USA Today newspapaers are running a special article about elderly care.

The articles are especially interesting because they could help give us some insight into the situations that families must deal with on a daily basis. These articles say that right now 48% of baby boomers are providing some care for their aging parents, and 8% have parents who have moved in with them, and this trend is growing.

If you click on the various links in the articles, they will take you to more articles which contain many interesting statistics. The comments made by readers at the bottom of the articles are also interesting.

The percentage of people over 75 in nursing homes fell from 9.6% in 1985 to 6.4% in 2004, according to the AARP Public Policy Institute.
The average annual cost for a semiprivate room in a nursing home is nearly $67,000, reports the MetLife Mature Market Institute reports. In parts of the country, it’s much higher. Still, if a senior citizen exhausts all her assets, Medicaid will cover her nursing-home care.

Not so with other types of long-term care. Except in isolated instances, Medicaid doesn’t cover assisted living or home-based health care. That means families often have to pay those costs. The average cost for an assisted-living facility was $35,616 a year in 2006, according to the MetLife Mature Market Institute. The average cost for a home health aide is $19 an hour.

I saw this article written by a family member who failed to read the contract when admitting his mother to the nursing home.  When she was neglected and he wanted to remove her, the nursing home charged him extra money because the family did not provide one week’s notice!! Incredible.  Make sure you read every clause in the contract especially to see if there is an arbitration clause in the contract. If you see one, strike it out of the contract; you do not want to waive your right to a jury trial.  Below are excerpts from the article.

I sent my mother, Sarah, to ManorCare in Easton for physical therapy after she suffered a fractured right hip. On my interview to sign her contract, everything seemed in order. My mother did not receive the care I had hoped for and what ManorCare said would be performed. I informed the nursing home that I wanted to remove her.

They told me she needed a release from her doctor, which I obtained. As I was wheeling her out, an official from ManorCare stopped and told me I hadn’t given them a week’s notice and would be charged for an extra week, which was $1,757. They said it was stated in the contract.

Neither my wife nor I remember being told about the week’s notice at the time of signing the contract. We paid the bill but are not happy about it. My mother, who lives on a limited income, should get her money back.

 

Below is from the SC DHEC website. DHEC is the state agency that has the responsibility to oversee and supervise nursing homes in SC.  Typically, they do nothing.

Do you have a complaint to file?
We ask that you carefully read the following information before filing a complaint. If you have supporting documents, please submit a copy – do not send originals. Listed below is the information you will need in order to mail or phone in your complaint.

Investigation and resolution of complaints are a critical Division of Health Licensing responsibility. A complaint is defined as an allegation that relates to a condition, events relative to a licensed activity, or to an activity subject to licensure. The Department is required to investigate any written or verbal complaint which indicates that there may be a violation of the licensing standards.

Any individual making a complaint against a licensed activity or provider may do so anonymously. If a complainant reveals his/her identity and requests confidentiality, the Department will not disclose the complainant’s identity unless mandated by state or federal law.

Your complaint will be assigned to an inspector who will determine if the Department can assist you. Written acknowledgement of our receipt of your complaint will be sent to you. Because of record keeping requirements and the need for accuracy, we ask that your complaint be submitted in writing, however you may call us with your concerns.

To generate an investigation, the Department must receive a complaint from an individual regarding an expression of discontentment, concern, and/or distress which may involve the conduct of the staff, conditions of the activity, care of the clients, etc., in an activity licensed by the Department. These expressions of concern could also involve a potentially unlicensed activity which may be operating illegally. In all instances, there must be an identification of a possible violation of a licensing standard.

Once an investigation is completed, the inspector will send a written report to you. Please contact the Department if your complaint is resolved before you hear from us.

The Department cannot always resolve complaints to the satisfaction of all complainants; however, we will investigate the complaint based on the facts, the appropriate regulation(s), and advise you of our findings. Our complaint inspectors are knowledgeable about the regulations and have access to attorneys who provide legal guidance for the staff.

Complaints regarding concerns not under the jurisdiction of the Department may be referred to another state agency or local authorities as appropriate.

Complaints concerning abuse – physical, sexual or psychological, or financial exploitation, or neglect or abandonment of a resident, (whether the incident occurred inside or outside of the facility) will be referred to the Lieutenant Governor’s Office on Aging, (800) 868-9095.

Complaints concerning Medicare and Medicaid should be referred to the Department’s Certification Division.

It is preferable that you try to resolve your own complaint before contacting the Division of Health Licensing. However, if you have exhausted your efforts to resolve the problem without success, contact us for assistance.

The Department receives a large number of complaints which require varying lengths of time to resolve. Your patience is appreciated and we will contact you as soon as possible.

Jim Perrow, Customer Service
DHEC Health Licensing
2600 Bull Street
Columbia, SC 29201
(803) 545-4370
(803) 545-4212 (Fax)

I read an article this weekend about a resident who was physically and sexually assaulted by the groundskeeper for a nursing home facility.  The family of an Alzheimer’s resident who was sexually assaulted by former Bedminster supervisor Robert Holland has sued him and the woman’s nursing home for civil damages.

The late Helen Priester was 92 and in a wheelchair when Holland, a groundskeeper at Pine Run Community in Doylestown Township, was caught with her in her room.

“We want to collect fair compensation for the injuries and damages Helen Priester suffered, but we also want to make sure that this doesn’t happen again,” said attorney Edward Shensky.

Holland, a Bedminster supervisor for 15 years, was sentenced in March to two to four years in prison for aggravated indecent assault, institutional sexual assault and related charges. Though he pleaded guilty, Holland maintained that Priester initiated the sexual contact and consented to the acts.

The suit says Holland was discovered May 5, 2006, by a Pine Run employee who noticed Priester’s door was closed.   The employee opened the door and found Holland assaulting Priester. The worker yelled at Holland to stop and went to get security when he would not.

When they returned, the door was again shut and Holland was continuing the assault.
Holland, who used a service entrance to come into the nursing home, admitted to assaulting Priester for at least three years, the suit said.
Shensky said the nursing home should have done more to restrict access to vulnerable patients.

There is a great discussion on abuse in nursing homes that I found here.

Nursing Home Abuse is on the rise even though less people are entering nursing homes with debilitating conditions according to recent data. The true number is probably much higher but The National Center on Elder Abuse estimates at least one in 20 nursing home patients has been the victim of abuse. There are nearly 1.4 million Americans that are living in nursing homes right now.

Unfortunately, a nursing home is not always the place of respite and healing it should be. According to the National Center’s study, 57% of nurses’ aides working in long-term care facilities admitted to witness, and even participating in, acts of nursing home abuse. The report sites systemic problems within the nursing home industry, like inadequate pay for workers and chronic understaffing, as contributing to the epidemic of abuse.

Neglect is the most common form of abuse. Residents in soiled beds and clothes, or those suffering from bedsores and frozen joints are most likely victims of neglect. Indications that a patient is over or under medicated can also signal neglect.

About 2500 cases of physical abuse or rape are reported each year.

Read More →

 A lawsuit against a Fort Smith-based nursing home company can proceed as a class-action suit, the Arkansas Supreme Court ruled this week.

The court affirmed a decision to grant class-action certification to a suit alleging Batesville Nursing and Rehabilitation Center failed to live up to contractual and statutory obligations to take care of the basic daily needs of hundreds of residents.

The suit, filed in 2005 by Annette Thomas, names the nursing home and its parent company, which was known in 2005 as Beverly Enterprises, as defendants. Beverly changed its name to Golden Horizons last year following its purchase by Golden Gate National Senior Care.

The suit alleges between Sept. 13, 2000, and June 30, 2004, the nursing home failed to care properly for 489 residents by, among other things, failing to provide adequate staffing and failing to provide a clean, safe living environment.

Attorney Philip Bohrer of Baton Rouge, La., argued the case did not include personal injury claims, but rather claims involving issues such as understaffing which would have affected all residents of the facility. Granting class-action status was preferable to "having 400 individual trials on the same issue and the same evidence," he said.

Bohrer also said many of the plaintiffs are elderly and unaware of their rights and would not be able to file individual claims against the company.

In its decision Thursday, the Supreme Court said the plaintiffs showed the case met the criteria for class-action certification. The justices agreed with Harkey the defendants would benefit from class-action status.

"A class action is clearly a more efficient way of handling a case where there is a predominating, common issue to be resolved for all 489 class members. A class action is also fair to both sides in this case, as it is a vehicle for all class members to have their claims heard, and Beverly will not have to defend against the same assertion of liability in a multitude of different lawsuits," Justice Robert Brown wrote.

 Police are investigating claims that a 91-year-old woman was raped at a nursing home.

The director of The Life Care Center says once they learned of the allegations on June 4, they immediately called the Department of Social and Health Services, Federal Way Police and the woman’s guardian.

Police say the rape happened about a month ago.

The family of the woman has removed her from the facility. The alleged rapist has been placed on leave during the investigation.

I wonder if they did a criminal background check or if they asked the suspect to undergo a polgrapg examination.

Here is an article about a nursing home company indicted in 2004 for the death of a resident.
Life Care Centers of America Inc. was finally indicted in the preventable death of an elderly woman whose body was found in her overturned wheelchair at the bottom of the front stairway of an Acton facility.

Life Care Centers of America Inc., which owns and operates the Life Care Center of Acton, was charged with manslaughter, abuse and neglect of a long-term care facility resident, and making a false Medicaid claim in connection with the death of 74-year-old Julia McCauley on April 17, 2004.

Attorney General Martha Coakley said that beginning in 1999, a physician had ordered McCauley to wear a device called a WanderGuard, which would set off an alarm and lock the doors of the facility if she approached them. The order also required nursing home staff to check the device daily to ensure it was functioning properly.

On the day she died, McCauley went through the front entryway of the Life Care Center and fell down the stairs. She was not wearing the WanderGuard device. 

The corporation will face a maximum fine of just $1,000 on the manslaughter charge, and no corporate official faces prison time.

I saw a great article discussing the process of choosing and entering a nursing home.  The article tells the story of a woman who scouted nursing homes with a home-like setting where the staff-to-resident ratio was low.

More than 5 million people in the United States receive some form of daily care, according to Joseph L. Matthews, a California attorney who specializes in elder law and is the author of "Long-Term Care: How to Plan and Pay for It."

More than 2 million people older than 65 are in some type of nursing facility or other residential care facility at a cost of between $30,000 and $150,000 each per year, according to Matthews.

One out of four of those nursing-home residents stay in a facility for longer than a year, and 10 percent stay for more than three years.

Medicare covers the first 20 days of care at 100 percent. After that, a 20 percent co-pay is required for the next 80 days.  Some supplemental Medicare insurance will pick up the co-pay, but patients without that coverage could find themselves paying $130 or more per night for the remaining 80 days, Honig said.

While Medicaid will cover the cost of nursing home, residents have to spend down their assets to qualify, she said. But the spouse still living at home can keep residential property, a car and a limited number of other assets. 

The Center for Medicare & Medicaid (CMS) is the component of the Federal Government’s Department of Health and Human Services that oversees the Medicare and Medicaid programs. 

Medicaid and Medicare dollars are used to cover nursing home care and services for the elderly and disabled. State governments oversee the licensing of nursing homes. In addition, State have a contract with CMS to monitor those nursing homes that want to be eligible to provider care to Medicare and Medicaid beneficiaries. Congress established minimum requirements for nursing homes that want to provide services under Medicare and Medicaid. These requirements are broadly outlined in the Social Security Act (the Act). The Act also entrusts the Secretary of Health and Human Services (DHHS) with CMS, a DHHS Agency, is also charged with the responsibility of working out details of the law and how it will be implemented, which it does by writing regulations and manuals.

CMS contracts with each State to conduct onsite inspections that determine whether its nursing homes meet the minimum Medicare and Medicaid quality and performance standards. The State conducts inspections of each nursing home that participates in Medicare and/or Medicaid about once a year.  The State also investigates complaints about nursing home care.

During the nursing home inspection, the State looks at many aspects of quality. The inspection team observes resident care processes, staff/resident interaction, and environment. Using an established protocol of residential rights, the team interview a sample of residents and family members bout their life within the nursing home, and interview caregivers and administrative staff. 

Depending on the nature of the problem, the law permits CMS to take a variety of actions; for example, CMS may fine the nursing home, deny payment to the nursing home, assign a temporary manager, or install a State monitor. CMS considers the extent of harm caused by the failure to meet requirements when it taken an enforcement action. If the nursing home does not correct its problems, CMS terminates its agreement with the nursing home. As a result, the nursing home is no longer certified to provide care to Medicare and Medicaid beneficiaries. Any beneficiary residing in the home at the time of the termination are transferred to certified facilities.