Republican Sen. Chuck Grassley has a long history of nursing home oversight and increasing quality of care for nursing home residents.  After the alert from the Department of Health and Human Services Office of Inspector General finding that 28 percent of 134 potential incidents of abuse or neglect in 33 states may not have been reported to law enforcement, as required, Grassley stated:

“A crime is a crime wherever it takes place. Abusing or neglecting nursing home residents are criminal acts. They have to be reported and investigated by law enforcement. It’s unacceptable for more than one-fourth of potential crimes in nursing homes to apparently go unreported. I intend to follow up with CMS to make sure the agency will take immediate action to fix this problem, as the inspector general recommends. The nursing home industry should do a better job of following the law. Nursing home residents, their families and the taxpayers deserve quality care and justice whenever crimes are committed.

The alert recommends the Centers for Medicare and Medicaid Services take immediate action to ensure incidents are identified and reported.

NJ spotlight reported the passage of “Peggy’s Law” which require nursing homes to notify the police within hours of suspected abuse — or staff must make 911 call if situation is an emergency.  This seems like it should have been required long ago.

Starting soon, elderly residents in New Jersey’s nursing homes and other long-term care facilities will benefit from additional protections designed to ensure law enforcement is looped into possible criminal abuse cases right from the start.

The measure is named for 93-year-old Peggy Marzolla who died several months after being injured while in the care of a nursing home in 2010.  Marzolla was treated for a broken eye-socket, cheekbones, and wrist, among other injuries, which nursing home staff blamed on an accidental slip and fall. Marzolla’s family didn’t accept the excuses she got from staff and was displeased with the state’s follow-up, leading her to lobby lawmakers to better protect seniors — a campaign she has continued ever since.

DHEC officials confirmed the agency is currently taking enforcement action against Brookdale Senior Living Facility in Charleston, where a resident died in July 2016 after wandering away and being killed by an alligator.

The action comes as a result of violations cited during a series of recent inspections and investigations, according to DHEC’s spokesman Robert Yannity.

According to DHEC’s website, when an agency takes enforcement action against a facility, administrative staff are called to attend a conference with DHEC officials to go over the violations and discuss corrective actions.

If DHEC and the violating facility come to terms, a mutually agreed upon “Consent Order” is issued outlining the actions which must be taken, and DHEC’s expectations.


New Mexico Attorney General Hector Balderas is trying to stop elderly abuse in nursing homes.  KFOX TV reported that New Mexico’s attorney general is launching a new campaign to prevent elderly abuse in nursing homes.

He’s ordered the state to review documents and evidence of abuse that would lead to an investigation on any facility.

“We also look at whether or not they are being cared for appropriately, according to their care plan, and we also look at a variety of injuries and things of that nature,” said Richard Chavez, the AG’s special agent supervisor.

Once enough evidence is gathered, the attorney general’s office will try to prosecute offending homes.

The Miami Herald reported the criminal charges of bribery against Bertha Blanco, a Florida health care administrator in exchange for helping a nursing home owner accused of orchestrating a $1 billion Medicare and Medicaid fraud scheme keep his license.  The wide-ranging investigation that federal authorities are calling the nation’s biggest health fraud case.

Blanco made about $31,300 a year overseeing inspections at nursing facilities owned by Philip Esformes, a wealthy businessman who owns dozens of Miami-Dade nursing facilities as well as homes in Miami, Los Angeles and Chicago.

A criminal complaint filed against Blanco accused her of taking tens of thousands of dollars in cash in exchange for tipping Esformes off about violations so he could address them before state inspections.  Blanco’s aid allowed Esformes to keep his license active and continue billing the federal government for questionable patient services.

Federal authorities say Blanco took the bribes and provided patient and inspection records to intermediaries, who delivered the information to Esformes.  Two of those intermediaries, brothers Gabriel and Guillermo Delgado, have made plea deals and are expected to testify against Esformes. The brothers helped investigators get to Esformes by videotaping a cash transaction that prosecutors said was meant to go for bribes.

Esformes is accused of using his 20 nursing facilities to file false Medicare and Medicaid claims for services that were not necessary for 14,000 patients.

Prosecutors said his health care network and other co-conspirators billed $1 billion for fraudulent services between 2009 and 2016.

The New York Times had an article about “Special Focus Facilities”.  Special Focus Facilities are the worse of the worse nursing homes.  “Special focus facility status is reserved for the poorest-performing facilities out of more than 15,000 skilled nursing homes. The Centers for Medicare and Medicaid Services, or C.M.S., assign each state a set number of slots, roughly based on the number of nursing homes. Then state health regulators pick which nursing homes to include.”

Designation requires the facility to immediately fix violations in care while under increased inspections or be stripped of federal funding by Medicare and Medicaid — a financial deprivation few homes can survive.

“While special focus status is one of the federal government’s strictest forms of oversight, nursing homes that were forced to undergo such scrutiny often slide back into providing dangerous care, according to an analysis of federal health inspection data. Of 528 nursing homes that graduated from special focus status before 2014 and are still operating, slightly more than half — 52 percent — have since harmed patients or put patients in serious jeopardy within the past three years.”

Yet, despite recurrences of patient harm, nursing homes are rarely denied Medicare and Medicaid reimbursement.  Regulators rarely return homes to the watch list, instead issuing fines for subsequent lapses. Some homes continue operating despite multiple penalties. Especially troubling is that more than a third of operating nursing facilities that graduated from the watch list before 2014 still hold the lowest possible Medicare rating for health and safety: one star of five, the analysis found.

More than 900 facilities have been placed on the watch list since 2005. But the number of nursing homes under special focus at any given time has dropped by nearly half since 2012, because of federal budget cuts. This year, the $2.6 million budget allows only 88 nursing homes to receive the designation, though regulators identified 435 as warranting scrutiny.  Too few nurses, particularly registered nurses, provide care at some of the most troubled homes, the analysis shows.

WSOCTV reported that the North Carolina Department of Health and Human Services investigators visited Lake Park Nursing and Rehabilitation Center three days after Channel 9 exposed allegations of patient abuse.  Investigators spent four days at Lake Park nursing home and found repeat problems.

State officials said that their visit was in response to a new complaint in March.  The investigation stated that a patient had not received a shower in two weeks and staff provided him with a washcloth to wash his face, “but that’s it.” The facility was also cited for “neglecting to feed and provide incontinence care for dependent residents.”

Channel 9 uncovered two lawsuits against the facility that are alleging sexual assault and abuse.

The continued failure of the facility during three federal surveys of record show a pattern of the facility’s inability to sustain an effective Quality Assurance Program.

Lake Park nursing is a special focus facility, one of only about 80 in the country, which means it has a history of persistent poor quality, according to Medicare.  Medicare said the facility has shown ‘no improvement for 12 months.

In the report, the facility’s administrator blames family members. “One of the biggest barriers to achieving substantial compliance is difficult families,” it read.


The state is now investigating a local nursing home days after a Channel 9 investigation exposed allegations of abuse. [Nursing home faces lawsuits after employee pleads guilty to sexually assaulting patient].

The Channel 9 investigation aired Thursday and by the weekend, state investigators were at Lake Park Nursing and Rehabilitation Center in Indian Trail. Eyewitness News anchor John Paul went back to the facility looking for answers.  Paul talked to new family members who said they’re concerned about some of the conditions they’ve witnessed there.

Before this investigation, two lawsuits were filed on behalf of residents who are now deceased. The suits alleged sexual assault, poor treatment and untimely death.

According to Nursing Home Compare on the Medicare website, Lake Park is a one-star facility owned and operated by PRINCIPLE LONG TERM CARE, INC tha tis on the Special Focus facility watch list. On January 15, 2016, the facility was fined $132, 600 and then again on November 2, 2016 for $277,052.

Sexual assaults are among the most severe cases against residents of nursing homes. However, it is also the least detected, reported, and acknowledged type of problem in this institution.  The University Herald reported on a new study that found sexual assault is prevalent in nursing homes. However, this issue has been very under-reported to the point of being ignored.  The study observed 15 past studies in peer-reviewed journals that focus on the topic of sexual assaults on nursing home residents.

Moreover, white females suffering mental and physical conditions are more likely to be victims, since they are the most vulnerable. The study, published in “The Gerontologist” found that these sexual assaults happen because legal examinations aren’t done regularly due to administration complexities, Eureka Alert reported. Training and institutional policy in these nursing homes are also major problems that propagate the cases of sexual assaults. Ultimately, nursing homes are not equipped adequately to stop these sexual assaults.


The study suggests that nursing home staff should have more training to help them identify and handle these sexual assault cases. The study’s authors said there is a gap in knowledge about sexual assaults, which is why staff should be trained.

According to Monash University’s Daisy Smith, who is also the lead author, there is a lot more that is needed to be done for those that are most vulnerable in these nursing homes. Regulatory investigative personal doesn’t have the right resources to properly identify and handle these cases of sexual assaults in nursing homes, said Smith.

The Healthcare Finance News reported the settlement between Prestige Healthcare and the U.S. Department of Justice.  Based in Louisville, Kentucky, Prestige is an owner and operator of nursing homes in several states.  Prestige Healthcare has agreed to pay the federal government nearly $1 million to resolve allegations that it violated the False Claims Act in a scheme to falsely bill Medicare for unnecessary genetic testing, according to the U.S. Department of Justice.

Nursing home operators such as Prestige place orders with clinical laboratories for medically necessary diagnostic laboratory tests for their residents. In order to be considered medically necessary and thus reimbursable under Medicare, the laboratory test must be ordered by the physician treating the resident.

The allegations charge Prestige with failing to ensure that physician orders were obtained for the genetic testing prior to its being conducted, and that Prestige physicians were not aware of, and did not agree with, the medical necessity of the testing.

The United States alleged that in 2014 Prestige was approached by an entity known as Genomix, which claimed that it could perform genetic testing on Prestige’s Medicare residents in order to ascertain whether those patients were properly metabolizing their medications. The federal government alleged that in 2014 and 2015, Prestige provided Genomix with insurance and personal medical information, as well as access to patients in nursing homes in several states for purposes of conducting the testing. Genomix conducted the testing by taking cheek swabs of each Prestige patient and then sending the cheek swab to a laboratory for analysis.

Prestige failed to ensure that its patients were informed of the testing prior to its being conducted, and provided with the opportunity to decline the testing.

The DOJ said the lack of physician orders and patient consent was discovered during a survey conducted by state regulators in late 2015.