NorthwestGeorgianNews reported the arrest of Marquette Wallin, an employee at Cozy Manor nursing home, who is facing drug charges after, police say, they found prescription medication belonging to some of the residents in her purse.

According to LaFayette Police Department reports:

On Sunday, Aug. 16, around 10:50 a.m., Wallin was found unconscious in her vehicle at the Kangaroo gas station at 1111 North Main Street.  A police officer tried several times to wake her by knocking on the window. He was able to wake her after opening the driver’s-side door where she was sitting.  Wallin appeared confused and disoriented, with slurred speech, and had trouble communicating. Wallin told the officer she had left work at Cozy Manor around 9 p.m. and driven to the gas station.

The officer believed that Wallin was under the influence of some type of controlled substance but did not smell alcohol on her. The officer asked Wallin to get out of the vehicle, but she stumbled and was swaying as she stepped out. The officer asked Wallin if she had taken any narcotics. Wallin replied that she takes several medications, but she had not taken any at that time.

She told the officer she had her and her fiancé’s medications in her purse.  The officer asked to search her purse and Wallin consented. The officer located a prescription for hydrocodone listed to a former resident of Cozy Manor. The officer noticed several other different medications that were mixed in with her own medication. Those medications did not belong to Wallin.

According to LaFayette police Capt. Stacey Meeks, the additional medications found on Wallin belonged to residents of Cozy Manor, including some patients who had died. The listed medications found included hydrocodone, clonazepam, vyvanse, dextroamphetamine, phentermine hydrochloride, gabapentin, phendimetrazine, lasix, maxzide, lorazepam, and phendimetrazine. All the medications discovered were in Wallin’s purse.

Enid News reported that CNA Carla Jean Hill, a caregiver at Hennessey Manor Nursing Home and Care Center, is being charged with a felony count of alleged abuse of a nursing home resident.  She is accused of abusing a 90-year-old resident slamming the resident’s wrist onto a rail after a fall.

 “Resident … would not put her hand on the rail,” stated the affidavit. “Hill then grabbed resident left arm with her (Hill’s) left hand and slammed resident left wrist on the rail. Resident … let go of rail and Hill told her again to hold on to the rail. Hill again slammed resident … left wrist on the rail.”  The affidavit continued, stating that when the resident was in bed, Hill pushed her hard causing the resident’s head to hit the wall.

On Aug. 10, 2014, a co-worker named Lopez-Benitez reported the incident to the registered nurse, and the director of nursing was notified on the same day.  An investigation was conducted by the director of nursing, and according to the affidavit, when Hill was asked about the situation she responded that, “it could have happened.”

On Aug. 12, 2014, an X-ray was completed of the resident’s wrist, and according to the affidavit, the resident’s wrist has widening of the scapholunate distance with some rotation scaphoid caused by the trauma.  The scapholunate is a ligament located in the wrist. According to American Society for Surgery of the Hand, when the ligament becomes too stretched, injured or distanced from other items in the wrist it may become extremely painful. The wrist will swell and sometimes surgery is required to fix the ligament.

 

 

WBNG reported that nurse Lisa Rumsmoke Clark pleaded guilty to stealing nearly 200 narcotic pills from Elcor Nursing and Rehabilitation Center, the nursing home she worked in, according to the New York State Attorney General’s Office.  Clark was a licensed practical nurse at the facility.

“Nurses are responsible for providing comfort and care to their patients, not stealing narcotics from those who need them for pain relief,” Attorney General Eric Schneiderman said in a statement Wednesday.

An investigation revealed that over roughly one month, Clark filled out records saying she administered the pills to eight separate residents, but actually took the drugs for personal use.

Clark pleaded guilty to petty larceny and was sentenced to only 60 days in the Chemung County Jail and three years of probation.

The Des Moines Register had the below editorial on their website.

In January 2013, 80-year-old Esther Brown was found lying in her bed at a Pennsylvania nursing home with blood covering her hands and her pillowcase.

A nurse’s aide at the home reported that one of her co-workers had hit Esther and then had thrown a can of shaving cream in her face, striking the elderly woman above the eye. The incident was reported to the police, and Esther died several months later.

Her family sued the nursing home, alleging negligence and battery. But before the case could proceed to trial, the judge had to rule on whether the family had the right to file such a lawsuit. When Esther was admitted to the facility in 2011, she and her daughter signed a contract that required her, and her family, to submit any quality-of-care complaints to an arbitrator rather than to a judge or jury.

Late last year, Judge Jeffrey Sprecher upheld the family’s right to sue, finding the arbitration agreement “unconscionable” because it was presented to Brown at emotionally difficult time; consisted of long, confusing passages; improperly portrayed the deal as beneficial to all parties; and included a confidentiality provision that Sprecher said was “designed to bury all proof of bad things that may be alleged to occur in a nursing home.”

The sad reality is that these types of arbitration agreements are fairly common now among nursing homes, and they are often upheld by the courts. Prospective residents, who may be in the midst of a health care crisis, are asked to forfeit their right to sue as a condition of admission. As the judge in the Esther Brown case ruled, these binding arbitration agreements are sometimes “forced down the throat” of residents.

As Sprecher pointed out, these agreements also attempt to “inject fear in the patient by suggesting that a court action takes so much longer than arbitration, so that unless you select arbitration, the patient may die before his court case could be finished.”

At first glance, arbitration might sound like a reasonable, effective way to address complaints without resorting to litigation. The problem is that through litigation, complainants have the ability to use the discovery process to procure documents that speak to patterns of abuse or neglect. They can also subpoena witnesses for depositions, and secure sworn testimony as to the facts of the case. And all of that is handled through a public proceeding before a judge or a jury of one’s peers.

Many of the arbitration agreements restrict a complainant’s access to records, as well as the number of depositions and witnesses. Some place limits on how much a party can recover in damages.

The federal government could easily bar these types of mandatory agreements as a condition of a home’s participation in the Medicaid program — but it has repeatedly refused to do so. In fact, the federal Centers for Medicare and Medicaid Services is considering major changes in nursing home regulations, but under the proposed new rules, homes will only be required to “explain” arbitration agreements to residents.

Of course, many individuals are placed in nursing homes precisely because their cognitive abilities are greatly diminished. How many of them are in a position to understand the legal rights they are forfeiting by signing these agreements?

Fortunately, CMS says it is still considering whether it should simply prohibit binding arbitration agreements altogether, noting that residents who depend on nursing homes for urgently needed care may feel pressured to sign the contracts even when they’re not required as a condition of admission.

It’s time for CMS to ban arbitration agreements in nursing homes. If care facilities feel that’s an intrusion on their right to dictate the terms of admission, they’re free to bow out of the Medicaid program and accept only private-pay residents.

But as long as public money is paying for the care provided in these homes, the regulation of these facilities should be designed to protect the public and not to appease the industry.

Voice your opinion

CMS is accepting public comments through Sept. 14 on the proposed new nursing home regulations. To voice your opinion, go to regulations.gov, and enter “CMS-3260-P,” with the quotation marks, in the search engine. That will direct you to a link to the proposed regulations, labeled as Medicare and Medicaid Programs: Reform of Requirements for Long-Term Care Facilities. Through that link, you can submit your written comments.

NewsOK had an article on a CNA at Warr Acres Nursing Home arrested for neglect.  Her defense:  No one checked her work or cared if she got it done.  This is often what happens in nursing homes that are not properly staffed.  The caregivers are overworked, underpaid, and suffer burnout.  This leads to care not being provided and the residents suffer.

Kendra Leann Scott has been charged with neglect by caretaker, accused of ignoring the needs of a bed-bound resident who had soiled her clothing.  She told another caregiver she failed to clean up the patient because she knew no one cared or would check on her, according to a news release issued by Oklahoma Attorney General Scott Pruitt.

Scott worked the day shift. A night shift worker reported finding the neglected resident in bed with clothing and bedding soiled with feces and urine that appeared to have been there a long time.

 

WKRG reported the guilty plea of Elsie M. Sawyer, a nursing home employee at Crowne Health Care, for abuse of a protected person, a Class C felony.  She was sentenced to three years, which was suspended, placed on three years of probation and ordered to complete an anger management class.  In addition, she is barred from working in a care facility that receives Medicaid or public health funding.

When Sawyer was employed as a certified nursing assistant at Crowne Health Care of Mobile, she was observed striking a resident and causing injury to the face and nose.

“Those who work in nursing homes hold a serious position of trust that they will care for those who are vulnerable and in need of protection,” said Attorney General Strange. “For someone to instead abuse those who are helpless will not be tolerated.  I am pleased that this defendant has been held to account for her crime and that she will be barred from a position to abuse anyone else.”

 

The Wall Street Journal had an article on how profitable therapy is for nursing homes and how they exploit the regulations to make the most money.  Medicare pays nursing homes a daily rate for a person’s stay based largely on the duration of therapy.  Medicare pays for up to 100 days of nursing-home care following hospitalization; patients pay for a portion of that care in some cases.   Medicare’s own rules can provide financial incentives for institutions to say they give high levels of rehabilitative therapy.  More than two dozen current and former therapists, rehabilitation directors and others who have treated nursing-home patients in 17 states said in Journal interviews that managers often pressure caregivers to reach the 720-minute threshold.

Patients getting ultrahigh therapy—at least 720 minutes a week—generate some of nursing homes’ biggest payments from the taxpayer-funded program. Medicare’s ultrahigh rate averaged about $560 a day in 2013, a Wall Street Journal analysis of billing records found. The average was $445 a day for “very high” therapy of 500 to 719 minutes and $325 for the “low” category, 45 to 149 minutes.

Medicare adopted the payment rules in 1998 replacing its system of paying based on costs. Since then, nursing homes have billed for increasing therapy levels, a Journal analysis of their federal financial reports found. In 2002, nursing homes gave ultrahigh therapy to patients on about 7% of days they billed to Medicare; in 2013, they billed 54% as ultrahigh.  Medicare paid nursing homes about $28 billion in 2013, 10% more than it would have paid if the proportion of days billed at each therapy level had been the same as in 2008 and 24% more than if the proportions had mirrored 2002 billing patterns, according to a Journal analysis of payments.

Such therapy is delivered even when patients are unresponsive, aren’t likely to benefit or have declined such services, at times distressing vulnerable patients.  

 

WNEP reported a disturbing story about abuse and neglect at Watsontown Health and Rehabilitation nursing home.  Police are investigating claims of abuse which allegedly happened between a nursing home employee and resident.  Watsontown Health and Rehabilitation Center is home to around 125 vulnerable adults. One of those residents is a 76-year-old woman who was severely dehydrated, had a severe bladder infection and a sprained arm.

For her safety, the resident was moved to another care facility. Two employees were interviewed by police as part of the investigation. Both of those staff members are still employed.

 

HealthitOutcomes reported an interesting partnership between Yelp and ProPublica that is bringing medical information to the review site. Yelp will provide statistics for 4,600 hospitals, 15,000 nursing homes, and 6,300 dialysis clinics across the country, compiled by ProPublica from their own data and that of the Centers for Medicare and Medicaid Services (CMS). Updates will be provided quarterly.

As performance ratings and efficiency become increasingly important in healthcare, particularly with the Centers for Medicare & Medicaid Services (CMS) tying reimbursements to HCAHPS scores, public review sites are popping up to help consumers make the best decisions about their healthcare providers.

“Now the millions of consumers who use Yelp to find and evaluate everything from restaurants to retail will have even more information at their fingertips when they are in the midst of the most critical life decisions, like which hospital to choose for a sick child or which nursing home will provide the best care for aging parents,” Yelp CEO Jeremy Stoppelman said in a blog post.

The healthcare statistics will include:

  • Quality of doctor communication compared to state average in hospitals.
  • Whether hospital rooms are quiet at night compared to state average.
  • Emergency room wait times for hospitals.
  • Number of beds in nursing homes, as well as any fines paid out over the past three years and the number of serious deficiencies reported.
  • The number of dialysis stations in a particular clinic, and the rate of hospital readmission versus standard, and the rate of patient survival compared to the standard.

 

Sioux City Journal reported that Signature Care Centers, a for-profit chain of nursing homes, agreed to pay more than $415,000 to resolve allegations of false reports for Medicaid payments for the 2008 and 2010 fiscal years.

“This agreement signifies both the importance our office places on ensuring that all providers play by the rules and our office’s dedication to ensuring no federal money is misspent,” said Kevin Techau, U.S. Attorney for the Northern District of Iowa, in a press release