Articles Posted in Uncategorized

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Amendments to the American Health Care Act, the GOP bill to repeal and replace Obamacare, are set to be voted on by the House this Thursday. Among many of the proposed changes are several related to reducing federal funding towards Medicaid, the federally-backed but state-run public aid program that provides health care to millions of low-income Americans. The GOP argues that cutting funding to Medicaid is necessary in order to reduce deficits in other areas of our national budget.

About Medicaid & Long Term Care

Medicaid reductions are a dangerous prospect for many of America’s elderly. The National Consumer Voice for Quality Long Term Care estimates that 70% of people aged 65+ will need some form of long term care, whether within their own homes or within a nursing home. As of today, Medicaid spends $158 billion on long term care support services, including $55 billion towards nursing home residency and associated services. Medicaid is the largest payer of long term care, responsible for the payment of more than 50% of all nursing home costs. National Consumer Voice also says that yearly fees for a shared room in a nursing home cost nearly $83,000 in 2016. Considering the expense of nursing homes and other long term care support services, reducing funding for these programs at the expense of the disadvantaged elderly seems to be one of the cruelest ways to reduce our budget deficit.

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Long Term Community Care Coalition (LTCCC) just released its list of over 6,000 U.S. nursing homes with what they’ve termed ‘chronic deficiencies.’ LTCCC considers chronic deficiencies any violation of the same Centers for Medicare & Medicaid Services (CMS) regulatory standard 3 or more times within 3 years. LTCCC used Centers for Medicare & Medicaid Services’ own Nursing Home Compare database to analyze the infractions.

About LTCCC & Rankings

LTCCC is a non-profit advocacy group that describes itself as ‘dedicated to improving quality of care, quality of life and dignity for elderly and disabled people in nursing homes, assisted living and other residential settings.’ Along with the list of facilities with chronic health deficiencies, LTCCC has also included a spreadsheet of CMS’s star ratings for all the nursing homes found to be deficient. CMS uses a 5 star rating system to give those considering nursing homes an easy way to compare the overall quality of one facility vs. another and uses 5 as the highest indicator of quality and 1 as the lowest.

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An investigation by the Government Accountability Office (GAO) has revealed that for profit nursing homes have the highest profit margins, but the lowest staffing ratios compared to non profit and government run facilities. Nursing homes that are a part of a chain or network of nursing homes are the biggest offenders, with 19% higher profit margins than their counterparts.

Data Collection Made Difficult by Less than Forthcoming Nursing Homes

The largest obstacle that investigators faced was the reliability of data made available to them by the Centers for Medicare & Medicaid Services (CMS). GAO is responsible for ensuring that government agencies are properly functioning within the parameters of the responsibilities and duties entrusted to them. While CMS regulates all Medicare and Medicaid funding, the data given to them by nursing homes is believed to be somewhat unreliable, as the facilities are asked to self-report all data on expenditures. The motivation is there for nursing home operators to hide profits any way they can so as not to tip off the government that they are getting wealthy from Medicare reimbursements.  Therefore, the data passed on by CMS to the Government Accountability Office cannot be considered a reliable source. Knowing this makes the information reported to CMS even more frightening than it would be if taken at face value.

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In November 2016, The Centers for Medicare & Medicaid Services (CMS) enacted their revised nursing home regulations. The standards dictate which nursing homes are eligible to receive Medicare & Medicaid funding. Failure to follow the regulations set forth by CMS could ultimately result in termination of federal funding. It is vital that residents and their loved ones are informed of the revisions in order to keep nursing homes accountable for their actions and to protect themselves. Below are some of the updates that have been made to regulations surrounding transferring and discharging a resident against their wishes, known formally as involuntary transfer and discharge.

Revisions Not Drastic but A Definite Improvement

According to CMS, the new requirements state 6 specific reasons that justify an involuntary transfer or discharge:

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A lawsuit has been filed against Emerald South Nursing and Rehabilitation Center in Buffalo after an 82 year old woman was beaten to death by another resident. Late last August, Ruth Murray was suffering from dementia, mistakenly entered a fellow resident’s room in the same unit and was fatally beaten. The man thought a stranger had broken into his home and violently attacked Ms. Murray, leaving her with a broken neck, a collapsed lung, and other broken bones. Ruth Murray died after 3 days in the hospital.

Supervision a Basic Requirement for All Nursing Home Residents

Residents of nursing homes have chosen a facility to aid in their care when they or their loved ones are unable to provide that same level of care at home. It should go without saying that all nursing home residents should be adequately supervised based on their overall physical and mental health. It seems inconceivable that any resident, much less one living in a dementia unit, could wander into another patient’s room and have it go unnoticed. Unfortunately incidents such as these happen frequently. The reasons are typically poor training of staff and too many patients for too few staff members. However, the reasons for negligence never can justify the tragedy that has taken place.

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Last month, we posted on lawsuits brought forth by the Attorney General of Pennsylvania against nursing homes in the state. Facilities owned by Reliant Senior Care were named in the lawsuit and were sued for $2 million, the largest verdict of its kind in the state of Pennsylvania. Reliant was guilty of negligence, abuse and under staffing its facilities. This month, Priority Healthcare Group, a New York-based nursing home group, announced the purchase of 10 Pennsylvania nursing homes owned by Golden Living Nursing Homes. Golden Living is also being sued by the Pennsylvania Attorney General for violations that are strikingly similar to those committed by nursing homes owned by Reliant Senior Care.

Priority Healthcare has purchased the licenses for the nursing homes but not the actual buildings or land, which has led some skeptics to believe this was a move by Golden Living to meet promises it made to the attorney general as part of a to-be-announced deal. When questioned, Priority says that it was attracted to Golden Living’s 10 nursing homes because they are passionate about making over nursing homes in need of improvement. They also claim that they have a track record of improving such facilities, although data showing their past successes is not available.

Due Diligence is Always the Best Bet

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3 Certified Nursing Assistants (CNAs) have sued Carrington Place of Chesapeake, a Virginia nursing facility, for firing them after they reported abuse being committed by nurses during an overnight shift.

On May 12, 2016, the 3 CNAs were working the 11 pm – 7 am shift when they witnessed 2 staff nurses tying elderly residents to their wheelchairs using sheets around their waists. Once tied up, the nurses injected sedatives into the victims, despite not having physician’s orders to do so and left them drugged and tied to their chairs for a period of 5 to 6 hours.

Punished For Doing the Right Thing

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A Bradford, PA man is suing The Pavilion at Bradford Regional Medical Center and Bradford Hospital for failing to properly supervise its residents. In the lawsuit, the victim alleges that the staff’s lack of supervision resulted in a fellow resident attacking him and causing him to lose a testicle. The lack of supervision is especially egregious because the attacker had a known history of violent behavior.

Nursing homes and care facilities have a duty to properly supervise all residents in order to ensure their safety and well being. Nursing homes are known for under staffing in order to protect their bottom line, as well as underpaying employees and skimping on adequate training needed to successfully perform their job. Instances such as the one highlighted in this lawsuit are an unfortunately common occurrence in America’s nursing homes.

 

 

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Last month, AARP Texas released a report entitled Intolerable Care – a snapshot of the Texas nursing home quality crisis. Their findings revealed the sad reality of what is happening in nursing homes in Texas and elsewhere: poor care, abuse and neglect is allowed to persist because of insufficient oversight and policies that enable owners and administrators instead of the elderly and disabled.

The report shows that out of 17,466 state violations between 9/2014 and 9/2015, the state of Texas only pursued action in 40 cases.  This statistic alone is enough to to spark concern, but added to the fact that many of the nearly 18,000 violations were against facilities that had already been reported as violating state nursing home laws. Another stunning fact? Many of the violations reported to the state were for actions that could ‘immediately’ harm residents of a facility. Among the violations, the most common was medication errors and the second was for staff treatment of residents.

Why Do the Same Facilities Keep Making the List?

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There’s an epidemic in America that is rarely discussed and deeply troubling. Our most vulnerable population is being victimized by sexual predators employed by nursing homes across the country.

Today, CNN released findings from their special investigative report on the sad reality of sexual abuse and rape in nursing homes. In their report, CNN found that instances of prior sexual assault by the same perpetrator had been reported before the incident that ultimately landed the assailant in jail.  State departments of public health are sent to investigate reports of any abuse, including sexual assault, on behalf of the Centers for Medicare & Medicaid Services (CMS), the agency that oversees homes receiving government funding. These state agencies were all questioned by CNN, with some states, including Illinois, willing to give data. Since 2013, 386 cases of sexual abuse were reported in Illinois, and 201 of them were at the hands of a caretaker. Of all 386 cases, only 59 were substantiated.This means the other 327 cases were considered unable to be confirmed, an unsettling thought considering that in many cases that end up in court, the sexual abuser has been previously accused of the same behavior.

Many Facilities Part of the Cover Up