published an article discussing the lack of a requirement for nursing homes to keep track of fired nurses for incidents related to drugs.  The article referenced the case of Nurse Kathryn Sue Kennedy who was hired nine times by different nursing homes despite prior drug issues at each of her places of employments. After being diagnosed as an opiate abuser by the Indiana State Nurses Assistance Program (ISNAP), in 2007, Kennedy’s license was still renewed and she continued to work at nine different institutions with repeated offenses of drug abuse and stealing from patients.

In one incidence in 2010, Kennedy went to a patient’s house and stole Vicodin after reportedly coming to check the breathing machine. After being fired from her position, Kennedy was hired two weeks later as the Director of Nursing at Brookside Haven Care Center. Unfortunately, there is no law set in place that requires facilities to report the firing nurses and the reasons for the termination.

It is the duty and responsibility of the fired employee to inform her next employer.  Of course, they never happens because the nurse would not get thejob then.   In the past year more than 400 cases were filed against Indiana Nurses in which 85 percent were drug related incidents.
It is apparent that there is no accountability in this system, which allows Nurses with records to continue to work in nursing care despite prior drug incidents or terminations.

Redmond, Washington-based Aegis Living developed the first, for-profit, all-Chinese retirement home in the United States in Fremont, California ten years ago. While researching the demographics closer to home, Aegis Living founder and CEO Dwayne Clark found that a growing number of Chinese immigrants in the Seattle area wanted a similar community where they could express themselves in their native language and enjoy a luxurious lifestyle in their retirement.

“As we create our Newcastle community we have appointed a full Chinese advisory board that is sensitive to cultural issues,” explains Clark. He has chosen a picturesque lakeside property that is located within a block of Newcastle’s commercial center and just down the hill from the Newcastle Golf Club. Beyond the beautiful building and landscaping, the new community will offer top-notch personnel and services including a professional chef (serving traditional Mandarin and Cantonese cuisine), intergenerational programs, trained staff that speaks Mandarin and Cantonese, and incomparable medical care. The state-of-the-art dementia wing is close to Clark’s heart, since he lost his own mother to Alzheimer’s. Clark has recently published a memoir about the experience, “My Mother, My Son: A true story of love, determination, and memories…lost.”

“This will be a great epicenter for the Eastside Chinese community,” Clark says. “It will include Chinese adult day care and intergeneration exchanges.” Aegis takes pride in creating a sense of family and community at each of our properties. We believe we are uniquely suited to serve the communities of Factoria, Somerset, Newcastle, and Renton to create a place that can be a home as well as a community gathering spot and a cultural hub of activity,” Clark concludes.

Dwayne J. Clark is the founder and chief executive officer of Aegis Living. With more than 25 years of senior housing experience, Dwayne has helped thousands of seniors age with dignity, comfort and compassion, and he has overseen the care of over 20,000 people with Alzheimer’s during the course of his career.

Dwayne’s focus and passion in business is to redefine the concept of “corporate culture.” He has studied business models from companies known for world-class innovation, including Costco, Nordstrom and Starbucks. With the knowledge gained from these companies, he grew Aegis Living from a dream to a company of over 2,000 employees with the goal of staff satisfaction as the driving force. Aegis Living has been voted “best company to work for” many times by Washington CEO Magazine and has been chosen as “best workplace” by Puget Sound Business Journal.

Dwayne has been honored in numerous ways for his contribution to business, as well as senior housing. He was named Ernst & Young’s Entrepreneur of the Year, honored with the Lifetime Achievement Award from Senior Services and granted the Bastyr University Mission Award. He is frequently interviewed as an expert on aging by the local and national press.

Contact Information:

Stacey J. Miller, Publicist
S. J. Miller Communications
Randolph, MA

The L.A. Times had an interesting article revealing how and why Mary Brown, a Florida woman who owned a small auto repair shop but had no health insurance, became the lead plaintiff challenging President Obama’s healthcare law. Brown "doesn’t have insurance. She doesn’t want to pay for it. And she doesn’t want the government to tell her she has to have it," said Karen Harned, a lawyer for the National Federation of Independent Business. Court records reveal that Brown and her husband filed for bankruptcy last fall with $4,500 in unpaid medical bills. Her only income was $275 a month in unemployment benefits.

"This is so ironic," Jane Perkins, a health law expert in North Carolina, said of Brown’s situation. "It just shows that all Americans inevitably have a need for healthcare. Somebody has paid for her healthcare costs. And she is now among the 62% whose personal bankruptcy was attributable in part to medical bills."

The central issue before the Supreme Court is whether the government can require people to buy health insurance. Under the law, those who fail to buy insurance after 2014 could face a fine of up to $700.  Government lawyers argue that the requirement is justified because everyone, sooner or later, needs healthcare. Those who fail to have insurance are at high risk of running up bills they cannot pay, sticking the rest of society with the cost, they argue. Brown’s situation, they say, is a perfect example of exactly that kind of "uncompensated care that will ultimately be paid by others."


St. Louis Today reported that the daughters of a resident who died after wandering away from a nursing home here filed a wrongful-death lawsuit alleging negligence.  Aubrey Giles was reported missing from the Midwest Rehab and Respiratory Center on Jan. 14. His body was found two days later in a wooded, frozen ravine nearby. Officials said he appeared to have died of hypothermia.

The family alleges that the home knew Giles had a pattern of trying to leave but failed to monitor him. It further alleges the nursing home was negligent, violated various state regulations and failed to provide adequate supervised care. The suit also alleges the nursing home "failed to timely notify local law enforcement and Aubrey Giles’ family of his elopement."

The facility is better known by its previous name, the Calvin Johnson Care Center.  This month, the incident spurred the Illinois Department of Public Health to issue eight citations against the home.


Health Affairs Blog had a great article on the epidemic of preventable errors and malpractice in the health care system.  The number of Americans who die annually from preventable medical errors is unknown and that is part of the problem.  The article discusses an as-yet-unpublished new 90,000 estimate with a unique methodology.   The 90,000 figure may become one of the most important in health care because of how it was calculated by staff at the Department of Health and Human Services and how it is being used.

HHS launched a safety improvement campaign called Partnership for Patients.  HHS wants to reduce preventable “hospital-acquired conditions” (HACs) by 40 percent by the end of 2013 from the 2010 level.  In December, the department contracted with 26 “hospital engagement networks” to be safety improvement contractors for individual hospitals that join their group. The HENs will be paid $218 million during the first two years of contracts that contain specific improvement goals and measurable activities to reach them. HHS has budgeted $500 million over three years for the entire project, including efforts to reduce readmissions. To date, 3,835 of the nation’s 5,000 acute-care hospitals have joined a HEN, a step which at a minimum implies acknowledgement of a problem.

See an article on Kaiser Health News on the same subject.

Nancy W. Trentham represents the nonprofit Kentucky Initiative for Quality Nursing Home Standards.  She recently wrote a great editorial about Kentucky’s attempts to create "medical review panels".  House Bill 361 proposed by Rep. Melvin Henley, D-Murray "would create so-called "medical review panels" explicitly designed to thwart resident justice and provide specific benefit to well-heeled corporate interests". 

"It would have to funnel through a "star chamber" chock-full of attorneys and physicians (mind you, there are no consumer representatives on the panel) to obtain the official seal of approval before his case can make its way to court.
Unlike every other citizen, unlike every other injured person, you cannot go to court unless and until you go to the special panel. This will take you and your family more time and will cost you more money.
And, it is important to remember, these panels are tipped in the providers’ favor. Not only do operators have a cadre of shrewd lawyers defending them, but the panel members hearing the case would be professionally biased toward their nursing home pals. Even if you decide to engage in this bureaucratic nightmare, you might as well kiss speedy justice goodbye.
These panels could take up to six drawn-out months to render a decision, if all parties are able to participate. Some rural communities may have difficulty locating physicians or attorneys willing to close their practices for a day to take part in these panels. They know if they do participate that would be lost income for them and a hardship on their own patients and clients — not to mention a detriment to their local economies.
"So why are lawmakers picking on nursing home residents who have done nothing wrong? Money. Nursing homes rake in millions of dollars. The corporate fat cats have decided profiteering outweighs resident safety and care, and defending against lawsuits is a nuisance to their revenue stream.
If the industry can erect enough barriers to slow or stop lawsuits, then CEOs can fill the corporate coffers and ensure happy shareholders. Meanwhile, care worsens for residents by giving more protection to providers and less to residents

The solution is to employ sufficient numbers of qualified caregivers.  "According to the nursing home industry’s own data, both the cost and the frequency of lawsuits in Kentucky declined when staffing ticked higher. By investing in their own work force, nursing home companies will yield a higher rate of return Not only will residents enjoy a higher quality of life and care, but lawsuits will also decline. Seems like a no-brainer."


Kaiser Health News blog "The Capsule" had an informative article on the failure of Medicare’s seven-year effort to increase quality improvements in hospital care by publishing key performance metrics on its Hospital Compare website.  The effort has not resulted in fewer patient deaths, according to a new Health Affairs study. Health policy experts have hoped poor performing hospitals would be embarrassed enough by their public scores to make changes. 

The new study questions whether shame and embarrassment lead to better outcomes for patients, such as their chance of survival in the month after they were discharged.   Hospital Compare was found to have no effect on the 30-day survival rate of heart attack and pneumonia patients, according to the study.

Starting in October 2013, hospitals will have an added reason to improve their mortality rates. As part of the health law’s value-based purchasing program, mortality rates will be added to the factors Medicare uses in determining how much to reimburse hospitals

STATEMENT OF ADMINISTRATION POLICY–H.R. 5 – Protecting Access to Healthcare Act


The Affordable Care Act made significant improvements to our Nation’s health care system, including creating the Independent Payment Advisory Board (IPAB). The fifteen expert members of the Board, which will include doctors and patient advocates, will recommend to the Congress policies that reduce the rate of Medicare growth and help Medicare provide better care at lower costs. IPAB has been highlighted by the non-partisan Congressional Budget Office, economists, and health policy experts as an important contributor to Medicare’s long-term sustainability. The Board is prohibited from recommending changes to Medicare that ration health care, restrict benefits, modify eligibility, increase cost sharing, or raise premiums or revenues. Under current law, the Congress retains the authority to modify, reject, or enhance IPAB recommendations to strengthen Medicare, and IPAB recommendations would take effect only if the Congress does not act to slow Medicare cost growth.


H.R. 5 would repeal and dismantle the IPAB even before it has a chance to work. The bill would eliminate an important safeguard that, under current law, will help reduce the rate of Medicare cost growth responsibly while protecting Medicare beneficiaries and the traditional program. The Administration strongly opposes legislation that attempts to erode the important provisions of the Affordable Care Act.


Additionally, the Administration has serious concerns with key aspects of medical malpractice provisions included in H.R. 5. The goals of medical malpractice reform should be to provide fair and prompt compensation to patients who have been harmed by medical negligence, reduce preventable injuries, improve the quality of care, reduce defensive medicine, and lower medical liability premiums. However, H.R. 5 would establish inappropriate and harmful restrictions on health care lawsuits without effectively meeting these goals. Specifically, the Administration opposes placing artificial caps on malpractice awards which will prevent patients and other claimants who have been wrongfully harmed from receiving just compensation.


The Administration is committed to strengthening Medicare, protecting patients, and supporting the physicians who care for them. We believe that this legislation fails to accomplish these goals. If the President is presented with H.R. 5, his senior advisors would recommend that he veto the bill.



McKnight’s had an article about thenew GAO Report showing that The Centers for Medicare & Medicaid Services need to make serious improvements in the tools it uses to evaluate the quality of nursing home care.  The Government Accountability Office conducted an investigation to determine whether CMS was doing an adequate job in monitoring implementation of the Quality Indicator Survey process. The GAO found that CMS has not established quality measures or performance goals to evaluate if QIS objectives are being met.

Both the GAO and the Department of Health and Human Services recommended that CMS “routinely monitor the extent to which progress is being made in meeting the objectives of the QIS and systematic methods for monitoring and facilitating states’ efforts to implement the QIS.”


Oak Park nursing home failed to supervise two patients with histories of aggressive outbursts before a fight that left one dead, according to a report released by the Illinois Department of Public Health.  Anibal Calderon died Feb. 14 of head injuries from a fight two days earlier at Oak Park Healthcare Center.  After hearing yelling, nurses found Calderon lying on the floor and bleeding from his head while a 66-year-old resident stood beside him, the report states. It characterized the attack as "unprovoked," and the Cook County medical examiner’s office ruled it a homicide.  According to employees, normal staffing for that area was one nurse and two certified nursing aids. One of the CNAs should have been in the dining room monitoring residents there and the other should have been in a chair near the dining room doorway monitoring residents known to wander in the unit. Said one certified nurses aide, “That is why we have a (certified nurses assistant) seated in the hallway to monitor.”

However, the IDPH report said while there is evidence of prior inappropriate behavior by both men, it was not communicated to staff through any treatment plan. “(The nurse) said there was no supervision or monitoring in place for (Calderon or his assailant),” the IDPH report states. The nurse told state investigators she was “unaware of any unusual behaviors displayed by (the assailant).” She said unless such behavior is noted on the patient’s plan of care, she would not be aware of it.

Nursing home records indicate both became increasingly prone to "wandering, verbal outburst … signs of forgetfulness" and "aggressive disorder," according to the report.  Despite several  recommendations made to change the care plan, staff did not follow through, the report states. Also, the report found many staffers were unaware of the behavioral issues and did not supervise the men adequately when the fight occurred.

 Incredibly, the facility did not have a policy or plan to address coping with physically aggressive behavior according to the report.  The assailant was involved in an altercation with another resident whom he pushed to the floor, but his current comprehensive care plan did not note any methods to address the incident.

The victim’s family filed a lawsuit asking for reasonable compensation for their father’s wrongful death.  The lawsuit alleges that Oak Park Healthcare Center violated federal and state nursing home regulations by failing to protect Calderon from abuse and neglect. The complaint further alleges that the facility failed to provide Calderon with appropriate supervision and failed to employ sufficient staff to properly supervise and monitor residents.

The lawsuit also alleges that the facility failed to promptly report suspected incidents of abuse and ignored complaints regarding residents and staff at the facility.