Video footage caught two CNAs from Abington of Glenview nursing home abusing and taunting a 91 year-old demented and vulnerable adult named Margaret Collins. The video included an aid throwing gowns on the resident when staff was aware of her fear of the gowns. The cruelty made the family feel obligated to file a lawsuit, not only for their family member, but also to bring awareness to the all too common abuse of the elderly.

The two CNA’s, Brayan Cortez and Jamie Montesa, were both fired and arrested for their actions. Montesa was responsible for recording the video, including the caption of “Margaret hates gowns” with two laughing emoji’s. Cortez was actively waving and placing the gown on Margaret, even though she was clearly upset and in distress. Margaret’s daughter states that her mother suffers from anxiety due to the incident.

With the National Council on Aging reporting that 1 in 10 American elders over 60 experience some form of elder abuse, situations like Margaret’s cannot be left unreported. Furthermore, residents with Dementia oftentimes are unable to report their abuse, leaving it to their families to look for the signs. Margaret’s daughter, Joan Biebel, stated “If they [the CNAs] were in her room, they should have been there for a reason ― to help her, assist her ― not to exploit her and threaten her and demean her and post it on social media,”. Reporting these situations of elder abuse is a way to inform others of the signs of abuse and report it.

Rowenna Carlet Cann, a nurse’s assistant at the Willows of Wildwood, was recently arrested for an alleged attack on a dementia resident.

Cann’s coworker saw her kick the 81-year-old man who is  “nonverbal,” according to an arrest report from the Wildwood Police Department. The man had tried to get away from Cann, but she pursued and then kicked him. Prior to that she struck him three times on the shoulder.

Last year, a staffer was arrested in an attack on a fellow employee at the Willows of Wildwood. Earlier this year, a staffer was arrested in the theft of pain medication at the assisted living center.  These kind of incidents often happen because of short-staffing and burn-out.

She was arrested on a felony charge of crimes against a person and booked at the Sumter County Detention Center. She was released after posting $2,000 bond.

An audit of Pennsylvania nursing homes warns that staffing levels are insufficient and on track to get worse.  Residents will get harmed and injured from the short-staffing.  One of the main reasons for the staff shortage is the greed of nursing home owner/operators paired with relatively low pay and the intense physical and emotional demands of these jobs.

“Nursing home direct care workers are currently, and have been historically, underpaid. And that is part, I think, of the reason why people choose to work in other environments and other places,” said Ellen Flaherty, past president of the American Geriatrics Society, and director of Dartmouth Centers for Health and Aging in Hanover, New Hampshire.

“We are facing an eldercare crisis, and we continue to ignore it at our own peril,” said Pennsylvania Auditor General Eugene DePasquale.

“Without family-sustaining wages and benefits, the eldercare workforce will never grow to the size we need to care for aging Pennsylvanians,” said DePasquale. “The number of health care workers is clearly not keeping pace with current demand, and is currently not keeping pace with future demand, which is going to explode rapidly.”

It’s a deliberate decision by many of the owners to not hire adequate staffing,” said Charlene Harrington, a professor emeritus of the University of California San Francisco’s School of Nursing, where she specializes in nursing homes, staffing and scheduling.

Harrington said for-profit nursing homes are able to make “excessive profits” by employing minimal personnel.

The workers can’t get the work done because staffers don’t have enough staff to do it. Patients are neglected and abused,” she said. “Ulcers … falls … weight loss … overuse of anti-psychotic drugs … all the problems found in nursing homes are related to inadequate staffing.”

The Centers for Medicare and Medicaid Services recommends that, at minimum, nursing home residents receive 4.1 hours of direct care.

Katie Louise Boll, a nursing home employee, has been charged with allegedly diverting drugs from residents for her own use, according to information filed in federal court.  A grand jury returned an indictment charging Boll with acquiring a controlled substance by deception and tampering with consumer products in Iowa.

At least 13 patients were affected.  She allegedly injured one of the patients when she took part of the patient’s oral morphine sulfate solution and diluted it with mouthwash on Dec. 24, 2018. Later that week, on Dec. 29, 2018, she allegedly used her position to swap codeine, hydrocodone oxycodone, morphine and tramadol medications for at least 10 patients with Tylenol and other medicine.

Boll worked as a nurse at the Good Neighbor Society in Manchester, and between September 2018 and January 2019 she took about 50 hydrocodone pills.  What a waste.  I hope she gets the help she needs, and those poor residents get the justice they deserve.

 

 

The website Claims Journal reported on a study published in the July issue of Health Affairs where researchers analyzed payroll-based staffing data for U.S. nursing homes.  Researchers discovered large daily staffing fluctuations, low weekend staffing and daily staffing levels that often fall well below the expectations/standards of the Centers for Medicare and Medicaid Services (CMS).  The situation dramatically increases the risk of adverse events for residents.

The study paints a picture of the staffing levels of nurses and direct care staff at nursing homes based on a new CMS data resource, the Payroll-Based Journal (PBJ). CMS has been collecting data from nursing homes since 2016, and PBJ data have been used in the federal Five-Star Quality Rating System for Nursing Homes. CMS compares nursing homes’ reported staffing to expected levels based on the acuity of residents in the facility.

Using PBJ data from more than 15,000 nursing homes, the research team discovered that only 54% of facilities met the expected level of staffing less than 20% of the time during the one-year study period. For registered nurse staffing, 91% of facilities met the expected staffing level less than 60% of the time.

Relative to weekday staffing, the PBJ data showed a large drop in weekend staffing in every staffing category. On average, weekend staffing time per resident day was just 17 minutes for RNs, nine minutes for LPNs and 12 minutes for nurse aides (NAs).

Staffing in the nursing home is one of the most tangible and important elements to ensure high quality care,” said study co-author David Stevenson, PhD, a Health Policy professor at Vanderbilt University Medical Center. “Anyone who has ever set foot in a nursing home knows how important it is to have sufficient staffing, something the research literature has affirmed again and again. As soon as these new data became available, researchers and journalists started investigating them, and the government now uses the PBJ data in its quality rating system.”

“We found that the newer payroll data showed lower staffing levels than the previous self-reported data,” said Grabowski. “The lower levels in the PBJ data likely reflect both the fact that they are based on payroll records as opposed to self-report, and also that staffing levels were abnormally high around the time of the inspection. In fact, the PBJ data clearly show this bump, followed by a return to normal after inspectors leave.”

The new PBJ data offer a more transparent and accurate view of nursing home staffing, and Grabowski is hopeful future research will be better positioned to understand the implications of staffing fluctuations on residents’ well-being. Further, he noted that “these new staffing data also offer tools for regulators and other oversight agencies to monitor what nursing homes are doing day in and day out.”

NJ.com had an article about the lack of staff at nursing homes and how that directly affects the quality of care provided to the residents.  The short-staffing prevents supervision to prevent falls and resident to resident altercations.  The lack of staff prevents residents from being repositioned to avoid pressure injures or bedsores.  The under-staffing makes it impossible for the caregivers to spend the time with the residents to feed them or participate in social activities.  It is the key reason for the neglect suffered by nursing home residents.  And everybody knows it.

“Anyone who has spent any time in a nursing home has a story to tell. About a loved one suffered while waiting for help to go to the bathroom. Or someone who went hungry because there was no one to feed them. A call bell that went unanswered for hours.”

It takes time and staff to regularly turn a patient every two and a half hours, which is what needs to be done to avert pressure ulcers. When bed sores develop, it is a direct consequence of not having enough staff to prevent it.

Federal data shows N.J. nursing homes are understaffed. One-in-four of the more than 360 nursing homes in the state had staffing issues, according to reports issued this year by the Centers for Medicare & Medicaid Services.

They revealed 25 percent were rated “below average” or “much below average” in the number of nursing personnel available to take care of residents — a ranking that takes into account that some nursing homes have sicker residents and may therefore need more staff than other nursing homes whose residents aren’t as sick.  Half of those same facilities had poor health inspection reports as well.

At the same time, those self-reported numbers by the nursing homes themselves may not true.  It is well known that nursing homes inflate their staffing numbers to get a better star rating on Nursing Home Compare.  However, new payroll data being collected by the government will provide a more accurate picture of the number of staff on duty.

Families for Better Care, a non-profit advocacy organization, said the state ranked 45 nationwide in the amount of direct care service hours provided per resident. In its own analysis, the Texas-based group said nursing home residents here received 34 minutes less direct care daily, when compared to the country’s top-ranked states, or an average 2.27 hours of direct care staffing hours per resident.  The state minimum in New Jersey is 2.5 hours, according to the Department of Health.

“They like to keep the profits close to the vest — to give it back to shareholders instead of staff,” Lee said.  New Jersey is the seventh most expensive state for nursing home care, according to a study, by SeniorLiving.org, based on the most recent data from the 2018 Genworth Cost of Care Survey. The average cost of a semi-private room in New Jersey is $10,646 per month or $127,752 per year, the study found. That compares to the national average of $7,441 per month or $89,297 per year.

McKnight’s reported on an analysis that shows nursing homes where a majority of residents are black or Latino were more likely to receive a penalty in the first year of the Value-Based Purchasing Program. Nursing homes with more than 50% of residents who are black were nearly 25% more likely to be penalized by the Centers for Medicare & Medicaid Services compared to facilities with mostly white patients, according to the findings published July 1.  The study looked at how nursing homes that serve minority populations were impacted by fines and bonuses that were first doled out last October. About 85% of nursing homes with mostly Hispanic or Latino residents received a penalty, versus about 72% of white-majority homes.

“The patterns of performance among SNFs serving vulnerable populations underlie concerns about incentive-based approaches to quality improvement,” researchers from UMass reported in Health Affairs. “While SNFS that perform poorly should not be rewarded for delivering lower-quality care, it is concerning that vulnerable populations may be disproportionately affected by penalties.”

The data also strongly correlated penalties with high-Medicaid populations.  Most likely because they get less reimbursement so they spend less on staff.

 

Melanie J. Hunter, a caregiver and registered nurse at Dycora Transitional Health, was charged with taking narcotic drugs that were meant to go to nursing home residents.  Hunter is charged with intentionally abusing residents-causing bodily harm. She could face up to six years in prison and a $10,000 fine if convicted of the charge.

This is sad and just one example of how the opioid abuse epidemic can affect everyone.

Health Leaders Media had a great article by RN Jennifer Thew on the need for more RN staffing at nursing homes.  A new analysis of payroll-based staffing data for U.S. nursing homes, uncovered large daily staffing fluctuations, low weekend staffing, and daily staffing levels that often fall well below the standards and reasonable expectations of the Centers for Medicare and Medicaid Services. In fact, the average weekend staffing time per resident day was just 17 minutes for registered nurses, nine minutes for licensed practical nurses, and 12 minutes for nurses’ aides.

The study, published in the July issue of Health Affairs, found that when compared to weekday staffing there was a large drop in weekend staffing in all staffing categories, based on CMS’ data resource, the Payroll-Based Journal which is provided by the nursing homes under penalty of perjury. To meet a requirement of the Affordable Care Act, CMS has been collecting data from nursing homes since 2016. PBJ data have been used in the federal Five-Star Quality Rating System for Nursing Homes since April 2018. Unlike previous nursing home staffing data that was self-reported by facilities and covered only a narrow window of time around a facility’s annual recertification survey, PBJ data are linked to daily payroll information for several staff categories and cover the entire year.

Additionally, using PBJ data from more than 15,000 nursing homes, researchers discovered that 54% of facilities met the expected level of staffing less than 20% of the time during the one-year study period. For RN staffing, 91% of facilities met the expected staffing level less than 60% of the time.

Staffing in the nursing home is one of the most tangible and important elements to ensure high quality care,” study co-author David Stevenson, PhD, a Health Policy professor at Vanderbilt University Medical Center says in a news release. “Anyone who has ever set foot in a nursing home knows how important it is to have sufficient staffing, something the research literature has affirmed again and again. As soon as these new data became available, researchers and journalists started investigating them, and the government now uses the PBJ data in its quality rating system.

“We found that the newer payroll data showed lower staffing levels than the previous self-reported data,” says co-author David Grabowski, PhD, professor of Health Care Policy at Harvard University. “The lower levels in the PBJ data likely reflect both the fact that they are based on payroll records as opposed to self-report, and also that staffing levels were abnormally high around the time of the inspection. In fact, the PBJ data clearly show this bump, followed by a return to normal after inspectors leave.”

Stevens says he hopes families and future nursing home residents become aware of and push back against these staffing practices.

“Hopefully, the general public will gain a broader awareness of the information that is available, not only on staffing but on other aspects of nursing home care,” Stevenson says. “The only way nursing homes will change their behavior is if there is value in doing so. Some of that can come through the pressure of regulators, but it also needs to come from incentives in the marketplace, notably from expectations of current and future residents and their families.”

 

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.