ABC7News reported another resident care issue involving SavaSeniorCare, a national billion dollar for-profit nursing home chain based in Atlanta.  This time Sava is in trouble for allowing their facilities to illegally evict residents.  A class action lawsuit has been filed for victims of “patient dumping.”

One of the patients, Karen Mou, says she was given only a week’s notice when state law says she should have been given 30 days’ notice. he believes the facility wanted her to leave so it could replace her with a patient from whom Courtyard Care could receive higher compensation. Mou was covered by Medi-Cal.  Another plaintiff, Anita Willis of San Jose, was briefly homeless when she was told to leave.

The lawsuit alleges six California nursing homes owned by Sava Senior Care routinely refuse to provide residents with an advance written notice of discharge or their rights to contest that discharge.  Attorneys for affected residents want an injunction to stop the provider from allegedly illegally dumping others. They’re also seeking statutory damages.

SavaSeniorCare’s in-house attorney and compliance officer Annaliese Impink told a local television station the company was aware of the lawsuit and is investigating.  “According to our initial review, we see no merit to the allegations,” Impink said in an emailed statement. “We continue to focus on the care and services we provide to the residents we have the privilege to serve and we thank all of our staff for their diligence and commitment.”

New York Magazine had an article explaining how Trump’s recent sabotage of ObamaCare has dire consequences for all of us.  ” In interviews with major publications last spring, Donald Trump repeatedly threatened to deliberately destabilize the Affordable Care Act marketplaces by abruptly halting subsidies to insurers.”

Some of the sabotage includes spreading doubt about whether it would enforce the tax penalty for refusing to sign up for insurance; cut funding for the law’s outreach groups; slashed Obamacare’s advertising budget by 90 percent; spent a portion of the remaining ad budget on propaganda calling for the law’s repeal; cut the open-enrollment period by 45 days; announced that it would be taking (where people can enroll in Obamacare online) offline nearly every Sunday during that time period, for “maintenance” purposes; described Obamacare as “a bad deal” that Americans “won’t be convinced to sign up for” in official public statements; and, most recently, expanded access to “short-term” health plans that do not meet Obamacare’s benefits requirements (and thus, are useless to anyone with a preexisting conditions, or who develops a serious condition after purchasing the insurance).

What are the consequences of these actions?  As HuffPost’s Jonathan Cohn reports:

Come 2019, the number of people without health insurance will rise by nearly 5 million, while millions more will enroll in “short-term” plans, according to Urban Institute research released…Those short-term plans will be popular because they are dirt cheap, relative to the usual price of health insurance. But that’s only because they aren’t available to people with pre-existing conditions and leave out key benefits like mental health, maternity care and prescriptions ― which at least some of those beneficiaries will need when they get sick.

Meanwhile, some people who need or want more comprehensive coverage will have to pay more for it, as the study predicts premiums for such plans will rise 18 percent. And the federal government, which subsidizes plans for lower-income consumers through tax credits, will have to spend more money.


The GoodNewsNetwork had an interesting article about an intellectual-property attorney in Austin, Texas named Stacy Zoern.  She uses a wheelchair and had an idea to help people like her become more independent.  She designed and is now manufacturing an innovative electric car that provides easy access and drivability, without ever getting out of your chair.

Just push a remote button and the back of the Kenguru car lifts up, and its automatic ramp lowers for immediate entry. Then, just drive the tiny vehicle away while seated in your wheelchair.

The environmentally friendly car has a top speed of 35 mph and is designed for getting around on neighborhood or city streets. It is steered by a motorbike-style handlebar and has room for just the driver.

Kenguru has secured millions of dollars from investors and the company projects the cars will sell for around $25,000.

(WATCH the video below from Kenguru Cars)

The New York Times had an article on the ongoing problem of illegal evictions of residents from nursing homes.  The main reason for the evictions is that the residents’ better-paying Medicare coverage is ending and will be replaced by Medicaid.  Discharges and evictions have been the top-ranking category of grievances brought to state long-term care ombudsman programs, the ombudsman agencies say.

David R. Wright of the federal Centers for Medicare and Medicaid Services said in the memo that wrongful evictions were “of great concern” because they could be unsafe or traumatic for patients, uprooting them “from familiar settings” and moving them far from family and friends.

Reimbursement rates for Medicare and Medicaid differ substantially, according to the National Investment Center for Seniors Housing and Care, a nonprofit group that collects data on the industry. Nursing homes receive about $200 a day for a Medicaid patient on average, compared with about $500 for a patient in the traditional Medicare program and $430 for a Medicare patient in a managed care plan.

McKnight’s had an article about the importance of hand washing to prevent infections from spreading in nursing homes.  A new study finds that — by harnessing hand hygiene methods already popular in hospitals — infections in nursing homes can be prevented.  Researchers concluded that implementing simple hand-hygiene protocols in nursing homes helped drop both mortality rates and the number of antibiotic prescriptions doled out, according new study results published in the February American Journal of Infection Control.

“Hand hygiene protocols have traditionally focused on acute-care settings. Our study is changing this narrative, underscoring that we can take a proven intervention practice and make it work outside of the hospital space, by specifically adapting it to long-term settings,” said Laura Temime, lead author of the study and a professor at the Conservatoire National des Arts et Métiers, in Paris, in a press release.

The Times Herald-Record had an article on Sapphire Nursing and Rehab at Goshen.  The residents’ experience includes being “caked in excrement for hours, waiting 30 minutes or more for aides to respond to call bells, getting meals an hour late, receiving the wrong food, and wandering off unattended for extended periods.”  The allegations come after the state Health Department’s recently launched investigation into complaints at the 120-bed home following significant staff cuts by its new owners.

A renowned nursing home researcher said the home’s staffing levels appear to be potentially hazardous and below safe industry standards.  “They have very bad, dangerous staffing,” said Charlene Harrington, an emeritus professor of nursing at the University of California San Francisco, who helped the Record analyze the home’s staffing data. “They’re going to have a lot of bad things happen with those staffing levels.”

“The care of my mother by the new owners has made me sick,” said Majorie Fox of the Town of Wallkill, whose mother, Florence, is a Sapphire resident. “I have been to the doctor with high blood pressure. I’ve spoken about the cuts to everyone at Sapphire and the Department of Health when they were there.”

Sapphire Regional Administrator Jay Pepper acknowledged the home’s new owner, Goshen Operations, LLC – which bought the former Elant home and its three sister facilities in the fall – had “hit some bumps in the road” with staff resignations and “slight” staff cuts.

Between layoffs and resignations from September to December, Sapphire’s nurse tally plummeted 54 percent to 15 licensed practical nurses and two registered nurses, who are supervisors, according to 1199 SEIU United Healthcare Workers East, the employees’ union. Before the cuts, there had been 12 RNs and 25 LPNs, the union said.  In addition, more than a half-dozen of the home’s leaders and staff members, from administrators to kitchen help, have either resigned or been laid off since mid-December, and the home’s certified nursing assistant total is down 10 to 59, according to the union.

In recent weeks, the Record has communicated with about a dozen current and former staff members, relatives of residents and one former patient. The consensus: The home has skidded far and fast downhill since new owners took over in September.  Goshen Operations, LLC, promised “no significant changes to staffing levels” to the state Department of Health when it bought the four facilities in the fall.

Based on a full home, in a typical day, Sapphire’s Goshen location provides 1.87 hours of care per patient per day from CNAs, 0.73
from LPNs and no dedicated non-supervisor RN hours. The home should provide 2.58 from CNAs, 0.71 from LPNs and 1.32 from RNs based on the home’s federally reported acuity level, Harrington said.   Harrington said “the facility appears to have over-reported its staffing by a lot” to the federal government, based on Sapphire’s Medicare filings. “You can compare what the union reports as actual staffing with what they should have and see that they only have a small percent of what they should have.”



New York Magazine had an article on Trump’s lack of response to the opioid crisis.  His indifference is killing people.  Since taking office, Trump has put far more effort into promoting policies that would exacerbate the opioid epidemic than into ones that would mitigate it.

“The year Donald Trump was elected president, drug overdoses killed 63,600 Americans. That was 21 percent more drug deaths than America had seen in 2015, which had been the worst year for such fatalities in our nation’s history. It was also more unnatural deaths than gun violence, HIV/AIDS, or car accidents had ever caused in the United States in a single year. The scale of devastation wrought by the opioid epidemic was so vast, life expectancy in the United States fell for the second consecutive year — the first time that had happened since the early 1960s.”

The death toll will grow in 2017, according to preliminary data from the Centers for Disease Control and Prevention.  If the use of synthetic opioids like fentanyl continues to grow at its current rate, Stat News forecasts that more than 650,000 Americans will die from drug overdoses over the next decade.  In 2015 alone, the opioid crisis cost the American economy $504 billion, according to the White House Council of Economic Advisers.

“The drug-overdose crisis is concentrated in white, rural America (a.k.a. Trump Country). And on the campaign trail, the GOP nominee pledged to make ending the drug crisis a top priority of his administration. But since taking office, he has put far more effort into promoting policies that would exacerbate the epidemic than into ones that would mitigate it.”

“The president has tried to pass trillion-dollar cuts to Medicaid, one of the top sources of funding for addiction treatment in the United States; called for reducing spending on preventative anti-drug measures; proposed slashing the budget for the Office of National Drug Control Policy by 95 percent; neglected to nominate anyone to lead the Drug Enforcement Agency; declined to implement the vast majority of his own opioid-commission’s recommendations; declared the opioid crisis a “public health emergency” — but refused to ask for a single penny in additional funding to combat the crisis, even as he called on Congress to add $1.5 trillion to the deficit for the sake of cutting taxes; and put Kellyanne Conway, a career pollster and pundit — with no experience in public health — in charge of his administration’s opioids agenda.”

• Lawmakers “who have been leaders on opioid policy,” like West Virginia senator Shelley Moore Capito, “haven’t seen outreach from Conway or her cabinet.”

• One of the few people working on Trump’s “public education campaign” is “Andrew Giuliani, Rudy Giuliani’s 32-year-old son, who is a White House public liaison and has no background in drug policy.”

• The office’s big idea for combating the drug-overdose crisis is a “just say no”–style ad campaign, which would have premiered during the Super Bowl broadcast, if Conway’s staff hadn’t failed to put it together in time.

There is a long list of evidence-based reforms that he could implement to save thousands of Americans from its ravages. To take just one example, the most effective remedy for opioid addiction, bar none, is medication-assisted treatment (MAT). Under MAT, addicts are provided with methadone and buprenorphine — less powerful opioids that satiate most addicts’ cravings, and arrest their withdrawal symptoms, without inducing heroin’s debilitating, euphoric high. Decades of research, the World Health OrganizationCDC, and National Institute on Drug Abuse have all demonstrated MAT’s efficacy. Some studies suggest that the treatment reduces mortality among drug addicts by more than 50 percent. And yet, the therapy is only available in about 10 percent of America’s conventional drug-treatment facilities.

The New York Times had an incredible (and scary) article on assisted living facilities. Billions of dollars in government spending is flowing to assisted living industry even as it operates under vague standards and limited supervision. “Federal investigators say they have found huge gaps in the regulation of assisted living facilities, a shortfall that they say has potentially jeopardized the care of hundreds of thousands of people served by the booming industry.”

The federal government lacks even basic information about the quality of assisted living services provided to low-income people on Medicaid according to the Government Accountability Office, a nonpartisan investigative arm of Congress.  The report provides the most detailed look to date at the role of assisted living in Medicaid, one of the nation’s largest health care programs. Titled “Improved Federal Oversight of Beneficiary Health and Welfare Is Needed,” it grew out of a two-year study requested by a bipartisan group of four senators.  See GAO Report on ALFs here.

States reported spending more than $10 billion a year in federal and state funds for assisted living services for more than 330,000 Medicaid beneficiaries, an average of more than $30,000 a person, the Government Accountability Office found in a survey of states.

States are supposed to keep track of cases involving the abuse, neglect, exploitation or unexplained death of Medicaid beneficiaries in assisted living facilities. But more than half of the states were unable to provide information on the number or nature of such cases.

Just 22 states were able to provide data on “critical incidents — cases of potential or actual harm.” In one year, those states reported a total of more than 22,900 incidents, including the physical, emotional or sexual abuse of residents.

Congress has not established standards for assisted living facilities comparable to those for nursing homes. In 1987, Congress adopted a law that strengthened the protection of nursing home residents’ rights, imposed dozens of new requirements on homes and specified the services they must provide.

The Orlando Sentinel had an article about the need for enforceable Resident Rights in Florida (and elsewhere!).  Because of facilities with track records of putting their patients in danger, some advocates and industry experts want to change the Florida Constitution, adding a nursing home and assisted-living facility residents’ bill of rights. Doing so, they say, would not only add more protections, but it also would shield residents from state legislators and presidential administrations that might roll back existing regulations under pressure from the nursing home industry.

The public is completely in the dark about what happens in some of these facilities,” said Brian Lee, a former nursing-home watchdog for the state who now heads the national advocacy group Families for Better Care. “Even the tragedy of 12 nursing home residents dying from neglect after Hurricane Irma — deaths that were categorized as homicides — has not been enough to shame the industry into making changes.”

The Rehabilitation Center at Hollywood Hills in South Florida was evacuated Sept. 13 after power was knocked out by the storm and temperatures inside soared. A dozen elderly residents ultimately succumbed to heat exposure; one had a body temperature of 109.9 degrees. That facility is still fighting to keep its license.

It also prompted the governor to ask the state’s Constitution Revision Commission — which examines the Florida Constitution every 20 years for possible changes — to look at whether there are ways that the document could offer better protection for residents of long-term care facilities.

Proposal 88 establishes the right for residents to be treated “courteously, fairly and with the fullest measure of dignity,” given “adequate and appropriate health care” and live in “a safe, clean, comfortable and homelike environment” with “reasonable precautions” against natural disasters and extreme climatic conditions. , which is now being aired in public hearings throughout the state. If approved by the commission, it would go before voters in November.

It also says residents have the right to access courts, have speedy trials and sue without limitations for damages, that they can’t be asked to waive those rights, and that the facilities must carry liability insurance sufficient to ensure that residents and their families are “justly compensated.”

The industry as a whole is adamantly opposed to any such language in the state’s Constitution — even though some of the rights are already part of laws previously enacted by the Florida Legislature and the proposal doesn’t spell out the consequences for nursing homes that don’t comply.

Record-setting bed valuations, billions in guaranteed revenues and robust profit margins have pushed the senior care market to become one of the fastest growing, most highly profitable health care sectors.

The Fresno Bee reported on the nursing home resident of Bella Vista Memory Care Community who contends that he had to have his right eye removed after staff at the nursing home allowed him to be attacked twice by his roommate.  Josh Dansby Jr. is seeking compensation for injuries suffered as a result of the facilities failure to protect him.  The lawsuit says Bella Vista is understaffed and has a history of being issued deficiencies by the California Department of Social Services.

Sierra Meadows Senior Living, LLC runs Bella Vista and has called the lawsuit a “shakedown”.

The lawsuit states that Dansby suffers from Alzheimer’s and dementia and has a history of strokes and heart attacks. Around February 2017 he became a resident of the nursing home.  Bella Vista placed Dansby with a roommate who had a known history of aggressive propensities and physical assault.  In September, the roommate attacked Dansby.

After this assault, Dansby’s family complained to the Bella Vista staff, asking that Dansby be protected from the roommate including moving rooms or changing roommates. Bella Vista refused to make any changes.

Dansby was attacked by his roommate again in December. After the attack, Bella Vista staff did not provide Dansby with care for days. He was later taken to Saint Agnes Medical Center’s emergency room, where he was determined to have suffered a corneal detachment. Doctors removed Dansby’s right eye.