Universal Healthcare North Raleigh has a history of problems and was the subject of state and federal investigations last year over alleged patient abuse.  Universal Healthcare North Raleigh became the focus of a WRAL News investigation last May, after Rebecca Knaption shared footage captured on a hidden camera she installed in her father’s room. The video shows staff took more than an hour to respond after Richard Johnson fell out of his bed, and they then mocked and belittled him.

The incident led to state inspectors substantiating allegations of abuse at the north Raleigh facility and WRAL Investigates uncovering a history of violations at Universal Healthcare facilities across North Carolina.

Universal Healthcare officials promised changes, saying the staffers who mistreated Johnson were fired and the rest of the staff received additional training. But WRAL Investigates has found new problems at the north Raleigh facility in recent months. Sources also told WRAL Investigates that state inspectors are looking into the recent deaths of two residents of Universal Healthcare North Raleigh, who were both reported to have fallen, as well as unexplained bruises on residents.

A woman in need of constant care was sent home in December after she couldn’t pay her outstanding bill and was left to fend for herself.

The woman, a diabetic amputee in a wheelchair, said that Universal Healthcare staff pressured her to pay, and when she couldn’t, she was given a 30-day notice. Instead of finding another facility that would take her, she said she was transported to her Cary mobile home and left her with no food, family or care plan.

She said she had to call 911 after four hours and was taken to a hospital.

The Centers for Medicare and Medicaid Services threatened to terminate Universal Healthcare North Raleigh from the Medicare program, meaning it could no longer be reimbursed for services for Medicare-eligible patients, if violations found last year weren’t addressed by Oct. 15. As of last July, CMS also was levying daily fines on the facility for ongoing problems.

It’s unclear whether fines are still being levied, if the government ever collected any of the money owed or if Universal Healthcare was able to correct deficiencies to remain in the Medicare program.

 

As medical marijuana becomes legal in more jurisdictions, nursing home residents in New York City have seen improvements in pain management and other medical issues through the use of the medical marijuana. The marijuana is used to treat Parkinson’s disease, seizure disorders, and chronic pain.

The Hebrew Home at Riverdale launched its “innovative” new cannabis program in 2016. The facility provided both the residents and the families of the residents with facts about medical marijuana to combat the common myths of marijuana. The residents that have participated reported that with the help of the medical marijuana they have less pain and have received smaller dosages of their medication.

Cohousing is a community where people own their individual homes plus a share of common areas such as outdoor space and a clubhouse with kitchen, living and dining rooms. They typically prepare and share meals several times a week and become more than just neighbors.

They are usually structured as a condominium with a homeowners association, but are self-managed. Owners (called members) collectively make decisions, usually by consensus. Committees oversee the financial, administrative, maintenance and other work normally handled by a management company, although they may hire outsiders for some jobs. Each member is expected, and in some cases required, to pitch in, whether it’s cooking, cleaning or fixing the Wi-Fi.

Senior cohousing is a newer type designed for people who want to avoid the isolation that can happen when families move away and friends die. “There is a natural loss of community as you age. There is no way to replace it with jobs or schools,” said Christian Zimmerman, whose company developed Phoenix Commons, where he also lives.

JoAnna Allen called it “a great antidote to the loneliness that hits a lot of people.” She was familiar with cohousing, but her husband, Ken, was less gung ho. He came around “once he realized he could still have his privacy and independence,” she said.

There are 168 established cohousing communities in the United States including 14 that are senior-focused, said Karin Hoskin, executive director of the Cohousing Association of the U.S.  None have been established in South Carolina yet.

Some of the senior communities have minimum age requirements; others don’t but end up with mostly seniors because they lack the space and amenities most families want. In California, senior housing developments generally can exclude residents younger than 55 if they have at least 35 units and meet other requirements.

When members get sick, other members usually will help with meals or trips to the doctor, but “this is independent living. There is nobody there to take care of you if you really need greater levels of care. We are very clear about that,” said Katie McCamant, owner of CoHousing Solutions, a development and consulting firm.

Owners can sell cohousing units to whomever they want as long as they don’t violate antidiscrimination laws. Buyers must meet age requirements in senior communities that have them.

Cohousing is “a peculiar market,” said Bob Miller, a member of Wolf Creek Lodge. Buyers “are not buying real estate. They are buying into a very special community. It’s not going to work for everybody.”

Prices at his 30-unit community range from $300,000 to $500,000. “For Grass Valley that’s not cheap,” he said. “It’s significant to buy in,” but ongoing expenses are “very economical.” Association fees run about $360 per month.

There’s no solid research on cohousing resale values, but in 2010, Davis appraiser Lee Bartholomew did a limited study looking at new and resale prices at five all-age cohousing communities in Northern California. Initially, they sold for more per square foot than standard condos, but they also have green-building features that add to construction costs and appeal to cohousing buyers. From 2008 through 2010, they appreciated faster than standard condos, he said.

The Americans with Disabilities Act applies to Brookdale Senior Living’s assisted living communities in California, a federal judge ruled when allowing a discrimination case against the country’s largest senior living operator to continue.  This is the first class-action lawsuit against an assisted living operator to be brought under the ADA. Potential damages could exceed $45 million because the lawsuit is seeking a minimum of $9,000 for each affected resident, and more than 5,000 residents of Brookdale communities in California could become part of the class.

The complaint alleges in part that understaffing means that disabled residents’ activities of daily living needs are not being met, and U.S. District Judge Haywood S. Gilliam Jr. said that the claim was “sufficiently alleged.”  “Plaintiffs allege that those residents who are disabled are unable to receive the benefits of their residence — e.g., ‘assistance with bathing, dressing, brushing their teeth, toileting, incontinence care, and other hygiene assistance’ — without sufficient staffing,” he wrote, adding, “Non-disabled residents do not require staffing to receive these benefits.”

Brookdale had argued that its assisted living communities are similar to private apartment complexes that would not fall under the governance of the ADA, but “the court found that the Brookdale long-term care facilities are public accommodations,” Brookdale’s own filings with the Securities and Exchange Commission indicate that “[a]ll of our communities are required to comply with the Americans with Disabilities Act, or ADA,” Gilliam’s order noted.  That is consistent with the language of the statute, the regulations and governing Supreme Court authority that has stated that public accommodations should be broadly defined to ensure that people with disabilities get equal access to all kinds of programs and services.

 

A Centers for Medicare & Medicaid Services (CMS) official in a letter to the journal Health Affairs suggested that the public would benefit from more information about resident safety at nursing homes — including the explicit identification of bad actors.  Writing in response to a November study about the correlation between Nursing Home Compare star ratings and safety, CMS chief medical officer Kate Goodrich laid out a case for strengthening existing data sources for consumers

“While we view patient safety and quality improvement as a continuum, we agree that specifically ‘calling out’ facility performance on patient safety can resonate with and be beneficial to consumers,” Goodrich wrote. “In fact, CMS highlights performance on safety measures as a discrete domain in programs for other types of facilities, including those for hospitals and dialysis facilities.”

“We do believe that NHC contains additional measures that either directly capture harm or are highly correlated with harm that were not evaluated by the authors  — such as the measure for inappropriate use of antipsychotics, which is strongly linked to falls and other adverse events,” she wrote. “Nonetheless, we agree that NHC captures only a subset of harm, and a broader set of harm measures may be beneficial.”

McKnights reported on the ongoing saga between National Health Corp. and one of its former nurse leaders, Mary Lea Byrd. In 2012, she filed a complaint, alleging that NHC violated the False Claims Act in numerous ways.  Byrd has now filed an amended complaint, alleging that the skilled nursing provider illegally retaliated against her whistleblowing actions, eventually forcing her to resign. National Health Corp. — whose affiliates operate 76 skilled nursing centers — had moved to dismiss the complaint, because they believe it was barred by the three-year statute of limitations for violations of the False Claims Act.

In her original complaint, Byrd — who was hired as a director of nursing at a Farragut, TN, SNF in 1998 — alleged that NHC required patients to bring medication from home, upcoded claims, billed for services not rendered, and kept patients on services when they no longer qualified for skilled care. She alleges that, after she surfaced those allegations, NHC retaliated in various ways on at least five separate occasions, increasing pressure on her to quit. In September 2017, she felt she had “no choice but to resign,” giving her 30-day notice.

After the case was unsealed in 2017, Byrd filed an amended complaint, naming “National Health Corp.” rather than the original NHC. Those two are affiliated related entities, with common ownership and common control to the national for-profit chain. National Health Corp. argued that its access to a copy of the original complaint was not enough to make it aware that this particular retaliation claim had been filed, a contention with which a U.S. District Court of Eastern District of Tennessee judge disagreed last week.

To say that an organization so closely intertwined with another would not be aware of ongoing litigation arising from a FCA claim is, at best, a stretch,” wrote Judge Pamela L. Reeves.

 

 

WCSC reported that South Carolina’s Department of Health and Environmental Control is taking enforcement action against Phaire’s Care after a “history of noncompliance,” according to a DHEC representative.  Phaire’s Care is an assisted living home located in Orangeburg County.  A complaint from September said “bad things are happening at the facility.” That complaint listed problems including staff yelling at people who live there, deplorable conditions, underfed residents and possible rats in the building.

Enforcement from DHEC comes after 57-year-old Curtis Johnson Wilson went missing from the facility but was later found by police.

“We’re looking for him to be safe at all times,” Curtis’ sister Barbara Wilson said. “We’re looking for him to receive the sufficient amount of food, adequate care.”

DHEC representative Chris Delcamp said the department completed its most recent investigation. Since then, someone filed another complaint with the department, which Delcamps said requires investigating.

Investigation reports from DHEC show us during a site visit in January, crews found a laundry list of problems.

Medication was not administered to patients correctly, three of 11 employees did not have background checks on file, bed bug-like insects and mouse-like droppings were in one of the rooms–the list goes on.

Vox reported that the number of Americans without health insurance has increased by 7 million since President Donald Trump took office, new Gallup data released shows.  The country’s uninsured rate has steadily ticked upward since 2016, rising from a low of 10.9 percent in late 2016 to 13.7 percent — a four-year high.  This trend is especially surprising given that over the same time period, the unemployment rate has been declining. Usually, when more people have jobs, it means more people with access to employer-sponsored health insurance. But even during this period of job growth, America’s uninsured rate keeps climbing.

WBRZ reported the sad shenanigans of Andrea Lafayette.  Credible evidence shows that property manager Andrea Lafayette was leasing apartment space at the Howell Place Apartments as a licensed assisted living facility under her own business’s name. Many of the renters thought they were “residents” of a community residential care facility or assisted living facility (ALF).

Richard Anderson suffered a stroke three years ago and is paralyzed on one side of his body.  Anderson claims he paid Lafayette $740 a month to live at Howell Place Apartments. He thought he was moving into an assisted living facility, but quickly realized it was a sham.

Zaidra Walker’s son, Aaron, can’t live by himself and also moved into the Howell Place Apartments. Lafayette told her face-to-face that it was an “assisted living” facility. However, the Howell Place Apartments are not registered with the State of Louisiana as an assisted living facility. Instead, it’s just an apartment complex.

Walker provided the WBRZ Investigative Unit with a lease and the cashed checks she wrote to Lafayette’s company to have her son live there.  “She herself panned it off as an assisted living facility and told me everything that she could do for Aaron and how she would help Aaron,” Walker said. “It was all a lie.”  Walker said she realized something was fishy when she accidentally wrote a check out to the Howell Place Apartments for her son’s rent one month.

“The first month I paid her cash, and she gave me a handwritten receipt,” Walker said. “The second month I made a mistake and made the check out to Howell Place apartments. She told me she couldn’t cash it. She made me come get it and told me it needed to be made out to P.C.A.”

P.C.A. stands for Personal Care Advance or as it’s listed on the Louisiana Secretary of State’s website, Personal Advance Care. That’s the company that is registered to Lafayette according to records the WBRZ Investigative Unit tracked down. Both the names are used in the lease agreement.

Lafayette was even using an apartment unit at the Howell Place apartments for her business’s mailing address.

This week, Lafayette sat down with WBRZ attempting to set the record straight.

“I would never say that was an assistant living company…or complex,” Lafayette said. “That was an apartment complex and residents loved to live at Howell Place Apartments.”

Lafayette also claimed she had no idea why she had been fired.

“FDI [management company] said that they in actuality told me that I violated a rule,” Lafayette said. “I asked what rule… However, FDI was a new management company in Baton Rouge. They are from Texas. The company was owned previously for another owner, and I’ve been there 20 years.”

As Lafayette’s elaborate scheme continues to be investigated through an internal investigation by the management company, Walker wants to know why she did this to our community’s most vulnerable.

“I would like to know why did she lie,” Walker said. “Why did she lie to us? Why did she lie to all those other people? Why the scam?”

FDI, the company that manages Howell Place told WBRZ that Lafayette and her sister Tiffany were both fired after the scheme came to light. An FDI employee said in their 30 plus years of property management, this was the first time they had ever encountered anything like this.

The Miami Herald reported that New Era Community Health Center assisted living facility is facing $16,500 in fines after officials say improper care by staff led to the death of one resident, the attempted suicide of another and at least three runaways that resulted in serious injury.  The problem for many ALFs is that they keep residents who need more care and supervision.

An epileptic women went without being seen by a neurologist because she did not have private insurance and none of the neurologist wanted to see her. She later went on the have a seizure, fall and die in a hospital. The facilities reported that no one witnessed the resident falling but hospital records say otherwise.

Three residents from the South Florida assisted living facility attempted to run away. Walking more than 25 miles, one resident attempted to go to the mall, one went to a nearby clinic and one was found passed out on private property. All three residents had a past of attempting to leave the premises and they were not monitored by the facility.

The facility also housed a 53 year old woman who battled drug and alcohol addiction and was also mentally ill. It was known that this resident had attempted suicide before and the facility placed her on the second floor. She later went on to jump from the balcony resulting in a broken pelvis and shattered bones. In response to her suicide attempt, the facility stated that they will no longer accept patients with mental disabilities.

The facility told the local news that to correct their mistakes they now have security and wrist bands for all the patients.  Obviously, they should have done those safety interventions prior to residents getting hurt and injured.