The Buffalo News reported the disturbing tale of Thomas Moore who spent more than 20 years in prison for sexually abusing hospitalized women who were elderly, disabled or incapacitated.  But when time came to release him last year, he was accepted at Waterfront Rehabilitation and Healthcare Center in Buffalo – where he lived surrounded by elderly, disabled and incapacitated women. State law required Waterfront to be notified of Moore’s status as a level 3 “sexually violent and predicate sex offender” when he was released to its care, according to the state Department of Corrections and Community Services.

Barely a month after he moved into Waterfront, Moore was arrested and charged with sexually abusing a fellow resident in her bed.  Authorities accused Moore of entering the room of another Waterfront resident at about midnight on Jan. 3, pulling off her blanket and molesting her. Police arrested Moore nine days later, charging him with sexual abuse of a person incapable of giving consent and with endangering the welfare of a physically disabled person.

“It was like throwing the fox in the hen house,” said Dr. Charles P. Ewing of the University at Buffalo, an attorney and forensic psychologist who has studied sex offenders and the law. Ewing said that any facility responsible for the safety of others, whether they are young, elderly or infirm, has a higher level of obligation to stay informed if it agrees to hire or house someone on the sex offender registry.

The police report’s description of the January assault are similar to Moore’s first two convictions for sex crimes. In both cases, he assaulted women who were disabled or incapacitated.

Moore’s first sex offense conviction came in July 1996. Moore targeted a 79-year-old woman – a patient in a Manhattan hospital. Convicted of the sexual abuse of a person who was physically helpless, he spent four years in prison and was released in 2000.

By August 2001, Moore assaulted two female patients at Beth Israel Medical Center. First he pulled the sheet off a 58-year-old woman who had come out of surgery. Then a nurse spotted him on a bed with a semi-conscious 93-year-old woman.

Federal regulations require nursing homes to make every effort to protect their residents from abuse. Those rules “not only specify that these facilities may only admit residents they can appropriately care for, but they must also identify residents whose personal histories put them at risk for abusing other residents,” according to the state Department of Health.

“Staff must work diligently to prevent such occurrences by monitoring behavior of these residents and regularly reviewing their internal strategies for the prevention of abuse,” according to its statement to The News.

A 2015 study led by Cornell researchers found that more than 20 percent of nursing home residents are victims of some type of resident-on-resident abuse in the course of any given month, with the abuse ranging from cursing and threats, theft of personal items, inappropriate touching or hitting, all the way up to homicide.

 

A Florida federal jury in U.S. ex rel. Ruckh v. Genoa Healthcare, LLC, found the operators of 53 skilled nursing facilities liable for more than $115 million in damages stemming from false claims they submitted to Medicare and Medicaid after pretending patients needed and received more care than they did.

The jury ruled on False Claims Act allegations brought by whistleblower Angela Ruckh, who worked at two of the facilities as a nurse, and found that the four defendants — CMC II LLC, Salus Rehabilitation LLC, 207 Marshall Drive Operations LLC and 803 Oak Street Operations, LLC were liable for false claims.

Ruckh said she saw years of corporate scheming meant to “bill Medicare and Medicaid” by upcoding therapies.  Angela Ruckh, formerly of La Vie Management, proved that the providers listed in the case presented “false or fraudulent” claims for reimbursement.

The Government has many tools to help it prosecute False Claims Act cases.  One such tool is extrapolation—the act of using a sample of resident files to determine an error rate and applying that error rate to a greater universe of resident files.  After some initial setbacks including having their case dismissed for lack of necessary detail, the plaintiff complained that to show fraud with detail in every instance was not feasible.  The plaintiff instead asked to use the Government’s tool of extrapolation (to be able to have an expert pick out some files, determine an error rate and apply that error rate to a larger universe.)  The Federal Government filed a brief in support of permitting private parties this power.

The Court sided with the whistleblower, allowing her to use extrapolation and statistical sampling to estimate the volume of overpayments allegedly received by the defendants.  In issuing his decision, District Judge Steven Merryday relied on other cases that accepted statistical sampling methods as reliable and acceptable evidence in determining facts related to False Claims Act claims.  Judge Merryday echoed a recent District Court case in Tennessee that considered “the large universe of allegedly false claims” in finding that “it would be impracticable for the Court to review each claim individually” and to do so “would consume an unacceptable portion of the Court’s limited resources.”

Though this case is just the latest in a string of cases upholding the use of statistics and extrapolation to establish liability under the False Claims Act, this decision is unique in that it allows an individual qui tam whistleblower to utilize this powerful tool to demonstrate falsity even where the Government has declined to intervene in the case.

First Cost News reported the tragic and preventable neglect of Annie Hurley at San Jose Health and Rehabilitation Center.  Annie was transferred to the hospital with a large infected Stage 4 pressure ulcer and a fever of 104.  Annie’s daughter, Paris, questions the level of care her grandmother was given at the nursing home.

“The way the sore looks is awful,” says Paris Hurley. “It’s almost like her body is rotten.”  She adds there’s no way the staff there could’ve missed the huge sore – not just based on its size, but also the visceral smell. It was so ugly, Paris explains, the Emergency Room doctor was stunned.

“He said this is the worst case he’s ever seen in his life,” Paris says.

“And she had no response,” Paris says.

Family members maintain she deserves the best of care and now they don’t believe she received it.  “We trust the caretakers, the nurses, to take care of our family members every day and they don’t,” Paris says.

 

The Casper Star Tribune reported the settlement between SavaSeniorCare d/b/a Poplar Living Center and resident Gilbert Arellano.  The lawsuit involved a facility employee driving a van into the blind resident standing near the curb waiting for a ride in March 2014. Arellano was knocked to the ground, and injured.  The nursing home did not have someone stand with Arellano while he waited for his ride on the handicap ramp and the man was unable to avoid the danger himself because he is legally blind, the suit says. The suit alleges the facility failed to meet the legal standard of care because it is understaffed, did not accompany Arellano to the curb and allowed an employee to “negligently operate” a company van.

Since the incident, Arellano has had pain and numbness in his right arm.  The amount of the settlement reached on Nov. 1 could not be disclosed because of a confidentiality agreement.

The suit also alleges that SavaSeniorCare, the company that owns the Casper nursing home, kept staff numbers low and didn’t adequately train employees to save money, thus endangering the residents. That allegation is repeated across many of the other lawsuits. The Centers for Medicare and Medicaid Services also cited Poplar Living Center for understaffing the facility.

According to its website, SavaSeniorCare operates more than 230 nursing homes across the country, including two more in Wyoming: Cheyenne Healthcare Center and the Sheridan Manor.

“The nursing home’s settlement was the most recent conclusion to six wrongful death or personal injury lawsuits filed against it in the last six years. Repeated inspections by the Centers for Medicare and Medicaid Services also detail a pattern of understaffing, improper care and unsafe building conditions.”
The facility is on the Special Focus Facility list that needs close monitoring because of a “history of persistent poor quality of care.”   Inspection records show a pattern of the for-profit Sava nursing home failing to employ enough staff to keep residents safe, take care of residents who showed signs of depression and investigate complaints of neglect.
Improper wound care is repeatedly cited in the reports. The presence of pressure ulcers is an indicator of neglect and short-staffing.  One resident arrived at the facility in January 2015 without any wounds but developed open sores on her buttocks and legs in March.  The nursing home administrator told inspectors in January, “I’m nowhere near where I want to be in terms of staffing,” according to the agency’s Jan. 15 report.  According to a March 2015 report, there were many nights where only one nurse and one nurse’s assistant were in the building to care for more than 100 residents — many of whom require assistance to use the bathroom and navigate other simple tasks.

The reports repeatedly note that the nursing home fails to adequately record, investigate and resolve complaints about living conditions.  Residents who needed help using the bathroom reported they often waited long periods of time — sometimes up to eight hours — before they were taken to the restroom. One resident wandered the halls of the facility just after 8 p.m. March 29, 2015, with urine-soaked pants for at least 25 minutes before being helped.

Residents also told inspectors that the food served was inedible. A district manager who sampled a meal of steak and noodles also said the food was “not palatable,” according to the reports.

Families of previous residents have sued Poplar Living Center at least six times in the past six years alleging that negligence led to the death and serious injury of their loved ones. The nursing home settled four of those suits for undisclosed amounts and one is still ongoing.

The Ledger-Enquirer reported that a preliminary hearing was held in a nursing home assault case last week.  Columbus Police Officer Joshua Bailey said he was called to the Magnolia Manor nursing home on Nov. 10 after it was reported that a resident had been assaulted the day before at 10:15 p.m.  A certified nursing assistant allegedly assaulted a resident with dementia in November by slamming her onto a bed at a nursing home.  Diane Ruby Blair pleaded not guilty to one count each of simple battery and exploitation and intimidation of disabled adults and elder persons. However, testimony last week supports her arrest.

Bailey spoke to a LPN who saw 57-year-old Blair forcefully handle a resident with dementia after the woman got tangled in bedsheets.  The witness said the defendant closed the curtain between the victim and her roommate. She then jerked the victim up by her arm, shoulder and neck before slamming her back onto the bed, Bailey testified.

During the incident, Blair allegedly told her, “Bitch, I’m not doing this mess tonight,” according to police.

Another witness said “Blair was very rough with (the victim) given her age and condition.” Authorities said the victim struggles to communicate effectively because of her illness, but she confirmed that she was assaulted.

Blair was terminated from the nursing home after working at the facility for one month.

 

The Chicago Sun-Times reported on the lawsuit filed on behalf of a nursing home resident that  “developed a sexually transmitted disease as a result of being raped” while a resident of GlenShire Nursing and Rehabilitation Centre.  The 63-year-old woman who died last year claims she was sexually assaulted during her seven-week stay at the facility.

The woman, who suffered from Alzheimer’s disease, was admitted Dec. 7, 2014.  The woman lost nearly 30 pounds before she died Jan. 16, 2015, the suit alleges. An autopsy found the Harvey resident died of sepsis from a urinary tract infection, with heart disease contributing, according to the Cook County medical examiner’s office. Her death was ruled natural.

The five-count wrongful death suit claims she was neglected by her doctor and the staff at the facility, where “no plan was implemented to prevent sexual abuse” given her condition.

 

What the heck is going on in Arkansas?

Rosey Perkins and Rhonda Coppack, daughters of the late Martha Bull of Perryville, have sued nursing-home owner Michael Morton and former state Sen. Gilbert Baker, a lobbyist and political fundraiser.  The sisters contend the men conspired to bribe former Circuit Judge Michael Maggio to lower a Faulkner County jury’s $5.2 million judgment to $1 million in an earlier negligence lawsuit over Bull’s death in 2008.

In January 2015, Maggio pleaded guilty to a federal bribery charge and has since been sentenced to prison. He implicated Baker and Morton in his plea agreement. Baker and Morton have said they believe the agreement was referring to them.  Morton still owns and operates nursing homes in Arkansas.

Attorneys for the two sisters want Maggio’s plea agreement and sworn statements to be accepted as evidence in the current lawsuit, though Morton objects.

At the same time in another case involving Morton, Justice Rhonda Wood, an Arkansas Supreme Court justice, says she won’t recuse herself from hearing an appeal related to a wrongful-death lawsuit against a nursing home owner Morton despite the fact that Morton donated thousands of dollars to her campaign.

Wood cited several reasons for declining the motion, noting that Morton wasn’t involved in her campaign and didn’t host any fundraisers for her.

The Columbus Dispatch reported the sentencing of Susan Gwynne, the former nurse’s aide who made a living stealing valuables, keepsakes and trust from at least 46 senior center residents for more than 12 years, to 65 years in prison. Gwynne “frowned but showed little other emotion” as Judge David Gormley began reciting her prison sentence for each of 46 counts — each a charge related to one of Gwynne’s victims.

She feigned kindness and dedication to betray her former profession by stealing — in a prolific, multiyear spree — jewelry, credit cards, keepsakes and memories from those who were ill, confined to a bed or just in need of companionship.

Surveillance video showed Gwynne, dressed as an employee, entering rooms carrying an empty purse that was bulging when she left. She was charged with 31 counts of felony burglary and theft and 15 misdemeanor counts of receiving stolen property.

WJACTV reported that a consumer protection lawsuit was filed against Pittsburgh-based Grane Healthcare Co., which manages and operates 12 skilled nursing facilities statewide, as a result of an investigation by the attorney general’s health care section.

Attorney General Bruce R. Beemer accuses Grane of misleading consumers by failing to provide basic services to elderly and vulnerable residents. Grane is also accused of the chain-wide practice of billing consumers and the commonwealth for services that were not provided.  Grane violated Pennsylvania’s Unfair Trade Practices and Consumer Protection Law by making misrepresentations on its websites and in marketing materials regarding facility staffing and the basic care provided to the residents of its facilities.

“According to the lawsuit, Grane limited the number of certified nursing assistants on duty at its facilities, leaving the facilities incapable of delivering the basic care that Grane promised to provide. Despite that, Grane facilities advertised and marketed to consumers that they strive for a very high staff-to-patient ratio and that they base staffing on patient acuity levels, the lawsuit says. The lawsuit alleges that this conduct was deceptive, misleading and unfair.”

The allegations include:

· Incontinent residents were not checked and changed for hours at a time and were left in wet and soiled clothing and bedding.  “I’d say about three or four times, they let me sit in my own crap and they take a long time to come in,” one female resident at LaurelWood Care Center said.

· Continent residents did not get timely assistance for using the bathrooms, causing them to urinate and defecate in their clothes.

· Showers were skipped or rushed.

· Residents were left in their pajamas during the day, because staff did not have time to dress them.

· Residents were not repositioned every two hours as needed, but instead waited intervals of three to four hours between repositionings.

· Certified nursing assistants used mechanical lifts to transfer and reposition residents alone, even though this practice risked injury for both staff and residents.

· Excessive and inappropriate use of physical and pharmacological restraints.

· Residents were awakened at 5 a.m. or earlier to be showered and dressed for the day because of inadequate staffing on the day shift.

· Residents faced long waits after ringing call bells for assistance.

· Residents who required assistance with meals missed meals or did not get enough to eat, because staff did not have enough time to feed them.

· Range of motion exercises were rarely done with residents, though CNAs were instructed to document that they had been done.

· Records were falsified, showing that residents received more care than staff had really provided to them.

CBS News reported the arrest of nurse Elizabeth Tracey Mae Wettlaufer for the first-degree murders of eight elderly people at nursing homes in southwestern Ontario over a seven-year period.

“The victims were administered a drug. We’re not in a position at this time to comment further on the specifics of the drug as it forms part of the evidence that is now before the courts,” Ontario Provincial Police detective Dave Truax said. Truax would only say that a number of drugs were stored and accessible in the nursing homes where the suspect worked.

Wettlaufer was employed by Caressant Care Nursing and Retirement Homes, which operates 15 facilities in small Ontario towns. Police said seven of the victims died at a Caressant nursing home in Woodstock. She was also employed at the Meadow Park facility in London, where the other victim died.

The victims have been identified as James Silcox, 84; Maurice Granat, 84; Gladys Millard, 87; Helen Matheson, 95; Mary Zurawinski, 96; Helen Young, 90; Maureen Pickering, 79; and Arpad Horvath, 75.

Police said they believe Wettlaufer also worked at other long-term care facilities in the province but could not specify which ones, nor would they speak about a possible motive.