State regulators have fined a West Palm Beach nursing home $16,000 after a patient was found injured on the floor with maggots crawling out of his leg cast.

The state issued the fine in March against Azalea Court.  The nursing home somehow denies responsibility and has appealed the penalty.  They will probably either argue that the maggots were benficial or that the family put them there so they can sue!

An August 2008 report states that the 120-bed facility failed to provide the necessary care and services to a resident with the cast on his lower leg, which led to an infestation of maggots. The report says the patient’s leg was supposed to be treated every three days, but the documentation proved that the nursing home only cared for the wound about once a week.

If this isn’t evidence of neglect and understaffing, I’m not sure what it!

The West Virginia Gazette had an interesting article on a nursing home’s attempt to evict a mentally ill resident from the facility.  The judge has ruled that 77-year-old Helen Shank gets to stay at Golden Living Center in Morgantown…for now.  Medicaid must continue providing nursing home care for Shank, who is mentally ill and also a "brittle diabetic".

West Virginia Department of Health and Human Services tried to take federal Medicaid benefits away from Shank, despite recommendations by several of her physicians and psychiatrists. 
Shank has lived in the Golden Living Center since October 2004. But last year, a DHHR evaluator said she no longer qualified for nursing home care.

Dr. Ward Paine, a physician who treated Shank at the Golden Living Center, said she would be at a "very high risk of hospitalization" if she were released from the home.  Others agreed, including: Dr. Pamela Sullivan, another physician who saw Shank, and Dr. Janis Boury, a psychologist and case manager who gave Shank a mental-health evaluation in June 2008.  Dr. Logan Graddy, a psychiatrist at West Virginia University Hospital, diagnosed Shank as suffering from developing dementia, "a severe, persistent and progressive psychiatric illness."

In his ruling, Judge Kaufman wrote, "The U.S. Congress defined a nursing facility as an institution which is primarily engaged in providing … health-related care and services to individuals who because of their mental or physical conditions require care and services which can be made available to them only though institutional facilities."   Shank’s failure to meet "the minimum five daily living deficits," which do not include any psychological problems, does not make her ineligible to receive Medicaid benefits under federal guidelines, Kaufman ruled.

Once again, the nursing home industry proves that they are more concerned about making money than providing the care thier residents need.



 What kind of sicko nutjob can even imagine doing this kind of disgusting thing.  A Chesapeake nursing home, Chesapeake Health and Rehabilitation Center,  is being sued by the guardians of a comatose woman who was sexually assaulted by a male nurse while a patient there.  It is unclear which for profit chain owns this facility.

The lawsuit filed in Norfolk Circuit Court claims the nursing home should have known Mark S. Albright’s conduct would violate the woman’s privacy and dignity.   It is unclear if other complaints about this nurse was known or if th facility did any kind of background check or supervision of this nurse.

Center administrator Gregory Yanta declined to comment on the lawsuit.

Albright formerly worked as a licensed practical nurse at the nursing home. Police say another employee observed Albright with his mouth on the woman’s breast. Albright pleaded guilty in November to aggravated sexual battery. Last week, he was sentenced last week to only six months in prison, with another nine years and six months suspended.

The Seattle Times had a small blurb about Joseph Njonge, a former nursing assistant at the Garden Terrace Alzheimer’s Center of Excellence in Federal Way, who is on trial for the March 2008 slaying of a woman who was leaving the facility after visiting her husband.

Njonge was arrested three weeks after Jane Britt was found strangled to death in the parking lot. Britt often visited the property twice daily to see her 77-year-old husband, Frank, who lived there.  Britt was last seen leaving the building on the night of March 18. On March 19, her Mercedes-Benz was discovered in the nursing facility’s parking lot, and her body was found in the trunk, according to documents.  Investigators linked Njonge to the slaying through DNA found underneath Britt’s fingernails. Britt’s pocket was found turned inside out and her husband’s Costco card was found in Njonge’s wallet, according to charging papers.

If convicted, Njonge faces more than 20 years in prison.

Can you believe that these are th type of people that the nursing home industry hires to protect and care for our parents and grandparents?


 Below are excerpts from an article regarding arbitration clauses in nursing home contracts provided by Dollar, Burns & Becker, L.C.  Their firm website is here

Arbitration clauses in nursing home contracts have come under closer scrutiny in recent years. At the federal level, there has been a push in Congress to pass the Fairness in Nursing Home Arbitration Act, which would make any pre-dispute arbitration agreement between nursing homes and residents invalid and unenforceable.

At the state level, several state courts also have faced the issue of the enforceability of arbitration clauses in long-term care facility contracts. In Illinois, the appellate court upheld a ruling that the Illinois Nursing Home Care Act prevented nursing home residents from waiving their rights to a jury trial. The nursing home argued that the appellate court’s ruling contravenes the Federal Arbitration Act (FAA).

The Missouri Supreme Court ruled in Lawrence v Beverly Manor (273 S.W.3d 525) that arbitration agreements in nursing home contracts do not prevent the heirs or successors to the nursing home resident from bringing a wrongful death action in court against the nursing home.

In Lawrence, the daughter of a resident signed the nursing home contract with the arbitration agreement on behalf of her mother. Her mother died in the nursing home shortly after moving in. When the wrongful death action was brought against Beverly Manor, it sought to enforce the arbitration agreement against the daughter and son of the resident. The Missouri court refused to do so, holding that the arbitration agreement was not binding against the family in a wrongful death case.

 The Missouri Supreme Court ruled that a wrongful death action is a separate cause of action. The court reasoned that the arbitration agreement did not bind the daughter and son in Lawrence because the deceased mother could not have brought a wrongful death lawsuit against the nursing home had she lived.

Thus, under Missouri state law, arbitration agreements signed by nursing home residents — or by someone acting on their behalf, such as a son or daughter — are not enforceable against anyone seeking to bring a wrongful death action in state court.

The Lawrence decision did not invalidate arbitration agreements in nursing home contracts.  The Lawrence decision, however, may be used in future cases to attempt to invalidate arbitration agreements in nursing home contracts altogether. Special Judge Glenn A. Norton wrote that he believed any agreements between nursing homes and residents requiring arbitration for personal injury were unconscionable and should be unenforceable.


The Madison Record had an article about a lawsuit against a nursing home that allowed a disabled elderly woman to fall and fracture both her hips. Hazel Timmons, guardian of River Reed, filed a suit against Stearns Nursing and Rehabilitation Center on May 21 in Madison County Circuit Court.  Reed lived in the Granite City nursing home from May 25, 2007, through July 7.

When Reed was admitted to the nursing home, employees were aware she suffered from Alzheimer’s and dementia and was usually disoriented and confused.  Nevertheless, employees allowed Reed to wander unattended in the hallway during the middle of the night on May 29, 2007. During her unsupervised walk, Reed predictably fell and fractured her left hipYet again, on June 6, Reed was left unattended in a wheelchair and without a personal alarm. And, again, she injured herself when she fell out of the wheelchair.

Reed fractured her right hip after she was left unattended in her wheelchair with her tab alarm in the off position on June 15, 2007. During this incident, Reed attempted to walk unassisted when she was known to be non-weight bearing and at high risk for falling.


The Daily Journal of New Jersey had an article about a lawsuit filed against a facility that intentionally misled a resident by promising she could remain in the facility after she depleted her substantial personal savings, and then threatening her with eviction when she did. 

The family of the late May Elizabeth Hunish contends in the complaint that the threat of eviction from Maurice House was a factor in her death soon after she received the notice in June 2007. The  lawsuit echos the findings of an 18-month investigation by the state Office of the Public Advocate. The results prove that Assisted Living Concepts Inc. involuntarily discharged or threatened with discharge from the company’s facilities several elderly residents like Hunish when they drained their personal savings and became eligible for Medicaid.

Wisconsin-based Assisted Living Concepts operates Maurice House and seven other assisted living facilities in New Jersey.

Ronald Chen, state public advocate, said that administrators at the facilities "failed to inform and misled some residents" about their policy for accepting Medicaid.   Chen said the problem was caused by a change in corporate policy at the company in 2006, in which it sought to increase profits by reducing its number of Medicaid residents.

The lawsuit was filed in state Superior Court on behalf of Todd and Warren Buirch, the executors of Hunish’s estate.  Todd Buirch is Hunish’s grandson and Warren Buirch is her son.  The lawsuit  accuses Assisted Living Concepts of consumer fraud, breach of contract and negligence. The lawsuit contends that officials at Maurice House made verbal promises to Hunish’s family that she could remain in the facility once she depleted her personal savings and became eligible for Medicaid. But after Hunish did become eligible for Medicaid in March 2007 by spending her savings of $150,000, the facility informed her family that she’d have to move into an apartment at Maurice House with another resident or leave the facility.  Two months later, Hunish slipped and fell while she was unattended in her bathroom at Maurice House, shattering her femur. While she was hospitalized, her family told her about a discharge notice issued by Maurice House to her on June 12.

"She grew increasingly distraught and her will to live decreased," the lawsuit contends. "She constantly cried and expressed that life was no longer worth living."

Hunish died on June 16, 2007. She was 84.

Todd Buirch said in an interview Monday his family filed the lawsuit "to prevent any other parents or grandparents from having to go through this with Assisted Living Concepts. It’s not about money; it’s about stopping this. We want to change the way they do business. We don’t want to see any more people being evicted."




Below is an editorial from about geriatrician Dr. Bill Thomas, a proponent of Green House Project and The Eden Alternative.

Ready for a new idea? Nobody has to live in a nursing home anymore.

"Every person in a nursing home has an exact clinical double living at home," says Dr. Bill Thomas, of Ithaca.

A geriatrician and evangelist for sensible new kinds of "elder care," Thomas created The Eden Alternative to raise awareness and change the culture around aging; and the Green House Project, which seeks to replace big, institutional nursing homes with scattered-site housing.


Thomas was in town earlier this month as keynote speaker at Loretto’s Legacy Awards luncheon. Loretto has 17 facilities housing elderly residents in a variety of settings, and also runs PACE, a program that provides home-based care. Loretto CEO Michael Sullivan says PACE already keeps as many as 370 elderly clients out of nursing homes.

Although the numbers of the elderly in nursing homes has dropped in the last several years, beds are still filled in large facilities like Cunningham-Fahey, James Square, Rosewood and Van Duyn. Why are so many still living there, if home-like settings are feasible in every case, as Thomas argues?

"Because their daily needs are greater than family and friends can provide," Thomas explains. Back in the 1960s and 1970s, Syracuse made a major investment in what was then state-of-the-art elder care. "It was far-seeing — then," says Thomas. But it created what Thomas calls "legacy overhang." He says cities like Seattle, Wash., and Lincoln, Neb., now are ahead of Syracuse, moving to scattered-site elder housing.

"Use economies of scale for billing, records," says Thomas. "Get to the small scale for care." Smaller can be economical, he adds. "It’s a costly ballet to deliver 500 meals simultaneously," he says. "In Green Houses, food costs are way down. They cook what they want, when they want it."

Years ago, people with mental and developmental disabilities moved from institutions to community housing. Likewise today, there are alternatives to prison for nonviolent inmates.

In the case of the elderly, the transition to scattered sites could be easier, because community resistance — "not in my backyard" — is less of a factor. Thomas says there are 100 Green Houses in 12 states and more on the way.

He found a willing audience among Loretto’s leaders. CEO Sullivan said Loretto has two scattered sites, on Highland Street and Fayette Street, and he wants more. "We would like to do away with nursing homes, floor by floor, house by house," he said.

Getting there won’t be easy — particularly with state government cutting back aid. Thomas hopes to amplify his message of "culture change" via the Oprah Winfrey show. "The media still treat old people like a plague of locusts," he says. "I think aging is a good thing, though bad may come with it. It’s a kind of human development. What’s missing in the media is how age makes you better."


Mcknight’s had a recent article about the changes to the CMS ranking website.  The Centers for Medicare & Medicaid Services has announced a number of updates to its Web site. These include new information about the Five-Star rating system for nursing homes, which became available Thursday, May 28.

Five-Star provider preview reports were released May 20. Nursing home providers can access that information through the Minimum Data Set (MDS) State Welcome pages that are available at the state servers for the submission of MDS data, according to CMS.

May’s Five-Star data was added to the Nursing Home Compare Web site on May 28. For more information, visit

CMS has also updated the information under its FAQ section of the Recovery Audit Contractor (RAC) portion of its Web site. On May 19, CMS added answers to questions such as "Why is CMS using recovery audit contractors?" and "Who should providers contact with questions concerning recovery audit contractor communications?" For more information, visit


Barron’s Online recently discussed Sun Healthcare Group’s stock prices, and future expected profits.  The company gets three-fourths of its revenues from Medicare and Medicaid.  Though up since late March, the stock is 54% off the record high from January 2008.  Barron’s argues that  investors underestimate Sun’s prospects for expanding profits next year especially with a record-low price-to-earnings multiple that’s well below the broader industry.

In August, the federal government will set Medicare rates for 2010. Though officials have proposed a 1.2% cut, rates should remain flat, or rise slightly, boosting Sun’s profits beyond what’s expected next year.  Meanwhile, Sun remains focused on improving profitability by reducing its dependence on Medicaid, which covers two-thirds of the nation’s nursing-home patients. (Medicaid pays for custodial or long-term care for poor seniors who are too frail and sick to live alone. It’s Sun’s single largest revenue source.)  Sun and other operators want more patients coming off hospital stays, and are thus eligible for Medicare or private-insurance benefits that doll out far bigger payments.  Last quarter, Medicaid generated 43.7% of Sun’s in-patient revenues, down from 45% the previous year. Medicare’s contribution rose to 33.2% from 31.7%. Private insurers made 6.3% of Sun’s revenues, up from 5.5% last year, while private-paying patients fell below 16%, thanks to a weak economy.

Founded in 1989, Sun has survived bankruptcy and grown into the fifth-largest player in the $99 billion nursing-home industry.  The vast majority of the company’s revenues come from 185 nursing homes that provide short- and long-term skilled nursing care. This year, profits are expected to grow 23% to $1.14 a share, and climb another 8% in 2010, according to Thomson Reuters.

Thankfully, Sun has plenty of cash — almost $100 million as of March 31. Meanwhile, the company sees free cash flow rising as much as 17% this year to $53 million. And Oppenheimer’s Wiederhorn expects almost 57% of revenues next year to come from Medicare, private-pay and privately insured patients.