The New Hampshire Union Leader had an article on how some nursing homes are attracting potential nurse employees.  For example, the Grafton County Nursing Home offers $500 sign-on bonuses and a $10,000 loan-forgiveness program for registered nurses.

John Getts, president and CEO of Home Health & Hospice Care, said they offer employee referral bonuses, professional development and other programs to keep nurses on staff.

“We’re all doing the same thing. We’re all trying to do the same thing to offer incentives to bring people on board,” said Craig Labore, administrator of the Grafton County Nursing Home in North Haverhill.

But there’s one big incentive many providers say they are having trouble offering — health benefits.  Brendan Williams, president and CEO of the New Hampshire Health Association, said the inability to provide benefits is a common problem among those serving elderly patients at home and nursing home settings.

The state community college system is also trying to encourage students to go into nursing. The state’s community colleges are offering two-year associate’s degree nursing students the opportunity to get a four-year bachelor’s degree at Granite State College at community college prices.

This “pathway” program means a four-year bachelor’s degree in nursing will cost about $38,000. That compares to more than $57,000 at the University of New Hampshire.

With the loan-forgiveness program at Grafton County Nursing Home, a bachelor’s in nursing could be had for less than $30,000. The program began July 1. Labore said so far, only one student has taken advantage of the program; he expects many more this year. He said the forgiveness programs are more effective than sign-on bonuses.

There are also many scholarship opportunities available. The New Hampshire Long Term Care Foundation awarded more than $100,000 in scholarships to 45 caregivers in long-term care centers in 2016 alone. The foundation was established to promote the care and wellness of New Hampshire’s elderly.



CBS Austin reported the arrest of a nursing home employee after she allegedly stole an elderly resident’s credit card and racked up more than $1,000 in purchases.  Krishna Jaquay Arnold is facing charges for credit/debit card abuse, a third-degree felony.

On December 12th, police responded to the Harbor at Lakeway nursing home after a couple reported two of their credit cards were stolen and used for several unauthorized purchases at Wal-Mart, Whataburger, Walgreens, Family Dollar and Texaco.

Police say Arnold was arrested days later for an unrelated robbery warrant. She confessed to stealing the victim’s card, stating she felt she got treated poorly by her employers and did not get paid enough for the job she did at the Harbor.


First Cost News reported the tragic and preventable neglect of Annie Hurley at San Jose Health and Rehabilitation Center.  Annie was transferred to the hospital with a large infected Stage 4 pressure ulcer and a fever of 104.  Annie’s daughter, Paris, questions the level of care her grandmother was given at the nursing home.

“The way the sore looks is awful,” says Paris Hurley. “It’s almost like her body is rotten.”  She adds there’s no way the staff there could’ve missed the huge sore – not just based on its size, but also the visceral smell. It was so ugly, Paris explains, the Emergency Room doctor was stunned.

“He said this is the worst case he’s ever seen in his life,” Paris says.

“And she had no response,” Paris says.

Family members maintain she deserves the best of care and now they don’t believe she received it.  “We trust the caretakers, the nurses, to take care of our family members every day and they don’t,” Paris says.


The Econo Times had an article from Christine Zack.  Ms. Zack is an in-house attorney for the national for-profit chains Fundamental and Mariner.  She is also the Executive Vice President, Chief Strategy Officer at Mariner Health Central, Inc. and Senior Vice President, Chief Risk Officer of Fundamental Administrative Services, LLC.

Zack was recently a panelist in a discussion moderated by Linda Woolf, a partner at Goodell DeVries Leech & Dann, LLP.  The panel presentation was hosted by The Network of Trial Law Firms, Inc. and discussed whistle-blower actions

In 2015, more than 700 cases were commenced under the False Claims Act. More than 600 of them were whistle-blower cases where plaintiffs can win a share of the recovery. Whistle-blowers and fraud cases are commonplace and part of business for the profit driven health care industry.

In fiscal year 2015, the Department of Justice obtained more than $3.5 billion in settlements and judgments from civil cases involving fraud and false claims against the government.  Of the almost $3.6 billion, $1.9 billion was from the health care industry involving unnecessary or inadequate care, kickbacks to health care providers, or overcharging for goods and services paid for by Medicare, Medicaid, and other federal health care programs.

Ms. Zack recommended conducting internal investigations, working with current employees to appropriately prepare them for potential litigation and on protecting confidential information.  “The number of whistle-blower claims in healthcare and the related payouts have been growing in recent years.  In-house counsel must be champions for a company-wide culture of compliance to protect their respective organizations from both genuine and opportunistic whistleblower claims.” said Ms. Zack.


The Columbus Dispatch reported on the heroic firefighter Brian Severs who went with his gut feeling instead of listening to the nursing home employees.   A resident of Bryden Place was struggling to communicate with 911.  Then a nursing home employee came on the line, explaining that the nursing home resident who called was prone to complaining about his health.

To be honest with you, there’s nothing wrong,” the nurse said. “This happens all the time.

Severs listened to his gut and sent medics anyway. When they arrived, they found levels of carbon-monoxide high enough to evacuate a wing of the nursing home. Eventually, 10 medics were sent to the 143-occupant nursing home around 5 p.m. Ten residents and employees with elevated carbon-monoxide levels were sent to the hospital.

Firefighters clear a building at 35 parts per million of carbon monoxide. First responders measured readings of between 60 and 120 ppm on the second and third floors of Bryden’s south wing, and 350 ppm in its basement.  Fire officials said that the nursing home dodged a bullet, thanks to the 911 call and Severs’ actions.

There were no carbon-monoxide detectors in Bryden Place, and state law does not require them.  Because the gas is colorless, odorless and tasteless, people might not identify symptoms such as dizziness or nausea as carbon-monoxide poisoning.

The Daily Chronicle reported an editorial from Kaiya Marie about the benefits of video surveillance in nursing homes.

“At the beginning of 2016, the Authorized Electronic Monitoring in Long-Term Care Facilities Act became law in Illinois.

This act affects more than 100,000 residents living in nursing homes by providing video monitoring in patients’ rooms. This important legislation tackles the problem of patient physical and mental abuse by providing evidence of abuse that patients and other employees who were aware were hesitant to report out of fear of retaliation.

Over the years, patients have been subjected to substandard care, theft and malnutrition as investigators found by an average of 5,000 complaints from patients and their family members annually. Patients were having their medications stolen and being neglected.

Physical abuse of aged nursing home residents by younger, able-bodied staffers has been exposed by news reports many times.

Patients having dementia and Alzheimer’s disease were among the most targeted as well as those having few visitors because staff inclined to perpetrate malicious behaviors are less likely to be discovered when abusing residents whose mental state is questionable. A bruise caused by staff may be reported as a fall.

The annual cost to the government is $50,000 to provide for installation of these systems to nursing homes selected yearly by lottery. However, monitoring systems are not mandatory. Residents or their guardian must sign a consent form if they are uncomfortable because of privacy issues, although the monitoring is available to them to view.

But family members concerned about the care their loved ones receive will applaud this bill, which provides preventive measures to keep their relative safe, as well as administrators of these facilities because wrongdoers will risk having their license revoked and being held criminally liable for elder abuse.

With monitoring systems in place, administrators can more quickly respond to incidents occurring between residents as well. Another benefit for administrators is that employees who have been wrongly accused by patients experiencing mental problems can be cleared of wrongdoing. It’s a win-win for all stakeholders: The public can gain more confidence admitting their loved one into these facilities, many of which have earned a bad name in the public eye. Administrators of nursing homes are less likely to be sued for negligence perpetrated by their staff, and patients – especially those battling Alzheimer’s, which affects 5 million U.S. seniors – can receive better quality care at this time of life when they have become totally dependent.”



On this Christmas Day, I wanted to share an article I saw on Huffington Post from Ann Brenoff, Senior Writer/Columnist, The Huffington Post.  Brenoff discusses her experience when her husband had to go to a nursing home for a few weeks.  It is a tragic story on many levels, and should remind us all how difficult caring for vulnerable adults can be without the proper resources.  Hope everyone has a joyful and safe Christmas.

“For the past few weeks, my husband has been in a nursing home. After a recent hospital admission, we were advised that discharging him to this place ― “rehab facility” is the preferred term ― would help him rebuild his strength and enable him to transition back home. The idea that someone other than me ― someone with actual nursing/caregiving training and skills ― would be watching over him thrilled me.

In my more honest moments, I will admit that even his 12-day hospital stay felt like a mini-vacation from the constant caregiving I had been providing since last June. I actually begged the doctors to keep him hospitalized as long as they could ― run more tests, keep him for observation, anything but please don’t send him home just yet. I brought Thanksgiving dinner to the hospital and we celebrated the holiday there. I told a friend that it was the caregiver’s version of a day at the spa. All I had to do was cook a complete Thanksgiving dinner and transport it 20 miles. A walk in the park; a breeze. Just keep him, I whispered to every nurse, to every orderly, to every anyone who would listen.

On more than one occasion, I wept openly to doctors and nurses and social workers at the thought that he could be discharged before I was ready. “It will be fine. We will provide help,” they all assured me. But I know better. I know the reality. I know the scarcity of the “services” provided to family caregivers. I know that the care ― all of the care ― will land squarely on the family’s shoulders. My shoulders.

And so when the nursing home ― I mean “rehab facility” ― was recommended, I jumped for joy. I wanted ― make that, needed ― to entrust his care to someone else for a while, someone who presumably knew how to nurture, who knew the value of a kind word or soft touch. I wanted ― needed ― someone to do all the caregiving tasks for pay that I have been doing out of love. I wanted ― needed ― to be given a leave of absence from my job as a caregiver. I wanted the sheer bliss of merely having normal people’s problems for just awhile longer ― you know, worrying about my two teenage kids, working a full-time job, paying the bills and maintaining a house.

I wanted to luxuriate in deep concern over how well the school soccer team would do, whether I should make chocolate chip or oatmeal cookies for a fundraiser. I wanted to get my hair cut, to binge watch a Netflix show, to cook a meal without having to stick to renal-friendly meal planning and writing down carbs and phosphates and sodium counts. I wanted to not worry about how my husband would get to dialysis if I couldn’t drive him on Thursday, how my son would get enough behind-the-wheel hours to pass his driver’s test. I wanted to file clever tweets, to shop for holiday gifts, to take the dogs on a long hike like I keep promising myself I will. I wanted normal. Just for a little while: our old normal.

And because of all that, I pushed out of my head the images of old people hunched over in wheelchairs lining the hallways like zombies. I convinced myself that the smell of overpowering disinfectant was just proof that the place was clean. I ignored the chipped paint, the screen doors that were off the runners, the nurses whose impatience was tangible. I looked past the aides who wouldn’t make eye contact, who referred to patients by their bed numbers and not their names. “12 B needs to be cleaned up, can you do it Wanda?” When the man parked in the wheelchair kept asking for water, I found a cup and gave him some. He called me Donna and told me I was pretty. I wanted to erase him.

I wanted this to work. Desperately.

It was a good plan, at least in theory. And I’m intentionally not naming the nursing home because, quite frankly, they are all the same to some degree.

It’s not an awful place. They haven’t killed my husband ― either from neglect or kindness. They mostly ignore him with a dash of sometimes forgetting to give him his medications with food.

I did come upon him last Saturday sitting in his room alone in a wheelchair facing the blank wall. He was slouched over and when I first approached I thought he might be dead. He had been parked facing the wall by the driver who deposited him there after returning from dialysis. I have no idea how long he was left like that but I told myself that it couldn’t have been more than a few minutes.

He was glad to see me. He asked if I could get the nurse to help him back in bed and close the door so he didn’t have to hear the screams coming from the hallway.

I did that. And I sat there for awhile, watching my husband drift off to sleep.

I told myself that everyone has bad days, even nursing homes. That sometimes, a snapshot of a moment isn’t a true picture of a situation. The problem is that a nursing home is, of course, only as good as its most disgruntled worker. In an industry with turnover rates that range upward of 100 percent a year ― every job is filled and vacated at least once ― this is what we get. Human dignity is the first thing to go in the battle over the bottom line.

I stared at my husband’s chest, watching him breathe and grateful that he still could. And then I went home and hired an in-home caregiver that I really can’t afford. Because I realized that I can’t afford not to.”

McKnights had an article recently discussing the report (“Five-star ratings for sub-par service: Evidence of inflation in nursing home ratings.”) from the Brookings Institution and the University of Connecticut School of Business that found at least 6% up to 12.5% of skilled nursing providers inflate their self-reported staffing and quality measures, causing inaccuracies in their overall ratings.

Researchers identified a trend of facilities’ self-reported staffing and quality measures shifting to higher star ratings between 2009 and 2013. During that same time period, the distribution of on-site inspection ratings between the star levels remained unchanged.

The improved ratings are not legitimate but are rather a result of nursing homes’ success in developing strategies to manipulate the system and inflate their ratings.

“Although CMS has implemented minor improvements to its rating system, it is still largely based on self-reported measures and does not address the issue of inflation,” the researchers wrote. “[Our] results can be used to strategically focus future audits on the nursing homes which are most likely to be inflators, and help CMS improve the rating system.”

The Atlantic had a great article on the recent report on life expectancy in America.  There is some good news and some bad news.  Young Americans are dying at a faster rate.  Elderly Americans are extending their life expectancy.

A pair of new studies suggest Americans are sicker than people in other developed countries. The studies suggest so-called “despair deaths”—alcoholism, drugs, and suicide—are a big part of the problem, but so is obesity, poverty, and social isolation.  Deaths from unintentional injuries, including drug overdoses, are up, rising by 10,000 since 2014 which can partly be explained by the epidemic of heroin and prescription-painkiller abuse.

American life expectancy fell by one-tenth of a year since 2014, from 78.9 to 78.8, according to a report released last week by the National Center for Health Statistics. Meanwhile, the number of years people are expected to live at 65 remained unchanged, suggesting people are falling ill and dying young.Heart disease and cancer were the most common causes, accounting for nearly half of all deaths. Still, cancer deaths are declining, while deaths from all other causes, including heart and lung diseases, strokes, Alzheimer’s, diabetes, and suicides have ticked up.Much of the increase in mortality can be explained by obesity. However, poverty and its associated struggles, such as depression, stress, and poor nutrition, are also clearly playing a role. Americans are hit harder than other rich countries are by these forces, because of lack of preventive health care and because “the U.S. has higher income inequality and less comprehensive social safety net, so the ill-effects of poverty may take an undo toll.”

One paper published this month suggested that Americans would live nearly four years longer if the U.S. had a safety net as generous as those of European countries. Nationally, better health-care access could improve mortality rates. But if Obamacare is repealed, 30 million Americans might lose their health insurance coverage as early as January—unless, of course, Trump can create a better plan.

The Observer-Reporter had a disturbing article about Amy C. Durbin, a registered nurse from Greensboro, who worked at the assisted-living facility previously known as Golden Living Center (now known as Waynesburg Healthcare and Rehabilitation Center).

Durbin is accused of not logging prescription drug reports for medication she was supposed to be giving to patients.  Twelve charges of prohibited acts for fraudulent or omitted drug reports were filed against Durbin.

“Agent Andrew Sakmar wrote in court documents his investigation began in March after the office was notified of the nursing home’s internal investigation into medication that was unaccounted for. Durbin allegedly was not documenting medication administration properly for controlled substances, according to the criminal complaint.”

Records indicate Durbin was “withdrawing medications which were unaccounted for by documentation on pain evaluation forms and were not recorded as administered to patients on medical administration records,” the complaint said.  The medications include 40 oxycodone pills and six hydrocodone-acetaminophen pills, investigators said.

Durbin allegedly became “verbally hostile,” refusing to come into work to be questioned or tested.