U.S. Senator Barack Obama today released a statement on the report in the New York Times on nursing homes.

"The news that some private equity firms have been boosting profits at the nursing homes they own by cutting essential staff and compromising the quality of care for our seniors is unconscionable and unacceptable. America’s workers and America’s seniors deserve better, and the American public deserves to know exactly what’s going on in these nursing homes."

‘I led the fight in Illinois to pass the Hospital Report Cards Act that required hospitals to disclose details on nurse staffing and the quality of care so that the everyone was aware how well their health care system worked. When I’m President, this kind of transparency will be a part of my universal health care reform that provides every American with affordable, quality health care."

I wish South Carolina enforced the nursing home rules and regulations and issue fines when neglect has occurred. To my knowledge, SC has never fined any "for profit" nursing home.

A nursing home was fined $100,000—the most severe penalty under state law—after investigators ruled that poor health care led to the death of a 76-year-old patient.
Pleasant Care Convalescent of Petaluma operates a 54-patient facility where a woman died March 12 from an infection, said Norma Arceo, a spokeswoman for the California Department of Public Health.

The woman developed an infection and died from complications in a hospital eight days later, Arceo said. Records showed the patient had extensive cavities and food debris throughout her mouth, causing large swelling in her neck. 

Here is the full article

Below is from the SC DHEC website. DHEC is the state agency that has the responsibility to oversee and supervise nursing homes in SC.  Typically, they do nothing.

Do you have a complaint to file?
We ask that you carefully read the following information before filing a complaint. If you have supporting documents, please submit a copy – do not send originals. Listed below is the information you will need in order to mail or phone in your complaint.

Investigation and resolution of complaints are a critical Division of Health Licensing responsibility. A complaint is defined as an allegation that relates to a condition, events relative to a licensed activity, or to an activity subject to licensure. The Department is required to investigate any written or verbal complaint which indicates that there may be a violation of the licensing standards.

Any individual making a complaint against a licensed activity or provider may do so anonymously. If a complainant reveals his/her identity and requests confidentiality, the Department will not disclose the complainant’s identity unless mandated by state or federal law.

Your complaint will be assigned to an inspector who will determine if the Department can assist you. Written acknowledgement of our receipt of your complaint will be sent to you. Because of record keeping requirements and the need for accuracy, we ask that your complaint be submitted in writing, however you may call us with your concerns.

To generate an investigation, the Department must receive a complaint from an individual regarding an expression of discontentment, concern, and/or distress which may involve the conduct of the staff, conditions of the activity, care of the clients, etc., in an activity licensed by the Department. These expressions of concern could also involve a potentially unlicensed activity which may be operating illegally. In all instances, there must be an identification of a possible violation of a licensing standard.

Once an investigation is completed, the inspector will send a written report to you. Please contact the Department if your complaint is resolved before you hear from us.

The Department cannot always resolve complaints to the satisfaction of all complainants; however, we will investigate the complaint based on the facts, the appropriate regulation(s), and advise you of our findings. Our complaint inspectors are knowledgeable about the regulations and have access to attorneys who provide legal guidance for the staff.

Complaints regarding concerns not under the jurisdiction of the Department may be referred to another state agency or local authorities as appropriate.

Complaints concerning abuse – physical, sexual or psychological, or financial exploitation, or neglect or abandonment of a resident, (whether the incident occurred inside or outside of the facility) will be referred to the Lieutenant Governor’s Office on Aging, (800) 868-9095.

Complaints concerning Medicare and Medicaid should be referred to the Department’s Certification Division.

It is preferable that you try to resolve your own complaint before contacting the Division of Health Licensing. However, if you have exhausted your efforts to resolve the problem without success, contact us for assistance.

The Department receives a large number of complaints which require varying lengths of time to resolve. Your patience is appreciated and we will contact you as soon as possible.

Jim Perrow, Customer Service
DHEC Health Licensing
2600 Bull Street
Columbia, SC 29201
(803) 545-4370
(803) 545-4212 (Fax)

 At a hearing this month concerning the state of the nursing home industry 20 years after the landmark Nursing Home Reform Act (better known as OBRA ‘87), Senate Special Committee on Aging Chairman Herb Kohl (D-WI) addressed the deficiencies of a system that has allowed some poorly performing nursing homes to escape penalties.

Testimony by the Government Accountability Office (GAO) presented at the hearing concludes that many nursing homes shown to be providing substandard care are still not being subjected to any sanctions, and are therefore not be motivated to make the lasting improvements necessary to protect the health and safety of residents.

According to the GAO, in 2006 nearly one in five nursing homes nationwide was cited for poor care or, more specifically, care that can cause actual harm to residents.

“Without question, the Nursing Home Reform Act improved nursing home care in this country. Today, many of the nation’s 16,000 nursing homes are providing adequate or excellent care. But shamefully, quite a few nursing homes are getting away with providing a lot less, putting a good number of the seniors living in long-term care facilities at risk. This is unacceptable, and raises questions about how and why our enforcement system is failing,” said Chairman Kohl. “This committee has a long history of closely scrutinizing the quality of nursing home care, and we intend to reaffirm that commitment.”

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State and federal officials announced today a $550,000 settlement in a fraudulent medical billing case against Green Valley Pavilion of Smyrna.

Members of the Delaware Attorney General’s Office medicaid fraud control unit and the U.S. Attorney’s Office determined that some of Green Valley’s employees were altering patient charts in order to get more money from the Delaware Medicaid Program.

Because the investigation showed that none of the nurses personally profited from the scheme, state and federal prosecutors pursued Green Valley for restitution due to Medicaid. After months of negotiations, Green Valley agreed to pay more than a half million dollars.

“Caregivers have been sharply reminded of their responsibilities to their patients, and nursing home owners are on notice that they will be held responsible for the acts of their employees,” said Deputy Attorney General Dan MIller, the lead prosecutor in the case. “We have already seen a drop in the amount of questionable reimbursement requests submitted to the Medicaid program.”

See article here

An Orleans County nursing home has been fined $75,900 by the federal government for failing to comply with quality care requirements.

Orchard Manor was cited for civil money penalties based on a survey in November. Civil money penalties are given out by the Centers for Medicare and Medicaid Services.

According to The Monitor, the amount of Orchard Manor’s penalty “does not reflect a 35 percent reduction as the facility did not waive its right to a hearing as permitted under law.”

Leroy Village Green Residential Health Care Facility in Leroy, Genesee County, also made the civil money penalties list, being fined $3,412.50 for results from an October survey.

The former owner of several nursing homes has been sentenced to 42 months of imprisonment after being convicted of health care fraud and money laundering.  Rocky Lemon pled guilty on both charges.

In addition to the prison term the owner must serve three years of supervised release after completing his imprisonment and pay more than $4 million in restitution to Medicare and Medicaid. 

From 1997 to April 2001, Lemon owned and operated more than 50 nursing homes through TLC Healthcare Inc.

Lemon admitted that he executed a scheme to defraud the Medicare Program and the Texas Medicaid Program by diverting Medicare and Medicaid money to his own personal use and benefit.

Lemon used some of that Medicare and Medicaid money to finance his purchase of nursing homes, then sold some of the nursing homes for profit and funneled a portion of the net proceeds into his personal bank and brokerage accounts.

See article here

The Government Accountability Office (GAO) has finally concluded what we all knew to be true:  Nursing homes go unpunished for the abuse and neglect suffered by residents. See story here

Federal health officials impose only minimal penalties on nursing homes repeatedly cited for mistreatment of patients.  As a result, nursing homes cycle in and out of compliance with federal standards and pose a continued threat to the health and safety of patients.

”Some of these homes repeatedly harmed residents over a six-year period and yet remain in the Medicare and Medicaid programs,” said the report, to be issued this week by the Government Accountability Office, an investigative arm of Congress.

The Department of Health and Human Services ”fails to hold homes with a long history of harming residents accountable for the poor care provided,” the investigators said.

Congress established stringent standards for nursing homes in 1987. In 1998, the GAO reported that ”homes can repeatedly harm residents without facing sanctions.”  About 1.5 million people live in the nation’s 16,400 nursing homes on any given day.

The GAO said federal health officials hesitated to impose fines of more than $200 a day, in part because they believed that larger penalties ”could bankrupt some homes.” Fines are generally so small that nursing homes view them as a ”cost of doing business,” with ”no more effect than a slap on the wrist,” the report said.

Here is a good example where a nursing home was fined for overmedicating a resident and then officials withdrew the fine!

Many residents are totally reliant on staff for care, and rely on the federal Medicare program to pay the bills. The problem at nursing homes is poor staffing.  I just read an article that discusses the issue and explains how and why it is a system wide problem.

The article talks about an investigation that found the staffing shortage wasn’t an oversight.  The homes and their upper management were "padding their balance sheets on the backs of helpless residents in their care".

“They were all trying to make a buck,” said Alan Peak, an FBI agent in the white collar crimes unit. The probe revealed criminal conditions at the nursing homes—residents suffering from bed sores, malnutrition, beatings, neglect—all the result of their management company’s directives to cut costs. Meanwhile, managers rewarded themselves handsomely for their efficiency.

The fraud prosecution is one of the first of its kind. While systematically cutting back on service at the nursing homes, management continued to collect money from Medicare and Medicaid for services they knew were inadequate, or in some cases not performed at all.

The management company and its CEO, as well as the nursing homes, pled guilty last fall to fraud conspiracy charges. In February, the CEO was sentenced to 18 months in prison, and the nursing homes were each fined $180,000. The company president was sentenced April 20 to two months in prison for his role.

 

The Michigan AG is trying to stop the abuse and neglect of nursing home residents.  A Metron’s Greenville Nursing Home is facing a $100,00 fine for what the Michigan Attorney General calls "quality of care deficiencies."

The penalty was imposed against Metron for bed rail issues involving several residents earlier this year. This incident follows criminal charges the Attorney General brought in February 2006 against eight employees of the Metron facility in Big Rapids. The charges stemmed from the death of Sarah Comer in January 2005.

See more information here