I saw this article about a woman who was a resident of a Tennessee nursing home where they found maggots in her ear. How could this happen?  Who is checking her?  It is disgusting and unacceptable.  I’m surprised the facility isn’t claiming it is part of her care and treatment!

A Health Department investigation revealed that a resident at Johnson City nursing home had maggots in her ear because of a hygiene problem at the facility.

Records show the woman suffered from dementia and needed assistance with dressing, eating and bathing. But attendants at the Lakebridge Health Care Center had not washed her hair since July 23 when they found the maggots on August 4.

The state found the home deficient in providing daily hygiene to patients and is requiring a plan of action to fix the problem.  A Lakebridge administrator says that the woman did have her hair washed regularly, but that staff had failed to always record it.   The Administrator should know the Nurse’s Axiom:  If it wasn’t documented, it wasn’t done." All nurses are trained this way and most good facilities have a written policy to that effect.

 

The Bush Administration has decided to change the Medicare rules to prevent payment of "preventable" injuries.  Who decides what is preventable? How is that decided?  Here is part of the article I read:

In a significant policy change, Bush administration officials say that Medicare will no longer pay the  costs of treating preventable errors, injuries and infections that occur in hospitals.

Under the new rules, Medicare will not pay hospitals for the costs of treating certain “conditions that could reasonably have been prevented.”  

Among the conditions that will be affected are bedsores, or pressure ulcers; injuries caused by falls; and infections resulting from the prolonged use of catheters in blood vessels or the bladder.

In addition, Medicare says it will not pay for the treatment of “serious preventable events” like leaving a sponge or other object in a patient during surgery and providing a patient with incompatible blood or blood products.

The Centers for Disease Control and Prevention estimates that patients develop 1.7 million infections in hospitals each year, and it says those infections cause or contribute to the death of 99,000 people a year — about 270 a day.

“Hundreds of thousands of people suffer needlessly from preventable hospital infections and medical errors every year,” Ms. McGiffert said. “Medicare is using its clout to improve care and keep patients safe. It’s forcing hospitals to face this problem in a way they never have before.”

In most states, Ms. Foster said, hospital records do not show whether a particular condition developed before or after a patient entered the hospital. Under the new rules, she said, hospitals will have to perform more laboratory tests to determine, for example, if patients have urinary tract infections at the time of admission.

Some of the complications for which Medicare will not pay, under the new policy, are caused by common strains of staphylococcus bacteria. Other life-threatening staphylococcal infections may be added to the list in the future, Medicare officials said.

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I saw an article about resident abuse that is common and difficult to prove without the testimony of an honest employee of the nursing home.  The industry has labeled injuries caused by abuse to be "injuries of unknown origins".  Perhaps, they should polygrapg the employees who provided care and treatment to the resident to determine how it happened.

Peggy LeNoir expected to celebrate her father’s birthday, but instead was looking at disturbing pictures taken from his nursing home bed.

"I seen a black eye. He got a bruise on top of his head. He got bruises on his back. His back is bruised up and swollen and I see marks on his leg." says LeNoir.

When he came here he was walking and talking, now he can hardly move. She had already complained about the bed sores he was suffering. Then Peggy got a call Monday to check on her dad. What she saw shocked her.  The nursing home said her father may have fallen. But Peggy says how, since he can’t walk, talk and can barely move.   If he fell, who picked him up? Why didn’t they do an incident report then or notify the family as required by the regulations!

More frustrating, she says a staff member told her to leave and even called police.
Peggy’s brother, Randy, says it’s just time for some straight answers.

USA Today has an interesting but sad article about how some families choose to move their loved ones into Mexican nursing homes because of the poor care from the for profit chains in America.

For $1,300 a month — a quarter of what an average nursing home costs in Oregon — residents get a studio apartment, three meals a day, laundry and cleaning service, and 24-hour care from an attentive staff, many of whom speak English.

As millions of baby boomers reach retirement age and U.S. nursing home costs soar, Mexican nursing home managers expect more American seniors to head south in coming years. Mexico’s proximity to the USA, low labor costs and warm climate make it attractive.

An estimated 40,000 to 80,000 American retirees already live in Mexico, many of them in enclaves like San Miguel de Allende or the Chapala area, says David Warner, a University of Texas public affairs professor who has studied the phenomenon. There are no reliable data on how many are living in nursing homes, but at least five such facilities are on Lake Chapala alone.

"You can barely afford to live in the United States anymore," said Harry Kislevitz, 78, of New York City. A stroke victim, he moved to a convalescent home on the lake’s shore two years ago and credits the staff with helping him recover his speech and ability to walk.

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Although there is a concern regarding privacy issues, many families use hidden video cameras to document neglect by nursing home employees.  These cameras are useful especially when the nursing home denies neglect or fails to supervise employees apporpriately.

I ran across an article that illustates my point perfectly.  An ex-employee of a Rochester nursing home admitted today that she neglected a patient in a case that included the use of a hidden camera.

Tammy Devos, 43, who was employed as a certified nurse’s aide at the Jennifer Matthew Nursing and Rehabilitation Center in Rochester, NY pleaded guilty to the misdemeanors of second-degree falsifying business records and willful violation of health laws. 

She was sentenced to spend 16 weekends in county jail, beginning Sept. 1. As a condition of her plea, she agreed to surrender her nurse’s aide license.

She’s one of five former employees of the nursing home to face felony charges.
She was initially charged with first-degree falsifying business records, a felony.

Nine other former employees pleaded guilty to misdemeanors and received probation. The employees were charged after an investigation by the state Attorney General’s Office that involved putting a hidden camera in a patient’s room in the spring of 2005.

According to court documents, the 70-year-old patient, who suffered from dementia, was not turned regularly, was allowed to lie in his own waste, and was not given adequate food or hydration. False entries were made in the patient’s records to show that proper care was given.

This article is shocking and disgusting.  This woman should go to jail for a very long time!

A 79-year-old woman who has lost the use of her arms, legs and speech was humiliated in May when her caregiver at Homeland nursing home in Harrisburg smeared fecal matter over the woman’s face during a shower, city police reported.

Roseanne Anderson, 50, of the 2400 block of Market Street, Harrisburg, was arraigned Tuesday night before District Judge William Wenner on charges of simple assault and recklessly endangering another person. She was committed to Dauphin County Prison in lieu of $50,000 bail.
Police said the incident happened May 9 at the nursing home in the 1900 block of North Fifth Street.
Where was the woman’s supervisor?  Did she do this before?  How did the police find out?

Wisconsin Senator Herb Kohl is trying to prevent abuse by insituting a national system for criminal background checks on nursing home employees.  Please contact your Senators and encourage them to support this legislation.

Sen. Kohl says the best way to protect our elders from physical abuse is to institute a national system for background checks to determine whether those seeking to work in nursing homes and other long term care institutions have a criminal history before they are hired.

He and Sen. Pete Domenici (a Republican from New Mexico) introduced last month that would provide funding for a national register.   Kohl said the national register will be a tool employers can use to ensure they are hiring responsible people. It would also prevent workers with a history of abuse from moving from state to state to find new jobs.

Statistics and first-hand accounts prove that brutality and abuse exist in long-term facilities.
Nationally, one of every 20 elderly people will be abused in their lifetime. Between one and two million Americans age 65 or older have been injured, exploited, or otherwise mistreated by someone on whom they depend for care or protection, according to Kohl’s statistics.

The bill would require states to notify employers about whether an individual has a disqualifying criminal history and provides employers with immunity from anti-discrimination lawsuits filed by individuals who are terminated based on a disqualifying history. At the same time, the bill calls for an independent appeals process for those who are disqualified.

The bill would also allow each state to decide which crimes would be considered disqualifying.
States would also have the authority to penalize providers for knowingly hiring workers with histories of abuse.

See full article here.

I was sent this great editorial regarding how much staff could be hired if CEOs were compensated reasonably instead of exorbitantly like Manor Care’s CEO Paul Ormond.

SNF CEO’S WINDFALL COULD HAVE PROVIDED MORE STAFF AND SERVICES

To the Editor:

Reports that Manor Care’s CEO Paul Ormond would personally realize between $118 and $186 million when his company, the largest nursing home chain in the United States, is acquired later this year by a private equity group got us thinking about staffing in nursing homes. Knowing that the federal government has reported that more than 90% of nursing homes do not have enough staff to take care of their residents, we wondered how many nurses and nurse aides could be hired for a year at Manor Care’s nursing facilities with that same money.

Using federal wage estimates for nursing home workers, we calculated that Manor Care’s 278 nursing homes could hire an additional 5346 certified nurse aides or an additional 2198 registered nurses if $118,000,000 were spent on staff (19.2 aides or 7.9 RNs at each Manor Care nursing home). If Mr. Ormond’s $186,000,000 windfall were spent on staff, Manor Care could hire an additional 8427 certified nurse aides or an additional 3464 RNs (30.3 CNAs or 12.5 RNs at each Manor Care nursing home).

Like all nursing home chains, most of Manor Care’s revenues come from public programs, Medicare and Medicaid. How should our public health care dollars be spent? One man’s windfall or certified nurse assistants and registered nurses in nursing homes?

Sincerely,

Toby S. Edelman
Center for Medicare Advocacy
California Advocates for Nursing Home Reform
The John A. Hartford Institute for Geriatric Nursing
National Conference of Geriatric Nurse Practitioners

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Description of Federal Requirements

The federal regulation (483.12) articulates rights that the resident has related to admission, transfer, or discharge, some of the procedures facilities must follow, and records they must keep. The definition of transfer and discharge here applies to movement to a bed outside the certified facility (including differently licensed beds in the same physical plant), but does not apply to movement to a different bed in the certified facility. (Those Intra-facility transfers are discussed under 483.10, Resident Rights.)

The rules regarding transfer or discharge (a) establish the conditions under which a resident may be transferred involuntarily, including that the facility is closing, the resident has improved so that he/she no longer needs the care, the facility is unable to provide the resident with the necessary care, the resident is a danger to self or others, and the resident has failed to pay for care or (if supported by third parties, including Medicaid) has failed to have the care paid for.

The federal rule establishes expectations for documentation regarding transfers (including the reason), and written notice to the residents of at least 30 days, unless the reason for transfer is related to urgent medical needs of the resident or health and safety of others.

 The written notice must include the reasons for the transfer/discharge, the effective date, the location of discharge or transfer, the right of appeal, and notification of how to reach the long-term care ombudsman and/or the appropriate Protection and Advocacy agency in the case of individuals with developmental disabilities or persons who are mentally ill. Further, the facility “must provide sufficient preparation and orientation to residents to ensure safe and orderly transfer or discharge from the facility.”

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Buried within most admission contracts for nursing homes are unconscionable and hidden clauses requiring mandatory binding arbitration in case of a dispute. These clauses stack the deck against consumers and victims of nursing home abuse and neglect.  These hidden clauses force residents to sign away their rights before a dispute even arises, and denying them access to the courts, often the only place regular Americans can face powerful interests on a level playing field. 

The Arbitration Fairness Act of 2007 would secure citizens’ seventh amendment right to a trial by jury and allow consumers to get a fair opportunity.

In arbitration, consumers are forced into a private legal system that is stacked against regular Americans, where they must pay steep filing fees—often more than $750 just to file a case. These fees do not include the arbitrators’ hourly charges, which range from $200 to $500 per hour, often bringing the total cost of arbitration to tens of thousands of dollars for consumers.

While in arbitration, consumers’ fates are in the hands of a supposedly impartial arbitrator. However, the arbitrators are often biased in favor of businesses, since they will be repeat users of a particular arbitrator. Once an arbitrator reaches a decision, it is almost impossible to appeal and the arbitrators do not have to justify any of their findings.

The Arbitration Fairness Act of 2007 would eliminate these unfair contracts and preserve the right to a trial by jury—a pillar of our civil justice system.

We urge you to take action by telling your Senators and Representative to oppose binding mandatory arbitration clauses in consumers’ contracts by supporting the Arbitration Fairness Act of 2007.

Please go this website and fill out this form to fight mandatory arbitration