WNYC also had a recent article on the overuse of antipsychotics in New York City nursing homes. “There is widespread and poorly regulated use of anti-psychotic medications by several New York City nursing homes, according to a new investigation by the Gotham Gazette.” The series found that one-in-four nursing home residents in the city were given anti-psychotics in 2011, and one-in-three homes dose more than a third of their residents.
Anti-psychotics are sometimes known as “chemical restraints” because of their sedative effect. Under federal law, anti-psychotic drugs can only be given on doctors’ orders, and not so nursing home staff can better manage difficult patients. They are frequently prescribed for difficult patients, such as those suffering from dementia. Yet research has found that the drugs can also lead to falls, strokes and even death.
The Consumer Voice released the testimony of Mitzi E. McFatrich, Executive Director of Kansas Advocates for Better Care on HB 2348 to increase nursing staffing minimums in nursing facilities.
"My name is Mitzi McFatrich and I am here today to speak up for increasing the hours of nursing care received by older adults living in nursing facilities. KABC is a not for profit, whose 850 members and volunteers are dedicated to improving the quality of care for older adults needing long-term care.
Correlation between Nursing Care and Elders Outcomes
There is one reason that adults go to Kansas nursing homes–Nursing Care. There are approximately 19,000 adults living in Kansas nursing homes. There is an indisputable correlation between the number of nurses (registered and licensed practical) who provide direct care to residents on a daily basis (“nurse staffing” levels) and the quality of care and outcomes, along with the quality of life older adults experience. Numerous reports and studies confirm that nursing facilities provide better care to their residents, and residents have better outcomes, when facilities are adequately staffed. No report finds better quality with fewer staff.1
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The New Hampshire News had an interesting article about the “Battle Against Chemical Restraints in Nursing Homes”. Nursing homes around the country are under pressure from the Federal government to reduce their use of antipsychotics. This powerful class of prescription drug is meant for mental illnesses such as schizophrenia. But they are being used on people with Alzheimer’s Disease at startling rates.
MedPageToday also had an article stating that more than one in five U.S. nursing home residents are given antipsychotic medications — generally off-label, a national analysis revealed. In a sample of more than 1 million patients in nursing homes, 22% were given at least one prescription for an antipsychotic agent, according to Becky A. Briesacher, PhD, and colleagues from the University of Massachusetts in Worcester. The researchers analyzed data on dispensing during 2009-2010 by the long-term care pharmacy Omnicare, which provides medication services across the country and for up to half of all residents.
“The prescribing of antipsychotic medications persists at high levels in U.S. nursing homes despite extensive data demonstrating marginal clinical benefits and serious adverse effects, including death,” Briesacher and colleagues wrote in a research letter in the Feb. 6 issue of the Journal of the American Medical Association. “The most common antipsychotics prescribed are often used for off-label indications related to dementia, and the extended durations of use raise concerns about the care of frail elders residing in [nursing homes],” the researchers stated.
In more than two-thirds of cases, the agents used were from the atypical class of antipsychotics, which are primarily indicated for the treatment of schizophrenia and bipolar disorder:
Quetiapine (Seroquel), 31.1%
Risperidone (Risperdal), 24.4%
Olanzapine (Zyprexa), 13.1%
Meanwhile, the Hartford Courant reported that the Westside Care Center nursing home in Manchester, two-thirds of long-stay residents are receiving antipsychotic drugs, even though they do not have a psychosis or related condition that regulators say warrants their use. Westside’s rate of dispensing the drugs to 68 percent of its residents without a diagnosis is the highest in the state, according to federal data — and more than double the state’s average of 26 percent, which already ranks in the top-third of states nationally. The December data — newly disclosed by federal nursing home regulators — show that more than half of Connecticut’s nursing homes — 128 of 233 — were dispensing antipsychotics without a clinical diagnosis at rates exceeding the national average.
It’s Alyssa Holden from Stratford. I’m writing to let you know about new free guide available on “How to Pay for Assisted Living.” We put this together as a resource that both seniors and caregivers can benefit from. Most of the questions we receive deal with this difficult subject. So it’s important for us to get the word out!
Folks can view the free guide here: http://stratfordretirement.com/assisted-guide/
Could you please share this with your readers? It would go a long way in helping them know about the resources available to address the high cost of assisted living. If you need any further information please let me know!
A woman who was murdered in 1979 could change Florida nursing home laws today. Norma Thomas Page, a 28 year old mother of two, was brutally stabbed to death in 1979. The nature of the crime was so brutal that it was difficult to identify exactly how many times Page was stabbed. Thirty years later, police used DNA to find the man they believed killed her, but because of his ailing health, the judge sent him to a nursing home instead of standing trial. This infuriated the family because he gets to live in the ‘comfort of a nursing home, with all of his needs being met,’ as Kay Meyers, Page’s sister said.
Because of this, Page’s sisters and cousin are attempting to change Florida law so that nursing homes must require background checks on their residents. Currently, Florida homes require background checks on employees, but not patients. Illinois is the only state to require checks on residents as well.
Myers felt the judge was unfair in his dismissal of the case, saying, “It is not right for the justice system to use nursing homes as a dumping grounds for unwanted violent criminals.” Page’s family have been passing out flyers, encouraging support, and crafting a petition. The man died in February, but the family says that the issue goes beyond him. Although Florida Health Care Association said Florida has some of the toughest laws to ensure resident safety, Page’s family believe more is necessary. Workers and residents can be living beside someone with a violent criminal history and never be aware, says Cheryl Hickman, Page’s cousin. Based on the close nature of nursing home quarters, Page’s family is fighting to ensure and maintain the safety of Florida nursing home residents from each other.
See article here.
“The documents are likely to reinforce a perception held by many corporate clients — and the public — that law firms inflate bills by performing superfluous tasks and overstaffing assignments.” as qoted from an article in The New York Times.
DLA Piper is the world’s largest law firm and are accused of unethical overbilling. Internal emails discovered in a fee dispute between the law firm and Adam H. Victor, an energy industry executive show a pattern and practice of padding bills. After DLA Piper sued Mr. Victor for $675,000 in unpaid legal bills, Mr. Victor filed a counterclaim, accusing the law firm of a “sweeping practice of overbilling.”
The article mentions that DLA Piper lawyer, Christopher Thomson, noting that a third colleague, Vincent J. Roldan, had been enlisted to work on the matter wrote: “Now Vince has random people working full time on random research projects in standard ‘churn that bill, baby!’ mode,” Mr. Thomson wrote. “That bill shall know no limits.”
Other excerpts from a few of the emails include:”I hear we are already 200k over our estimate — that’s Team DLA Piper!”
“Through acquisitions, joint ventures and the aggressive hiring of partners from other firms, DLA Piper has grown into a global monolith of 4,200 lawyers in more than 30 countries, making it the world’s largest firm by lawyer count. Last year, it posted revenue of $2.25 billion, according to The American Lawyer magazine.”
DLA Piper represents Murray Forman and Leonard Grunstein and their nursing home companies in their fight against Rubin Schron.
A woman who runs a nursing home was sentenced to five years in prison for using the home as housing for illegal immigrants. The human smuggling operation housed and transported nearly 100 illegal immigrants from Brazil to Florida since 2008. Irene Burrows, 66, and her daughter in law housed immigrants in the nursing home for $150 per day. Burrows will be deported to the Bahamas and her daughter in law will be deported to Peru at the end of their sentences, in accordance with their plea agreements. Irene Burrows was described as a humanitarian who was helping stranded people in need. The question we should be asking is what happens to the residents of the Burrow Home for the Aged? With Burrows in jail for the foreseeable future, who will take care of these stranded people?
See artilce here.
The 2010 healthcare law is affecting a new push from nurses to gain more autonomy. Concerns over the law’s impact on doctor availability have instigated a major legislative push from nurses, national groups, and allies to grant nurse practitioners more independence in treating patients. In 11 states, nurses are pushing for more power in the exam room. Nurses want the ability to treat patients without having to serve under a doctor. Opposition to the push comes from physicians’ groups who state that the quality of care cannot be the same simply because of the imbalance in education. Doctors spend longer in educational institutions, giving them an advantage over nurses who spend less time. In response to this, some nurses claim that the training for nurse practitioners who run clinics, which requires a Master’s degree, and will in the future require a Doctorate, are better prepared than the community believes. Some nurse practitioners have diagnosed various forms of cancer, heart disease, and diabetes. They say that nurses are capable of handling more complex medical concerns. Another concern raised by physicians’ groups is that any legislation passed which allows nurses more medical freedom will splinter an already fractured health care system. These critics say that a team approach to health care is what’s needed to increase the standard of care, not an even stronger separation between doctors and nurses. The next few months will tell whether this country will be getting more nurse’s facilities, or whether the doctor still reigns supreme.
See article here.
In Brownwood, Texas, Christopher Cantrell was arrested after allegedly accused of sexually assaulting a resident of the nursing home where he worked. The 45 year old man initially denied allegations, but upon learning of a DNA match, said the woman ‘instigated it’.
The abuse occurred multiple times, with the woman never reporting it because she felt no one would believe her. The woman set out to prove the incident, preserving DNA evidence in a napkin, which she then gave to the police. The DNA matched a sample taken from Cantrell. The resident is a 68 year old wheelchair bound woman who appeared frightened to talk to investigators. The detective interviewing her stated that this type of reaction was common for victims of sexual abuse.
See article here and here.
The Tennessee Supreme Court reinstated a jury verdict for compensatory damages against Americare Systems, Inc., the management company of Celebration Way, an assisted living facility in Shelbyville. The Supreme Court remanded the jury verdict for punitive damages to the Court of Appeals for further review. A jury returned a verdict against various defendants, including Americare, totaling $300,000 in compensatory damages, and $5,015,000 in punitive damages, in favor of the daughters of Mable Farrar. Farrar died as a result of the failure of Celebration Way’s nursing staff to give Farrar her prescribed medicine and the negligent administration of an enema that caused her colon to rupture.
In 2003, Farrar, age 83 and in good health other than occasional constipation, resided at Celebration Way. The nursing staff was under doctor’s orders to give Farrar one dose of MiraLAX, an over-the-counter laxative, each morning, but frequently failed to give her the medicine over a number of months. After Celebration Way’s failure to give her any prescribed MiraLAX in March 2004, and only five doses in April, Farrar became seriously constipated. Her doctor prescribed enemas, which the facility’s staff failed to administer as directed. On May 29, 2004, the nursing staff gave Farrar an enema without first checking her abdomen. The enema caused Ferrar’s colon to rupture and she died shortly thereafter.
Farrar’s daughters sued, alleging that Americare’s failure to adequately staff Celebration Way caused or contributed to her death. The jury agreed and returned a verdict in the plaintiffs’ favor. The Court of Appeals reversed the judgment against Americare, ruling that there was no evidence that understaffing caused Farrar’s death. The Tennessee Supreme Court, in a unanimous opinion authored by Justice Sharon G. Lee, ruled that the plaintiffs presented material evidence supporting the jury’s finding that Celebration Way was understaffed, that Americare knew it and failed to remedy it, and that the lack of sufficient staff was a substantial factor causing Farrar’s death. The Supreme Court reinstated the jury verdict against Americare for compensatory damages but remanded the case to the Court of Appeals to review the punitive damages award.