Nursing home ownership and management can be lucrative for some, but the resulting greed has been known to overpower fiscally responsible care decisions. While busy lining personal pockets, investing dollars back into the care system to support staff and resident well-being will too easily fall off the priority list allowing the resulting struggles to quickly emerge.
Some Chicago nursing homes and rehabilitation centers are paying nearly $10 million back to the U.S. government after being caught lying about the level of care their patients required and for violating the False Claims Act by overbilling federal health insurers. Greed came through by abusing power over resident benefits paid for through Medicare and maximizing those amounts under fraudulent therapies and support.
At the center of the fraud sat Quality Therapy and Consultation Inc. of Orland Park, and its owner, Frances Parise. Parise allegedly worked with these four Chicago facilities.
Falls are the leading cause of injury-related deaths among persons aged 65 years and older, according to the Centers for Disease Control and Prevention (CDC), and the age-adjusted rate of deaths from falls is increasing as well. Ironically, as many as 75 percent of nursing facility residents are reported falling each year and carry twice the chances of falling compared to a senior who lives in their own home or community.
For elderly patients living in care facilities, hazards that contribute to fall injuries can include:
Nationwide, a majority of nursing homes voluntarily participate in the Medicare and Medicaid programs. Because of this partnership, facilities must adhere to minimum standards of care established by the federal Nursing Home Reform Law. Those who do not comply, should receive health violations leading to various penalties including fines or in some of the most severe cases, a group’s Medicare or Medicaid certification will be suspended or revoked by the Centers for Medicare & Medicaid Services (CMS), a part of the Department of Health and Human Services (HHS).
CMS data indicates that about 95 percent of these health violations are cited as causing “no harm” to residents. In a May 2019 newsletter published by the Center for Medicare Advocacy and the Long Term Care Community Coalition (LTCCC) several examples of these “no harm” deficiencies, taken from Statements of Deficiencies (SoDs) on Nursing Home Compare, were discussed. Surveyors classified all of the shortcomings listed below as “no harm,” meaning that they determined that residents were neither hurt nor put into immediate jeopardy for their health or well-being.
News of a recent lawsuit against Three Mile Curve Operations LLC, dba Logan Center, Genesis Healthcare LLC a nursing home in Logan Center, West Virginia alleges that poor care provided at the facility caused a woman who required rehabilitative services and assistance with day-to-day tasks to suffer from neglect related injuries and eventually die.
According to a March 25th report in the West Virginia Record, an incident took place on April 12, 2018, which triggered the untimely death of Ms. Lilian Messer soon after being admitted to the facility.
One of the nation’s largest for-profit assisted-living providers in the country, SavaSeniorCare, operates Cheyenne Healthcare Center, a Wyoming care facility that recently settled a 2018 lawsuit alleging negligent care of a patient in 2015. The man claimed to have suffered multiple injuries from several falls and blamed an “inadequate level of staffing care and the facility not developing a comprehensive care plan that met his medical and physical needs.”
In addition, the lawsuit allegedly claimed the facility failed to notify the man’s family of his injuries and other medical issues that developed during his stay.
Just last week, a 12-person jury deliberated for four days before finding Philip Esformes, a 50-year-old entrepreneur and owner of a network of 16 nursing homes and assisted living facilities in Florida, guilty on 20 out of 26 charges related to healthcare fraud. This is believed to be the largest fraud scheme ever charged by the U.S. Justice Department and a reflection of the business owner’s greed through receiving kickbacks, money laundering and conspiracy to commit federal program bribery totaling $37 million. In an April 5th, 2019 public statement, prosecutors called him a “despicable,” “vampire” who was fueled by “unbounded greed.”
“Esformes exploited and victimized patients by providing inadequate medical care and poor conditions in his nursing homes. We will continue the fight against such parasites.”
The former long-term care residents of the LeRoy Manor building, located in the central Illinois community of Bloomington-Normal, have moved to other nursing homes throughout Illinois. The private nursing home closed on February 15, 2019, displacing 75 employees and 66 residents. Administrators say about 90 percent of the residents were receiving Medicaid and poor reimbursement by the state was to blame for the closure. The group announced plans to end long-term care services at the home in January of 2019.
Thankfully, regional ombudsman from the East Central Illinois Area Agency on Aging told local news outlets that residents and their family members felt individual rights and desires were protected during the transition and that staff saw the process out appropriately. Unfortunately, this is not always the case and many residents preparing for a move out of their control will find themselves neglected or abused during a time of uncertainty and when changing staffing challenges become present. The move may be tough though for many of the LeRoy Manor residents who were originally from the area and able to stay connected with family and friends on a regular basis. These are relationships important when addressing basic care and medical needs and identifying nursing home neglect and abuse symptoms of loved ones.
On Wednesday, March 6, 2019 another government session, this time led by the US Senate Committee on Finance, was held to discuss several disturbing reports of nursing home abuse and neglect and the lack of preventative measures and faulty reporting system used by the Centers for Medicare and Medicaid Services (CMS) to create environments for quality resident care. The hearing was led by Chairman, Chuck Grassley (R – IA) and Ranking Member, Ron Wyden (D – OR) with special panelist testimony delivered by family members of residents fallen victim to nursing home abuse or neglect.
A Minnesota woman heartbreakingly remembered her mother, an Alzheimer’s patient who was raped by care staff. During the hearing she said, “My final memories of my mother’s life now include watching her bang uncontrollably on her private parts for days after the rape, with tears rolling down her eyes, apparently trying to tell me what had been done to her but unable to speak due to her disease.” A woman from Iowa shared her family’s concern after their mother died in a nursing home ranked with the highest possible quality of resident care scores from CMS even though the organization had been seriously fined for physical and verbal abuse. The elderly woman was allegedly left in severe pain and may have been dehydrated days before her nursing home death.
The Long Term Care Community Coalition, in partnership with the Center for Medicare Advocacy, is preparing a strong agenda for 2019 starting with a joint statement concerning the chaos that has occurred in the nursing home industry as operators, even those of large care groups, are undertaking money hungry risks at the cost of their own staff resources and vulnerable patient residents. The joint statement highlighted investigative findings reported by The Washington Post, The Kansas City Star, The Philadelphia Inquirer and The New York Times of these U.S. nursing homes chains.
Illinois Nursing Home Abuse Blog