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GEORGETOWN OFFICE 121 Screven Street Georgetown, SC 29440 • Medical Malpractice
• Workers’ Comp. • Dram Shop Liability • Nursing Home Abuse • Hospital Negligence • Jail Misconduct CHARLESTON OFFICE 635 East Bay Street, Suite F Charleston, SC 29403
• Car Accidents • Personal Injury • Truck Accidents • Wrongful Death
DECEMBER 2023/JANUARY 2024
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TAKING A STAND FOR DIGNITY Safeguarding Mentally Ill Residents in Boarding Homes
In October, we squared off again against our frequent opponents at the South Carolina Insurance Reserve Fund (IRF) on behalf of the estate of our client who died due to medical malpractice. The South Carolina Insurance Reserve Fund is a government-run insurance company that functions as a private/traditional insurance company, even though its employees are employees of the state of South Carolina. The Reserve Fund sells policies to both governmental agencies and private hospital systems. In the case we tried in October, the IRF offered a total settlement of $85,000 pre-trial, whereas the jury returned a verdict of $5 million. This is the fourth time in two years that this insurance company has offered our clients exponentially less to settle a case than the jury ultimately awarded at trial. In the case, Estate of Adrianne Branton v. The Regional Medical Center of Orangeburg and Calhoun Counties , our client was a 69-year-old great-grandmother who had a history of mental illness. When her condition was properly controlled with medications, she lived an active and normal life. In the 19 years leading up to her death, she had lived in her own apartment in Columbia and enjoyed cooking for and visiting with family members (particularly her two great- grandchildren). However, as many of us know all too well,
mental health medication regimens that have been effective for many years can suddenly become ineffective. This is particularly true for patients above the age of 65 whose medications can suddenly stop working due to conditions such as infections. When this happens, prolonged hospitalization may be necessary so that the medication regimen can be slowly adjusted under the supervision of a physician until a new mixture of medications is perfected. In the spring of 2019, Mrs. Branton’s medications suddenly became ineffective after she suffered from a normal infection. She spent many months in various mental health hospitals as new mixtures of antipsychotic medications were tried in an attempt to get Mrs. Branton back to her baseline. Over that summer, Mrs. Branton was sent by one of the hospitals to live in a boarding home, due to the delusion that her family members were out to get her. This is a common symptom, as individuals with mental health diagnoses can become paranoid and form the delusion that those closest to them who actively encourage them to take their medications are not on their side. Shortly before Mrs. Branton’s death, she was discharged from a mental health facility in Spartanburg to a boarding home she had been placed in by the Three Rivers Behavioral Health Hospital earlier in the summer. When she got back from the hospital, she immediately stopped taking her medications and became manic. The operator of the boarding home called 911, since she was concerned that Mrs. Branton was already refusing medications so soon after coming back from the hospital. She was taken by EMS to the Regional Medical Center in Orangeburg. In the emergency room, Mrs. Branton was evaluated by an ER physician who signed involuntary commitment paperwork and recommended that Mrs. Branton be hospitalized for continued medication management. A veteran psychiatrist
Mrs. Branton’s family with her trial team at the Orangeburg County Courthouse.
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Beware the Risks of Unregulated Care Our Judgment on Boarding Homes?
As noted on the cover, in the last several years, our firm has had the unfortunate experience of representing grieving families whose loved ones have died from neglect after being discharged by South Carolina hospitals to “boarding homes.” Oftentimes, if the patient is over the age of 18, this discharge is made without notice to a mentally ill patient’s family. While some suggest that a boarding home is akin to an assisted living facility, these boarding homes are anything but. What is a boarding home? The South Carolina Department of Health and Environmental Control (DHEC) characterizes a boarding home as a facility that provides room and board to people who are not related but does not provide assistance with the resident’s activities of daily living. Activities of daily living include such things as assisting a patient with medications, arranging medical appointments, or helping with daily tasks such as grooming and bathing. As soon as a facility crosses the line by providing any assistance with these activities, it then qualifies as a community residential care facility/assisted living facility under DHEC regulation. Assisted living facilities are closely regulated by DHEC, which has certain requirements for staffing, employee qualifications, training, medication management, and living conditions. How do assisted living facilities differ? Assisted living facilities are also required to be licensed by DHEC, insured, and subject to regular and random inspections by DHEC inspectors. However, boarding homes are not required to be licensed by DHEC and require only a business license from the local town or county. Boarding homes are not regulated by DHEC in any fashion and are often uninsured. Boarding homes usually house people who have been deemed disabled by the Social Security Administration due to mental illness or other health conditions. In exchange for residence, boarding home operators can require that the
operator becomes the resident’s Social Security “payee.” Once a third party becomes a Social Security recipient’s “payee,” that individual or business then receives the monthly Social Security payments directly. Boarding home operators often house 8–10 residents in a single building. The operators then receive an average of $1,000 in disability benefits per month per resident, deposited directly into their bank accounts by the federal government each month. Unscrupulous boarding home operators can move two single-wide mobile homes onto a piece of rural property and then collect $20,000–$30,000 in monthly income on behalf of the residents. Unfortunately, the lack of DHEC oversight can result in extreme and inhumane living conditions. Real problems arise when hospital social workers, who are often dealing with bed shortages in mental health inpatient units but are hesitant to discharge a patient out the front door of the hospital, discharge their patients to these boarding homes. A physician recently described how boarding home operators hang around hospital lobbies, explaining that they have vacancies and hoping to get referrals from hospital staff — much in the way unlicensed cab operators hang out at the baggage claim at LaGuardia Airport hoping to get new customers. Not surprisingly, the conditions within these boarding homes often lead to tragic consequences for the residents, particularly if a patient is discharged into this environment in an unstable mental condition. If you receive a call from a hospital social worker on behalf of a mentally ill friend or relative, make sure you inquire about the status of any facility to which discharge has been recommended. You can take some comfort if a community residential care facility or assisted living facility is recommended, but be very careful if a boarding home is suggested. Just as you would not want your loved one to ride through New York in an unlicensed cab, you would not want that same individual in a facility not licensed and regulated by DHEC.
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Mental Health Reminders for the Season During this time of the year, it’s natural for people to say “Happy Holidays” to each other. However, for many people, the holidays can be anything but joyful. Each year, many Americans suffer in silence, battling varying levels of sadness and sometimes even depression. According to the National Alliance on Mental Illness, about 64% of people find that the holidays make their mental health worse than during other times of the year. MAINTAINING A HEALTHY MINDSET FOR THE HOLIDAYS
then consulted with Mrs. Branton and agreed that she needed to be placed in the hospital for a new mixture of medications to be tested. However, a young psychiatrist who oversaw the Behavioral Health Unit then assessed Mrs. Branton and disagreed, reversing the involuntary commitment paperwork and discharging Mrs. Branton back to the boarding home with no changes to her medications. At the boarding home, Mrs. Branton continued to exhibit manic behavior and sat in the yard of the home wearing a wool U.S. Army dress blazer that had been passed down to her from her father. Tragically, Mrs. Branton sat outside for such an extended period that she succumbed to fatal heat stroke. At trial, our team emphasized how mental health conditions touch all families. Testimony revealed that Mrs. Branton was charged $4,000 for her short hospital stay but was discharged back to the community in an unstable and unsafe condition. The physician who discharged her in this unsafe condition had relocated to Tennessee and refused to attend the trial. Instead, he offered his testimony by way of prerecorded video deposition. The two physicians who recommended admission to the hospital and who continue to treat patients in South Carolina both showed up to trial and testified as to why they believed Mrs. Branton needed hospital admission. Ultimately, the jury agreed with our expert witness and these two treating physicians and awarded $5 million in damages. Mental health diagnoses are serious medical conditions. With proper treatment, people with serious and severe diagnoses can live long and normal lives. However, this trial indicated how extreme the consequences can be when these conditions are not managed properly or taken seriously. Unfortunately, this is the second case in the last few years our firm has handled that involved the heat-exposure death of a manic patient who was discharged to a boarding home. At trial, we were joined by Robert Goings of the Goings Law Firm, who brought our firm into the case, as well as local counsel David Williams of Williams & Williams Law Firm in Orangeburg. While the Branton and Davis families still have a long road ahead as the IRF appeals the jury’s verdict, they have the peace of mind of knowing that a jury of 12 strangers took Mrs. Branton’s mental health condition seriously.
Even though most people associate the holidays with happiness and celebration, there is an underlying current of added stress that comes with the season. Part of that, experts say, is that people can often feel like they are
expected to be in a happier mood during that time. Instead, they likely have feelings of sadness, fatigue, frustration, tension, loneliness, or even loss.
It’s natural for each of us to have ebbs and flows in our “happiness” levels. But there are things we can do to help ourselves better cope with these blue times.
One way is by prioritizing the things that are the most important in life. It can also help to take a personal inventory of the good things in life that we are thankful for. Another source of stress is that many people feel pressured to make everything “perfect” during holiday gatherings. Of course, the truth is that there is no perfect. If we give ourselves a break and strive for enjoyment rather than perfection, we will likely realize that enjoyment is a much easier bar to reach — and we can let ourselves be happy. A great way to stay focused on life before, during, and after the holidays is to think about the resolutions we have made and can make for the new year. Even if you don’t like making New Year’s resolutions, you can think of them as overall goals, which is precisely what resolutions are. Think back on past resolutions you have set, then look forward to building on your past successes in the new year. That sense of purpose can overcome those temporary times of feeling down because your mind will focus on what you can do to make your future goals come true. The task of getting through the holidays if you’re not feeling “in the spirit” is nothing to make light of. At the same time, it’s good to remember that we can find the good in the season and beyond.
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GEORGETOWN OFFICE 121 Screven Street Georgetown, SC 29440 (843) 995-5000
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INSIDE THIS ISSUE 4. 3. 2. 1. A Closer Look at Boarding Home Care A Word of Caution on Boarding Homes Healthy Holiday Mindset Discover the Most Enchanting Christmas Towns in the US
Explore America’s Most Magical Christmas Towns From Snowy Villages to Year-Round Holiday Cheer
every year, and they certainly don’t hold back when it comes to the holidays. The town lights up and decorates almost 21 miles, where you can find reindeer farms, carolers, gingerbread competitions, and Christmas markets. Every step of the way offers an Instagram-worthy photo opportunity! Solvang, California A slice of Denmark right in sunny California, Solvang brings endless holiday cheer, especially with their annual Julefest. Pronounced “Yule-fest,” this month-long festival takes place every December and features picturesque events, including a ballerina-filled tree lighting ceremony, visits from Santa, culinary delights, traditional Danish celebrations, and much more! Woodstock, Vermont During Woodstock’s Wassail Weekend, you’ll find the town in peak Christmas
mode, where you can experience parades, horse-drawn carriages, carolers, and the Billings Farm, a local favorite of the season. Stroll down Main Street to witness an idyllic Christmas spot filled with cozy small-town shops and restaurants. North Pole, Alaska If you ever feel like celebrating Christmas in the middle of summer, we know the perfect destination. North Pole, Alaska, offers Christmas decor and festivities year-round! Here, you can get up close and personal with Santa’s reindeer, meet the man himself, and enjoy the snow that covers the entire town. Be sure to check out their ice sculpture competition, which features artists from all over the world! Ready for the Christmas celebration of your dreams? Start planning your next holiday vacation at any of these destinations, and we promise your dreams will most definitely come true!
It may be too late for less spontaneous travelers to start planning a Christmas vacation. But that shouldn’t stop you from planning next year’s holiday journey! The good news is you don’t need to venture to another continent to find a Christmas wonderland. There are countless picture-perfect Christmas towns across the country. Make your next Christmas trip feel like a Hallmark movie at one of these festive towns! Leavenworth, Washington Many have dubbed Leavenworth the most Christmas-centric in the U.S., and it’s easy to see why. This Bavarian-style village experiences nearly 96 inches of snowfall
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