LoHud reported the arrest and indictment of Claire Wieland, an employee of Livingston Hills Nursing Home and Rehabilitation Center, for stealing thousands of dollars from residents in the nursing home.  Wieland took more than $6,000 from a resident trust fund.  The indictment alleges that between April 2013 and February 2014, Wieland drew up and cashed 24 checks for residents who had not requested the money, keeping it for herself, authorities said.

Wieland worked as a receptionist at the nursing home and was responsible for maintaining the resident trust fund, which was comprised of residents’ personal money and held in a single bank account, with a small amount of cash kept at the nursing home for daily use. Wieland was responsible for submitting requests to have checks drawn for residents who requested funds, authorities said.

USA Today reported that the FBI raided the extravagant 9,000-square-foot house of the owner/operator of a chain of nursing homes.  The home is owned by James G. Burkhart, the CEO of American Senior Communities, according to Hamilton County property records. Investigators from multiple agencies, including the FBI, Office of the Inspector General and the Internal Revenue Service, worked inside and outside of the home, carrying papers and folders.  Three days after federal agents searched the home and the company’s headquarters, the for profit company fired Burkhart.

“The FBI is conducting an investigation into criminal activity in the Carmel area,” FBI spokeswoman Wendy Osborne told The Indianapolis Star. She declined to provided any details.

The Office of Inspector General for the U.S. Department of Health and Human Services participated in the raid, but a spokeswoman said she could not provide any details about the raid or what might have been seized. The office investigates allegations or suspicions of fraud, waste and abuse in federal health care programs like Medicare and Medicaid.

In 2010, American Senior Communities agreed to pay $376,432 in penalties to settle a complaint that it employed seven workers who were ineligible under federal rules for reasons including the loss of licenses and a criminal conviction.

 

The bipartisan leadership of the House Energy and Commerce Committee is asking the Food and Drug Administration how it monitors the safety of the popular blood thinner Coumadin, particularly in light of deaths and hospitalizations of nursing home residents taking the drug.  Between 2011 and 2014, at least 165 nursing home residents were hospitalized or died after errors involving Coumadin or its generic version, warfarin. About 1 in 6 of the nation’s 1.3 million nursing home residents take an anticoagulant, according to federal data from earlier this year; the majority are believed to be on Coumadin or its generic.
 
Story here:
http://www.propublica.org/article/congressional-leaders-ask-fda-about-coumadin-safety?utm_source=et&utm_medium=email&utm_campaign=dailynewsletter&utm_content=&utm_name=
 
Committee’s letter to FDA:
http://energycommerce.house.gov/sites/republicans.energycommerce.house.gov/files/114/Letters/20150902-Coumadin-Letter-to-FDA-Acting-Commissioner-Stephen-Ostroff.pdf

The Atlantic had a great article on the health benefits of having a meaningful life.  With the steady increase of the average life expectancy and the fast growth of the elderly population, new research has sought to determine how having a sense of meaning and purpose in one’s life impacts health and overall well-being and how this can be used to directly benefit the lives of seniors. Previous studies conducted in the late 1970s have demonstrated that a sense of autonomy and purpose can greatly improve the quality of life for seniors but there have been challenges with implementing this knowledge. Although volunteering has long been popular among seniors, ageism among these volunteer opportunities meant that older adults were often unable to fully utilize their wealth of knowledge, skills, and experiences. Relegated to mundane and meaningless tasks, seniors did not feel an adequate sense of purpose and were not contributing as much as they could.

In an effort to combat these problems, Linda P. Fried and Marc Freedman partnered to form the Experience Corps, referring to it as “a new, high-impact, social model for senior volunteering.” Senior citizens were assigned to different schools with the goal of helping children from kindergarten to 3rd grade improve academic skills and ability. This program both improved the physical and mental health of the participating seniors and decreased behavioral problems within the schools. By giving seniors the opportunity to use their academic skills and knowledge while also giving young children the opportunity to receive guidance from these older adults, significant benefits for both parties were achieved through this program.

Similar to this initiative, the Foster Grandparents mentor program paired older adults with troubled teenagers and young mothers and provided more opportunities for seniors to share their knowledge and life experiences. Several other programs, such as OASIS Intergenerational Tutoring Program and the Across Ages Program, have all achieved “measurable positive outcomes, typically for both the recipients and the volunteers.” The positive outcomes afforded by these opportunities range from decreased need for diabetic medication to a sense of “never feeling lonely” among the volunteers. By implementing cost-effective volunteering programs that fully utilize the talents and skills of older adults, both the individual and the entire community benefit.

Fox’s WRBC reported that Marie Tucker, director of nursing at North Hill Nursing and Rehabilitation Center nursing home, is accused of stealing prescription drugs from residents.  Tucker is charged with second degree theft of property for allegedly stealing hydrocodone while she was working as a registered nurse and the director of nursing at North Hill Nursing and Rehabilitation Center.  Authorities believe Tucker stole more than 1,800 hydrocodone pills and tried to cover it up by manipulating and hiding the medication logs.  Staff members noticed the medications hadn’t been logged correctly, so an audit was conducted, according to the Attorney General’s Office.

 

 

WKRG reported that Alabama Attorney General Luther Strange announced the arrest of Latrice Michelle Robinson, a caregiver at Sea Breeze Healthcare Center, for theft from a patient. The indictment charges Robinson with one count of theft of property in the second degree and 14 counts of fraudulent use of a credit or debit card.  It is alleged that Robinson, who was a certified nursing assistant at Sea Breeze Healthcare Center, used a patient’s credit/debit card to steal more than $1,000 from the patient.

The patient had given Robinson the credit/debit card to purchase snacks and supplies for his room. Over the course of the next two days, however, Robinson used the card 14 times to buy her own personal items, as well as several trips to the ATM for cash.  She did not have the patient’s permission to do any of this and a review of his bank statement alerted him to the theft almost immediately.   The patient contacted Robinson to return his card.  She had not bought any of the items he had requested.

The Marshall Project had an interesting article on how the aging prison population is rapidly graying, forcing corrections departments to confront the rising costs and challenges of health care in institutions that weren’t designed to serve as nursing homes.  Between 1995 and 2010 the number of inmates aged 55 and up almost quadrupled, owing in part to the tough-on-crime sentencing laws of the 1980s and 90s, according to a 2012 ACLU report. In 2013, about 10 percent of the nation’s prison inmates—or 145,000 people —were 55 or older. By 2030, the report said, one-third of all inmates will be over 55.  At the same time, it is widely accepted that prisoners age faster than the general population because they tend to arrive at prison with more health problems or develop them during incarceration.

Caring for elderly inmates can cost up to twice as much as caring for younger ones. Despite these runaway costs, there is no national oversight to determine how prisons handle the challenges of an aging population, says Marc Stern, a consultant in correctional health care. “If a Medicaid or Medicare auditor walked into [a large urban hospital] to do an audit’’ Stern said, “they would say, ‘O.K., where’s your geriatric unit? Where’s your dementia unit?’ It’s part of the audit process, it’s part of the intelligence phase that is part of being part of a national organization.”

Here is a look at some innovative programs in New York, California and Connecticut.

New York: The Unit for the Cognitively Impaired

In the Unit for the Cognitively Impaired at the Fishkill Correctional Facility in upstate New York, residents play board games and bingo. This unit is specially designed to meet the needs of inmates with dementia-related conditions. It is part of the state’s medical hub at Fishkill, a medium-security prison 70 miles north of New York City. The 30-bed unit, opened in 2006, is set up to resemble a nursing home more than a prison ward. The walls are painted white and the lights are bright, intended to elevate and stabilize mood. Inmates are allowed to walk freely around the unit (wandering is common for those with dementia or related conditions). The staff includes specially trained physicians, nurses, clinical psychologists, psychiatrists, social workers, and corrections officers. The average age of the unit’s 24 inmates is 62.

Care in this unit is expensive, which may be why more states have not copied the model. In 2012, according to the state corrections department, it cost $93,000 per bed annually, compared with $41,000 in the general prison population.

California: Gold Coats

California has taken a less expensive and more unconventional approach. Inmates with dementia and other age-related impairments are cared for by healthy inmates (with good records). The Gold Coats—the caretakers wear gold-colored jackets— assist patients with daily tasks such as dressing, shaving, showering, and other personal hygiene issues. They escort patients to the dining hall, and to the doctor. They act as companions, protecting their patients from being bullied, and make sure they get food at meal time. The Gold Coats also lead exercise classes and activities designed to stimulate memory. There are Gold Coat programs at 11 California prisons.

For their services, Gold Coats are paid $50 a month—which is very good by prison job standards. The Gold Coats at the Men’s Colony go through extensive training. Dr. Steed reviews topics like the effect of dementia on behavior, how to communicate with low-functioning patients and how to avoid caregiver burnout. The local chapter of the Alzheimer’s Association has prepared a video specifically for the program, as well as a manual on dementia.

Connecticut: 60 West Nursing Home

It may seem like a logical solution: parole those who are too frail to take care of themselves, much less commit another crime, and place them in nursing homes outside of prison. Officials in Connecticut tried, and failed. So, officials from the state’s departments of Mental Health and Addiction Services, Correction, and Social Services decided to build their own nursing home for those to difficult to place elsewhere.

The 60 West Nursing Home in Rocky Hill, a bedroom community south of Hartford, opened its doors in May 2013. It is run by a private nursing operator, iCare, under a state contract. At present, about a third of the 60 patients there were referred from the Department of Corrections. Most of the other patients were referred from the state’s psychiatric hospital, and a handful from the community—people who showed up at local mental health facilities or a hospital emergency room and who needed nursing-home care.

The Oregonian reported the horrific and tragic case of a 60-year-old man who says Oregon City Health Care Center and its parent company, Prestige Care Inc., ignored his repeated complaints about a painful catheter infection claiming his penis became so infected that surgeons were ultimately forced to remove it.  The man’s lawsuit alleges that staff at the Oregon City Health Care Center committed “gross negligence” that led to gangrene and life-threatening septic shock.

The man had arrived at the nursing home on Dec. 26, 2013, to recover from a kidney infection. He continually complained about pain and bleeding around his catheter, but staff at the nursing home failed to address the problem, the suit says.  By Jan. 20, 2014 — 25 days into his stay — the pain had become so bad that the man discharged himself from the nursing home against the staff’s advice, the suit states. The man sought medical care at Providence St. Vincent Medical Center, where doctors immediately treated him for sepsis, according to the lawsuit.

So far, he has incurred up to $2 million in medical bills, lost wages and other economic damages, the suit claims. He also seeks $6 million for pain and suffering. His wife seeks $1 million for loss of “affection, society, assistance and companionship of her husband.”

The Oregon Board of Nursing has proposed revoking both nurses’ licenses for their treatment in this case and another. The nurses are contesting the move.

Eight months into Donna Colcher’s stay, her family installed a hidden camera because they thought she was showing signs of abuse. In the video presented to prosecutors, Donna is seen repeatedly yelling for help after being both verbally and physically abused.

Geofrey Nyangweso is a nurse who pleaded no contest to mistreating a resident at Victoria Falls nursing home was sentenced to only 60 days in jail.  Nyangweso was originally charged with felony abuse, but pleaded guilty to a lesser charge of mistreatment of a dependent adult in an incident September of 2013.

“I’m so sorry that they felt I was mistreating their mother- I’ve never done anything to hurt one of my residents,” he said.

Obviously he is not taking responsibility, or showing remorse.

LJWorld reported a story on the heroic whistleblower Megen Duffy.  She was an emergency room nurse at Lawrence Memorial Hospital that witnessed the falsification of records to increase reimbursement payments from Medicare and Medicaid.  Duffy worked at LMH from August 2009 to October 2013 as an emergency department nurse.  The suit alleges that arrival times of patients with chest pains were falsified in the Emergency Department to appear to coincide exactly with the time of the automatically generated time produced by the EKG monitor. Changing this time, the complaint says, conceals any time the patient spent in the waiting room, at registration or in triage.

Hospital senior staff and supervisors told Emergency Department staff members that the purpose of going to such lengths to falsely document arrival times, and other times related to treatment, was “to maximize reimbursement from CMS (the Centers for Medicare and Medicaid Services).”

The Affordable Care Act established a program in which Medicare makes incentive payments to hospitals based on quality of care as measured by performance on several tracked metrics. Duffy’s complaint says that falsely documenting arrival time then meant other times and measures were falsely reported as a result, and that put patients at risk.