Donald Chinn, an employee of an assisted living center, was arrested and charged with one count of raping an 84-year-old resident. He is no stranger to the law, with drug offenses, including drug trafficking, stretching back to at least 1999.  Chinn’s next-door neighbor in Shelby, Brad Sammons, said living near the man has been a nightmare. He said he supports people being given second chances, but can’t believe Chinn was allowed to be with vulnerable seniors.

The daughter of the alleged victim alerted the Waterford assisted living facility in Mansfield about the alleged crime and the executive director then called 911.  No one at the facility would answer questions about the incident or Chinn’s employment. But a spokesperson later sent a statement saying in part that management is “disappointed and concerned.”

NBC News recently reported on Operation Brace Yourself.  The federal investigation discovered that medical brace manufacturers were allegedly paying kickbacks and bribes to doctors working with fraudulent telemedicine companies in exchange for Medicare patient referrals for medically unnecessary braces.

At least, two dozen people, including doctors and owners of medical equipment companies, were charged in a more than $1 billion Medicare scam. As many as 130 medical equipment companies were implicated in the scam that resulted in a total of $1.2 billion in losses, prosecutors said.  As part of the scheme, doctors profited by prescribing braces to patients they had little to no relationship with. Prescriptions frequently came after doctors had brief conversations via phone or video conference with patients they had never met, prosecutors said.

Investigators uncovered the sprawling plot that targeted elderly and disabled people by setting them up with back, neck and knee braces that they didn’t need, according to federal prosecutors.  The ill-gotten gains were then laundered through shell companies and used to buy exotic cars, yachts and luxury real estate in the United States and overseas, prosecutors said.

The taxpayers should be outraged by this,” Gary Cantrell, who oversees fraud investigations for the Health and Human Services inspector general’s office, said in an interview with NBC News. “These are losses to the Medicare program that we all, as taxpayers, fund.”

“White-collar crime is not victimless,” Sherri Lydon, U.S. attorney for the district of South Carolina, where the probe originated, said at a press conference announcing the indictments. “All taxpayers will endure the rising cost of health care premiums and out-of-pocket costs as a result of fraud on our Medicare system.”

Mark I. Korn, the former owner of several nursing home was sentenced to 18 months in prison and ordered to pay more than $3 million in restitution and back taxes.  Korn pleaded guilty to bank theft and willful failure to pay tax. He had faced up to two years in prison for each charge.  Korno also committed bank theft in connection with his actions concerning a credit card and loan from Fifth Third Bank. He also failed to pay over employment taxes related to his nursing homes over three quarters in 2009.

In 2008, Korn sought a loan to refinance the Batavia Nursing Home from Fifth Third Bank. In June 2008, Fifth Third Bank provided $3,900,000 to refinance the nursing home and provided the defendant with a credit card. As part of the application for the loan, Korn submitted a personal financial statement and guaranty on which the bank relied when underwriting the loan. The statement contained numerous falsehoods, including the overvaluation of his primary residence. The defendant stated that the property was valued at $1,465,000 when, at the same time, he was contesting its value with the Town of Amherst for purposes of property taxes, alleging it was worth between $500,000 and $550,000. Additionally, Korn provided the bank with statements of bank accounts that he claimed to own. However those statements also contained falsehoods – including one statement in which the defendant claimed ownership of an account containing $50,000 in February 2008, when the account actually contained $1.00 and belonged to someone else. The loan and payments on the credit card went into default, and Fifth Third Bank lost more than $2,400,000.

Prior to March 2009, for both Batavia Nursing Home and Fairchild Manor Nursing Home, Korn used a service to collect and pay over employment taxes owed. However, beginning in March 2009, the defendant ceased using the service and subsequently intentionally failed to pay to the IRS employment taxes owed for the second, third and fourth quarters of 2009. Instead of paying the taxes owed to the IRS, Korn spent the funds on personal expenses including restaurants, hockey tickets, jewelry, and to pay his children’s college tuition.

Amy McLellan was a critical care nurse who worked at Mid Coast Hospital and Central Maine Medical Center and pleaded guilty to felony misuse of entrusted property.   Police said she bilked an elderly couple out of $274,000 but will only have to serve two days in jail.  McLellan was indicted in August 2018 on charges of Class B felony misuse of entrusted property of a vulnerable person more than $10,000 and Class B theft by unauthorized taking more than $10,000.

McLellan purchased a building — more recently the Skofield House nursing home — for just more than $1 million in August 2016. She renovated the building into an upscale elderly living complex with on-site skilled nursing care.

Brunswick police Cmdr. Mark Waltz wrote in a request for a search warrant that he learned from interviewing the alleged victims that they met McLellan while the husband, 89 at the time, was her patient at CMMC. McLellan allegedly visited him while he stayed at several rehabilitation facilities in the Lewiston-Auburn area and then at their Auburn home.

According to the affidavit, in April 2016, while the man was at Clover Manor in Auburn, he executed a general power of attorney naming McLellan as his agent.

His wife, who was 92 at the time, told Waltz that her husband, who suffered from Parkinson’s disease, had been “in love” with McLellan and that she had seen McLellan kiss him on the lips.

Prosecutors said McLellan ultimately convinced the man to drain his savings account to allow her to finance the assisted living complex in Brunswick.

Waltz wrote that McLellan had taken approximately 60 percent of the couple’s net worth, and had used the initial $200,000 from the alleged victims as collateral for a $1.6 million mortgage from Norway Savings Bank.

 

 

Tulsa World reported on a bill pending in the Oklahoma House to crack down on the administration of antipsychotic drugs to nursing home residents. Oklahoma ranks first in the nation in giving antipsychotic medication to nursing home residents, according to AARP Oklahoma, which is backing Senate Bill 142, by Sen. Stephanie Bice, R-Oklahoma City.

This legislation will provide a stop to this immoral practice of drugging our seniors,” said Sean Voskuhl, AARP Oklahoma director.  “We rank No. 1 in the country in this category with the high use of antipsychotic drugs,” Voskuhl said. “We owe it to our most frail and vulnerable citizens to provide dignity and care.”

The measure defines antipsychotic drugs as a “drug, sometimes called a major tranquilizer, used to treat symptoms of severe psychiatric disorders, including but not limited to schizophrenia and bipolar disorder.”

Bice said the legislation requires written informed consent from the patient or legal representative.

If the nursing home resident is given the antipsychotic in an emergency situation, a physician would need to do a follow-up exam to ensure the proper diagnosis, according to the measure.

The medications are being prescribed for nonpsychotic reasons, Bice said.

“We want to ensure that if there is a medical diagnosis and they need it, they get it,” she said.

But if a patient doesn’t need it, caregivers must be careful about over prescribing, she said.

Some of the medications have negative side effects, such as sedation, which can increase the risk of a fall, Bice said.

There is a high occurrence of nursing homes giving antipsychotic medication when it is not necessary.

Nico Gomez is president and CEO of Care Providers Oklahoma, which represents about 200 nursing homes. Gomez said his organization is not opposed to the measure.

“It is an issue we have been working hard to improve for a number of years,” Gomez said. “We can understand that people who care for our residents like we do are getting frustrated with the lack of progress that other states have made.”

He said his organization is working to educate its members and with physicians to make sure “we are prescribing the right medications to the right person at the right time.”

Gomez said he didn’t have an answer as to why the state ranks first in the nation on administering the drugs to nursing home residents.

Service Employees International Union’s national pension fund is suing SavaSeniorCare for more than $260,000 in unpaid worker contributions, late fees and penalties.

In a 20-page filing submitted in U.S. District Court for the District of Columbia, attorneys for the union’s fund argued that Sava and eight of its locations in Michigan and California have ignored previous written requests for payment.

Neither a phone nor an email seeking comment from Sava were returned on Monday.

SEIU argued that the payments were contractually required, including a 10% surcharge from the employer for 2010 because the plan was in “critical status” and in need of financial rehabilitation.

The alleged missing payments were unearthed through payroll audits of the years 2010-2011 and 2015-2016.

The union is seeking damages, arguing in its filing that the loss of earnings “endangered the eligibility of covered members’ pension benefits.”

“Defendants’ failure and refusal to comply with its obligations creates an atmosphere in the industry that encourages other employers to do the same,” the union argued.

 

Recently, Laurens County Sheriff Don Reynolds said his office received a report that Carolyn Penland, the administrator of Laurens Memorial Home, had assaulted a client.  The administrator of the Upstate assisted-living facility was arrested on third-degree assault and battery charge.

Reynolds said after investigators interviewed the victim, multiple witnesses and reviewed surveillance video, Penland was arrested.

Reynolds did not give any specific information about the nature of the assault. Penland is being held in the Johnson Detention Center.

USA Today had the tragic and preventable story of James “Milt” Ferguson Sr., a blind World War II veteran, who died from a head injury suffered at a VA nursing home in Iowa. Ferguson was removed from one-on-one supervision, and he wandered into other residents’ rooms repeatedly, medical records show. When he rolled his wheelchair into one room unsupervised Dec. 20, 2018, his son said VA staff told him the resident of the room flipped Ferguson backwards out of his wheelchair. He landed on his head, causing a massive brain bleed.  A surveillance camera captured footage of James Ferguson Sr.’s fatal injury at a Veterans Affairs nursing home.

People are outraged that he wasn’t monitored more closely and what policies are in place to prevent a similar injury or death.  A USA TODAY investigation that chronicled Ferguson’s case and what specialists say was a concerning series of decisions by VA staff, before and after his deadly injury.

Nursing staff didn’t report the incident for 40 minutes, according to the records and surveillance video. They didn’t take him to the emergency room for more than two hours and he wasn’t transferred to a trauma hospital until five hours after the fall. He died from the injury two days later.
Ferguson was admitted to the acute psychiatry ward at the VA Medical Center in Des Moines in November after his dementia worsened. He had been in a private nursing home but became aggressive and wandered into other residents’ rooms. VA healthcare providers adjusted his medications and placed him on one-on-one observation with an aide to prevent him from straying into other rooms.

But on Dec. 11, 2018, staff removed the strict observation even though he was still determined to be a danger to himself and others, the medical records show. He was transferred to the VA nursing home on the medical center’s campus the next day. Ferguson continued to enter other residents’ rooms repeatedly, but records show staff did not reinstate strict observation.

After the head injury at 3:49 p.m. Dec. 20, Ferguson wasn’t taken to the emergency room until about 6:30 p.m., and he wasn’t transferred to a trauma hospital until 8:55 p.m.

In recent years, many states have made changes and simplifications to the way they pay nursing homes through Medicaid. Florida, whose nursing home industry is massive and whose annual budget is taken up so much by Medicaid spending, wanted to do the same. Not only did they want to make the system less complicated, they also wanted to even the playing field of nursing home Medicaid payments by increasing funding for the previously least-funded nursing homes in the state and decreasing funding for their previously highest-funded nursing homes, therefore bringing all of these facilities closer to the middle of the pack in terms of Medicaid. They also wanted to transform the way these payments were made, moving from a retroactive system in which nursing homes are given Medicaid at the end of each year based on their annual costs to a system under which funds would be given at the beginning of each year based on what the state determined each facility would need based on its own formula. Before all of these changes were even implemented, the new plans raised eyebrows for the higher-quality nursing homes in Florida who would get cuts to their funding and receive that funding under a new state-devised formula.

The Problems

The proposed changes would be directly on the Medicaid funding to Florida’s nursing homes. Some homes, regardless of their quality, take in more Medicaid recipients than others. Nursing homes that do house a large number of patients dependent on Medicaid need those funds in from the state government to act in place of what other patients would be expected to pay through their own insurance or out of pocket. If a high quality nursing home with a large number of patients on Medicaid were to experience drastic cuts in funding, which many of them are, they would have to alter their quality of care and/or the number of Medicaid-dependent patients they could take in, damaging the quality of good nursing homes and sending patients away to even worse ones.

In addition, there’s currently no check in place dictating that the facilities experiencing an increase in funding use that money to better their quality of care. If a nursing home with historically bad ratings gets an increase in Medicaid funding through this new system, which is meant to benefit that facility’s patients, there’s nothing stopping that nursing home from siphoning those funds to further the profit of its corporate leaders, which already happens in the realm of the large-scale nursing home industry.

In general, under this new plan many good nursing homes would see a decrease in funding that will act as a detriment to their business and their patients. Meanwhile, many subpar or worse nursing homes will see financial incentives which, possibly, will never benefit their patients.

The Lobby

Part of the reason a plan like this could go through in the first place is the powerful group of companies from the nursing home lobby that pushed for it.  Organizations like the Florida Health Care Association and Consulate Health Care, both members of the nursing home lobby, donate to the campaigns of politicians all over the state of Florida in order to block legislation which would punish negligent behavior and celebrate actions which would help their businesses to continue operations.

Rick Scott, the former two-term governor of Florida and current Senator, who receives more funds from the nursing home lobby than any other Florida politician, is a massive proponent of the nursing home industry. But he also signed this new payment plan into law as some of the state’s best nursing homes were crying out in pain from the cuts. Similarly, Joe Negron, the former President of the Florida Senate, received hundreds of thousands of dollars from the nursing home lobby and had an FHCA award named for him after he left the State Senate. These officials could have a lot of power to block actions which would be detrimental to the state’s best nursing homes, but that would mean an end to the funds the lobby provides.

The American Health Care Association also has the power to make changes to the state of long-term care in Florida. With proof that low-rated facilities cause harm to their patients, the AHCA could shut down bad nursing homes, revoke their licenses, or dole out other punishments. Instead, they more often decide to send these facilities threats with a loss of license, which rarely go through and rarely change the nursing homes’ quality of care. For example, at one time the AHCA had sent fifty-three of Consulate Health Care’s nearly eighty facilities a threat of revoked license, but none of those threats ever went through and over the course of five years Consulate’s nursing homes received an average of two point four out of five stars.

The Conclusion

This new system of payment is going to be detrimental to some of the best nursing homes in Florida and its patients. The system’s largest beneficiaries will most likely be the lobbyists who pushed for its implementation in the first place. But as long as those lobbyists continue to turn over part of that money as campaign contributions to some of Florida’s most powerful politicians, they will continue to get what they want, even at the cost of patients’ quality of care.

Modern Healthcare website had an article written by Merrill Goozner about the management’s neglect of the caregivers at nursing homes.

Mr. Goozner “was struck by how little attention was paid to a point raised by Olthoff’s daughter, the lead witness. It was echoed by almost every other speaker, but only in passing. Grassley made no mention of it in his opening remarks.”