Cleveland’s The Plain Dealer reported that certified nursing assistant jobs have one of the highest reported rates of injury in Ohio and across the nation, according to researchers and government reports. Nursing assistants are injured three times more often than the average worker, data show.  The rate of injury among nursing assistants is similar to the rate among construction workers, police and firefighters, according to 2016 data from the U.S. Bureau of Labor Statistics.

For the more than 75,000 residents of Ohio’s 960 nursing homes, nursing assistants provide nearly all of the hands-on care. It is a job that requires dedication, passion and empathy.  State and federal officials have issued reports on injuries at nursing homes, dating back to 1999. The studies found that the lifting and moving of residents and the nonstop pace necessary to meet residents’ needs have caused thousands of Ohio nurses and nursing assistants to suffer injuries from overexertion and falls.

The pay in Ohio has trended downward for more than a decade, according to the Paraprofessional Healthcare Institute, a New York watchdog group that advocates for nursing assistants and home health-care workers. In 2006, their average wage was $12.80 an hour. In 2016, it was $11.96.  (It is about $10.50 in South Carolina).

“It’s appalling,” said Toby Edelman, the senior policy attorney for the Center for Medicare Advocacy in Washington, D.C. “That’s not a living wage for anyone.”

The low pay and the physical demands of the job result in an unusually high turnover rate. In Ohio, that rate was 54 percent for nursing assistants at nursing homes in 2015, the most recent data available, said John Bowblis of the Scripps Gerontology Center at Miami University in Oxford.

To offer quality care, staffs at nursing homes should provide an average of 4.1 hours of care for a resident each day, researchers said.

“A large proportion of people in nursing homes need two [assistants] to help them move, and many nursing homes just don’t have enough staff to offer that,” said Charlene Harrington, a professor emeritus of nursing at the University of California at San Francisco and an expert on nursing home staffing. “The better the staffing in nursing homes, the better the care and the less likely workers will get injured.”

This is a gargantuan problem in nursing homes,” said Brian Lee, who leads a Texas-based national advocacy group for nursing home residents called Families for Better Care. “[Nurses and nursing assistants] are overworked, short-staffed and underappreciated. The burnout, the frustration, the injuries. They can all be prevented if employers just hire more people.”

 

The Anderson Independent Mail had an article about Orianna’s bankruptcy due to corporate mismanagement and how that affects pending lawsuits and victims.  Lawsuits incuding thos einvolving wrongful death of residents at Orianna’s nursing homes have been halted since the company’s bankruptcy filing last month in Texas.  Lawyers handling pending suits against Orianna have hired bankruptcy attorneys in Texas as part of an effort to have their clients heard in the company’s bankruptcy proceedings. Victims of abuse and neglect are classified as unsecured creditors, and may not be able to get any compensation for their injuries and wrongful death.

Orianna, which is the Upstate’s top nursing home operator, currently runs 42 nursing homes with more than 4,000 beds in seven states. It has about 5,000 employees.

The company intends to sell its Upstate nursing homes and several other facilities throughout South Carolina and Georgia under terms of a restructuring agreement with its landlord, Omega Healthcare Investors Inc. Plans call for Orianna’s 23 other nursing homes to be transferred to a new operator.

However, the U.S. government has objected to a plan by the bankrupt operator of the Orianna Health Systems nursing home chain to protect companies that would acquire facilities through its restructuring from successor liability. The nursing home operator, 4 West Holding Inc, has facilities in seven states. It is seeking a court order that would allow the transfer of assets free of any liability, which the government said is not allowed by Medicare provider agreements.

Besides seeking to halt all litigation in pending cases as a result of its bankruptcy filing, the company has stopped making payments related to some previously settled suits.

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.”

The Des Moines Register and KRCG reported an obscene travesty of justice.  Prosecutors have dropped felony dependent adult abuse-exploitation charges against nursing home owner and operator Marc Johnson whose company runs the Danville Care Center. In December 2016, Iowa’s Medicaid Fraud Control Unit charged Johnson with two felonies: Fraudulent practices and dependent-adult abuse in the form of financial exploitation. Evidence shows that Johnson stole about $1,700 from a resident to buy a television and other items.

The bizarre decision not to prosecute means Johnson, the president of Cardinal Care Co., will not be tried for an alleged offense that would legally disqualify him from employment as one of his company’s nurse aides, housekeepers or janitors.

“For the county attorney to close her eyes to this and leave this man in a position of authority so the business can remain open just seems absurd to me,” said Dean Lerner, an advocate for seniors who once ran the Iowa agency that inspects nursing homes.

“This doesn’t pass the smell test,” said John Hale, a consultant and advocate for Iowa’s elderly. “A person isn’t prosecuted because of the impact it might have on their business? I was taught that justice is blind. It certainly doesn’t appear so in this case.”

Last fall, a representative of the development company that owns the home contacted prosecutors and warned that if Johnson was convicted, his company would have to sever ties with Cardinal Care, and the home would have to close.  However, the president of the development company, Matthew Hauptman, said this week that while he feels it was unlikely the home would have closed, his company had to guard against that possibility.

The federal Centers for Medicare and Medicaid Services rates the quality of care at the Danville Care Center as “below average.”

The second-largest U.S. nursing home operator, HCR ManorCare, filed for Chapter 11 protection with $7.1 billion of debt, and transfer ownership to its landlord, Quality Care Properties Inc (QCP.N).  The deal includes a settlement agreement for ManorCare’s former chief executive, Paul Ormond, who was owed more than $100 million when he stepped down in September.

The New York Post had an interesting article about the history of Carlyle Group and now bankrupt HCR ManorCare, one of the largest national for-profit chains in the country.   Carlyle paid $6.3 billion in a highly leveraged buyout in 2008 to purchase HCR ManorCare. In 2018, ManorCare collapsed into Chapter 11 bankruptcy, a victim of a $7.1 billion pile of debt created by Carlyle’s greed and mismanagement.

“Ten years ago, angry nursing home workers faced off against private equity mogul David Rubenstein — accusing his Carlyle Group of being interested in nothing but sucking profits from HCR ManorCare, the nursing home behemoth it had purchased the previous year.”  Clearly, they were correct.

Carlyle’s history with ManorCare was troubled almost from the beginning. In 2010, Carlyle sold HCR’s real estate in 338 facilities to HCP, a real estate investment trust, for $6.1 billion — forcing ManorCare to pay rent.  The real estate sale allowed Carlyle to lock in a profit on ManorCare despite the care provided.

From Carlyle’s perspective, they got all their money out a long time ago,” the investor said.

“It’s really the classic sale-leaseback situation where the PE-owned company loses,” the investor said.

By 2012, ManorCare’s revenue did not cover monthly rent obligations.  HCR ManorCare had owed its landlord more than $300 million in rent.

 

New York Magazine had an interesting article discussing how Trump and the Republicans want to limit the lifetime amount Medicaid will pay for individuals.  This will dramatically affect nursing home residents.  Five states are asking for the power to impose arbitrary lifetime time limits on benefits for politically disfavored categories of recipients.  Given Trump’s inclination to destabilize the individual market segment of Obamacare (and the policies governing it), the Medicaid expansion is now looking like the most successful part of the Affordable Care Act, despite the Supreme Court making the expansion a state-by-state option that still leaves larges portions of the country uncovered.

It’s clear that importing time limits to Medicaid has the intention of indirectly killing off the Affordable Care Act’s Medicaid expansion, by radically curtailing benefits for the low-income childless adults without health insurance.

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 healthcare.gov (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.