Bridgeport Health Care Center Inc., a Connecticut nursing home sued by the federal government over allegations it diverted millions of dollars from the company’s retirement plan to itself and to a Brooklyn-based Jewish nonprofit, has filed for chapter 11 bankruptcy protection, WSJ Pro Bankruptcy reported.  Em Kol Chai, a New York religious corporation that lists Stern as its president and trustee on its certificate of incorporation received millions of dollars.

Bridgeport, which filed for chapter 11 in the U.S. Bankruptcy Court in Bridgeport, Conn., listed Brooklyn-based health-care company Caretech Supplies Inc., with a $4.2 million claim, as its largest unsecured creditor. The Internal Revenue Service, owed $3.3 million, is listed second, followed by People’s United Bank, located in Bridgeport, owed $2.3 million. All the claims are disputed. The Labor Department sued Bridgeport and its chief financial officer in September 2016, claiming they diverted millions of dollars from the company’s retirement plan improperly to a religious corporation and to themselves.

Skilled Nursing News reported that a federal bankruptcy judge approved HCR ManorCare’s prepackaged Chapter 11 plan to emerge from bankruptcy under the ownership of its landlord, Quality Care Properties (QCP).  QCP will lose its status as a real estate investment trust (REIT).  The action means ManorCare is the largest long-term care chain which operates 295 skilled nursing and assisted living facilities to go through the process over the last decade, according to Reuters.

Under the new management team, ManorCare will begin the process of selling off 74 facilities, as previously reported.   The judge’s approval also means that former CEO Paul Ormond’s sizable payout will go forward as planned, with Reuters pegging the final total at $116.7 million.

CNBC reported that Wall Street titans Goldman Sachs asked the incredible and amoral question: “Is curing patients a sustainable business model?”  Goldman Sachs addressed biotech companies, especially those involved in the pioneering “gene therapy” treatment and wondered if cures could be bad for business in the long run.

“Is curing patients a sustainable business model?” analysts ask in an April 10 report entitled “The Genome Revolution.”

The potential to deliver ‘one shot cures’ is one of the most attractive aspects of gene therapy, genetically-engineered cell therapy and gene editing. However, such treatments offer a very different outlook with regard to recurring revenue versus chronic therapies,” analyst Salveen Richter wrote in the note to clients. “While this proposition carries tremendous value for patients and society, it could represent a challenge for genome medicine developers looking for sustained cash flow.”

Richter cited Gilead Sciences’ treatments for hepatitis C, which achieved cure rates of more than 90 percent. The company’s U.S. sales for these hepatitis C treatments peaked at $12.5 billion in 2015, but have been falling ever since. Goldman estimates the U.S. sales for these treatments will be less than $4 billion this year, according to a table in the report.

“GILD is a case in point, where the success of its hepatitis C franchise has gradually exhausted the available pool of treatable patients,” the analyst wrote. “In the case of infectious diseases such as hepatitis C, curing existing patients also decreases the number of carriers able to transmit the virus to new patients, thus the incident pool also declines … Where an incident pool remains stable (eg, in cancer) the potential for a cure poses less risk to the sustainability of a franchise.”

The report suggested three potential solutions for biotech firms:

“Solution 1: Address large markets: Hemophilia is a $9-10bn WW market (hemophilia A, B), growing at ~6-7% annually.”

“Solution 2: Address disorders with high incidence: Spinal muscular atrophy (SMA) affects the cells (neurons) in the spinal cord, impacting the ability to walk, eat, or breathe.”

“Solution 3: Constant innovation and portfolio expansion: There are hundreds of inherited retinal diseases (genetics forms of blindness) … Pace of innovation will also play a role as future programs can offset the declining revenue trajectory of prior assets.”

Newsweek had an article about a new study finding evidence to suggest that Alzheimer’s begins in childhood, with babies younger than a year old displaying signs of the disease. The research emphasized that earlier intervention is necessary to prevent the disease and addressing air pollution may play a key role.

Researchers examined the autopsies of 203 residents of Mexico City and published their findings online in Environmental Research. The bodies ranged in age from 11 months to 40 years old.

The researchers specifically looked at levels of two abnormal proteins associated with Alzheimer’s—hyperphosphorylated tau and beta amyloid. Many of the bodies displayed heightened levels of these two proteins in the brain, even in children less than a year old. Evidence of early signs of Alzheimer’s disease was found in 99.5 percent of the subjects examined.

The study theorized that exposure to air pollution may be behind these heightened abnormal protein levels in young brains. Children exposed to cleaner air performed better in various categories, including cognitive performance, lead study researcher Dr. Lilian Calderón-Garcidueñas, a professor in the department of biomedical and pharmaceutical sciences at the University of Montana, told Newsweek. Calderón-Garcidueñas, who also collaborates with Universidad del Valle de Mexico, compared children by age, gender, socioeconomic status, the IQ of their mother, nutrition and education.

WSPA reported that officials are working to establish a nursing home for veterans in Cherokee County.  The federal government has finally approved funding for its portion of the cost.  The federal government approving its portion of roughly $40 million to build a 108 bed nursing home for veterans on 35 acres off Hampshire Drive. He said 85 percent of the nursing home is being funded by the VA (Veterans Affairs), and the other 15 percent from the state.

“It’s going to be a very nice facility with security and very nice grounds,” Humphries said.

He said Cherokee County is paying for the land, and it’s an investment expected to impact the county’s economy through jobs during and after construction.

“As long as we have veterans, we’ll have this nursing home so this is a forever business coming to our community,” Humphries said. “We think it’s just a great opportunity to serve our community.”

“Especially the elderly people that are disabled… They need help,” Martin said.

McKnight’s had an interesting article about the changing demographics in nursing homes throughout the United States.  Younger residents are using facilities more often — bringing with them fewer physical demands and more behavioral health diagnoses.  Across the country, the under-65 proportion of residents climbed steadily from 16.5% of residents in 2011 to 17.4% in 2015. The rate jumped most for those between 55 and 64, up from 9.8 % to 11.1% in 2015.

“We’ve typically had this image of a nursing home of being (for) older adults, and now they are middle older adults,” said Ian Matt Nelson, a research scholar at Miami University’s Scripps Gerontology Center.  Nelson recently co-authored a report on this new generation of nursing home residents for the state of Ohio, where 20% of Medicaid long-stay residents were under 65 in 2015. That puts it 11th in the nation.

Co-author John Bowblis told McKnight’s that unpublished data from the study shows Utah leads the nation in the prevalence of young long-term care Medicaid patients, followed by Illinois, Nevada, Missouri and Arizona.

Almost half of the young Ohio residents had a diagnosis of severe mental illness — including bipolar disorder or schizophrenia — and nearly a quarter had paralysis. Those numbers compared to one-quarter and one-tenth, respectively, among seniors.

Meanwhile, younger residents are less likely to need help with activities of daily living that nursing home workers are typically trained to handle. In 2015, 28% of Ohio’s under-65 population had one or fewer ADLs.

Katherine Judge, a professor of psychology at Cleveland State University, told Crain’s Cleveland that younger adults will present a challenge for nursing homes.

“I think the implications are what are we doing on the community side and on the nursing home side to address the needs?” Judge asked. “It’s not clear for example what community services would best meet the needs of these individuals, or at this point how nursing homes might be able to offer different services to address their needs.”

 

The Daily Beast had an article about the investigation into the nursing-home death of the father of Trump’s ex-security advisor H.R. McMaster Jr. in Philadelphia last month.  According to the Philadelphia Medical Examiner’s Office, 84-year-old H.R. McMaster died at Cathedral Village nursing home in Pennsylvania and suffered “blunt impact head trauma”. Philadelphia State Police have labeled the death “suspicious.”

The allegations are that McMaster Sr. did not receive proper care, according to 6ABC. McMaster supposedly fell, hit his head and was placed in a chair, then died, 6ABC reported. The senior was admitted to the facility after having a stroke, the station said.

“As soon as we became aware of the alleged incident, we began an internal investigation and contacted the appropriate authorities,” Cathedral Village said in a statement to CNN, adding the “safety” and “welfare” of the patients is the facilities “utmost priority.”

However, over the last two years, Cathedral Village has failed four state inspection reports, according to Pennsylvania Department of Health records.

Last January, an inspection report revealed that four nurses were working despite expired Nursing Assistant Certifications. Nearly six months later, the agency failed to follow a doctor’s requirement of applying daily gauzes on a patient’s surgical incision. According to observation reports, the patient’s sheets were filled with blood and “yellow and brown colored drainage.” A fetid odor was also emitted from the dressing area, records show.

Two years ago, the nursing home failed to provide one-on-one activities for a clinically depressed patient who also had a stroke, state records show. According to the report, the only activity the patient had was a “television in the room.” That year, the facility also failed to keep accurate clinical records, reports show.

The Kansas City Star had an interesting article about Skyline Healthcare–whose headquarters are above a pizza parlor in New Jersey.  Last month, the Kansas Department for Aging and Disability Services petitioned the courts to take control of Skyline’s 15 nursing homes across Kansas, saying Skyline was on the brink of financial collapse and 845 nursing home residents were at risk.  Nebraska officials had taken similar action about a week earlier with 21 facilities owned by a subsidiary of Skyline.

Formed in 2008, Skyline grew exponentially as its owners took over operations of 110 nursing homes in six states between 2015 and 2017. In two years, Skyline — through dozens of subsidiary LLCs — took control of dozens of homes in Massachusetts, Florida, Arkansas, Nebraska, Kansas and South Dakota.

William Murray III, an attorney who has filed malpractice and neglect suits against Skyline nursing homes in several states, said the numerous LLCs associated with Skyline — like Dorothy Healthcare Management — are gimmicks.

“Oftentimes in the change of ownership process, new operators will create companies that have no track record and no history, even though the people behind them do, in order to escape any scrutiny about whether they’re qualified to take over the facilities,” Murray said.

“Where are all the people who supposedly work on the second floor of a New Jersey pizza parlor? The people who are supposedly working for Dorothy Healthcare Management, taking care of all these frail, elderly Kansans?”

When Skyline took over the ownership and operation of the nursing homes, vendors didn’t get paid and staff paychecks would be direct deposited, taken back and then re-issued days later on paper checks.

“I really think there needs to be a more intensive financial review for them coming in,” said Cindy Luxem, the executive director of the Kansas Health Care Association. “Because I honestly don’t believe the Skyline people had a year’s worth of working capital.”  “The people that own Skyline, they’re not health care providers,” Luxem said. “They’re merely people looking for an investment. Unfortunately, there’s a lot of that in our industry right now, but I wish the state of Kansas had a little bit better checks and balances on people coming into our state.”

The company was owned by a single family, the Schwartzes (Joseph, Rosie, Michael and Louis).  Stephen Monroe, a partner at a research firm called Irving Levin Associates that specializes in the senior housing and health care investment markets, said nursing home industry watchers used to joke about their office above the pizza joint in Wood-Ridge, N.J.

“It’s a group of good ol’ boys from the East Coast buying up a whole bunch of nursing homes in the Midwest because we’re the cheaper ones,” said Carol Tsiames, a former administrator at the Kaw River Care & Rehabilitation Center in Edwardsville, who left about eight months after Skyline took over.  “They abuse the system. Encourage you to use local vendors, and then they don’t pay. … It puts an administrator in a bad position.”

1011Now reported the arrest of nursing home employee after officials said she stole pills that were for residents.  The Lancaster County Sheriff’s Office said Joan Jilek was taken into custody and charged with acquiring a controlled substance by fraud.

According to LSO, one of Jilek’s duties at the Waverly Care Center was to distribute medicine to residents.  LSO said Jilek is suspected to have been stealing pills for about three weeks and stole 22 Oxycontin and oxycodone pills.  Eventually, other employees noticed that pill counts were off and reported prescriptions missing.

 

 

 Tennessee‘s health commissioner has suspended admissions to two nursing homes for significant violations found during separate investigations.  Health Commissioner John Dreyzehner said that Diversicare of Claiborne in New Tazewell and Brookhaven Manor in Kingsport are barred from admitting new residents until the violations have been corrected.  The health commissioner can suspend admissions to a nursing home when conditions are detrimental to the health, safety or welfare of the residents.

The health department says problems with administration, performance improvement, records and reports, and resident rights were found at Diversicare.

At Brookhaven Manor, an investigation found violations related to administration, admissions, discharges and transfers, performance improvement and social work services.