The Wall Street Journal wrote an article about the NY prosecutor’s probe which led to civil and criminal charges against the operators and nine employees of a suburban New York nursing home. The 58-page civil complaint states that operators and staff of the Medford Multicare Center for Living, Inc., had shown a "history of neglect of Medford’s vulnerable residents," since the 320-bed facility on eastern Long Island opened in 2003.

Six nursing home employees had previously been prosecuted in 2008 on charges of neglecting patients, and contended conditions at the facility had not improved since. "Medford’s owners have instead dedicated themselves to lining their own pockets and improving their families’ philanthropic reputation at home and abroad while turning a blind eye to the persistent neglect of its residents by senior management and staff."

In the criminal case, one employee identified as Kethlie Joseph is charged with criminally negligent homicide in the October 2012 death of a 72-year-old patient who was supposed to be connected to a ventilator. Court documents allege that the patient’s "pulse oximeter alarm sounded every 15 seconds for two hours during the night shift. No one responded despite the fact that alarms were sounding at three locations on the unit and one staff member was specifically tasked with watching the monitor at the nursing station."

Six others, including the licensed administrator, David Fielding and Christine Boylan, director of respiratory therapy, also were charged with participating in a cover-up of the death, which was eventually reported to authorities by a whistleblower at the nursing home. Two other employees were charged with falsifying documents involving injuries to other patients at the facility.

 

The NY Daily News reported the horrific assault on a vulnerable nursing home resident.  Rosemarie Brooks, a certified nursing aide at Bronx Park Rehabilitation and Nursing Center, was arrested for beating and bloodying a defenseless elderly grandmother whose injuries required staples.  Surveillance video caught her pushing 73-year-old Norma Rosario.

“This defendant was charged with the protection and well-being of her resident, but violated that trust with her conduct” Schneiderman said. “My office will continue to hold nursing home employees to the highest responsibility to ensure that New York’s most vulnerable receive the best and most compassionate care possible.”

The video shows Brooks pushing Rosario out of a room and into a door across the hallway, Schneiderman said.

Rosario sustained injuries after banging her head against the door. She was taken to an area hospital where she received staples to close the laceration. Brooks is also accused of falsifying her report to cover up the incident, the complaint said. Brooks told police that Rosario tried to attack her.

 

McKnights reported an interesting new study on the benefits of culture change at nursing homes. Nursing homes that initiated culture change between 2004 and 2009 saw a noteworthy decrease in health-related survey deficiency citations, according to recently published research. The culture change movement has emphasized making long-term care facilities less institutional and more homelike, with a focus on “person-centered care” that takes resident choices and preferences into account.

Using data from The Pioneer Network, they identified 251 nursing homes that adopted culture change between 2004 and 2009. They then identified a group of comparison facilities that did not adopt culture change. The adopting facilities exhibited a 14.6% decrease in health-related survey deficiencies relative to the comparison group. The adopting facilities improved their survey results while maintaining consistent staffing levels.

In a separate report, the researchers identified which nursing homes have been most likely to adopt culture change: They tend to be nonprofit facilities that are fairly large, with fewer residents paying through Medicaid and Medicare.

The Daily Journal reported that Christi Franklin, a 27-year-old nurse in Ellisville, Missouri was charged for stealing morphine from elderly patients at an elderly care facility. The facility is operated by Bethesda Health Group. The theft of medicine occurred for three months (April 6 – July 6) before being discovered. Franklin had been diluting patients’ medicine with water and mouthwash in order to try and conceal her wrongdoings. Bethesda says that they immediately fired Franklin as soon as her theft was discovered. They also claim that only one or two of the residents were affected.

The undue pain and suffering these patients suffered from April to July was not reported. Unfortunately, cases like these are all too common. The majority of medication thefts in elder care facilities go unreported. Even when cases are reported, it is rare that care facilities provide any sort of compensation for the harms that patients suffered while staff helped themselves to a patient’s medication.

Often, when a person is diagnosed with Dementia, they and their loved ones view the conditions as a death sentence. However, rather than focusing on the limitations of person with Dementia, we should embrace their abilities and celebrate their strengths.

 Theresa Klein, an occupational therapist at Augustana Emerald Crest Assisted Living in Minneapolis states that by focusing on what matters most, caregivers can help Alzheimer’s patients optimize their daily potential. The most important thing caregivers and loved ones can do is to get educated about the disease. Alzheimer’s makes up 80% of those diagnosed with Dementia. It is NOT strictly a disorder of memory, it affects a person’s ability to pay attention and put together rational thoughts.

After an initial diagnosis, a person with Alzheimer’s can live an additional 15-20 years. In Klein’s 23 years of practice, she has discovered that the most important element in a person with Dementia’s life is routine. Her first observance of this was in her grandfather’s ritual of attending weekly mass. Typically mute, when attending mass, her grandfather was brought back to a more vial version of himself during the service.

Klein advocates that caregivers actively engage patients in these types of ritual activities. She has witnessed across-the-board positive effects by having patients sing hymns and ring bells during services. We must always remember that a person suffering from Dementia, regardless of the stage, is still a person, with feelings and emotions. We must always care for them with the compassion and respect they deserve.

See article at The Atlantic.

Thanks to the work of Congressman John Conyers, a bill known as the Nurse and Health Care Worker Protection Act is currently being considered by a House Subcommittee. While some dislike the idea of more regulation, the facts on the issue are startling, and do point to a need for change in the industry.

In 2011, nursing assistants had the most musculoskeletal injuries of any occupation in the US, with registered nurses coming in fifth. Most of these injuries were found to be caused by the task of lifting, repositioning, and transferring patients. Patients are put in danger when the workers are unable to properly move them. New safer ways of transport can reduce skin tears, pressure ulcers, and dropped patients. These new methods involve using technology such as lifts, and can make the riskier manual transfers a thing of the past. Facilities which have already switched have shown promising results. Fewer injuries are recorded, staff turnover is lower, and workers compensation claims are fewer as a result of safer transfer methods.

The bill proposes to set an OSHA standard for safe patient handling, mobility, and injury prevention. This would give facilities a benchmark of appropriate procedures. The new standard, among other things, would require facilities to “include the use of mechanical technology and devices to the greatest degree feasible” for these tasks, and would give health care workers the right to refuse unsafe assignments. This would mean that workers could refuse to do tasks which don’t seem to meet the minimum safety requirements if they have a reasonable concern that it would injure themselves or others.

Hopefully this bill or some version of it will be passed into law. It is currently being considered by the Subcommittee on Workforce Protections http://edworkforce.house.gov/committee/wp.htm and the full text of the proposed legislation can be read here.
 

The Guardian reported the tragic death of Veronica Roake.  Roake was a nursing home resident that wandered away from the facility unnoticed and unsupervised.  Her disappearance was brought to the attention of nursing home staff after an unknown member of the public discovered Mrs Roake lying on the pavement with fatal head injuries.

The facility admitted that Roake had two unauthorised exits from the home on July 19 and August 13 and were no notice of her propensity to elope.

Dr Michael Hall, pathologist who carried about the post-mortem examination said there was “traumatic head injury”, which would be consistent with a fall and said the cause of death was a head injury and fractured ribs.

Since Mrs Roake’s death, changes have been made at the home, with automatic door closures, keypad codes, back gate security and signs to suggest the importance of door closures all in place. Unfortunately, these dilatory measures did not protect Roake.

 

The Toronto Sun reported the bizarre decision of an arbitrator who allowed a nursing home employee to return to work after video footage of abusive treatment at the facility surfaced. The man was one of four staffers fired after Camille Parent hid a camera in his mother’s room at St. Joseph’s at Fleming last April. Footage captured the man canoodling with a female co-worker while Parent’s mother lay in bed beside them.

Another employee was seen shoving a feces-filled cloth in the senior’s face, and roughly handling her while she changed her diaper on another occasion. Another clip caught a worker wiping his nose on Parent’s mother’s sheets while he changed them.

“The truth is, they don’t care,” Parent said.

 

Filling out a comprehensive assessment for a nursing home resident takes five hours on average, and nurses’ workloads can make it difficult to carve out this time, according to survey results from the American Association of Nurse Assessment Coordination. The survey questioned Minimum Data Set coordinators/nurse assessment coordinators about how much time they spend on a variety of work duties. Nearly half their work hours are spent doing activities other than assessment or care planning, the results showed.

Completing Care Area Assessments takes an average of 193 minutes, according to the survey. The OBRA Comprehensive Assessment takes an average of 74 minutes, while 41 minutes are spent on care planning.  Committee participation and meetings take up 18 hours a week, on average, the survey found.

Carter encouraged nursing home managers to use the survey results to ensure that scheduling allows enough time for proper assessments and care planning.  When the facility is short staffed, this prevents a proper assessment to be done.  See full article at McKnights.

 

The Times News reported that Gina Bradley, aka Gina Begley, nursing director of now defunct Brian Center nursing home, pleaded guilty in federal court to a single felony count connected to wrongdoing at the facility including giving a false statement relating to health care matters. Bradley is the second former Brian Center/ContiniumCare employee to be found guilty in recent months of wrongdoing at the now-closed nursing home. The crime carries a maximum punishment of five years in prison, a $250,000 fine and three years of supervised probation.

Bradley was originally indicted Sept. 12 on eight counts of making false statements related to health care matters in connection with her time at the Brian Center which was part of the SavaSeniorCare national for-profit chain, but changed its name to ContiniumCare of Weber City several months before closing in August 2012.

Melissa Ann Forester, a registered nurse at the Brian Center, pleaded guilty to a single count of making false statements related to health care matters. The charges against Bradley resulted from the treatment of two patients who lived at the Brian Center during her tenure as director of nursing.

One of the patients, who was also named in Forester’s indictment, reportedly had a severely infected pressure sore with feces-filled bandages covering it, while another had pressure ulcers neglected to the point that maggots were discovered inside one of the wounds.

The multi-agency investigation centered on possible violations of wire fraud, mail fraud, health care fraud and money laundering. Federal authorities have said that more charges in the case could be filed in the future.