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nursing home surveillance

With Elder Abuse on The Rise, Wisconsin Looks at New Way to Prosecute Offenders

Horrific. Demonic. These are the words some nursing home residents (and their family members) are using to describe their abusers. And if the thought of having your loved one beaten, left without food or resting in dirty linens, being overmedicated, sexually abused, robbed, or neglected is painful to think about, the process to prosecute a guilty party without any physical evidence can be even more gut-wrenching. Because most investigators have only the victim’s statements to go on, police struggle to build cases on just accusations. More so, the most vulnerable nursing home residents, those with cognitive issues or memory diseases, may not be able to speak up or even be aware of the abuse.

As these cases increase every year across the nation, it’s simple to see that getting away with elder abuse is just too easy. Cases remain unresolved because of the lack of evidence needed to prosecute nursing home mistreatment or crime and the trends continue. Illinois, including Texas, Oklahoma, New Mexico, Washington, and Maryland have already passed laws allowing some form of surveillance in nursing homes. In addition, Wisconsin’s Attorney General Brad Schimel recently decided enough-is-enough after county data reported 7,019 complaints in 2016, up 21 percent from just three years earlier. The state has announced a move to stop abuse by gathering reliable evidence for prosecutions via state loaned surveillance cameras to family members, free of charge for 30 days, so they can secretly record staff suspected of abusing their loved ones. This move, which is only the second video surveillance loaner program of its kind in the U.S., the other in New Jersey, has ignited protests by the elderly care industry, providers and privacy advocates.

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A recent review of nursing home data reveals that despite initiatives to reduce their use, the number of nursing home residents on antipsychotic drugs remains high in 2018. The Long-Term Care Community Coalition found that 20% of residents are taking an antipsychotic medication, even though the conditions the drugs are intended to treat are present in only 2% of these residents.

A Decades Old Argument 

Antipsychotic drugs are sometimes given to patients off-label to calm behaviors associated with dementia and Alzheimer’s. These medications make patients easier to handle, and have been known to be used without the patient’s physician or family’s knowledge or consent, a dangerous tactic given that off-label use of these drugs have been known to cause sudden death. This practice, officially known as chemical restraint, is not new. Since at least the mid-80s, consumer interest groups have pushed to curtail the use of antipsychotic drugs in nursing home residents with dementia.

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The state of Georgia has strengthened their law on background checks for nursing home employees and owners who have routine resident contact or access to any of their personal information. Effective October 1, 2019, all owners, applicants and employees of long term care facilities will be subjected to fingerprint and name background checks through the FBI’s database. Previously, state law required a name-only background check through a state database. The group behind the push for the new law, the Georgia Council on Criminal Justice Reform, said the stricter laws of surrounding states left Georgia open to employing those from neighboring states with a checkered past.

The new law, officially titled the Georgia Long-Term Care Background Check Program, applies to not just nursing homes, but assisted living facilities, home health agencies, and private in-home providers.

Illinois Nursing Home Employee Law

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nursing home reform delay

Impact of Centers for Medicare & Medicaid Services (CMS) Decision to Delay Enforcement of Protections For Nursing Home Residents

On May 30 several State Attorneys General, including Illinois Attorney General Lisa Madigan, sent a joint complaint to Alex M. Azar II, Secretary of the U.S. Department of Health and Human Services and Seema Verma, Administrator Centers for Medicare & Medicaid Services and expressed extreme concern over the Centers for Medicare & Medicaid Services (CMS) actions to slow regulatory enforcements that support the safety and wellbeing for Medicare and Medicaid beneficiaries who receive care in nursing homes and long-term care facilities. In the letter, the Attorneys General are holding CMS responsible for not pushing forward a 2016 series of skilled nursing facility reforms that were set to move out in three future stages. The current administration’s delay will bring major challenges in holding facilities accountable for providing appropriate resident care and well-being.

“We write this letter to express our concern and to alert the Centers for Medicare & Medicaid Services (CMS) about the substantial and foreseeable detriment of CMS’ actions to delay enforcement of protections for Medicare and Medicaid beneficiaries who receive care in skilled nursing facilities (SNFs). The recent CMS guidance significantly decreases the protections in SNFs by rolling back reforms to improve the safety and wellbeing of nursing home residents. If allowed to proceed, recent regulatory changes will not only threaten the mental and physical security of some of the most vulnerable residents of our states, but also potentially create additional challenges for MFCU investigation and prosecution of grievances, violations, and crimes occurring in SNFs. We therefore urge you not to lower the level of regulatory oversight.”

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financial exploitation

Investors Claim Rabbi Stole Millions Out of Chicago Nursing Home Deals

Several investors have come forward alleging a Skokie-based investment firm run by a rabbi, stole more than $20 million in a series of nursing home and retirement home funds around the Chicago suburbs in Norridge, South Holland and Morris, along with one Downstate, one in Indiana and the New Jersey facility. The suit alleges the investors are owed a total of more than $24 million counting interest due on their initial contributions.

According to a May 2018 report by The Real Deal, a publication catering towards Chicago real estate professionals, “a similar lawsuit filed in September in federal court in Chicago that alleges violations of the RICO act … In that suit, the investment firm created a series of LLCs to buy and sell nursing homes and retirement homes across the country, including several in the Chicago area and one in Wayne, New Jersey, according to the plaintiffs’ attorney, Craig Tobin.” Soon after, the firm was found to be keeping profits for themselves and not giving any to the investors and filling their pockets by taking from others who rely on nursing homes to survive. The scheme victimized “a 90-year-old Holocaust survivor, school teachers and sophisticated banking institutions,” the suit says. The federal lawsuit seeks more than $20 million in damages.

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There’s yet another acronym in the healthcare world that we’ve been hearing often. According to the Centers for Medicare & Medicaid Services (CMS), Accountable Care Organizations, or ACOs are “a group of doctors, hospitals and other health care providers who come together voluntarily to give coordinated high-quality care to their Medicare patients.  The goal is to ensure that patients get the right care at the right time while avoiding unnecessary duplications of services and preventing medical errors.”

Essentially, ACOs are a network of healthcare providers helmed by a Medicare fee-for-service patient’s primary care physician that all share information about the patient. Instead of seeing one doctor here and one doctor there and having to obtain records and experience gaps in care, healthcare providers within an ACO all have access to the same information. These groups are not insurance-based, so although a provider might refer a patient to another within the ACO, the patient isn’t required to see only providers within that ACO.

Hospitals have been under pressure to better care for patients and reduce costs since the 2012 passage of the CMS’  Hospital Readmissions Reduction Program (HRRP). The program seeks to cut down on the number of hospital readmissions within 30 days of discharge, namely by slashing their reimbursements paid to hospitals. It is the very real threat of reduced payments, as well as the lure of shared savings bonus from CMS that has led many hospitals and health networks to band together to form ACOs.

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A Virginia family is suing their mother’s former nursing home over her death following a fall. The woman, Fannye Doris Holden Scruggs Rorer, was an amputee who had only one eye and suffered from Alzheimer’s. On April 15, 2016, she had been a resident of Woodhaven Hall at Williamsburg Landing in Williamsburg, VA for 5 years when a lone CNA attempted to transfer her from her bed using a hoyer lift. During the transfer, Ms. Rorer fell and X-rays later showed she suffered compression fractures on her lumbar spine. Instead of moving Ms. Rorer to a hospital for treatment, the facility chose to keep her on site. Ms. Rorer died 8 days late at age 87.

Victim Suffered Repeated Falls Before Death

The lawsuit also alleges that Ms. Rorer had been dropped 6 times in the months leading up to her fatal fall in April 2016. The Virginia Department of Health had also cited the facility in 2015 and again in 2016 during an inspection conducted less than 2 months prior to Ms. Rorer’s fall. The citations from that inspection include nursing staff’s failure to notify a resident’s doctor that she was in severe pain following a fall, as well as a lack of care plan for a patient following a bowel surgery.

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90% of seniors 65 and older say they would prefer to stay in their own homes as long as possible                             (Source: 2012 AARP survey)

Taking care of aging parents or loved ones is one of the largest responsibilities we will ever take on.  A question many of us have already had to answer or will face in the coming years is “Is it financially and physically possible to keep Mom and Dad safe in their own house as they get older?” Today we’ll discuss what you should know about helping your loved one age in place.

Nursing Homes, Assisted Living Facilities, or Living at Home: What’s More Expensive?

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nursing home legionnaires disease

Medical Documents Show “Questionable” Record-Keeping Related to Legionnaires’ Disease Victim’s Care and Family’s Concerns Prior To Death

The family of Dolores French, one of the 13 residents of the Illinois Veterans Home who died from the horrific Legionnaires’ disease outbreak in 2015, recently spoke out to WBEZ reporter Dave McKinney after “newly obtained health documents related to her case demonstrated a litany of questionable procedural and record-keeping practices at Illinois’ largest state-run veterans’ home….”

French had only been a resident of the Quincy Veterans Home for six weeks when Adams County Coroner James Keller examined her already decomposing body, possibly of two days, on the floor in her room. Although state officials deny the claim, her family was told her body was not in a condition to be embalmed and an open-casket funeral would not be an option.

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A Texas hospice operations director has admitted to following instructions from her boss that resulted in $60 million in fraudulent billings to Medicare and Medicaid. The executive, Melanie Murphey, was employed by Novus Health Services in Frisco, one of the largest hospice providers in North Texas. Murphey reported directly to Bradley J. Harris, the company’s CEO and owner. According to Murphey, Harris quickly put hospice patients on Continuous Care (CC), a designation that requires around the clock care and is covered at a higher rate than standard hospice services. More often than not, this care was not required.  If a patient was on Continuous Care for several days and they still were alive, he would tell Novus nurses to administer lethal drug doses to cause their death in order to prevent Medicare from digging into why a patient was classified as needing CC when it was not medically necessary.

Harris was not alone in his scheme. He worked with at least 5 doctors and 5 nurses who knowingly gave unnecessary medication doses and falsified records in exchange for kickbacks. NBC5 Dallas-Ft. Worth reports that patient records falsely read that one physician conducted appointments, but the time and dates overlap with vacations she took out of the country.

Melanie Murphey took a plea deal with the government in exchange for her testimony in the case, while Brad Harris, his wife, 5 doctors, 5 nurses, and 3 others have been indicted and are awaiting trial.