September 25, 2015

Wandering and Elopement Can Have Catastrophic Consequences

by Levin & Perconti
LinkedIn

The decision to have a loved one spend his or her final years in a nursing home is a difficult one to make. The primary reason many families make this decision is that the family is unable to provide the quality of care to their loved one that they believe will be available in in a professional setting. This is particularly true when the older family member is living with dementia. Unfortunately some of these nursing homes act negligently, and that negligence can result in wandering or elopement. As a recent story from Washington shows, the effects of wandering and elopement can be catastrophic.

What are Wandering and Elopement?

Wandering and elopement are two separate but related phenomena. Elopement refers to a nursing home resident to leave the nursing home unsupervised and unnoticed and the resident is put in danger as a result. The term “wandering” applies to situations where residents are allowed to move aimlessly throughout the nursing home and the residents are put in danger because, due to their medical conditions, they lack an ability to appreciate danger. Both of these problems stem from a facility’s failure to properly supervise and care for its residents.

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September 1, 2015

Illinois Law Passed to Allow Nursing Home Residents to Install Cameras

by Levin & Perconti
LinkedIn

Governor Rauner and the Illinois legislature have come together to pass a vitally important piece of legislation that will help to protect seniors against nursing home abuse and that will make it easier for victims to prove their cases where abuse does occur. This landmark piece of legislation will help deter physical and sexual abuse, make a record of neglect, and document negligent treatment that occurs in a patient’s room. The way this new law achieves all of these goals is by allowing nursing home residents to install cameras in their rooms.

Governor Signs Bill that Allows Nursing Home Residents to Install Cameras

The Chicago Tribune reports that Governor Rauner signed a bill that will allow nursing home residents to install cameras in their rooms so long as they pay for them. If a patient has a roommate, everyone living in the room has to agree before a camera can be installed. If a roommate refuses to allow a camera, but one patient wants one, then the nursing home has to give the resident an opportunity to move to another room so that he or she can use a camera. If a doctor determines that a resident is not mentally capable of consenting to the use a camera, then the resident’s legal guardian or family members are allowed to give or refuse consent. The law specifically states that the footage produced by these cameras can be used in court proceedings.

Why are Cameras Necessary?

Many Americans including many elderly Americans bristle at the thought of more cameras in our society. As red light cameras, security cameras, and cell phone cameras take over our society it can feel like privacy no longer exists. This is why it was important that the bill allow roommates to refuse a camera in their room. But nursing home abuse has become such a widespread and severe problem in our society that given seniors and family who want to prevent and prosecute it the tools to do so was vitally important. ABC News reported early this year that more than 25 percent of nursing homes are so substandard that they are a threat to their residents’ health.

The president of the American Health Care Association, a nursing home industry group, complained that laws like the one that has just passed in Illinois damage the trust between caregivers and patients. This criticism ignores the real cause of the erosion of trust between residents and caregivers: too many caregivers have committed horrible acts of abuse or neglect, and too many nursing homes have refused to give good caregivers the resources they need to do their jobs well. Resident health should be the paramount concern.

How Cameras Will Help Residents

There are two main ways in which these cameras will help residents. They are actually much like security cameras in the a convenience store in that regard. The first way they will help is through deterrence. Just as a store uses cameras to deter shoplifters, the hope is that caregivers who may otherwise abuse patients will not do so if they know the abuse will be caught on camera. The other way the cameras will help seniors is by helping to prove claims against facilities that neglect or abuse residents despite cameras. Just like a footage of a theft can convince a jury to convict, footage of abuse or neglect happening will be extremely persuasive in convincing a jury to hold a nursing home liable for abuse. Because this video footage is such strong evidence, it may also lead more nursing homes to be willing to settle claims without forcing residents or their families to go to court.

See Related Posts:

Resident Abuse Caught on Camera

Illinois Close to Making Cameras Permissible in Nursing Homes

August 28, 2015

Medicare Fraud May Make Opioid Abuse More Common Amongst Seniors

by Levin & Perconti
LinkedIn

Often people think of drug abuse as a young person’s problem. While young people do make up more than their fair share of the drug addiction and abuse community, they are far from having exclusive ownership of the problem. Older Americans, particularly those who suffer from chronic pain, can easily become addicted to prescription drugs. In fact, it is possible that Medicare fraud could be contributing to opioid abuse amongst the elderly. This could be particularly frightening when this abuse occurs in a patient living with dementia. Medicare fraud by seniors could also be a result not of their own opioid addiction but rather the addiction of a caretaker who is engaged in elder abuse and who uses the elderly person’s medications.

Lawmakers Raise Concerns Over Link Between Opioid Abuse and Medicare Fraud

Modern Healthcare reports that in a recent congressional hearing lawmakers interrogated officials from the Centers for Medicare & Medicaid Services (CMS) regarding a potential link between Medicare fraud and opioid abuse. Medicare fraud happens, and the lawmakers are concerned that some questionable Medicare billing discovered by the Office of the Inspector General dealt directly with opioids. Medicare Part D data shows that between 2006 and 2014 the number of beneficiaries who received commonly abused opioids grew by 92 percent. The number of beneficiaries of drugs over all increased by 68 percent during that same time period,

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August 22, 2015

Long-term Care Insurance: Still Worth Buying?

by Levin & Perconti
LinkedIn

Every year it seems another company drops long-term care insurance from its portfolio of products. Companies from MetLife to Genworth have either reduced benefits or eliminated the policies altogether. This begs the question, is it still worth having? Some experts say no. On one hand, the certainty of having a set dollar value available for covering the cost of nursing home care can be comforting. On the other hand, the premiums are not.

Rising Premiums are Unpredictable

Most sources agree that the majority of those age 65 and older will ultimately require nursing home care at some point in their lives. Average nursing home costs are skyrocketing to over $83,000 per year. With this fact in mind, it seems that investing in the possibility of needing care is a fairly safe bet. Still, with premiums rising out of control, that bet is pretty tough to accept. Some have seen premiums go from just $1,500 per year in 2004 to well over $5,000 per year now. Some seniors see these premiums rise every year, regardless of health. Therefore, this makes one wonder if there really is any certainty to purchasing these policies.

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August 19, 2015

A Blood Thinner is Causing Deaths and Injuries in Nursing Homes

by Levin & Perconti
LinkedIn

Medications are often just a part of aging. As we get older we are more likely to suffer from a whole host of medical issues. Unfortunately much of the testing that is done regarding these medications is done on health middle-aged or young people, rather than focusing on elderly people or people living in nursing homes. As a result, the use of these medications in nursing homes can sometimes have unexpected effects. Additionally, the unique needs of senior patients sometimes require that a very delicate balance be stricken with medication administration. When a nursing home is not up to this task, the results can be disasterous.

A Popular Blood Thinner is Causing Injuries and Deaths in Nursing Homes

The Washington Post reports that a popular blood thinner is causing injuries and even deaths in nursing homes. The brand name of the drug is called Coumadin, and its generic version is called warfarin. This drug is often used in patients who are at a high risk of stroke. There is a delicate balance in its administration. If a patient is not given enough of the drug he or she may develop deadly blood clots, but if he or she is given too much then he or she can bleed uncontrollably. Between 2011 and 2014 at least 165 residents of nursing homes wound up in the hospital or died as a result of an error administering this drug. Twenty of those reported incidents occurred in Illinois. Some studies indicate that there may be thousands of these incidents that go unreported. For example, a 2007 study in the American Journal of Medicine estimated that residents of nursing homes experienced 34,000 serious, life-threatening, or fatal events related to this drug each year.

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August 17, 2015

Nursing Home Accused of Abuse and then Accused of Retaliating Against Whistleblower

by Levin & Perconti
LinkedIn

Too often nursing home abuse goes unnoticed and unreported. The victims of neglect or overt abuse are often unable to report what is happening to them, or they may be ashamed of being victims. Fortunately there are some brave men and women working in the industry who have come forward and reported the abuses they have witnessed. These whistleblowers have legal protections, but sometimes they can find themselves fired for doing the right thing. A former Illinois nursing home employee claims this is exactly what happened to her.

Whistleblower Claims she was Fired for Reporting Nursing Home Abuse

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August 14, 2015

Illinois’ Lack of a Budget Endangers Services to the Elderly

by Levin & Perconti
LinkedIn

While nursing home abuse is a severe and pervasive problem in our society, it is not the only kind of neglect Illinois seniors have to worry about. Unfortunately our lawmakers’ unwillingness to pass a budget has left many seniors in a position where they may lose access to vital and necessary services.

Illinois is Failing to Fund Services to Seniors

Illinois legislators and the governor have failed to reach an agreement on the budget that is needed to run the state. The budget was supposed to have been passed by July 1st, but now a full month and a half later an agreement still has not been reached. A patchwork of court orders and small agreements have made sure that state employees continue to be paid for their work and that institutions like prisons have continued to function, but certain very important services have gone overlooked and unfunded. In particular, as reported by the Chicago Tribune, the state has failed to fund social service agencies that care for elderly people and people with disabilities. This social service agencies typically rely on grants from both the federal and state governments in order to function. Without the state funds, many may have to slash services.

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August 11, 2015

Corporate Guardianship: Choose Wisely

by Levin & Perconti
LinkedIn

We all want to be taken care of in our old age. We want to maintain autonomy, freedom, and dignity, but we also want to know that our loved ones will look out for us and provide us with the best care possible. However, sometimes our family may not be able to do so. Or perhaps we don’t have family. On a sadder note, some family members may simply not want to care for us. So where do seniors turn in these situations when they can no longer provide for their own financial and day-to-day needs?

Professional Guardianship and Conservatorship Companies
Professionals in this arena are a relatively new creation. Over the past 10-15 years, people have begun turning to these companies to provide in-home care, financial management, and even companionship. But what exactly do they do, and how much do they charge? To answer this, we must first look at the different types of providers. They come in a couple flavors.

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August 7, 2015

Risk of Dementia Higher in Women and those with PTSD

by Levin & Perconti
LinkedIn

Researchers continue to learn more about organic brain syndrome all the time, and it seems that scientists are learning more about all forms of every day. This term is a broad definition for a host of physical conditions in the brain that result in diminished mental competence, such as dementia (including Alzheimer's disease), Pick's disease, and several others. Still, no amount of research can make caring for an aging parent or spouse easier. It is, however, possible to understand the risk factors and prepare for the future. Just like most diseases, there are lifestyle and genetic factors that increase risk.

Women develop dementia faster than men

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August 3, 2015

Aging in Place: Financing Long-term Care at Home

by Levin & Perconti
LinkedIn

The question for many American seniors is no longer "what will happen when I die?" but "what will happen if I live?" Americans are living longer, but this can mean long-term health complications that require expensive treatment. Therefore, a lot of Americans are considering how to pay for the cost of long-term care. While nursing homes and assisted living facilities have been the traditional choice for those requiring routine medical care and daily living assistance, there is a growing trend toward aging in place. But remaining in one's home means finding affordable and quality in-home care and figuring out how to pay for it. Thus, Medicaid planning is an important part of a comprehensive estate plan.

Nursing Home Cost of Care

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July 30, 2015

Miami Nursing Home Settles over Alleged Kickback Scheme

by Levin & Perconti
LinkedIn

False Claims and Kickbacks

We have continuously seen the importance of whistleblowers in the world of healthcare, and specifically in nursing homes and long-term care facilities. The government typically uses the False Claims Act and the Anti-Kickback Statute to go after such fraud. These laws are implicated where healthcare providers make claims for reimbursement of services to patients and residents insured by federally funded Medicare and Medicaid, yet those claims are for fake services, or consist of overbilling.

They are also implicated where healthcare providers provide kickbacks for referrals of business, such as for prescription drugs, or for patient referrals. These types of activities are illegal. Sometimes insiders at companies or medical providers, who are privy to the illegal activity, can aid the government by reporting it. These whistleblowers not only do a good thing, but can stand to benefit financially, as the False Claims Act provides for whistleblowers to receive a certain percentage of the financial recovery. This rewards their participation, which can be stressful and put their own careers in jeopardy, as well as incentivizes others to come forward.

Kickback Scheme

In Miami, a nursing home agreed to a substantial settlement with the U.S. Department of Justice to pay $17 million over allegations that the company made kickbacks in violation of federal law. The Hebrew Homes nursing home was accused of making financial kickbacks to doctors and medical directors in exchange for making patient referrals. The kickbacks were orchestrated as contractual salaries for these individuals even though their positions did not truly exist at the nursing home. Rather, the home simply paid doctors to send patients to the facility. Such payments in exchange for referrals amount to kickbacks which is illegal. Where federal funds are involved because medical providers (like nursing homes) have patients insured by Medicare or Medicaid, which are federally funded programs, making such claims for reimbursement for these “fake doctors” amount to false claims against the government and a basic theft of taxpayer funds.

In addition to fraud on the government and taxpayers, it is also a terrible affront to patients and facility residents, since Medicare and Medicaid funds should be spent on their care, rather than in a scheme to gain more business. Such fraud can lead to civil and/or criminal prosecution. As with many settlements, the nursing home in this case did not admit liability. It was also reported that in addition to the settlement with DOJ, the nursing home operator also came to an agreement with the U.S. Department of Health and Human Service’s Office of Inspector General to reform its policies to ensure this does not happen again.

Whistleblower started it all

The nursing home company’s chief financial officer was the tipster that alerted the government to the kickback scheme. Under the False Claims Act, individuals can themselves bring a lawsuit on behalf of the U.S. government. This is known as a “qui tam” action. The Department of Justice can then elect to participate as plaintiff, which it did in this case. As a result of the CFO’s participation, he will reportedly earn over $4 million. This case overall demonstrates the importance of enforcing the false claims and kickback laws, as well as the importance of insiders as whistleblowers to root out fraud.

See Other Blog Posts:

Massive Medicare Fraud Takedowns

Medicaid Fraud Units Also Target Abuse and Neglect

July 28, 2015

Beware Online Scams against Seniors

by Levin & Perconti
LinkedIn

By now, many of us hear horror stories about the hacking of emails, government agency servers, company servers, and the theft of personal information. The recent attacks on the federal government’s Office of Personnel Management’s servers potentially exposed the personal information of about 21.5 million individuals who worked for or may have only applied for jobs within the federal government. Many of us all know the years-old comical story of emails from a mysterious (and fictitious) Nigerian prince seeking financial help.

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