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A nursing home in Westborough, Massachusetts is facing two separate lawsuits for falls that ended the lives of two its residents within a 7 week span in 2015.  The lawsuit alleges that staff at for-profit Beaumont Rehabilitation & Skilled Nursing Center ignored and purposely defied physicians’ orders that mandated the use of fall prevention devices, resulting in the tragic falls that caused blunt force head trauma and the death of two elderly residents.

Properly Used Safety Devices Can Aid in Fall Prevention

Per doctors’ orders, both fall victims, 89 year old Betsy Crane and 85 year old Vincent Walsh, were to wear wrist or ankle bracelets that function as tracking devices, referred to as a wander management system.  Devices such as these alert staff to the whereabouts of each resident, including leaving protected areas (such as the resident’s room or designated safe zone) or even making the smallest of movements. When combined with adequate supervision, wander management systems can be a valuable tool in ensuring the safety of nursing home residents who are at risk for wandering, as well as those at risk for falls.

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A major nursing home chain with locations in Aurora, Rockford, and Dixon, Illinois is in the middle of a $60 million lawsuit brought by the U.S. government. The lawsuit alleges that Meridian Senior Living Group (some former Meridian facilities are now owned by Affinity Living Group) submitted at least that amount in false billings to North Carolina’s Medicaid program for services provided in their facilities’ Special Care Units. These units are intended to treat specialized conditions within long term care facilities and nursing homes. The lawsuit names 45 separate Meridian facilities in North Carolina, Meridian’s owner, and their management and billing departments. As a combined entity, Meridian and Affinity operate the most adult care facilities in the state of North Carolina and are one of the top 10 largest adult living networks in the country.

Scam: Too Few Staff for High Billable Care Hours

Information about the scheme was brought forward by a whistleblower who was aware that the submitted claims to Medicaid were purposely overstated to reflect more frequent and extended periods of care than were actually provided. Among other allegations, the whistleblower alleges that the number of staff to the number of residents could never provide for the amount of 1:1 care for which Meridian Senior Living facilities billed. The facilities are accused of charging Medicaid for 1.5 – 1.75 more hours on average than a staff member actually spent with a resident. The lawsuit also alleges that Meridian would bill the maximum allowed per month, regardless of the release date or the date on which a resident was given a diagnosis, a requirement for allowing certain charges to be submitted and reimbursed by Medicaid.

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Every month, the Centers for Medicare & Medicaid Services (CMS) update their list of nursing homes that have proven to be in dire need of improvement to avoid patient safety events and to hang on to funding from Medicare and Medicaid. The nursing homes, referred to as Special Focus Facilities (SFFs), have all been found to have higher than average numbers of safety violations or deficiencies, including actions that have the ability to cause immediate harm or death to residents. Facilities are only able to graduate from the SFF list by having a clean record during two consecutive inspection visits by CMS.

‘Graduation’ from SFF Not the Same Thing as Giving Better Care

In a report by Kaiser Health News, over half of the 528 facilities that graduated from the SFF list before 2014 have gone on to seriously harm and even kill patients. The report says that the same facilities still have nurse staffing levels at an average of 12% lower than typical resident to nurse ratios that many other nursing homes maintain, a significant difference in an industry where ratios are already at shockingly low levels.

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On July 18th, a Cook County jury gave justice to the family of Dolores Trendel. Awarding $4.1 million dollars, a record-setting verdict under the Nursing Home Care Act, the jury found Assisi at Clare Oaks Senior Living in Bartlett, Illinois, liable for stopping a medication that caused a stroke and ultimately ended 85 year old Dolores Trendel’s life.

Doctor vs. Staff

In January 2011, Ms. Trendel was admitted to Assisi at Clare Oaks to undergo physical therapy after a fall at her Schaumburg home caused a broken hip.

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A nursing assistant with a past history of abusive and negligent behavior toward nursing home residents is accused of taking 88 year old Lois Moreland to the bathtub at St. Sophia Health & Rehabilitation Center and leaving her overnight to die. Mrs. Moreland’s son is suing the nursing home for his mother’s death, accusing the facility of deliberate understaffing as a cost-saving measure.

Investigation Reveals Nursing Assistant Forgot About Victim

A Centers for Medicare & Medicaid Services (CMS) investigation into the woman’s March 2016 death at the Florissant, Missouri nursing home revealed that the victim’s physician recommended she never be left unattended longer than 30 minutes, while her psychiatrist advised never allowing her to be alone more than 10 minutes. Mrs. Moreland, a former stay-at-home mother and widow, had been suffering from Alzheimer’s, depression, and several other physical ailments. The supervision recommendations of both her physicians were documented in her chart, but were ignored by St. Sophia staff.

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A female resident at Frankfort Terrace Nursing Center in Frankfort, Illinois is suing the for-profit facility for allowing a known sexual harasser to continue to freely wander the building, despite previous knowledge of his tendency to harass women.

The victim says that in August 2015, the offender, Roger Martin, showed her his genitals and used slang terms to tell her he was going to have sex with her. The victim says that she notified Frankfort Terrace’s Director of Nursing, who made no mention of the incident in Mr. Martin’s chart, nor made any attempt to investigate the incident.  The lawsuit alleges that the lack of follow through by the facility is especially egregious, given that the facility was aware of Mr. Martin’s past sexual harassment of other female residents.

Illinois Department of Public Health Investigation

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With the future of American health care hanging on an upcoming Senate vote on the Better Care Reconciliation Act of 2017, a recent New York Times piece revisits the grim reality of nursing homes in the 1970s. In that decade, 12 states were swept up in an epidemic of elder abuse happening in long term care facilities and nursing homes. Illinois, Wisconsin and Michigan were 3 of the 12 states that had facilities who frequently left patients in soiled undergarments and bedding, riddled with bedsores, malnourished, dehydrated, and otherwise neglected and abused. In New York, another hard hit state, hospital staff would hear of a transfer from a nursing home and knew to expect a patient with limited mental faculties who was suffering from one of many ‘common’ conditions plaguing abused and neglected nursing home residents. Those sadly common conditions were urinary tract infections, pneumonia, and bedsores, among many other ailments.

Repeating History

The author notes that the economic and societal conditions of the 1970s created a prime environment for elder abuse and given the trajectory we are on now with our potential healthcare plan, we’re at risk of repeating history.

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A nursing home in Boardman, Ohio is facing criminal charges and a civil lawsuit for the death of a 70 year old resident who was given unprescribed morphine. Employees of the nursing home are also being accused of falsifying records in the days following the man’s death.

Greenbriar Health Care Center admitted William Wolfe in late March 2015. Three months later, he was given extended release morphine at 10:05 pm and was found unresponsive in his bed the next morning. He was taken to a local hospital where he was pronounced dead.

Records Tampering

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Michael Morris was just 43 years old when he died from complications that arose from infected tracheostomy and gastrostomy tubes, as well as multiple pressure ulcers. He was a resident of Salem Village Nursing and Rehabilitation Center in Joliet, Illinois for just over a year at the time of his death last September.

In a lawsuit filed in Will County, the administrator of his estate alleges that the facility is directly responsible for his death by failing to provide the adequate care required for a resident in Mr. Morris’ condition.

How do Pressure Ulcers Develop?

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A woman who served more than 10 years as a New Mexico long term care ombudsman and claimed she was fired in 2016 for lawfully giving records under a Freedom of Information Act request has received an undisclosed settlement against the Department of Aging and Long Term Services. The woman, Sondra Everhart, handed over boarding home records to the Albuquerque Journal only to have the information turn up in a scathing newspaper article of the facilities. Boarding homes are used in New Mexico as living centers for mentally ill patients who have recently been released from state-run psychiatric facilities.

In the lawsuit, Everhart alleged that she was the target of extensive efforts by her employer, the Department of Aging and Long Term Services, to get rid of her. Providing records in response to a public information request was not against policy, but the state used it as an excuse to finally get rid of her. Everhart had spent her career as a long term care advocate, arguing that boarding house residents deserved better care and conditions, that the elderly be given more assistance in preventing financial scams from happening to them, and was vocal about exposing Medicaid fraud within her department.

Prior to her termination, Everhart filed a complaint with the federal government, alleging that the department was purposely making her job difficult, which is illegal. After her complaint, the department sought legal counsel on their ability to fire Everhart. Despite being advised that her firing would be seen as retaliation, the department moved ahead and fired her under the premise of violating policy by sharing records.