Kentucky.com had an article about the greedy nursing home Administrator of Golden Years that stole money intended for patient care.  James "Chum" Tackett admitted that he stole $300,000 intended for disabled residents and used some of that money to buy trucks for himself.  He pled guilty to theft, exploitation and tax-evasion charges.  As part of his guilty plea, Tackett admitted that he took more than $300,000 from mentally ill and disabled residents at the home. 

He used the money to buy a GMC Hummer, a Chevrolet Silverado, a Ford F-150 and a Suzuki XL-7. About $60,000 was stolen from one Golden Years resident.

Meanwhile, conditions at the personal care home were horrible including expired medicines, the building in disrepair and no milk for residents because the food bill had not been paid.

 

Bristol-Warren Patch wrote an article about the tragic and preventable assault on a resident of Crestwood Nursing Home.   David Ficorilli, a registered nurse, pled nolo contendere on the assault of the vulnerable and defenseless resident.  Nolo contendere is used when a criminal defendant is guilty but doesn’t want to plead guilty. If a defendant pleads nolo contendere, he neither admits nor denies that he committed the crime, but agrees to a punishment as if guilty."
The Warren police department investigated the complaint when the resident was in the hospital receiving treatment for the injuries sustained in the assault.

Ficorilli was only given a two year suspended sentence, two years probation and must complete 100 hours of community service and attend anger management counseling.

If this was a vulnerable child, would he have received no jail time?

 

 

Des Moines Register had an article on a resident to resident assault at Pomeroy Care Center after an 8-year old girl witnessed a female resident in her 90s being sexually assaulted, allegedly by a registered sex offender. The registered offender was ordered to live in Pomeroy Care Center.

The nursing home was well aware of the threat, and should have done something to prevent it and keep the residents safe.  The suspect, William Cubbage, and his roommate have both been convicted of several sex offenses over the years.  Further, State records say that Cubbage had a history of harassing other residents and attempting to go into their rooms uninvited.   After the incident on August 21 the administrator told workers to write the victim’s injuries on notebook paper rather than her medical chart because she questioned whether the assault had taken place. She was quoted as saying "Cubbage likes little girls, not old ladies."

  "Both of the men have a history of pedophilia according to the sex offender registry and court records.  But according to state nursing home inspection reports, the men were allowed to interact with first-graders who visited the Pomeroy Care Center as part of a regular program."  The school district knew of the sex offenders and asked if the men could be confined to their rooms when the children were there but the facility informed them that confinement would violate their rights.  Are you kidding me?

Several employees reported incidents were the children did interact with the men and expressed frustration at not being allowed to say anything.  

The Register identified 27 sex offenders living in 15 of Iowa’s 188 residential care facilities.  Unfortunately, this case is not an uncommon incident and nursing homes must be better trained and staffed to avoid this kind of incident. 

Last month, a California nursing home called Meadow View Manor in Nevada County received a $75,000 fine due to the death of a patient.  MercuryNews.com stated that this is the highest fine under state law. The fine comes after a nursing assistant single handedly used a mechincal lift chair to assist the patient after bathing, although the nursing home’s policy and the standard of care required a two person assist for a safe transfer.

This corner-cutting resulted in head and neck injuries and the patient’s death four days later. The nursing home has since been puchased by Plum Healthcare Group.

The Washington Post had an article on a possible reimbursement cut for doctors who provide services to Medicare patients.  Unless Congress acts before Jan. 1, doctors face a 27 percent cut in their fees for treating Medicare patients. That could undermine health care for millions of elderly and disabled beneficiaries.

"The cuts are the consequence of a 1990s budget law that failed to control spending but never got repealed. Congress passes a temporary fix each time, only to grow the size of reductions required next time around.  A nonpartisan panel advising lawmakers is recommending that doctors share the pain of a permanent fix with a 10-year freeze for primary care physicians and cuts followed by a freeze for specialists. Doctors aren’t buying that."

 

Recently, the White House laid out new steps to cut fraud in Medicare and Medicaid.  Many of the moves that support Obama’s “we can’t wait” mantra are modest  including the newest measures being pilot programs intended to further cut waste and fraud in the Medicare and Medicaid entitlement programs. The Health and Human Services Department will oversee the changes, such as testing changes to outdated hospital billing systems to prevent overbilling.

To show that its broad campaign to cut government waste is working, the White House says the administration cut improper payments by nearly $18 billion in 2011.  The NY Times Economix blog had an article with a simple way to save more Medicare money without hurting patients. Don’t pay for treatments found to be useless.

The article mentions that The Food and Drug Administration revoked the approval of the drug Avastin as a treatment for breast cancer because “the drug was not helping breast cancer patients to live longer or control their tumors, but did expose them to potentially serious side effects such as severe high blood pressure and hemorrhaging.”

However, the drug remains on the market for other uses, meaning doctors can prescribe it if they wish to do so and Medicare will continue to pay the unnecessary bills.

 The article explains:

Medicare is obligated to pay for off-label use of cancer drugs that are listed in references known as compendia, such as the one published by the National Comprehensive Cancer Network, an organization of major cancer hospitals.

In July, shortly after the F.D.A. advisory committee voted to revoke the approval, a committee of breast cancer specialists assembled by the cancer network reaffirmed that Avastin should remain listed as “an appropriate therapeutic option for metastatic breast cancer.”

So a committee that includes doctors who may stand to profit from getting the government to pay for useless medicines — or even have ties to the drug maker — can get to overrule the F.D.A. on how to spend scarce taxpayer money.

Several media outlets have reported the investigations that found maggots in the throat and pubic area of two elderly women in Michigan nursing homes. The Department of Licensing and Regulatory Affairs, and the Michigan Protection and Advocacy Service, Inc., said the two women suffered severe neglect and abuse. The two nursing home were cited for several serious violations.

The first case involves a woman who had been complaining of “itching and burning around her catheter.” She could not attend to her own personal hygiene without help. Bed baths were not routinely provided. Both a CNA and the charge nurse said the woman did not get a shower because the nursing home did not have enough staff. Maggots were found to be infesting in and around the catheter area. The woman was sent to the hospital where they discovered she suffered septic shock secondary to an untreated urinary tract infection, skin wounds and kidney stones. Later tests and examinations revealed she had a broken hip and extensive skin changes due to poor hygiene and not being turned in bed.

The survey also indicates that a Registered Nurse manager was instructed by clinical corporate staff to document the discovery as “debridement” (removal of dead tissue) rather than “maggots.” The documents show that a nursing assistant said maggots were still in the genital area of a 66-year-old woman three days after their initial discovery. Staff members told a state inspector they had observed flies on and near the woman about two weeks before the discovery of the maggots and one staffer even reported telling a supervisor “she’s gonna get maggots.”

The violations at Whitehall Healthcare Center of Ann Arbor included failure to supervise two residents in wheelchairs, both of whom were injured as a result; failure to provide a sanitary, comfortable and orderly interior; failure to adequately monitor the fluid intake and output for a patient who became dehydrated; and failure to maintain complete staff personnel files and complete required certification, license and background checks. Whitehall was fined $17,000 for the violations, and the state recommended other penalties to the Centers for Medicare & Medicaid Services.

The documents shed more light on conditions at the 102-bed nursing home, which has been identified through state inspections as among the worst in Michigan. Now three former CNAs have sued the nursing home and its parent company alleging they were fired for reporting patient abuse and neglect at the facility. One was fired after filing a complaint that brought the state to the facility to investigate a patient’s fall, the lawsuit states. Two others were fired after they and the employee who filed the original complaint told state investigators about the discovery of the maggots, the lawsuit claims.

The lawsuit also alleges the nursing home tried to prevent employees, including two of the nursing assistants and a nurse and a nurse manager, from participating in the investigation into the maggot discovery by suspending them while it was under way, then firing them.

The lawsuit filed Nov. 22 by Nikenda Morton, Wanda Mosley and Latasha Bryant seeks relief under the state’s Whistleblower Protection Act, asks for a jury trial and seeks unspecified compensatory damages for economic injury, including loss of employment, mental and emotional distress, humiliation, all attorney fees and court costs.

The other investigation involved a female resident at Cambridge South Nursing Home who had a trachea and “had been coughing more than usual but she was not immediately assessed because staff was ‘rushed.’” “The resident’s condition became so severe that emergency medical services were called to the facility where they found her airway obstructed by maggots,” the report said. Very active maggots, estimated to be in the first to second stage of development were found, as the woman’s throat was being suctioned to open her airway, the report said.“This is a disgrace and an outrage, not only are there outrageous abuses occurring, but the multiple layers of agencies and regulatory safeguards to protect the residents have failed miserably,” said Elmer Cerano, executive director MPAS.

See articles at The News-Herald, Ann-Arbor.com, and Ann-Arbor.com.

Fox40 reported the fine levied against Crystal Ridge Care Center.  Crystal Ridge received a Class AA citation from the California Department of Public Health and faces a $75,000 fine for failing to ensure a resident remained free of injury.   In February, a certified nursing assistant transferred a resident by herself out of a bathtub using a mechanical lift.  Two people are required when using the lift. 

According to the investigation by the CDPH, the male resident fell out of the chair and broke his neck and injured his head. The man died four days later.

During the investigation, the Director of Staff Development said they had not done any lift training for the nurses, and the Administrator admitted the facility does not verify the competencies of the nursing staff.  The CDPH found Crystal Ridge failed to ensure the man’s safety by their nurse incorrectly using equipment.  
 

The Miami Herald had an article on Florida’s Supreme Court recent decisions on mandatory arbitration in nursing home admissions paperwork.  The Court held that nursing home arbitration clauses that limit remedies allowed by state law are invalid. The opinions said lower courts erred by compelling arbitration in negligence cases against nursing homes.

In one case, Gayle Shotts sued OP Winter Haven Inc., as personal representative of the estate of Edward Henry Clark, her uncle, following his death in 2003.   See decision here.

In the other case, Angela Gessa accused Manor Care of Florida Inc., of negligence, violation of resident’s rights and breach of legal duties during a stay at its Carrollwood facility in Hillsborough County.  See decision here.

The majority also ruled that a 2010 U.S. Supreme Court decision that an arbitrator, not a court, had to decide whether an arbitration agreement was unconscionable did not apply to nursing home cases.

 

From J. M. Reinan’s Blog:

On Tuesday, November 8, 2011, a division of the Colorado Court of Appeals heard arguments from counsel on SavaSeniorCare’s appeal of the verdict entered against it in Reigel v. SavaSeniorCare et al. An Adams County jury entered a verdict against SavaSeniorCare’s Thornton nursing and rehabilitation facility, Alpine Living Center, in the amount of $450,000.00 stemming from the death of Dennis Reigel, a former resident of Alpine, as well as for the extreme and outrageous conduct that facility displayed toward his wife.

The primary issue argued on appeal was whether the trial court erred in instructing the jury on what is known as the Loss of a Chance Doctrine. SavaSeniorCare argued, in essence, that there should be no way for a patient’s family to prevail against the nursing home if the nursing home resident simply lost a chance for treatment due to the nursing home’s failure or refusal to timely transfer the resident to a hospital. In the Reigel case, Dennis Reigel, 66, suffered a heart attack at Alpine. His wife repeatedly asked for medical attention and requested that her husband be transferred to a hospital, but was told that Dennis was fine and was made to feel that she was overreacting. When Dennis was finally transferred to the hospital, he was in critical condition and the window of time for performing a life-saving angioplasty had lapsed. The hospital records reflect that his heart attack had occurred some 24-48 hours earlier.

The jury was given both the Loss of a Chance instruction and the stock jury instruction for medical causation (i.e., the facility’s negligence must have been a cause of the wrongful death). The Law Offices of J.M. Reinan argued that the Loss of a Chance Doctrine is the law in Colorado and even if that instruction is determined to have been given in error, such error was harmless because the jury also received the stock causation instruction.

The Court of Appeals is expected to rule on this and the other issues before it within the next few months.