Nursing homes provide care to about 1.4 million nursing home residents—a vulnerable population of elderly and disabled individuals. CMS, an agency within the Department of Health and Human Services (HHS), defines standards nursing homes must meet to participate in the Medicare and Medicaid programs.  The Centers for Medicare & Medicaid Services (CMS) is responsible for ensuring nursing homes meet federal quality standards, including that residents are free from abuse. To protect vulnerable nursing home residents from abuse, the Centers for Medicare & Medicaid Services (CMS) contracts with state agencies—known as survey agencies—that can cite nursing homes for incidents of abuse.  Most are overworked and without adequate budgets and support for enforcement.

Abuse citations doubled from 2013-2017. GAO recently reviewed a 2016-2017 sample of narratives substantiating abuse citations and determined that physical and mental/verbal abuse were more common than sexual abuse, and that perpetrators were often staff.

CMS can’t readily access this information, which it could use to improve its oversight by focusing on the most prevalent problems. GAO recommendations address this and other issues GAO found.

Nursing Home Abuse by Type and Perpetrator among the Sample of Narratives in Our Review

Bar chart showing physical and mental/verbal abuse and staff perpetrators most common

GAO also found gaps in CMS oversight, including:

Gaps in CMS processes that can result in delayed and missed referrals. Federal law requires nursing home staff to immediately report to law enforcement and the state survey agency reasonable suspicions of a crime that results in serious bodily injury to a resident. However, there is no equivalent requirement that the state survey agency make a timely referral for complaints it receives directly or through surveys it conducts. CMS also does not conduct oversight to ensure that state survey agencies are correctly referring abuse cases to law enforcement.

Insufficient information collected on facility-reported incidents. CMS has not issued guidance on what nursing homes should include when they self-report abuse incidents to the state survey agencies. Officials from all of the state survey agencies in GAO’s review said the facility-reported incidents can lack information needed to prioritize investigations and may result in state survey agencies not responding as quickly as needed.

The death of an elderly man who fought with his Brooklyn nursing home roommate over a pair of pants has been declared a homicide.  First responders were called to the Crown Heights Center for Nursing and Rehabilitation about 3:15 p.m. on Aug. 10 after the staff failed to supervise and prevent Eitel Vargas from brawling with his roommate.

Nursing home staffers called 911 but the injuries were too severe. Vargas died three days later at Kings County Hospital, police said. The city Medical Examiner declared his death a homicide. The assault exacerbated the heart condition, which led to his death, officials said.

Vargas’ death remains under police investigation, said an NYPD spokesman who added that the department was never told of the fight.

The state Department of Health is also investigating.

“The New York State Department of Health takes these disturbing allegations with the utmost seriousness,” DOH spokesman Jeffrey Hammond said. “Upon learning of this incident, we immediately opened an investigation. As this is an ongoing investigation we cannot comment further.”

Nursing homes are required to report any incidents of assault and sexual abuse at their facilities to the state, and are required to identify residents whose personal histories put them at risk for abusing other residents, according to federal rules.

Vargas’ roommate still lives at the nursing home and has not been criminally charged, staffers said.
Relatives of nursing home residents were stunned by the news and said they were never told of the fatal fight.

“I wish I’d have known,” said one woman who was visiting her husband. “I’m not saying I would move (my husband), but I might have been more vigilant (about) his roommates and who’s up and down the hallway.”

A registered sex offender named Olander Grant was arrested for sexually assaulting a woman who has an intellectual disability at Brentwood Place nursing home in Dallas, police say.  Grant is 59 and was booked on one count of aggravated sexual assault. He remained in custody Tuesday, with bail set at $100,000.  Officers were called to Brentwood Place, a 450-bed nursing and rehabilitation facility after a sexual assault was reported.

How did a registered sex offender gain access?  Where was the staff?  How long had he been doing this? Outrageous.

WTKR reported on the issue of sexual assaults in nursing homes.  The problem has been there since the beginning of institutional care but it has significantly increased in the last couple of years.  Many experts and consumer advocates question whether nursing homes that have demented and vulnerable adults attract sexual predators or if the failure to supervise and monitor employees allow for such assaults to occur regularly.  There were several cases in 2018 of medical staff accused of patient abuse in nursing homes and hospitals, and a 2017 CNN report found the federal government had cited more than 1,000 nursing homes for failing to prevent sex abuse at their facilities or mishandling the reports.

The article on WTKR has many tragic examples which illustrate a troubling concern for patients and families involved with medical facilities: Staff who may take advantage sexually of the weak and most vulnerable, regardless of age.

“I’ve wondered if nursing home care draws that particular type of predator,” said Dominique Penson, a partner at the law firm Barasch McGarry Salzman & Penson.  Penson believes many of these abuses happen on overnight shifts and early morning hours.

“I think it’s pervasive,” Penson said of alleged abuse in nursing homes and other medical facilities.

“I don’t think there’s any question it’s pervasive.”

“Unfortunately, it could be a physician, it could be some sort of health care professional, it could be maintenance,” forensic psychologist Dr. NG Berrill said of the staff who have access to patients.

Psychologist Dr. Patrick Suraci said this kind of sexual activity is like a fetish that stops just short of necrophilia, sex with dead people.

“In this case, what these men are doing, it’s a minor form (of necrophilia) because they will have sex with a living body, but also one that cannot respond. So, they have complete control over this body.”

“And this is exciting to them,” Berrill said.

“It’s sort of an issue of power and it probably fulfills some sort of morbid fantasy.”

In New York City, Dr. David Newman, once an emergency room doctor at Mount Sinai Hospital, pleaded guilty to sexually abusing four female patients.

One of the women said he immobilized her with the anesthetic Propofol and ejaculated on her chest. She was able to preserve DNA evidence.

Newman pleaded guilty and was sentenced to two years in state prison.

 

 

Stephanie Thomas, a nursing home employee at the Berks Heim Nursing and Rehabilitation facility, faces abuse of corpse charges after allegedly photographing dead residents, according to a criminal complaint provided to BuzzFeed News.  Police say Stephanie Thomas is a certified nursing assistant who took several photos of residents after they’d died and sent them to friends and coworkers.  Wait, what?

Police seized the woman’s phone as part of the investigation.  According to police, Thomas admitted to sending the photos, telling the officer it was a mistake and that she did it because her ex-boyfriend “liked that kind of thing.”

According to the criminal complaint, in addition to the photos of the deceased residents, they found numerous pictures of dead animals, including deer skulls, decapitated deer heads, an online image of a dog skull, a small embalmed shark, and a photo of herself posing with a deer skull and antlers.

Witnesses who were interviewed by police said Thomas had shown them up to seven different photos of dead residents. One witness said Thomas collects “dead things” and has “an obsession with death.”

Another witness said they’d been shown a photo of a dead resident emitting a bloody discharge, adding that Thomas said “it looked cool.”

Police also interviewed the families of the deceased residents, all of whom “expressed disgust” at Thomas’s alleged actions, according to the affidavit.

“None of the family members consented to these photographs and were outraged such conduct would take place in a senior living facility,” police said.

Thomas was charged with abuse of a corpse, a second-degree misdemeanor. She faces a maximum sentence of one to two years in prison, Berks County District Attorney John T. Adams told BuzzFeed News.

 

 

Nursing homes can be dangerous places. In the past 20 years of reviewing and investigating nursing home abuse and neglect cases, I have heard and seen some unbelievable acts of greed, cruelty, and exploitation but this latest story is one of the sickest.  A teenager named Josh Howarth has been arrested for attempting to rape an elderly woman in a ‘sickening attack’ as she lay in her nursing home bed.

Howarth, 18, broke through a ground floor window to try to attack his vulnerable victim – in her 80s – in the early hours of August 4. He was disturbed by a member of staff at New Thursby Nursing Home at around 5am and fled the scene.  He was found after a manhunt and arrested on suspicion of attempted rape.  Unfortunately, his victim never saw Howarth brought to justice as she died on October 24.

Detective Inspector Jamie Lillystone of Lancashire Police said: ‘This was a sickening attack on a vulnerable elderly lady at a place where she should have felt safe. ‘Howarth went to great lengths to break into her bedroom and had intentions of carrying out the most despicable crime. ‘The only consolation is that he was disturbed by a member of staff, but nonetheless this was an extremely traumatic experience. ‘Haworth’s actions were predatory and dangerous. He will now spend a significant amount of time behind bars.’

 

 

 

Boston 25 News obtained a letter sent out to residents, their families and staff members at Lutheran Rehabilitation and Skilled Care Center in Worcester discussing what they are calling “an isolated incident.”  The alleged isolated incident is the tragic and wrongful death of a resident under suspicious circumstances.  As a nursing home attorney for over 20 years, we can smell a rat.

The incident in question involves a certified nursing assistant and one resident dead. A state investigation is underway.

The facility released a meaningless statement that omitted any key facts:

“The resident was injured and sadly passed away the following day at the hospital. As a result of this unfortunate event, Lutheran is the subject of various enforcement actions and additional review by the Massachusetts Department of Public Health.”

The center’s administrator, Ziad Baroody, declined to go in front of a camera, but sat down with Boston 25 News to answer some questions.

While Baroody could not comment on the specifics of the incident, he confirmed the nursing assistant involved is no longer employed by Lutheran and the rest of their staff has undergone additional training and new safety measures related to the incident have been implemented. The type of training was not mentioned.

In a statement, a DPH spokesperson said that after the serious incident on Sept. 15 they “immediately conducted an unannounced onsite inspection to ensure the health and safety of residents, imposed a freeze on admissions and continues to work with the nursing home on a corrective action plan to address identified deficiencies.”

 

Mecklenburg Health and Rehabilitation Center nursing home facility in Charlotte was fined, and could lose its Medicare provider agreement after at least two elderly residents received “poor patient care,” following an inquiry that stemmed from a FOX 46 investigation. An official with the Centers for Medicare and Medicaid Services (CMS) is treating the findings of its investigation “seriously.” Last month, FOX 46 discovered the nursing home let a 71-year-old dementia patient, Alexander Rose, sign his own discharge papers put him in a taxi to his son’s locked and empty home.  He was found disoriented and lost wandering around the neighborhood, Rose said.  He could have died.

“You can’t do an elder like that,” said Alexander’s son, Tarance. “You can’t just put them in a cab, incompetent, not knowing where to go and not know what to do.”

A court deemed Alexander incompetent this year and awarded guardianship to Rose, who says he was caught off guard when he received a voicemail that his dad was discharging. He says, by law, he should have signed off on his father’s release.

“Like a relief off my shoulders of joy that the state and federal [officials] went in and found information saying this facility was doing wrong things to the elders,” said Rose.

CMS found Alexander’s discharge to be improper, noting there was no post-care plans in place.

Mecklenburg Health and Rehabilitation Center was fined $10,210 for its handling of the Rose case, which FOX 46 first uncovered, and for another situation where a resident was now allowed to return after a four hour therapeutic leave.

 

A patient at West Vue Nursing and Rehabilitation Center in West Plains reported the sexual contact to police. The victim is a 68-year-old resident who told police that Stroman had had sex with her twice since August. The first encounter was consensual, she said, but the second one was not, according to documents. Another nurse explained to officers the victim “was getting scared” after Stroman had sex with her a second time on Sept. 7. Stroman allegedly gave the patient a pain pill before each encounter.

Police collected an item of clothing from the patient as possible evidence, the West Plains Daily Quill reported.

Stroman agreed to talk to police and initially denied any wrongdoing, the documents said. When police told Stroman that they had clothes from the patient with possible DNA evidence on them, Stroman allegedly said that the patient had inappropriately touched him.

He eventually admitted that there had been sexual contact as the woman described, according to the documents. Stroman had been employed as the weekend nurse supervisor at the facility for one year.

 

 

 

I thought I had seen it all.  I have been a nursing home abuse and neglect lawyer for over 20 years and this latest story surprised even me.

Apparently, three caregivers at a facility owned and operated by the Affinity Living Group have been charged with creating a makeshift fight club at Danby House in North Carolina. Their “fighters” were victims of dementia under their care at Danby House, a facility in Winston-Salem, police say.  The Winston-Salem Police Department received a tip in June about elder abuse at the assisted living and memory-care facility, according to Fox 8.

Marilyn Latish McKey, Tonacia Yvonne Tyson, and Taneshia Deshawn Jordan were arrested and charged with assault on an individual with a disability in early October, according to authorities. McKey, Tyson and Deshawn filmed two residents in Danby House’s “special care unit” for dementia patients and encouraged them to fight.

Resident 8 and Resident 9, as the women are referred to in the documents, fought in Resident 8′s room as the trio of health-care workers encouraged them and and recorded the assault.  The three caregivers can be heard in the video saying, “Stop screaming, [expletive].” Someone also prompts one of the residents to “punch her in the face.” Another is concerned that the phone is actually recording the video, so that it could be sent to her later.  Video shows the patients falling onto a bed in Resident 8′s room as Resident 9 continued her assault, according to court documents reviewed by Journal. The anguished pleas for help were ignored.

Staff members took video of the fight, which led to “one resident being strangled with her face turning red,” and shared it on social media.  The employees let the fight happen because one of the residents “always caused problems.”

They were only charged with Class A misdemeanors, which only come with a maximum penalty of 150 days of incarceration and a discretionary fine. Their next court date is Nov. 14.  Incredible.

Affinity Living Group is the fourth-largest provider of Alzheimer’s care and memory care in the country, according to its website.

McKey faces an additional charge after shoving one of the residents during a separate incident when staff took video while McKey pushed the woman “into a room, turned off the light and yelled to the resident to go to sleep, and then closed the door leaving the resident in the dark room,” according to the report.