WSPA reported that two assisted living facility employees have been arrested following the alleged abuse of a vulnerable adult at Rolling Green Village Memory Care Assisted Living in Greenville.  According to the Sheriff’s Office news release, investigators charged Diana Rochelle Garrett and Stephanie Ann Lowden for their connection with the abuse of a vulnerable adult.

An investigation began after deputies were called to Greenville Memorial Hospital on May 22 for an 89-year-old victim who received injuries while living at the facility. An investigation revealed that the victim’s son grew suspicious of maltreatment after he noticed injuries pop up on the victim’s body.

“At some point in time the victim’s son placed a camera in his mother’s room, and upon video review, noticed Garrett and Lowden using physical force and psychological abuse on the victim after she was resisting the staff’s demands to take a shower,” according to the release.

The video was given to investigators, who charged Garrett and Lowden with abuse of a vulnerable adult.  Stephanie Ann Lowden is also a Greenville pastor and blames the elderly woman as the aggressor, not the other way around.  Lowden said the elderly woman at Rolling Green suffers from dementia and was “combative” with the staff and resisted them while the staff was attempting to get the woman into the shower.

“The whole staff was trying to get her to stop being combative. We weren’t aggressive. We didn’t strangle her. We didn’t grab her. We didn’t throw her around. We didn’t do nothing,” Lowden said. “We were trying to get her in the shower. She was fighting. She even ripped a pole off the wall, and I came in there in the middle of it.”

Lowden said based on the woman’s needs, she should have been placed in the facility’s skilled nursing center, not the facility’s “memory care” neighborhood.

The affidavit said on May 17, Garrett did commit abuse of a vulnerable adult and that she caused the victim have an injury while “forcing the victim to take a shower. Diana was also involved in psychological abuse that cause the victim fear, agitation, and confusion.”

Investigators made administrative staff at the facility aware of the incident.

 

Guettie Belizaire, an employee at Brookshire Assisted Living Facility in Melbourne, Florida, is accused of sexual battery of an elderly male patient last year, according to authorities.  Belizaire is facing a charge of lewd and lascivious molestation of an elderly person.

Belizaire denied she was in the room with the victim. However, managerial staff at the facility told police Belizaire was found naked in the bedroom of a patient.  The patient said she had sexually abused him.  The victim was taken to Holmes Regional Medical Center where a sexual assault kit was completed. DNA evidence from the sexual assault kit was returned and the results confirmed the victim’s claim of sexual battery leading to Belizaire’s arrest.

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.

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.

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.”

Florida Today explained a new proposal to create teams to review deaths of the elderly when abuse or neglect is suspected and to prevent future deaths are moving forward with Republican pushback in the Florida Legislature. Experts and elder advocates say establishing elder death review teams in Florida could help cut down on the number of cases of nursing home neglect and mistreatment.

The proposal, included in Senate Bill 452 by state Sen. Audrey Gibson, D-Jacksonville, has unanimously passed three committees since mid-February with little discussion. Most recently, the Senate’s Governmental Oversight and Accountability committee approved it March 26. Gibson’s bill would limit reviews to closed cases and to deaths where abuse or neglect has been verified by a state attorney, a potential roadblock that could prevent probing of many nursing home deaths in Florida.

The bill would allow, but not mandate, the creation of elder death review teams in each of Florida’s 20 judicial circuits. The teams would review cases in their judicial circuit where abuse or neglect has been found to be related to or the cause of an elderly person’s death. The teams would be comprised of volunteers from a variety of vocations, including attorneys, police officers, medical examiners, nurses and members of the state’s Long-Term Care Ombudsman program.

The AHCA rarely takes serious action against poor-performing nursing homes, and it has allowed dozens of Florida nursing homes to limp along for years providing substandard care, and abusing, neglecting and even killing patients with little consequence. The goal of the elder death review teams would be to identify problems or gaps in service, to recommend solutions, and to author annual summaries of their findings, according to the bill.

The Daily Beast had an incredible article written by Jordan Rau of Kaiser Health News on exorbitant salaries of hospital doctors.  The problem, according to the government, is that the efforts run counter to federal self-referral bans and anti-kickback laws that are designed to prevent financial considerations from affecting physicians’ clinical decisions. The Stark law prohibits a physician from referring patients for services in which the doctor has a financial interest. The federal anti-kickback statute bars hospitals from paying doctors for referrals. Together, these rules are intended to remove financial incentives that can lead doctors to order up extraneous tests and treatments that increase costs to Medicare and other insurers and expose patients to unnecessary risks.

Reports from the South Carolina Department of Health and Environmental Control show there have been several inspections and investigations of the Sandpiper Rehabilitation and Nursing facility in the last few years, which have revealed problems with inadequate staffing.  That data from Medicare also notes the facility has received 11 health citations, which is almost 4 more than what Medicare lists as the state average.  An inspection report from October 2018 shows DHEC even found the nursing home was not meeting the needs of the residents.

One woman, Jordan Winters, said her mom lives inside Sandpiper Rehab and Nursing claims she has noticed inadequate staffing at the facility. Winters said she is worried about how the staffing is impacting some of the people who live there, including her mom.

“We have some concerns because of low staffing,” Winters said. “Every time that she has problems, they always say, oh we’re low staffed. But they always seem to be low staffed.”