Another sad story of an overworked nurse stealing medications from a resident.  Talisa Milam Haygood was arrested Dec. 20 on a felony charge for allegedly stealing medication from residents in October and falsifying records indicating she had given the drugs.  Haygood is charged with obtaining a controlled substance by fraud, punishable by up to 10 years in prison.

 She was employed at Lakewood Therapy and Living Center when the alleged theft and fraud occurred. According to the probable cause affidavit, the administrator at Lakewood filed a report with police on Oct. 10 after reviewing video surveillance footage at the center following a complaint by a resident about some missing Nexium pills.

In viewing the footage, he reportedly saw a nurse, identified as Haygood, removing a hydrocodone pill from the medication cart shortly before 1:30 p.m. on Oct. 9 and placing it in her mouth. The administrator counted the pills in the cart and compared it to the entries made by Haygood in the prescription log book.

He then spoke to the residents Haygood had indicated received their pain medication and found two residents who had not received any medication. One patient told him Haygood had refused to give her any hydrocodone at the prescribed time but instead gave her a Tylenol pill.

One patient was reportedly not capable of advising if he received any medication, but a review of the security footage showed Haygood never entered the man’s room at the time indicated and only went into his room once during her eight-hour shift for about three seconds.

The administrator noted that in the entry for that patient Haygood had indicated she had crushed the pill up in a solution and injected it into the patient, but the video showed Haygood never retrieved a syringe from the storage closet.

Police Detective Jjesus Anaya spoke to the administrator and one patient who confirmed the same information. The administrator noted he has video evidence of 17 “pill diversions” by Haygood and is still reviewing the footage to compile more evidence.

 

 

A resident who was sexually assaulted in her Balboa Nursing & Rehabilitation Center nursing home in October has filed a claim against the facility operators, alleging they failed to provide proper security and staffing to keep her and other residents safe. The claim states that employees at Balboa routinely left the back door open, which allowed a man to slip inside, walk past a nursing station and reach the second floor where the victim lived.

Staff heard the woman and her roommates scream for help and saw a naked man dash out of the building. The woman’s arm was broken in the assault, but she is recovering and now living in a different skilled nursing home. Using DNA evidence, San Diego police arrested Lusean Arline, 49, about a week later. He has pleaded not guilty to charges related to the incident. He had just been released from prison after a conviction for following two women and exposing himself.

The state Department of Public Health opened an investigation of Balboa within a week of the assault and issued findings that the facility failed to maintain safe and secure premises. Employees would leave the building’s back door open on a regular basis, despite problems of loitering and trespassing at the building and in the neighborhood. The facility failed to hire sufficient security and staffing to keep costs low.

“This is a terribly shocking case, one that is most unfortunate and violates our trust we place in these facilities when we place a loved one in their care,” the woman’s attorney, William Berman. “This could have happened to any female resident at Balboa.”

The state’s online records show Balboa Healthcare, Inc. as the legal name of the 194-bed nursing facility since 2005. The records say eight complaints were filed against the nursing home in 2019, with 14 findings of “deficiencies” involving pain medications, diet and accommodation for a disability. The government levied a $2,000 fine in one case. In 2018, the records show, 10 complaints were filed with seven findings of deficiency. In 2017, 18 complaints were filed with 19 deficiencies found.

As we have discussed previously, nursing homes often abandon residents and kick them out of the facility without legal justification.  The facility must have a reason and give the resident time to find a new home.  There is a problem in this country where the facility makes up a reason the kick “low paying” residents (i.e. those on Medicaid) so they can replace the resident with a high paying resident (i.e. private insurance, Medicare, Hospice,etc.).

Richard Bloxham, a paraplegic man from Oklahoma claims he was kicked out of his nursing home on New Year’s Eve.  Richard says he lived at Hillcrest for six months before being told he had to be out by January 27th.  Authorities told Hillcrest that a court order is needed for an eviction.

“I was supposedly a danger to other residents and myself. Which was a lie,” said Bloxham.  The 34-year-old wheelchair-bound paraplegic Bloxham is obviously not a danger to others at the facility.  But after a short stay in the hospital, Richard returned on New Year’s Eve only to be told he wasn’t allowed in the building.

“I go to the hospital and they act like they don’t even know what I’m talking about,” said Bloxham. ”They were just trying to get me out quicker.”

However, officials at the Hillcrest Nursing Home are holding firm on this ridiculous assertion and refuse to allow Bloxham back.

He called Moore Police, who spoke with Hillcrest COO Tammy Whorton.  The police report quotes the officer who investigated, “The staff on scene did not have any issues with Richard”.  Going on to say, “They did not agree with the decision.”  The report also says Tammy admitted to telling Richard “he had until the 27th to gather his belongings and vacate the facility.”

 

 There was no New Year celebration for the father of Andrea Leech.  Andrea is demanding answers after discovering her 82-year-old father was physically assaulted by a caregiver at Riverside Care Center nursing home on New Year’s Day.  Andrea told Channel 11 she couldn’t believe this happened to her father. She took pictures of every single bruise left on his body, including marks on his face, arm and leg.

Leech said a certified nurse aide (CNA) saw her father in the hallway and tried to force him to the restroom, but he said he didn’t want to go. Once he got back into his room, Leech said “they heard a big commotion” from inside.  Other nurses then found her dad with multiple bruises on his body. He had to be taken to the hospital, and police were called and are investigating.

“You put your loved one in a nursing home, expecting them to get tested with proper care. It didn’t happen that way,” Leech said.

A jury has awarded $10.5 million to Carolyn Boerste who had to have her leg amputated after University of Louisville Hospital personnel left a sponge inside her during heart surgery years earlier.  Boerste was only 54 when she underwent bypass surgery in 2011 and nurses left an 18-by-18-inch sponge inside her.  The hospital failed to discover and then lied about it for years.  The verdict included $1 million in punitive damages and about $8 million for pain and suffering for Boerste. 

On March 10, 2011, Boerste underwent bypass surgery. The surgery successfully improved blood flow to the legs of Boerste, who was a diabetic. However, Dr. Marvin Morris, a vascular surgeon, inadvertently transected a renal vein, causing a “bloody mess” and a medical crisis.  The incident occurred just before lunch, and a nurse testified that nurses did not do a “lunch sponge count” required by hospital policy. Nurses viewed the policy as a “mere guideline” and not the “standard”.

A preliminary hearing was recently held for a man accused of breaking into Balboa Nursing and Rehab Center nursing home and sexually assaulting an 88-year-old patient.  During the testimony, Defendant Lusean Arline kept his head down in shame.  Prosecutors said that days after being released from jail on a drug charge, 49-year-old Arline snuck into Balboa Nursing and Rehab through an unlocked door after dark and was found completely nude on top of the victim. Arline has a prior conviction from 2017 for following two elderly women home to their apartment and exposing himself to the victims.

He is accused of breaking in during the early morning hours of Oct. 27 and entering a room shared by patients.  Arline was arrested about a week after the alleged assault. San Diego Police say DNA from the victim’s body was put into a federal DNA database and Arline was a match.

The roommate of the 88-year-old victim told the court she saw a man in their room. The roommate, who is being referred to as “Louise”, said the man was naked and on top of the victim.  “Louise,” said she screamed for help and when employees ran into the room the suspect took off running.

The victim’s daughter said she received a call on Oct. 27 from the facility saying her mother was at Scripps Mercy Hospital. When she arrived at the hospital, she noticed her mother’s arm was broken and she was emotional.

“She cried out to me, ‘Am I dreaming?’ I said mom do you think you’re having a dream, she said, ‘I had a terrible nightmare.'” the victim’s daughter said.

The victim’s daughter went on to testify that since the assault her mother is agitated and withdrawn.

He is facing charges of sexual assault, burglary, and elderly abuse.

 

Arkansas has done something that more states need to do–question the transfer of ownership of nursing homes to shady characters.  Christopher Brogdon is well-known in the long term care industry.  Brogdon’s past had also previously been the subject of scrutiny in the Democrat-Gazette, which in April reported that the state approved his assumption of other licenses in Arkansas despite an $83.1 million Securities and Exchange Commission judgment against him in a separate bond fraud case.  He has owned and operated hundreds of nursing homes.  Unfortunately for the residents of those nursing homes, he has not done a very good job.  Now Arkansas has done something about it.

Brogdon’s request to take over a pair of facilities was denied but he has struck back with a lawsuit, claiming that the authorities didn’t provide “sufficient justification” for their decision.  Brogdon claims that Arkansas health officials made an “arbitrary and capricious” decision when they blocked his attempted takeover of properties.

The facilities in question were previously run by the New Jersey-based Skyline Healthcare, whose stunning financial collapse across several states led to calls for increased scrutiny on nursing home owners and operators — particularly those without a historic presence in a given state.

After another operator took over from Skyline in 2018, a firm run by Brogdon assumed control of the properties on an interim basis, the Democrat-Gazette reported, investing about $700,000 in their operations — with the assumption that his affiliates would eventually receive approval to take over on a full-time basis.

But the state’s Human Services Department denied the applications, according to the publication, after officials determined that Brogdon failed to provide sufficient information about 11 other properties he owned in Georgia, Arkansas, and Oklahoma.

Though that rule — which requires applicants to prove that their other properties met state and federal regulations for the previous one-year period — had been in effect for nearly three decades, a spokesperson told the Democrat-Gazette that the Brogdon case was the first time it had been used to deny a transfer.

Ownership and operational transfers could be a key area of nursing home enforcement on both the state and federal levels over the next decade, as officials look to prevent providers with checkered pasts from setting up shop elsewhere. Kansas, which saw 15 Skyline properties fall into receivership, rolled out more stringent application rules for prospective nursing home operators last April, while also making it easier for officials to blacklist providers and owners deemed unfit.

Ohio followed suit in October, with lawmakers enshrining tighter transfer rules as part of its 2020-2021 operating budget; Pennsylvania was also in the process of developing new regulations around skilled nursing ownership changes, Skilled Nursing News reported at the time.

In one of the largest verdicts against a nursing home in New York State, a jury rendered a verdict to a grieving widow of neglected man  totaling $5,032,281 consisting of $2,980,00 in compensatory damages and $2,052,000 in statutory interest against the Northern Manhattan Nursing Home in New York City.  Represented by New York personal injury law firm Jacoby & Meyers, LLP, the case was argued at trial by Partner Michael Feldman.

The nursing home was negligent for ignoring the medical needs of resident Frederick Smith leading to brain damage which caused his untimely death.

“Fred was deprived of his right to adequate and appropriate medical care at Northern Manhattan Nursing Home.  Fred was 75 years old and was left alone for hours in his room, lethargic due to a very low blood sugar count.  Had a nurse checked on him regularly his blood sugar would have been properly monitored and treated.  Instead of taking care of Fred, the nursing home totally ignored him, causing him to go into Hypoglycemic shock.  The lack of care itself was negligent.   What makes this case even more disturbing is that Northern Manhattan Nursing Home, despite Fred being unresponsive for hours, failed to timely call an ambulance for him.  The resulting lack of oxygen to Fred’s brain caused him to suffer from permanent, but preventable brain damage.  Fred lived the rest of his life in a coma, on a feeding tube, and unresponsive.  Fred survived for six months in this terrible condition before he died” according to attorney Michael Feldman.

Feldman continued, “The Public Health Law was written so that our society’s most vulnerable population, those in nursing homes who can’t take care of themselves, can have laws on their side that even the playing field against large corporate-owned nursing homes. This law provides for adequate and appropriate medical care for any nursing home resident. Nursing homes are required to maintain the highest practical, physical, mental and psychosocial well-being of their residents. If they do not, then they are responsible for all of the damages that they do.  The jury today sent a message to all nursing home owners that they better invest in staffing their homes so the residents get the services they have a right to receive.”

Carolyn Lundy Smith, the widow of Fred Smith, expressed satisfaction in the jury finding; “Fred would give the shirt off of his back to anyone who needed help. This tragedy could have been prevented if Northern Manhattan Nursing Home did their job. I am just so happy there is finally some justice and this jury was held accountable for neglecting my husband.”

 

Alex Spanko covers the skilled nursing industry for Aging Media Network, with a particular focus on the intersection of finance and policy. He recently wrote a great article discussing the decline in occupancy at the nation’s nursing homes.  Occupancy “stayed flat between the most recent two quarters, but the proportion of residents covered under Medicaid hit a record high — while the share of bread-and-butter Medicare residents fell to a record low.”

Medicaid accounted for 67.6% of resident days at nursing facilities in the third quarter of 2019, according to the most recent data analysis from the National Investment Center for Seniors Housing & Care (NIC).  However, fee-for-service Medicare, the gold standard for nursing homes with daily rates higher than all other payer sources, dipped to a record low of 10.9% of patient days.

The difference, from a financial standpoint, is stark: Traditional FFS Medicare provided reimbursements of $523 per day in the third quarter, NIC’s analysis found, compared to just $214 per day for Medicaid. That $214 daily average revenue per Medicaid patient day actually represents a high water mark since 2012 as well.

The gain in overall day share translated to revenue mix, with Medicaid accounting for a record-high 51.5% of nursing home income in the third quarter; Medicare revenue mix slid to 20.7%.

Consisting primarily of Medicare Advantage, managed Medicare accounted for about 6.3% of all patient days; these plans reimbursed at a rate of $431 per patient day, a slight drop, for a total revenue share of 9.8%.

“Medicaid is continuing to apply pressure to state budgets, because reimbursement rates are not keeping up with rising labor and other operating costs,” NIC chief economist Beth Mace said in a statement announcing the results. “This is not just a rural state issue. Continued growth in Medicaid may also be contributing to financial and budgetary pressures for bigger states like New York and Massachusetts.”

The nation’s nursing homes were 83.6% full in the third quarter, NIC found, a decrease of just a tenth of a point from the second quarter — and a 48-basis-point increase from June 2018.

“The fact that skilled mix decreased 50 basis points and occupancy was relatively flat in the third quarter suggests that Medicaid demand is helping to stabilize occupancy,” NIC concluded.

NIC senior principal Bill Kauffman echoed that sentiment in the statement.

“After a period of declining and then flat occupancy rates, the data this quarter suggest increased demand for skilled nursing from Medicaid patients is driving continued occupancy stability,” Kauffman said. “It’s too early to know if this trend will continue into the fourth quarter.”

 

The Medicaid Asset Protection Trust (MAPT) is a tool that may protect your house from going to reimburse Medicaid for nursing home costs but only after the house is in the trust for at least five years. A trust is a legal entity that owns assets.  The MAPT is a good option to consider to keep the family home and other assets for your family and not the nursing home.

After the house is transferred to the MAPT, you still receive your STAR, veterans and other real estate exemptions. You maintain your house and pay your taxes like normal. You may even forget your house is in the trust. Your lifestyle stays the same.

If you put the house on the market, the trustee (manager) — usually one or two adult children — signs the binder and contract. At the closing the purchaser pays the trust. The trustee deposits the proceeds check into a bank account in the name of the trust. The grantors of the MAPT (the parents who transferred their house to the trust) still have their capital gains tax exclusions —$250,000 each, for living in the primary residence two out of the last five years.

The MAPT is an “income only” trust, which means the grantors (parents) only have a right to take income from trust assets but may not spend the principal. However, the trustee may purchase a new house with the proceeds and the new house is owned by the trust. Buying the new house does not start a new five-year period because the assets, whether real estate or cash, all stayed in the trust.

If the parents do not buy a new house with the sale proceeds, they may make gifts of trust principal to the children who are beneficiaries of the trust. The children and parents do not pay tax for the gifts.  If there is a house and cash in the MAPT, the parents may direct the trustee to use trust assets to pay for real estate taxes, home maintenance and repairs, and home insurance for the house in the trust. The parents may also invest the money in the trust and take income distributions from the investments.

As opposed to common thought, adding children’s names to the deed of the house is not a good idea. If your child is sued, their judgment creditor can put a lien on your house. If the child dies before you, you may own the house with their spouse. If the parents sell the house, the child may have to pay capital gains tax because they were not living in the house. The MAPT avoids these complications.

The MAPT allows preservation of assets, including the family home, from the devastating cost of care in a nursing home and at the same time provides flexibility upon the sale of the home.