Fox4KC reported that Joy Titus is now banned from Redwood of Independence after filing a complaint against the nursing home last month about her husband’s treatment in the dementia unit. The state of Missouri is investigating the company running the nursing home which has a troubled history, including an ongoing wrongful death lawsuit.

Joy was forced to make a painful choice and sent her husband to the rehabilitation center just after Christmas 2016.

“The guilt is so overwhelming. It’s almost impossible to live with — that I’m not taking care of him myself,” she said.

But Joy felt good about the facility, knowing her mom had gotten good care there, as had a few family friends. It was an added bonus the facility was just 5 minutes from her home.  “I had no qualms about taking him there,” Joy said.

But she said things rapidly changed in April 2017 when Redwood Post Acute Network bought the place. In June, her husband escaped from a window and wasn’t found for hours.

“The care, just got to be less and less,” she said.

In November 2017, state and federal inspections and complaints reveal patients repeatedly missing medications. In one case, a diabetic patient didn’t get insulin for four days, and their blood sugar went extremely high. Staff took a “couple hours” before anything was done.

In March 2018, a wrongful death lawsuit was filed against Redwood after an epilepsy patient allegedly failed to get medicine and died.

For Joy, the last straw came two weeks ago when she went to visit Richard.  “I walked in, and he was naked from the waist down. In the middle of the hall. With four women in chairs, sitting there watching him, and he`s covered in feces.  And I hollered and hollered for help, and there was no help,” she said.  “My husband was saying over and over, ‘They hurt me. They hurt me. Get me out of here,’” Joy said.

Richard’s now in a new nursing home, and his outlook is already improving.  “He’s calm.  No anxiety attacks,” Joy said.

She’s now hoping others learn from her ordeal and is encouraging others to check online inspection reports from Medicare and the state before choosing a nursing home for your loved one. Then make regular check-up visits and report any concerns you have.

 

The L.A. Times reported on a state audit that shows that California health regulators allow poor care at nursing homes around the state, and the number of incidents that could cause serious injury or death has increased significantly in recent years.  The state auditor singled out the California Department of Public Health for specific criticism, saying it had not performed necessary inspections or issued timely citations for substandard care. The audit also found that the department’s nursing home licensing decisions were inconsistent and lacking in transparency.  We have the same problems in South Carolina.

In California, confirmed cases of substandard care at nursing homes statewide increased by 31% from 2006 to 2015, according to the audit. And incidents of nursing home noncompliance that caused or could have caused serious injuries or fatalities rose by 35% in the same period.  Safety and accountability problems at nursing homes across the United States are rampant. Federal inspection reports, for example, show that infection control is routinely ignored. At the same time, the Trump administration has scaled back the use of penalties to punish nursing homes that put residents at risk of injury.

The audit showed that in the vast majority of cases where investigators found problems that could severely harm patients, the public health department failed to cite or fine the facility involved.  The quality of care at nursing homes will be critical as baby boomers age and demand for these services grows.

The state audit also investigated three large private nursing home operators whose net incomes have skyrocketed over the past decade — from less than $10 million each in 2006 to between about $35 million and $54 million in 2015. The report confirmed that the owners of the three companies are increasing their profits by doing business with companies they own or in which they have a financial interest, and siphoning money away from patient care to these “related entities”.  The three companies, Brius Healthcare Services, Plum Healthcare Group and Longwood Management Corp., paid between $37 million and $66 million to related companies from 2007 to 2015, according to the audit.

Kaiser Health News found last year that about three-quarters of nursing facilities in the country outsource services to companies that they control or in which they have an interest.  The obvious and inherent risks of such arrangements are that owners will inflate their prices to increase cross-company profits, and that it is easier for commonly owned companies to engage in fraud and conceal it.

Michael Connors, with California Advocates for Nursing Home Reform, expressed alarm that nursing home operators are making such big profits by doing business with their own companies. Nursing home chains are using these deals to “siphon off money intended for care in order to pad and hide profits” — and that hurts residents, he said.

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.

See article about the tragic and preventable death of a long time nursing home resident.  Mark Billiter died as a result of the nursing home’s failure to realize and communicate to police that he was missing from the nursing home.  Billiter suffered from a heart attack-induced dementia which made him confused and wander away from the nursing home.  Police reports  indicate he used the elevator security code and walked out while following another patient’s visitor.  A nursing home staff member ushered them both out, the reports show.The nursing home is required to supervise him to keep him safe.

Billiter had slipped out the care facility where he had lived for years. Billiter had not been reported missing by the time a Canton police officer encountered him hours later.  The police found him but no one informed them he was missing from a nursing home.  They drove him to the city limits. National Weather Service records show the temperature dropped to 32 degrees and was below freezing Monday into Tuesday with a wind chill consistently in the 20s.  He was found dead there two days later.

“This is a person who has obviously lived in a sheltered care facility for three years and is now outside …,” said Tracey Laslo, the family’s attorney. “He lacks cognition to live outside of a nursing facility. This was supposed to be a safe harbor and a place of protection for him.  He was a known risk. That’s the reason he was in a secured unit,” she said.

“If the nursing facility had reported this to the family and to police, this tragic ending would not have happened. The police would’ve been able to secure him and return him, and Mark would’ve been OK at this point. The travesty in this case is the nursing home did not follow (its) own policy. There should’ve been an immediate perimeter check of the facility by the staff, the family should have then been contacted so that they could assist and the police should’ve been contacted.”

The St. Louis Post-Dispatch had an article on the neglect that led to a resident almost freezing to death outside the home on three different occasions.  Two other residents were also allowed to wander away from the facility.  Staff at Autumn View Gardens assisted living facility put residents in imminent danger in January when three residents with dementia were found outside the building in freezing temperatures, according to a state investigation.

The facility, owned by Colorado-based Bethesda Senior Living Communities, satisfied investigators’ citations by installing a new door alarm system, retraining staff on supervision policies and adding a full-time receptionist at the front desk.

One resident with Alzheimer’s disease went outside without a coat for 10 minutes on Jan. 3 when the temperature was 27 degrees. The next day, the resident again went outside without a coat or shoes when the temperature was 18 degrees. On Jan. 6, with a temperature of 4 degrees, the resident went outside a third time without coat or shoes. Family members had previously expressed concern about the resident’s tendency to wander, inspectors from the Missouri Department of Health and Senior Services wrote in a February report after a visit to the facility.

During the inspectors’ visit, there was no documentation of the resident as an “elopement risk” and no picture posted at the front desk as recommended. The resident’s doctor told the inspectors that the resident had worsening dementia and should not be allowed to go outside unsupervised.

A second resident with dementia was found sitting on the ground two blocks from the facility on Jan. 24 with no coat and wet pants in 42-degree weather. A passer-by had alerted staff at the facility of “an older person walking down the street.”

A pastor at St. Richard’s Catholic Church across Schuetz Road from the facility brought back a third resident with known confusion and memory problems who had walked into the church without a coat on Dec. 30, when the high temperature was 25 degrees.

Staff members told the investigators that the front doors were locked at night but that residents could still get outside. They need to ring a bell to get back in, but “if a resident got confused and did not understand how to ring the bell or if staff were busy assisting another resident, he/she could be outside for a long time,” the report states.

When opened, the facility’s front door and side exit doors send alarms to staff members’ pagers, “but staff did not always have time to check the doors if they were busy assisting other residents,” according to the investigators’ interviews.  This occurs when the facility is short-staffed.

On Feb. 2, investigators found no one sitting at the front desk at 9 a.m. and watched a resident walk outside without signing out. Staff did not respond to the resident or to several other instances when investigators opened various doors in the facility, according to the report.

An aide told investigators that he or she had brought concerns to management about the lack of supervision of residents. There were 72 people living in the facility at the time of the investigation.

“They are supposed to be assisted living, but cannot check on everyone, assist with activities of daily living, pass medications and supervise residents when there are only two or three of them on duty,” the aide said in an interview with investigators.

Lauren Weiler for CheatSheets wrote about the dark secrets nursing homes do not want the public to know.

1. Some contracts don’t allow you to sue if something goes wrong:

Knapp & Roberts notes you should review all of the print in your paperwork, and keep a watchful eye out for anything noting “binding arbitration agreements.” Essentially, this agreement means you must settle your differences outside of court, removing your right to sue. If anything serious happens, you certainly don’t want to be bound by this clause.

2. Residents don’t always have as much freedom as they want:

One study found out of 65 nursing home residents interviewed, about half felt depressed due to a lack of independence and freedom, as well as loneliness. The interviewees also seemed to prefer homes that had programs designed to reduce their sense of isolation from others.

3. Residents don’t always get enough to eat:

 A 2015 overview from Nursing Older People found nursing home residents are among those who have higher rates of “anorexia of aging,” and over 50% of residents studied also complained of constipation. Your home of choice should have a plan in place to combat these issues.

4. Some of the ‘nurses’ aren’t nurses at all:

Every nursing home has some number of permanent nurses — but not everyone working is a staff member you’ll see again. Bottom Line Inc. explains “agency nurses” are often employed when a home is low on permanent staff. These temporary nurses work for staffing agencies and rarely form bonds with residents because of their position. For your comfort, it’s wise to choose a home with a staff that’s at least 80% permanent nurses.

5. Residents often have to leave the doctors they’re used to behind:

Knapp & Roberts explains most nursing homes have assigned physicians, which makes it difficult for residents to keep the doctors they’re used to seeing. If you’re really attached to your current doctor, it’s best to ask a potential home about their rules regarding this. You should also ask the home how often the physicians see their residents and what the health care plans may look like before committing.

6. Low staffing levels are a huge issue:

Up to 95% of American nursing homes may be understaffed.

Some homes have a difficult time finding enough staff, but other homes purposely understaff to cut costs. Having a bad patient to staff ratio is stressful for the staff and bad for your care. It may also leave you vulnerable to neglect and abuse. Be sure to ask what the patient to staff ratio is in your chosen home so you can ensure you’re getting the care you’re promised.  There should be at least 4.1 hours per person per day of direct nursing care.

7. Nursing homes may send a bill to relatives for the resident’s care:

According to Mass Mutual, the average amount paid for assisted living in 2017 was $3,750 per month. While you may have multiple ways of taking care of these costs, you should ensure none of the expenses accidentally get sent out to relatives. This happened in 2012 to a man who was forced to pay nearly $100,000 of his mother’s care without realizing it. Know what your state laws are regarding billing, and as always, have both you and your family members read the fine print.

8. The staff isn’t always clean:

Nursing home staff are careful with washing their hands, right? While this may seem like an obvious practice of personal hygiene and to prevent the spread of infections and communicable diseases, not all staff members participate. The New York Times reports many nursing homes are being cited for “hand hygiene” deficiencies.  Unsurprisingly, the nursing homes that were understaffed found the most hand-washing issues. Finding a well-staffed home may be key to your overall health.

9. Nursing assistants don’t need as much training as you think:

They may seem official, but many nursing assistants have no formal training at all to take care of you. NursingAssistantGuides.com explains some clinics will hire untrained workers and train them to be nursing assistants at the facility. Even for those who have a degree as a CNA, that can be acquired online with no hands-on experience. And many CNAs start at nursing homes and then move on to jobs with better pay, making the turnover rate incredibly high.  CNAs are not licensed health care providers.

10. Neglect is a common issue in the homes:

Next Avenue explains out of all the cases of nursing home abuse, neglect is the most common. While there are times when neglect is intentional, it isn’t always this malicious. Inadequate staffing and high turnover rates can also lead to this issue.  When choosing a nursing home, take a look at the other residents. Do they seem clean and well taken care of? The living quarters should also be clean and safe, with little wear and tear.

11. Some nursing homes may tell you to get extra aid outside of their care:

Staff in your chosen home are required to provide you with the care you need. If you’re ever told you need an outside aid to assist you for additional costs, Knapp & Roberts says to take note. This is negligence on the part of the nursing home.

12. The physical therapy units aren’t always up to snuff:

While you may be more concerned with what the rooms and eating areas look like, don’t forget to tour the physical therapy unit. Bottom Line Inc. explains if you require rehab of any kind, this is particularly important. Take a look at the machinery and ask if physical therapists are on the staff itself or just doing contractual work. If your nursing home is staffed with physical therapists, it’s likely to give you better service.

13. The ‘activities schedule’ might be a total bust:

U.S. News & World Report reminds us many nursing homes are still lacking in the activities department. While birthday parties and Bingo are commonplace, you’ll need more than that when choosing a place for your future. And the best homes will ask each resident about their interests to try and accommodate as many people as possible. Certain homes offer gardening clubs, cooking classes, and art therapy, so make sure you ask what’s available.

14. Most residents will have a lack of privacy:

While many folks in nursing homes like having company, there’s also another issue you may not have thought of: a lack of privacy. Bottom Line Inc. explains most homes offer a wide range of shared rooms, with private rooms costing serious cash. Not all shared rooms are bad, however. You’ll just want to make sure what’s dividing your bed from someone else’s is sturdier than a thin curtain.

15. More serious forms of abuse take place, too:

The National Council on Aging report about one out of every 10 Americans over 60 experience abuse — and it can even occur in nursing homes, Spangenberg Shibley & Liber LLP says. Neglect aside, the publication notes sexual assault and abuse has also been cited in certain homes. And many other instances of abuse go unreported. Do your research to see if any abuse allegations have been filed against your home of choice.

Many people suffer in nursing homes either from abuse or neglect. Nationally, more than 1 in 5 Medicare recipients do, according to a 2014 study from the federal Department of Health and Human Services. Almost 60 percent of those abuse or neglect cases could have been prevented. The harm came from “substandard treatment, inadequate resident monitoring, and failure or delay of necessary care,” according to the study.

Under a measure advancing in the Louisiana statehouse, families would be able to install video cameras in loved ones’ nursing home rooms.  Under the legislation, nursing homes would be prohibited from denying entrance or retaliating against residents who opt for monitoring devices.  The cameras would be voluntary. Costs would have to be paid by the nursing home patient or family member. Any roommate would have to agree to the installation.

Rep. Helena Moreno (D-New Orleans) said her proposal would offer peace of mind to family members monitoring a parent or grandparent while also ensuring residents’ safety.  “What’s wrong with just having an extra set of eyes, with having a loved one being able to check up on you?” Moreno said.

Missouri is also considering allowing video cameras in nursing home rooms.  See article here.  Two bills have been introduced in the Missouri House this year allowing cameras in nursing home rooms, which advocates say could help prevent elder abuse. One would give families the ability to install cameras and mandate that nursing homes couldn’t prevent the installation. The other, which has already been handed over to the Senate, would give nursing homes the final say.

AARP, the Missouri Coalition for Quality Care and VOYCE, a St. Louis-based organization that sends volunteers to inspect nursing homes, supported the version giving families more power. That version received a public hearing last week but, so far, isn’t scheduled to be debated on the floor. Less than two months remain in the legislative session.

In-room cameras would go a long way toward giving residents and their family members a greater sense of security and could deter potential abuse or neglect, said Mary Lynn Faunda Donovan, VOYCE’s executive director.

“Surveillance cameras are not a suitable replacement for the personal involvement of the staff and family members,” she said. However, “video can provide compelling evidence” of abuse or neglect.  “A camera in the room could exonerate a staff member from any accusations of wrongdoing,” she said. “It works for both sides.”

As of 2017, five other states had nursing home camera laws, with additional rules for assisted living in two.  Andrew Muhl, advocacy director for AARP Louisiana, called it “a very common-sense approach.”

WFAA reported on the investigation into over-medication at Duncanville Healthcare and Rehabilitation Center.  Parkland Hospital investigators are conducting a review for possible over-drugging of patients in an alleged practice known as taking patients “to China.”  The reviews follow the WFAA series, “Drugged and Dying,” that investigated the unnecessary use of alleged powerful antipsychotic drugs to sedate or control patients.

In an effort to cut costs on staffing, many nursing homes drug the elderly rather than hire needed staff, patient advocates warn. They have dubbed the practice “chemical restraints.”  WFAA found in its “Drugged and Dying” series that about 70 percent of a typical nursing home expense goes to staffing.

Several witnesses have come forward stating that residents at Duncanville Healthcare and Rehabilitation were being sedated unnecessarily and inappropriately.   “They said: ‘Take this lady to China,’” the former employee told WFAA.  “It just can be any medication that will put a person to sleep,” the worker said.  “They took that lady to China, and she went to the hospital,” the worker said. “The lady never did come back from the hospital.”

The former employee claims the patient was given the antipsychotic drugs Risperdal and Seroquel. However, the patient, who had been awake and talkative – after receiving the drugs – was placed in bed and became nonresponsive, and within six hours was picked up in an ambulance – and later died, the worker said.  Advocates say the medications – particularly antipsychotics – may become another form of abuse when inappropriately and unnecessarily given. In fact, antipsychotic drugs may be potentially fatal for elderly patients.

Other patients at the Duncanville facility also may have been unnecessarily medicated, according to several workers.

 

 

 

CBC reported a horrific case of neglect and abuse at Harbourstone Enhanced Care nursing home.  The family found their mother bloodied and bruised in her nursing home room.  Daughter Lois Foster has filed complaints with the police and the province over her mother’s injuries, which she says are the result of a lack of care.

“It’s disgusting, unnecessary negligence,” said Foster.

Foster says she received a call on March 18 that her mother, Kathleen MacDougall, had fallen.

“When I went over to the home, the ambulance attendant told me to brace myself,” she said.

Foster, a nurse herself, was shocked.

“She had bruises on both arms, both shoulders, her legs, the skin ripped off her arm, her face on both cheeks, all down her neck,” said Foster. “She had the worst facial appearance that I’ve seen in any of my clients in my 35 years of nursing.”

Foster says her 95-year-old mother’s injuries are a result of neglect she suffered while in her nursing home. She said she’s asked to have the nursing home’s surveillance camera footage reviewed.

“They couldn’t have been caring for her to have her look like this,” said Foster. “That’s not care. They have a duty of care, and there’s there’s no way even a half-hour check could end up with her looking like that.”

She said she wants to see changes implemented so that other families won’t experience similar issues.

“They need more staff, they need more trained staff, and they need to individualize their care,” said Foster.

Foster said concern for her own mother as well as others compelled her to speak out.

“I also thought it was a responsibility of mine as a nurse,” she said. “I can’t sit back and let this happen to another person. It isn’t right. Something must be done.”

The Laurinberg Exchange reported the alleged rape of a resident with mental deficiencies at Willow Place Assisted Living.    The brother of the rape victim contacted police to report that his sister had been raped by another resident.  An employee of the facility called the brother to let him know about the incident, the family said.

Last year, the facility was cited for 16 violations and issued a provisional license. One of the charges was, failure to protect a resident from another violent, combative resident suffering from Alzheimer’s.

Following the spring 2017 inspections, Willow Place was cited for having violated serious state codes concerning patient care and staffing during. The short staffing caused issues with patients’ personal care and safety because patients with dementia were not being kept in a separate hall or being properly monitored.

DHHSR conducted a second inspection in August to deal with additional complaints from patients and their families. Following that investigation, Willow Place was written up for an additional 18 violations some of which the home had been cited for in the first inspection.

The assessment determined that the home failed to follow state regulations for staffing after investigators sampled records for 10 days between June and July and found that “the facility failed to assure staffing met minimal requirements according to the census, for 36 of 45 shifts sampled,” according to the report.

If the facility had adequate staff, they could fulfill their duty and responsibility to supervise the residents and protect them from rape and assault.