Connecting the Dots
Recently, Tom Leverage and Ingrid Rodriguez met with nursing supervisors at Jamaica Hospital Nursing Home to emphasize the importance of accurate and complete documentation. In the holiday spirit, a few of the supervisors were asked to complete diagrams of Christmas trees by “connecting the dots” that gave the contours of the tree. The diagrams contained varying degrees of information to follow and one diagram had missing dots. The most beautiful tree was created from the diagram that contained the most initial information. The drawing that was completed from the diagram with missing dots was agreed by all to be a decidedly ugly tree.
What does this have to do with nursing home litigation? Tom and Ingrid explained to the nursing supervisors that at a trial, the dots that will be connected to make a picture for the jury come from the notes and entries made in the chart. Even when all the “dots” are present, anyone can connect them in a way that makes an ugly picture. Certainly, when the “dots” are missing or inaccurate, it is easier to connect the dots to make an ugly picture even when we know that that picture is not the true picture.
The amount of information conveyed in the notes gives the attorneys at trial the directions on how to connect the dots. The use of photographs is also very helpful as a great deal of detailed information is recorded that would take a “thousand words” to convey.
Tom and Ingrid then led a discussion of various types of entries that are routinely made in nursing home charts that provide the “dots” to be connected at trial.
By having complete and accurate notes in the chart supplemented with photographs when appropriate, the jury’s ability to see and understand the care and treatment given to the resident is enhanced. In this way, the trial attorney is better able to demonstrate the care that was in truth given to the resident.