The Anderson Independent Mail had an article about Orianna’s bankruptcy due to corporate mismanagement and how that affects pending lawsuits and victims.  Lawsuits incuding thos einvolving wrongful death of residents at Orianna’s nursing homes have been halted since the company’s bankruptcy filing last month in Texas.  Lawyers handling pending suits against Orianna have hired bankruptcy attorneys in Texas as part of an effort to have their clients heard in the company’s bankruptcy proceedings. Victims of abuse and neglect are classified as unsecured creditors, and may not be able to get any compensation for their injuries and wrongful death.

Orianna, which is the Upstate’s top nursing home operator, currently runs 42 nursing homes with more than 4,000 beds in seven states. It has about 5,000 employees.

The company intends to sell its Upstate nursing homes and several other facilities throughout South Carolina and Georgia under terms of a restructuring agreement with its landlord, Omega Healthcare Investors Inc. Plans call for Orianna’s 23 other nursing homes to be transferred to a new operator.

However, the U.S. government has objected to a plan by the bankrupt operator of the Orianna Health Systems nursing home chain to protect companies that would acquire facilities through its restructuring from successor liability. The nursing home operator, 4 West Holding Inc, has facilities in seven states. It is seeking a court order that would allow the transfer of assets free of any liability, which the government said is not allowed by Medicare provider agreements.

Besides seeking to halt all litigation in pending cases as a result of its bankruptcy filing, the company has stopped making payments related to some previously settled suits.

McKnight’s had an article on how Preferred Care of Plano is using bankruptcy to avoid responsibility for the abuse and neglect suffered by their residents.   Preferred filed for bankruptcy in November claiming in court that lawsuits led to its financial demise.  Consumer advocates and industry experts — including families who allege their loved ones were mistreated in facilities in Texas, Kentucky or New Mexico — say the company is trying to avoid accountability.

“If their quality of care were higher, they wouldn’t be getting sued,” said Dallas lawyer Gabriel Canto, who represents the family of a Preferred Care resident who died after falling twice in the same day.

Preferred Care was incorporated in 1992 by Thomas Scott.   Today it’s a web of corporations that includes technology services, rehabilitation services and nursing homes linked to Scott including Preferred Care Partners Management Group, Preferred Care Inc., Preferred Care Partners, Pinnacle Health Management and Pincomputing.   The company has annual revenue estimated at $750 million, it is one of the country’s largest senior care providers, with more than 100 skilled nursing, assisted and independent living centers in 12 states, including 38 locations across Texas.

A Dallas Morning News investigation published last week strung together state and federal inspection reports and dozens of lawsuits to illustrate the nursing home operator’s horrific track record and history of abuse and neglect. Allegations of neglect, injury and wrongful death included the beating death of two residents at the hands of a mentally ill roommate, a resident found dead with his wheelchair on top of his body and a state attorney general’s allegation that residents were left for hours in soiled clothes and sheets.

An unusually large share of Preferred Care facilities have poor ratings, based on federal inspection data. About a third of Preferred Care homes in Texas received 1 star overall in the Five-Star Quality Rating System, compared to a quarter of all nursing homes statewide.

State health departments, lawyers and the hundreds of families they represent say that the company is using bankruptcy as a way to escape the consequences of a long-standing pattern of substandard care.

Scott and his wife live on a 155-acre property in Celina that’s valued at $3.7 million, records show. Scott owns several other properties in Collin and Grayson counties, as well as a home in Fort Lauderdale, property records show.

St. Louis Today reported that infamous and disgraced nursing home company CEO Johnnie Mac Sells admitted stealing more than $667,000 from Medicaid and been sentenced to 41 months in federal prison.  Now , he also admits to stealing from employees’ 401(k) accounts and health benefit plans, although he may face no more time in prison.

Sells waived indictment by a grand jury and pleaded guilty in U.S. District Court to two counts: stealing from an employee benefit plan and stealing from a health care benefit program.

 Assistant U.S. Attorney Dorothy McMurtry told U.S. District Judge Henry Autrey that money for their 401(k) plans was withheld from Legacy Health Systems employees’ pay from August to October 2016, but was not added to their accounts. Employees didn’t know because Sells failed to file annual reports, she said.  She also said that there was more than $800,000 in the plan in December 2015, and nothing 15 or 16 months later.
 McMurtry said that the employee health care plan was terminated in May 2016 for nonpayment, but Sells continued to withhold a total of $20,000 from employee paychecks. Those employees only found out they didn’t have health insurance when their health claims were rejected, she said. McMurtry said there was more than $124,000 of unpaid health claims.

Legacy Health, the Sells family business, once employed 1,600 who cared for 2,000 patients in 27 facilities across Missouri, Kentucky and Tennessee.  But by 2016, there were only three nursing homes left. And patients in Benchmark Healthcare were going hungry while Sells spent Medicaid money on strippers, gambling, pet care and country club fees, prosecutors have said.

A Post-Dispatch investigation documented the company’s fall.

In 2014, when Florida officials wanted to permanently shut down the now infamous The Rehabilitation Center at Hollywood Hills, Governor Rick Scott interceded on behalf of a lobbyist and frequent campaign contributor. The role of one of the Governor’s friends lobbying state officials on behalf of Dr. Jack Michel so Michel could obtain the license for the Hollywood Hills nursing home has not been previously reported.  An attorney for Michel said the lobbyist, Bill Rubin, “performed routine lobbying efforts in connection with assisting us with the AHCA regulatory process required for licensure.”

The nursing home is now drawing intense scrutiny following the deaths of more than a dozen residents after its air conditioning system lost power during Hurricane Irma. This case reveals the nature of how business is often done in Tallahassee where political connections are the currency of the realm.

In 2014, Michel wanted to buy the nursing home, whose owner at the time, Karen Kallen-Zury, had just been convicted of Medicare fraud and was sentenced to 25 years in prison.  Unfortunately for Michel, the state’s Agency for Healthcare Administration (AHCA), was set to revoke both licenses, filing two complaints against the nursing home and hospital on February 14, 2014.

In April 2014, he hired Bill Rubin, founder of the Rubin Group. Rubin is powerful player in Tallahassee whose ties to Governor Rick Scott are well known.  Rubin had no trouble arranging a meeting between Michel and Dudek, the AHCA Secretary.  State records show that between April 2014 and September 2015, Rubin’s firm was paid between $100,000 and $160,000 by one of Michel’s companies.  And by October 2014, Dudek signed an order reversing AHCA’s decision to revoke the license thereby clearing the way for the licenses to be transferred to Michel.

Political leaders have questioned whether Michel should have been granted a license given the fact that Michel and two former business partners paid $15.4 million to the federal government to settle fraud claims.  Rubin also represents HCA, the hospital chain once owned by Scott.

For its part, given the deaths at the nursing home in September, the state is once again trying to permanently revoke the nursing home’s license. The nursing home, which is currently closed, is fighting the state. A hearing on the matter is scheduled for January.

Here is a blog from The Hill that sets forth an absolutely heartbreaking case, being handled by Public Justice Foundation member Mike Foley, that exemplifies what’s most unfair about Congress passing H.R. 1215 imposing arbitrary caps on medical malpractice damages.  The woman mentioned in the blog is Kathleen Astleford.

Her doctor performed 26 unnecessary radiation treatments on the wrong side of her tonsils.  Astleford received horrendous medical care including burning her and not addressing her cancer, and then ran out of treatments because one can only get so much radiation, and the other treatments caused her many other problems.

The pain and suffering Astleford endured was unimaginable. However, a cruel bill recently passed by the U.S. House and now making its way towards the Senate, would add insult to her injuries — and to countless other patients who have suffered at the hands of careless health care providers — by placing restrictions on how much they can recover, no matter how outrageous or invasive their mistreatment might have been.

From medical malpractice to sexual assault, damages caps prevent victims of some of the vilest and most egregious crimes from ever receiving the justice they deserve. They also tie a jury’s hands, and make their verdicts nearly irrelevant, by allowing legislators instead of jurors to decide the maximum award allowed in these cases.

“Under H.R. 1215 the misleadingly titled “Protecting Access to Care Act” Astleford would only be able to collect a maximum of $250,000 for her pain and suffering. That’s because lawmakers behind the bill think those 26 unnecessary doses of radiation and the invasive surgery that would have been unnecessary had doctors administered the correct treatment to begin with are “noneconomic damages.” In other words, those 26 treatments didn’t actually “cost” Astleford anything, other than some discomfort that couldn’t possibly have caused more than $250,000 of troubles for her.”

 

 

 

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.

 

The Business Times reported the financial difficulties of one of the major national for-profit nursing home chains.

US healthcare landlord Quality Care Properties Inc said on Friday that it can seek receivership for the country’s second-largest nursing home chain, HCR ManorCare, after it failed to make a US$79.6 million payment for current and past rent.

In a statement, Quality Care said it had delivered a notice of default to HCR ManorCare, its main tenant, regarding the missed payment, which Quality Care said triggers immediate payment of $265 million in additional overdue rent.

Private equity firm Carlyle Group bought HCR ManorCare in a 2007 leveraged buyout for $6.3 billion and sold the properties to HCP for $6.1 billion in 2010.

I guess they are done siphoning funds away from patient care to line their own greedy pockets.

New Jerseyans can now monitor how their loved ones are treated in nursing homes and other institutional care facilities with hidden cameras provided for free by the state.

Want to get a Safe Care Cam? Call (973) 504-6375 and leave a message in a voice mailbox that will be regularly monitored by Division staff responsible for the program’s day-to-day operation. Or call the Division on its toll-free line and follow the voice prompts to leave a message: 1-800-242-5846 .

Attorney General Christopher S. Porrino and the Division of Consumer Affairs announced that they’d opened the program to residents who want to use micro-surveillance cameras in nursing homes, assisted-living facilities, residences for the developmentally disabled and other care facilities.

“Extending Safe Care Cam’s reach into residential facilities permits more people to monitor how caregivers are treating their loved ones when they think no one is looking,” Porrino said.

The Safe Care Cam program was launched last December to address New Jersey’s growing concerns about patient abuse. Those fears, being played out across the nation, have been fueled by increased media accounts of caregivers caught on hidden cameras physically or verbally assaulting innocent patients and residents.

The Safe Care Cam provided “insight to what really goes on when nobody is supposedly watching” and gave her family reassurance that their mother was receiving the care they had hoped and expected she would, the woman said.

The New York Times reported the Trump Administration’s attempt to take away poor and elderly Americans right to compensation when they are victims of medical malpractice or defective drugs or medical devices under a bill drafted by House Republicans as part of their plan to replace the Affordable Care Act.

The bill would set a $250,000 limit on “noneconomic damages,” which include compensation for pain and suffering, permanent impairment, scarring, mental anguish etc.

The bill would impose new arbitrary limits on lawsuits involving care covered by Medicare, Medicaid or private health insurance subsidized by the Affordable Care Act. The limits would apply to some product liability claims, as well as to medical malpractice lawsuits involving doctors, hospitals and nursing homes.

Kimberly A. Valentine, a lawyer in Orange County, Calif., who has represented scores of nursing home residents, said the House bill “would make it much more difficult for victims of elder abuse to seek redress and would eliminate one of the most powerful tools we have to improve care in nursing homes.”

 These arbitrary limits would not reduce health costs, increase access to care, or save taxpayers any money.  The only things it will do is limit restitution and increase malpractice. Several studies suggest that litigation costs, including damage awards, legal fees and the alleged effects of “defensive medicine”, may represent only 2 percent to 2.5 percent of national health spending.

The bill would also restrict the ability of victims to contract with lawyers in clear violation of the Constitution. Why is the government involved in a private contract between attorneys and their clients?

A new study conducted by researchers at Brigham and Women’s Hospital, an affiliate of Harvard Medical School, has found that the number of medical malpractice claims paid by physicians have substantially decreased over the last two decades. The study, entitled “Rates and Characteristics of Paid Malpractice Claims Among U.S. Physicians by Specialty, 1992-2014,” is one of the first of its kind, as it analyzes and categorizes the data by medical specialty.

The study, published online by the American Medical Association’s medical journal, JAMA Internal Medicine, was conducted for the purpose of characterizing by specialty the trends in medical malpractice claims paid on behalf of United States physicians. The National Practitioner Data Bank, a centralized database of paid medical malpractice claims, was utilized by the researchers to gather data from 1992 to 2014. All dollar amounts were adjusted to 2014 dollars using the Consumer Price Index.

The researchers found that over the course of the twenty-two year time period, the overall rate of medical malpractice claims paid on behalf of all United States physicians decreased by 55.7 percent.

The research indicated that the most common allegations of malpractice were misdiagnosis (31.8 percent of all claims), errors related to surgical procedures (26.9 percent), and treatment-related mistakes (24.5 percent). Approximately 32 percent of all paid claims involved the death of a patient.