George Sumo Kpingbah, a Minneapolis nursing home aide at Walker Methodist Health Center  has pleaded guilty to the rape of a woman suffering from dementia and Alzheimer’s disease.  Kpingbah pleaded guilty to third-degree criminal sexual conduct for the assault that took place in December 2014. He originally pleaded not guilty in January.  Family members of the elderly rape survivor held hands in the front row as Kpingbah calmly nodded and said, “yes,” when asked to confirm that he inserted his penis in the woman’s vaginal area.

According to the criminal complaint, at 5:30 a.m. on Dec. 18, a nurse making rounds at the nursing home saw Kpingbah having sex with the victim, who was described as basically being in a comatose state. The woman said she saw Kpingbah standing between the victim’s legs pumping his groin area in and out of the victim’s legs about five times for 5-10 seconds.

The nurse said she knocked on the door and Kpingbah pulled back and placed the victim’s legs to the side. Kpingbah had no reason to be in the victim’s room. The nurse left the room and reported what she saw, the complaint states. A day after the rape, the elderly woman repeatedly pointed at her pelvic area and mumbled; and then cried after she was told that she was safe and her assailant was in jail, according to court documents.  The elderly woman’s attempt to communicate the rape, by pointing and mumbling, was evidence that she suffered emotional and psychological trauma despite her inability to articulate her thoughts, according to an affidavit from Dr. Ann Burgess, a psychiatric nurse and professor of mental health nursing at Boston College who has researched sexual assaults and dementia patients.

“What we had here was a woman suffering from extreme dementia — a disease that is taking away her mind — and her last shred of dignity was stripped away by this guy,” said Mark Kosieradzki , a Plymouth lawyer representing the rape survivor through her daughter, who is also her guardian. “We can’t turn back the clock on what happened here, but we can make a loud enough statement so that other people will think twice about doing this.”

McKnight’s had the below article discussing CMS’s arbitration related proposals.

A coalition of consumer groups and lobbyists, boosted by former U.S. Rep. Henry Waxman (D-CA), are calling upon the Centers for Medicare & Medicaid Services to “do the right thing” and end pre-dispute arbitration agreements.

AARP, the Fair Arbitration Now coalition and the National Consumer Voice for Quality Long-Term Care are among the groups that submitted formal comments and a petition to CMS Wednesday. They ask that the agency ban binding arbitration agreements from nursing home contracts. Wednesday marked the end of the 90-day comment period on CMS’ proposed regulatory update for nursing homes, which includes potential revisions to arbitration agreements.

The American Health Care Association also weighed in to say CMS should abolish the proposal but for a different reason. The agency is attempting to “exceed” its authority, AHCA’s top executive said.

“CMS’s arbitration-related proposals should be withdrawn,” wrote AHCA President and CEO Mark Parkinson in a prepared statement. “These proposals exceed CMS’s statutory authority and are not necessary to protect resident health and safety.

Waxman said the agreements need to be abolished because their sole function is to help nursing homes “evade accountability” for injuries and deaths caused by neglect and abuse.

“Once [residents] sign these agreements … they are giving away their rights to ever go into court against the nursing home,” Waxman told reporters during a press call Wednesday. “Nobody should accept denial of justice as the price for the care their loved ones deserve.”

The coalition argued agreements are often signed by residents or family who don’t fully understand the consequences of the pre-dispute arbitration, and are under stress from entering a nursing home. While CMS’ proposed revisions include making arbitration agreements more transparent and clearer, critics say it still wouldn’t be enough to protect nursing home residents.

Simply put, no amount of requirements placed on pre-dispute arbitration clauses could make this practice fair in the nursing home context,” said Marybeth Williams, public policy associate at the National Consumer Voice for Quality Long-Term Care.

On Wednesday, 27 House of Representatives members sent a letter calling for similar legislation against forced arbitration. Reps. Hank Johnson (D-GA) and John Conyers (D-MI) spearheaded the letter. A similar letter was sent by 34 senators to CMS last month.

Christine Benz is Morningstar’s director of personal finance and author of 30-Minute Money Solutions: A Step-by-Step Guide to Managing Your Finances and the Morningstar Guide to Mutual Funds: 5-Star Strategies for Success.   She wrote a great article with a number of statistics on long-term care: usage, costs, caregivers, insurance, and the role of government programs in paying for long-term care. Each statistic includes a link to its source material, and all of the facts and figures are based on U.S. data. She aimed to use the most current information possible, taken from objective sources.
Usage
8 million: Number of U.S. citizens experiencing difficulty with self-care/activities of daily living, 2011.
13 million: Number of adults who experience difficulty living independently, 2011.
44%: Percentage of men who will need long-term care during their lifetimes.
58%: Percentage of women who will need long-term care during their lifetimes.
8.5%: Percentage of individuals 65 years and older who said they spent at least one night in a nursing home in the past two years, 2010.
40%: Increase from 2000 to 2010 in the percentage of people 65 and older who said they spent at least one night in a nursing home in the past two years.
13.9%: Percentage of individuals 65 and over who said they used some kind of professional home health-care service in the previous two years, 2010.
50%: Increase from 2000 to 2010 in the percentage of people 65 and older who said they used some kind of professional home health-care service in the previous two years.
0.88 years: Average duration of nursing-home stay for men.
1.44 years: Average duration of nursing-home stay for women.
22%: Probability of needing more than one year in a nursing home, men.
36%: Probability of needing more than one year in a nursing home, women.
2%: Probability of needing more than five years in a nursing home, men.
7%: Probability of needing more than five years in a nursing home, women.
14%: Percentage of population age 71 or older who have dementia.
40%: Expected increase between 2015 and 2025 in number of people age 65 and older who have dementia.
64%: Percentage of nursing-home residents who have been diagnosed with Alzheimer’s or some form of dementia.Cost of Care
$17,904: Average annual cost for adult day care (five days/week), 2015.
$43,200: Average annual cost for assisted living facility, 2015.
$80,300: Average annual nursing-home cost, semi-private room, 2015.
$91,250: Average annual nursing-home cost, private room, 2015.
$182,500: Average annual nursing-home cost, private room, Manhattan, 2015.
$55,115: Average annual nursing-home cost, private room, Monroe, Louisiana, 2015.
4%: Five-year annual inflation rate in nursing-home costs, private or semiprivate room, 2015.
22%: Percentage of long-term-care costs that are paid out of pocket.
13.2%: Percentage of people who receive professional home health care who have long-term-care insurance coverage, 2010.
$5,518: Median total household wealth for people who have lived in a nursing home for six months or more.
$0: Median housing and transportation wealth for people who have lived in a nursing home for six months or more.
Caregivers
43.5 million: Number of adult family caregivers who provide care for someone older than 50 years of age.
14.9 million: Number of adult caregivers who provide care for someone who has Alzheimer’s disease or other dementia.
$450 billion: Estimated value of care delivered by unpaid caregivers, 2009.
66%: Percentage of caregivers who are female.
48: Average caregiver age.
70%: The percentage of caregivers who suffered work-related difficulties due to their caregiving-rules.

State and Federal Funding

51%: Percentage of long-term-care services that are paid by Medicaid.
28%: Percentage of Medicaid funding that went to pay long-term-care costs in 2013.
29.5%: Percentage of nursing-home entrants who were covered by Medicaid upon entry, 2010.
47.2%: Percentage of people who spent more than six months in a nursing home who were covered by Medicaid, 2010.
$119,220: Maximum amount of assets that a healthy spouse can retain for the other spouse to be eligible for long-term-care benefits provided by Medicaid, 2015. (Actual amounts vary by state.)
100: Days of care in a skilled nursing facility (“rehab”) covered in full or in part by Medicare following a qualifying hospital stay.
Insurance
8%: Percentage of all long-term care delivered in the U.S. that is covered by long-term insurance.
13%: Percentage of single individuals over 65 with long-term-care insurance.
$7.8 billion: Amount of long-term-care claims paid out in 2014.
71%: Increase in short-term-care insurance sales in the first six months of 2015 relative to the first six months of 2014. (Short-term-care insurance policies cover periods of one year or less.)
17%: Percentage of applicants ages 50-59 denied long-term-care coverage due to health issues.
45%: Percentage of applicants ages 70-79 denied long-term-care insurance due to health issues.
$2,170: Annual premium for a long-term-care policy for a married couple, both age 60, providing a total of $328,000 of long-term-care insurance coverage.
$3,930: Annual premium that the same 60-year-old couple would pay for a policy that includes an inflation-growth option and builds their benefit pool to a combined $730,000 at age 85.
8.6%: Percentage increase in cost of new long-term-care insurance policies between 2014 and 2015.
33.4%: Percentage rate increase requested by John Hancock Life Insurance in 2015 for long-term policies sold in Connecticut between 1991 and 2010. (Rate increases requested–and, in some cases, approved by regulators–in other states and from other insurers have ranged from 15% to 60%.)

 

Paul Bland, Executive Director of Public Justice wrote the below excellent article on the inherent unfairness of mandatory pre-dispute arbitration clauses hidden in nursing home admission paperwork.

John Mitchell, only 69 years old, was recovering from a stroke at a nursing home in Dennis, Massachusetts when — one week after he was admitted — staff dropped him while moving him from his bed to a chair. A call to an ambulance was made, but then cancelled when his vital signs seemed to stabilize. Later that night, John became unresponsive. After he was rushed to the hospital, doctors discovered that the fall had caused extensive bleeding in his brain; he died a few days later. It was only after his sons hired an attorney to investigate the circumstances surrounding their father’s death that they found — among dozens of pages in the admission contract signed by John’s guardian — a pre-dispute arbitration agreement.

Fortunately for John’s family, a court ruled the clause in their contract unenforceable. But that isn’t always the case.

John’s story underscores the reality that many new residents face. Nursing homes have complete control over some of the most vulnerable and fragile people in the entire country: people who are gravely ill, who are often cognitively impaired in ways that make it hard for them to protect themselves, are completely at the mercy of these institutions. Unfortunately, nursing homes are increasingly being taken over by huge corporate entities that are often driven more by profit than a sincere commitment to taking care of residents. Thousands of nursing homes across the country have been snapped up by large Wall Street companies. Sixty percent of the market is now occupied by for-profit entities, increasingly private equity groups. One report discovered that in 60 percent of the homes purchased, managers cut the nursing staff to the point where they were providing only one clinical registered nurse for every 20 residents.

Just as they’ve done in other parts of our economy, these giant corporations are using forced arbitration clauses — contract terms that say that people cannot sue them, no matter what laws they break, and instead people harmed by illegal acts can only bring cases before private arbitrators who are generally beholden to the corporations. These clauses make it far harder for the victims of mistreatment to hold a facility accountable where there’s abuse or serious negligence, and they minimize the incentive to provide the highest quality of care.

The Obama Administration is seriously considering doing something about this. The Centers for Medicare and Medicaid Services has an opportunity to say that nursing homes can no longer receive federal funding if they use arbitration clauses in their contracts. If CMS will take this step, it will return to the nation’s most vulnerable population their basic constitutional rights, and let people hold nursing homes accountable in case of abuse and neglect. My organization, Public Justice, just filed extensive comments with CMS urging it to take this opportunity to protect these vulnerable residents.

The Stakes are Huge. While millions of people get caring and competent treatment every day, there are times that the system fails disabled and often elderly nursing home residents in horrifying ways. Far too often, people who can’t move are left in one place for so long that they develop pressure sores, and then far too often, are left in their own excrement until the pressure sores become infected. There are other instances where people have actually been intentionally physically abused by people who never should have been put in charge of vulnerable patients. Our comments trace through a number of instances of genuinely horrific treatment, as do comments to CMS from a number of state attorneys’ general. Our comments also document in detail how neglect and mistreatment spread and expand when nursing homes are bought up by large Wall Street entities, and how harmful these corporate acquisitions are for real people who are completely dependent on the facilities for medical care, food, everything.

The circumstances surrounding admission to a nursing home are uniquely stressful. It’s often an emotionally devastating experience for both the patient and their family. These facilities are often a last resort for patients and families, and the decisions are often made under emergency circumstances. No sane person in that setting is going to be focused on the fine print of an admissions contract, looking to see if the facility is trying to gain some legal advantage and strip the patients of their rights. People are understandably thinking about different things, filled with other feelings. For nursing homes to use these painful moments as a chance to slip arbitration clauses past families is ugly and unreasonable, and the argument “well, everyone knowingly agreed to give up their right to go to court” is unrealistic.

Arbitration Clauses Enable Abuses. As our comments establish, nursing home industry consultants have openly acknowledged and other studies support that arbitration clauses reduce the liabilities of nursing homes. When liabilities are reduced, there is strong evidence that the quality of care gets worse.

In addition, unlike the public court system (where trials are open to the public, press and regulators), nursing homes benefit enormously from the secretive system of arbitration, where the facts about abuses can be (and often are) buried. “Confidentiality” provisions – which really translate into gag orders – and non-transparent, non-public handling make it easier for systemic problems to stay hidden, and to continue.

If nursing homes are permitted to continue opting out of the civil justice system, we can expect to see lower levels of care, and higher numbers of preventable injuries and deaths.

Now Is the Time. CMS has a historic opportunity to do something about this ugly, abusive practice. It should tell nursing homes that they can’t use arbitration clauses and still benefit from federal dollars. Protecting desperately vulnerable people is more important than squeezing out an extra percentage of profit for hedge fund owners.

This is not a problem that the government can solve on its own. CMS does some great work, but it doesn’t have the resources to police the thousands of nursing homes spread throughout the country. When patients are injured or die due to mistreatment or neglect, they and their families should be able to go to court to protect their own rights. It’s been the American system for hundreds of years that injury victims have a right to a day in court, and it shouldn’t be thrown overboard at the whim of some Wall Street guys who find secretive private judges a more congenial system.

Photo: Mark Phillips | Flickr

ABC News had an article about the careless indifference shown to Charles McCulloch who was found beaten in his bed a day after he was moved into the high-needs dementia ward at the Jindalee Aged Care Residence in January 2012.  The court was told when trained assistant nurse Bobby Joseph came to check on McCulloch, he found his body covered with a doona. When he pulled it back he found Mr McCulloch’s face was covered in blood and it was suspected he had been bashed.

Joseph told the court that when he discovered Mr McCulloch he was shocked and did not think to check his pulse. Joseph also said he did not think to check the room to see if anybody else was there. When Joseph returned with a RN, staff found a pillow over Mr McCulloch’s face and paper napkins shoved down his throat.

 

A coronial inquest is investigating how the incident occurred and whether the appropriate managerial policies and procedures were in place and followed at the time of the death.  Coroner Peter Dingwall has already raised concerns that staff did not immediately call police and left Mr McCulloch alone while they called a doctor to first determine how he had died.

The suspected killer, who lived in the same ward as Mr McCulloch, has since died. Questions have also been raised about the ease with which certain residents were able to move between wards, as another two residents were allegedly attacked on the same day as McCulloch was killed. This is the third coronial inquest into deaths at the aged care home.

 

The Exponent Telegram reported the horrific theft of medications from military veterans.  Zane Ray George, a nurse at the West Virginia Veterans Nursing Facility, didn’t administer nearly 500 oxycodone pills to six patients on 103 dates, instead stealing the powerful painkiller.  George was charged with six felony counts of obtaining a prescription for a controlled substance by false pretenses.

George, working at the nursing home for an outside hiring agency, began removing 5mg oxycodone pills multiple times a day starting Nov. 28 and lasting through mid-June, the complaint alleges.  “The defendant on (June 25) admitted to taking the medication, but was unable to specify how many or for how long,” Swiger alleged.

“The defendant has a code that is specific for him to be able to obtain medication and is only known by the defendant and also needs a finger swipe,” Clarksburg Police Officer Bill Swiger alleged. “The defendant was taking medication from different wings of the nursing home, outside of the area where the residents he (cared) for were located, which is not common practice.

WBTW reported the following:

Two nursing homes in the Grand Strand and Pee Dee areas have been named in a report for repeat violations of health or fire procedures.  Heritage Home of Florence, located at 515 South Warley Street, was named in the report, along with The Lakes at Litchfield, located at 120 Lakes at Litchfield Drive in Pawleys Island.

The Coalition for Quality Care, a national coalition that supports quality care, used federal inspection records to name the nursing homes which had three or more years of repeat health violations.

The violations for Heritage Home of Florence include failure to create individual health care plans for patients, improperly installed electrical wiring causing a potential fire hazard, and improper storage of food. The Lakes at Litchfield is documented for having improper storage of food.

Click here to see the full report and to look up specific violations for each home in South Carolina.

Oregon Live reported the $3 million jury verdict on behalf of the nurse– agreeing that she was wrongfully terminated by Legacy Good Samaritan Medical Center after she complained to management that cost-cutting measures were jeopardizing patient care.  Registered nurse Linda Boly said that she felt vindicated by the verdict. She hopes it sends a “big message” to Legacy Health System that “rushing patients through” the process endangers them.

Legacy contended that it fired Boly in June 2013 for “poor job performance”.  However, Boly had a stellar track record during her 34-year career at the Northwest Portland hospital.  From December 2012 to June 2013, Boly was written up three times for failing to meet productivity quotas and for “working off of the clock” by completing chart work at the end of the day. Boly contended that she was being singled out — disciplined when other nurses weren’t when they didn’t meet quotas or they worked off the clock.

Legacy managers all the way up to the top were getting bonuses for staying within budget. In 2013, the year Boly was fired, Legacy CEO Dr. George Brown received a $340,000 bonus, on top of a base salary of about $960,000, according to Legacy’s tax records.  Meanwhile, Legacy Health System — which includes Legacy Good Samaritan, Legacy Emanuel Medical Center in North Portland, Legacy Mount Hood Medical Center in Gresham and others — was working on overdrive to rein in its biggest expense: its staffing cost.  In late 2011, Legacy announced plans to reduce its workforce by 400 employees.

“I think Legacy’s behavior was shameful,” Boly’s attorney said. “…People need to trust when they go through the door of Good Samaritan that the nurses have the time to do the work they need to deliver safe patient care. I think there needs to be a top to bottom review, and there needs to be a change.”

A 12-person jury awarded Boly $916,000 in lost wages up until a retirement age of 67, $625,000 for emotional distress and $1.5 million in punitive damages. Under Oregon law, 70 percent of the $1.5 million in punitive damages will go to the state.

On top of that, Legacy will be ordered to pay Boly’s attorney’s fees.  Boly is now a nurse at Providence St. Vincent Medical Center.

Fox2Now reported the devastating conduct of Robert Leensvaart against a vulnerable adult in his care at the Crystal Oaks Nursing Home.  Leensvaart is a nurse’s aid at the Crystal Oaks Nursing Home. Leensvaart is accused of fondling a 92-year-old woman’s bare breast about 100 times.   He was caught lying in bed with the victim on February 19th, according to the probable cause statement. He told investigators that he found her attractive. Police say he admits to fondling the elderly woman’s breast many times before he got caught.  Leensvaart is charged with first degree sexual abuse. The victim is in the late stages of Alzheimer’s.

Crystal Oaks Nursing Home Administrator James Amold tells police that the victim would not be able to give or refuse consent. The victim’s condition is described as being, “retracted.” She is suffering from Alzheimer’s disease and curled up almost in a fetal position.

The Green Bay Press Gazette reported that a caregiver is accused of sexually assaulting a 76-year-old patient at Rennes Health & Rehab Center nursing home.  Theodore William Schartner is charged with two felonies: second-degree sexual assault, and intentionally subjecting an individual at risk to abuse, according to a criminal complaint.

The complaint alleges that Schartner entered the room of a rehabilitation patient the night of Sept. 15 as she tried to sleep. He measured her blood pressure and then allegedly began touching her inappropriately with his bare hands. The woman yelled, “you get your hands off me” and “Get out of here and don’t come back,” the complaint states.

The woman reported the incident the following morning to another staffer at the facility. Rennes officials suspended Schartner and notified police the same day, according to the complaint.

“What’s particularly (disconcerting) is that he was trusted to care for this victim, and he violated that trust,” prosecutors said. He said Schartner assumed the victim suffered from dementia and would not be believed if she reported the assault.

“But this victim,” Dorsey told Hock, “does have full mental capacity.”