Good news for whistleblowers!  McKnight’s had an incredible story about a whistleblower case that resulted from comments made during a therapy provider’s public conference call in 2006.  An audience member became suspicious, investigated the situation, found fraud, and then filed a whistleblower lawsuit.   Remarks about a “therapist recruiting fee” on the public call did not sound right to Mark Essling, CEO of Health Dimensions Rehabilitation Inc..  Essling brought a False Claims Act lawsuit after spending about a year investigating the fees

The whistleblower filed against RehabCare who hosted the 2006 call.  He alleged that RehabCare overbilled Medicare and Medicaid and paid more than $10 million in kickbacks after taking over therapy at Missouri nursing homes.  Kindred Healthcare has owned RehabCare since 2011.

RehabCare argued that Essling should not qualify as a whistleblower because he based his suit on publicly available information. Only individuals identified by the False Claims Act, such as an attorney general, can sue a company based on public information. The defendants asked the judge to remove Essling from the action, which would then have proceeded with the government as plaintiff. His removal would have protected RehabCare from potentially paying Essling’s attorney fees.

Judge Audrey G. Fleissig denied RehabCare’s motion in a May 20 ruling. The “essential elements” of a fraud must be exposed publicly to trigger the public disclosure bar, and the government would not have understood this alleged fraud based only on RehabCare’s public disclosures, Fleissing wrote. Because Essling’s analysis of the information was needed to bring the case, he can remain a whistleblower plaintiff, the judge ruled.
 

BizJournal reported that for profit nursing home chain Kindred announced that Stephen R. Cunanan was appointed as its chief people officer. In the newly created position, Cunanan will serve on the company’s executive committee and will report to CEO Paul J. Diaz.  Cunanan’s responsibilities will include employee engagement and satisfaction, leadership development, advancing patient safety and human resources, according to a news release.

“The mission of Kindred’s People Services team is to provide integrated, cost effective and efficient human resources services that leverage the strength of our people to drive Kindred’s clinical and business strategy,”  “People Services will foster a culture of quality and engagement to enable our people to promote hope, healing and recovery for patients, residents and families.”

Kindred Healthcare (NYSE: KND) has about 76,000 employees in 46 states, providing health care services through rehabilitation hospitals, nursing and rehabilitation centers, sub-acute-care units and other settings.

 

MedPageToday had an interesting article on the need for hospitalists in long term care facilities.  Hospitals discharge patients before they are ready to go home.  Often the hospitals transfer the patients to nursing homes.  This has caused the acuity in nursing homes to skyrocket while staffing remains the same.  Hospitalists can fill a void in skilled nursing care the way they have done in hospitals. Hospitalists know how to provide critical care, have knowledge of area hospitals, and understand the needs of patients fresh out of hospitals.

5% of hospital patients account for roughly half of hospitals’ costs. "As a result, managed care plans are increasingly steering patients away from acute-care hospitals to less expensive SNFs and long-term acute care hospitals; roughly 45,000 post-acute facilities are in existence now, said Kerry Weiner, MD, chief medical officer at IPC, a North Hollywood, Calif., hospitalist company."

The American Medical Directors Association (AMDA), a professional society of long-term care facilities based in Columbia, Md., is developing a set of core competencies for physicians in nursing home care.   Clearly physicians need to become more skilled at handling patient transitions, learn palliative care, depression, dementia, and pain management.

 

WDSU News reported that Stephanie Ducre, an employee at a nursing home in Sidell, LA, has been arrested for stealing jewelry and a digital camera from residents.  The resident whose camera was stolen had memory loss and used the pictures on her camera to help her memory.

Because the theft constituted a gross violation against the elderly, Ducre was not only charged with four counts of theft by fraud, but with four counts of exploitation of the infirm and four counts of theft of assets of an aged person as well. Police Chief Randy Smith stated, "We want this to be a strong message that taking advantage of the elderly citizens in our community will not be tolerated."

 

Canberra Times reported on a study by researcher Jane Kellet of the University of Canberra which found that 22% of nursing home residents in the Australian state were moderately to severely malnourished. Another report that covered all of Australia stated that 50% of residents in nursing homes across the country were malnourished.

Ms. Kellet’s study included 101 residents who volunteered from five different nursing homes. The study assessed weight change, dietary intake, fat and muscle stores, and frequency of gastrointestinal symptoms in each participant. It found that 20% of the participants were moderately malnourished, while 2% were found to be severely malnourished. Patients requiring high levels of medical care and those suffering from dementia were not included in the study.

According to Kellet, natural signs of ageing like reduction in skeletal muscle mass, difficulty swallowing, and decreased appetite closely resemble those of malnourishment. She notes that the similarity of symptoms often allows malnourishment of patients to go unnoticed or ignored, and states that "We need to recognise that malnutrition isn’t part of ageing."She suggests that these similarities make it extremely important to monitor nursing home patients’ nutrition so that those who are malnourished can be properly treated.

 

A Florida nursing home, Casa Mora Rehabilitation and Extended Care, will pay an $18,500 fine after neglecting a dying resident, and mishandling the resident’s death.  A nurse failed to administer life-saving attempts to a 58 year old woman who was unresponsive. The nurse thought the resident had requested not to be resuscitated, even though the woman wasn’t wearing a bracelet that identified DNR.

The resident’s daughter claimed that the facility hadn’t followed the necessary procedures to keep her mother alive.  The Florida Agency for Health Care Administration investigated her claim and agreed that the facility was negligent.  In addition to the fine, the facility will implement new procedures which will hopefully prevent incidents like these in the future.

See article at MySunCoast.

CBS New York reported that two nursing home aides, David Rover and Thomas Mocera, have been accused of taking graphic photographs of approximately eleven nursing home residents in three Suffolk County nursing homes. New York Attorney General Eric Schneiderman asserts that among the photographs taken by the two were images of bed sores, patients’ private areas covered in feces, and an overflowing colostomy bag. These images were reportedly taken without the patients’ consent, violating both their privacy and dignity.

The incidents reportedly occurred at Woodhaven nursing home in Port Jefferson Station, Long Island State Veterans Home in Stony Brook, and Jefferson’s Ferry in South Setauket. Representatives from Woodhaven declined to comment to CBS New York, and representatives from Jefferson’s Ferry denied that there was any evidence that such an incident occurred. Fred Snanga, the director of Long Island State Veterans Home was “completely outraged” by the actions of the two men.

Rover and Mocera are both pleading not guilty to the charges. Family members of the victims are calling for better screening processes for nursing home employees.

CTV News reported that four employees from St. Joseph’s at Fleming long- term care facility in Ontario, Canada have been suspended with pay after video footage showed them abusing a patient. The footage was captured by Camille Parent, who installed a camera in the room of his mother, Hellen MacDonald, an 85 year-old patient at St. Joseph’s suffering from dementia. Parent was prompted to install the camera after his mother suffered a suspicious black eye.

The footage shows a staff member blowing his nose in Mrs. MacDonald’s sheets while making her bed, another staff member changing her diaper with the door open, and yet another shoving a rag covered in fecal matter in Mrs. MacDonald’s face. The incidents all occurred within a period of three weeks.

In 2010, the Long- Term Care Homes Act was passed, enacting a zero tolerance for abuse policy in Ontario extended care facilities. When asked whether or not the footage depicted what he would classify as abuse, Alan Cavell, CEO of St. Joseph’s, told CTV news, "I don’t want to give my opinion directly. I would think that most people would say that it was." Investigations are under way by both St. Joseph’s and the Ontario Ministry of Health.

CTV News reported that there were over 10,000 incidents of seniors suffering abuse in nursing homes in Canada last year. In light of these disturbing figures, Parent continues to raise awareness about residents’ safety and the quality of care they receive in long-term care facilities through his new organization, Ontario Cares.