The Bennington Banner reported the police investigation into a suspicious death at Crescent Manor Nursing Home.  Bennington Police Chief Paul Doucette said that the incident occurred on Nov. 24. An investigation indicated that Dorothy Papero, 84, went into the private room of Rodolpho Davalos, 58. He said staff reported having heard Davalos become upset and tell Papero to leave.

Doucette said Papero was found on the floor, bleeding, having suffered broken ribs as well as injuries to her back and head. She was pronounced dead from those injuries two days later. He said it’s believed that Davalos grabbed Papero and they both fell, Davalos landing on top of her. Davalos was not injured and remains at the nursing home.

Police were notified of the incident five hours after it occurred by staff at Southwestern Vermont Medical Center. Doucette said police have been told that both Papero and Davalos suffer from dementia, and was not questioned by police.

Crescent Manor Administrator Claudette Werner said she could not comment extensively because of confidentiality issues, but said the incident is being considered an accident.
 

 

The Dayton Daily News reported another investigation into a suspicious death at an Ohio nursing home.  Daniel Brown was beaten in the face and head and died. He went to the long-term care unit at St. Vincent Charity Medical Center after suffering a stroke.  A roommate is suspected in the fatal beating of a nursing home patient in Cleveland.  Police say his roommate claimed he had been attacked by Brown, although he was partially paralyzed. The death has been ruled a homicide.

The roommate, 41-year-old Rudy Litto of Cleveland, was indicted last week on an attempted murder charge. With the death, police said Friday they will open a homicide investigation. Litto’s attorney, Daniel Chaplin, says Litto was disoriented while coming out of a 27-day coma and should have been restrained.

 

The Denver Channel reported the police investigation into another suspicious incident at a nursing home. Police have launched a criminal investigation into an incident at an Adams County nursing home after a patient suffered deep lacerations to her face and a fractured eye socket.

"They said she was walking and fell into a wall," explained Kayla Gonzalez-Poblano while describing the injuries suffered by her 57-year old mother Angela Guerra.  Gonzalez-Poblano told 7NEWS that the Administrator of the Woodridge Park Nursing and Rehabilitation Center, Angela Aragon-Herrera, had told her, "[Guerra] ran at the wall, but two nurses were there to catch her… so she didn’t get any trauma to the head."  "Then that story completely changed to ‘no one was around but the maintenance man and that she was running full speed at the wall, hit the wall and fell down,’" said Gonzalez-Poblano.

Administrator Aragon-Herrera will not show the family the nursing home’s internal incident report created from the investigation by the nursing home which is required to be done pursuant to the rules and regulations of all nursing homes for any and all incidents at a nursing home.

Guerra has spent several days in the hospital with severe lacerations to her face, a fractured eye socket and may lose vision in her eye.  According to Gonzalez-Poblano, the social worker told them, "the surgeon says the wounds on her face do not match up to the story they are saying of her hitting a wall."

The Woodridge Park Nursing Home and Rehabilitation Center was the subject of a CALL7 Investigation in November which reported that Aragon-Herrera was under investigation after complaints that she was ordering patients medication be altered without a doctor’s approval.

The CALL7 Investigators also found the state Health Department had substantiated a series of complaints against Woodridge including, failure to provide adequate supervision of patients, insufficient food, and lack of proper sanitation procedures.

"The health department did come in and investigate and did find deficient practice with [administrators] not having enough supplies in the facility," said Kay, a former nurse manager at Woodridge who asked that we not reveal her last name. And the nurses said that when they called the corporate hot line to complain, Aragon-Herrera would intervene.

"This is literally what [Herrera] would say: ‘Every time you call that number, they call me. So please don’t call that number. If you have an issue, bring it to me.’ If you brought the issue to her, two weeks, three days, whatever the time frame was, you were gone," said Jennifer.

In November, A state ombudsman explained that Woodridge is not unique and in this current economy there are many nursing homes with similar or worse issues.

 

 

The Buffalo News had a story about the arrest of Paul Scott, a nursing assistant at Hawthorn Health Multicare Center for Living for alleged sexual abuse of a resident.  Scott was charged with first-degree sexual abuse with a disabled person in an incident that involved a 77-year-old woman resident.  Police were called to the nursing home at about 6:45 p. m. on Saturday, the day the incident was alleged to have occurred, said Michael De- George, police spokesman.

 

The Orlando Sentinel reported a bizarre story about a former University of Central Florida Nursing professor named Dr. Nancy Rudner Lugo, filing a lawsuit against the school after she was let go because she refused to use a textbook that "contains antiquated and offensive racial, ethnic and other stereotypes."

The federal lawsuit claims Dr. Lugo was a tenure-track professor in UCF’s College of Nursing when the university decided not to renew her contract in 2008.  Rudner Lugo contends her termination came after she complained about and later refused to use "Guide to Culturally Competent Health Care" in her Community Health Nursing class.

In her suit, Rudner Lugo accuses the university of ignoring or deflecting her concerns about the book after she said students complained "of how their ethnic groups were depicted" in the text.

The lawsuit lists several specific examples of allegedly stereotypical depictions of particular races or ethnicities:

•In the third chapter, titled "People of African American Heritage," authors Larry D. Purnell and Betty J. Paulanka explain that, "Because significant numbers of African Americans are poor and live in inner-cities, they tend to concentrate their efforts on day-to-day-survival."

•The text says that in the black community "being overweight is seen as positive," asserting that, "It is important to have meat on one’s bones to be able to afford weight loss during times of sickness."

•The chapter states that African-Americans tend to be loud, "high-keyed, animated, confrontational and interpersonal." The text includes "voodoo doctors" among a list of "folk" healthcare practitioners common to African-American culture.

•The lawsuit lists similar commentary on numerous other groups. Traditional Italian-American families, the text states, "recognize the father’s authority as absolute; nothing is purchased, and decisions are not made without his approval."

•The text claims that Japanese wives "care for husbands to a great extent. Japanese men are presumed not to be capable of managing day-to-day matters."

•It explains that, in the company of Jewish people, jokes "that refer to the Holocaust or concentration camps" or "implying that Jews are cheap or pampered" are inappropriate.

Co-author Purnell, a faculty member in the University of Delaware’s nursing department, developed the "Purnell Model" of cultural competence, which has been cited in the American Academy of Colleges of Nursing’s "Tool Kit of Resources for Cultural Competent Education for Baccalaureate Nurses."

 

Journal Star had an article about a program to keep residents mobile to increase independence and avoid pressure ulcers. Sue Coffman, three days a week, leads a group of residents at Heritage Manor Nursing Home in Chillicothe through a series of exercises designed specifically to get them up and moving, whether they use wheelchairs or walkers. The goal of the Stepping Up program is to improve balance and muscle strength to the point that fewer residents need wheelchairs.

Coffman’s work at the nursing home is a part of a national movement pushed by GROW, or Getting Residents out of Wheelchairs, an advocacy group based in Mundelein. Nursing home staff, health care professionals, even family members and residents have to get out of the mindset that wheelchairs are the norm in long-term care facilities, says Mary Harroun, a co-founder of GROW.

In 2005, when Harroun and Diana Waugh, a nurse, founded GROW, federal statistics reported 64 percent of nursing home residents nationwide used wheelchairs as a primary source of locomotion. The problem is wheelchair dependency affects every part of the body and too much of the wheelchair use in nursing homes is unnecessary.

The industry claims putting residents in wheelchairs is a "safety" issue. Reliance on wheelchairs prevents falls and injuries. It’s also staff-centric, Harroun says, in that pushing residents down the hall in wheelchairs is less time-consuming than waiting while they walk.

Over-reliance on wheelchairs have negative effects on breathing, nutrition, digestion, bone density, bowels and muscle strength. Harroun became interested in the topic five years ago while reading a new set of nursing home regulations that included 63 pages on guidelines for treating pressure ulcers, more commonly known as bed sores.

"There shouldn’t be anything in the regs on pressure ulcers because there shouldn’t be any pressure ulcers. That’s from bad care. That’s from not getting them up and walking."

Harroun thinks too many residents may not be properly assessed for movement functions and rehabilitation potential before they’re automatically confined to a wheelchair.  Many doctors, as well as caregivers "don’t understand the importance of keeping the elderly walking," Harroun says. "I want to see them up and moving instead of sitting around the nurse’s station rotting in wheelchairs."

Coffman and other staff members at Heritage Manor heard Harroun’s presentation at a Culture Change Coalition symposium.  The Culture Change Coalition’s goal is to change the culture of care at long-term care facilities.

Heritage Manor instituted GROW’s Stepping Up exercise program soon after the symposium.  In less than a month, Cohenour says he’s seen some of the class participants become more functional. Contrary to conventional wisdom, he says, a wheelchair-dependent population does not necessarily make residents safer from falls or make work easier for staff.

"They fall out of wheelchairs, too," Cohenour points out.

Improving a resident’s mobility with movement and exercise decreases the potential for falls. Improvements also take strain, physical and otherwise, off CNAs such as Coffman.

"The more they can do for themselves, the easier it is for the CNA," she says.

 

 

Ohio’s Fox8 News reported the conviction of nursing home aide Lemar Daniels for raping a patient.  Lemar Daniels was found guilty of six counts of rape by a Summit County jury.  According to Summit County Prosecutor Sherri Bevan Walsh, in May of this year Daniels, a state tested nurses aide who worked at Middlebury Manor Nursing Home, raped a 50-year-old woman who was a resident at the facility. Bevan Walsh says Daniels’ victim is mildly mentally challenged.

Daniels faces up to 30 years in prison when sentenced on December 28.
 

The Milwaukee-Wisconsin Journal Sentinel reported the lawsuit filed by the family of a woman who died after she was sexually assaulted by another resident at Franciscan Villa nursing home. The lawsuit claims that administrators and staff at the home were negligent because they failed to take action earlier against the perpetrator despite prior sexual outbursts against residents and staff.

According to the complaint and state records, a 90-year-old male resident was caught trying to sexually assault a different woman in a dining room on Jan. 25, 2009. A state Department of Health Services review later found that the initial assault on Jan. 25 had never been documented.

He was pulled away and led to his room by a manager, who then left him unattended while she went to get medication to stop his sexual urges. He was found shortly thereafter in another female resident’s room with his pants down.

Staff responded but again left him alone in the hallway, and he next found the victim alone in her room and raped her. A visitor to another resident heard the woman’s distress and went to her room, where he found the man assaulting the victim. She stopped eating from the shock and trauma of the attack and died 18 days later.

 

Medicaid is the health lifeline for more than 3 million of the most vulnerable Texans, but some Republicans including Gov. Rick Perry are talking about opting out of the program as a state budget shortfall looms.  I guess making sure corporations do not pay any taxes is better than taking car eof the old and vulnerable.

The proposal will affect poor children, people with disabilities, pregnant women and the elderly. Medicaid covers at least part of the cost for more than 60 percent of nursing home residents.

"What we’re talking about is public policy that literally could turn people out of nursing homes," said state Rep. Garnet Coleman, D-Houston. "People who now receive care will have their care removed. So imagine somebody who’s on Medicaid, a child getting cancer treatment, and all of a sudden there’s no payment for the cancer treatment. Imagine a woman with breast cancer. Imagine somebody with heart disease. Imagine anyone who’s developmentally disabled."

The discussion highlights the frustration as Texas faces a budget shortfall that some project at $21 billion or more through the next two years and Republicans who gained strength in the election promise they won’t raise taxes.

The Texas Health and Human Services Commission is looking at what the effect would be if Medicaid were abolished in Texas or federal matching funds were slashed.  Perry told Fox News that he thinks Texas could find a "private insurance solution" that would save the state and federal government $40 billion apiece over six years while covering more people.

Advocates for the poor say they see no way for Texas to keep the program’s federal dollars – projected to total $16.6 billion of $24.7 billion in total Medicaid spending in Texas this fiscal year – if it’s not part of the federal program. Texas also would lose federal funds for the Children’s Health Insurance Program if it did not have a Medicaid program.

Opting out, some lawmakers say, would force local communities to bear an increasing share of the cost with nowhere to turn but higher property taxes.

"They say they don’t want to throw grandma out of the nursing home. Well, the fact is that 70 percent of our elderly that are in nursing homes will be kicked out of care if we turn away the $20 billion of federal support," said Rep. Mike Villarreal, D-San Antonio. "They can’t have it both ways. They can’t talk down the federal government, and have their handout."

Health and human services make up close to one-third of the state’s budget, and local health-care providers depend on Medicaid reimbursements and Medicaid-related payments to help keep their doors open.Villarreal said of the economic impact, "You can basically look at Medicaid as a tool for buying down property taxes… Our public hospitals have an open door to the very large population of uninsured. They rely on property taxes to pay for their operations."

"They’ll come to our emergency rooms and to our hospitals in increasing numbers. That puts pressure on the local taxpayers who fund our hospital district, so it will have a really devastating impact," Wolff said.

In a case of first impression, the Eleventh Circuit ruled that Medicare is not entitled to the proceeds of a wrongful death settlement paid to the surviving children of a Medicare recipient. Reversing a lower court decision, the appeals court found that “any claim of the estate is separate and distinct from the claim of a survivor” and that Medicare is entitled only to “the estate’s allocated share of the proceeds.” (Bradley v. Sebelius, 2010 WL 3769132 (11th Cir. Sept. 29, 2010).)

Robert Peck, president of the Center for Constitutional Litigation in Washington, D.C., who represented the plaintiffs, said the decision provides long-overdue clarity on a question that has confounded courts.

“Medicare’s insistence that it is entitled to first and full reimbursement has been a problem in settlements, and also in bringing such cases to begin with,” he said. “This ruling clears the way to making these cases viable and allowing lawyers to bring real benefit to their clients.”

In 2005, Charles Burke died while under the care of a nursing home in Gainesville, Florida. His daughter, Carvondella Bradley, presented a wrongful death claim to the nursing home on behalf of Burke’s estate and his 10 surviving children.

The case settled for the facility’s insurance limits of $52,500 before a lawsuit was filed, and Bradley notified the Department of Health and Human Services (HHS)—which administers Medicare—of the settlement. In response, HHS claimed that it was entitled to $22,481.89 of the settlement proceeds as reimbursement for its share of Burke’s nursing home medical expenses.

A Florida probate court hearing to adjudicate the matter was set. Bradley notified HHS of the hearing, but no agency representative attended. The probate court awarded $787.50 to HHS. The rest was allocated to Burke’s children for their nonmedical losses.

HHS disputed the probate court’s decision, arguing that it was merely “advisory in nature or superseded by federal law.” The agency argued that a clause in its Medicare Secondary Payer Manual should control in the case. The clause provides that HHS will accept an allocation of settlement proceeds to nonmedical losses only “when payment is based on a court order on the merits of the case.”

HHS ordered Bradley to pay the $22,480.89 within 60 days. Bradley paid the agency, exhausted her administrative remedies, and then appealed to the district court, which found for HHS.

Writing for the court of appeals, Judge James Hill noted that the facts of the case were not in dispute and that “the issue of first impression in this case is therefore: ‘Whose property is the settlement?’”

In answering that question, Hill found HHS’s reliance on the Medicare Secondary Payer Manual “unpersuasive” and said it would “have a chilling effect on settlement” because it would force all plaintiffs to bring their claims to trial. Hill also cited Florida’s wrongful death statute as the controlling statute in this case.

“Under Florida law, any claim of the estate is separate and distinct from the claim of a survivor,” Hill wrote. “All loss of consortium or companionship recoveries are the property of the person who incurred the loss. Not the secretary of HHS. A child’s loss of parental companionship claim is a property right belonging to the child. Not the secretary of HHS.”

Hill also criticized HHS for “citing no statutory authority, no regulatory authority, and no case law authority, merely rely[ing] upon the language contained in one of its many field manuals,” and for failing to attend the probate court hearing.

“Essentially, the court said, ‘They had their chance, and they declined, and it’s too late to cry now,’” said Peck.