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Iowa Appellate Court Reverses $6 Million Nursing Home Negligence Decision Because of Hearsay Testimony

By George F. Indest III, J.D., M.P.A, LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm

On June 21, 2023, the Iowa Court of Appeals overturned the verdict in a nursing home negligence case that awarded $6 million in compensation and damages to the plaintiff. The case was reversed and remanded for a new trial because the trial court judge admitted inadmissible hearsay testimony into evidence. The testimony being appealed was that of staff members who claimed to have heard “reports” and “rumors” of alleged abuse by a nurse on staff toward not only the resident in question but other residents.

Hearsay in Iowa law is defined as “a statement, other than one made by the declarant while testifying at the trial or hearing, offered to prove the truth of the matter asserted.” Click here to read the Iowa Rules of Evidence concerning hearsay. This is the same definition used by the federal and most other courts.

Essentially, hearsay is when someone repeats something they heard from another person and presents it as if they know it to be true. Hearsay is often equated to rumor. Hearsay is not admissible due to the nature of speculation required in making such a statement, the fact that such statements are inherently unreliable and that the actual witness is not in court to answer questions about it. Thus there is no way for a party or the judge to test the credibility of the actual witness or determine facts that may have influenced the observation and statement.

Hearsay is considered unreliable because the person who knows what happened (who saw what happened or heard what happened) is not to be questioned about it. Therefore, there is no way to know what really happened for sure.

Details of the Case.

In this case, the estate of the former nursing home resident, who succumbed to her injuries after a fall in the nursing home, claimed adult abuse and that negligence caused a wrongful death. In its defense, the nursing home focused on the alleged abuse by a nurse on the staff. The statements challenged in the appeal included testimony made by six nursing home staff members that residents, other unnamed employees, and an Iowa Department of Inspections and Appeals surveyor told them that the nurse in question had been physically rough with and swore at residents.

The employees testifying did not actually witness any such incidents. They were only testifying about someone else’s words (“hearsay”).

The trial court admitted these statements, allegedly not for their truth, but in an attempt to show that abuse had been reported and there had not been any follow-up investigation. The appellate court stated that this was not a valid reason to admit inadmissible hearsay into evidence because the estate must prove that the conduct existed to prevent the jury from engaging in rampant speculation based on unreliable hearsay evidence.

People in today’s society, yes, even judges, often forget this basic principle of law. With all of the fabricated lies being put out as “news” on some news channels, Internet rumors running rampant, and politicians making egregiously false statements, it’s often hard to remember how to distinguish a fact from an unreliable rumor or hearsay.

This is one of the problems with hearsay. It is often just gossip and rumor, which change from person to person. Especially egregious conduct, criminal activity, and salacious acts become increasingly exaggerated with each retelling. The founding fathers in English and American law realized the inherently unreliable nature of such “evidence.”

Under the hearsay rule, the Court of Appeals agreed with the nursing home that the statements being challenged were inadmissible hearsay evidence that influenced the jury’s verdict. Due to this, the court reversed the verdict and remanded the case for a new trial. To read the court’s opinion in full, click here.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents health professionals and health facilities in civil and administrative litigation. We also represent physicians, nurses, and other health providers in investigations, regulatory matters, licensing issues, board hearings, inspections, and audits involving the DEA, Department of Health (DOH), and other law enforcement agencies. Its attorneys include those who are board-certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys. We represent medical students, interns, resident physicians, and fellows in disputes with their graduate medical education (GME) programs. We represent clinical professors and instructors in contract disputes, employment disputes, clinical privileges matters, and other disputes with their employers. We often act as the physician’s personal counsel in medical malpractice litigation.

To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Source:

Kang, Y. Peter. “Iowa Court Overturns $6M Nursing Home Negligence Verdict.” Law360. (June 22, 2023). https://www.law360.com/health/articles/1691891?nl_pk=0cbd4c0b-c6c8-416a-9e67-b4affa63b102&utm_source=newsletter&utm_medium=email&utm_campaign=health&utm_content=2023-06-23&nlsidx=0&nlaidx=9

About the Authors: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Hartley Brooks is a law clerk with the health law firm. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

Attorney Positions with The Health Law Firm. The Health Law Firm always seeks qualified attorneys interested in health law practice. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: KBrant@TheHealthLawFirm.com or fax to: (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.

Iowa Appellate Court Reverses $6 Million Nursing Home Negligence Decision Because of Hearsay Testimony

By George F. Indest III, J.D., M.P.A, LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm

On June 21, 2023, the Court of Appeals of Iowa overturned the verdict in a nursing home negligence case that awarded $6 million in compensation and damages to the plaintiff. The case was reversed and remanded for a new trial because inadmissible hearsay testimony was admitted into evidence by the trial court judge. The testimony being appealed was that of staff members who claimed to have heard “reports” and “rumors” of alleged abuse by a nurse on staff toward, not only the resident in question but other residents as well.

Hearsay in Iowa law is defined as “a statement, other than one made by the declarant while testifying at the trial or hearing, offered to prove the truth of the matter asserted.” Click here to read the Iowa Rules of Evidence concerning hearsay. This is the same definition used by the federal courts and most other courts.

Essentially, hearsay is when someone repeats something they heard from another person and presents it as if they know it to be true. Hearsay is often equated to rumor. Hearsay is not admissible due to the nature of speculation required in making such a statement, the fact that such statements are inherently unreliable, and the fact that the actual witness is not in court to answer questions about it. Thus there is no way for a party or the judge to test the credibility of the actual witness or determine facts that may have influenced the observation and statement.

Hearsay is considered unreliable because the person who actually knows what happened (who saw what happened or heard what happened) is not present to be questioned about it. Therefore, there is no way to know what really happened for sure.

Details of the Case.

In this case, the estate of the former nursing home resident, who succumbed to her injuries after a fall in the nursing home claimed adult abuse and that negligence caused a wrongful death. In its defense, the nursing home focused on the alleged abuse by a nurse on the staff. The statements that were challenged in the appeal included testimony made by six members of the nursing home staff that residents, other unnamed employees, and an Iowa Department of Inspections and Appeals surveyor told them that the nurse in question had been physically rough with and swore at residents.

The employees testifying did not actually witness any such incidents. They were only testifying as to what they had heard someone else say (“hearsay”).

The trial court admitted these statements, allegedly not for their truth, but in an attempt to show that abuse had been reported and there had not been any follow-up investigation. The appellate court stated that this was not a valid reason to admit inadmissible hearsay into evidence because the estate must show clear proof that the conduct existed in order to prevent the jury from engaging in rampant speculation based on unreliable hearsay evidence.

People in today’s society, yes, even judges, often forget this basic principle of law. With all of the completely fabricated lies being put out as “news” on some news channels, with Internet rumors running rampant, and with politicians making egregiously false statements, it’s often hard to remember how to distinguish a fact from unreliable rumor or hearsay.

This is one of the problems with hearsay. It is often just gossip and rumor which change from person to person. Especially egregious conduct, criminal activity, and salacious acts become more and more exaggerated with each retelling. The founding fathers in English and American law realized the inherently unreliable nature of such “evidence.”

Under the hearsay rule, the Court of Appeals agreed with the nursing home that the statements being challenged were inadmissible hearsay evidence that influenced the jury’s verdict. Due to this, the court reversed the verdict and remanded the case for a new trial. To read the court’s opinion in full, click here.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents health professionals and health facilities in civil and administrative litigation. We also represent physicians, nurses, and other health providers in investigations, regulatory matters, licensing issues, board hearings, inspections, and audits involving the DEA, Department of Health (DOH), and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys. We represent medical students, interns, resident physicians, and fellows in disputes with their graduate medical education (GME) programs. We represent clinical professors and instructors in contract disputes, employment disputes, clinical privileges matters, and other disputes with their employers. We often act as the physician’s personal counsel in medical malpractice litigation.

To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Source:

Kang, Y. Peter. “Iowa Court Overturns $6M Nursing Home Negligence Verdict.” Law360. (June 22, 2023). https://www.law360.com/health/articles/1691891?nl_pk=0cbd4c0b-c6c8-416a-9e67-b4affa63b102&utm_source=newsletter&utm_medium=email&utm_campaign=health&utm_content=2023-06-23&nlsidx=0&nlaidx=9

About the Authors: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Hartley Brooks is a law clerk with the health law firm. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

Attorney Positions with The Health Law Firm. The Health Law Firm is always looking for qualified attorneys interested in health law practice. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: KBrant@TheHealthLawFirm.com or fax to: (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.

Iowa Appellate Court Reverses $6 Million Nursing Home Negligence Decision Because of Hearsay Testimony

By George F. Indest III, J.D., M.P.A, LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm

On June 21, 2023, the Iowa Court of Appeals overturned the verdict in a nursing home negligence case that awarded $6 million in compensation and damages to the plaintiff. The case was reversed and remanded for a new trial because the trial court judge admitted inadmissible hearsay testimony into evidence. The testimony being appealed was that of staff members who claimed to have heard “reports” and “rumors” of alleged abuse by a nurse on staff toward not only the resident in question but other residents.

Hearsay in Iowa law is defined as “a statement, other than one made by the declarant while testifying at the trial or hearing, offered to prove the truth of the matter asserted.” Click here to read the Iowa Rules of Evidence concerning hearsay. This is the same definition used by the federal and most other courts.

Essentially, hearsay is when someone repeats something they heard from another person and presents it as if they know it to be true. Hearsay is often equated to rumor. Hearsay is not admissible due to the nature of speculation required in making such a statement, the fact that such statements are inherently unreliable and that the actual witness is not in court to answer questions about it. Thus there is no way for a party or the judge to test the credibility of the actual witness or determine facts that may have influenced the observation and statement.

Hearsay is considered unreliable because the person who knows what happened (who saw what happened or heard what happened) is not to be questioned about it. Therefore, there is no way to know what really happened for sure.

Details of the Case.

In this case, the estate of the former nursing home resident, who succumbed to her injuries after a fall in the nursing home, claimed adult abuse and that negligence caused a wrongful death. In its defense, the nursing home focused on the alleged abuse by a nurse on the staff. The statements that were challenged in the appeal included testimony made by six nursing home staff members that residents, other unnamed employees, and an Iowa Department of Inspections and Appeals surveyor told them that the nurse in question had been physically rough with and swore at residents.

The employees testifying did not actually witness any such incidents. They were only testifying about what someone else said (“hearsay”).

The trial court admitted these statements, allegedly not for their truth, but in an attempt to show that abuse had been reported and there had not been any follow-up investigation. The appellate court stated that this was not a valid reason to admit inadmissible hearsay into evidence because the estate must prove that the conduct existed to prevent the jury from engaging in rampant speculation based on unreliable hearsay evidence.

People in today’s society, yes, even judges, often forget this basic principle of law. With all of the completely fabricated lies being put out as “news” on some news channels, Internet rumors running rampant, and politicians making egregiously false statements, it’s often hard to remember how to distinguish a fact from an unreliable rumor or hearsay.

This is one of the problems with hearsay. It is often just gossip and rumor, which change from person to person. Especially egregious conduct, criminal activity, and salacious acts become increasingly exaggerated with each retelling. The founding fathers in English and American law realized the inherently unreliable nature of such “evidence.”

Under the hearsay rule, the Court of Appeals agreed with the nursing home that the statements being challenged were inadmissible hearsay evidence that influenced the jury’s verdict. Due to this, the court reversed the verdict and remanded the case for a new trial. To read the court’s opinion in full, click here.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents health professionals and health facilities in civil and administrative litigation. We also represent physicians, nurses, and other health providers in investigations, regulatory matters, licensing issues, board hearings, inspections, and audits involving the DEA, Department of Health (DOH), and other law enforcement agencies. Its attorneys include those who are board-certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys. We represent medical students, interns, resident physicians, and fellows in disputes with their graduate medical education (GME) programs. We represent clinical professors and instructors in contract disputes, employment disputes, clinical privileges matters, and other disputes with their employers. We often act as the physician’s personal counsel in medical malpractice litigation.

To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Source:

Kang, Y. Peter. “Iowa Court Overturns $6M Nursing Home Negligence Verdict.” Law360. (June 22, 2023). https://www.law360.com/health/articles/1691891?nl_pk=0cbd4c0b-c6c8-416a-9e67-b4affa63b102&utm_source=newsletter&utm_medium=email&utm_campaign=health&utm_content=2023-06-23&nlsidx=0&nlaidx=9

About the Authors: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Hartley Brooks is a law clerk with the health law firm. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

Attorney Positions with The Health Law Firm. The Health Law Firm always seeks qualified attorneys interested in health law practice. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: KBrant@TheHealthLawFirm.com or fax to: (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.

By The Health Law Firm|2023-07-31T11:39:25-04:00July 31, 2023|Categories: Nursing Law Blog|Tags: AHCA hearing defense lawyer, assisted living facility (ALF) defense lawyer, board of mental health counselors defense lawyer, Board of Psychology defense attorney, complex medical litigation attorney, Florida physician defense attorney, formal administrative hearing defense attorney, health care facility defense attorney, health care lawyer, health care provider defense attorney, health law, health law attorney, home health care defense attorney, Legal representation for Department of Health (DOH) investigations, legal representation for health care facilities, legal representation for health care professionals, legal representation for home health care facilities, legal representation for license issues, legal representation for mental health professionals, legal representation for nurses, legal representation for nursing homes and skilled nursing facilities, medical malpractice defense lawyer, mental health counselor defense attorney, mental health professional defense attorney, nursing home defense lawyer, physician defense lawyer, psychiatrist defense counsel, psychologist defense attorney, reviews of The Health Law Firm, the health law firm, The Health Law Firm reviews|0 Comments

Illinois Implements New Regulations That Allow Psychologists to Prescribe

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Illinois clinical psychologists can now obtain licenses to prescribe medications for mental conditions under new regulations passed by the state. The new regulations issued by the Illinois Department of Financial and Professional Regulation (IDFPR) took effect in October 2017.

Psychologists traditionally have not had the authority to write prescriptions for medications, except in a very few states. Therefore, their patients have been unable to obtain psychotropic medications to treat their mental illnesses without seeing a physician, or in some cases a nurse practitioner or physician assistant with prescribing authority. This makes such treatment of mental illness more cumbersome and more expensive for the patient, and creates another obstacle for needed mental health services. Also, it is questioned whether nurse practitioners and physician assistants have any greater expertise in such medical issues than properly trained psychologists. Mental health, substance abuse and child welfare agencies have faced challenges in serving clients and the new regulations come in hopes of expanding access to care.

The New Illinois Regulations.

Illinois is now allowing psychologists with specialized training to prescribe medications. This prescriptive authority will extend to a wide range of medications to treat mental health conditions for patients between ages 17 and 65.

An Illinois-licensed clinical psychologist will now be eligible to obtain a prescribing psychologist license upon the completion of seven biomedical undergraduate level courses; the completion of psychopharmacology-related course work typically culminating in a master’s degree in clinical psychopharmacology; obtaining at least 14 months of supervised clinical training in a program meeting regulatory criteria, with rotations in emergency medicine, family medicine, geriatrics, internal medicine, obstetrics and gynecology, pediatrics, psychiatry, surgery, and an elective area; and achieving a passing score on the Psychopharmacology Examination for Psychologists.

The Stipulations.

Before prescribing, a psychologist must enter into a written collaborative agreement with an Illinois-licensed physician who prescribes medications for mental health conditions. The collaborative physician is not required to be a psychiatrist. This is similar to what is currently required in most states for nurse practitioners and physicians assistants.

The statute and regulations set forth a number of issues that must be addressed in a written collaborative agreement between a psychologist and the collaborating physician, including provisions that:

1. Describe the working relationship between the psychologist and collaborative physician;

2. Delegate prescriptive authority;

3. Promote the exercise of professional judgment by the prescribing psychologist;

4. Provide methods and guidelines for communication between the collaborating physician and the prescribing psychologist;

5. Provide for collaboration between the physician and the prescribing psychologist, including joint formulation and approval of orders or guidelines, consultation and review of medication orders; and

6. Address termination or change of status.

With this Authority Also Comes Restrictions.

A psychologist prescribing in Illinois is subject not only to training, continuing education and collaborative agreement requirements, but also to significant limitations. In particular:

1. The delegation of prescriptive authority must be limited to medications that the collaborating physician generally provides in the normal course of clinical practice to treat mental conditions;

2. A psychologist is not allowed to prescribe for patients who (a) are under 17 years of age; (b) are over 65 years of age; (c) are pregnant and have disclosed their pregnancy or who the psychologist knows are pregnant; (d) have disclosed serious medical conditions, such as heart disease, cancer, stroke, or acute seizures; or (e) have developmental and intellectual disabilities;
3. Prescriptions are not allowed for (1) benzodiazepine Schedule III controlled substances, (2) any injected controlled substance, (3) any Schedule II substance, or (4) any narcotic drug; and

4. Any delegation of Schedule III through V controlled substances must identify the specific controlled substance by brand or generic name.

The expansion of psychologists’ prescribing authority will also present new opportunities and challenges not only for psychologists but also for patients, payers, physicians, agencies and other health care providers.
With the incorporation of psychologist prescribing into patient care models, health care professionals hope to increase access to effective mental health treatment. You can read the new regulations in full here.

To stay on top of laws and regulations for mental health care professionals, be sure to check our Mental Health Law Blog regularly.

Many Educational Programs Exist for Psychologists Interested in Prescribing.

There are many schools of psychology and universities that offer comprehensive courses and programs, some leading to a separate degree, for psychologists interested in prescribing. These programs may exist even in states which do not allow psychologists to prescribe, such as Florida. We believe it is time for each state to change its laws and regulations to allow properly educated and trained psychologists to prescribe medications associated with the treatment of mental illnesses.

States should be taking action to make it easier for mental health patients to access the medications that may very well help them control their mental illnesses. Psychologists, mental health professionals, and advocacy groups for persons with mental health issues should be lobbying hard to get their state legislatures to enact similar legislation. Unfortunately, this will probably denigrate to nothing more than a turf battle, as so often happens with progressive changes in medical regulation. The physicians , nurse practitioners, and physician assistants who currently have such prescribing authority will doubtless fight such change since they will see it as affecting their future income.

The Health Law Firm.

For more information on how The Health Law Firm can assist you with licensure and compliance issues, click here to read one of my prior blogs.

Contact A Lawyer Experienced in the Representation of Psychiatrists, Mental Health Counselors, Social Workers, Licensed Marriage and Family Therapists and Other Mental Health Professionals.

We routinely provide deposition coverage to psychiatrists, mental health counselors, social workers, licensed marriage and family therapists and other mental health professionals being deposed in criminal cases, negligence cases, civil cases or disciplinary cases involving other health professionals. The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing psychiatrists, mental health counselors, social workers, licensed marriage and family therapists and other mental health professionals in investigations at the Board of Psychology, Board of Medicine, Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health Counseling, and the Board of Nursing.
Call now or visit our website www.TheHealthLawFirm.com.

Sources:

Hindman, Rick. AHLA. “Illinois Implements Licensing Process for Psychologist Prescribing.” Physician Organizations Practice Group and Behavioral Health Task Force. (January 30, 2018). Web.

“Illinois law allows psychologists to prescribe.” American Psychological Association. (January 30, 2018). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.Copyright © 2018 The Health Law Firm. All rights reserved.

By The Health Law Firm|2020-02-13T15:01:55-05:00May 15, 2018|Categories: Mental Health Law Blog|Tags: Board of Clinical Social Work representation, Board of Psychology defense attorney, Department of Health (DOH) investigation defense lawyer, health care law attorney, licensure defense attorney, licensure representation, Marriage & Family Therapy and Mental Health Counseling defense counsel, mental health counselor defense lawyer, mental health law attorney, professional license defense attorney, professional license discipline representation, psychiatrist defense attorney, psychiatrist representation, psychologist attorney, psychologist defense counsel, psychologist representation, representation for health care professionals, representation for mental health professional, representation for psychologists, reviews of The Health Law Firm, social worker attorney, The Health Law Firm attorney reviews|0 Comments