Here is an article talking about another rape of a resident at a nursing home.  Where is the supervision? Where is the criminal background check? Wher eis the good ol fashioned judgment!?

Salt Lake Police arrested a worker at a nursing home today accused of raping an 85-year-old resident.  Jacob Bolith was arrested on suspicion of rape. The CNA is accused of raping a patient at St. Joseph’s Villa nursing village July 1.

Police said Bolith has worked at various nursing facilities in the Salt Lake Valley over the past decade. Bolith told police that he faced similar accusations in the past, according to a probable cause statement released by the jail.

I do not understand how nursing homes continue to say that they can’t make any money taking care of their residents.  The corporate executives of Manor Care will get more than $200 million for their sale to the Carlyle Group.  See the article here.

The head of America’s biggest nursing-home company is about to get intensive financial treatment. 

Chief Executive Paul Ormond will receive $118 million to $186 million from cashing in his company stock when the deal is completed this year.  Sixteen other top executives and recently retired officers at the firm to be purchased by the Carlyle Group, of Washington, can receive a total of $68 million for their stock.

In total, Manor Care officials stand to receive $200 million or more from their stock holdings.

The amount to be paid by Carlyle, a global private-equity firm that owns stakes in more than 500 companies and real-estate developments, may not be known for weeks.

The buyer said it will purchase Manor Care for $6.3 billion and hopes to complete the deal by the end of the year.

Mr. Ormond, CEO and chairman of the company that had $167 million in profits on $3.6 billion in revenue last year, is typically among the top-compensated corporate CEOs locally each year. Last year, he was compensated $18.8 million, an SEC filing shows.

The biggest chunk of looming stock payouts from Carlyle are to Mr. Ormond, whose 1.8 million company shares will be worth more than $118 million. They could be worth another $68 million if options on another 1.9 million shares he has are exercised for prices ranging from $20 to $53 each.

But the most recent regulatory filings show $55.5 million in stock payments could go to R. Jeffrey Bixler, former vice president and general counsel; Geoffrey Meyers, former executive vice president and chief financial officer; and M. Keith Weikel, former senior executive vice president and chief operating officer.

Company officers, directors, key employees, and some retirees stand to collect about $200 million for their existing stock, and possibly more than $250 million if unexercised stock options can be cashed in, the new SEC filings show.

Manor Care, No. 565 on the Fortune 1,000 list of the largest U.S. corporations, was once part of Owens-Illinois Inc. and started acquiring health-care facilities in the early 1980s. It spun off and became Health Care & Retirement Corp. and in 1998 merged with Manor Care Inc. of Gaithersburg, Md.

Former NY Mayor Ed Koch wrote a great article on the budget cuts to home health that have forced many older citizens into nursing homes.  Below are excerpts of the article:

In the last seven years, while the Medicare budget for nursing home stays has dramatically increased from $13.6 billion to $15.7 billion, home health care has been cut by 25 percent, from $14 billion to $10.5 billion. It is cut further in the Bush administration’s proposed fiscal year 2008 budget, which calls for an "inflation freeze" that would slash $410 million in fiscal 2008 and $9.68 billion over five years.

None of this makes common sense. Home care allows the elderly who have become frail to maintain their dignity and independence, sleep in their own beds, use their own kitchens and stay in the house they have long enjoyed (or in the house of a child or relative) – unless their condition deteriorates to the point where moving into an institution is absolutely necessary.

Besides offering a higher quality of life, home care is far cheaper than the alternatives – averaging one-fifth the price of nursing homes and a tiny fraction (3 percent) of the cost of hospitalization. It costs roughly $109 per visit, compared to $499 per day in a skilled nursing facility and $3,838 for hospitalization, according to Medicare statistics.

Starting in 1997, under the Balanced Budget Act, Medicare home health spending was cut by half. This forced the closing of nearly 25 percent of all home health agencies in the United States.

According to the Center for Responsive Politics, "hospitals / nursing homes" gave more than $30 million to candidates in the 2004- 2006 federal election cycles, based on Federal Election Commission data, and they are among the top third of 80 "industries" ranked. Home health does not even rate a mention on the chart.

There are some 1.6 million people in nursing homes today. Sometimes, senior citizens are able to live normal lives and care for themselves, but as people age, many have problems compounded by poor health and need caretakers. They should not be forced into nursing homes for lack of alternatives.

This article is very disturbing.  I cannot believe that the nursing home did not recognize this obvious sociopath.

A Victorian nursing home employee accused of pinning down a 98-year-old dementia patient "like an animal" and raping her was just doing his job, according to his defense lawyer.   Henry Alexander, 35, of Mount Martha, is accused of sexually assaulting four women in their 80s and 90s at a nursing home on the Mornington Peninsula in November 2005.

"Mr. Alexander’s care of these particular residents is based on the fact that what he did was reasonable … and it was all to do with the proper hygienic care of residents who had become incontinent with feces and urine,” Gipp said.

Alexander’s former colleague, Anne Girvasi, who no longer works at the home, said on one occasion she saw him pin a 98-year-old woman to the bed with his legs and digitally penetrate her.

"She was pinned down like an animal,” Girvasi said. "Henry Alexander is an animal and a rapist, okay? What he did was disgusting.”

She said she did not file an incident report about Alexander’s conduct because six-month old reports would pile up in the nurses’ station and no action was taken.   Friend and former colleague Janine Blythe said she tried to make an appointment with Susan Younger, the Director of Nursing, but Younger cancelled.

She said she then submitted an incident report to CEO Heila Brookes, which detailed Alexander’s alleged "inappropriate and rough” touching of an 87-year-old woman on Nov. 4, 2005.

"She just ripped it up – she said it wasn’t done the way it should be.

Blythe was fired from the nursing home for failing to immediately report the incident.

Here is the full article.

I wish South Carolina enforced the nursing home rules and regulations and issue fines when neglect has occurred. To my knowledge, SC has never fined any "for profit" nursing home.

A nursing home was fined $100,000—the most severe penalty under state law—after investigators ruled that poor health care led to the death of a 76-year-old patient.
Pleasant Care Convalescent of Petaluma operates a 54-patient facility where a woman died March 12 from an infection, said Norma Arceo, a spokeswoman for the California Department of Public Health.

The woman developed an infection and died from complications in a hospital eight days later, Arceo said. Records showed the patient had extensive cavities and food debris throughout her mouth, causing large swelling in her neck. 

Here is the full article

The NY Times has an interesting article about how health care providers misuse HIPAA to conceal medical mistakes or neglect from family members.

An emergency room nurse told Gerard Nussbaum he could not stay with his father-in-law while the elderly man was being treated after a stroke. Another nurse threatened Mr. Nussbaum with arrest for scanning his relative’s medical chart to prove to her that she was about to administer a dangerous second round of sedatives.

The nurses who threatened him with eviction and arrest both made the same claim, that access to his father-in-law and his medical information were prohibited under the Health Insurance Portability and Accountability Act, or Hipaa, as the federal law is known.

Mr. Nussbaum, a health care and Hipaa consultant, knew better and stood his ground. Nothing in the law prevented his involvement. But the confrontation drove home the way Hipaa is misunderstood by medical professionals, as well as the frustration — and even peril — that comes in its wake.

Government studies released in the last few months show the frustration is widespread, an unintended consequence of the 1996 law.

Hipaa was designed to allow Americans to take their health insurance coverage with them when they changed jobs, with provisions to keep medical information confidential. But new studies have found that some health care providers apply Hipaa regulations overzealously, leaving family members, caretakers, public health and law enforcement authorities stymied in their efforts to get information.

Experts say many providers do not understand the law, have not trained their staff members to apply it judiciously, or are fearful of the threat of fines and jail terms — although no penalty has been levied in four years.

Read More →

NEW YORK (MarketWatch) — Manor Care Inc. has agreed to be acquired by private-equity firm Carlyle Group for about $6.3 billion in cash, the nursing-home operator said Monday.
Under terms of the deal, Manor Care’s stockholders will receive $67 in cash for each share of common stock they own.
This represents a premium of less than 3% to Friday’s closing price of $65.29, but it’s 20% higher than Manor Care’s $55.75 price on April 10, the day before the company announced it was exploring strategic alternatives.

This sale proves the healthy financial condition of the nursing home industry, and the lack of need for so called tort reform to insure their profitability.

for more information about Carlyle Group, click here.

David McGuffey is a great nursing home and elder law attorney from Tn.  He is kind enough to share with other nursing home attorney his summary of important cases and legal theories.  Recently he wrote an article about direct liability of parent corporations in the nursing home industry.  Below are excerpts:

In Forsythe v. Clark USA, Inc., 864 N.E.2d 227 (Ill. Sup Ct. February 16, 2007), the Illinois Supreme Court affirmed the court of appeals, finding that a parent corporation may be directly liable where it exerts budgetary control over its subsidiary. In Forsythe, the court said the parent “can be held liable if, for its own benefit, it directs or authorizes the manner in which its subsidiary’s budget is implemented, disregarding the discretion and interests of the subsidiary, and thereby creating dangerous conditions.”  Mere ownership alone by a parent corporation is insufficient, as is having individuals serving on boards of both the parent and the subsidiary. Setting budgetary goals is likely insufficient. However, where a parent corporation specifically disrespects the actions of its subsidiary, using its ownership interest to command, then direct liability may be imposed over a specific controlled transaction. Under this theory, a parent is held liable for its own actions against a third party through “the agency of subsidiaries.”

So how is Forsythe applied to nursing home cases? In Heritage Hous. Dev., Inc. v. Carr, 199 S.W.3d 560 (1st Dist. Tex. App. August 3, 2006), the court held that the evidence was legally insufficient to support a verdict against the nursing home’s parent corporation and reversed a $2.2 million verdict. In support of the verdict, Plaintiff argued that the employment paperwork the nursing home staff completed that had the parent corporation’s name (HHD) on it, or refers to HHD as the employer, demonstrates HHD’s employment of the nursing home staff and establishes HHD’s vicarious liability. Plaintiff pointed to employment-at-will statements, job description acceptance forms, substance abuse policy notices, Equal Opportunity Employment statements, acknowledgment of time clock procedures, no solicitation policy notices, ethics and conduct policies, disciplinary and termination forms, and receipt of employee handbook acknowledgments as evidence supporting a finding that HHD employed the nursing home staff. Plaintiff also observed that the nursing home used administrative manuals containing HHD’s policies and procedures, thus further indicating that HHD controlled the details of the work performed.” This, however, was insufficient because there was no evidence that HHD controlled “the details of the care.” The transaction specific inquiry found some elements of control (the first element), but none that related to the negligent care itself (the second element).

Where an injury results from insufficient staffing, if the parent assumes budgetary control which limits staffing, then the parent is controlling the details of care. There are now ample studies linking quality of care to appropriate staffing making dangers imposed by short staffing foreseeable. See, e.g., AHRQ, Nurse Staffing and Quality of Patient Care (March 2007) (See also Press Release describing study on how chain planning practices can hurt patient care). In light of a subsidiary’s contractual quality of care obligation to the Medicare and Medicaid programs, control that prevents the subsidiary from providing quality care under its provider agreements is likely eccentric.

Read More →

The U.S. Attorney’s Office and the Pennsylvania Department of Public Welfare filed a complaint Thursday against the Holland-Glen Nursing Facility in Hatboro, Pa..  See article here.

The complaint alleges the facility has been operating without a nursing facility license and its services "substantially depart from generally accepted professional standards of care, thereby exposing patients to significant risk and, in some cases, to actual harm."

Among the specific allegations in the complaint are that Holland-Glen fails to properly administer medications, provide proper general resident care, check the backgrounds of its employees, and has falsified both resident medical records and records of billings to governmental and other payors.

The complaint seeks an injunction to prevent Holland-Glen from continuing to provide unlicensed care.

Here is an article discussing the recent $54 million verdict in a nursing home neglect case in New Mexico.

Lori Keith was awarded the compensatory and punitive damages against ManorCare Inc., a nursing home corporation out of Toledo, Ohio, for neglecting her mother causing her death.  At the time of her death, Barbara Barber was due to leave the ManorCare Camino Vista facility within a week to stay with family, Keith said. So when a phone call came about Barber’s death, Keith said she knew something was wrong. 

The verdict reached yesterday in Albuquerque includes four million dollars in compensatory damages and 50 million in punitive damages over the 2004 death of 78-year-old Barbara Barber.

The doctor who did the autopsy said Barber died of internal bleeding. The family’s attorneys produced evidence that the bleeding had been going on for several days without response.

Tthe nursing home tried to cover up the death by taking away sheets and other items in the room.

The corporation was responsible for the death, jurors decided, and they said the corporation owed Barber’s family for it.   The company declined to comment on specific details of the litigation.