ABC reported a maintenance worker from a California nursing home is thankfully behind bars, after an investigation into allegations of sexual assault included  DNA evidence to corroborate the victim’s report.  After pleading guilty to one felony count each of sexual battery on an institutionalized victim and sexual penetration by foreign object of an incompetent victim, he was sentenced to three years in prison and a lifetime sex offender registration.

While no system of screening potential employees is foolproof, this case is one more that goes to show that employers should be extra careful to avoid giving sexual predators access to vulnerable populations such as children, elderly and people who suffer from cognitive problems such as dementia or mental illness.

 This past November, the legislators in Oklahoma took steps to help protect their aging citizens by explicitly giving them and their families the right to put hidden cameras in their rooms at nursing home facilities. It remains unclear, however, whether the footage gathered from these devices will be able to be used in state investigations into facilities.

One woman was told that her mother had fallen out of bed twice in a 12 hour period. Nobody could tell her how long she was left on the floor, but photos of the wound showed a large amount of congealed blood soaked into the 93-year-old’s hair. She was sent to the hospital where she was diagnosed with severe dehydration, and it was discovered that the sippy cup she was using in the facility was completely clogged with black mold. The two alleged falls took place the day after she filed a complaint against the facility. Whether the falls were a coincidence or an act of retaliation, she pulled her mother from the facility to spend her remaining year of life at home.

When she called the state agency to report the incidents she informed them that she had photo evidence of the injuries, only to be told that they would not use them in their investigation because they could be doctored. However, when the Oklahoma State Department of Health was reached for comment they said that they could accept photographs and videos, but may not use them if they could not prove a chain of ownership or authenticity, which is a difficult task for the average family. Wes Bledsoe, a local elder advocate, commented on the reality of retaliatory actions by nursing home staff, and states he fears video evidence will be equally ignored.

The final segment of this report series focused on the lunacy of the slow and ineffective procedure of the Oklahoma Stated Department of Health’s investigations by comparing them to the action taken when a puppy mill is discovered. When the state discovers a puppy mill, where dogs are being bred and kept for profit, often in poor conditions, an outside vet is brought in immediately to check all the animals on site for signs of neglect and abuse. The logic here is that if one animal is being mistreated, there is a problem with care and likely other animals are being mistreated. However, when abuse or neglect in a nursing home facility is exposed, the facility is allowed to complete it’s own investigation, and the state merely reviews the reports the facility gives them. No outside doctor is brought in to check other residents for signs of substandard care. It seems bizarre that the state seems to take more action to stop animal abuse than elder abuse.

Hopefully, the work Fox23 and journalist Clay Looney did to help uncover some of these realities in their four part series will help sway public opinion and create enough awareness that legislators and regulators will be forced to effectively address the problem.

John O’Connor is the Editorial Director of McKnight’s.  He wrote an article on how and why national for profit chains hide behind corporate shells to avoid responsibility for neglect and negligence.

 "For years, some nursing home operators have relied on an unusual tactic for avoiding lawsuits and other trouble: a catch-me-if-you-can corporate structure. But the future is looking less bright for this dubious if effective business model.

It’s hardly a secret to the feds, consumers or plaintiff attorneys that some operators have put elaborately layered ownership structures in place. Some critics describe the practice less tactfully: They call it a corporate shell game.

By cutting themselves into tinier and tinier pieces, such operators try to make sure that outsiders seeking restitution are likely to find there’s no there there. Certainly, such slicing and dicing may also happen to unlock tax advantages and other bottom-line sweeteners. But let’s not kid ourselves about its core purpose: disguise and cover.

However, recent developments at the federal and state levels may force such operators to reconsider this way of doing business.

One is the new federal health law. Specifically, coming Obamacare rules are expected to require extensive reporting of nursing home ownership, management and financial connections.

At the state level, a pending bill in Connecticut might soon emerge as a national model for ensuring ownership transparency. This measure would require nursing homes to reveal the financial status of any "related party" businesses that contract with the facilities — including associated companies that own the facility properties, or spinoff businesses that provide rehabilitation or management services. Further, the bill would require nursing homes to report profits for any side businesses exceeding $10,000 a year.

To be fair, groups representing nursing homes are saying they already report on related businesses in detailed cost reports filed with the Department of Social Services, and that the new measure is simply a favor for unions. They add that no other state-funded health care entities are forced to reveal losses or profits from side businesses. Those are certainly legitimate provider concerns.

Unfortunately, the actions of relatively few operators have harmed the field’s reputation — and continue to do so. As the sector has taken no action to police such behavior, it can hardly be surprising that regulators and lawmakers are now beginning to take matters into their own hands."

 The insurance expansion under the Affordable Care Act will cost $1.383 trillion over the next decade, more than $100 billion less than previous forecasts, according to the nonpartisan Congressional Budget Office.

The nonpartisan budget office’s report, an update to projections from February, shows the law costing less than in previous estimates in part because of the broad and persistent slowdown in the growth of health care costs. The news is welcome to deficit hawks but Republicans are still complaining about the law because it is an election year (Lowrey, New York Times 4/14).

 

Alice Paylor, 2013-14 S.C. Bar President, published a call to arms for SC lawyers on the South Carolina Bar website.  I would to thank the SC Bar for allowing us to share this information. Here it is below.

"The political season has blossomed, and a few people are again attacking the Constitutional principles that are essential to a free society. Every day lawyers step up to the plate and ensure that each citizen is afforded the rights guaranteed to us all and essential to protect our liberties. It would be refreshing to see comment on the merits of positions rather than attacks seeking to evoke a gut response. I keep hoping.

In the meantime, your Bar is taking steps to defend the legal profession against blanket political attacks against lawyers and those who criticize certain types of lawyers. For example, I submitted letters to media outlets in response to coverage of a recent press conference featuring comments suggesting that there is a conflict of interest between representing criminal defendants and representing South Carolina as its governor.

The truth is that each and every one of us has a professional duty to ensure that justice is not rationed but is available to everyone. It is the job of a criminal defense lawyer to ensure his or her client has a fair trial, not to defend the crime.

Also, the Bar recently launched a website called sclawyerfacts.org. This site references false claims perpetuated in the media and provides education about the legal profession and the service provided by lawyers to the citizens of South Carolina. The site also features videos, pictures and news coverage that illustrate lawyers’ commitment to their clients and the community, as well as a recent economic study that outlines the reality of what the legal profession contributes in economic activity and jobs for South Carolinians.

Members of the South Carolina Bar fall all along the political spectrum, and as such, the Bar does not pledge support for political candidates. Irrespective of party lines, candidates and those supporting them should present their own credentials and experience and allow intelligent voters to make informed decisions as to how to vote based on those facts. Vigorous debate is what democracy is all about, but those involved should stick to an honest discussion about the facts. Misleading political rhetoric clouds the opportunity for honest debate on substantive issues important to our state.

When you encounter smear tactics against lawyers in your community, I encourage you to help the Bar fight back. Lawyers promote good government and economic growth. They represent the individual, the small business, the larger entities and the government. Some of those individuals are the poorest in our communities, and lawyers go to court for them without charge.
Help spread the word about what you already know about our state’s lawyers, or point them to sclawyerfacts.org for just that—the facts."

 

Crain’s Detroit Business had an interesting article about the difficulty in providing quality nursing home care when profits are the major concern.  Nursing homes complain about the amounts Medicaid pays nursing homes for services.

David LaLumia, CEO of the Health Care Association of Michigan, said Medicaid payment rates often do not cover nursing home costs. "It is a challenge with the low Medicaid rates," LaLumia said. "Financing Medicaid and Medicare in Michigan will change to more managed care" administered by health plans and accountable care organizations in the next several years, he said.

Over the past several years, the state has been increasing payments for home health services to keep as many patients out of higher-cost nursing homes, LaLumia said.

"We are supportive of that," he said. "Not everybody needs to be in a nursing home."

Chris Berry, Witzke Berry Carter & Wander PLLC Chris Berry, an elder care attorney with Witzke Berry Carter & Wander PLLC, in Bloomfield Hills, said he represents families on Medicaid who sometimes have a difficult time placing relatives in high-quality nursing homes.

"When a nursing home is needed, we want our clients to get into the best one possible," Berry said. "Some nursing homes play a little game. We accept Medicaid, they say, but we don’t have any Medicaid beds available. But if it is private pay or Medicare, they have beds."

Kelly Gasior, vice president of strategy and housing operations with Livonia-based CHE Trinity Senior Living Communities, acknowledged there often is a waiting list for Medicaid patients, especially those converting from Medicare after their 100-day annual benefits run out.

 

 

Arkansas Business reported that nursing home profits in Arkansas are up.  "About 70 percent of the nursing homes in Arkansas made a profit in the year that ended June 30, 2013, according to cost reports audited by the Arkansas Department of Human Services."

Net incomes ranged from just over $1.4 million at both the Nursing & Rehabilitation Center at Good Shepherd and Briarwood Nursing & Rehab Center, both in Little Rock and both with 120 beds, to a loss of almost $1.5 million at 140-bed Northridge Healthcare & Rehabilitation in North Little Rock.  The total net income for the profitable facilities was a hair under $56 million, up from $49 million in 2012. The remainder had losses that totaled just under $14 million, including that of Northridge. That’s up from about $9 million.

 

 

14 year old Marie Freyre was suffering from seizures and cerebral palsy. After being denied home health care by the Agency for Health Care Administration, Marie was forced to go to a nursing home in Miami, 5 hours away from her Tampa home. A judge had previously ordered that Marie be returned to her mother to be cared for, but the Agency for Health Care Administration refused to pay for this manner of care. During Marie’s transport to Miami, she was not given food, water, or her seizure medications. Such poor treatment, in her fragile condition, led to Marie’s death 2 days later.

Up until recently, Marie was able to have stabilized care from her mother. Being forced into unfamiliar and incompetent hands ultimately led to her wrongful death. Her case highlights a growing conflict between Florida healthcare regulators and the U.S. Department of Justice. In spite of a binding court order, health care providers has the callous audacity to refuse to comply with federal laws. Large healthcare corporations should not be allowed to break a judge’s official ruling. The Agency for Health Care Administration needs to be held responsible to such a degree that they do not continue to look at the bottom line, rather than what is best for a patient.
 

Emma Banks is a a wife, mother, and one of the primary caretakers of her widowed father. She was kind enough to offer to write an article advising other caretakers.  Hope you enjoy her writing.

Fun for Seniors

As we’re all getting older, our parents are aging as well, and their lives, like ours, are changing in monumental ways. I just got married three years ago, and my mother passed away two years later. It’s been extremely hard on everyone, including my brother and I, but it’s been especially rough for my father. He’s been struggling to adjust to life on his own, without his best friend, and I’m doing everything I can to keep him engaged with everyday life. My brother lives out of state, so it’s just me and my dad now. Here are some of the fun activities I’ve been trying to set him up with in his new ‘senior citizen’ life (he hates to be called that!).

Exercise

My dad has always been big on exercise. He loves the outdoors, so I try to spend a lot of time with him outside whenever I can. We go on long walks together as often as possible. He was also big on biking when he was younger. My dad was the king of mountain biking, and would explore all kinds of trails wherever he went. That’s why when his birthday rolled around this year, I picked up an exercise bike for him! He keeps it in the den and uses it all the time, watching TV or reading a book or magazine while he cycles. It’s great for keeping him in shape—since staying active has always been so important to him, it was definitely something he wanted to keep in his life, even as he ages!

Social Stimulation

You may think I’m crazy, but I also set my dad up on Facebook recently. Yes, it’s true—Facebook is getting more popular with senior citizens. How do you ‘Like’ that? My dad loves it! He has reconnected with tons of his high school buddies from the rugby team, plus tons of his fraternity brothers from Dartmouth. My dad is pretty tech-savvy, but even if your parent is not, Facebook is user friendly and easy to learn! It’s an exciting tool seniors can use to stay in touch and keep some kind of social interaction going. Definitely worth a shot!

Food Freedom

My mother always did most of the cooking, but recently, my dad has been trying to pick up a few tips and tricks so he can cook for himself! I’ve actually signed him up for cooking classes, too, at the local senior center. They offer some basic introductory courses to teach older folks simply, easy-to-make meals. It’s certainly an adjustment cooking for one—I remember having to do that when I first got my own apartment, and it was tough! I also go over to his house as much as I can to help him out with meals. Cooking is always more fun together! I also help him by delivering groceries making sure that he has a nice variety of snack, food for meals, and some treats for now and then.

Being a senior citizen (or having an elder parent!) doesn’t have to be scary. It can certainly be lonely and isolating at first, but there are ways to combat that. Between exercise, socializing, and staying healthy, your elder parent can definitely live a good life! Whether it’s an exercise bike or a group exercise class, making a Facebook account or joining a church group or poker-playing group, there are plenty of ways to fill their time and make things fun as a senior citizen. Plus, don’t forget the senior citizen discount! That’s why I love shopping and going out with my dad.