KSPR reported on a proposal to keep residents safe, and to deter theft, fraud, and abuse, by allowing video cameras in Missouri nursing homes.  Under the proposed law, families can choose to put a camera in their patient’s room, at their own expense and would be able to view the cameras at any time.

Supportive lawmakers say families could monitor how much and how often medications are given and how their loved one is being taken care of overall. Rep. Andrew McDaniel backs the bill after his staff says they received hundreds of complaints about abuse, neglect, rape and fraud.

Nursing home lobbyists claim they are concerned about patients’ privacy, and their lobbyists have killed similar bills in past legislative sessions. However, McDaniel says the camera can be turned off during baths or if a patient is exposed.

 

The Columbus Dispatch reported that Autumn Health Care of Zanesville, a nursing home operator, has been ordered to repay tens of thousands of fraudulently obtained Medicare and Medicaid dollars, after an investigation by the Ohio Attorney General’s Office. The investigation found that the owner and other employees habitually altered documents to make it appear patients were being properly cared for in order to receive government aid.

With permission from family members, investigators hid surveillance cameras in patients’ rooms, the first time such measures had been used in a state nursing-home investigation.  While the nursing home’s records reflected a high level of care, the investigation found that several patients missed treatments or were given therapy they didn’t need, the attorney general’s office said.

The corporation pleaded guilty to multiple charges in October, including forgery, tampering with evidence, Medicaid fraud, telecommunications fraud, theft and engaging in corrupt activity.

Autumn Health Care of Zanesville must pay back $53,390 to the Ohio Department of Medicaid and $75,250 to the federal Centers for Medicare and Medicaid, as well as $40,000 in investigative costs.

Its owner, Steven Hitchens, entered pleas to single counts of tampering with evidence, tampering with records and forgery. Hitchens was ordered to serve three years of community control and conduct 100 hours of community service.

 

 

 

A new study from researchers from Rowan University School of Osteopathic Medicine has found that delirium affects nearly 18 percent of nursing home residents and has a one-year mortality rate of 40 percent. The symptoms of delirium usually last one week, but can take weeks or months to resolve. The symptoms are similar to dementia, resulting in misdiagnosis in nursing home residents.

Delirium is a syndrome of altered mental status shown to produce disorganized thinking, deficits in attention and a fluctuating course, which plays a significant role in mortality of nursing home patients.  However, maintaining hydration and minimizing medication exposure is an effective means to prevent delirium. Pain can lead to delirium, and managing it well can improve outcomes.

The study was published in The Journal of the American Osteopathic Association.

Hall of Fame magazine reported on the abuse at Winters Park Nursing Home.  Minnie Graham is 98 year old and living in Winters nursing home in Texas. One day, she told her family that one of the staff abused her.  The family became suspicious and more concerned when they found black eyes and bruises on Minnie’s face. The nursing home caregivers said that Minnie had fallen out of her wheelchair several times.

The family set up a hidden camera to find out for themselves what was really going on.  What the family saw terrified them.

One of the Winters Park Nursing Home workers, who was identified as Brenna Tiller, was caught on camera, hitting Minnie. She was also cursing and mocking at the elderly woman. While Minnie was screaming in pain, Tiller sprayed water to her face and placed a towel on her mouth. The towel that Tiller put on Minnie’s mouth was the one she used to clean the old woman’s body.

Another worker, who goes by the name Louis, was also caught on camera hitting Minnie. He also punched the old woman.

Louis was arrested while Tiller was convicted for felony with 5 years of probation.

The Chicago Tribune reported that two social workers, Kenneth Allen and Olufunmibi Ogunyipe, allege they were fired from Burnham Healthcare now known as Bria of River Oaks nursing home after refusing to fabricate medical records related to incidents of patient abuse.  Some of their patient-abuse allegations were investigated separately by the Illinois Department of Public Health, which cited the facility for safety violations, records show.

The nursing home has withstood years of state citations for violence, patient neglect and filth. Last year it received $16.5 million from Medicaid and Medicare while reporting $1.38 million in profits.  Records show that some of those federal health-care dollars went to Weinfeld’s uncle, nursing home magnate Morris Esformes, whose son and close business partner, Philip Esformes, is being held without bond in a Miami federal detention cell on charges that he orchestrated a $1 billion Medicaid kickback scheme in Florida.

Allen alleges that a supervisor told him to falsify the medical chart of a female resident who was hospitalized in 2012 with facial bruises and black eyes. Allen believes the woman was beaten by a fellow resident, but he was told to write that she had fallen. A state inspection report later found that the facility failed to properly investigate her family’s complaint that she was assaulted.

Allen alleges that after he documented a resident’s rape complaint, a supervisor ripped Allen’s report out of the medical file and tore it up. The state health department inspection concluded the facility had failed to thoroughly investigate the sexual assault allegation and to notify authorities.

Ogunyipe alleges that, in the case of a 60-year-old resident who had repeatedly requested a discharge, a supervisor told him in 2013 to write up medical notes falsely stating that Ogunyipe had tried repeatedly to transfer the man but couldn’t find a program with an open bed. A state health department inspection cited the facility for failing to assist the resident’s request for a discharge.

Ogunyipe alleges that a supervisor tried to deceive state inspectors by removing disheveled residents who might trigger state scrutiny because they appeared neglected. A supervisor gave him $30 to $50 to take the residents out of the building, buy them cigarettes, feed them at a McDonald’s and claim they were going on a field trip, saying: “They can’t be in the building,” the suit states.

Ogunyipe said that the administration wanted to conceal residents with untrimmed hair and soiled clothes because “you would know that they were not being cared for.”

He witnessed fellow employees entice residents back to their rooms with a cigarette or snack, then punish them. “They would just close the door and — boom, boom, boom! Deal with the resident. Beat him up. Spit on his face and then walk out, close the door,” Ogunyipe said.  (A 2012 state inspection report said two residents alleged guards beat or roughed them up in separate incidents. The report says that at least one guard at the home was fired as a result.)

The Indianapolis Business Journal had an article about the fraud and greed that led to the indictment of nursing home owner and operator James Burkhart.   In an explosive federal indictment unsealed in October, kickback money was used to buy gold bullion, casino chips, and vacation homes in a massive fraud scheme.  The fraud and kickbacks combined totaled more than $16 million, with the proceeds going to fund the men’s lavish lifestyles.

The indictment states that Burkhart, former CEO of Indiana’s largest nursing home company, and three other men orchestrated a scheme that used kickbacks and shell companies to defraud American Senior Communities which is owned by the Jackson family of Indianapolis; Health & Hospital Corporation of Marion County, which hired ASC to operate its nearly 70 nursing homes; and federal health care programs.

The defendants are former CEO James Burkhart, former Chief Operating Officer Dan Benson, Joshua Burkhart and Steve Ganote.  A 35-page indictment alleges that the four launched the brazen scheme to enrich themselves in 2009 and continued it until Sept. 15, 2015, the day FBI agents raided the nursing home company’s offices.

“The scheme was characterized by unbridled greed,” U.S. Attorney Josh Minkler said.

Herald Mail Media reported on the accusation of resident dumping by the owner/operator of five Maryland nursing homes.  The suit alleges that during a 17-month period between Jan. 1, 2015, and May 31,  Neiswanger Management Services LLC issued involuntary discharge notices to at least 1,061 residents at the five facilities it operates.

NMS and a number of its officers were named in a civil suit and charged by the state Office of the Attorney General with dumping “frail and disabled” Medicare and Medicaid residents in sham assisted-living facilities and homeless shelters, and submitting false claims to the state.

A number of dumping incidents are listed in the 62-page complaint including a woman with cancer who was driven to an unlicensed care facility in Baltimore and a woman who was left in the driveway of a relative’s home on a 95-degree day, the document said.

 “In at least 1,038 of these cases, the reason for discharge cited by NMS was the resident’s failure to pay for his or her care, or to arrange for payment by Medicare, Medicaid or another third party payor,” the suit states. By contrast, the suit noted, Maryland’s other 225 nursing homes issued about 510 such notices during that period.

NMS facilities received more than $100 million in Medicare and Medicaid reimbursements in 2015, $35 million of that from the Maryland Medical Assistance program, the suit states.

NMS preferred Medicare patients for admission because of the higher rates of reimbursement, then “aggressively seeks to evict Medicare participants as close as possible to their last covered day” without regard to their medical needs, the suit alleges.

An email from owner and former chief executive officer Matthew Neiswanger is quoted in the suit. In the email, he states, “Total of 22 empty beds! … Fill beds with Medicaid if you can’t get Medicare!!!”

 

 

 

Every year, hundreds of thousands of Americans are sickened and tens of thousands die from infections by antibiotic-resistant bacteria and C. difficile, a pathogen linked to long-term antibiotic use. Timely reporting of outbreaks of these infections is essential to stopping the spread of disease and saving lives, public health experts and patient advocates say. Reuters assembled one of the most comprehensive counts yet – identifying at least 300 superbug outbreaks around the nation from 2011 to 2016. The number of people affected was impossible to determine because many reports didn’t include a count of the infected or the dead.

MSN reported the fascinating and tragic facts related to “Superbug” outbreaks.  One example was at Casa Maria nursing home in January 2014.  A resident of the nursing home was diagnosed with Clostridium difficile, a highly contagious and potentially deadly “Superbug” characterized by fever, abdominal cramps and violent diarrhea caused by unsanitary conditions that plague hospitals, nursing homes and other healthcare facilities.

By the end of February, six more Casa Maria residents were suffering from the infection.  Under New Mexico regulations, healthcare facilities must report a suspected outbreak of C. difficile to the state Health Department within 24 hours.

Casa Maria did not contact authorities until March 4, 2014.  By then, nine of the nursing home’s 86 residents had active infections.  By June, fifteen residents had been infected, and eight were dead. The public was never informed — until now.

The outbreak and the way it was handled exposed dangerous flaws in U.S. efforts to control the spread of superbug infections. An examination of cases across the country reveals a system that protects the healthcare facilities where superbugs thrive, while leaving patients, their families and the broader public ignorant of potentially deadly threats.

The United States lacks a unified nationwide system for reporting and tracking outbreaks. Instead, a patchwork of state laws and guidelines, inconsistently applied, tracks clusters of the deadly infections that the federal government 15 years ago labeled a grave threat to public health.

Most states require that hospitals, nursing homes and other healthcare facilities report suspected outbreaks of infectious disease, drug-resistant or otherwise, within one business day or less of identifying the problem so that health officials can intervene to halt their spread.

 

 

 

 

Many state health officials say disclosing information about outbreaks to the public or punishing facilities risks dissuading hospitals and nursing homes from reporting. They say they see themselves as collaborators with healthcare facilities. The collaborative approach fails the public.

 

Reuters showed that hospitals and nursing homes do not alert each other when they transfer an infected patient, which can allow contagion to spread among multiple locations.  Reuters documented cases in which infected patients were transferred, sometimes multiple times, without any of the receiving facilities being notified.

 

A Reuters analysis of death certificates found that from 2003 to 2014, annual superbug-related deaths at long-term care facilities increased 62 percent, from about 1,400 to almost 2,300.

 

 

 

 

 

 

 

New York Magazine had a great article on the epidemic of opioid deaths and who and what is to blame.

“During the worst year of the HIV/AIDS crisis, 43,000 Americans lost their lives to the virus. In 2015, 52,000 died of a drug overdose. Never in recorded history had narcotics killed so many Americans in a single year; the drug-induced death toll was so staggering, it helped reduce life expectancy in the United States for the first time since 1993.”

The article suggests that “a great deal of blame belongs to our system of pharmaceutical patents, and the sociopathic greed that it incentivizes.” The for profit pharmaceuticals companies spend upwards of $200 million a year lobbying Congress to ensure that no profit-reducing regulations are imposed on them.

Pharmaceutical research is an expensive and uncertain endeavor therefore the government provides pharmaceutical companies with a motivation for researching new drugs — and a means of recouping losses from failed experiments — by offering those companies a temporary monopoly on newly discovered medications. This formula for pharmaceutical innovation has many downsides including legal price-gouging that patent monopolies enable and concealment of the harmful effects of their products.

“American doctors have been free to prescribe morphine and other generic opioid painkillers since the early 20th century. But they started prescribing such narcotics at drastically higher rates in the mid-1990s, when Purdue Pharma patented OxyContin, and began aggressively marketing the drug to doctors and patients.”

The problem with this focus is that there’s little evidence that treating chronic pain with opioids is effective — and a lot of evidence that it’s dangerous. The Centers for Disease Control and Prevention have concluded that there is “insufficient evidence” that opioids provide effective pain relief when taken for a period of longer than three months.

A recent study by the Center for Economic and Policy Research found that the total cost of OxyContin abuse in the U.S. between 1998 and 2007 — as measured by spending on “abuse treatment, medical complications, productivity loss (minus mortality), and criminal justice proceedings” — totaled $38.6 billion.

The CDC has also concluded that roughly a quarter of those who use opioids on a long-term basis become addicted. But you can make a lot of money selling dope to addicts; and Mundipharma has shown little deference to the CDC’s findings.

In 2007, Purdue and three of its executives pleaded guilty to federal charges of misbranding drugs — and were forced to pay a $635 million fine (a sum far lower than their profit of $35 billion). But by then, 29,600 Americans had already died of OxyContin overdoses – and the notion that opioids were a low-risk treatment for chronic pain had become widespread.

 

Consumer Voice, in partnership with Justice in Aging, has released a new fact sheet entitled “Why-the-Recently-Revised-Nursing-Home-Regulations-Are-Vital-for-Nursing-Home-Residents

After four years of work from the Centers for Medicare & Medicaid Services (CMS), newly revised federal nursing facility regulations were released in September, and most provisions went into effect on November 28.  These revised regulations provide critical consumer protections.  This fact sheet provides an overview of some important new revisions and how they protect long-term care consumers.  Stakeholders and policymakers can use the fact sheet to better understand the role the revised regulations have in improving nursing care, including an increased focus on addressing a resident’s needs and preferences.

Protections Include:

Greater focus on addressing a resident’s individual needs and preferences. A nursing home must learn more about who the resident is as a person, provide greater support for resident preferences, and give residents increased control and choice.

Prompt development of a care plan. The original regulations allowed a resident to be without a care plan for as long as 21 days following admission. Now, a facility must develop and implement a care plan within 48 hours of a resident’s admission.

More comprehensive care. Treatment and services have been expanded to include pain management, dialysis, and behavioral health services.

Improved training. Training requirements have been expanded to apply to all staff, contractual employees, and volunteers. Mandatory topics include communication, residents’ rights, and prevention of abuse, neglect and exploitation. Training for nursing assistants is expanded to include dementia management and resident abuse prevention.

Improved protections against abuse, neglect and exploitation. A nursing home must not employ a licensed individual with a disciplinary action, and must report suspicions of a crime to law enforcement and the state survey and certification agency.

Better protection of resident property. Nursing homes are now required to take reasonable care of resident belongings and can no longer seek waivers of their responsibility for lost or stolen property.

Increased visitation rights. A resident can accept visitors at any time of the day.

Protection against evictions. Eviction for non-payment is not allowed when a third-party payor (such as Medicaid) is evaluating a claim for payment. For evictions based on a nursing home’s supposed inability to meet a resident’s needs, the nursing home must document its attempts to meet the resident’s needs, and the ability of a receiving nursing home to meet those needs.

Limiting nursing home’s ability to “dump” a resident at the hospital. In an effort to evade eviction safeguards, some nursing homes “dump” residents by refusing to readmit them from hospitalizations. Now, a nursing home must follow eviction procedures and give a hospitalized resident an opportunity to appeal, when the nursing home claims that the resident cannot return.

Prohibiting forced arbitration of claims of misconduct. Currently, many nursing home admission agreements compel a resident to bring any future claims about abuse, neglect or other quality of care issues through private arbitration. The revised regulations prohibit nursing homes from forcing residents to arbitrate disputes, but allow voluntary arbitration agreed to after a dispute arises.