Syracuse.com had an article about a class action lawsuit against James Square Health and Rehabilitation Centre claiming residents of the Syracuse nursing home are left lying in their own urine and feces for extended periods of time.  The suit says the nursing home does not have enough staff to regularly care for incontinent residents, many one of whom frequently goes entire nights without being changed.  The state Attorney General’s Medicaid fraud unit has been investigating James Square for months over patient care issues. The AG’s office raided the 440-bed facility at 918 James St. June 13 and seized records as part of the investigation.

A class action suit is one in which a group of people who have suffered similar harm sue the defendant as a group and potentially share in any settlement.  If the court certifies the lawsuit as a class action, the complaint says “hundreds if not thousands” of current and former James Square residents could automatically become part of the case. The class action complaint says James Square is unsafe, understaffed and negligent in its care of residents.

 

York Daily Record reported that Woodland Terrace lost its license to operate a nursing home after finding “gross incompetence” following the death of a patient who wandered away from the home.  Audrey Penn’s body was found in a roadside ditch nearly a month after she was reported missing from Woodland Terrace at the Oaks nursing home.

The agency said that on the morning of Penn’s Aug. 23 disappearance, a staffer noticed she wasn’t in her room but violated policy by waiting 90 minutes to alert a supervisor and start a search.  Penn had a history of trying to leave the home’s secure dementia unit. Earlier this year, the report said, she used a keypad to unlock a door and went to a staff break area. At other times, she was seen pushing on doors in the dementia unit and pressing buttons on the keypad.

 The agency said Woodland Terrace failed to “adequately address the resident’s exit-seeking behaviors,” calling her a “victim of neglect.”

The Charleston Gazette-Mail reported that Veneford Blankenship who oversaw financial operations at a nursing home pleaded guilty to federal mail fraud, according to a news release from U.S. Attorney Carol Casto.  Blankenship worked as the business office supervisor  and embezzled more than $80,000, according to the release.

Blankenship admitted that in beginning in June 2015, she secretly diverted residents’ payment checks from an operations account, to another account that allowed residents to collect funds that were occasionally spent on dinner, outings and small events for residents. She then wrote checks to herself from the account, forging the names of the people with signature authority, according to the release.

Blankenship faces up to 20 years in federal prison when she is sentenced. Blankenship agreed to pay restitution in the amount of $82,926.15, as a part of her plea agreement, the release says.

Vox had an interesting article explaining how Trump’s admission and attempts to destroy the Affordable Care Act violates his sworn oath to the Constitution.  “The president has a legal obligation, under Article II of the US Constitution, to “take Care that the laws be faithfully executed.” That means he must make sure that our laws are implemented in good faith and that he uses his executive discretion reasonably toward that end.”

Additionally, his Administration and agencies also have a legal obligation, under the Administrative Procedure Act not to abuse their power by engaging in arbitrary action.  The intentional sabotage of the ACA that we have seen over the past nine months violates both Trump’s constitutional obligations and quite possibly the obligations of his Department of Health and Human Services.

His legal responsibility and moral obligation is to “take care” that the laws are enforced and implemented. Since he has flouted this obligation, lawsuits by individuals and states harmed by the damage will be filed.

Trump refuses to support the open enrollment period — in which individuals must sign up for insurance or lose their chance to do so. The ACA requires the federal government to, among other things, maintain a website and work with local “navigators” and other groups to educate consumers and encourage them to sign up for insurance.  Trump instead has set out to make open enrollment a failure.

He cut the enrollment period in half, from three months to six weeks. He shut down the federal enrollment website for nearly 12 hours every Sunday during the crucial period. He has canceled events in which federal officials had planned to help with enrollment. He cut advertising for enrollment by 90 percent, from $100 million to $10 million, even though his administration charged insurers on the exchanges user fees to generate money for that same advertising. (Those fees far exceeded $10 million.)

Trump announced his plan to cut off important cost-sharing payments that the ACA promises to insurers to compensate them for reducing what individuals have to pay in premiums, creating extreme instability in the insurance industry.

“The president has a right not to like the ACA. But so long as it is the law of the land, he does not have the right to undermine it through the use of executive power.

“Faithful” execution of a law that is validly on the books is what the words of the Constitution require of Trump — until Congress decides otherwise.”

 

WREG reported that maggots were found inside the wound from an amputation according to police.  Memphis Police said they are investigating an elder abuse case involving a patient.  According to a police report, the elderly resident of Ashton Place was transferred to the hospital after he started running a high fever. Hospital workers discovered five open wounds to different parts of his body and a bruise to his stomach during treatment.  Ambulance service employees also said they had found the man in feces.

“Even the police got violently ill witnessing that,” the victim’s daughter said.  “I’ve been in the medical field for a while and this is one of the worst I’ve ever witnessed and this is my father,” the victim’s daughter said. “It’s indicative he wasn’t getting basic care.”

As nurses were treating the individual, they discovered the staples had not been removed from his right leg and the bandages were labeled “October 7.”

 

The New York Times had an article on how Trump’s latest decision on health care will lessen coverage, increase premiums, and hurt the health insurance market.  “The Affordable Care Act remains the law of the land, and none of the proposed changes would substantially alter its main provisions. The funding cut and executive order could result in higher insurance premiums for some Obamacare customers and lower premiums for less regulated coverage for those who want to try new insurance options. They could cause some insurers to exit some markets in the long term.”

The executive order alters the rules for parts of the insurance system as a way of offering more Americans access to those types of insurance.  The biggest risk to consumers is that insurance companies, faced with the news about the subsidies going away, will drop out of the market for next year.

 

The Age had an article about Australia’s “broken” nursing home industry.  Elderly people are being sent in record numbers from nursing homes to be treated in hospitals.  The hospital transfer figures come in the midst of a debate on the quality of aged care in Australia, and accusations that nursing homes are in crisis.

The bulk of the transfers happen during the week, with the number plunging on weekends, which, according to the nurses’ union reflects a serious lack of staff on hand in many nursing homes on Saturdays and Sundays to make clinical decisions.

The Hill reported the five things to know about Trump’s awful decision on ObamaCare.

  1.  ObamaCare remains the law of the land.  Trump’s sabotage will not kill it.
  2.  Premiums will increase because of Trump’s sabotage.
  3.  Insurance companies will leave some marketplaces because of Trump’s reckless decision.
  4.  Lawsuits will be filed to protect the insurance markets.
  5.   Trump now owns the healthcare issue and will be blamed.

HCR ManorCare, one of the largest U.S. nursing home operators, has a deadline tomorrow in a dispute over unpaid rent, a growing problem in an industry where eviction would put thousands of elderly out on the street.  In a lawsuit filed in August, HCR ManorCare’s landlord, Quality Care Properties Inc, said the chain owes more than $300 million in rent at its 292 skilled nursing and assisted living locations.  Many nursing home chains spun off their properties to real estate companies over the last decade to siphon money and increase profits.  ManorCare is the largest senior housing chain in financial distress but other over leveraged chains are losing profits because of mismanagement, declining reimbursements, higher management costs, and increased federal scrutiny over improper billing.

ManorCare must respond tomorrow.  Generally, a landlord can evict a tenant who fails to pay rent.

“However, because the leased properties care for approximately 30,000 patients – many of whom are elderly, vulnerable and require specialized care – abrupt eviction could cause substantial harm,” Quality Care said in its lawsuit, filed in California state court on August 17.

With more skilled nursing facilities defaulting on leases, property owners are increasingly looking to receiverships as an alternative to evictions or bankruptcy, lawyers and advisers told Reuters.

A receiver can ensure continuity of care for patients and residents while preparing the facility for a transition to a new owner or operator. The process is cheaper and more stable than bankruptcy proceedings.

 

AARP reported on CNN’s investigation into Nuedexta. “A “little red pill” being aggressively marketed to long-term care residents is bringing in more than $100 million a year in Medicare money for its manufacturer, even though it “may be unnecessary or even unsafe,” CNN is reporting.”

“The drug, Nuedexta, is approved to treat pseudobulbar affect (PBA), a relatively rare condition marked by uncontrollable laughing or crying. However, the pill “is being propelled by a sales force focused on expanding the drug’s use among elderly patients suffering from dementia and Alzheimer’s disease, and high-volume prescribing and advocacy efforts by doctors receiving payments” from manufacturer Avanir Pharmaceuticals, CNN reported.”

The full report, which also contains details about possible health risks of Nuedexta, can be found at CNN.com.

The Washington Post reported how Big Pharma bullied and bought the Federal Drug Administration and Drug Enforcement Administration.  In April 2016, Congress stripped the DEA of its most potent weapon against large drug companies suspected of spilling prescription narcotics onto the nation’s streets.  For years, some drug distributors were fined for repeatedly ignoring warnings from the DEA to shut down suspicious sales of hundreds of millions of pills, while they racked up billions of dollars in sales. One internal DEA memo obtained by The Post and “60 Minutes” noted that the bill essentially eliminates the agency’s power to file immediate suspension orders of drug shipments. The new law “is fixing a problem that doesn’t need fixing,” a DEA official wrote.

The new law made it virtually impossible for the DEA to freeze suspicious narcotic shipments from the companies. That powerful tool had allowed the agency to immediately prevent drugs from reaching the street.  The chief advocate of the law that hobbled the DEA was Rep. Tom Marino, a Pennsylvania Republican who is now President Trump’s nominee to become the nation’s next drug czar.

Political action committees representing the industry contributed at least $1.5 million to the lawmakers who sponsored or co-sponsored four versions of the bill, including nearly $100,000 to Marino and $177,000 to Hatch. Overall, the drug industry spent $106 million lobbying Congress on the bill and other legislation between 2014 and 2016, according to lobbying reports.

“The law was the crowning achievement of a multifaceted campaign by the drug industry to weaken aggressive DEA enforcement efforts against drug distribution companies that were supplying corrupt doctors and pharmacists who peddled narcotics to the black market. The industry worked behind the scenes with lobbyists and key members of Congress, pouring more than a million dollars into their election campaigns.”

By then, the opioid war had claimed 200,000 lives. Overdose deaths continue to rise. There is no end in sight.  Drug industry officials and experts blame the origins of the opioid crisis on the overprescribing of pain pills by doctors.