April 27, 2015

Illinois Camera Bill Passes through Committee

by Levin & Perconti

The State of Illinois has taken a role toward the front of the progressive nursing home camera movement. A few states across the country already have laws on the books permitting nursing homes operating in their respective jurisdictions to allow patients and their families to place surveillance cameras in the patient’s room if they choose to do so. The advantages should be obvious: cameras capture footage of abuse and neglect (for example a physical hitting, or a long lapse of time in which no staffer comes to check on the patient), and allow patients and their families to know what is going on, and to put a stop to it and hold the right people accountable. In most cases signs must be posted warning visitors and staff that there is a camera in a particular room, thus this also serves as a deterrent to one who might otherwise commit abuse, neglect the patient, or steal from the patient.

Some decry this permission as creating concerns over the privacy of visitors, but posting of signs at least provide notice to individuals that they are being taped. And such laws and policies typically ensure that where residents share a room, that consent is provided by roommates and their families where necessary in order to have a camera placed in the room. The Madigan proposal ensures such consent, requires residents and families to pay for the equipment, ensures that footage can be admitted in legal proceedings, and prohibits anyone from retaliating against a resident for using monitoring equipment or tries to tamper with or prevent the use of the cameras.

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April 24, 2015

Resident’s Fall and Death at Low-Rated Illinois Nursing Home Raises Questions

by Levin & Perconti

In Southwest Illinois, at the Midwest Respiratory and Rehabilitation Center in Belleville, there was a horrific and tragic death of an 85-year old resident at the facility. According to local report, the victim “was found dead strapped to a wheelchair at the bottom of a flight of stairs.” The tragic death occurred in the early hours of March 12th. In addition to the possible negligence that led to this, the victim’s sisters reportedly noticed signs of abuse such as cuts, bruises, and stitched up areas on the victim’s body.

Authorities Notified First by the Funeral Home, Not the Nursing Home

Rather than the nursing home facility informing authorities of her awful death, it was a local funeral home, over an hour away, which had retrieved the body after the victim’s daughter made a call to the funeral home. The funeral home called the county medical examiner to clarify how the death certificate should be filled out because if there were an accident (as opposed to natural causes), this would require the medical examiner to establish a cause of death and sign off on the death certificate. The medical examiner subsequently went to pick up the victim’s body. Reportedly, the only call to authorities from the nursing home was for an ambulance.

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April 22, 2015

Nursing Staff Fails to Notify Doctor of Severe Symptoms

by Levin & Perconti

When it comes to vulnerable individuals, particularly the elderly or infirmed, pneumonia presents not just an illness, but a condition that could lead to death if left unattended by doctors. In western Minnesota, an elderly nursing home resident was hospitalized after he was found to have numerous open sores on his body, very dry skin, and exhibited symptoms of malnourishment and dehydration. Prior to being rushed to the hospital, the nursing home staff gave him extra oxygen as well as cough syrup to help with his breathing problems as well as his changing body temperature. They added Tylenol to the mix as well, and used a cold cloth to try to control his temperature. When he got to the hospital, he was not responsive. Hospital staff diagnosed the pneumonia there, and noticed that he had very little food or liquid, in addition to the clear sores and dryness on his skin. Sadly, within three days he had succumbed to the pneumonia.

Staff Never Notified the Doctor

There is a particularly disturbing aspect of this case that will undoubtedly put this nursing home in a bigger spotlight, and should be of tremendous concern to nursing home consumers and their families. While clearly there must have been questions as to the chosen methods to treat the patient – Tylenol, cough syrup, and oxygen – for pneumonia symptoms, the astounding discovery was that nursing home staff allegedly failed to even once consult a doctor about the patient’s symptoms that affected his body temperature and breathing abilities.

They merely tried to treat the patient themselves until a more heightened temperature and worse breathing finally prompted them to do something else and send him to the hospital. However, too much damage was possibly done, and he eventually passed away. To add to this sad story, the victim’s family was not notified of this man’s bad condition, either, until the night before he was hospitalized when they were told he had a cold and high temperature.

History of Documented or Alleged Negligence

According to newspaper reports, the owner of this particular nursing home operates a total of 26 facilities in Minnesota alone, and nearly 300 across the country. This one patient is one of others who have problems as a result of alleged negligence at other facilities owned by this particular owner. As is typically the case when incidents of abuse or negligence occurs and a facility is put on warning or subject to sanctions, this facility reportedly submitted a plan to make fixes and re-train staff with regard to when to notify a doctor of problems. Notably, the victim’s doctor was reported as having said he expects to be notified of a “patient’s failing condition” days prior to resorting to hospitalization.

Scrutinize Nursing Homes Carefully

This particular facility’s apparent history of negligence and consequent citations makes it clear the importance of consumers researching facilities as thoroughly as possible through state health or aging departments as well as through the federal government’s Centers for Medicare and Medicaid Services, which publishes ratings on its Nursing Home Compare website. The alleged negligence in this Minnesota case is horrendous, as the patient is said to have not received water or food, did not have adequate oxygen, and was left with open sores which can initially develop due to being in the same position for prolonged periods, a failure to change bedding, and/or failure to adequate bathe a patient and can only get worse without cleaning and proper treatment and dressing. Staffers seemingly lacked the training to know best when to consult a doctor when a patient had deteriorating circumstances. Properly trained and educated nursing home staff is crucial to the proper care of residents.

See Related Blog Posts:

Selecting the Best Nursing Home for Your Needs

Investment Firm Takes Over Family-Run Nursing Home

April 20, 2015

Daughter of Nursing Resident Killed by Overdose Calls for Independent Investigation

by Levin & Perconti

As we have discussed in multiple posts, and as has been followed in the news in recent weeks, a 98-year old resident of a nursing home in South Holland, Illinois, died in a mysterious incident in early February 2015. At first it was unclear what had happened, and initially news outlets reported that the victim was one of six residents who experienced abnormal blood pressures and respiratory issues.

However, the other five residents initially survived those ailments, while the 98-year old resident passed away (the causes of their problems were as yet deemed unknown; by early March, two of the other victims – aged 88 and 98, had passed away, though any connection to this initial incident is unclear). Fire officials ruled out any gas or carbon monoxide poisoning. Authorities opened investigations into the matter, including conducting a toxicology test. A nurse at the facility was suspended after these latter deaths.

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April 17, 2015

Alleged Cover-Up after Resident Fall and Injury at South Holland Home

by Levin & Perconti

Fall and Injury at The Villa

As if things could not get any worse for nursing homes and nursing home residents in the South Holland, Illinois area, there is now more news of a horrific incident in which a nursing home resident at The Villa at South Holland suffered severe injuries. The victim in this case suffers from dementia and is thus unable to speak and unable to move on her own volition. Due to her inability to move on her own, nursing home staffers are supposed to employ what is called a “hoyer lift” in order to lift and move the resident.

However, in this particular instance, a registered nurse (RN) directed a certified nursing assistant (CNA) to move the patient directly. When one of them inadvertently stepped on the resident’s blanked and caused her to fall out of her wheelchair, the resident fell to the floor and suffered a major head wound. She was subsequently taken to the emergency room, where she had to receive nine staples in her head to mend the gash on the back of her head.

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April 15, 2015

As Elderly Population Grows, Long-Term Insurance Scales Down

by Levin & Perconti

We have written before about how the elderly population will continue to grow in the years to come, as the members of the enormous baby boomer population enter their golden years. As they grow older, the need for various levels of third-party care will be necessary or at least preferred to keep them as healthy as possible and in some cases allow them to lead relatively independent lives. As this segment of the population grows, the costs of caring for so many will increase, possibly putting a strain on finances and the abilities of insurance companies to adequately cover care for their policyholders.

Life Spans & Insurance

In recent decades, in addition to health insurance, other long-term insurance policies such as life insurance were considered essential parts of planning ahead for the eventual need for care in later years. In recent news, however, this fact-of-life type of insurance is on the cusp of becoming much less affordable, and thus much less available to the growing crop of elderly Americans. The expectations about life spans of policyholders and how much it would cost to care for them influenced policy provisions and premium rates, yet this sector has apparently hit a breaking point because those past assumptions have not matched the current reality as costs increase for an aging but still living part of the population.

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April 13, 2015

Rauner Proposed Budget Would Slash Home Services

by Levin & Perconti

In recent news and a recent post in this blog space, it was reported and discussed that new Illinois Governor Bruce Rauner has submitted his new budget for the next fiscal year in 2016, and that budget as proposed does not take it easy on certain public services in the area of health care. For one, the governor proposed to cut Illinois’s Medicaid spending by approximately $1.5 billion, lowering spending to approximately $19 billion, and affecting close to 3.6 million Illinoisans who rely on that public health insurance benefit.

These cuts are projected to effectively reduce hospital budgets by 13% statewide which could lead to not only lesser care but job losses at those hospitals. Approximately $216 million would be lost for nursing homes that make those reimbursements for caring for patients on Medicaid. Pharmaceutical expenses would also be cut by around $40 million if this budget goes through, and the budget for substance abuse treatment would decrease by approximately 20% to $99 million in 2016 (down from $124 million). Furthermore, the Rauner budget is overall slated to hit social services hard in general, and estimated to cut approximately $400 million from the Illinois Department of Health and Human Services budget.

Cuts to Home Services

One specific target of cuts is the Illinois Home Services program, which provides in-home assistance for those residents with certain physical disabilities. The budget proposal calls for a reduction of $110 million from that program’s fund. This assistance gives individuals the chance to do things like work and support their loved ones, while leading an independent life outside of the strictures of a nursing home. In general, the program entails workers to check in on patients at their homes in lieu of round-the-clock staff at a nursing facility. This is also consistent with the general growing trend toward community-based nursing care in which individuals can stay at home or in a more community-oriented place and receive the one-on-one attention they need. It is theorized that this environment is more positive and avoids the unfortunate pitfalls at some nursing homes where abuse may occur, or simple negligence leaves residents without the attention they need.

Home Services May be More Cost Efficient

According to some advocates for the disabled, in the case of the Illinois Home Services program it actually may cost the state less to help fund these in-home services, than to cover costs associated with nursing home care, which is a big business and can be quite costly. Under the proposed budget, the cuts would actually be a byproduct of the state changing the eligibility criteria for the program to make it stricter. Disability advocate group Access Living warn this could mean close to 10,000 individuals (or one-third of the program’s participants) will lose that assistance, as also reported in the Chicago Tribune and on progressillinois.com. These same advocates report that Illinois Medicaid saves $17,000 per person each year thanks to the home services program.

Implications of the Cuts

Current participants in the program, if ruled ineligible under the new budget guidelines, may not be able to support their families with the help of the periodic assistance under the home services program. If these cuts are implemented as part of the next year’s budget, it will likely mean less home services care for the physically disabled. It may also mean that patients who are denied eligibility and removed from the program may have to enter nursing home facilities for care, potentially costing the state more money in the long-run, and putting these individuals in possibly less suitable environments. Stay tuned as budget negotiations continue in the capital.

See Related Blog Posts:

Governor Rauner Seeks to Cut Medicaid by $1.5 Billion

Revamped Rating System Downgrades Nearly One-Third of Homes

April 10, 2015

Protection for Nursing Home Employees and Whistleblowers who Stand Up for the Elderly

by Levin & Perconti

Effective July 29, 2010, the Illinois General Assembly amended the Nursing Home Care Act to include what it termed “whistleblower protection”. 210 ILCS 45/3-810 (West 2010). Section 3-810 specifically provides a private right of action for nursing home employees who are retaliated against for reporting or threatening to report to a supervisor or a public body any action or incidents they believe to be a violation of the law, a rule, or a regulation regarding care and treatment of nursing home residents. Prior to this amendment, Illinois Courts did not recognize a private right of action for nursing home employees who reported violations and were retaliated against. In Young v. Alden Gardens of Waterford, Bethany Young, RN filed suit alleging, in part, that she was retaliated against for refusing to falsify medical records on November 9, 2009. The trial court dismissed her claim under Section 3-810 based on the fact that the Nursing Home Care Act did not provide a private right of action for retaliatory discharge at the time the conduct occurred. The court noted that because the amendment affected a substantive change in the law, it could not be applied retroactively to Young’s claim. Young v. Alden Gardens of Waterford, LLC, 2015 IL App (1st) 131887 ¶ 11.

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April 9, 2015

Medicare Fraud in Illinois Highlights Importance of Law Enforcement

by Levin & Perconti

Recent news provides another example of the effort of medical providers, such as nursing homes, to defraud the government through healthcare fraud. The agencies are Adonis Inc. and BestMed-Care Services Ltd., headquartered in Dolton, Illinois. The operator of two nursing home agencies in Illinois was arrested and charged with healthcare fraud. The allegations specified that he stole over $5 million “for unnecessary home care services” for nearly four years. The charge carries a maximum penalty of 10 years behind bars and a fine of the greater of $250,000 or twice the amount of the fraud.

The charges stem from the agencies paying a marketing company to refer patients to them for ostensibly “free services” only to tell the patients they needed certain care from skilled nurses, and then billing Medicare for providing that unnecessary care. This also included filing falsified nursing assessments for these patients. This most recent case again puts the spotlight on the importance of Medicare and Medicaid Fraud Units. In this case, the Medicare Fraud Strike Force’s investigation led to this arrest. It also highlights the importance of our laws in combating Medicare and Medicaid fraud to protect the system and patients:

False Claims Act

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April 7, 2015

Use of Antipsychotic Medications Drops since Start of CMS Initiative

by Levin & Perconti

When a person must decide on a nursing home, or their loved ones must choose one for them, there are so many factors and considerations that go into making that crucial and life-impacting decision. One of the many pieces of criteria should be the nursing home’s record of use of antipsychotic drugs to control and subdue residents. The use of antipsychotic drugs in the past was a more commonplace and accepted way to restrain patients, especially those who suffered from some type of psychosis, dementia or Alzheimer’s and could become easily irritable or even violent.

However, the use of such medications has come to be considered an improper form of chemical restraint by so many, as it can cause irreversible physical and/or mental damage, push the patient into a drug dependency, or into a hard cycle of uppers, suppressants and other medications in between. Medical providers, including nursing home doctors and nurses, have also typically used these drugs because of the ease of administering them rather than taking alternative, more humane and chemical-free methods.

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April 5, 2015

State Bill Would Make Inspection Information Inadmissible in Court

by Levin & Perconti

In the world of medical care and specifically nursing homes and long-term care facilities, the authority and resources of the federal and state governments to inspect and evaluate nursing home performance, quality of care, staffing levels, and overall compliance with relevant law and regulations, is paramount.

This keeps nursing homes honest, pushes them to hire and train staff appropriately, and to ensure that abuse is eliminated and that residents get the proper attention and treatment rather than have their health and lives risked by neglect. In recent news, and as we’ve discussed in this space numerous times in recent months, the federal government’s rating system was found to have been faulty, limited, and relied on unverified self-reported data from nursing homes when ranking them and evaluating them for consumers. Investigations and inspections are thus all vital parts of this effort, and the federal and certain state governments have ramped up efforts to meet this oversight obligation.

New Proposed Nursing Home Law

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April 2, 2015

West Virginia Judge Will Not Recuse in Nursing Home Case

by Levin & Perconti

We previously posted about a fascinating situation in the West Virginia judicial system involving an apparent conflict of interest by a judge on the state’s highest bench, and a nursing home case. The Chief Justice of the West Virginia Supreme Court, the state’s highest court, was called upon to recuse herself from a case before the court that found against a nursing home at the trial level and resulted in a $90 million award to the family of an elderly nursing home resident that passed away after nearly three weeks at the facility.

There was conflict over whether the resident’s dementia led to her ultimate death, or if it was dehydration from a possible neglect by nursing home staffers that led to her death. The high court upheld the ruling against the Heartland Nursing Home, also refusing to throw out punitive damages, and modifying the damages award to reduce it to about $48 million. The Chief Justice wrote the majority opinion rendering the decision in the plaintiff’s favor. The case went up on appeal in part on the argument that state law capped certain medical malpractice damages. The controversy over the Chief Justice’s involvement in that case centered on over $30,000 in campaign contributions she received for her re-election campaign and that was coincidentally arranged for by the attorney of the plaintiff in the Heartland case, who himself reportedly made a contribution of $1,000. This attorney also bought a Learjet plane for $1 million from the Chief Justice’s husband.

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