In 1959, the Department of Housing and Urban Development (HUD) created a program that provides loans to start up new nursing homes and assisted living facilities across the US.  This program was meant to keep care for the elderly viable and affordable in rural or lower-income communities which would otherwise be unable to sustain such a facility. Since the program began, however, it’s become an easy way for some business owners to get loans backed on for-profit nursing homes that are practically doomed at the start.

Back in late 2013, Zvi Feiner and a group of investors bought the Rosewood Care Centers, a chain of 13 nursing homes and assisted living facilities in Illinois. The Department of Housing and Urban Development insured the loans for the centers’ creation, so they were automatically implicated when the Rosewood Care Centers went on a downward spiral. Feiner started losing money on the facilities soon after he bought them, with a team of investors, and began diverting Rosewood’s government-backed funds to other businesses. The HUD program eventually had to come to Rosewood’s rescue when their operation ran out of money and the agency had to take it over.

This HUD program is increasingly known for its lack of oversight and its loss of money on these nursing homes and assisted living facilities. Yes, owners like Feiner are at fault for moving those funds and allowing negligence in those facilities, but HUD backed those for-profit facilities and paid little attention to their nefarious activities before it was too late. Not only is the program poorly run and bad for the government financially, it’s also bad for the residents. Some studies are finding these facilities which take government backing, especially the for-profit ones, are more likely to receive bad quality ratings and ultimately endanger their residents.

The families of many Rosewood patients have filed lawsuits due to the facilities’ negligence. Other facilities backed by the HUD program face similar widespread issues. If the program continues the way it is, it might only further the danger surrounding the businesses it backs.

Back in 2015, the drug company Pfizer found a strong possibility that Enbrel, their rheumatoid arthritis medication, could significantly reduce the risk of Alzheimer’s disease. Based on an analysis of insurance claims, researchers from Pfizer found that Enbrel could potentially reduce Alzheimer’s risk by 64 percent.

Researchers in the company wanted to do more research relating to Enbrel’s connection with Alzheimer’s. Pfizer decided against it because it would not be as profitable.  Around the same time Pfizer made its decision not to support Alzheimer’s research with Enbrel, they also decided to shut down their neurology department where the testing would have occurred and lay off 300 employees.  Pfizer also had the option to publish its data for other researchers to use, but decided not to share the important research.

Some outside researchers and scientists think Alzheimer’s might be very closely related to inflammation and the correlation between Enbrel and Alzheimer’s prevention might not be coincidental.

 

The Wisconsin State Journal recently reported a tragic tale of greed and avarice.  An assisted living facility evicted a resident last month because she went on Medicaid, even though the facility said it would keep her once she was in the program if she first paid out of pocket for six months, which she did.  Pols went on Family Care, a state Medicaid program, in early June, after depleting her savings by paying nearly $30,000 to Heritage from December to June, Redmond said.

Jenny Pols’ involuntary discharge from Heritage Senior Living appears to be a wrongful eviction stemming from low Medicaid reimbursement rates. Facilities verbally pledge to keep residents after they go on Medicaid, but rarely put those promises in writing.

Pols, who received an involuntary discharge notice from Heritage June 25, moved last week to Willow Pointe, an assisted living facility in Verona.  Margo Redmond, Pols’ caretaker, said Heritage told Pols and Redmond in November that Pols could stay even after going on Medicaid if she first paid privately for six months. Redmond called the facility’s actions “fraudulent inducement.” Heritage on June 25 refunded about $6,000, apparently for Pols’ advance payment for June, Redmond said.

“I should have walked, but I had already heard from many people in the aging field that these facilities never put anything like that in writing,” she said. Pols, born in the Netherlands, worked in the United States as a nurses’ aide at a nursing home run by Redmond’s mother and became a family friend.

 The June 25 notice to Pols from Bobbi Stoltz, executive director of Heritage, said: “We are not required by law to continue residency for any individual once they convert to the Family Care Program and the lower monthly reimbursement rate. Therefore, we are issuing this 30-day Notice of Discharge.”

Heritage’s executive director at the time said Pols could stay once on Medicaid if she first paid privately for six months, Redmond said. When Redmond asked him to put that in writing, he said he couldn’t but shook hands in agreement, she said.

Amanda Runnoe, Heritage’s vice president of clinical and quality operations, told the Wisconsin State Journal in a statement that “there was discussion as to our commitment and efforts to retain current residents if and when they must transition to Medicaid reimbursement … but it was made very clear that we do not and can never make such a guarantee or promise.”

Most assisted living facilities in Wisconsin accept some residents on Medicaid, but facilities sometimes limit the number of such residents to remain financially viable, said John Sauer, president and CEO of LeadingAge Wisconsin, which represents assisted living facilities and nursing homes. Heritage is not a member of the association.
With assisted living becoming more widely used, consumers need to fight for their rights, Redmond said. “If enough of us say we’re walking unless we have something in writing, this will stop,” she said.

Forbes reported on the New York Times story on Rosewood Care Centers, a bankrupt for-profit nursing home chain, plagued by mold, disrepair, and wrongful death lawsuits. The nursing home chain is accused of misusing a government loan program by diverting the money for another investment, ignoring quality issues, and allowing wrongful deaths to occur.

Readers’ comments on the Times story were specific and detailed. One former manager of a nursing home wrote that despite the alleged bad intentions of the nursing home owners featured in the story, many nursing homes in America will struggle even if they have good intentions. Several factors conspire to weaken the industry’s bottom line. The homes are mostly structured as for-profit enterprises, their workers are among the most poorly compensated in any industry, individual families can’t pay for adequate care, and the government has not budgeted enough money for Medicare and Medicaid nursing home care.

The federal agency charged with helping people in need of housing is clearly not working. It is unsettling while 10,000 aging boomers turn 65 every day, prompting a predictable surge in nation’s nursing-home population. Baby boomers, defined as the 77 million Americans born between 1946 and 1964, significantly outnumber the generations that came immediately before and after. Most of them will need custodial care at some point.

In 1995 the Government Accountability Office reported that oversight on quality of care and financial stability of nursing homes was scattered and inadequate among state and federal governments.

If you have been lucky enough to have accumulated wealth throughout your working life—and avoided setbacks like divorce, job loss, or health shocks—then you may have enough money to afford a home nurse or a nice assisted-living facility. As we age we will all likely need some sort of custodial care, and whoever takes care of us will be mentally and physically drained, whether they be family members or hospital staff. If the pay for certified nursing assistants, personal care workers, and home health workers is not improved, that drain could prove unsustainable for care workers.

As the Rosewood example shows, an increased role for government in long-term elder care is sorely needed. Not only is there not enough money to meet standards of care, add the requirement to make profits for the shareholders and the system is doomed. We might all be doomed if there is no adequate care for us as we age.

More maternal deaths and injuries occur in the U.S. than any other developed nation.  The vast majority are preventable. In this country, already the most dangerous in the developed world in which to have a baby, South Carolina has one of the worst track records when it comes to women’s health during childbirth. The state ranks in the top ten in the most maternal deaths and the most maternal harms.

The hospitals and doctors often blame the victim’s age, weight, and socioeconomic status of the woman giving birth. But as more research comes out regarding these incidents, including about two deaths every day, it seems negligence on the part of the healthcare provider could have much more to do with these incidents than a woman’s personal history.

The two leading causes of life-threatening incident when it comes to childbirth are blood pressure and blood loss. When a mother’s blood pressure becomes too high before, during, or after delivery, there’s a chance of serious complications like a stroke. When she begins losing too much blood her internal organs could shut down or cause a number of other life-threatening issues. Neither of these issues are particularly difficult to detect, nor do they necessarily correlate to a fault of the mother’s, but hospitals across the country are still failing to make sure their patients have what they need to prevent life-threatening cases. They could be weighing bloody pad to measure their patients’ blood loss, measuring their blood pressure and prescribing medication for it when it gets too high, and taking a number of small steps to prevent disaster. But they aren’t.

Part of the reason it’s so hard to make large-scale changes to the way childbirth is handled in America is that the medical community has to come to a consensus that their current methods aren’t enough and they need to implement new techniques to save these mothers. Doctors and nurses who’ve been working for years, who have experience watching these kinds of stories unfold, don’t necessarily want to change the way they treat patients, or they sometimes don’t even know of these new medical advancements.

In other developed countries, it’s often easier to get new standards of care implemented because they have a universal healthcare program. When all hospitals are publicly funded they have to abide by all the new, agreed upon techniques the government wishes to implement.

In the U.S., doctors and nurses are freer to treat how they please. That freedom, however, might come at the price of negligence and treatment methods that harm new mothers across the country.

Federal prosecutors disclosed that Dr. Ronald Hargrave of Mount Pleasant, S.C. has been convicted of trading painkillers and anti-anxiety drugs for money and sex.  The jury found Dr. Hargrave guilty of distribution of controlled substances after a four-day trial.

Investigators said they started looking into Hargrove in 2105 after he went with a woman to a Columbia pharmacy around midnight on a Saturday with a Xanax prescription.

Prosecutors said in a statement the pharmacist refused to fill the prescription because it was odd to have a doctor accompany a patient to the drug store, especially out of town.

Authorities six Hargrove exchanged sex in his office for painkillers in another case in 2017.

Hargrove faces up to 20 years in prison when he is sentenced later.

McKnight’s reported on the forseeable suicide of an assisted living resident in a Five Star Senior Living community in Arkansas.  Staff members at Morningside of Springdale assisted living community cut back on the number of checks they conducted on his room which allowed the man time to commit suicide.  The man had a history of considering suicide and had objected to the every-two-hours room checks required by the state, according to an investigation by the state’s Office of Long Term Care.

Staff members agreed to accommodate the resident’s request for less frequent checks. He died April 23 in his room, and Morningside reported the death to the state and local authorities, officials said.

Last year, a jury compensated a former resident of Renew Saddle Rock $3.6 million after the resident was beaten by another individual who resided there, identified as “Anne B.”  The facility is being sued again for the same resident beating another wheelchair-bounded 92-year-old and failing to report it.  Apparently the facility cannot keep the residents safe or keep Anne B. from harming others.  Anne B. has also been accused of assaulting a third female resident who has had only her first name released, Josephine.  Many of the residents have Alzheimer’s and dementia so the facility knows altercations are inevitable and foreseeable and therefore preventable with adequate staff to supervise and intervene if necessary.

The latest lawsuit accuses the center of putting profits over people and engaging in under-staffing to save money.  Renew regularly staffs just one employee for as many as 28 dementia clients throughout evening and weekend shifts, the lawsuits alleges, and when an attack occurs, the center doesn’t have the resources to report it in a timely manner.

It was filed on behalf of Joanna Dryva whose mother, Maria Pallman, was the elderly wheelchair-bound women assaulted.  According to the lawsuit, Pallman was sitting in the hallway in her wheelchair when the assault occurred.  Now, according to court documents, she suffers from anxiety and other recurring medical complications.  The nursing home refused to hand over surveillance footage Pallman’s family request that they believe documented the incident.

The lawsuit additionally accuses former director, Britny Otto, of violating state law when she denied throughout her testimony in court that Anne B. had assaulted the individual in the first case that was presented.  It says that Otto the facility as having higher levels of staffing than its competitors even though she and the company were well-aware that it was chronically understaffed.  Otto also didn’t report the assault of the first resident to the police or adult protective services, as required by state law.

 

 

Nine people have been charged with defrauding dozens of residents at assisted living facilities in South Carolina.  201 warrants for nine suspects, charging them with either financial identity fraud and/or exploitation of a vulnerable adult. According to the Spartanburg Sheriff’s Office, at least 45 residents from Summit Hills, Woodland Place and the Charles Lea Center lost more than $100,000 collectively.  Officials dubbed it a “criminal enterprise,” involving the re-selling of smart phones.  The victims became aware when they started getting bills in May 2019 for mobile phones they hadn’t purchased.

Investigators said one of the suspects, Tamara Marqueeshia Shardana Taylor, worked at all three facilities. Taylor confessed to taking pictures of the residents’ intake sheets, which had their birth dates and social security numbers, and sending them to another suspect, Joshua Jonathan Rashaad Glenn.  Glenn would take the residents’ information to Walmart stores and Target and would then pay third party Verizon or AT&T representatives to “force” the identification portion of wireless phone contracts.

Deputies said Glenn posted to Facebook, asking for assisted living facility employees to contact him, and recruited seven people through it.

Eight of the suspects have been arrested, but Glenn is still at large.

  • Dushawn Michael Woodson, Spartanburg, a Verizon/AT&T representative at Target
  • Tiffany Marie Griffith, Spartanburg, another Target employee
  • Tamara Shante Carson, Inman
  • Davien Montrell Rodgers, Taylors, a Walmart Verizon representative
  • Rajshunda Chenell Ojayeria Holmes, Spartanburg
  • Clifford Ulyess Brown, Wellford
  • Malik Divine Gray, Inman, a Walmart Verizon representative

The sheriff’s office told WSPA that they had identified five additional potential suspects.

 

 

Does it seem fair that you must lose your constitutional right to a jury trial just to get nursing home care?

The Trump Administration issued a final rule allowing forced arbitration agreements in nursing home admission paperwork.  It will keep Obama’s prohibition from requiring residents to sign them as a condition for admission and to inform residents or their representatives that they do not have to sign a binding arbitration agreement.

In addition, the CMS mandated that nursing homes explain the agreement to the resident “in a form and manner that he or she understands.”  In addition to removing the use of “plain language” in arbitration agreements from the final rule, nursing homes will no longer have to post notices describing their arbitration policies for patients and families.

Finally, nursing homes must retain copies of signed binding arbitration for five years after the resolution of any dispute and those documents must be available for inspection upon request by the CMS, accrediting organizations or state surveyors.

The history of binding arbitration agreements has been checkered. In October 2016, the Obama administration banned their use in long-term care facilities, but a legal challenge and subsequent injunction forestalled that effort. Then, in June 2017, under a new administration, CMS proposed a rule that would remove the ban and sought public comment. Long-term care providers are strongly in favor of arbitration agreements because they pay less for neglect and abuse and the results are confidential.