Beginning Sept. 11, the Brian Center Center Health and Rehabilitation, a for-profit facility owned and operated by national chain SavaSeniorCare will no longer provide services for those with Medicare and Medicaid because it failed to comply with guidelines of those programs, according to a federal government agency.  Inspections found that the Brian Center had 28 compliance deficiencies between July 1, 2016, and June 30, 2017.  According to that report, several of the deficiencies noted put residents in “immediate jeopardy.”  Brian Center had paid two fines in the last two years totaling more than $30,000.

According to a public notice from the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services, the Brian Center will undergo an “involuntary termination” of its Medicare and Medicaid provider agreement.

“The Medicare/Medicaid programs will not make payment for inpatient nursing services to residents who are admitted after Sept. 11, 2017,” the notice reads.

According to Centers for Medicare and Medicaid Services measures, the facility has a one-star rating, out of a possible five stars, on overall health care and a three-star rating for quality of patient care.

Annaliese Impink, spokesperson for SavaSeniorCare, responded to the allegations: “According to the Federal Regulations (42 C.F.R. 488.456(c)(2)), the State and/or the the Centers for Medicare and Medicaid Services must post a notice in a local newspaper regarding a pending termination of a Center’s participation in the Medicare and Medicaid programs,” Impink wrote. “The notice must be posted at least 15 days before the termination takes place.”

“Brian Center Health and Rehabilitation Center/Salisbury has requested that the Centers for Medicare and Medicaid Services approve a visit by the North Carolina Department of Health and Human Services to determine whether the violations that were cited have been corrected,” Impink continued.  “The Center is currently awaiting that visit.”

See articles at WBTV, WSOCTV and Salisbury Post.

A former nurse, who previously pled guilty to tampering with a consumer product, was sentenced to imprisonment for a term of 48 months.  Christina Lovern Calloway, while working as a nurse in a nursing home, diverted liquid morphine intended for patients to her own use. The defendant, on more than one occasion, took some of the liquid morphine from a bottle and used it herself. She then used tap water to refill the bottle in an attempt to hide her crime. The diluted morphine was then administered to patients.

 

Bangor Daily News published a letter from Phillip Bennett, an administrator at Bangor Nursing and Rehabilitation Center.  See below.

As a nursing home administrator, I read with great interest the BDN report “Worn to the Sole” about the Maine woman who protects the dying and can barely make ends meet. This article accurately and empathetically portrayed the daily life of a dedicated CNA in a Bangor-area nursing home. It highlighted her sincere commitment to the residents for whom she cares and the quality of care that comes from an intimate knowledge of their likes and needs, developed over months or years of daily personal attention. And it reflected her pride and confidence in working as a professional caregiver.

But “Worn to the Sole” is aptly named, reflecting the difficulties faced by CNAs in all nursing homes, where the work is hard, the hours sometimes unexpectedly long, and wages insufficient to pay the bills and provide a satisfactory living.

Maine nursing homes face an intractable CNA shortage with no precedent, and they have been struggling for some time with how to deal with it. The CNA hourly wage, adjusted for inflation, has fallen over the last 10 years — a long time during which every dollar a CNA brings home buys less — and in any case, it has never provided much more than a subsistence wage.

Together with the stress the job entails (both because of reasonable and unreasonable supervisor and family member expectations) and risk of injury (Maine CNAs are injured as often as construction workers), there has been a disincentive for CNAs to remain in the field — and they are either leaving the field altogether or for better pay elsewhere.

 As nursing homes see CNA vacancies appear with greater frequency, they turn to temporary staffing agencies, often paying twice as much to maintain minimum staffing. The agencies fill the vacancies by paying temporary CNAs a higher hourly wage. The work the agencies offer may be less certain, and benefits may or may not be available, but CNAs need a better income. Many CNAs have moved to those agencies for the higher hourly pay they receive. Many end up working in nursing homes in the same area, which are befuddled by their lack of staff and what to do about the matter. Additionally, to reduce the extraordinary and ongoing costs of temporary CNAs, nursing homes require additional hours of work on short notice, a practice all too common in health care but unacceptable in other walks of life.

It seems to me that the answer is fairly clear: CNAs in nursing homes need to be paid more. The CNA shortage is a long-term structural change caused partly by nursing homes not paying enough to attract and retain workers — a problem compounded by requiring additional shifts or weekends to cover staff shortages.

Bangor Nursing and Rehabilitation has done both — significantly increasing CNA wages and eliminating the requirement for them to stay for additional shifts. It makes no business sense to pay exorbitant fees for CNAs from staffing agencies while waiting for MaineCare, the state’s Medicaid program, to increase reimbursement rates. It is ethical and practical to pay better wages. Nursing homes already pay more for temporary CNAs than if they paid a higher wage to recruit or retain their own staff. Not to do so flies in the face of reason, regardless of state legislative action.

Our experiment is early. We still have unexpected turnover, but we do receive more applications for vacancies and fill them faster than before, and have greater employee satisfaction by not mandating additional hours. We also hope to improve our retention by offering better wages and not requiring our employees stay beyond their scheduled shifts.

Perhaps an independent nonprofit can do this easier than a corporate for-profit entity, but this change is inevitable. The sooner CNAs make more and have reliable hours, the more likely nursing homes will be able to reduce their dependency on staffing agencies and reduce their wage expenses. In the process they will likely find satisfaction in caring for their employees as those employees care for their residents. It is the right thing to do.

 

KTLO reported that additional charges have been filed against a nurse who fled from law enforcement officers earlier this month following a traffic stop after police responded to a complaint of an intoxicated driver on July 16. When they located the vehicle and attempted to conduct a traffic stop, the driver refused to stop, and a short pursuit ensued.

The driver, Geneva Liveley, was apprehended and taken into custody. An inventory of the vehicle revealed numerous prescription medications belonging to other individuals, a loaded firearm, drug paraphernalia and cash totaling $1,110.

Liveley was charged with simultaneous possession of drugs and firearms, possession of a controlled substance (Hydrocodone), both felony counts, as well as misdemeanor charges.

Chief Manuel says an investigation began into Liveley’s possession of prescription medications belonging to other individuals. It was learned she worked at a local nursing home and stole medications from residents. The medications in her possession were logged by her as being received by the residents.

Liveley was arrested again and charged with four felony counts of controlled substances-fraudulent practices and six misdemeanor offenses.

Goupstate reported the arrest of Natalia Mikhailovna Roberts, a caregiver at Lake Emory Post Acute Care in Inman, S.C.  Roberts is accused of taking medications from patients and charged with two counts of violating drug distribution laws and theft of a controlled substance.

Warrants from the Department of Health and Environmental Control accuse her of intentionally taking doses of hydrocodone and oxycodone that were intended for patients.

In one incident on May 27, records reflect that there were 78 doses of oxycodone for a patient when there should have been 96 tablets remaining, according to a warrant.

Another warrant states that on June 17, a page was missing from a controlled medication utilization record for another patient regarding hydrocodone doses.

Until a few months ago, Lake Emory was designated as a Special Focus Facility and was even fined almost $200,000 on Jan. 11, 2017.  Lake Emory is owned and operated by Fundamental Long Term Care now known as Hunt Valley Holdins, a national for-profit chain with hundreds of nursing homes in numerous states.

The Dayton Daily News reported that Pristine Senior Living of Beavercreek sent a letter to their families informing them that their employee, Steven Douglas McDowell, a licensed practical nurse, is facing sex charges involving residents at the facility.  At least, three Pristine Senior Living residents have been identified as possible victims.

McDowell has also been indicted on 11 counts of illegal use of a minor in nudity oriented material, one count of voyeurism and three counts of gross sexual imposition, according to the prosecutor’s office.

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.

Yolanda Monsalvo. a nurse aide was found guilty of falsifying business records at Medford Multicare Center for Living nursing home to cover up patient neglect, prosecutors said, joining other co-workers also convicted of various crimes.

Monsalvo left her dementia patients with no supervision — and one of them broke an arm and suffered head injuries from a fall, officials said. She was convicted partly due to video surveillance footage, which showed she left the building where she was supposed to be monitoring her patients, including the one who then fell.

“Nursing home caregivers are entrusted to provide the highest level of safety and care to our most vulnerable residents,” he said. “There are serious consequences for abandoning nursing home residents and then trying to cover up neglect.”

Last June, the firm and its owners paid $28 million to settle a lawsuit charging them with looting the nursing home, committing fraud and breaking the law in running a business, according to Attorney General Eric T. Schneiderman.

The corporation paid a $10,000 fine after pleading guilty to attempted falsifying business records, part of a coverup in the death of a 72-year-old patient, he said.

Monsalvo, now facing a maximum sentence of 4 years, was indicted in April 2016 for “lying in an investigation report” about another patient’s fall from a wheelchair, Schneiderman said in a statement on Friday.

The Advocate had a letter explaining why staff turnover is so high in nursing homes.

“As with all nursing homes, there is a poor retention rate for the certified nursing assistants who keep the doors open; no one who owns a nursing home would do what they do. This is a backbreaking job that requires lifting, tugging and pulling to provide the care the residents need. They contend with medical equipment that includes a tracheostomy, feeding tube, ventilator, colostomy bag, Foley catheter, IV’s, oxygen mask/line, etc. They deal with bed sores and bathe, dress and groom the residents. All of this at a starting salary of $8 or less per hour depending on your experience.”

The average unit at a nursing home has at least 30 residents, and most of the time, there are 3 CNAs assigned. If you are assigned 10 residents, and five of them are to be spoon-fed or are incontinent, someone is going to get cold food, be hungry or lay in soiled clothing for some time because the CNA only attended to one resident at a time.

The Seattle Times reported the sexual assault of a resident at SeaTac assisted-living facility.  Police are investigating the attack.  The assailant used an open window to get into her room.  According to the Fire Department, the woman suffered serious head injuries and showed signs of having been sexually assaulted, the release said. She was taken to the hospital.

 The woman told police she was alone in her room, watching TV with the window open, when she heard a noise and saw a man remove the window screen and climb inside, the Sheriff’s Office said.

He went to where the woman was sitting, hit her several times on the side of the head, wrapped his hands around her throat and choked her before sexually assaulting her, according to the Sheriff’s Office.

The man left through the window, the release said. Out of fear, the woman waited several minutes before screaming for help, the Sheriff’s Office said.

Deputies responded and a police dog used to help search for the assailant.  The man was described as black, 5 feet 8 inches tall, with a slender but strong build, wearing a black-and-white shirt, black pants and a black skull cap.