Articles Posted in Uncategorized

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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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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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The family of a 95 year old woman who died last November after becoming trapped between her bed rail and mattress at Pillsbury Manor South nursing home in Burlington, Vermont is suing for inadequate staffing and supervision, as well as use of an inappropriate bed.

Injuries and suffocation from becoming trapped in a bed rail or between a bed rail and a mattress are unfortunately not-so-rare tragedies in nursing homes and assisted living facilities. Unlike those used by children, there is not a uniform set of safety standards to which bed rails used by the elderly must adhere.

Bed Rail Deaths Not Tracked

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The House-approved American Health Care Act of 2017, recently renamed the Better Care Reconciliation Act (BRCA) of 2017 by the Senate, is on course to drastically cut Medicaid benefits for many Americans. According to the New York Times, Medicaid pays for most of the 1.4 million Americans who reside in a nursing home. The bill is the Republican party’s answer to repealing and replacing Obamacare and is currently awaiting a senate vote.

Medicaid a Lifeline for Elderly

Of all the changes called for with the BRCA, one of the most controversial is slashing funding given to the states to support their Medicaid programs. Medicaid is a federal program but is run by the states themselves. If funding is cut, states will be forced to reduce the amount they are able to pay for services such as nursing home care. In an article in the New York Times, a Dogwood Village nursing home in Virginia serves as an example of what the population of a typical nursing home looks like. A common misconception is that Medicaid is a program meant for only poor Americans. For many of the elderly that rely on it, Medicaid has become a life raft because they have outlived their savings. The article notes ‘Many entered old age solidly middle class but turned to Medicaid, which was once thought of as a government program exclusively for the poor, after exhausting their insurance and assets. ‘ With average annual nursing home costs higher than $80,000, it has become unaffordable for most Americans to continue to live in a nursing home without the assistance of Medicaid. At Dogwood Village, many residents had lifelong careers and simply have spent everything they had on nursing home care before turning to Medicaid.

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Per a settlement agreement, 5 employees of Genesis Healthcare subsidiaries are owed $10 million for exposing an ongoing scheme of deceitful billing for unnecessary hospice services. The total settlement agreed to by Genesis is $54 million.

Despite their exposure for hospice fraud, the chain took over Skilled Healthcare Group and Sun Healthcare Group, two of the subsidiaries named in the lawsuit. The acquisitions made Genesis Healthcare one of the largest nursing home chains in the country, with over 500 facilities in 34 states.

In the lawsuit, the employees describe how co-workers regularly falsified paperwork by stating they had conducted in-person patient evaluations to determine their eligibility for hospice. In reality, the facilities had not formally evaluated patients to classify the severity of their illness and instead kept them regardless of whether or not their condition was considered terminal. By keeping patients who were not facing a terminal illness, Genesis subsidiaries were able to rack up charges for services that were deemed medically unnecessary. This practice is specifically forbidden in the False Claims Act and the Patient Protection and Affordable Care Act of 2010.