NJ.com reported that Todd Fulton, a nursing home caregiver has been charged with sexually assaulting an elderly female patient.  A grand jury returned a three-count indictment charging Todd Fulton with aggravated sexual assault, sexual assault and official misconduct for his alleged attack on a resident of the Geraldine Thompson Nursing Home.

Fulton was a certified nursing assistant at the facility, which at the time had been owned and operated by Monmouth County.

The investigation started on April 4, 2015, after a female patient said she had been sexually assaulted by a staff member, the prosecutor said. Administrative staff at the nursing home contacted Wall Township police, he said.

 

Democrats reintroduced federal legislation aimed at limiting the use of forced arbitration clauses, arguing they prevent Americans from seeking justice through the court system. U.S. Sens. Al Franken, D-Minn., and Patrick Leahy, D-Vt., along with U.S. Rep. Hank Johnson, D-Ga., introduced the Arbitration Fairness Act of 2017.

The legislation, previously introduced in 2011 and 2015, would eliminate forced arbitration clauses in employment, consumer, civil rights and antitrust cases. The Arbitration Fairness Act, like the Federal Arbitration Act’s original intent, would require agreements to arbitrate employment, consumer, civil rights or anti-trust disputes be made after the dispute has arisen. The bill would not prohibit arbitration, but instead ensure that individuals have a meaningful choice about how to proceed with their claim.

“For years, I’ve been fighting to re-open the courtroom doors to consumers, workers, and small businesses in Minnesota,” said Franken, a member of the Senate Judiciary Committee. “Our legislation, the Arbitration Fairness Act, would help restore everyday Americans’ right to challenge unfair practices in court and ensure meaningful legal recourse.

“We’re at a point where big corporations can write their own rules and insulate themselves from liability for wrongdoing. That needs to change.”

“Forced arbitration closes the courthouse doors to Americans wishing to seek justice for a variety of civil claims, including sexual harassment and workplace discrimination,” Johnson said. “These arbitration clauses are often unwittingly entered into by consumers when they sign everyday contracts such as cell phone, car rental, credit card and nursing home agreements to name a few.”

The Georgia congressman argues forced arbitration undermines fundamental rights and protections guaranteed by the Constitution, federal and state law.

Contrary to popular belief, arbitration decisions are final, binding, non-appealable, and strongly in favor of corporations,” he said. “The result is a secretive and rigged process that prevents citizens from exercising their fundamental 7th Amendment right to a trial by jury.”

Leahy agreed.  “These dangerous provisions force us to abandon our Constitutional right to protect ourselves in court, and instead send hardworking Americans to face wealthy corporations behind closed-doors in private arbitration,” he said. “This must change.”

 

 

 

The use of antipsychotic medication in nearly 100 Massachusetts nursing homes was significantly reduced when staff was trained to recognize challenging behaviors of cognitively impaired residents as communication of their unmet needs, according to a new study led by Jennifer Tjia, MD, MSCE, associate professor of quantitative health sciences. See article at News Medical.  Results of the study were published in JAMA Internal Medicine on April 17.

This study examined the rate of off-label antipsychotic use in 93 Massachusetts nursing homes enrolled in the OASIS intervention from 2011 to 2013, compared to 831 nursing homes in Massachusetts and New York who were not using that program, (although some were using a different reduction program.) Among OASIS facilities, the prevalence of antipsychotic prescriptions was cut from 34 to 27 percent after nine months, a 7 percent drop. At the comparative facilities, the prevalence of those drugs was cut from 23 to 19 percent; a 4 percent drop. No increases in other psychotropic medicine or behavioral disturbances were observed. Over the maintenance period of the intervention, however, the decreases did not continue.

This is the largest study to show that it is possible to reduce antipsychotic use in the nursing home population,” said Dr. Tjia. “This intervention focused on treating the residents as human beings with needs, not as patients with problems. We don’t medicate babies when they cry or act out, because we assume that they have a need that we need to address. However, when people with dementia are unable to communicate, the current approach medicates them when they have undesirable behaviors.”

The off-label prescription of antipsychotics for nursing home residents with dementia is common and dangerous, despite numerous studies that have shown it increases risk of stroke and death and is only minimally effective in controlling behavioral symptoms of dementia.

“The OASIS program asks nursing staff to create care plans that include what residents can do, shifting away from the model that focuses on what they can’t do,” Tjia said. “This is a fundamental shift in how to think about caring for persons with dementia and we showed that it is effective.”

“Since 1987, no fewer than 11 controlled studies have been published that report varying efficacy in reducing antipsychotics in nursing homes using a variety of approaches. The largest successful intervention enrolled 12 nursing homes; however, it was time and resource intensive. In contrast, the OASIS program reached almost 100 nursing homes, and was effective,” Tjia said.

Tjia said nursing homes using the OASIS program need to reinforce training periodically to maintain success at reducing the rate of antipsychotics.

The Herald-Standard reported the assault of a nursing home resident by a certified nursing assistant.  Ryan M. French worked as a certified nursing assistant at Havencrest Health and Rehabilitation Center nursing home. French was charged with
assaulting a 75 year old resident.

Township police Officer Robert Tekavec said he was called to the nursing home on Jan. 28 to investigate the alleged assault. Police alleged French assaulted the man because he took French’s Red Bull energy drink. In a statement to risk management director at the facility, French said that the man swung at him first, according the affidavit filed with the case.

Tekavec indicated in court papers that the alleged victim had buttons missing from his shirt and red marks on his neck, face, arms and leg.  When he talked to the alleged victim and his daughter, Tekavec wrote, the two were initially reluctant to press charges.

 

The St. Louis Dispatch reported on the guilty plea of Johnnie Mac Sells, owner and operator of Benchmark Healthcare that has a history of neglect and deficiencies.  A Post-Dispatch investigation in September showed how Benchmark Healthcare, a nursing home on Highway TT, became a dirty and dangerous place as Sells, its president, faced a mountain of debt.

Bills went unpaid. The phones were shut off. Paychecks bounced. Trash piled up. Flies swarmed. And food deliveries stopped. A patient advocate described the situation as “a disaster.”

How did conditions get so bad at a Festus nursing home that the state needed to rescue 60 residents?

That question was finally answered in federal court when Sells admitted he stole more than $667,000 from Medicaid and spent much of it on strippers, gambling, pet care and country club fees.

Prosecutors revealed that for three years starting in 2013, Sells stole a large portion of funds provided by Medicaid for Benchmark residents, jeopardizing their health. During periods of 2014 and 2015, Sells used Benchmark’s debit card to pay $185,000 at adult entertainment clubs and $15,000 on pet care. He also spent $4,500 at casinos and $12,000 at his country club.

He wrote company checks and made wire transfers totaling $439,000 into his personal accounts, separate from “the substantial salary that he was paid by Benchmark.” He also transferred $153,000 to a close relative.

Sells pleaded guilty to two counts of health care fraud. The accusations were first made public at the hearing. He could face 37 months in prison at sentencing, set for July 25. He also will have to pay back the money.

 On Sept. 13, the state finally took the rare step of closing the nursing home and relocating 60 residents to other facilities.

Sells was charged with domestic abuse and sexual misconduct. According to prosecutors, he slammed his girlfriend through a glass coffee table and exposed his genitals to her 12-year-old son.

 

The Augusta Chronicle reported the settlement between James M. Mason and his family and the Augusta nursing home The Place at Deans Bridge Road.  Mason was admitted to The Place at Deans Bridge Road on Sept. 24, 2012. He was 62 and in need of skilled nursing care.  Mason developed urinary tract infections, injuries from numerous falls, dehydration, weight loss and renal failure. After he was hospitalized with pneumonia in September 2015, his family Mason moved to Golden Living. He died Nov. 3, 2015.

The litigation against the owner/operator Golden Living Center and its nursing home administrator Elize Joseph continues. The family alleged that neglect led to a Mason’s injuries and suffering by putting corporate profits above patient care by not staffing at adequate levels to provide residents proper care.

Harris agreed to a one-time lump sum payment, the amount is to remain confidential under the agreement. Attorney fees and court cost, and medical expenses for his father will come out of the settlement payment.

Sexual assaults are among the most severe cases against residents of nursing homes. However, it is also the least detected, reported, and acknowledged type of problem in this institution.  The University Herald reported on a new study that found sexual assault is prevalent in nursing homes. However, this issue has been very under-reported to the point of being ignored.  The study observed 15 past studies in peer-reviewed journals that focus on the topic of sexual assaults on nursing home residents.

Moreover, white females suffering mental and physical conditions are more likely to be victims, since they are the most vulnerable. The study, published in “The Gerontologist” found that these sexual assaults happen because legal examinations aren’t done regularly due to administration complexities, Eureka Alert reported. Training and institutional policy in these nursing homes are also major problems that propagate the cases of sexual assaults. Ultimately, nursing homes are not equipped adequately to stop these sexual assaults.

 

The study suggests that nursing home staff should have more training to help them identify and handle these sexual assault cases. The study’s authors said there is a gap in knowledge about sexual assaults, which is why staff should be trained.

According to Monash University’s Daisy Smith, who is also the lead author, there is a lot more that is needed to be done for those that are most vulnerable in these nursing homes. Regulatory investigative personal doesn’t have the right resources to properly identify and handle these cases of sexual assaults in nursing homes, said Smith.

The New York Times reported the Trump Administration’s attempt to take away poor and elderly Americans right to compensation when they are victims of medical malpractice or defective drugs or medical devices under a bill drafted by House Republicans as part of their plan to replace the Affordable Care Act.

The bill would set a $250,000 limit on “noneconomic damages,” which include compensation for pain and suffering, permanent impairment, scarring, mental anguish etc.

The bill would impose new arbitrary limits on lawsuits involving care covered by Medicare, Medicaid or private health insurance subsidized by the Affordable Care Act. The limits would apply to some product liability claims, as well as to medical malpractice lawsuits involving doctors, hospitals and nursing homes.

Kimberly A. Valentine, a lawyer in Orange County, Calif., who has represented scores of nursing home residents, said the House bill “would make it much more difficult for victims of elder abuse to seek redress and would eliminate one of the most powerful tools we have to improve care in nursing homes.”

 These arbitrary limits would not reduce health costs, increase access to care, or save taxpayers any money.  The only things it will do is limit restitution and increase malpractice. Several studies suggest that litigation costs, including damage awards, legal fees and the alleged effects of “defensive medicine”, may represent only 2 percent to 2.5 percent of national health spending.

The bill would also restrict the ability of victims to contract with lawyers in clear violation of the Constitution. Why is the government involved in a private contract between attorneys and their clients?

Sarah Kliff at Vox had a great article on the GOP’s new proposal to automatically enroll people without insurance into high-deductible health plans. Sens. Bill Cassidy (R-LA) and Susan Collins (R-ME) included the idea in their Obamacare replacement plan. The Senate Finance Committee also has a health care plan called the Patient CARE Act that envisions an auto enrollment feature to scoop up the people who don’t buy coverage themselves.

Republicans disagree with a mandate but can agree on automatically enrolling people into a health plan that they did not choose?

A short summary of how the plan would work:

Lawmakers could require insurers to offer products whose premiums match the value of the federal tax credits. If the basic, age-adjusted federal tax credit for a 40-year-old man in a given state is, say, $3,000, then every insurer in the state would have to make a policy available for such customers with a $3,000 premium.

Insurers would adjust the upfront deductibles in these plans as necessary to ensure that the premium equals the credit. Most consumers in the individual market would thus have the option to get an insurance plan with no cost to themselves. This no-premium coverage would necessarily have higher deductibles than costlier options, but it would provide financial protection against expensive medical claims, which is the primary purpose of insurance.

There are major problems with this proposal including that no system exists to track who is uninsured, and it would be tough to build it, and the health care plan would not cover anything.

 

 

Secretary Tom Price had a strange and somewhat incoherent interview with CNN’s Dr. Sanjay Gupta.

Here are the most insane moments of their interview:

#1 – Price refused to admit that it “defies common sense” to strip away $1 trillion from healthcare funding when Trump promised to get all Americans insured with the government’s help.

#2 – Price declared that Medicaid patients are only concerned about losing their Medicaid because they are afraid of something “new.”

#3 – Price struggled to defend efforts to gut the requirement for essential health benefits, which provide coverage for things like hospitalizations, maternity care and prescription drugs, offering such sweeping generalities that the only reply Dr. Gupta could offer was, “I don’t know what that means.”

#4 – Price could not refute Gupta’s assertion that TrumpCare would legalize healthcare “plans that are cheap but useless.”

#5 – Even though the TrumpCare plan he tried to push through Congress would put insurance out of reach for 24 million people and repeal the individual mandate, Price proved himself utterly divorced from realty by agreeing that “absolutely,” everyone should have insurance.