Author Archives: Ray Mullman

McKnight’s reported that a judge has ordered the appointment of a special prosecutor to investigate an $80,000 wire transfer from a nursing home owner to a former state senator’s construction company — money that allegedly moved just days after the lawmaker introduced an amendment to limit negligence claims in Arkansas.

Sebastian County Prosecutor Dan Shue asked for an outside investigator to avoid any potential conflict of interest. The Times-Record also reported that Shue has asked the local U.S. Attorney to determine whether the wire transfer violated any federal law.

Jake Files (R), the one-time Fort Smith lawmaker at the center of the case, pleaded guilty in January to unrelated charges and is scheduled to be sentenced June 18. He faces counts of wire fraud, bank fraud and money laundering in relation to improper use of state improvement funds intended for a local sports complex.

The Times Record first discovered the 2014 nursing-home related transfer in civil court documents last year.

The money came from David Norsworthy, part owner in a dozen Arkansas nursing homes. It followed on the heels of a constitutional amendment that sought to limit damage lawsuits — like negligence claims commonly pursued against nursing homes — to $500,000.

That amendment failed then, but it found new life in the current session, before Files resigned in January.

Neither Files nor Norsworthy have explained the $80,000 transfer with media or in court.

The Arkansas Times reports the case has become an issue for those who support  limiting lawsuits through Issue 1, a bill that has been publicly backed by nursing homes, doctors and chambers of commerce.

Fox25Boston reported a tragic incident that occurred at a Rhode Island nursing home.  Frank Palin, age 67, was arrested for sexually assaulting a patient with dementia in a nursing home. Palin is charged with a single count of indecent assault and battery on a person over age 65, stemming from an incident through his work with Old Colony Hospice.

According to the police report, on May 19th, Palin showed up to Cornerstone without an appointment, asking and employee to unlock the secured facility where the victim stays.  According to authorities, the woman’s children had installed a video camera inside her room, so they could check in on her, which helped them find out what was happening.

Palin is a contract employee with Old Colony but was working as a nurse practitioner at Cornerstone at Canton, where the victim is a resident of the facility. She reportedly suffers from dementia and lives in the memory care unit at Cornerstone.

Bob Larkin, the president of Senior Living Residences, the management company in charge of operations at Old Colony Hospice and Cornerstone at Canton, issued the following statement on Friday afternoon:

“The alleged violation of a vulnerable elder is appalling beyond words. We support the victim’s family and the police department in seeking criminal prosecution to the fullest extent of the law. Nothing is more important to us than the safety and well being of our residents. The accused nurse practitioner was not an employee of our company; he worked for a third-party local hospice agency that has no contractual or other relationship to our assisted living community. Any questions about the individual’s employment or exact duties should be directed to his employer, Old Colony Hospice in West Bridgewater, 321 Manley St, West Bridgewater, MA,  781-341-4145. Also please call the Canton Police for any information about the ongoing investigation. Please note, HIPAA patient privacy and confidentiality standards preclude me from providing specific information about any resident. “

Western Slope Now had an interesting article on a new treatment at the Palisade Life Center.  The nursing home is taking Alzheimer’s and Dementia treatments line by line and stanza by stanza.  They’re using poetry to exercise the minds and creativity of the patients in their care.  The group meets once a week to create poems, reaching back into their memories and emotions in a way to express themselves and communicate.

“You can really just see it in their eyes when things are clikcing and coming together,” Caleb Ferganchick, the life engagement coordinator at the center, said, “it allows them the space to share their memories in a structure way to engage and structure conversation that they otherwise wouldn’t be able to do themselves.”

“Actually stimulating the brain,” Jennifer Sims, the specialty programs director for Sava Senior Care, the parent company for the facility in Palisade, said, “Our brain is no different than a muscle in that sense that  if we use it, it’s going to slow the progress of the disease.”

The poems have been created into a book for a self-published collection.

“We took all of the poems we created and we created kind of an anthology called “My Father is in the Arbor” Ferganchick, who started the poem program, said. “It’s named after one of the poems in the book that I really liked.”

The book is for sale online at http://www.blurb.com/b/8750722-my-father-is-in-the-arbor

The profits benefit the residents in the Alzheimer’s and Dementia facility at the Palisade Life Center.

Politico had an article about Trump’s continued attempts to sabotage Obamacare.  The Trump administration asked a U.S. District Court in Texas to strike the most popular part of Obamacare.  “Republicans who have tried to repeal Obamacare for nearly a decade believe the Trump administration is reviving a politically risky battle with a court filing that could eliminate one of the most popular parts of the law: protections for people with pre-existing conditions.”  The Trump administration wants a federal court to strike the protections despite their popularity and the needed protection against insurance companies unfair practices.

Few congressional Republicans agree with the Trump administration and none rushed to defend the administration’s move, instead emphasizing their support for preserving pre-existing condition protections.  “I’m not going to have to defend anything I don’t agree with — regardless of who says it,” said Rep. Phil Roe of Tennessee when asked if he would defend the administration’s request on the campaign trail this fall.

Sen. Susan Collins of Maine — one of three GOP senators who blocked the Obamacare repeal effort last year — also pushed back, warning the administration’s new bid “exacerbates our current challenges” and could undermine key patient protections.

In 2017, “I introduced [an amendment that] would guarantee coverage for pre-existing conditions. I think that’s a pretty essential pact with the American people,” said Rep. Tom MacArthur (R-N.J.). “We need to let them go forward and see if it goes anywhere. Right now they’ve simply made an appeal to the court.”

The insurance industry has already blamed the Trump administration of increased premiums because of decisions to undermine the health law, such as cutting off a key subsidy program to help low-income people pay their out-of-pocket health expenses.

“The insurance industry trade group America’s Health Insurance Plans swiftly broke with the Trump administration Friday, warning that eliminating Obamacare’s major protections would be “destabilizing” to the market and drive premiums even higher. AHIP signaled it will file an amicus brief in the case, officially siding with the blue states that have stepped in to defend the law’s constitutionality.”

“Removing those provisions will result in renewed uncertainty in the individual market, create a patchwork of requirements in the states, cause rates to go even higher for older Americans and sicker patients, and make it challenging to introduce products and rates for 2019,” the group said in a statement.

Naples News had a great article on a growing and disturbing trend in nursing home ownership–a large corporation made up of a network of related businesses operating nursing homes at a profit for their investors.  This type of ownership structure allows the parent corporation to profit from the lack of funding that causes injuries and avoid accountability.  It is a scam meant to siphon as much of taxpayer resources as legally allowed.  It is morally repugnant.  See the investigative report Naples News did on Consultate Health Care.  At the crux of the story: how Consulate — and most other large nursing home operators — allegedly use a network of related businesses to shift assets and make a profit for their owners and investors.

The article discusses Consulate Health Care which operates as the nation’s sixth-largest nursing home provider. Consulate reported operating revenues of $1.7 billion in 2016, according to the American Health Care Association.  Taxpayer money flows to Consulate nursing homes and profits earned go to the chain’s owner, the Atlanta-based private equity firm Formation Capital.  Related (meaning common ownership and/or common control) real estate, management, rehabilitation and other companies receive payments from Consulate’s nursing homes.

“Everybody knows what’s going on. Everybody knows about this shell game,” said Brian Lee, former head of Florida’s Long-Term Care Ombudsman Program in the Department of Elder Affairs, now heading the nonprofit Families for Better Care.

Despite the big money generated from Medicare and Medicaid programs, Consulate’s nursing homes are intentionally designed to appear cash-strapped. While individual nursing home LLCs are essentially empty shells, they pay rent, management and rehabilitation service fees to Consulate or Formation Capital-affiliated companies.

The convoluted corporate structure is designed to make it difficult for lawyers to recover damages, said Dale Ewart, assistant regional director of the 1199 SEIU health care workers union in Miami.

“It’s also baffling, I think, to disguise the real profitability of the nursing home industry,” he said.

 North Carolina has substantiated claims that a nursing home mistreated a resident after a daughter secretly recorded staff insulting her father.  Knapton said she placed a camera in her father’s room after he told her that staff routinely insulted him. She also suspected she wasn’t being told about all the times her father, who had had a stroke, had fallen out of bed.  The hidden camera Rebecca Knapton placed in her father’s room at Universal Health Care/North Raleigh captured staff belittling him after he had fallen out of bed and was calling for help.

ichard Johnson, 68, is recovering from a stroke, and video from the hidden camera shows that he fell out of his bed early on April 10. It took more than an hour for staff to respond, and they berated him when they did.

“Man, you stink,” one worker told Richard Johnson as he lay on the floor. He told them he fell trying to get to the bathroom.  One worker told the 68-year-old that he shouldn’t complain about lying on the cold floor.

“You were on the bed, you decided to go on the floor, so that’s your fault,” one worker said. “You decided to go on the floor, so don’t complain that it’s cold.”

“How old are you? You’re supposed to be enjoying your retirement. Instead, look what you are doing, pooping on yourself. Shame on you,” a staff member says.

At one point a worker told him that his suffering was his own fault. “You must have done something really, really bad,” she said.

Knapton said her father told her, “they talked down to him, they treat him mean, they call him names, they fuss all the time.”

A state investigation triggered by Knapton’s complaint pointed out problems with the care of other patients.

According to documents Knapton received, surveyors for the state Division of Health Service Regulation interviewed staff and residents and reviewed document at the nursing home from April 10-15.

One patient complained of chest pain for two days, but there was no indication that he received nitroglycerin as the doctor ordered, according to the state report. The man was sent to the hospital on the second day. Hospital records show a nurse saw him at 1:30 p.m. in the emergency room, and that he died about four hours later. However, a nurse’s record at the nursing home had the man leaving for the hospital at 7 p.m.

The N.C. Department of Health and Human Services said that the Centers for Medicare & Medicaid Services will initiate enforcement action and notify the facility.

Steven Bryant recorded a recent visit he made to Universal Healthcare of Lillington to see his 82-year-old mother. Sudie Bryant had complained of the care she had been receiving, he said, so he wanted to document what happened while he was there.  Sudie had been lying in a puddle of urine for so long that it had turned brown.

“Sir, I’ll be honest with you. We’ve been doing our best,” an aide said. “It’s just two [aides] in this hall, and honestly, we’re doing the best we can.”

As one aide leaves to get an administrator, the other explains staff cutbacks are the problem.

“I am glad that you are here to see it because we tell them time and time again that it’s too much, too much,” she said. “They don’t listen to us. We need the families to complain. We need families to see how it really is.”

Choice Health Management Services has 16 facilities in North Carolina, most operated under the Universal Healthcare brand. Medicare has levied fines totaling $567,976 for problems at six of the facilities since 2015.

Universal Healthcare Fuquay-Varina topped the list, with $234,260 in fines, followed by Universal Healthcare Lillington, with fines of $151,483. Universal Healthcare North Raleigh was fined $31,186 two years ago, the smallest fine against any of the six facilities.

The Raleigh facility has a history of repeat federal violations for insufficient staffing and failing to answer patients’ call bells in a timely manner.

The fines assessed against the three Universal Healthcare facilities in the Triangle combined to top the $246,000 in fines Medicare levied against 22 other nursing homes within a 25-mile radius of Raleigh in the past three years.

The incident at Universal Healthcare Lillington, where a man recently recorded a video showing improper care for his mother, involved a patient infested with maggots.

A doctor from an outside clinic found “maggots living in a wound on the resident’s foot” when he removed the patient’s shoes, according to a report. An aide at Universal Healthcare told investigators she discovered the maggots the previous day and went “screaming out of the room” without taking further action.

Universal Healthcare of Fuquay-Varina was fined after a resident at risk for wandering walked out the front door and across the parking lot. Inspectors checked all of the bracelets worn by at-risk patients to alert staff if they were about to wander off and found that none of them worked, according to a report.

“That’s ridiculous,” Powell said when he heard about the issues at Universal Healthcare facilities. “I am at a loss for words. I got to find a place to move my mom.”

See more information at WRAL, The News & Observer, and WFMY.

Bustle published John Oliver’s excellent investigation into how guardianships may exploit the elderly.  John Oliver’s guardianship segment picked apart the disturbing system that so many senior citizens face, demonstrating how it can strip people of their rights and resources.  Guardianship often comes into play when a senior citizen is showing signs of not being able to care for themselves. At that point, anyone can petition a court to appoint a guardian for this senior citizen. The guardian, depending on the court’s findings, may either be a family member or a private guardian. A private guardian is a professional, usually a stranger, who is paid to manage a ward’s personal affairs.

As Oliver explained, the system is unfortunately fraught with problems, guardians have a significant amount of control over the affairs of their wards and, thus, have access to a myriad of very personal entities, like bank accounts and health records. Moreover, being placed in a guardianship often means that senior citizens are stripped of many of their rights. As Judge Steve King of Tarrant County, Texas explained in a clip played on Oliver’s show, “Guardianship is a massive intrusion into a person’s life. … They lose more rights than someone who goes to prison.”

LastWeekTonight on YouTube
As the host explained, private guardians can charge their wards for each service they provide and can withdraw that money directly from wards’ accounts. Moreover, charges are often questionable and exorbitant.  Moreover, Oliver noted that only 12 states require professional guardians to have any type of certification, meaning that, in much of the United States, anyone can become a guardian. As the host noted, the lack of guardianship oversight “is worrying in a system that can be easy to fall into and very difficult to get out of.” As Oliver pointed out, it took one elderly couple that he highlighted on his show over two years to be freed from a guardianship — and, by that time, much of their money had been drained from their account.
The late-night host then played a clip of several older celebrity guests, including Cloris Leachman, Rita Moreno, William Shatner, Lily Tomlin, and Fred Willard, who had collectively recorded an infomercial for the show about the guardianship process, as Time reported. In the clip, the guests advocated for senior citizens talking with their families about plans for their care as they age — and for making sure that anyone who is appointed as their guardian is someone they know and trust.
There is also a great documentary that will provide more information to protect you and your loved ones.  See  http://www.cbc.ca/documentarychannel/m/docs/the-guardians

In 2016, the Labor Department sued Bridgeport Health Care Center and Bridgeport Manor and the nursing home’s chief financial officer, Chaim Stern, alleging they funneled $4 million from the facility’s retirement plan to themselves and a religious organization.  The feds alleged Stern diverted at least $4 million in plan assets to Bridgeport Health, himself, and Em Kol Chai, a New York-based Jewish organization that lists Stern as its president and trustee.

Workers accused Stern of failing to pay them on numerous occasions and failing to pay the company that manages their healthcare benefits. The nursing home filed for bankruptcy April 18 leaving many workers high and dry.  The 240-bed facility has a two-star rating on Nursing Home Compare and had been dinged for a high number of days without registered nurse staffing.

A spokesperson for the U.S. Attorney’s Office confirmed to News12 that “federal law enforcement activity” was taking place at the nursing home, but would not say which federal agencies were involved.  A warrant was served and the FBI, Department of Labor staff and others were on the scene raiding the facility’s administrative offices.

Alex Spanko is the Assistant Editor at Aging Media Network and covers the skilled nursing and reverse mortgage industries for Aging Media.  He wrote an interesting article on Georgia’s new law on background checks for Skilled Nursing News.  The new law will subject the owners and management to the same requirements as direct care caregivers and other employees who provide treatment and services to the  residents. But the threshold for who qualifies as an owner remains unclear.

“Employees, owners, and administrators will be required to undergo fingerprint background checks starting October 1, 2019, according to an analysis of the law from the firm of Arnall Golden Gregory, LLP. That check involves a search of the FBI’s registry, and long-term care stakeholders will also be required to submit to a check of Georgia’s sex offender registry — as well as those of states where the applicant or potential owner lived in the previous two years.”

Unfortunately and bizarrely, who the nursing home designates as an owner, however, will be largely up to interpretation.  The law exempts so-called “passive investors” who control the operations but do not admit to directly overseeing the operations at a facility.  For example, an owner is defined as someone with a 10% or greater ownership stake who, among other things, “purports to or exercises authority of a facility,” has an office on site, can directly access the building, or who even agrees to buy a specific facility.

“Most surrounding states use the FBI’s fingerprint-based national background check to screen prospective employees seeking work at long-term care homes,” the government-sponsored group wrote in its report. “This ensures that applicants who are convicted of a crime that makes them ineligible to work in such homes do not move to an adjoining state and obtain employment in a facility.”

But Georgia only used a name-based system that searched for crimes that occurred within the state’s borders, a structure that concerned the members of the council — which include state lawmakers, judges, and the executive counsel to Gov. Nathan Deal.

“In 2017, the council learned that there are approximately 25,000 employees in more than 10 different facility categories that provide care for the elderly and are subject only to the name-based background check,” the members wrote.

 

WSLS ran an article on the epidemic of bullying in today’s nursing homes.  Around the U.S., caregivers say they’ve seen gossip, exclusion and even incidents of physical violence popping up.  Arizona State University professor Robin Bonifas says for some who see their independence and sense of control disappear late in life, bullying gives them a feeling of regaining lost power.  Bonifas, a social work professor at Arizona State University and author of the book “Bullying Among Older Adults: How to Recognize and Address an Unseen Epidemic,” said existing studies suggest about 1 in 5 seniors encounters bullying. She sees it as an outgrowth of frustrations characteristic in communal settings, as well a reflection of issues unique to getting older.

Every month, as many as 20 percent of older Americans who live in nursing homes are subjected to seriously bad behavior from one of their fellow residents, such as physical and verbal abuse, privacy invasions or unwanted sexual attention. “The findings suggest that these altercations are widespread and common in everyday nursing home life,” says study co-author Karl Pillemer, Ph.D., professor of gerontology in medicine at Weill Cornell Medical College in a press release.

Nationwide, that translates to hundreds of thousands of people who endure abuse. Many incidents of name-calling, bossy behavior, loud arguments and, at its most extreme, physical violence go unreported.