The Post and Courier reported that the Medical University of South Carolina’s Board of Trustees approved the purchase of community hospitals in four rural counties Monday night following a discussion in a meeting not open to the public. MUSC leaders were not immediately available for interview following the meeting.  Why the secrecy?

The four hospitals are owned by Community Health Systems, which operates about 115 hospitals across 20 states. The ones being sold to MUSC include Springs Memorial Hospital in Lancaster; Chester Regional Medical Center in Chester; and Carolinas Hospital System outposts in Mullins and Florence. A resolution authorizing the sale states MUSC would also buy clinics and other services attached to the hospitals.  This will double the number of beds under MUSC’s ownership and control from 713 to 1428.

It is the first time MUSC has acquired other hospitals in its history. No dollar figures were discussed. Financing will still need to be approved by the State Fiscal Accountability Authority.

 

9News’ 9Wants to Know investigated why nursing homes are illegally dumping or abandoning vulnerable residents in hospitals.  113 at-risk adults were stranded in Denver-area hospitals on a single day in September. Hospitals said 31 of those adults were left by another facility, including assisted-living and nursing homes who won’t let the patients come back.

“It is cruel. It is cruel,” said Eileen Doherty, the executive director of the Colorado Gerontological Society, a group that advocates for seniors.

9Wants to Know obtained the reports from CDPHE on this case and six others since January 2017 where nursing homes were cited for a deficient practice related to improper discharges. 9Wants to Know learned the state had substantiated at least 40 complaints against nursing homes related to the improper discharge of residents over the last year and a half.

9Wants to Know reviewed the nursing home deficiency reports and found:

  • In five of the seven cases, the adults who were improperly discharged had a known mental health condition or disability including dementia, depression, bipolar disorder or delusions and hallucinations
  • The tenants ranged in age from 38 to 75 years old
  • Nursing homes were cited for a range of issues related to “discharging” residents, including a failure to identify a safe place for them to go or not allowing the residents to return after being treated at the hospital.

One of the worse offenders is SavaSeniorCare.  A national for-profit chain with over a billion in revenue.  A Sava nursing home in Greeley called Kenton Manor dumped a resident suffering from seizures.  The administrators willfully defied state regulations and got rid of the resident with no proper plan of action, according to state inspection reports obtained by 9Wants to Know.  According to the report, after the resident was left in the lobby of his former independent living facility, “the resident had an episode of vomiting and three Fentanyl patches were found on his back; one of the patches was a day old and the others were undated.”  Of course, SavaSeniorCare blamed it on the resident’s “behavior”.

According to the BBC, Niels Hogel, a registered nurse, admitted to killing over 100 of his patients since 1999.  How did none of his supervisors recognize what was happening?!

Niels Hogel wanted to badly to impress his colleagues therefore he would administer an extremely high dosage of medication to patients in the hope that he could save them and look like a hero.  This often led to his victims going into cardiac arrest, and often Hogel would not be able to save them.

He got away with this at two German hospitals. Over 100 bodies have been exhumed, in order to run toxicology tests on Hogel’s victims. Investigators caught the former nurse, by examining hospital death rates, and discovered that there was a significant influx of deaths during the shifts in which Hogel worked. Although, Hogel is already serving a life sentence for the death of six of his patients, it is estimated that many more of his patients could have been harmed, leaving the families still with answers as to how a nurse, someone who should protect their family members, are responsible for their deaths.

This case prompted conversation amongst readers about their experience with health care professionals, and even shared their scary stories about similar events with doctors across the world. These stories included a nurse from the UK who allegedly killed 8 babies, and several stories of physicians in Canada who have harmed their patients by simply not be qualified surgeons, or planning to harm patients.

Now these stories within the comments could be false or mere exaggerations, but it is alarming that there are healthcare professionals across the globe that intentionally harm patients.

 

Since 2009, The U.S. News and World Report started to provide ratings for over fifteen thousand of nursing homes in the Country. According to the U.S. News and World Report, on any given day in America, approximately 1.4 million people will wake up in a nursing home. The U.S. News stated that their reasoning for adding nursing homes to their many institutional ratings is that they wanted families of those who needed care, to have a starting point for their research.

The U.S. News assigns the ranking of a nursing home by evaluating the facility in three different areas. These areas are State conducted health inspections, nurse staffing, and medical quality measures.  There is also a reliance on the data received from Nursing Home Compare, which is operated by Medicare and Medicaid services. Much of the information relied on is self-reported and not accurate.

Nursing home rankings have decreased due to several factors and changes within the ranking system. Some of these changes include federal level policies regarding health quality surveys and regulations. The way that Nursing homes have started to submit employee data is also changing. Nursing homes are now using payroll based journal systems.

It is important to note that all Medicare and Medicaid facilities were eligible for evaluation. Out of the thousands of nursing homes evaluated, “A total of 2,975 facilities were recognized by U.S. News as Best Nursing Homes — 1,837 in overall care and 1,874 in short-stay rehab. 736 nursing homes received this designation in both overall and short-stay care” (U.S. News).

Furthermore, U.S. News capped some of the Nursing Home rankings, “…for example, if a facility exhibited a pattern of rehabilitation care that appeared to be billing centered…rather than patient centered” (U.S. News). Again, like previous articles regarding Nursing Homes rankings, the U.S. News states that these rankings should only be the beginning of research, and that the best way to evaluate a facility is if you make a personal visit.

According to the Topeka Capital-Journal, all of these changes have caused lots of confusion and discrepancies. The Journal also states that because of these issues, Nursing home rankings have slipped, and some into the one star level. Furthermore, another key challenge is staffing. The VP of Kansas Health Care Association, Linda Mowbray stated that her organization has brought workers from overseas in order to fill the very large staffing gap in Nursing Homes, and that immigration could be beneficially to the industry. This is not a Rankings are important; however, no matter the ranking, it is best to visit the Nursing Home, and develop a relationship with staff, versus relying solely on rankings.

WebMD recently had an article about the new study about the poor care at for-profit nursing homes published recently in the journal GerontologyNo surprise but older adults who live in for-profit nursing homes are nearly twice as likely to have health problems linked to poor care than those in nonprofit nursing homes and those who live in private homes, a new study finds.

“We saw more — and more serious — diagnoses among residents of for-profit facilities that were consistent with severe clinical signs of neglect, including severe dehydration in clients with feeding tubes which should have been managed, clients with stage 3 and 4 bed sores, broken catheters and feeding tubes, and clients whose medication for chronic conditions was not being managed properly,” said study leader Lee Friedman.

Friedman, an associate professor of environmental and occupational health sciences at the University of Illinois at Chicago, added that substandard care falls within the definition of elder abuse.

Along with finding that neglect-related health problems were more common in for-profit nursing homes than in nonprofits, the researchers also found that community-dwelling patients had fewer of these problems than those in any type of nursing home.

According to Herald-Mail Media, Matthew Neiswanger, a former nursing home owner, settled allegations of Medicare Fraud with the Maryland’s State Attorney General’s office for $2.2 million. The former owner paid the 2.2 million to the State Attorney’s Medicaid Fraud Control Unit.

The state attorney office found Neiswanger was submitting false claims to Maryland’s Medicaid office. The facility would issue eviction notices to its patients, and the patients would have to resort to homeless shelters or non-licensed facilities. It is important to note that there were four other nursing home facilities named within the lawsuit. NMS frivolously countersued the Maryland Department of Health and four of its employees, but the countersuit was later dropped.

Another condition of the settlement was that Neiswanger is no longer to operate in the state of Maryland. However, this doesn’t prevent him from moving to another state to continue his fraudulent acts.

 

The Atlanta Journal-Constitution had an incredible article about nursing home owner/operator Christopher Brogdon.   Brogdon is a national player in the nursing home and assisted living industry, as well as being an owner of the J. Christopher’s restaurant chain. The 69-year-old businessman’s extravagant lifestyle was earned by misleading investors, neglecting vulnerable adults, and taking advantage of lax oversight by regulatory agencies.

His lifestyle includes a $5 million residence near the top of the St. Regis in Atlanta’s most elite addresses, and for leisure there’s the $2 million beach house on St. Simon’s Island. He owns multiple vehicles including a Lexus SUV, a BMW coupe, a Porsche Panamera and a King Air private plane worth $1.5 million.

The details of what happened and what took place inside some of his facilities offer an example of how the long-term care business can profit by taking advantage of both naive investors and elderly people who need 24-hour care.

He is a con man who cheats investors at the expense of assisted living and nursing home residents,” said Florida attorney Jim Wilkes, whose firm filed a lawsuit this year accusing a bank of enabling Brogdon to carry out what it calls a massive healthcare scheme. “He’s got a history that goes back 30 years.”

Brogdon’s career has been marred, at several points, by charges of wrongdoing — including allegations of poor care to frail elderly people.  Now there is a federal case involving fraud.  The Securities and Exchange Commission accused him of fraud in a 2015 civil case. In the case of the Brogdon bonds, the SEC found that brokers and the bank involved in the deals failed to protect investors, as they were obligated to do, especially when it came to notifying investors of risks and of Brogdon’s failures on earlier projects. By failing to disclose problems, they paved the way for him to do more bond deals, the SEC found.

A court ordered that $89 million be paid to trusting investors in his nursing home or assisted living deals. Brogdon diverted bond cash for other purposes, the SEC charged, including moving money from one assisted living or nursing home project to another and funding his family’s high-end lifestyle. The SEC also accused brokers who sold the bonds of misleading investors — many of them retirees.

Between 1992 and 2014, he bought or renovated at least 60 nursing homes, assisted living facilities or retirement housing developments, according to the SEC’s complaint. Brogdon got money for his projects through bonds authorized by local authorities, private financing or banks. Brokers he had relationships with would sell the bonds, often to unsophisticated investors, bringing in cash for the projects and fees for themselves.

In a 1993 article with the headline “Hello, sucker,” Forbes magazine highlighted Brogdon’s bond deals, saying “sleazy brokers” enticed novice investors with high-yield bonds that they assumed were safe but, in fact, were shaky. In spite of the attention, the bond projects continued to get approved by the local authorities and sold by the brokers.

It didn’t take long before regulators questioned the quality of care at some facilities operated by Brogdon companies.

Nearly 20 years ago, a Florida prosecutor announced the arrest of five people and three corporations in a nursing home abuse case. When announcing the charges in 1999, prosecutor Rod Smith said the five people accused in the case will not “have anything to do with taking care of elderly people again,” according to news coverage of the arrests.

Brogdon was among those arrested and accused of racketeering, elder abuse, Medicaid fraud and theft. But the criminal charges against Brogdon and the others were dropped once a corporate consent order was reached, according to Florida records obtained by The Atlanta Journal-Constitution.

Since then numerous lawsuits have accused Brogdon of a pattern of opening long-term care facilities and enticing families to place loved ones in personal care homes — which are assisted living type facilities — that couldn’t provide the level of medical and personal care residents needed. The homes would be owned by shell corporations with no assets and would have no liability insurance as part of a scheme to avoid the costs of abuse lawsuits, the lawsuit said.  Avoiding responsibility by playing a corporate shell game.  To avoid paying verdicts for neglect and abuse, Brogdon would transfer the nursing home ownership to other related entities, all controlled by Brogdon, according to a lawsuit filed this spring by Wilkes’ firm.

“This man is a common thief,” said Wilkes, the Florida attorney. “He has stolen a couple of hundred million dollars and he has committed securities fraud and he has done it over and over and he gets away with it. At some point, the courts have to get outraged.”

 

 

Shocking video has sparked patient abuse accusations at Holland Home nursing home. The troubling claims come from the family of an elderly man alleging several caretakers coerced the man into exposing his genitals on Facebook Live.  The video, according to attorneys for the alleged victim, is both disgusting and shocking, and shows the abuse and humiliation of a man who survived a stroke, put on Facebook for others to see.

In the video recorded this summer, a 76-year-old man identified as “Reggie Doe” is seen surrounded by staff from his nursing home. He’s holding his adult diaper after being coerced by at least six staffers, allegations laid out in a lawsuit. In more than 150 pages, lawyers outline what they say are violations of the man’s privacy and other accusations that staffers inflicted emotional distress, did not provide proper supervision and made his dementia worse.

Plaintiff attorney Margaret Battersby Black says the video shows the 76-year-old man in bed, surrounded by a half-dozen workers taunting and laughing at him.  “Reggie, take off your pants, Reggie,” a woman is heard saying in the video, the family’s lawyer said, according to The Chicago Sun-Times.  The lawsuit identifies Moe Odele, Keyaira Garrett, Destiny Waller and Cecilia Whittenburg as four of the nursing assistants.

Battersby told NBC5 that the caregivers had “taunted and bullied” her client, who had been at the nursing home for eight months, “in a demoralizing, disgusting and demeaning way.”

“We’ve seen almost every kind of abuse and neglect that can go on in a nursing home. this kind of raises the bar,” Battersby said. “What happened after this? How many times did it happen before this? How many times did it happen where it wasn’t videoed?” Battersby said. “I don’t think this is the last time, unfortunately. it’s going to happen, given what our culture is with social media,” Battersby said.

Battersby Black added in a statement to The Chicago Sun-Times that the incident was especially harmful because it was broadcast on social media. The lawsuit says the caregivers put the video on social media “so the whole world could laugh at him, just as they did.”

Reggie Doe’s family has since moved him to another nursing home, making the change as soon as they saw the video. His attorneys are asking for damages to be determined by a jury.

The Chicago Tribune reports the lawsuit accuses the nursing home and employees of violating the Nursing Home Care Act, including causing emotional distress to a mentally disabled man, publicly revealing health information and negligent supervision. The family is seeking $50,000 in punitive damages.

 

 

 

Human Rights Watch received The National Consumer Voice for Quality Long-Term Care’s annual Public Service Award on October 22, 2018.  The National Consumer Voice for Quality Long-Term Care presents the award to an individual or organization whose work has expanded coverage and public understanding of long-term care for older people. The award was presented in recognition of Human Rights Watch’s 2018 report “‘They Want Docile’: How Nursing Homes in the United States Overmedicate People with Dementia.”

The report estimates that every week in US nursing facilities, more than 179,000 people, most of them older and living with dementia, are given antipsychotic drugs without a diagnosis for which their use is approved. In many cases, nursing facilities use these drugs without obtaining or even seeking informed consent.  Human Rights Watch found that nursing homes routinely give antipsychotic drugs to residents with dementia to control their behavior. Regulations prohibit this misuse of drugs as “chemical restraints.” This abusive practice remains widespread even though the use of antipsychotics on older people with dementia is associated with a nearly doubled risk of death.

Using antipsychotic medications as a “chemical restraint” – for the convenience of staff or to discipline residents – violates US federal regulations and may amount to cruel, inhuman, or degrading treatment under international human rights law. Using the drugs without adequate indication for use or appropriate monitoring is also barred under federal standards.

“We are honored to receive Consumer Voice’s recognition for this work,” said Bethany Brown, researcher on older people’s rights at Human Rights Watch. “We are proud of our partnership with them and with other dedicated advocates around the country to promote equality and dignity for older people living in nursing facilities.”

Human Rights Watch recommended that national government and state agencies should strengthen their enforcement of federal regulations regarding antipsychotic drugs. Residents and their families should be told they have the right to be informed of their treatment alternatives and their right to refuse. The government should ensure that nursing homes employ enough staff to provide adequate care.

“Human Rights Watch research and reporting sparked a greater understanding of some of the risks to older people in nursing homes in the United States,” said Lori Smetanka, executive director of the Consumer Voice. “With this award, we recognize this important contribution to public awareness and encourage government and state agencies to ensure all older people have the right to choose and refuse treatment for themselves.”

Nursing homes across the United States routinely give antipsychotic drugs to residents with dementia to control their behavior, despite regulatory prohibitions on this misuse of drugs as “chemical restraints.” This abusive practice remains widespread even though the use of antipsychotics is associated with a nearly doubled risk of death in older people with dementia.

The Henley House long-term care home in St. Catharines is trying something new base don the Butterfly Program. The program focuses on social and emotional happiness for people with dementia. Instead of one big unit of 25 people, the home will be broken into two small living spaces for people with moderate and severe dementia. Workers will be trained to express empathy and spend time chatting, playing cards or dancing with people living in the home, rather than rushing from one task to the next. Walls will be painted in fuchsia, tangerine or neon green to help people navigate the hallways. The hope is to turn a drab dementia unit into a place of warmth, energy and friendship.

“The scourge of dementia is old news — now is the time to do something about it,” Primacare president Matthew Melchior said at the launch of the Butterfly program in St. Catharines last week. “Standing still is stagnation. The status quo is not the answer.”

Candace Chartier, CEO of the Ontario Long Term Care Association, which represents mostly for-profit long-term care homes like Primacare, told the St. Catharines crowd, “This is something that is going to change the lives of every person in this room and the staff members, volunteers and every resident and every family member that come through the doors. “I’ve had the chance to look at the Butterfly Model…it truly is what the future of long-term care is, what senior care is,” Chartier said.

The Green House Project and Eden Alternative — both created by American geriatrician Dr. Bill Thomas — share similar philosophies that favour small homes, social interaction and friendships between staff and people in their care.