving Under the Influence case.

DON‘T HESITATE!!!   PROTECT YOUR RIGHTS!!! 

CALL DUI LAWYER THOMAS C. GRAJEK NOW !!!

863-838-5549 cell

Because you only have 10 days to request a Formal Review or get a hardship license! 

NCDD

INTERESTING THAT ALMOST EVERY TIME A POLICE OFFICER IS ARRESTED,

THE OFFICER REFUSES TO SUBMIT TO A BREATH TEST!!!

Why is that? Because the officer does not trust the machine? The officer does not want to give untrustworthy evidence to the police or prosecutor? Is it because the DUI penalties are increased if the driver blows over 0.15?  Because it could result in an interlock ignition device being placed on a vehicle if the blow is over 0.15?

In addition, under Florida DUI statute 316.193 (3), any person who causes property damage or personal injury to another while driving under the influence is guilty of a First Degree Misdemeanor which increases the penalty to a fine of not more than $1,000 and 1-year imprisonment.

If you have been arrested for DUI, hire an attorney that is a member of the National College for DUI Defense (NCDD) and knows how to defend a DUI case!

TIME MATTERS IN A DUI – DON‘T HESITATE!!!   

Because you only have 10 days to request a Formal Review or get a hardship license!

 CALL POLK COUNTY DUI ATTORNEY THOMAS C. GRAJEK NOW!!!

 863-838-5549 cell

NCDD

One of the most interesting parts of the seminar was a mock trial that was conducted from an actual case.  The jury deliberations were monitored by audio and video so that I could see exactly how a jury comes to their decision in a DUI case.  The insight gained from this part of the seminar was invaluable to a DUI. defense lawyer.

In addition to the mock trial, nationally and internationally known experts spoke on all phases of a DUI case.  Even A.W. Jones the leading researcher and expert in alcohol and its effects on the human body spoke at the DUI conference.

If you have been arrested for DUI, retain the only DUI attorney in Polk County, FL for your case that is a proud member of the National College for DUI Defense (NCDD).

Retain an DUI attorney who is experienced at handling DUI’s and located in Polk county in order to get the best defense and the best result to your driving under the influence case.

 DON‘T HESITATE!!!   PROTECT YOUR RIGHTS!!! 

CALL POLK COUNTY DUI ATTORNEY THOMAS C. GRAJEK NOW !!!

 863-838-5549 cell

 Because you only have 10 days to request a Formal Review or get a hardship license!

NCDD

The seminar will cover the latest issues and strategies in defending DUI’s.  This includes Blood Testing which is extremely important if you have been arrested for DUI Manslaughter or DUI with Serious Bodily Injury in Florida.  In these types of DUI cases, the police do not request a breath test, they can forcefully take your blood in Florida.  That is why if you are researching DUI lawyers and who you want to defend you in court, you want a lawyer that keeps up on the latest issues and defenses to these serious crimes that carry substantial prison time.  There is a four (4) year minimum mandatory prison sentence for DUI Manslaughter in Florida, but due to “Death Points” on the scoresheet, a person accused of DUI Manslaughter will be “scoring out” to more than 10 years in prison.

The speakers at this seminar include international leading experts in alcohol absorption, elimination, retrograde extrapolation, accreditation of labs testing your blood and all areas of a DUI case.  Dr. A.W. Jones, the world’s preeminent toxicologist will be one of the featured speakers.

Retain an DUI attorney who is experienced at handling DUI’s and located in Polk county in order to get the best defense and the best result to your driving under the influence case.

 DON‘T HESITATE!!!   PROTECT YOUR RIGHTS!!! 

CALL POLK COUNTY DUI ATTORNEY THOMAS C. GRAJEK NOW !!!

 863-838-5549 cell

NCDD

 Because you only have 10 days to request a Formal Review or get a hardship license! 

http://www.youtube.com/watch?v=nh0MKeZdHNA – driving video

http://www.youtube.com/watch?v=xqR_iOXwcz0 – surveillance video

This is a copy of the police report obtained by TMZ.  WARNING! The police report contains profanity and strong language!

Bieber DUI police report

The police report alleges that Bieber and another person also driving a Lamborghini were drag racing and reached 55-60 miles per hour.  The problems with this allegation?  The car Justin Bieber was allegedly racing was a Ferrari, not a Lamborghini.  The second officer involved was readily able to distinguish between a Ferrari and a Lamborghini.  This shows that the officer’s observations are suspect and may not be credible.  Also, if you look at the video, the two vehicles do not appear to come close to reaching such a high rate of speed.  In order to issue a ticket for speeding, police officers are supposed to estimate a vehicle’s speed and then clock the speed using radar or pacing the car using their speedometer.  This was never done.  If the officer is wrong about these simple observations, what else is the officer wrong about?  Does he have a bias against people driving expensive sports cars?  Was the officer’s mind made up to stop the cars or request a DUI investigation based on the vehicles alone?  What affect did it have once he learned it was Justin Bieber driving?

The police report also indicates there were no problems with Bieber’s driving pattern.  He even made a right hand turn with no issues.  One of the “cues” or indicators of impairment and officer looks for in a DUI case is problems with the driving pattern.  Here there does not appear to be any.  This fact could then for the basis for a Motion to Suppress in which a DUI attorney asks the court to throw out evidence of the stop due to the illegal stop by the police.  In a DUI case, that would result in ALL the evidence being thrown out of court and the DUI charge and any additional charges would be dismissed.

Once pulled over, there were very few indications that Bieber was impaired.  He protested his innocence (with a lot of profanity).  He did not slur his words, he did not have trouble exiting the vehicle, Bieber did not need to use the vehicle for support, or lean on the vehicle.  These are all indicators that a driver may be under the influence that DUI officers are trained to look for in a DUI arrest.  It is not easy to exit and get out of a low-to-the ground sports car, but Bieber apparently did so perfectly.  Another problem with the prosecutor’s case.

The next problem is that Bieber was immediately arrested for DUI with NO Field Sobriety Exercises performed on him!  The police did not even call a DUI officer to the scene or ask if he would perform Field Sobriety Tests before arresting him.  That means he was arrested based on allegedly racing or speeding (does the video bear this out?), having blood shot eyes (up all day and tired? Coming from a smoky environment), a flushed face (because he was angry for being pulled over for no reason?), and the odor of alcohol on his breath (it is not illegal to drink and driver in Florida, it is only illegal if you have so much to drink that it affects the driving). You must not ignore the other facts that indicate Bieber was NOT IMPAIRED when determining whether there was probable cause to make a DUI arrest.  The perfect driving, not slurring his words, exiting the vehicle perfectly, not stumbling at the roadside, not swaying at any point in time, protesting his innocence, stopping the car immediately and pulling over the vehicle without any issues.  These are factors that bear on probable cause also.  Under Florida law, the odor of alcohol alone is insufficient to establish probable cause for arrest. State v. Kliphouse, 771 So.2d 16 (Fla. 4th DCA 2000).  So the motion to suppress the stop and have the case dismissed could prove to be very strong in Bieber’s case.

Bieber again protested his innocence at the jail.  Bieber was finally asked to submit to Field Sobriety Exercises and he refused.  The Field Sobriety Tests are voluntary under Florida law!  A suspected impaired driver does not have to do them.  Bieber again explained that he was innocent and was not impaired, drunk, or intoxicated so why should he have to do them.

Bieber took the breath test result which came in at allegedly at .011 g/mL and .014 g/mL of alcohol.  Breath Test results are NOT reported as a percentage and DO NOT represent the percent of alcohol in a person’s body.  The legal limit in Florida is 0.08 g/mL of alchol.  This means that Bieber’s breath test result was way BELOW THE LEGAL LIMIT.  Not only the legal limit for a DUI case, but even below the legal limit for an underage driver in Florida.  The legal limit is 0.08 no matter what your age is in a DUI case.  However, the administrative law states that the Dept. Of Highway Safety and Motor Vehicles (DHSMV) will suspend an underage drinker’s license if their breath test level is 0.02 or higher!  (Florida Statute Section 322.2616).  Bieber was below even this small amount.  There will be no administrative suspension of his driving privileges and no need to request a Formal Review because his license will not be immediately suspended by Florida’s DHSMV.

Finally, Bieber was allegedly requested to undergo a drug evaluation.  There is no information in the police report to indicate whether the DUI officer who performed the evaluation was a Drug Recognition Expert (DRE) or whether Bieber underwent the 12 step protocol for the Drug Influence Examination (DIE).  DUI officers are required to get extra training in Driving Under the Influence of Drug cases (DUID).  It is illegal to drive while impaired by a controlled substance in Florida.  A controlled substance can be a lawfully prescribed medication.  Whether the lab analyst will find anything in the urine sample is fact we will learn at a later time.

However, there are a number of issues with the Drug Influence Evaluation.  The police need probable cause to request this evaluation.  There is nothing to indicate that Bieber was impaired by drugs in this case.  Unless Bieber made statements that he was currently taking medications or took some controlled substance, there is no reason to think drugs played any part in this case.  In addition, there are number of ways to defend against a DIE.  Was the DRE trained properly? Is the officer even a DRE?  Did he perform the DIE correctly?  Has the DRE kept up with the requisite training to maintain his status as a DRE?  Was the drug evaluation videotaped?  It does not have to be, but it can lead to valuable evidence in this case.  As part of the 12 step protocol, an arrested driver for DUI is asked to perform the Field Sobriety Exercises.

This case has a lot of legal issues and there may be a number of defenses to this DUI charge.  Roy Black is a phenomenal criminal defense lawyer and is representing Justin Bieber in his DUI case.  I will continue to post about Bieber’s DUI case as we learn more.

If you have been arrested for DUI, retain a DUI attorney that is part of the National College for DUI Defense (NCDD).

Retain an DUI attorney who is experienced at handling DUI’s and located in Polk county in order to get the best defense and the best result to your driving under the influence case.

DON‘T HESITATE!!!   PROTECT YOUR RIGHTS!!! 

 CALL POLK COUNTY DUI ATTORNEY THOMAS C. GRAJEK NOW !!!

 863-838-5549 cell

 Because you only have 10 days to request a Formal Review or get a hardship license!

NCDD

NCDD

Who do you want defending you of your DUI or DUI Manslaughter case?  I want to make sure I receive continuing education on DUI laws and issues.  It allows me to network with DUI attorneys throughout the country that I can consult with on DUI cases.  DUI’s are different from other crimes because, unlike other crimes, you can be convicted based upon solely the opinion of an arresting officer.  Also, a DUI case contains more science than most other criminal charges.  How alcohol is absorbed and eliminated into the body, how the Intoxilyzer breath test machine works, where to find the documents regarding the breath test, how to get a video in a Polk County Sheriff DUI arrest, and how to try a DUI case before a jury.

If you have been arrested for DUI, retain a knowledgeable DUI lawyer who is not afraid to stand up and fight for you in court!

DON‘T HESITATE!!!   

Because you may be eligible to keep driving the entire time your DUI case is pending. 

Call immediately for more information about your Formal Review!

863-838-5549 cell

What would some of the possible penalties be for a 3rd time DUI offense in Florida?  It depends in part on when the prior DUI offenses occurred.

• Because the breath test result is greater than 0.15, the fine would be at least $4,000.00 with a maximum of $5,000.00
• If the 3rd conviction is within 10 years of the 2nd DUI conviction, there is a 30 day mandatory jail sentence and at least 48 hours must be consecutive.   This is a felony offense under Florida statute 316.193 (3)(b)1.
• If the 3rd conviction is more than 10 years since the second DUI, then imprisonment is capped at 12 months.
• If the 3rd conviction is within 10 years of the 2nd DUI conviction, there is a 90 day impoundment of the vehicle.
• A 3rd DUI conviction within 10 years of the 2nd DUI is a felony punishable by up to 5 years in Florida State Prison (FSP).
• If the 3rd conviction is within 10 years of the 2nd DUI conviction, there is a 10 year driver’s license suspension.  The driver may be eligible for a hardship reinstatement after 2 years.
• If the 3rd conviction is more than 10 years since the second DUI, then the license suspension is 6 months.
• If the 3rd conviction is within 10 years of the 2nd DUI conviction, there is a 2 years requirement of an ignition interlock device on any car owned or jointly owned by the convicted DUI driver.

A DUI is a very serious offense and expensive criminal offense.  It is best to not drink and drive and to use a designated driver.  However, if you have been arrested for a DUI, call an experienced DUI attorney that is also a member of the National College of DUI Defense that knows the DUI laws.

DON‘T HESITATE!!!   YOU ONLY HAVE 10 DAYS AFTER YOUR ARREST TO REQUEST A FORMAL REVIEW!

 CALL POLK COUNTY DUI ATTORNEY THOMAS GRAJEK NOW !!!

 863-838-5549 cell

In Florida, a person is guilty of DUI if they are driving a “vehicle” while impaired.  Notice that “motor vehicle” is not used in this statute.  The definition of a “vehicle” determines whether or not a bicycle would qualify for a DUI, which is:

“Vehicle’’ is every device, in, upon or by which any person or property is, or may be, transported or drawn upon a highway, except devices used exclusively upon stationary rails or tracks.  Florida Standard Jury Instructions 28.1.  Florida courts have also held that a bicycle qualifies for a DUI.  State v. Howard, 510 So.2d 612, (Fla. 3d DCA 1987).  This person could be charged with DUI.

Whether or not the prosecutor can prove was guilty beyond a reasonable doubt, and whether the DUI investigation was conducted properly by the police is a question for the court and jury.

How weak is this “DUI case?  It’s only a bike and more importantly, he had a breath test level of 0.04!!!  At that level a driver, or in this case a bicyclist, is PRESUMED NOT IMPAIRED under the law!!!  The DUI officer allegedly requested a urine sample, but what many officers do not realize is that just because someone blows under the legal limit, does not mean the officer can request a urine sample to determine the presence of drugs or a controlled substance.  From the police report it does not appear that a Drug Recognition Officer (DRE) was called in to conduct a Drug Influence Evaluation (DIE) in this DUI case.  That means that the Polk deputies did not do a complete and thorough investigation and did not even try and develop probable cause that the guy on the bicycle was under the influence of drugs.

Just because a driver blows under 0.08 does not mean that he must be under the influence of “something.”  Usually, it means the DUI officer made a mistake and a wrongful arrest.  I find many times officers that do not know how to properly conduct a DUI investigation and the field sobriety exercises according to the NHTSA manual.  These mistakes lead to people wrongly being arrested for and accused of DUI!

If you have been arrested for DUI, call an attorney that knows the DUI laws and how a DUI investigation should be properly conducted. If you’re looking for a fighter, call me!

DON‘T HESITATE!!!   PROTECT YOUR RIGHTS!!! 

CALL POLK COUNTY DUI ATTORNEY THOMAS C. GRAJEK NOW !!!

 863-838-5549 cell

Because you only have 10 days to request a Formal Review! 

Now, you can AUTOMATICALLY obtain a hardship license for the ENTIRE period of suspension.  What does a person arrested for DUI give up for this benefit?  The driver MUST WAIVE their right to a Formal Review.

• That means the DUI license suspension will appear on your license.
• That means you have no chance of having the administrative suspension set aside and having your full driving privileges reinstated.
• That means you lose a valuable discovery tool to prepare your DUI case for court and trial.

I am hearing from more and more people arrested for DUI that their insurance company is cancelling their policy if they are arrested for DUI or lose the Formal Review.  So you may get a hardship license, but have no insurance.  This decision becomes an extremely important decision based upon each individual driver’s priorities.  It also depends on which law enforcement agency arrested the driver.  That is why you need an experienced DUI trial lawyer representing you!  You need an attorney that can explain the benefits of each choice and select the best option for your criminal case.

If you choose to have a Formal review, the rules will remain unchanged as far as temporary permits and hardship licenses.  However, if an DUI officer or deputy fails to appear at your Formal Review, the DUI suspension will be INVALIDATED! No more having to file a lawsuit to enforce subpoenas.  Many lazy DUI lawyers that NEVER subpoena witnesses better learn the new rules quickly or they may make a huge mistake for the client’s they represent.  Retain an attorney that is not lazy and will continue to fight for his clients like I always have.

DON‘T HESITATE!!!   PROTECT YOUR RIGHTS!!! 

 CALL POLK COUNTY DUI ATTORNEY THOMAS GRAJEK NOW!!!

 863-838-5549 cell

You only have 10 days to request a Formal Review!

Recent case results at: http://www.flcrimedefense.com/case-results/

A motion for Judgment of Acquittal is a request for the judge to dismiss the charges because the prosecutor failed to put forth sufficient evidence to prove a prima facie case. That means the prosecutor has to put on evidence of each element of the alleged crime. In an Improper Exhibition of Firearm case the elements are:

1. The accused carried a gun,
2. The defendant exhibited the gun in a rude, careless, angry, or threatening manner, and
3. did so in the presence of one or more persons.

These are very difficult motions to win because when looking at the evidence the court must make all inferences in favor of the prosecutor. They are terrific wins because if you can get the criminal court to grant the Motion for J.O.A., the charge is dismissed and the jury does not even deliberate. In this case the Motion for J.O.A. was granted, my client was acquitted, the charge was dismissed, and we went home early because the jury was dismissed without the need to deliberate the case and reach a verdict.

If you are charged with Improper Exhibition or any gun or Firearm charge in Polk County, call Thomas C. Grajek and experienced trial attorney today.

DON’T HESITATE!!! CALL NOW!!!

Thomas C. Grajek 863-789-6404 cell

Case 2012-MM-014408-BA tried and dismissed May 14, 2013

by Steve Moran

Suit: Facility let woman ‘waste away’ is the title of a front page article in the Sacramento Bee, my local paper. Here is a brief summary of the lawsuit: Joan Boice was suffering from Alzheimer’s and was no longer able to live at home. In September 2008 she was moved into Emeritus at Emerald Hills, in Auburn (a community in the foothills outside of Sacramento) Three months later the community discovered pressure ulcers had formed on both of her feet, her right hip and her right elbow. Emerald Hills staff immediately began the process of having her transferred to a skilled nursing facility. She died 3 months after being moved the memory care building to a skilled nursing building. Here are the charges being made by the family: Emeritus is only commitment is to growing their empire and making money. They had inadequate staffing and staff training They should never have admitted her to the community as frail as she was It is unclear if they are suggesting they should have never let the wounds develop or if the primary error was not promptly noticing and addressing them. Here are the questions/issues (some legal, some operational) Should she have been admitted in the first place? Did she have pressure sores when she was admitted? When were the pressure sores first discovered? (There is conflicting evidence) Should the community have discovered the pressure sores sooner? Is this a case of being too aggressive about getting one more head in a bed? At what point should care givers have noticed newly formed pressure sores? Is this just a case of greedy lawyers taking advantage of a terrible situation or do they have a righteous cause? Who’s fault was this . . . if anyone’s? Does the family have any responsibility in all of this? Given that she may very well have died in the same time frame, should the company have any financial obligation here?

US News and World Reports 2013 Best Nursing Homes Report

by Steve Moran

California has better nursing homes than any other state in the US . . . it has to be a joke right? The vaunted magazine US News & World Report has just released their 2013 list of best nursing homes. I was astonished to see that California led the way in having the most and highest percentage of highly rated skilled nursing facilities. California did not lead by just a little bit. It “has twice as many highly rated homes as any other state, or in a region”. I found myself saying “Huh?” I live in California and in my many years in the senior housing industry I have been in maybe 2 or 3 thousand senior housing communities across with country and in more than half of all the licensed skilled nursing buildings in the State of California. I don’t think anyone who is objective about skilled nursing in this country, would ever try to make a credible argument that overall, California has the best nursing homes in the country. Within the skilled nursing community it is well known that the 5 star system is very flawed and in fact provides consumers very little in the way of useful information. A quick google search will provide a variety of articles that question the 5 star rating system. Here is my take after reading the article and browsing the list: US News & World Report has done a shabby job of reporting. In fact, they didn’t do any serious reporting or they would have been more cautious about equating a 5 star rating with the highest quality care. It confirms that the 5 star system continues to be flawed. This is not to say it has no value, but I would argue that at best, it’s value is primarily as a early detection tool to identify and rule out terrible nursing homes. The one reliable conclusion you can draw from the list is that the highly rated skilled buildings are experts at getting a high rating 5 star rating. There are some really great skilled nursing buildings in California and other states that don’t have a 5 star rating. In fact often these buildings take on patients with complex problems and get terrific results, but because those patients are complex it hurts their star rating.

How do you place your MDS Coordinator on the organizational chart?

Do they report to the DON or to the NHA? Analyzing trends related to enhanced realized gains/maximization. We agree that the MDS Coordinator role is “intrinsically integrative,” with potential to impact quality of care. However, the potential of the MDS Coordinator to influence important care processes such as assessment, decision-making and care planning may be moderated by the quality of their relationship patterns across the organization. Maximizing that potential by attention to relationships patterns among staff can help to unlock that capacity of the MDS Coordinator to positively influence care processes and improve quality of care. Its not Just the DON or NHA Good connections exists when there is latitude to interact and freedom to share information with others who can best use that information. Some connections occur naturally when staff members interact to do work. The number, variety, and quality of these connections influence the extent to which staff learns and the extent to which the organization is capable of change. New information flow refers to the exchange of information within or across levels of the organization. New information of good quality provides knowledge that the staff can use to adjust their work behavior. This information may be general, such as the mission of an organization, or specific, such as communication from a Certified Nursing Assistant (CNA) to a floor nurse that a resident appears more confused than is usual. This new information flow promotes mutual exchange of information for the purpose of understanding and making sense of a situation, allowing staff to adjust their behavior to meet emerging demands

Family Communications Important Aspect of Long-Term Care Facility Norovirus Prevention Measures

From Groupcast

Norovirus prevention measures implemented at senior living and skilled nursing centers demand improved family and visitor communications. Restricted access and containment measures are often at odds with family members’ desire to visit their loved ones. Immediate and ongoing communications with family members at the outset and during the quarantine are key to success. The norovirus, a fast-moving gastrointestinal virus, spreads quickly in settings where the community members are in close proximity and share eating facilities. Nursing homes, cruise ships, hotels, and schools are all locations where such a virus can rapidly spread from member to member. Unlike the vast majority of schools in the US, which now have implemented school-wide notification systems, many senior living and skilled nursing centers lack the ability to immediately reach key family members. For nursing facilities, the CDC recommends fast action to prevent norovirus outbreaks, including restricting visitation, separating residents during mealtimes, restricted activities, and quarantining known cases. Each of these measures can be of major concern to a family member, especially those who are accustomed to unfettered access to their mom, dad, or other senior family member. The key to addressing the concerns of family members is by increasing the level and frequency of communication, preferably by way of direct messaging, beginning with the instant the heightened measures are implemented. With a system such as GroupCast, which is already in use at numerous senior living centers, a facility administrator could effortlessly record a personal message to family members and broadcast it instantly to their home and cell phone numbers. As the conditions persist or expire, periodic norovirus communications should also be sent advising family members of facility conditions, how to get more information on the loved one’s status, expectations as to the duration of the restrictions,etc. According to the CDC, nearly 60% of norovirus cases occur at long-term care facilities: “Healthcare facilities, including nursing homes and hospitals, are the most commonly reported settings for norovirus outbreaks in the United States and other industrialized countries (see Norovirus in Healthcare Settings). Nearly two-thirds of all norovirus outbreaks reported in the United States occur in long-term care facilities.”

Outbreaks can sometimes last months according to the CDC: “Outbreaks in these settings can be quite long, sometimes lasting months. Illness can be more severe, occasionally even fatal, in hospitalized or nursing home patients compared with otherwise healthy people.” Prolonged modification of visitation and care programs can place extreme stress on caring family members. Heightened levels of mass communication with the family members is the key to successful disease management. Otherwise, the facility will be fighting two battles – the norovirus and irate family members demanding to know what is happening with their loved ones. Proactive communication will reduce stress on both sides and will serve to reduce inquiries to care staff from family members seeking information on the restrictions and when they will be lifted. Systems like GroupCast are the answer. Low-cost, easy-to-use, and highly effective, a mass notification system such as GroupCast can cover all forms of notification including phone broadcast, email broadcast and text messages. These are the very reasons why they have been so heavily embraced by schools, and why they should be equally embraced by long-term care facilities.

Do call your agent as soon as a covered event takes place. As soon as you get home from the car accident, or even before you go to the doctor, call your agent.

Do review and understand your coverage before talking to your insurer or your agent. Read the “Coverage” and “Exclusion” sections of you policy in particular.

Do take and keep detailed notes of all conversations with insurance company representatives, and get names, phone numbers, and job titles of people you speak with, including their supervisor’s name.

Do consider whether you might have insurance coverage under some other insurance policy as well. Many people have more than one policy that might cover a claim. In particular, look at homeowner policies, “umbrella” policies, and materials that came with your credit cards.

Do take pictures, if possible. That doesn’t mean you should sneak a “PatientCam” into surgery with you, but take pictures of your destroyed vehicle, fire-damaged home, or injuries if you can.

Do be honest and forthcoming with your insurer. Even if it is embarrassing, it is better if your insurer knows all the facts. Failing to be candid with your insurer might invalidate your policy or cause a denial of coverage.

Do understand the difference between replacement coverage and depreciated or actual cash value. If your policy provides replacement coverage, don’t settle a personal property loss for “actual cash value.” You may be required to replace the lost items before getting your full reimbursement if you have replacement cost coverage.

Do keep all receipts of meals, lodging, and purchases made in connection with time spent pursuing your claim or recovering from your injuries from the time of the covered event until final settlement with your insurance company.

The Don’ts

Don’t give any recorded or written statements to your insurer until you are sure you understand your coverage. Remember you are not required to allow the insurance company to record your telephone conversation. If you have doubts, do consult an attorney.

Don’t automatically accept the estimate or appraisal of your losses given to you by the insurer. Insurance companies will often try to get you to accept their estimator’s or contractor’s repair or replacement estimates, which might be a bit low. DON’T sign any releases or waivers of any kind until you obtain legal advice. A bad financial situation after a major loss may make it seem necessary for you to accept a premature, inadequate settlement from your insurer. But you may remember destroyed items after you have signed a release as to payment for your personal property inventory or other claims. For these reasons, it is advisable to consult an attorney before signing a release or waiver. Be sure to read the fine print on any payment from the insurance company.

Don’t accept any check that says “final payment” unless you are ready to do so.

Don’t ignore time limits set by your policy. Most policies require a signed proof of loss within a certain time limit. Be sure you comply with this requirement unless you obtain a written waiver from your insurance company. Many policies allow you only one year from the date of loss in which to bring a legal action if your claim has not been adjusted fairly. If your claim has not been settled to your satisfaction eleven months after your loss, consult an attorney immediately. A failure to do so could result in the loss of your right to sue.

Don’t forget that you have a contract with your insurer. Your insurer has a legal obligation to provide the coverage it promised to you. Be insistent about enforcing that obligation.