LoHud.com had a story about Carolyn M. Wheeler, a 29-year-old nursing home employee, who was arrested after other employees caught her engaging in sexual contact with a 60-year-old male patient who suffers from a severe mental defect.  How could the nursing home let this happen?  Who was supervising this employee?

 

 

The employee was charged with felony second-degree endangering the welfare of a vulnerable elderly person and misdemeanor second-degree sex abuse.  Wheeler was caught by a staff member engaging in sexual contact with the patient at about 6 p.m. Aug. 17, police said. The man apparently suffers from several medical conditions that would have prevented him from giving consent to the sexual contact.  It is unclear if Wheeler had multiple sexual contacts with the patient.   Police also are investigating whether other patients may have been victims, though that was difficult because many of the patients in the home suffer from dementia and other mental conditions.

 

 

 

 

The State Journal-Register reported in an article that  police are investigating numerous allegations including but not limited to a nursing home employee’s threat to cut a resident’s throat, slapped a woman in the face, taunted and insulted other disabled and sick adults, and took food away from a hungry resident of Golden Moments Senior Care Center. 

The nursing home has been fined $20,000 in connection with the allegations.  The nursing home Administrator said the for-profit nursing home, a skilled-care facility that is home to 57 people, is fighting the fines. The fines were undeserved because of the facility’s "quick response".  However, the report indicated that residents had been complaining about the aide’s conduct for weeks, and that several staff members either observed, knew about or suspected physical and mental abuse of residents was going on, but failed to report the situation to their superiors.

An unspecified amount of separate federal fines is accumulating against the nursing home in connection with the state’s allegations, and the facility remains out of compliance with federal health standards, according to Elizabeth Surgener, spokeswoman for the Chicago regional office of the U.S. Centers for Medicare and Medicaid.

 

 

The New York Times had an interesting article about a medical student named Kristen Murphy who chose to move into a nursing home for 10 days.  The move was part of a novel program that allowed her to experience life as a nursing home patient.   Students are given a “diagnosis” of an ailment and live as someone with the condition does. They keep a daily journal chronicling their experiences. Of course, she probably got better care than most residents considering the nursing home knew she was going to share her experience. 

Ms. Murphy, who is in perfect health, said her time at the nursing home, where she ate, slept and used a wheelchair, solidified her desire to work with older people.

Geriatric specialists hope the program and others like it help generate interest in the profession, one of the most underrepresented fields in medicine.  Medical schools and residencies require hardly any geriatric training.  Many students are reluctant to get into the field because it is among the lowest paid in medicine.

 

 

 

 

The Jackson Sun had a lengthy and informative article about the problems especially with understaffing at Western Tennessee nursing home facilities.  The most common problems in West Tennessee relate to staffing levels, where state requirements lag behind the average for the nation. An attorney whose firm represents nursing home patients says staffing is where nursing homes cut corners to make more money. Another advocate said nursing home administrators often fall short in holding their employees accountable. 

The Jackson Sun examined three years of detailed ratings for 41 nursing homes in West Tennessee and more than 3,400 rating and state inspection documents. The most recent ratings reviewed were from Aug. 12.  Among the findings:

Six of the homes are considered "much below average" with the lowest rating of one star.
Of the 38 nursing homes rated in the category of staffing levels, more than one-third have the lowest possible score and more than half are rated below average or much below average. Over the last three years, five nursing homes have had new admissions temporarily suspended by the state and been fined. During inspections, problems that placed residents in "immediate jeopardy" were found.  Only five nursing homes are judged "well above average" overall with five-star ratings.

A lack of quality staffing is the most common problem among West Tennessee nursing homes. 
More than 50 percent of the homes received a sub-par one-star or two-star rating for staffing levels, and almost 37 percent had the lowest possible score. Statistics are worse statewide.  More than 40 percent of Tennessee’s nursing homes have a one-star rating for staffing levels. Nursing homes report their staffing levels to the state, and the government converts that data into the number of staff hours per resident per day. That determines the nursing home’s rating for staffing levels. 

Registered nurses, licensed practical nurses and certified nursing assistants, or CNAs, provide care for residents. The certified assistants usually spend the most time with residents, providing care for daily living such as brushing hair and teeth, feeding, bathing and turning disabled residents in their beds to prevent sores. They also clean residents who are incontinent or become sick in their beds. But certified assistants are not allowed to provide medical care, such as administering medicine.

Tennessee requires nursing homes to provide a minimum of two hours of personal care per resident per day. But many believe that figure is too low. The national average is about three hours of care per resident per day. 

Litigation rules are strict concerning nursing homes in Tennessee. The plaintiff has only one year to file suit over an incident, and a unanimous jury verdict is required in cases that go to trial. Before a lawyer can file a suit, he must notify the nursing home of a potential case, request records from the facility and give the records to experts, who must agree that the case has merit. That is a long process that often involves significant paperwork. If the procedure is not started quickly enough, the one-year statute of limitations could expire.

Poor care in nursing homes often is tied directly to payroll.  For profit corporations place profit over care given to residents.  Staffing levels should be increased and any raise in Medicaid and Medicare reimbursement should go to resident care and not the pockets of the CEOs and CFOs.

 

 

 

The California Department of Public Health issued a $90,000 fine to a nursing facility, Del Rosa Villa, after the facility failed to prevent a patient’s suicide.   Public Health’s investigative report shows that the patient was admitted to Del Rosa Villa on May 22 about one month after he broke two bones in his left leg by throwing himself in front of a car.  The man had been diagnosed with depressive disorder, schizophrenia and "suicidal ideation."   A care plan dated June 1 set forth that he was to be on "suicide watch at all times," according to Public Health’s report.  On June 11 the man was found hanging from a fence in the parking lot.

A nurse told Public Health that around 12:30 a.m. June 11, she saw the man leaving the nursing home’s laundry room alone in a wheelchair to smoke.  About 20 minutes later, the man was found outside hanging from a fence with a belt around his neck. He could not be revived after being cut down and given CPR.

Public Health concluded that Del Rosa Villa personnel failed to abide by the care plan’s call to place the man under suicide watch and was a "direct proximate cause of the death of the patient."   The report says the man was supposed to be under a constant suicide watch, but that was not done.

The report said "suicide watch at all times" was written on the man’s care plan, and that a licensed vocational nurse working at the facility told investigators, "I missed it. I didn’t see it."

The state issued a AA citation to the facility, which is the most severe penalty under law.

 

National Senior Citizen Law Center does a great job analyzing and sharing information about long term care facilities.  Recently, they did a study on nursing home admission agreements, along with an accompanying consumer guide. The link to the material is available here.   The study looks at unfair admission contracts that have arbitration clauses, personal guarantees, and other unfair trade practices.  Everyone who plans on researching options for their loved ones should get to know this website.
 

Boston.com had a story about a nurse’s aide, Marie Michel, accused of punching and threatening an 83-year-old nursing home resident who has Alzheimer’s disease.  She was arraigned in Malden District Court this week on assault and battery charges. The state attorney general’s office said that the nursing home employee punched the woman twice in the chest and stomach about 4 a.m. on Sept. 17, 2008, pushed her down onto her bed, and ordered her not to get up again.  The elderly woman had gotten out of bed at the Epoch Senior Healthcare center in Melrose and was apparently wandering around her room when Michel allegedly entered and starting hitting her.

Investigators say that the victim’s roommate witnessed the attack and that an investigation was launched last October.  Michel was charged with assault and battery on an elderly person and threatening to commit a crime. Through her attorney, she entered a not-guilty plea on Thursday and was released on personal recognizance. She was ordered not to have contact with victim or witness and not to work in patient care.

 

The Dallas Morning News had an interesting article about new advancements in the field of fall prevention.  The article talks about a new business called Slip Doctors.  They treat floors with a chemical that will make floors more resistant to slips, slides and falls.  Slip Doctors also use a high-tech robot that scoots across the floor of a home or senior-living community and identifies slick spots. Slip Doctors joins an industry springing up from people’s concern over falling.   Aside from promoting longer lives and greater independence, the new efforts to prevent falls may help control health care costs as the oldest boomers qualify for Medicare in about a year.

Every year, about a third of Americans 65 and older fall, and about a third of those who lose their footing require medical treatment, according to the federal Centers for Disease Control and Prevention.  More than 1.8 million older adults are treated annually in emergency departments for injuries from falls, 433,000 are admitted to hospitals and 16,000 die because of their injuries, the agency reports.   More than $19 billion is spent annually on treating seniors who fall. Without better prevention, that cost is projected to escalate to $43.8 billion a year by 2020, and Medicare will pay for most of it.

"The good news is that we can reduce the risk of falling. It doesn’t have to be an inevitable part of growing old," said Lynn Beattie, vice president of injury prevention at the National Council on Aging.

 At the University of Texas at Arlington, researchers are putting older adults through a battery of tests to determine their risk of falling and to teach them to maintain their balance.  Patricia Elder, a 63-year-old Grand Prairie resident who worries about tripping because of her poor eyesight, held her ground by shifting her weight when she took the test.

Dallas-based AT&T Inc. and 24eight LLC of New York are working on a high-tech monitoring system that will signal caregivers when it detects someone is at risk of falling.  The system will use a shoe insole with built-in sensors that track changes in the wearer’s gait, said Bob Miller, executive director of AT&T’s communications technology research department.  "If, for example, someone becomes dizzy because of a bad reaction to medication, we should be able to detect the unsteady walk and alert caregivers in time to head off trouble," he said.  Texas Tech University will begin testing the monitoring system at a geriatric care center in Lubbock in about a month, Miller said. He expects the technology to be on the market within two years.

Low-tech approaches are also reducing older adults’ risk of tumbling.  Many home health care agencies are creating services tailored to fall victims.  Gentiva Health Services, a national home health care company, aggressively markets its "Safe Strides" program.  A therapist evaluates each patient and designs an in-home exercise program to improve balance. The home is also checked for hazards, and medications are reviewed for possible side effects.

Older adults can significantly lower their risk of falling if they make better use of "old technology" such as walkers and canes, said Candy Wade, who teaches "Matter of Balance" classes to Dallas area seniors.  Seniors sometimes borrow walkers or canes from friends, Wade said, which can be dangerous because a walking aid needs to be fitted to each person.

The industry that’s done the most to prevent falls is the one with the most to gain – long-term care providers such as nursing homes, assisted-living facilities and senior independent-living communities.  About 1,800 residents die each year from falls.

 

The Bakersfield Californian had an article about one of the defendants charged with over drugging patients at a nursing home causing three deaths.  Debbi Gayle Hayes, a former pharmacist at a Lake Isabella nursing facility, has accepted a plea bargain that involves testifying against director of nursing and the nursing home doctor.   All three worked at the Kern Valley Healthcare District’s skilled nursing facility until they were arrested in February on charges of elder abuse and causing harm or death.  Hayes pleaded no contest last week to conspiracy to obstruct justice. She was sentenced to three years probation and one year in jail, but the jail sentence won’t be imposed if she cooperates truthfully in the case and completes her probation with no further problems.

The California Attorney General’s Office alleged the trio played an instrutmental role in providing unnecessary drugs on at least 22 elderly residents as a means to control them.  The mood-altering medications were used to stop their complaints and control them.

 

 

WLOX.com had an article about Greg Sullivan who is the owner of a nursing home called "A Connected Heart".  The article states that he is accused of doing business illegally.  The Mississippi Attorney General’s office charged Sullivan with operating an institution for the aged or infirmed without a license and six counts of neglect of a vulnerable adult.   No details were included regarding the facts of the neglect except  that Sullivan admitted a blind resident who needed daily insulin injections but failed to secure a licensed medical professional to monitor the dosage.

If convicted, the state officials say Sullivan could face up to a year in jail.  WLOX contacted Greg Sullivan by phone at his business and asked him if he was operating without a license. He refused to comment.