Politico’s Samuel Loewenberg wrote an article about how high priced lobbyists are attempting to get rid of necessary reforms for nursing home care to improve.

The profitable nursing home industry is mobilizing Washington’s most well-connected lobbyists to fight needed reforms,  Recently state and federal investigators and outside experts have agreed to certain reforms as a gaggle of industry lobbyists plotted strategy.

Among the lobbysts was The Carlyle Group, the politically connected and powerful private equity firm that recently bought Manor Care, one of the nation’s largest nursing home chain, for $6.3 billion.  

“In spite of existing oversight mechanisms, we continue to see examples of horrific treatment of nursing home residents,” testified Lewis Morris, general counsel for the Department of Health and Human Services’ Office of the Inspector General.

The lobbyists are carefully watching the Senate, where legislation could increase the oversight and enforcement of the industry.  It is well documented how deficient the oversight and enforcement of the industry is as evidenced by the recent GAO Report.  The senators are expected to try to attach the legislation to the upcoming Medicare payments package.

The industry lobbyists are fighting provisions to fully disclose ownership of nursing homes.  Why? No one knows. Clearly, families of residents should be able to understand who owns and operates the facility where they place loved ones. 

Additionally, penalties would be increased to as much as $100,000 if a patient is harmed or dies due to poor care. The penalties, which have not been changed in two decades, are now capped at $10,000.

To gird for the increased regulation, the industry is using a half-dozen of Washington’s most politically potent lobbying firms on both sides of the aisle.  “It is going to be pretty much battening down the hatches, because we’re not going to have a fair shake with a Democratic majority,” said a nursing home industry lobbyist who spoke on the condition of anonymity.

Since Carlyle took over Manor Care, some homes have reported significant patient care problems, said SEIU spokeswoman Julie Eisenhardt.   Meanwhile lobbyists for The Carlyle Group are stating that there is no evidence that private equity ownership negatively impacts care.   Both the Government Accountability Office and the Senate Finance Committee are still investigating the negative effect of private equity ownership on nursing home quality.

The issue is at the heart of one of the most controversial parts of the Grassley-Kohl legislation: a requirement that the sometimes-twisted ownership structures of nursing homes be made more transparent.   Congressional staff, experts, and advocates for the elderly say that private equity firms often establish layers in ownership structure as a way to dodge responsibility and legal liability.

And GAO reported how federal government regulators often miss signs of abuse and care deficiencies, ranging from failure to ensure “proper nutrition and hydration and [prevent] pressure sores” to serious deficiencies that could lead to “actual harm and immediate jeopardy.”

CBS affiliate KDKA in Pittsburgh had an article about another sexual assault at a nursing home facility.  Do they even bother to do background checks or supervise their employees?

A nursing home employee is facing charges after he allegedly sexually assauted a patient who uses a motorized wheelchair.  Allegheny County Police have charged Marc Lane, 37, of Kittaning, with involuntary deviate sexual intercourse, two counts of indecent assault, indecent exposure and criminal attempt.

The 65-year-old male victim who suffers from Parkinsons Disease said in a police report that Lane came into his room at the Consulate Health Care facility on Saxonburg Boulevard in Indiana Township between April 11 and April 25 and drew the curtain for privacy.

Lane allegedly told the patient he would treat a skin condition, but that in fact led to a sex act. The victim is refered to as "John Doe" in the affidavit.

"Lane then asked Doe if he had ever been with a man," according to the affidavit. The resident told police he resisted the advances but that led to another sex act until a nurse walked into the room.

After a mini mental status exam, the victim scored 28 out of 30. Police determined the victim is of sound mind.

KPTV.com has a video and story showing a nursing home worker stealing from the residents.   A worker at an assisted living center was arrested and charged with theft after she was caught on camera stealing from patients, police said.

Deputies arrested the woman at the Regency Park Assisted Living Center.   The Washington County Sheriff’s Office received multiple reports of thefts going on at the center, so they set up a hidden camera to try and catch the thief.  Police set up a hidden camera and plant a purse with money in it in order to catch the thief.   Three days after setting up the camera, Quanecka Thompson, 23, was caught on camera going through the purse, pulling out the wallet, taking money, putting it in her pocket and leaving the room, police said.

Detectives said they set up the purse a second time, and again, Thompson was witnessed stealing money from it.   Deputies arrested Thompson last week.

I wonder if they did a background check on this nurse?

WNBC.com had a story about how a nursing home lied to a resident’s family regarding her death at the facility.  This typeof cover up oftens happens in nursing homes. The staff is typically the only ones who really know what happened to a resident.   The staff are worried about their job or are instructed by their corporate masters to mislead or cover up the neglect and abuse.

Olive Chase was 94 when she died at Sunrise at Fleetwood, an expensive assisted-living home in Mount Vernon, in February 2007.  The nursing home told Chase’s son that she had died in her sleep. The nursing home created an elaborate story that his mother had breakfast, was left alone at one point, and the aide returned to find she had died peacefully in her sleep.  The staff said Chase was sleeping at 7:30 a.m., but was "unresponsive" four hours later. Days after Chase was cremated, however, her family got a tip from someone with second hand knowledge of her death that the woman did not die peacefully.

Bob Chase, son of the woman who died, spoke with some of the staff and to the source who was the first nurse on the scene after his mother’s death.   The nurse saw Olive’s head caught between the bars of her hospital bed with her feet hanging off the side. The nurse said it appeared as if she struggled and then died of strangulation.

"Her tongue was protruding. It was purple," the nurse said.

The nurse said one of the maintenance workers then lifted Olive’s legs while she held onto one of her shoulders.

"We brought her up, laid her flat on her bed," said the nurse. "I brushed her hair. This nursing coordinator told us, ‘Don’t say anything.’"

The nurse said the last person to treat Olive for a bedsore raised the bed for the treatment but did not lower it after, despite instructions to do so. Olive was known to wander, the nurse said.

"We had a sign on the top of the bed, readily visible, stating to lower the bed at its lowest level when finishing care," the nurse said.

An anonymous call to the state Department of Health days after Olive’s death reported that the woman appeared to have died of asphyxiation after her head was caught in the bars, which triggered an investigation. The department concluded the caller’s complaint was valid. The department found that Olive’s body had been rearranged after her death, but it was not reported that way in Sunrise’s records.

San Mateo Daily Journal had an article about a settlement three years after a mentally disabled woman was scalded nearly to death in a Redwood City nursing home.  The resolution came May 13, one day after the county was set to square off in court with Res-Care and employees, including Oretha Ocansey who was criminally convicted for her role in the severe burning of Theresa Rodriguez in May 2004.

The county, which is Rodriguez’s legal guardian, sought both punitive and actual damages for Rodriguez who was left so badly injured her hospital care costs $3,000 a day.  The lawsuit was filed after Ocansey was sentenced for placing the woman in the boiling hot stream of water but the defendants argued the entire company was not responsible for the actions of the single employee.

On May 4, 2004, Rodriguez was seated in the shower at Res-Care, located on McGarvey Avenue, when 145-degree water poured onto her lap. Rodriguez, who is unable to speak or walk, suffered third-degree burns over 60 percent of her body. Nurse’s aide Oretha Ocansey placed a diaper on Rodriguez and did not alert a supervisor for two hours. An hour after the supervisor learned of the situation, Rodriguez was airlifted to a Santa Clara County hospital and spent more than two hours on life support.

During the investigation in Ocansey’s role, prosecutors learned that Res-Care forbid workers from calling 911 until they first contacted a supervisor. Prosecutors still considered Ocansey culpable, however, for waiting two hours before even contacting her boss.  In August 2004, Ocansey pleaded no contest to felony elder abuse in return for an immediate sentence of the 34 days she had already served plus probation and a ban from working at health-care facilities. The plea bargain spared her trial and up to four years in prison if convicted by a jury.

The county went after the nursing home and its corporate owners the following January, claiming the facility knew of the water temperature problem for six days before Ocansey placed her in the shower.

Pantagraph.com had an article about a Bloomington nursing home paying a reduced $14,500 fine for failing to protect residents from a sex offender who was a patient at the facility.  This is outrageous and shows why lawsuits are necessary to insure that nursing homes are held accountable for their negligence and gross stupidity. 

Asta Care, 1509 N. Calhoun St., failed to screen a male resident who made inappropriate sexual advances to staff and two mentally disabled residents. The acts were noted in nursing records dating to October 2006 at the 117-skilled bed facility but were ignored by management.  The man, who was identified as a sexual offender,  was allowed to remain at Asta Care even after complaints were made by staff. 

Clearly this situation was avoidable if the nursing home simply checked the man’s background.  It is shocking that the nursing home only had to pay a small fine for such outrageous conduct.

Newport News Dailypress.com had an article about a suspicious death of a resident of a nursing home.  There appears to be a link between his death and medicine he got the day before.

A nurse who gave unauthorized medicine last week to a nursing home resident who later died has been fired.  Police are considering whether the medication caused or contributed to the death of John P. Stratton, 76, of Newport News, who was staying at the James River Convalescent and Rehabilitation Center.  Stratton was given the medicine on May 5, and died about 4 a.m. on May 6.

The nurse’s decision to give Stratton the medicine was not an accident.   "She intentionally gave him the medication," police said. "Her intent in giving it to him will have to come out later."

Police are trying to find out whether Stratton was given an increased dose of a medicine he was prescribed, or medicine he wasn’t supposed to get at all.

Joseph Law, James River Convalescent’s administrator, said the nurse — whom he declined to identify — was fired after an internal investigation. The actual reason for her firing, Law said, was separate from the issue surrounding Stratton’s death. "The nurse was terminated because of facility protocol," Law said. "During our investigation some other information was discovered." He did not elaborate. What a bunch of nonsense. Clearly the facility does not want to admit what happened or what they found out in their "internal investigation". 

It could take a month or longer for the toxicology results.  The examination will include any possible interaction between the medicine the nurse gave him and other drugs Stratton was taking.

One of Stratton’s daughters, Denise Barnes of Newport News, said the family doesn’t know what drug or drugs the nurse gave her father.   A staffer at the home brought to his attention the possible link between the medication and Stratton’s death. He then called police and state agencies.

I’m surprised they didn’t fire the staffer who refused to cover it up.

Knoxville News had an article about a nursing home resident who lost a leg due to the nursing home’s neglect.    Neglect of a resident at Hillcrest-West nursing home led to the amputation of her leg last month, according to state reports quoting a doctor who consulted on the case.

The state has censured Hillcrest nursing homes for providing substandard care three times in the past two years.   Obviously the corporate managers ignored the problems and did nothing to correct them.

Now, as in the past, Hillcrest is in danger of losing federal funding if problems aren’t corrected. Hillcrest-West has until May 25 to submit a detailed plan of correction, said Lee Millman, a spokeswoman for the Centers for Medicare and Medicaid Services.   During a survey conducted April 28 through May 2, the state found violations of "resident protection, administration, records and reporting, and nursing services standards."

Details in the recent state report on Hillcrest-West state that the amputee’s pressure wound was at the most severe level when first noted by staff Feb. 7. The leg was amputated above the knee April 22. Doctors said the bone likely was infected and the wound was "exquisitely (intensely) painful" when manipulated.

A podiatrist said the pressure wound was the "result of neglect … the worst wound I have seen in 12 years," and the surgeon who removed the leg concurred, the report states.   The same patient didn’t get the amount of tube-fed nutrition and saline ordered by her doctor, with feedings skipped repeatedly, the report notes. Also, the family was not informed of the pressure wound and was shocked when they learned of the pending amputation, the state report said.

State inspections from 2006 and 2007 report Hillcrest-West patients found on the floor after apparently falling from beds or wheelchairs, failure to properly use restraints or alarms, patients who were unclean, and inadequate staffing.

The North Country Gazette had an article about a recent jury verdict involving a nursing home’s negligence.  A Washington jury ordered Washington County to pay $300,000 to the family of a woman who died as the result of a fall at the county-owned Pleasant Valley Adult Home in Argyle.

Former Fort Edward resident Esther Nolan, 75, died at the adult home in March 2003 following a fall from a toilet. The woman’s death was caused by inadequate staffing and the improper installation of the toilet seat.

This is not a post about a nursing home case.  But it is interesting.  I was emailed a blurb about an article on how the VA is directing their staff (presumably doctors) to avoid diagnosing patients with Post Traumatic Stress disorder. 

The email was titled "suggestion" – and it "suggested" diagnosing patients with a diagnosis which would provide lower disability payments.  Now, of course, the email doesn’t come out and say that – it does, however, come out and say that they should consider a diagnosis of "Adjustment disorder R/O PTSD" – Adjustment disorder certainly sounds less expensive. 

I think all of us have had or will have adjustment disorder ~ adjusting to a new job, adjusting to a new marriage, adjusting to a new divorce, adjusting to a new baby, adjusting to a new house . . . . This is a far cry different from what some of our Soldiers returning home from war experience.  Adjustment disorder doesn’t seem to accurately cover it.


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