WKRG reported that maggots were found in a nursing home resident’s catheter. The Arkansas Department of Health and Human Services details conditions at Capital Health and Rehabilitation Center that no one should endure.  The nursing home “failed to ensure necessary care and services were provided for hygiene and urinary catheter maintenance” for one resident who had an indwelling catheter.

According to the documents, nurses said, “They [maggots] were, like, going inside his penis. It’s just gross. Nasty. I’m not going to say it was a handful, but it was a lot. They were little.”

“The flies were real bad down there,” a nurse said in the report. “We had fly swatters. I have killed a couple of flies in his room and one was under the covers. But I didn’t think anything about that.”

The nursing home also “failed to ensure adequate supervision… interventions… and increased monitoring” for a 92-year-old resident with dementia who requires total supervision.  The resident escaped from the facility twice. A visitor let him out the first time, and employees found him under a tree on the grounds. The second time, he was found at a nearby restaurant.  According to the documents, the nursing home was not aware the resident was missing either time, which caused his son to question his father’s safety there and request his transfer to a different facility.

Their corporate office, Skyline Highland Holdings, has several corporations in Arkansas that own or manage nursing facilities, with a total of 21 across the country.

Business leaders across Arkansas are pushing for limits to payouts in certain lawsuits.  They want voters to pass a constitutional amendment in next year’s midterm election that would cap non-economic and compensatory damages in lawsuits.

 

 

The Annals of Internal Medicine had an article about inappropriate medication use in nursing homes.  “Inappropriate prescribing is a well-known clinical problem in nursing home residents, but few interventions have focused on reducing inappropriate medication use.”

They studied if the Multidisciplinary Multistep Medication Review (3MR) consisting of an assessment of the patient perspective, medical history, critical appraisal of medications, a meeting between the treating elder care physician and the pharmacist, and implementation of medication changes was beneficial.

The study proved that the 3MR is effective in discontinuing inappropriate medication use in frail nursing home residents without a decline in their well-being.

Public Opinion had an interesting article on how the nursing home industry is changing for the Baby Boomer generation.  ““The entire senior living industry is in the midst of great change right now,” Menno Haven CEO Hugh Davis said. “The post-war generation, those born between 1945 and 1965, is the largest population wave this nation has ever seen, and they are now at retirement age and looking for senior living communities in waves. This shift is causing the entire industry to look at their products and services. These folks have grown up very differently than their World-War-II-era parents, and they have different wants and expectations.”

The need for short-term rehabilitation services such as physical therapy, occupational therapy and speech therapy has increased. The goal is to prepare people to return home after a hospital stay for acute illness, traumatic injury or elective surgery.  Local retirement communities already are moving to “small houses,” an innovative model for assisted living. The concept balances social interaction and privacy; with residents sharing a kitchen, living room and meals at a family-style dining room table.

Industry research shows these environments reduce anxiety, medication use and confusion in memory care residents.

The Wall St. Journal had an interesting article on immunotherapy also known as biologic therapy, is a type of cancer treatment that boosts the body’s natural defenses to fight cancer. It uses substances made by the body or in a laboratory to improve or restore immune system function.

The science of using immunotherapy to treat cancer is advancing rapidly, marked by the National Cancer Institute’s recent disclosure that a metastatic breast-cancer patient is now cancer-free, regulators’ expected approval of a major lymphoma treatment this fall and the unveiling Thursday of a partnership between government researchers and drugmakers.

This therapy shows tremendous progress in the fight against cancer.

Banks, credit card issuers and other financial companies will be able to block customers from banding together to sue over disputes, after the Republican Senate narrowly killed a rule banning the firms from using “forced arbitration” clauses.  Republican Vice President Mike Pence  cast the tie-breaking vote.  The prior rule prohibited major financial institutions from using fine print in buried in consumer contracts to block class-action lawsuits by consumers.

Customers now must agree to the clauses as a condition of opening accounts, saying they will take any disputes to closed-door arbitration instead of joining class-action lawsuits, where complainants band together to share litigation costs. The clauses are used for nearly every U.S. consumer product and service since the Supreme Court ruled them legal in 2011.  Arbitration means customers have no recourse but to bring any disputes to private, arbitration panels. In general, that keeps the corporate wrongdoing shrouded in secrecy, and the costly arbitration process itself with limitations on discovery is often stacked against consumers.

Financial services companies have forced consumers to use arbitration in case of disputes because, as analysis has shown, arbitrators rule overwhelmingly in favor of corporations. As part of arbitration requirements, companies like banks have insisted that, to get service, consumers had to give up the right to a jury trial.

“Wall Street won and ordinary people lost,” Richard Cordray, the director of the consumer bureau, said in a statement. “It robs consumers of their most effective legal tool against corporate wrongdoing. As a result, companies like Wells Fargo and Equifax remain free to break the law without fear of legal blowback from their customers.”

Victims of the Equifax Inc. hack were outraged last month when the company included forced arbitration fine print in offering them free credit monitoring.  At the same time, Wells Fargo & Co customers whose identities were used in last year’s phony accounts scandal have had difficulty suing the bank because they are bound by arbitration clauses in contracts they signed for legitimate accounts.

Arbitration clauses are now commonplace in the financial industry: About three-fourths of banks analyzed by Pew Charitable Trusts, for instance, had mandatory arbitration agreements in place.

Next Avenue had an interesting article on how 4 states have lowered nursing home admissions. Nursing home care is the most expensive form of long-term care. According to the 2017 Genworth Cost of Care report, a private room in a nursing home now costs an average of $97,455 per year. A semi-private room runs more than $85,000.

“If you are hospitalized at age 65 or older, there is a one in five chance you will be discharged to a nursing home.   Certain states — like Minnesota, Maine, Oregon and Connecticut — have implemented policies that lower the chances of getting “stuck” in a nursing home, said Wendy Fox-Grage, a senior strategic policy advisory with the AARP Policy Institute and co-author of “State Strategies to Reduce the Risk of Long-Term Nursing Home Care After Hospitalization.”  The new report, released Oct. 6, highlights some of those innovative policies.

Minnesota: ‘Return to Community’

Minnesota uses “community living specialists” to work with older adults to get them back to their communities. The community living specialists, who are nurses or social workers, assist the nursing home to identify new residents who may want to return home. Then, after the residents return home, the community living specialists follow up with them to make sure they are getting the services and support they need over the following months.

Another Minnesota initiative lauded in the report is its Performance-Based Incentive Payment Program. This program rewards nursing homes with incentive payments for designing projects to lower their numbers of long-term residents.

Oregon: Downsizing Nursing Homes

Oregon does a better-than-average job of keeping people out of nursing homes by providing services in the community: just 3.3 percent of state residents age 85 and older live in nursing homes. (The national average is 9.5 percent, according to the AARP report.)

A 2013 law provided a financial incentive for nursing homes to buy another facility and then take the excess capacity out of use — a process known as “buy and close.” Some providers have diversified into hospice care, assisted living, home health and independent living, the report said.

Connecticut: Home Care for Older Adults

Connecticut’s Home Care Program for Elders provides financial assistance for home care services so older adults can delay or avoid going to a nursing home. There are varying levels of service depending on a person’s financial resources, but unlike other programs, those who don’t qualify for Medicaid are not automatically excluded.

The services may include housekeeping, companion services, home-delivered meals, a personal emergency response system, adult day care, assisted living, mental health counseling and minor home modifications. Family caregivers can receive payments of between $42.58 and $107.06 per day.

The program “represents a significant state investment in the delivery of home care services to people who, despite being at risk for nursing home admission, do not qualify for Medicaid,” the report said.

Maine: Getting to People Early

Maine has been working since the 1990s to limit nursing home admissions to the people who most need them, according to the report. It does that, in part, by mandating medical assessments before admission. Maine also provides prospective residents and their families with a “community plan of care,” which gives information about services they may be able to use instead of going to a nursing home.

The program also provides individuals with a service plan that has estimates of how much the home care services will cost. The service plan doubles as an authorization for payment by Medicaid, if the person qualifies, or the state-funded home- and community-based care services program.

 

 

 

Mic reported that the nonpartisan Congressional Budget Office concludes that the Bipartisan Health Care Stabilization Act of 2017 intended to stabilize the individual health care marketplace created by the Affordable Care Act would actually reduce the deficit by $3.8 billion over the next 10 years.  The bill, drafted by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) and co-sponsored by other Republican and Democratic senators, would fund the cost-sharing reduction subsidy payments to insurers that President Donald Trump refused to pay.

“Implementing the legislation would reduce the deficit by $3.8 billion over the 2018 to 2027 period,” the CBO report says, adding that “the legislation would not substantially change the number of people with health insurance coverage.”

The bill would also increase funding for outreach to enroll people into the individual health care marketplace, and would make it easier for states to receive waivers from ACA regulations.

Insurance companies blame Trump’s refusal to pay the cost-sharing reduction subsidies for the increased cost of insurance premiums for Americans.

The Sun Sentinel reported that Rehabilitation Center at Hollywood Hills where the central air conditioning failed during Hurricane Irma causing 14 wrongful deaths sent a bill to a family member of one of the deceased residents, Albertina Vega.

The facility sent it on the day she would have turned 100 years old.  Carmen Fernandez went to the bank to close Vega’s account only to learn there was no money in it. Instead, there was an automatic payment of $958 to Hollywood Hills that resulted in an overdraft fee.

The shock of it was magnified by the fact that the payment was posted on Oct. 10, the day Vega would have become a centenarian had she not perished in the stifling nursing home.

Vega was the first of the victims who died Sept. 13 inside the overheated facility or at Memorial Regional Hospital across the street. The eight residents who died that day were living on the second floor of the nursing home, which had no functioning air conditioning for three days.

 

St. Louis Today reported that Johnnie Mac Sells, owner of Benchmark Healthcare nursing home, who admitted stealing more than $667,000 from Medicaid was sentenced to 41 months in prison, the maximum under federal sentencing guidelines.

Sells spent most of the money on strippers, gambling, pet care and country club fees. He pleaded guilty in April to two counts of health care fraud. Sells will be on supervised probation for three years after his release. He also must pay back the money.

 Conditions got so bad at Benchmark Healthcare in the summer of 2016 that the state needed to rescue 60 residents. A Post-Dispatch investigation later showed how the nursing home became a dirty and dangerous place as Sells, its president, faced a mountain of debt.

“It is incomprehensible to believe he was doing these things knowing full well the residents, the most in need of support and care” were being denied medicines and food and living in a facility in need of maintenance, said Judge John A. Ross.

Detroit News reported that two nursing home caregivers pled guilty to intentionally placing false information on a chart involving medical records. Denise Filcek and Yahira Zamora were charged in the death of an 85-year-old woman who was found in cold weather outside an assisted living center.  A resident with dementia, Kathryn Brackett, wandered outside and was found dead on Oct. 27, 2016.

Filcek was responsible for making bed checks. She told the judge, however, she didn’t check on everyone. Sentencing is Nov. 28.

Zamora pleaded no contest to second-degree vulnerable adult abuse. Authorities say she reset a door alarm without determining whether anyone was outside Crystal Springs Assisted Living Center. She’s also awaiting sentencing.