The Star-Tribune reported the tragic and preventable death of Gary A. Schmidt from reckless administration of medications at North Ridge Health and Rehabilitation nursing home.  Schmidt was given a dose of oxycodone that was 20 times too strong and caused the death of the short-term resident.  He was only 53 years old.

Schmidt was found on the floor at North Ridge Health and Rehabilitation and was dead by the time paramedics arrived the morning of April 2, 2017, according to results of the state Health Department’s investigation.  North Ridge Health and Rehabilitation is owned and operated by Mission Health, a for profit chain from Florida.

Investigators found that a nurse administered 30 milliliters instead of 30 milligrams which is at least 20 times too much of the narcotic. In an interview with a state investigator five days after the overdose, the nurse said “she did not verify the concentration and dose of the oxycodone administered because she was very busy with multiple patients.”

Commercial Appeal reported on the lawsuit unsealed in federal court in Memphis alleging that Spring Gate Rehabilitation and Healthcare Center nursing home gave heavy anti-psychotic drugs to residents to keep them “docile.”  The complaint alleging Medicaid and Medicare fraud by the facility argued that the company provided “worthless” services to residents between 2012 and 2015. Now the company will pay a $500,000 settlement, and has entered into an agreement with the Department of Health and Human Services to prevent such conduct in the future, the U.S. Attorney’s Office said.

According to the lawsuit, Spring Gate, operated by Memphis Operator, LLC, prescribed a resident heavy doses of anti-psychotic and anti-anxiety drugs in 2013 “despite the fact that there was never a medically accepted indication justifying such heavy-duty medications.”

“After Spring Gate prescribed these psychoactive drugs, (her) condition quickly deteriorated,” according to the complaint. “Spring Gate internal reports described her as confused and unsteady, prone to staring off into space. She fell multiple times …”

Her nephew raised concerns to Spring Gate and “to his great surprise, the nursing staff openly admitted to (him) that (she) was being prescribed these drugs ‘to keep her in the bed,'” according to the lawsuit.

KPCC reported the latest data from the federal Centers for Medicare & Medicaid Services, known as CMS, regarding the percentage of long-term nursing home residents being given antipsychotic drugs dropped from about 24 percent in late 2011 to under 16 percent last year. Decreases were reported in all 50 states, with the biggest in Tennessee, California and Arkansas.  However, 16 percent is still way too high.

“Given the dire consequences, it should be zero,” said attorney Kelly Bagby of the AARP foundation, which has engaged in several court cases challenging nursing home medication practices. Bagby contends that the drugs are frequently used for their sedative effect, not because they have any benefit to the recipients.

Experts and advocacy groups — including the Washington-based Center for Medicare Advocacy and AARP Foundation Litigation — say even the lower rate of antipsychotic usage is excessive, given federal warnings that elderly people with dementia face a higher risk of death when treated with such drugs. Some nursing homes are finding other medications that sedate their patients into passivity without drawing the same level of scrutiny as antipsychotics.

Analyzing the latest government data, Human Rights Watch estimates there are now about 179,000 people in nursing homes who get antipsychotics every week without having a diagnosis for which the drugs are approved.

“Antipsychotic drugs alter consciousness and can adversely affect an individual’s ability to interact with others,” the new report says. “They can also make it easier for understaffed facilities, with direct care workers inadequately trained in dementia care, to manage the people who live there.”

The report also says that nursing homes, in violation of government regulations, often administer antipsychotic drugs without obtaining consent from residents or the relatives who represent them.

Hannah Flamm, the report’s lead author, said the recent data showing a decline in antipsychotic usage demonstrated how extensive the overmedication problem had been. In an interview, she said the lower numbers don’t impress her.

Would you want to go into nursing home if there’s a one in six chance you’d be given a drug that robs you of your ability to communicate?” she asked. “It’s hard for me to applaud the reduction when it’s inexcusable to ever misuse these drugs.”

Advocacy groups contend that federal enforcement of medication regulations has been too lax and will only grow more lenient as President Donald Trump’s administration pursues an agenda of deregulation.

“They’re helping the industry, not the patients,” said attorney Toby Edelman of the Center for Medicare Advocacy:

 

CNN had a great article on the new Human Rights Watch report, “‘They want docile:’ How Nursing Homes in the United States Overmedicate People with Dementia.”  “Children complained about parents who were robbed of their personalities and turned into zombies. Residents remembered slurring their words and being unable to think or stay awake. Former administrators admitted doling out drugs without having appropriate diagnoses, securing informed consent or divulging risks.”  The under-staffing of nursing homes is a major factor of such over-medication.

The 157-page report estimates that each week more than 179,000 people living in US nursing facilities are given antipsychotic medications, even though they don’t have the approved psychiatric diagnoses — like schizophrenia — to warrant use of the drugs. Most of these residents are older and have dementia, and researchers say the antipsychotic medications are administered as a cost-effective “chemical restraint” to suppress behaviors and ease the load on overwhelmed staff.
What’s revealed in this report echoes the findings of a CNN investigation published in October. The CNN story described how one little red pill, Nuedexta, was being misused and overprescribed in nursing homes. What’s more, CNN learned that this overuse benefited the drugmaker to a tune of hundreds of millions of dollars, largely at the expense of the US government. The CNN report prompted an investigation into a California-based pharmaceutical company.
The Food and Drug Administration has not deemed antipsychotic drugs an effective or safe way to treat symptoms associated with dementia — including dementia-related psychosis, for which there is no approved drug. In fact, the FDA cautions that these drugs pose dangers for elderly patients with dementia, even doubling the risk of death, the report shows. Other possible side effects outlined in the report include an onset of nervous system problems that may cause “severe muscular rigidity” or “jerking movements,” as well as low blood pressure, high blood sugar, blood clots and other problems.
There are plenty of ways to deal with dementia-related symptoms or behaviors that don’t involve pharmaceuticals, the report lays out. Improvements can be achieved through providing activities, reducing loneliness, creating routines, encouraging relationships with familiar staff members, offering exercise and promoting programs like music therapy and pet therapy.
The government has long-recognized the problem of overusing antipsychotic medications and is required to monitor the use of such drugs, the report shows. In fact, in 2012, the Centers for Medicare & Medicaid Services established the National Partnership to Improve Dementia Care in Nursing Homes in acknowledgement of this issue.  “The US government pays nursing homes tens of billions of dollars per year to provide safe and appropriate care for residents,” said Hannah Flamm, a New York University Law fellow at Human Rights Watch. “Officials have a duty to ensure that these often vulnerable people are protected rather than abused.”

Provo Rehabilitation and Nursing facility and a former nurse must pay $1.4 million for the death of a man who was given the wrong medications, a jury has ruled.  The facility was ordered to pay the bulk of the damages to the family of Jack Adams who died Feb. 11, 2010, after a nurse at the facility gave him the wrong medications, then altered medication records in an attempt to cover up her mistake, according to the complaint.

The nurse, Camille Jensen, reportedly gave Adams three medications meant for another patient. Jensen did not report the error, instead giving Adams’ medications to another patient so that medicine counts would appear correct, according to the lawsuit.

Adams died two days later. Jensen allegedly waited until five days after the man’s funeral to inform Provo Rehabilitation and Nursing about the mix-up.

Had Jensen reported the mistake, Adams’ life likely could have been saved, experts who reviewed the case agreed.

Following Adams’ death, the care facility informed the man’s family about the mistake but denied responsibility, then billed the family for the nursing services, according to the family’s attorney. Details about the exchange were not allowed in the four-day jury trial.

The jury ascribed 35 percent of fault in Adams’ death to Jensen and 65 percent of fault to Provo Rehabilitation and Nursing.

A Utah appellate panel said the nursing home must pay the entire $1.4 million jury verdict in a suit accusing a nurse of negligence in fatally giving a patient the wrong medication, saying that as the nurse’s employer, the home must assume responsibility for both the act and its concealment.

25 News-Week reported that Katrina Wesemann won a $5.2 million settlement against Bloomington-based Heritage Enterprises and its Dwight-based facility, Heritage Manor – Dwight. The jury awarded the sum to a local nurse who says she was fired after refusing to chemically restrain residents and reporting that her nursing home employer was ordering her to “double-dose” patients and cover up injuries.

Wesemann said she refused to follow the director of nursing’s orders to “drop a pill,” or double dose agitated residents with anti-anxiety medications. She also said she refused to delete or omit records of suspicious injuries, her attorney Timothy Coffey said in a press release.

She made a call to her corporate hotline to report her supervisor’s activities, and was fired in retaliation in 2012, Coffey said.

New York Magazine reported that 63,000 Americans died of a drug overdose.  About 42,200 of last year’s drug deaths were linked to opioids, up from 33,000 the year before. In October, President Trump declared the opioid epidemic a public-health emergency – but declined to call for a single dollar in new funding to address the crisis.  Nothing is being done about it.  It is a national tragedy that affects every strata of society.

This epidemic of drug deaths reduced life expectancy in the United States for the second consecutive year — the first time that’s happened since the early 1960s. Beyond the incalculable human toll of all this death, the opioid crisis cost the American economy $504 billion in 2015 alone, according to the White House Council of Economic Advisers.

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.

WKYT reported that Polly A. Campbell, who was a registered nurse at Signature at Heritage Hall, was arrested after police say she stole medicine from a nursing home.  Officers say Campbell stole from multiple patients at the center. They say she worked at Heritage Hall for five or six months.

Campbell is charged with multiple counts of Theft by Unlawful Taking Controlled Substances, multiple counts of Theft of Medical Records and Presciption Controlled Substance Not in Proper Container.  More charges are possible after the nursing home completes an audit of their medications.

WREX reported that Forest City Rehab & Nursing Center nursing home was fined $25,000 after the state says the facility caused a resident’s death.  The first incident reported by the Illinois Department of Health says a female resident, who lived at Forest City Rehab & Nursing Center since 2001, got medications she wasn’t supposed to.  The report says she was given multiple opioids that were meant for other residents.  The report says the woman was unresponsive and needed Narcan after the opioids were given to her.

A physician ordered the facility to monitor her vital signs every hour, something the facility did not do, according to the report. The resident died one week later.

But Forest City Rehab and Nursing didn’t just get penalized because of that fatal error. The state says says the facility failed to take proper care of her after the incident happened. On top of that, the report says it failed to let the woman’s power of attorney know what happened. That power of attorney later told the state in that report, “I was called when (R1) went into hospice in April, but I have not received any calls from the facility since then.”

Forest City Rehab & Nursing Center is also facing punishment for another incident to a different resident. The IDPH report went on to say that resident fell, breaking  both his arms and legs. The reason the nursing home faces a penalty is because the report says two people were supposed to help that resident move, but only one did.

That resident told IDPH, “There was just one girl helping me and I told her my legs weren’t working and then down I came. There was no belt around my waist, they usually don’t use one. I don’t recall hitting anything on my way down. I was just weak that day. I broke both my arms and my legs.”

Click here to read the full report.

McKnight’s reported that a pharmacist involved in a scheme to repackage drugs that went unused by area nursing homes was sentenced to probation and community service.  Correna Pfeiffer, manager for Aliquippa Med-Fast Institutional Pharmacy, was part of an investigation into Med-Fast’s repackaging practices that concluded with a $2.7 million settlement and charges against an executive.

Pfeiffer, the first employee named in the case, pleaded guilty to charges that she helped facilitate a scheme in which the pharmacy would pick up unused drugs from nursing homes and bring them back. Pharmacy employees would then remove the medications from their original packages and restock them for use in future prescriptions, the Pittsburgh Post-Gazette reported.

As a result, medications with different makers and expiration dates were mixed in with other stock. Employees would use fake labels on the repackaged drugs.