Tom Schroeppel wrote the below letter to Tampa Bay Times on the Florida bill that will give corporate owners immunity for negligence that affects resident’s safety. My favorite line was “It’s like exempting an airline from lawsuits after a plane crash because the corporate leaders weren’t flying the plane.”

“As the son of a nursing home resident and as a longtime advocate for nursing home residents’ rights, I’m surprised and disappointed by Florida Senate Bill 670/House Bill 569. This bill effectively shields investors in nursing homes from civil lawsuits on behalf of injured or dead nursing home residents. As your article indicates, this bill appears specially designed to punish one law firm that has successfully tracked down and extracted legitimate damages from the real and often hidden owners of neglectful nursing homes.

The bill says that if you or a loved one is injured or dies due to nursing home negligence, you can sue everyone from the nursing home license holder — which can be a shell company with no assets — down to the overworked and low-paid nursing assistant actually providing care. Just don’t think about suing the parent company, because “passive investors” are exempted from all lawsuits.

A passive investor is defined as “an individual or entity that does not participate in the decisionmaking or operations of a facility.” This definition would encompass both the corporate owners of large nursing home chains and the private-equity companies that are increasingly seeing nursing homes as easy targets for acquisition, looting and disposal. It’s like exempting an airline from lawsuits after a plane crash because the corporate leaders weren’t flying the plane.

I also can’t understand how the many good nursing homes that belong to the Florida Health Care Association — the primary mover behind this bill — can back a bill that will benefit only their most venal and neglectful competitors, companies that put profits ahead of care and want to get off cheaply when they injure or kill their residents.

For the sake of all our vulnerable nursing home residents, I urge anyone who has a loved one in a nursing home or who may someday end up in a nursing home to contact his or her state legislator and urge them to kill this terrible bill. It does nothing but help bad nursing home operators avoid the legal consequences of injuring or killing their residents.”


Lubbock Avalanche-Journal reported that Southwest Regional Specialty Hospital was fined almost $40,000 for violating state health and safety codes.  Southwest Regional’s nearly $39,000 in fines made it top on the list of penalty-payers and the only institution to be listed twice in the 12-month period.  Southwest is a 30-bed facility owned and operated by Fundamental Long Term Care Holdings.  Fundamental also owns the 58-bed Southwest Regional Skilled Nursing Center at the same address, according to Fundamental’s Web site.
Southwest Regional Specialty Hospital was fined $25,000 in January after an inspection found it violated eight Texas Health and Safety codes.  Among the categories violated were “infection control,” “emergency services,” “pharmacy services,” “nursing services,” “requirements for transfer of patients between hospitals,” and “governing body.” The Jan. 22 report also shows the hospital must serve a period of “probated suspension,” under which the hospital is able to continue operations.

Previously, the hospital was fined $13,950 for six violations relating to “patient rights,” “staffing,” “nursing services,” “non-employee licensed nurses,” “authentication of orders” and “governing body,” according to the report.



The Wall Street Journal: Federal officials plan to release reimbursement information on April 9 or soon after that would show billing data for 880,000 health-care providers treating patients in the government-run insurance program for elderly and disabled people. It will include how many times the providers carried out a particular service or procedure, whether they carried it out in a medical facility or an office setting, the average amount they charged Medicare for it, the average amount they were paid for it, and the total number of people they treated (Radnofsky, 4/2).


The Medicare News Group warned about a new medicare fraud strategy involving hospice.  Hospice is a palliative care program that gives patients with life-ending illnesses a choice to forgo intensive treatment at the end and focus instead on dying more comfortably.  Up until a decade ago, hospice was primarily used by patients diagnosed with cancer whose stay in the program was relatively short, given the terminal nature of their illness.  Hospice services have grown dramatically in recent years, becoming well-known and widely used.  Over the past decade, Medicare spending on hospice has increased at a staggering average rate of 17 percent per year, totaling $13 billion for just 1.2 million patients in 2010, up from the 513,000 patients it served and $2.9 billion it cost in 2000. Furthermore, Medicare payments to hospice providers are growing disproportionately: since 2000, beneficiaries’ use of hospice services has nearly doubled, while payments to hospice agencies have more than quadrupled, the Medicare Payment Advisory Commission’s (MedPAC) 2012 report found. The impact of hospice’s changing demographic is already visible in Medicare’s payments to agencies. Since 2000, the average hospice payment per beneficiary has increased by 7 percent per year, from $5,653 in 2000 to $11,217 in 2010.

The current structure encourages agencies to push hospice care onto those whom they expect to continue to live in the program for a significant amount of the allowable six months, ensuring a continuous and steady stream of payments to for-profit hospice providers at taxpayers’ expense. Nursing homes may be particularly attractive to hospice workers, because often times the full-time nursing home staff does the bulk of the care-giving work, while hospice receives payment for what are oftentimes very brief care visits.  In 2012, a hospice agency could receive a maximum payment of $25,377 per patient. MedPAC reported that in 2009, more than 12.5 percent of hospices exceeded Medicare’s annual payment cap.




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Rep. Eric Turner, a House Republican secretly lobbied colleagues to kill a measure that would have been disastrous for his family’s nursing home business. Multiple fellow Republicans with direct knowledge of the discussions told The Associated Press that Turner lobbied to kill legislation that would have temporarily halted construction of new nursing homes and elderly care facilities.

Last year, The Associated Press reported that Turner had pushed a measure to benefit a client of his daughter, who is a Statehouse lobbyist. In light of that, House Speaker Brian Bosma, R-Indianapolis, said last year he’d review how the House handles conflicts of interests. Turner’s private lobbying marked an about-face from his public actions during the session, during which he regularly excused himself from votes on the measure and stayed quiet through public hearings.

House ethics rules bar lawmakers from voting directly to benefit themselves. Turner’s children and others launched a last-minute campaign at the end of the session, bringing in top-tier Republican  lobbyists to sway lawmakers.  But it was his father’s decision to swoop inas the session raced to a close that became deciding factor in defeating the nursing home measure.



The Washington Post had an article on the dust up between the prosecutors for the State of South Carolina and the Honorable Justice Donald Beatty (one of the best and most honorable Justices in SC history) of the South Carolina Supreme Court.

The prevalence and condonation of prosecutorial misconduct is a serious epidemic in this Country and worse in South Carolina.

South Carolina State Supreme Court Justice Donald Beatty had the courage and audacity to address these problems at a state solicitors’ convention in Myrtle Beach, SC.  “Beatty cautioned that prosecutors in the state have been “getting away with too much for too long.” He added, “The court will no longer overlook unethical conduct, such as witness tampering, selective and retaliatory prosecutions, perjury and suppression of evidence. You better follow the rules or we are coming after you and will make an example. The pendulum has been swinging in the wrong direction for too long and now it’s going in the other direction. Your bar licenses will be in jeopardy. We will take your license.”

The article states: “You’d think that there’s little here with which a conscientious prosecutor could quarrel. At most, a prosecutor might argue that Beatty exaggerated the extent of misconduct in South Carolina. (I don’t know if that’s true, only that that’s a conceivable response.) But that prosecutors shouldn’t suborn perjury, shouldn’t retaliate against political opponents, shouldn’t suppress evidence, and that those who do should be disciplined — these don’t seem like controversial things to say. If most prosecutors are following the rules, you’d think they’d have little to fear, and in fact would want their rogue colleagues identified and sanctioned.”

“The state’s prosecutors didn’t see it that way. Beatty singled out South Carolina’s 9th Judicial District in particular. There’s a good reason for that: He noted in his talk that two prosecutors from that district, overseen by Solicitor Scarlett Wilson, had already been suspended for misconduct and at the time of his talk, another complaint was pending. A recent complaint by the state’s association of criminal defense lawyers recently laid out a list of other complaints (PDF) against Wilson’s office. (You can read Wilson’s response here.)”

“But Wilson took personal offense at Beatty’s comments. She accused him of bias and sent a letter asking him to recuse himself from criminal cases that come out of her district. In one sense, Wilson is unquestionably correct. Beatty is biased. He’s clearly biased against prosecutors who commit misconduct. But that’s a bias you probably want in a judge, particularly one that sits on a state supreme court. It’s also a bias that isn’t nearly common enough in judges.

Now at least 13 of the 16 head prosecutors in the state’s judicial districts, along with South Carolina Attorney General Alan Wilson, are asking for Beatty’s to be recused from criminal cases. This would presumably end his career as a state supreme court justice.  Absolutely ridiculous.


Four families claim and describe shocking allegations in civil lawsuits filed in Florence County that their loved ones were neglected and mistreated by the staff of Laurel Gardens Senior Living Community owned and operated by Emeritus Corporation. The lawsuits — filed against Emeritus Corporation, Laurel Gardens Senior Living Community, HCP Senior Housing Properties Trust and Laurel Gardens executive director Alicia B. Owens — allege gross negligence, breach of fiduciary duty, vicarious liability and corporate negligence.

In one case, the plaintiff claims her mother did not receive appropriate medication as ordered and suffered numerous falls and injuries due to negligence. Another claims her mother suffered such extreme emotional and verbal abuse at the hands of the staff that she regressed and withdrew. In one incident cited in the lawsuit, she claims her mother asked a staff member to get her lunch and was told to “get it herself.” On other occasions, the suit claims staff members refused to assist her mother in the bathroom as needed, resulting in her mother falling and suffering head injuries so severe it required staples. The plaintiff said her mother’s weight dropped drastically, but staff members didn’t do anything about it or notify family members. Other plaintiffs explain similar situations in which their loved ones suffered significant injuries that went undocumented. One woman said her father was diagnosed with a case of scabies so severe he said “he felt as though his skin was on fire,” yet the staff failed to investigate the matter, put precautions in place to prevent the spread of the disease or report it as required by state law.

“These families came to me when they saw the mistreatment their loved ones were enduring,” attorney Robert E. Lee said. “Their ultimate goal is to put a stop to this treatment of their family members and other residents at Laurel Gardens. It’s not about money, but corporations exist to make money and the only way to make them stop doing something is to take something that means something to them. And that’s money. These corporations are in other cities and states. They don’t know you and certainly don’t have to ever face you.”



See story at WBTW and SCNow.

Although the vast majority of nursing facilities nationwide do not have sufficient staff to provide necessary care to their residents, an analysis by the Center for Medicare Advocacy (CMA) finds that the federal enforcement system cites very few facilities with staffing deficiencies. The federal government often does not impose any financial penalties on the nursing homes, even when it finds that facilities do not have sufficient staff.

The federal Nursing Home Reform law requires nursing facilities to have “sufficient” staff to meet their residents’ needs. Sufficient nursing staff is universally recognized as a key requirement for making high quality of care possible and available for residents.

To determine whether nursing facilities are in compliance with nurse staffing (and other) federal standards of care, state agencies conduct scheduled annual surveys and complaint surveys. They use survey protocols that are developed, tested, and validated by the Centers for Medicare & Medicaid Services (CMS). As a matter of policy, however, CMS generally limits the penalties to facilities that are cited with deficiencies that are classified as causing harm to residents.


The Huffington Post had an interesting article on the German study of memory abilities of older people.  The study likened the memory abilities of older people to full hard drives: They don’t lose cognitive power over time; they just function slower because of an increasing amount of information.

The team of researchers from Tübingen University in Germany used computers to replicate different stages of an adult’s memory recall. The computer models were fed small amounts of information each day (much like young adults), but as the devices gathered more information, their performances mirrored those of older people, according to the study, which was published this month in the journal Topics in Cognitive Science.

Researchers concluded the brains of senior citizens do not deteriorate over time due to aging, as traditionally thought to be the case, but they slow down because they hold more information.


The Wall St. journal reported that recalls of defective medical devices nearly doubled in the decade from 2003 through 2012, according to a Food and Drug Administration report. The total number of recalls rose to 1,190 in 2012, up from 604 in 2003. There was a sharp increase in recalls where the defective product carried a reasonable probability of death.  In 2012, there were 57 of these so-called Class I recalls, up from seven in 2003.