Newsday reported that the director of nursing services at Woodmere Rehabilitation and Health Care Center was sentenced to a conditional discharge after a felony conviction for falsifying records.

Riadel Manzano will be barred from working for any health care programs the government funds and faces losing her nursing license.

Prosecutors charged that Manzano knowingly gave a Department of Health investigator a record showing the home’s nursing staff had monitored a patient as required.  However, the patient seriously injured after repeatedly falling when he was not being monitored.  After one fall, he had to be hospitalized and his head wound required stapling, he said.

 

Donald Pressley has been charged with first-degree murder for allegedly killing his year old roommate at Anson Health and Rehabilitation nursing home.  Police said Pressley brutally beat Bill Hooks, an 89-year-old Air Force veteran.  It is unclear why no one at the nursing home was able to stop the assault.

Police responded on Aug. 14 after one resident reportedly beat another who was placed in the same room.  After 10 days in the hospital, Hooks died from his injuries.

As the investigation continues, Eyewitness News anchor Liz Foster looked into the facility’s history and learned state and federal inspectors have cited the nursing home multiple times, including for incidents involving violent behavior.

Just last year, state inspectors found numerous deficiencies, including faliure to “follow the plan of care for evaluation by a mental health provider to address assaultive behavior,” and “obtain a psychiatric consultation as ordered to address an unnamed resident’s assaultive behavior.”

The federal government has fined the center twice in three years, totaling more than $83,000.

“I don’t think it’s a safe environment, and I don’t think it has been for quite some time,” Anson County resident Ann Poplin said.  “I think somebody needs to go in with a close eye and figure out who’s doing their job and who isn’t and get rid of the ones who aren’t,” Poplin said.

 

NJ.com reported the tragic case of Anna Burkhart who developed a large, painful and deadly bedsore while in the care of staff at Oradell Health Care Center.  Burkhart was accepted by Oradell after she suffered a fractured right hip on Oct. 30, 2015.  Oradell either failed to notice or ignored the bedsore as it developed and grew.

Burkhart was kept in a hospital bed in Oradell for 100 days – until her insurance ran out.  Then Oradell discharged the woman, the family brought her home and discovered she was suffering from the sore on her sacrum or lower back.

They rushed her to the hospital, where doctors determined the bedsore, called a Stage 4 decubitus ulcer, had festered for so long that Burkhart had developed fatal sepsis.

The suit alleges “reckless indifference and deliberate disregard” and contends the center violated the New Jersey Nursing Home Responsibility and Rights of Residents Act.

“There was inadequate staff supervision, understaffing and the intentional underutilization of critical services,” the lawsuit states.

New York Magazine had an article explaining how and why ObamaCare has survived Trump’s reckless attempts to sabotage the market.  for the last seven years, Republicans have stated that Obamacare was “collapsing,” “on its last legs,” in “a death spiral.”

Trump did what he could to destabilize the insurance market including actively discouraged Americans from seeking insurance through the exchanges.

Obamacare has proven strong enough to withstand judicial challenge, legislative attack, and administrative sabotage: Every county has insurer for its exchange, as CareSource  agreed to provide coverage to the good people of Paulding County, Ohio.

The source of Obamacare’s resilience appears to be twofold:

(1) Even in red America, state-level officials did not want to see their health-care markets fail, and they worked to convince insurers to cover less desirable areas.

This last point was likely the most significant. As Vox’s Dylan Scott explains:

[Obamacare] provides financial assistance for people making 100 percent of the federal poverty level (about $12,000 for an individual) up to 400 percent (about $48,000). It caps the premiums that people have to pay at a certain percentage of their income; the less money you make, the lower the premium you have to pay.

So in an empty county, where an insurer doesn’t have to worry about a competitor undercutting them, companies can set premiums to cover their costs without worrying that they’ll price their coverage too high for many of their customers. It’s going to be the federal government, not a person with a subsidy, picking up much of the extra cost.

Anytime one insurer decides to leave a county fully abandoned, another will see an opportunity to establish a federally subsidized monopoly in its place.

NPR had a story on Trump’s reckless decision to side with industry over nursing home residents making it almost impossible for nursing home residents to get their day in court.

Trump is allowing nursing homes to require residents sign arbitration agreements as a condition for getting nursing home care.  “That means that no jury will ever hear his case. The parties hire a private judge and use a different set of rules that can be more restrictive than civil court. Studies also show that awards to plaintiffs can be as much as 35 percent lower.”

That’s why 17 state attorneys general and 31 members of the Senate have urged the Trump administration not to adopt the proposed rule. Arbitration procedures are generally more secretive than civil court. So they’re not just bad for the plaintiff, they’re also bad for everyone else whose victimization could’ve been stopped if they’d have known that this was a bad facility.

NJ spotlight reported the passage of “Peggy’s Law” which require nursing homes to notify the police within hours of suspected abuse — or staff must make 911 call if situation is an emergency.  This seems like it should have been required long ago.

Starting soon, elderly residents in New Jersey’s nursing homes and other long-term care facilities will benefit from additional protections designed to ensure law enforcement is looped into possible criminal abuse cases right from the start.

The measure is named for 93-year-old Peggy Marzolla who died several months after being injured while in the care of a nursing home in 2010.  Marzolla was treated for a broken eye-socket, cheekbones, and wrist, among other injuries, which nursing home staff blamed on an accidental slip and fall. Marzolla’s family didn’t accept the excuses she got from staff and was displeased with the state’s follow-up, leading her to lobby lawmakers to better protect seniors — a campaign she has continued ever since.

The Corporate Whistleblower Center is launching an ambitious initiative to assist a nursing home or skilled nursing facility employee to potentially get rewarded if they possess proof their employer is gouging Medicare for hours never worked or billing Medicare for services never rendered.

The group believes nursing homes or skilled nursing facilities billing Medicare for hours never worked by staff is a huge national problem and they believe these practices are easy to prove. The group refers to this specific type of practice as ‘short staffing’ and they are convinced the potential whistleblower with proof of these types of practices could get a substantial reward as they would like to discuss anytime at 866-714-6466. http://CorporateWhistleblower.Com

As an example of what the Corporate Whistleblower Center is referring to, in June 2017the Justice Department announced a national healthcare company that specializes long term care agreed to pay the federal government $53 million dollars over allegations that the company or their affiliates violated the False Claims Act by causing the submission of false claims to government health care programs for medically unnecessary therapy and hospice services, and grossly substandard nursing care.

More specifically, the settlement resolves allegations that the healthcare company violated certain essential requirements that nursing homes are required to meet to participate in and receive reimbursements from government healthcare programs and failed to provide sufficient nurse staffing to meet residents’ needs. In this instance, the whistleblowers will receive a million dollar+ reward for their information.

The Corporate Whistleblower Center says, “We provided this recent Department of Justice whistleblower reward information if for no other reason to demonstrate how significant federal whistleblower rewards can be. We would be very happy to hear from a nurse manager or employee of a nursing home or skilled nursing facility with proof of their employer billing Medicare for hours never worked by staff, and or billing Medicare for medical procedures or therapy that never took place over the last three or four years.

“If you possess this type of information and your information is detailed please call us anytime at 866-714-6466. This type of information could produce whistleblower rewards starting at about one hundred thousand dollars and go up based on how widespread the wrongdoing is, and the level proof on the part of the whistleblower. If we are talking about a whistleblower that has proof of numerous nursing homes or skilled nursing facilities engaged in overbilling Medicare for staff hours never worked or for medical procedures that never happened the reward potential increases dramatically as we would like to discuss. Why sit on a winning lotto ticket without ever knowing what it might have been worth?” http://CorporateWhistleblower.Com

Simple rules for a whistleblower from the Corporate Whistleblower Center: Do not go to the government first if you are a major whistleblower. The Corporate Whistleblower Center says, “Major whistleblowers frequently go to the government thinking they will help. It’s a huge mistake. Do not go to the news media with your whistleblower information. Public revelation of a whistleblower’s information could destroy any prospect for a reward. Do not try to force a company or individual to come clean stark on anti-kickback laws or overbilling Medicare. Come to us first, tell us what type of information you have, and if we think it’s sufficient, we will help find the right law firms to assist in advancing your information.”

The Corporate Whistleblower Center is the premier advocate for whistleblowers in the United States. Unlike any group in the US, they can assist potential whistleblowers with packaging their information and providing the whistleblower with access to the most accomplished whistleblower attorneys in the nation. For more information, potential whistleblowers can contact the Corporate Whistleblower Center at 866-714-6466 or visit http://CorporateWhistleblower.Com

For information about Medicare’s required staffing levels at nursing homes please refer to their website on the topic:  https://www.medicare.gov/NursingHomeCompare/About/Staffing-Info.html

 

The New York Times reported on Trump’s decision to abandon a rule that would have protected nursing home residents from injuries caused by substandard care, abuse or neglect.  Trump will now allow nursing homes to require residents to waive their constitutional right to a jury trial by requiring the residents to sign mandatory pre-dispute arbitration clauses as a condition of admission to the home.

“About half of nursing home residents have Alzheimer’s disease or other dementia, according to the National Center for Health Statistics, and consumer advocates say harried family members could easily miss the arbitration clauses as they move a loved one into a home offering care.”

The attorneys general of 16 states, led by Brian E. Frosh of Maryland and Xavier Becerra of California, and consumer advocates strongly opposed the Trump administration proposal.  Thirty-one senators, led by Ron Wyden of Oregon and Al Franken of Minnesota, both Democrats, also objected to the Trump administration proposal. With Medicaid and Medicare spending more than $80 billion a year on nursing home care, they said, nursing homes should not be able to cover up wrongdoing by forcing patients to relinquish the right to sue.

Long-term care ombudsmen, who receive federal funds to serve as advocates for nursing home residents in each state, are skeptical of the new initiative. “The proposed rule would undermine the rights of people living in nursing homes — rights established in a 1987 law,” said Patty Ducayet, the Texas ombudswoman, who is a state employee.

Health in Aging reported on new research published in the June 2017 issue of the Journal of the American Geriatrics Society.

Medical experts know that older adults who have dementia or other mental health concerns that impact thinking or decision making should avoid certain “potentially inappropriate medications” (PIMs). PIMs can worsen confusion and raise the risks for falls, fractures, and even death, particularly for people with complex health needs.

PIMs may include treatments like:

  • Benzodiazepines (medications sometimes called “tranquilizers” and used to treat sleep problems, anxiety, or to relax muscles)
  • Antipsychotics (medications sometimes used to address mental health conditions)
  • H2-blockers (medications sometimes used to decrease the production of stomach acid)
  • Anticholinergics (medications that block a substance called acetylcholine, a “neurotransmitter” that transfers signals between certain cells to impact how your body functions. Anticholinergics have been used to treat several different conditions, including incontinence and chronic obstructive pulmonary disorder, or COPD).

Researchers investigated how often healthcare providers prescribed PIMs to older adults living with dementia or other mental health concerns in nursing homes. The research team discovered that 44 percent of people with dementia or cognitive impairment were taking a PIM. The frailer the person, the more likely they were to be taking a PIM.

After admission to a nursing home, many residents who were initially prescribed PIMs stopped taking PIMs:

  • 5 percent stopped taking antipsychotic medications.
  • 3 percent stopped taking benzodiazepines.
  • 9 percent stopped taking H2-blockers.
  • 2 percent stopped taking medications with anticholinergic properties that worsen memory or thinking.

A smaller percentage of study participants–from 1.2 percent to 10.9 percent, depending on the specific medication–were newly started on PIMs in the nursing home. Antipsychotics and benzodiazepines were the most frequently prescribed PIMs.

The researchers concluded that many nursing home residents with dementia or other cognitive impairments enter nursing homes on PIMs. They also concluded that PIMs are more likely to be prescribed for frail older adults after admission. The researchers suggested that strategies for a person-centered approach to discontinuing PIMs should be encouraged, especially for frail older adults.

It’s also important to remember that “potentially inappropriate medications” are just that: potentially inappropriate. They should be considered carefully before use, but that doesn’t mean that they should never be used in all cases or for all older people. If you have been prescribed a PIM or if you’re concerned about the way a treatment may affect your health, be sure to speak with your healthcare provider first before changing your routine or stopping the use of specific medications.

New York Magazine reported on a proposal to allow people to pay for Medicaid instead of requiring them to purchase insurance coverage on the insurance market.

Allowing states to offer Medicaid as a public option would certainly make health care more affordable for those buying insurance on the individual market. It would also help control health-care costs, since the program’s reimbursement rates would be lower than those of a typical insurance provider.

As Vox reports:

Schatz’s bill would give all states the option of opening up their Medicaid programs to uninsured Americans who wish to purchase coverage. It would be similar, functionally, to how states currently have the option under Obamacare to expand their program to all Americans making less than 133 percent of the federal poverty line (about $15,000 for an individual).

It would preserve Medicaid as is for the low-income Americans who already are enrolled on the program. But it would let those who are currently too high-income to qualify pay a premium to join the program. Those who qualify for Affordable Care Act tax credits would be able to use the subsidies to buy into the Medicaid program, just as they do right now to buy private coverage on the marketplace. That would make Medicaid into the Affordable Care Act’s public option, creating another insurance plan in markets with few or no private plans and putting private payers in competition with the much cheaper Medicaid system.

Incredibly, Medicaid buy-in would achieve all this without requiring tax increases; throwing anyone off their employer-provided plans; or, even, negatively altering the health-care systems in any way.