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.

The New York Times had an article on the ongoing problem of illegal evictions of residents from nursing homes.  The main reason for the evictions is that the residents’ better-paying Medicare coverage is ending and will be replaced by Medicaid.  Discharges and evictions have been the top-ranking category of grievances brought to state long-term care ombudsman programs, the ombudsman agencies say.

David R. Wright of the federal Centers for Medicare and Medicaid Services said in the memo that wrongful evictions were “of great concern” because they could be unsafe or traumatic for patients, uprooting them “from familiar settings” and moving them far from family and friends.

Reimbursement rates for Medicare and Medicaid differ substantially, according to the National Investment Center for Seniors Housing and Care, a nonprofit group that collects data on the industry. Nursing homes receive about $200 a day for a Medicaid patient on average, compared with about $500 for a patient in the traditional Medicare program and $430 for a Medicare patient in a managed care plan.

McKnight’s had an article about the importance of hand washing to prevent infections from spreading in nursing homes.  A new study finds that — by harnessing hand hygiene methods already popular in hospitals — infections in nursing homes can be prevented.  Researchers concluded that implementing simple hand-hygiene protocols in nursing homes helped drop both mortality rates and the number of antibiotic prescriptions doled out, according new study results published in the February American Journal of Infection Control.

“Hand hygiene protocols have traditionally focused on acute-care settings. Our study is changing this narrative, underscoring that we can take a proven intervention practice and make it work outside of the hospital space, by specifically adapting it to long-term settings,” said Laura Temime, lead author of the study and a professor at the Conservatoire National des Arts et Métiers, in Paris, in a press release.

AARP published an article on their website about the GAO Report detailing the lack of regulatory oversight for the emerging and very profitable assisted living industry.

“State Medicaid agencies are required to protect the health and welfare of residents in their assisted living facilities, including monitoring cases of abuse, neglect or exploitation. Yet 26 state agencies could not tell federal investigators how many critical incidents of this kind had occurred in the homes and other places under their supervision, the U.S. Government Accountability Office reported this week.”

State agencies also varied in what types of incidents they monitored, the GAO found. “A number of states did not identify other incidents that may indicate potential harm or neglect, such as medication errors [seven states] and unexplained death [three states],” says the report titled “Medicaid Assisted Living Services.”  See GAO Report on ALFs.

“Thirty-four states made information about critical incidents available to the public by phone, website or in person,” the report says, “while another 14 states did not have such information available at all.”

The reporting gaps prompted the GAO to recommend that federal officials keep a closer watch on state agencies to see that they properly monitor conditions in nursing homes and other facilities to protect residents.

The investigators recommended clarification of state requirements and annual reporting of critical incidents. Officials at the Department of Health and Human Services concurred with the need to clarify and said they would consider requiring yearly state reports.

Agencies in 48 states reported spending more than $10 billion on assisted living services in 2014, covering more than 330,000 beneficiaries.

The Orlando Sentinel had an article about the need for enforceable Resident Rights in Florida (and elsewhere!).  Because of facilities with track records of putting their patients in danger, some advocates and industry experts want to change the Florida Constitution, adding a nursing home and assisted-living facility residents’ bill of rights. Doing so, they say, would not only add more protections, but it also would shield residents from state legislators and presidential administrations that might roll back existing regulations under pressure from the nursing home industry.

The public is completely in the dark about what happens in some of these facilities,” said Brian Lee, a former nursing-home watchdog for the state who now heads the national advocacy group Families for Better Care. “Even the tragedy of 12 nursing home residents dying from neglect after Hurricane Irma — deaths that were categorized as homicides — has not been enough to shame the industry into making changes.”

The Rehabilitation Center at Hollywood Hills in South Florida was evacuated Sept. 13 after power was knocked out by the storm and temperatures inside soared. A dozen elderly residents ultimately succumbed to heat exposure; one had a body temperature of 109.9 degrees. That facility is still fighting to keep its license.

It also prompted the governor to ask the state’s Constitution Revision Commission — which examines the Florida Constitution every 20 years for possible changes — to look at whether there are ways that the document could offer better protection for residents of long-term care facilities.

Proposal 88 establishes the right for residents to be treated “courteously, fairly and with the fullest measure of dignity,” given “adequate and appropriate health care” and live in “a safe, clean, comfortable and homelike environment” with “reasonable precautions” against natural disasters and extreme climatic conditions. , which is now being aired in public hearings throughout the state. If approved by the commission, it would go before voters in November.

It also says residents have the right to access courts, have speedy trials and sue without limitations for damages, that they can’t be asked to waive those rights, and that the facilities must carry liability insurance sufficient to ensure that residents and their families are “justly compensated.”

The industry as a whole is adamantly opposed to any such language in the state’s Constitution — even though some of the rights are already part of laws previously enacted by the Florida Legislature and the proposal doesn’t spell out the consequences for nursing homes that don’t comply.

Record-setting bed valuations, billions in guaranteed revenues and robust profit margins have pushed the senior care market to become one of the fastest growing, most highly profitable health care sectors.

The Pilot reported an astonishing video of a drugged up employee at Tara Plantation of Carthage.   An employee of the assisted living facility shared video of what appears to be an unconscious coworker on social media.  “The video was recorded about 5:20 a.m. on Monday, Feb. 12, by Stephanie Alston, a former nursing assistant at Tara Plantation of Carthage. In the nearly three-minute clip, a female employee who appears to be sleeping or heavily sedated is slumped over in a swivel chair with her head between her knees.”

According to Alston, the video was sent to the Moore County Department of Social Services. Alston claims she and her coworker Rachel Hough, who is heard talking to Alston in the video, were fired the next morning for filming the incident. Tara Plantation is now the subject of a multiagency investigation involving DSS, the Carthage Police Department and the state Division of Health and Human Resources.

“We was wrongfully terminated from my job today because I wanted to protect the residents that were in danger,” Alston wrote in video’s description. “I’m leaking this to the world to show everyone what your family could be dealing with on a regular basis.”  He went on to state “I don’t feel bad about losing my job over this,” Alston said. “God has bigger plans for me.”

Hough said the employee in the video has a history of passing out on the job. Angel Dooley, the acting administrator of the facility, was made aware of previous incidents, Hough said, but “nothing was done.”

“I just want justice for the residents that deserve better,” Alston said in an interview with The Pilot. “It’s not right for a family’s loved ones to live in those conditions and pay $2,000 and $3,000 (per month).”

Alston also shared photographs of Tara Plantation that show wastebaskets overflowing with trash and disposable cups left sitting out with food still in them. One of the photographs shows a visibly soaked adult diaper lying on the floor.

Tara Plantation
Some of the photographs of Tara Plantation shared on Facebook by Stephanie Alston.

Tara Plantation is an 80-bed assisted living facility that cares for patients suffering from dementia and Alzheimer’s disease.  The nursing home was roiled by a previous controversy when the facility’s then-director and four other employees were charged with conspiring to sell medication that had been prescribed to residents.

The Fresno Bee reported on the nursing home resident of Bella Vista Memory Care Community who contends that he had to have his right eye removed after staff at the nursing home allowed him to be attacked twice by his roommate.  Josh Dansby Jr. is seeking compensation for injuries suffered as a result of the facilities failure to protect him.  The lawsuit says Bella Vista is understaffed and has a history of being issued deficiencies by the California Department of Social Services.

Sierra Meadows Senior Living, LLC runs Bella Vista and has called the lawsuit a “shakedown”.

The lawsuit states that Dansby suffers from Alzheimer’s and dementia and has a history of strokes and heart attacks. Around February 2017 he became a resident of the nursing home.  Bella Vista placed Dansby with a roommate who had a known history of aggressive propensities and physical assault.  In September, the roommate attacked Dansby.

After this assault, Dansby’s family complained to the Bella Vista staff, asking that Dansby be protected from the roommate including moving rooms or changing roommates. Bella Vista refused to make any changes.

Dansby was attacked by his roommate again in December. After the attack, Bella Vista staff did not provide Dansby with care for days. He was later taken to Saint Agnes Medical Center’s emergency room, where he was determined to have suffered a corneal detachment. Doctors removed Dansby’s right eye.



SCNow reported in 2013 that Richard C. Cooke pleaded guilty to several crimes connected to fraudulent activity in his operation of six nursing homes, including three in the Pee Dee.  Cooke pleaded guilty to two indictments charging him with forgery and four indictments charging him with medical assistance provider fraud.  Cooke was sentenced to 10 years on the two forgery indictments, suspended to five years probation and three years each on the Medicaid fraud charges, all suspended to probation. Cooke’s probation conditions include house arrest for one year and 500 hours of community service, plus the full restitution.  So Cooke steals more than a million dollars from the taxpayers and only gets probation?

“Fraud committed against the Medicaid program deprives funds needed to pay for medical services, including nursing home care for elderly citizens who can’t afford it otherwise,” S.C. Attorney General Alan Wilson said after the sentencing.

Indictments show Cooke submitted fraudulent cost reports to the South Carolina Medicaid program in his role in Cooke Management Company Inc. of Lake View, which operated six nursing homes across the state. Those nursing homes included Florence Rehab and Nursing Center in Florence, Sunny Acres in Fork and Kingstree Nursing Facility in Kingstree.

Under South Carolina Medicaid regulations, nursing homes are required to submit annual operational cost reports for their facilities. The Medicaid program pays the nursing home based on that and on the number of Medicaid residents. From 2009 through 2011, the six nursing homes Cooke oversaw were overpaid more than $1 million as a result of fraudulent items listed on cost reports submitted to Medicaid.

Under the terms of the plea agreement, Cooke was required to plead guilty to all charges, to make full restitution to the S.C. Medicaid program, to be excluded from the Medicaid program for life and to cooperate with the ongoing investigation by the S.C. Attorney General’s Office.

11Alive wrote another article about the SavaSeniorCare facility in Atlanta where a decorated World War II veteran died while gasping for air and begging for help as the SavaSeniorCare caregivers were seen on a hidden video, laughing.  The DeKalb County District Attorney may file criminal charges against nursing home staff for not responding appropriately while one of their residents slowly died in front of them.

Dempsey died while begging for assistance inside the Northeast Atlanta Health and Rehabilitation Center. Video shows he yelled “help” numerous times and pressed his call button half a dozen times. It took nursing home staff about an hour to call 911.

In November, the Brookhaven Police Department launched a criminal investigation into 89-year-old James Dempsey’s death after an 11Alive Investigation uncovered hidden camera video and court depositions of nursing home staff who responded to the World War II veteran.

The SavaSeniorCare facility is Northeast Atlanta Health and Rehabilitation. 11Alive obtained both videos in 2017 through public records requests after the family filed a lawsuit.  Police say 11Alive’s story was key to re-opening the investigation. “It was very instrumental…because there was information in the news report that you guys aired that our detectives had not seen yet,” said Gurley.

One of the nurses seen in the video is Wanda Nuckles, who worked the night Dempsey died. In a court deposition, the nursing supervisor testified under oath that she rushed to the room and started CPR on Dempsey and did not stop until paramedics arrived.  That is clearly not true.  The video shows she did not start CPR immediately. The video also shows her starting and stopping CPR numerous times, only picking up right just before paramedics arrived.

At one point, the hidden camera video caught nursing home staff laughing while they tried to fix his oxygen machine when Dempsey had already stopped breathing.  Last year, operators of the nursing home, Sava Senior Care, took 11Alive to court in an attempt to stop the video from getting released. Attorneys for Sava even attempted to appeal to the Georgia State Supreme Court, but withdrew its appeal after a lower court already released the video to 11Alive.

The Atlanta Journal Constitution confirmed that arrest warrants have been issued for three nursing home employees accused of repeatedly ignoring a World War II veteran’s pleas for help. A grand jury indicted the women — Loyce Pickquet Agyeman, Wanda Nuckles and Mable Turman — four years after James Dempsey was found dead in his room at the SavaSeniorCare facility.

Agyeman, a former licensed nurse, was charged with murder and neglect to an elder person, Jones said. Nuckles, also a former licensed nurse, was charged with depriving an elder person of essential services. Turman, a certified nurse assistant, was charged with neglect to an elder person. All face concealing a death charges.

Commercial Appeal reported on the lawsuit unsealed in federal court in Memphis alleging that Spring Gate Rehabilitation and Healthcare Center nursing home gave heavy anti-psychotic drugs to residents to keep them “docile.”  The complaint alleging Medicaid and Medicare fraud by the facility argued that the company provided “worthless” services to residents between 2012 and 2015. Now the company will pay a $500,000 settlement, and has entered into an agreement with the Department of Health and Human Services to prevent such conduct in the future, the U.S. Attorney’s Office said.

According to the lawsuit, Spring Gate, operated by Memphis Operator, LLC, prescribed a resident heavy doses of anti-psychotic and anti-anxiety drugs in 2013 “despite the fact that there was never a medically accepted indication justifying such heavy-duty medications.”

“After Spring Gate prescribed these psychoactive drugs, (her) condition quickly deteriorated,” according to the complaint. “Spring Gate internal reports described her as confused and unsteady, prone to staring off into space. She fell multiple times …”

Her nephew raised concerns to Spring Gate and “to his great surprise, the nursing staff openly admitted to (him) that (she) was being prescribed these drugs ‘to keep her in the bed,'” according to the lawsuit.