U.S. News had an interesting article discussing how Louisiana‘s payments to private nursing homes for taking care of Medicaid patients have risen substantially over the last decade increasing profits even as their occupancy rates stayed flat, according to an audit. The state Medicaid program spent $8.7 billion in federal and state dollars on nursing home care for people who are elderly or disabled from 2006 through 2016, as daily rates paid to about 260 nursing homes increased 54 percent from $112.34 to $172.82. In the last budget year that ended June 30, Medicaid payments to the facilities reached $1 billion. Occupancy rates over the same period, however, “have generally remained the same,” growing by less than 1 percent.
One easy explanation is that the nursing home industry is powerful and a hefty campaign contributor at the state capitol. In fact, inadequate monitoring and enforcement caused the department to fail to recoup $3.2 million in Medicaid payments for ineligible patients in 2014.
“Even with the increasing payments to nursing facilities, Louisiana continues to rank poorly in regards to quality of care,” auditors wrote.
Auditors also said the Louisiana Department of Health needs to improve its oversight of payments to ensure they’re accurate. They said the agency should issue penalties for late cost reports from nursing homes and tougher sanctions for facilities that have repeat audit violations.
Ashton Place Health and Rehabilitation Center nursing home has been hit with record fines after inspectors found widespread neglect resulting in actual harm to multiple patients including one who died after transfer to a hospital showed widespread wounds with maggots that apparently had gone untreated. A male patient who was admitted to the home on July 26 of this year with no visible wounds ended up being transferred to a hospital for ulcers and ultimately died on Oct. 11 where hospital staffers found maggots in wounds that appeared to be untreated.
The 98-page inspection report cites multiple cases of patients suffering actual physical harm due to failure to follow a physician’s orders, failure to administer prescribed drugs and failure to inform physicians’ of their patients deteriorating condition. According to the report, the home’s medical director stated, “I have support, no direction. I have talked (to them) about the staff they have here. I don’t have much confidence in them.”
The fines totaling $50,000 were imposed on the 211-bed nursing home. In addition to the fines Tennessee Health Commissioner John Dreyzehner ordered a rare freeze of any new admissions to the facility and appointed a monitor to oversee its operations.
Neglect and poor care was also detailed for other patients, including a female patient suffering from ovarian cancer whose worsening condition was not reported to her doctor. She died on Oct. 24.
The report was highly critical of managers at the facility and noted that top officials contended they were unaware of the problems reported by direct care staffers. What is worse? Knowing of a problem and ignoring it or not even being aware of what is going on at the facility?
The Department of Justice announced four San Diego-area nursing homes owned by Los Angeles-based Brius Management Co. have agreed to pay at least $6.9 million to resolve allegations that their employees paid kickbacks for patient referrals and submitted fraudulent bills to government health care programs. The four nursing homes involved in the settlement are: Point Loma Convalescent Hospital, Brighton Place – San Diego, Brighton Place – Spring Valley, and Amaya Springs Health Care Center in Spring Valley. The settlement resolves an investigation into allegations that their employees paid kickbacks to discharge planners at Scripps Mercy Hospital San Diego to induce patient referrals to the nursing homes in violation of the federal Anti-Kickback Statute.
“Kickbacks for patient referrals are illegal under federal law because of the corrupting influence on our nation’s healthcare system,” said Acting United States Attorney Sandra R. Brown. “This settlement demonstrates our resolve to combat fraud that compromises the care provided to patients served by a government healthcare plan. This case further shows the power of whistleblowers to shine a light on corrupt activities and obtain significant recoveries on behalf of United States taxpayers.”
The investigation examined additional allegations made in a “whistleblower” lawsuit that the nursing homes submitted false claims to Medicare and Medi-Cal for services provided to patients referred from Scripps Mercy Hospital. Bills submitted for patients referred as a result of illegal kickbacks would constitute fraud against the United States and the State of California.
The settlement resolves a lawsuit brought by a former employee of one of the nursing homes under the qui tam – or whistleblower – provisions of the federal and state False Claims Acts, which allow private citizens to file lawsuits on behalf of the United States and California and share in any recovery. The whistleblower, Viki Bell-Manako, will receive 20 percent of each settlement payment. Pursuant to the settlement, United States District Judge John F. Walter today dismissed the lawsuit, United States of America, State of California ex rel. Bell-Manako v. Brius Management Co., et al., CV11-2036-JFW.
Nursing home employees conspired to pay kickbacks allegedly without the knowledge of Brius Management Co. The nursing homes admitted that their employees used corporate credit cards to pay for gift cards, massages, tickets to sporting events, and a cruise on the Inspiration Hornblower that were given to planners at Scripps Mercy Hospital as kickbacks.
“Skilled nursing facilities that pay kickbacks in order to boost profits will be held accountable for their improper conduct,” said Christian J. Schrank, Special Agent in Charge of the U.S. Department of Health and Human Services Office of Inspector General. “We will continue to crack down on kickback arrangements, which can corrupt medical decision-making and undermine the public’s trust in the health care system.”
WFLA had an article about the horrific neglect and abuse suffered by Willie Johnson at the hands of the caregivers at Habana Health Care Center owned and operated by Consulate Health Care. His daughter Tonya Baker said her elderly father is living in poor conditions and shared photos to prove it. “Not taking care of my dad, not feeding my dad, going in there finding my dad, wet Pampers, Depends, not being changed,” she said.
“My daddy’s not getting the care that he’s paying for to stay in that facility,” Baker told me. Baker has filed five complaints with the State’s Agency for Health Care Administration about the nursing home. Four out of five times, they found the nursing home violated its own rules or law. But despite the state’s involvement, Baker says problems persist.
“I also went in there and had them take my daddy’s air conditioning out the wall because he had a lot of mold in there, in the air conditioner and in the air conditioner wall,” explained Baker.
The photos include one where he has a busted lip. Baker said the facility told her he was punched by a roommate. Another photo shows her father with a gash on his forehead after a fall in the shower.
Nationwide, eviction is the leading complaint about nursing homes. In California last year, more than 1,500 nursing home residents complained that they were discharged involuntarily. That’s an increase of 73 percent since 2011. NPR reports on AARP’s lawsuit against the illegal practice. Nursing home residents have a lot of rights guaranteed in state and federal law. For example, they have to be given 30 days’ notice before they’re moved involuntarily. And the nursing home has to hold their bed for a week if they’re in the hospital.
The California Long-Term Care Ombudsman Association joined the lawsuit as a co-plaintiff. The organization represents long-term-care ombudsmen. Those are the public officials who track complaints about nursing homes and advocate for residents. But Leza Coleman, the group’s executive director, says the spike in complaints about evictions is so overwhelming, that it’s “impacting our ability to handle other complaints.”
The Pittsburgh Post-Gazette reported the tragic and preventable death of Pittsburgh businessman Robert Frankel who died from asphyxiation from an incident in which his neck was trapped in bed rails. Mr. Frankel died late Sept. 17 at the nursing home from what the medical examiner deemed at the time accidental asphyxiation, “due to compression of the neck.” The Charles Morris Nursing and Rehabilitation Center has discontinued using such railings in response, according to a Pennsylvania Department of Health report.
“Based on review of facility policy and documentation, clinical records and staff interview, it was determined that the facility failed to identify a hazard created by the use of side rails resulting in the death,” the report said. The report said that at 11:30 pm. on Sept. 17, “a nurse aide was performing first rounds to check on the residents and found Resident R1 (Health Department inspection reports do not identify individuals by name) pulseless and without respirations, lying with his body on the floor and his neck between the air mattress and the side rail.” A nursing supervisor pronounced him dead at 11:40.
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.
Forbes had an interesting article about nursing homes “dumping” residents. This problem is only getting worse because it is becoming common corporate policy to evict low-income residents to make room for more lucrative Medicare or private pay residents. In other words, they dump Medicaid people so they can make more money on other residents who are paid by better sources than Medicaid. Some elders are low income and receive Medicaid. Some live in nursing homes, as they need full time care. Medicaid recipients are vulnerable and can be subject to terrible treatment, including being kicked out of a home just because they have to get temporary treatment at a hospital.
“It is disgusting to think that a nursing home will not only violate the law in refusing to allow its own resident back into the home after going to a hospital, but it will callously separate spouses by doing so. Neither has the luxury of choice. One spouse can stay while the other gets the boot?”
The AARP Foundation, the affiliated charity of AARP, is fighting for the residents to stop this despicable practice. According to Foundation attorney Kelly Bagby, a clear legal right to return to the place where she lived exists, and should be enforced by the state health agencies. The law prohibits it and the law is ignored.
If your own aging loved one is ever mistreated, threatened with being evicted or dumped from a nursing home, know that he or she has rights that can be enforced. The place to start is with the Office of the State Long Term Care Ombudsman. The ombudsman is assigned the task of being the liaison between the facility and the resident or resident’s family.
WPRI reported the family of an elderly woman who was assaulted at Coventry Center Skilled Nursing and Rehabilitation nursing home has filed a lawsuit against the owners of the home and her alleged assailant. On Oct. 14, police arrested Francis Kinsey on a charge of first-degree sexual assault after an employee at Coventry Center Skilled Nursing and Rehabilitation reported seeing him assaulting an 80-year-old resident.
Now, the alleged victim’s family is suing Kinsey and the owners of the nursing home, Genesis Healthcare. In the lawsuit, the family claims the suspect should not have been in the nursing home since he was out on bail from a pending child molestation charge. Police learned Kinsey had been arrested for first-degree child molestation in 2012, and that case was still open at the time of the alleged nursing home assault.
“Genesis Healthcare, LLC knew or should have known that Defendant Francis E. Kinsey, Jr presented a danger to residents he came into contact with for reasons including, but not limited to, his arrest record,” the lawsuit states. The family claims the nursing home did not take adequate steps to ensure the woman’s safety when Kinsey was moved to or allowed to roam a floor specifically treating mentally frail individuals, such as the victim.