WHNT reported another nursing home employee accused of sexually assaulting a nursing home resident at Mitchell-Hollingsworth nursing home.  Zack Reeves, a nursing home aide has been arrested and charged with sodomizing a male nursing home resident.  The 21-year-old was arrested following a week-long investigation into possible abuse on November 2nd.

Police say a co-worker witnessed an incident and immediately notified authorities.  Florence police say Mitchell-Hollingsworth is playing a crucial role in the on-going investigation by speaking with other residents.  “We are kind of letting them lead that part of it since they know their patients. We don’t want to cause any undue stress or trauma to any of the patients,” said Sgt. Greg Cobb with Florence Police.

 

WKYC reported the horrific death of James Dempsey, a decorated World War II veteran from Woodstock, Georgia.  An 11Alive investigation uncovered hidden camera video catching nursing home staff laughing while an elderly patient dies in front of them. The video was recently released as part of a lawsuit filed by the family.   Hidden cameras are an important way to prevent abuse and neglect and to prevent cover-ups like this one.

The incident happened at the Northeast Atlanta Health and Rehabilitation owned and operated by the national for-profit chain, SavaSeniorCare.  Attorneys representing SavaSeniorCare tried to prevent 11Alive from obtaining the video. They asked a DeKalb County judge to keep the video sealed and then attempted to appeal to the Georgia State Supreme Court. The judge ruled in favor of 11Alive and the nursing home eventually dropped its appeal to the state’s highest court.

Watch the extended deposition here where her story changes after watching the hidden video.

The video includes almost six hours of video court deposition from a nursing supervisor explaining how she responded to the patient before she knew the hidden camera video existed. The video shows a completely different response. SavaSeniorCare was made aware of the video in November 2015, but the nursing home did not fire the nurses until 10 months later.

In the video deposition, former nursing supervisor Wanda Nuckles tells the family’s attorney, Mike Prieto, how she rushed to Dempsey’s room when a nurse alerted her he had stopped breathing.

Prieto: “From the time you came in, you took over doing chest compressions…correct?”
Nuckles : “Yes.” 

Prieto: “Until the time paramedics arrive, you were giving CPR continuously?”
Nuckles : “Yes.”

The video, however, shows no one doing CPR when Nuckles entered the room. She also did not immediately start doing CPR.  The video shows the veteran calling for help six times before he goes unconscious while gasping for air. State records show nursing home staff found Dempsey unresponsive at 5:28 am. It took almost an hour for the staff to call 911 at 6:25 a.m.

When a different nurse does respond, she fails to check any of his vital signs. Nuckles says she would have reprimanded the nurse for the way she responded to Dempsey. She called the video “sick.”  When nurses had difficulty getting Dempsey’s oxygen machine operational during, you can hear Nuckles and others laughing.

Prieto: “Ma’am, was there something funny that was happening?”
Nuckles : “I can’t even remember all that as you can see.”

11Alive showed the video to Elaine Harris, a retired nursing professor and expert in adult critical care. “In 43 years in nursing, I have never seen such disregard for human life in a healthcare setting, is what I witnessed,” said Harris.

In the video, nursing staff repeatedly start and stop doing CPR on Dempsey. Harris says once you start doing CPR, it should not be stopped until a doctor makes the decision not to resuscitate.  “That is absolutely inappropriate. You never stop compressions,” said Harris.

The nursing home operators, owned by Sava Senior Care, declined interview requests.

State health inspection records show Northeast Atlanta Health and Rehabilitation continued to have a history of  problems after Dempsey’s death. Medicare records show the nursing home facility was cited at least two dozen times for serious health and safety violations, including “immediate jeopardy” levels, the worst violation. Medicare withdrew one payment and the facility has been fined $813,113 since 2015.  The facility has a one-star rating from Medicare, the lowest score the agency can give. The nursing facility remains open today.

 

WNCN reported that Natalia Mikhailovna Roberts has been accused of stealing medication.  Warrants state Roberts worked as a nurse for Lake Emory Post Acute Care in Inman.  Lake Emory is owned and operated by the national for profit chain Fundamental Long Term Care.

Authorities say there were 78 doses of Oxycodone for a patient when there should have been 96 doses. Warrants state Roberts “intentionally…omitted information” required for records keeping.

Records showed another patient was missing 124 doses of Hydrocodone on June 17, another arrest warrant states.

Roberts is charged with theft of a controlled substance and two counts of violating drug distribution laws by the S.C. Department of Health and Environmental Control.  A temporary order of suspension has been issued for Roberts by the S.C. Department of Labor, Licensing and Regulation.

It is unclear if she was using the pills or selling them to make money.  The investigation into why the facility failed to notice the missing opiods is ongoing.

The St. Louis Dispatch reported the tragic and preventable wrongful death of Donna Chapman who caught fire and suffered fatal burns in May while smoking a cigarette in her wheelchair.   On May 13, a member of the staff wheeled Chapman onto the patio, then left her alone to smoke a cigarette before dinner. Chapman somehow ignited her clothing and was found ablaze by an attendant.

“I am burning alive, I am burning alive,” Chapman kept saying, according to an investigative report from the Missouri Department of Health and Senior Services.   She suffered third-degree burns to her scalp, chest, neck and shoulders.

Chapman died May 15, two days after she caught fire while smoking unsupervised on a patio at NHC HealthCare. Her son, Dean Chapman filed the wrongful-death suit Oct. 23.

The suit claims the nursing home improperly left the disabled woman alone while she smoked without a special burn resistant apron that was supposed to protect her from ashes and dropped cigarettes. The suit also says the nursing home failed to adequately assess her ability to smoke unsupervised and detect changes in her mental and physical condition.

Chapman had dementia, and because of her paralysis, limited use of her legs and left arm. She was a longtime smoker. The nursing home performed eight “smoking assessments” for her between 2012 and March 17, 2017, the suit says. All of the assessments determined she could smoke without supervision, despite concern expressed by staff in October 2016 and the discovery of burn marks on her clothing in February, the suit adds.

In March, the nursing home did tell Chapman she had to wear a special smoking apron to protect her from hot ashes and dropped cigarettes. Despite concerns that her dementia was worsening and that burn marks continued to be found on her clothes, she was put on the back porch alone on May 13 without a smoking apron, the suit says.

Peimann, the nursing home administrator, told the Post-Dispatch in May that Chapman’s death was “a bad accident.”

David Terry, an attorney for Dean Chapman, said: “For a nursing home to provide a safe environment for its residents, there must be enough staff members to properly supervise the residents and the staff needs to be sufficiently trained to meet the needs of each resident. We believe in this case the NHC facility failed to do that.”

The Des Moines Register had an article on the need for video surveillance of nursing home residents.  The article references the Des Moines Sunday Register investigation by Clark Kauffman that told the tragic story of Cheryll Scherf.   Her family installed a motion-activated camera in her room. This captured, among other incidents, staff repeatedly leaving Scherf in bed, naked from the waist down, with the door to the room left open. The video also showed she wasn’t given her prescription medication.

“A reasonable person would feel degraded, embarrassed and ashamed” by this treatment, according to the Iowa Department of Inspections and Appeals.  The family could not have proven neglect without the video.  The neglect was covered up with false documentation and tampering with patient records, according to criminal charges filed against the caregivers.

The story of this Iowa woman underscores the need to ensure all residents in long-term care facilities are guaranteed the explicit right to possess and use cameras in their rooms.

The Centers for Medicare and Medicaid should implement a rule specifically guaranteeing residents can use cameras for their own protection as long as the privacy of other residents is respected. The agency administers Medicaid, the federal health insurance program that pays the bills for more than 60 percent of the 1.4 million people in this country’s nursing homes.

Nursing homes should welcome such personal use of cameras anyway. Families bear the cost. Workers who know they’re being watched may be motivated to follow guidelines and provide good care. That helps protect nursing homes from allegations of mistreatment and vulnerable patients from abuse.

Syracuse.com had an article about a class action lawsuit against James Square Health and Rehabilitation Centre claiming residents of the Syracuse nursing home are left lying in their own urine and feces for extended periods of time.  The suit says the nursing home does not have enough staff to regularly care for incontinent residents, many one of whom frequently goes entire nights without being changed.  The state Attorney General’s Medicaid fraud unit has been investigating James Square for months over patient care issues. The AG’s office raided the 440-bed facility at 918 James St. June 13 and seized records as part of the investigation.

A class action suit is one in which a group of people who have suffered similar harm sue the defendant as a group and potentially share in any settlement.  If the court certifies the lawsuit as a class action, the complaint says “hundreds if not thousands” of current and former James Square residents could automatically become part of the case. The class action complaint says James Square is unsafe, understaffed and negligent in its care of residents.

 

The Huffington Post reported on Medicaid cuts in Iowa.  “The aging population is fueling what some health experts call an “Alzheimer’s tsunami” for which Iowa, and the rest of the nation, is ill-prepared. Unless a cure is found, an estimated 7.1 million Americans age 65 and older could have Alzheimer’s by 2025, almost a 35 percent increase, according to the Alzheimer’s Association. Iowa’s 65-plus population is above the national average.   In South Carolina, the total number of cases of Alzheimers in 2015 was 86,000; 120,000 are expected by 2025, according to Alzheimer’s Association estimates.

But instead of preparing for the onslaught, Iowa and other states have begun tightening Medicaid, the only government program that pays for nursing home care, in ways that increase the burden on those with Alzheimer’s and their loved ones.

Medicaid, typically seen as the government health insurance program for people with low incomes and those with disabilities, spends about one-quarter of its $4.8 billion in annual funding in Iowa for nursing home care. The program pays for half the nursing home residents in the state, according to the Kaiser Family Foundation.

Already, Iowa’s move last year to a Medicaid system managed by three for-profit companies is affecting people diagnosed with Alzheimer’s and their caregivers.

Kathy Horan, vice president of AbbeHealth Aging Services, which operates adult day health centers in Marion, Cedar Rapids and Iowa City, said managed care organizations, or MCOs, that coordinate Medicaid recipients’ care have started to decrease the number of days covered at those centers.

Dove Press had clinical guidelines on prescribing psychotropic medication for nursing home residents with dementia on their website.

Objective: The aim of this study was to identify factors influencing the prescribing of psychotropic medication by general practitioners (GPs) to nursing home residents with dementia.

Subjects and methods: GPs with experience in nursing homes were recruited through professional body newsletter advertising, while 1,000 randomly selected GPs from south-eastern Australia were invited to participate, along with a targeted group of GPs in Tasmania. An anonymous survey was used to collect GPs’ opinions.

Results: A lack of nursing staff and resources was cited as the major barrier to GPs recommending non-pharmacological techniques for behavioral and psychological symptoms of dementia (BPSD; cited by 55%; 78/141), and increasing staff levels at the nursing home ranked as the most important factor to reduce the usage of psychotropic agents (cited by 60%; 76/126).

Conclusion: According to GPs, strategies to reduce the reliance on psychotropic medication by nursing home residents should be directed toward improved staffing and resources at the facilities.

The Santa Fe New Mexican reported that Casa Real nursing home in Santa Fe owned and operated by Preferred Care Partners Management Group has at least temporarily improved persistent quality-of-care problems enough to resume billing Medicare and Medicaid for newly admitted residents.  Casa Real is one of only two homes in Santa Fe that accept Medicare and Medicaid patients.

For more than two months, Casa Real had been barred from charging Medicare or Medicaid for new residents after the Centers for Medicare and Medicaid Services found the nursing home wasn’t in compliance with federal care standards.

Inspections this year turned up a long list of problems, including medication errors, expired food and drugs on shelves, unreported resident injuries and assault, poor care of bed sores, nursing understaffing and inadequate safeguards against the spread of dangerous infections.

The former director of nursing at Casa Real from May to August has accused management of forging patient records in an attempt to show the facility was in compliance with care standards dealing with monitoring of medication effects on residents.  Of course, she was soon fired.

The August inspection found residents weren’t receiving medications as directed by their physicians and that the nursing home wasn’t doing enough to ensure that residents didn’t receive unnecessary drugs, including psychotropic medications.

The federal agency in May designated Casa Real as a “special focus facility” because of its poor record of complying with care standards, and it said the nursing home would be subject to more frequent inspections. The designation is given to the nation’s poorest-performing nursing homes and is meant to address the “yo-yo” problem of facilities routinely falling in and out of compliance with care standards.

The state Attorney General’s Office is suing Preferred Care, alleging it has defrauded Medicaid by having insufficient staff to meet the needs of residents at its Santa Fe nursing homes, as well as its facilities in five other New Mexico communities. Preferred Care has denied the allegations.

NPR had an article about the effect of Medicaid cuts on nursing home residents.  The nation has 1.4 million nursing home residents — two-thirds of whom are covered by the state-federal health care program for people with low incomes or those with disabilities.  Medicaid pays less than other forms of insurance. As a result, nursing homes make more than 10 percent on Medicare residents, but lose about 2 percent on the rest of their residents because so many have care paid for by Medicaid.

“Nursing homes that rely the most on Medicaid tend to provide the worst care for their residents — not just the people covered by the program but also those who pay privately or have Medicare coverage.”

The reason for the disparity in quality of care, researchers have found, is that nursing homes with the most Medicaid residents can’t afford as many nurses and aides so they operate short-staffed. ”

The average five-star home has enough nurses and aides to provide 5.4 hours of care a day for each resident, while the average one-star home provides 3.0 hours of daily care per resident. At the best-staffed homes (five stars), only 4 of 10 residents are on Medicaid, meaning the remainder of residents are more lucrative for those facilities. At the worst-staffed homes (one star), 7 of 10 residents are on Medicaid.”

At nursing homes with worst inspection records (one star), an average 65 percent of residents are on Medicaid. Places with the best inspection records (five stars) have an average 47 percent of residents on Medicaid.