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16 on the ECS panel

Nursing home nurse expert witness

Most nursing home cases are nursing cases. The resident's day is shaped by the assessments nurses complete, the care plans they write, the aides they supervise and the calls they make or fail to make, and the chart that records all of it is written almost entirely by nursing staff.

There are two different nurse witnesses, and choosing the wrong one is a common mistake. A bedside or charge nurse speaks to what should have happened at the bedside. A Director of Nursing speaks to the nursing system: skill mix, assignments, training, policy and whether the department was run to standard. Many cases need the second more than the first.

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What this expert addresses

  • Admission and ongoing assessment, including risk scoring for falls, pressure injury and elopement
  • Care plan development and revision after a change in condition (F656, F657)
  • Delivery of ordered interventions, and whether the documentation shows care or only charting
  • Change-in-condition recognition and physician and family notification (F580)
  • Medication administration and transcription practice (F760)
  • Supervision of certified nursing assistants and the nursing department's systems

Retain this discipline when

  • The question is what nursing staff should have done, and when
  • The chart contradicts itself and someone must explain what the entries mean
  • Notification timing is disputed
  • The facility argues the care was delivered and the records say otherwise

What they will ask you for

  • The full chart, with nurse notes, MAR and TAR
  • Assessments and every version of the care plan
  • ADL and repositioning flow sheets
  • Change-in-condition and SBAR documentation
  • Staffing assignment sheets for the shifts at issue
  • Nursing policies in effect at the time

Read: Nursing home records checklist for attorneys and paralegals

How to vet one

Ask for these with the CV. ECS sends the CV and fee schedule within 24 hours and testimony history on request.

  1. Long-term care experience specifically, not only acute care
  2. Whether they have served as a Director of Nursing if the theory is systemic
  3. Survey experience: two ECS panel nurses are former state surveyors, one SMQT-qualified by CMS
  4. Current licensure
  5. Testimony history, requested with the CV

Panel members in this discipline

Availability and conflicts are confirmed on the call.

Tammy Starion, director of nursing, registered nurse, licensed administrator, ECS nursing home expert panel

Tammy Starion

Director of Nursing, Registered nurse, Licensed administrator

Case types where this discipline leads

Pressure injuries and bedsores

Avoidable versus unavoidable, turning and repositioning, staging, and nutrition.

See this case type

Falls and fractures

Fall risk assessment, supervision, devices, and what happened after the fall.

See this case type

Sepsis and infection

Change in condition, notification timing, delayed transfer, and infection control.

See this case type

Medication errors

Wrong drug or dose, omitted doses, psychotropic use, and pharmacy oversight.

See this case type

Other disciplines

Nursing home administrator expert witness

Operational standard of care: staffing, policy, supervision, reporting and corporate direction.

See the discipline

Wound care and pressure injury expert witness

Avoidable or unavoidable, staging, treatment and healing trajectory.

See the discipline

Physician and geriatrician expert witness for nursing home cases

Causation, clinical judgment, medication, sepsis timelines and medical director duties.

See the discipline

Need this kind of expert?

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