The Duluth News Tribune and Twin Cities Pioneer Press had articles on the tragic death of a resident at Bethel Care Center. When a St. Paul nursing home resident’s ventilator tube became detached and sounded an alarm during a worship service at the facility last summer, there weren’t any nursing staff around to help, according to a report by the Minnesota Department of Health.  Staff didn’t notice the detached tube for an hour, at which point it was too late to save the resident, the report said.

According to the Health Department:

Around 2 p.m. on July 16, 2017, the resident was brought to a church service in the nursing home. His ventilator was functioning properly. Two minutes later, his ventilator alarm sounded. A pastoral staff member claimed to hear the alarm, but he or she had previously been instructed to ignore it. About an hour later, the same staff member noted poor color in the resident and called for help.

Nursing staff arrived, reconnected the tubing and called emergency services. At 3:36 p.m., emergency medical services pronounced the resident dead.  The resident’s cause of death was listed as asphyxia due to disconnection of the ventilator tubing. The resident physician said he had recently examined the man and thought it unlikely he would have died otherwise, the report said.


The Daily Report reported on the recent nursing home verdict in Valdosta, Georgia where a jury compensated the family of a neglected resident with a $7.6 million verdict after the man died from complications of a bowel obstruction he suffered at Heritage Healthcare at Holly Hill nursing home.  The key issue was a lack of appropriate medical staff at the facility the night 71-year-old Bobby Copeland began vomiting and complaining of a distended abdomen in October 2012. When Copeland’s symptoms became obvious, the only medical staffer was a licensed practical nurse, who called an off-site physician assistant to ask whether to send Copeland to an emergency room less than a half-mile away.  The physician assistant allegedly said no and ordered some tests, but it was only the next day that Copeland was taken to the hospital, where he died hours later.  Had a registered nurse been available, she could have performed a skilled assessment of his symptoms and mental faculties. The nursing home had a policy of only using LPNs at night.

By the time Copeland got to the emergency room at South Georgia Medical Center, he was showing signs of having aspirated fecal matter in his lungs, and his stomach was severely distended.  Copeland died about 12 hours after arriving at the hospital.

Heritage Healthcare at Holly Hill is operated by Lowndes County Health Services, a division of the PruittHealth chain of nursing homes.

The jury found the nursing home liable for both ordinary and professional negligence and apportioned only 20 percent of the fault to the facility, with the rest divided among four nonparties.  The family offered to settle for $600,000 or $650,000 under Georgia’s offer of settlement statute, by which a party that declines a settlement offer and then loses at trial by at least 25 percent more than the rejected offer may have to pay the winning party’s attorney fees from the date of the offer.

The jury took about three hours to award $7.5 million for the value of Copeland’s life and $121,200 to his estate for pain and  suffering, medical and funeral expenses.

The panel allocated 20 percent of the liability to the nursing home, 35 percent apiece to the physician assistant and medical director, and 5 percent apiece to South Georgia Medical Center and the ER doctor.


Skilled Nursing News had some depressing news to report on nursing home caregiver wages.  “Hourly wages for nursing home employees who provide direct care and services tend to be lower than wages for the same job titles in assisted living facilities and continuing care retirement communities, recent survey findings show. But salaries for leadership titles and director positions did not follow the same trend.”  So management staff–all of which receive higher salaries in nursing homes on average than they do in assisted living facilities–are getting paid more but the actual caregivers get less despite having more responsibilities and work!  No wonder nursing homes have trouble keeping staff.

Certified nurse aides (CNAs), resident assistants, medication aides, activity aides, housekeeping staff, laundry staff, and maintenance, transportation and dining services staff all take in lower hourly wages at nursing homes than at assisted living facilities, the survey shows.

A staff nurse (RN) in a nursing home makes an average of $27.84 per hour versus a staff nurse in an assisted living facility, who makes $29.39 per hour — or roughly 5.6% less per hour, according to data released in the 20th annual Assisted Living Salary & Benefits Report, published by Hospital & Healthcare Compensation Service (HCS) this week. The comparable hourly wage in a CCRC was $28.90.

Licensed practical nurses (LPNs) in nursing homes make 6.8% less per hour than their assisted living counterparts, at $21.56 per hour versus $23.13 per hour in ALFs.

Several key players in the skilled nursing mergers-and-acquisitions space identified wage pressures as a key issue for providers in 2018, as the stable economy gives workers more choices and bargaining power.

Findings of the survey were collected from 602 respondents throughout the U.S., with data effective October 2017. The report is published in cooperation with LeadingAge and supported by the National Center for Assisted Living (NCAL).

The Sun Sentinel reported the trauma suffered by first responders to Hollywood Hills Rehabilitation Center after Hurricane Irma. Many are still haunted by the dying nursing home residents they tried to save as they sweltered in a building with no air conditioning.  Some reported that it was cooler outside the nursing home than inside where the residents struggled to breathe in the heat.

“In a span of about three hours on Sept. 13, the Hollywood firefighter/paramedic and fellow crew members treated two critically ill residents. They had trouble breathing and registered body temperatures of 107.5 degrees. When the paramedics returned to the Hollywood Hills Rehabilitation Center for a third time that day, they found the head nurse performing CPR on a dead male patient.

The lack of care that these people were experiencing and just the conditions they were experiencing,” Wohlitka said. “In all honesty, this call is still very much haunting.”

Wohlitka and other fire-rescue workers who responded to the nursing home testified in court. This is the first time the rescue workers who responded to the nursing home where 12 ultimately died have publicly given their accounts of what they saw during those deadly pre-dawn hours.  It was part of a series of hearings this week to determine whether the nursing home should be allowed to re-open. The nursing home is challenging the state’s move to revoke its license.

After finding the dead man, the crew decided to check out other residents. Wohlitka said he noticed a woman inside her room looked “unwell” from where he stood in the hallway. He tried to figure out if she was OK, but nursing home staff insisted they had already done their round of checks.  “I attempted to enter the room and evaluate her and I was stopped by a Hollywood Hills staff member who basically told me that they had just done rounds and everybody was fine,” he testified. “I asked her, ‘Are you sure? That woman doesn’t look good’ and she said, ‘No, she just looks like that.’

“I just felt bad for that woman,” Wohlitka said. “You beat yourself up and maybe I should have told that facility member ‘no,’ but an RN is higher than a firefighter and a paramedic. We had no reason to doubt her.”

But eventually the paramedics did doubt the competency of the nursing home staff.  “I believe that they were panicked, that they were overwhelmed by the amount of patients that we were deeming critical,” Parrinello testified.


As she tried checking on patients’ vital signs, she said the head nurse told her that his staff had already done that. Parrinello testified that at this point she doubted the staff had been truthful about their assessment of patients. She said she told the head nurse: ’Well, you told me that before and now we have multiple deceased patients. So, with all due respect, I don’t trust your judgment and we’re going to check everyone ourselves.’

Ultimately, a dozen residents died from heat exposure and the medical examiner determined their deaths to be homicides.

Said Wohlitka, the firefighter/paramedic: “The uncomfortable heat alone was unbearable for myself, I won’t speak for anybody else. I was very uncomfortable inside the facility; I can only imagine what somebody who wasn’t able to go outside or get out was dealing with. I think it’s pretty evident… it just wasn’t safe.”


Healthcare Finance News reported on how many for-profit chains are cheating the Five-Star Quality Rating System on Nursing Home Compare. The five-star rating system that Medicare uses to compare nursing homes is made up of three components: employing a base score from an on-site inspection, along with two scores from information on staffing and quality reported by the facility.  These overall ratings have climbed higher as self-reported scores have inexplicably trended upward.

A new study of nursing homes in California, the nation’s largest system, by faculty at Florida Atlantic University and the University of Connecticut found that nursing homes inflate their self-assessment reporting to improve their score in the Five-Star Quality Rating System employed by Medicare to help consumers.   Among the findings were that nursing homes that have more to gain financially from higher ratings are more likely to improve their overall rating through self-reporting.

The report states “We find a significant association between the changes in a nursing home’s star rating and its profits, which points to a financial incentive for nursing homes to improve the ratings.”

USA today reported that Phyllis Campbell, a nursing home resident with dementia and a history of wandering off, was outside in temperatures hovering around zero for about eight hours before staff members noticed she was missing and found her dead from hypothermia, a state investigation found.

The state’s findings say Campbell had wandered into the courtyard twice during the week before she died and that she got out of her room several times that day and said, “I’m going home.”

The woman told a nurse’s aide she was going home.  She went through a door into a courtyard even though she was wearing a monitor that should have set off alarms, the report said.  Tests later showed the sensors did not always work, the state’s report said. Staff members also told investigators the device didn’t always work.

Two aides told investigators they did not do scheduled checks that night even though they were marked as completed, according to the Ohio Department of Health investigation.  She was found in the courtyard about 30 feet from its doors the morning of Jan. 7.

Authorities say a 76-year-old woman found dead outside the Ohio nursing home where she lived died of hypothermia.

The Putnam County sheriff is investigating Phyllis Campbell’s death at the Hilty Home in Pandora, roughly 50 miles southwest of Toledo.

Campbell was found outside the facility on a Sunday morning, when temperatures around much of Ohio were still below freezing.

The sheriff’s office says an autopsy showed Campbell died from hypothermia. Authorities haven’t released details about what happened.

The facility is part of Mennonite Home Communities of Ohio, whose CEO said by email Wednesday that it’s grieving Campbell’s death and extending sympathies to her family. CEO Laura Voth says administrators are working with authorities to conduct a thorough investigation but can’t publicly discuss details of the case.

The Star Tribune reported on the tragic and preventable death of Delores Rowan.  Rowan suffocated and died on May 31, according to the Ramsey County medical examiner’s office. The woman’s injuries included fresh bruising on her neck, the autopsy found.  The facility is at fault for allowing Rowan’s head to become trapped between the mattress and the bed’s grab bar.

Langton Place, which is operated by Presbyterian Homes, “had no policy, procedure or system to ensure the proper sizing of mattresses, the fit of the grab bars [or the proper] space between the mattresses and the grab bar device to reduce the risk of entrapment,” according to a state Health Department report released last week.  The report said a nurse saw the resident on her back and asleep about 4 a.m. In a routine check 90 minutes later, the woman was discovered with her head wedged between the mattress and a grab bar. Resuscitation efforts failed.

Her husband, Michael Rowan, said that his wife’s suffocation “wasn’t the only problem we had with that place.”  Langton Place one day ran out of the liquid nutrition she was fed through a tube. He also said she came down with cellulitis, a bacterial skin infection, and needed to be hospitalized. He said he also found caked feces in his wife’s pubic area.

The Nonprofit Quarterly had an article explaining  that nonprofits produce better outcomes for less money than for-profits do. Prime among these fields are hospice and long-term care. The research is relatively consistent: Do mission-driven nonprofit organizations deliver higher quality care to elders? When it comes to nursing homes, it appears the answer is a decisive “yes.

Multiple studies over the last two decades indicate that for-profit ownership of nursing homes, particularly for-profit chain ownership, correlates with substandard care.

Since the 1990s, corporate chain ownership has grown steadily and now dominates the market. Today, nonprofits own less than one in four nursing homes, while for-profits control nearly 70 percent. (The remaining five to six percent are government facilities.)

The latest analysis of nursing home ownership comes from Kaiser Health News (KHN), which examined organizations with complex corporate structures that can be used to pad the pockets of owners while protecting them from lawsuits.

Increasingly, KHN explains, owners of nursing homes outsource services to multiple entities in which they also have an ownership interest. For example, buildings are owned by real estate trusts, while the nursing home is leased by a management company. Physical therapy services, pharmacy services, dining, and maintenance can all be outsourced to sister companies.

Nearly three in four nursing homes outsource much of their business to related companies, according to KHN. This includes some nonprofit organizations as well. These structures, when not used to make and hide profits, can be cost efficient, with related companies charging the nursing home less than average for their services. But this is not normally the case.

In an examination of federal inspection, staffing and financial records nationwide, KHN found that nursing homes structured with related entities showed significant shortcomings. Homes with complex corporate structures:

  • employed, on average, 8 percent fewer nurses and aides;
  • averaged 53 validated complaints per 1000 beds, as compared to 32 per 1000 beds in independent homes; and
  • were subject to 22 percent more fines for quality deficiencies, and paid penalties averaging seven percent more than independent homes.

Charlene Harrington, professor emeritus of the School of Nursing at the University of California-San Francisco, who has extensively studied for-profit nursing homes, told KHN, “Almost every single one of these chains is doing the same thing. They’re just pulling money away from staffing.” In numerous studies, staffing has been shown to be a critical variable in quality care delivery.

Complex corporate structures not only undermine care for nursing home residents; they also provide a legal screen for owners, making it difficult for consumers to hold owners accountable.

To bring related companies into a lawsuit, attorneys must persuade judges that all the companies were essentially acting as one entity and that the nursing home could not make its own decisions. Often that requires getting access to internal company documents and emails. Even harder is holding owners personally responsible for the actions of a corporation—known as “piercing the corporate veil.”

Perhaps more importantly, it is time to rethink public policies that favor corporate ownership of nursing homes, as Charlene Harrington argues: “The considerable evidence from observational studies that care delivered in for-profit facilities is inferior to public or nonprofit services supports the need to develop new policies that would favor the development and maintenance of public and nonprofit homes.

CNN had an article with a video showing a resident assaulting another resident for several minutes before staff intervened.  The video is tough to watch.  The beating, which was first reported by the Gainesville Sun, lasted on and off for nearly 2 minutes. The beating occurred October 3 in a secure unit of Good Samaritan, a 45-bed assisted living facility.  It occurred in a common area of a secured unit within the facility while other residents ate and watched television mere feet away. The video of a resident beating another resident raises new questions about the safety of the elderly in places meant to protect and care for them.

In the video, a 52-year-old resident is seen punching an 86-year-old resident with dementia more than 50 times as the older man lay curled up on the floor. The younger resident accused the older resident of eating his cupcake, according to law enforcement.  At the time the beating took place, there was no staff member attending to residents in the unit, and no one had been assigned to monitor the unit’s video surveillance, according to official reports.
The video was taken by the facility’s closed circuit surveillance system in October and later turned over to the police, who shared it with CNN.
The facility — the Good Samaritan Retirement Home in Williston — had a history of violations, and more sanctions in the past five years than any other assisted living facility in Florida. In December, two administrators were arrested in connection with separate incidents on charges of neglect of the elderly.  One of the facility’s administrators, Nenita Alfonso Sudeall, later broke down and cried as she told police she was “overwhelmed” at the facility, which she said was short-staffed and had poorly trained employees, according to a police report.
The elderly resident was hospitalized with bruising and swelling to his face, as well as hip pain, according to the police report.
Also earlier this year, a CNN report found that the federal government has cited more than 1,000 nursing homes for mishandling or failing to prevent alleged cases of rape, sexual assault and sexual abuse at their facilities between 2013 and 2016.
“There are far too many cases of abuse and neglect happening in nursing homes and assisted living facilities,” said Brian Lee, executive director of Families for Better Care, a national advocacy organization for residents and their families. “We’ve been seeing cases for decades. This one incident in Florida shows how bad the problem can be.”