News4Jax had an article about a nursing home Administrator indicted for embezzlement, money laundering, credit card fraud and identity theft, accused of stealing hundreds of thousands of dollars from Riverview Nursing and Rehabilitation Center.  Mary Burroughs stole the money over a one-year period from the center, a nonprofit organization that received millions of dollars in federal funding.

"The U.S. Attorney’s Office is committed to investigating and prosecuting financial fraud and regaining what victims of these crimes have lost," U.S. attorney Edward Tarver said in a news release.

According to the indictment, between May 1, 2009, and April 30, Burroughs used her position as administrator to cause Riverview to issue multiple checks from its Wachovia money market account to cash, which she then used to purchase cashier’s checks made payable to Burrough’s Heating & Air and others.  Burroughs embezzled more than $235,000 from the Riverview money market account.  In addition, the indictment says that Burroughs used a Riverview credit card in the name of an employee she had terminated to make thousands of dollars of unauthorized and personal charges.

The indictment also says that Burroughs, without permission or authority, had others rip out copper piping and other metal objects from a Riverview building to be sold as scrap metal.

The indictment charges Burroughs with five counts of stealing from a program receiving federal funds and one count of credit card fraud.  Finally, the indictment charges Burroughs with one count of aggravated identity theft, which requires a two-year consecutive prison sentence to any other sentence imposed.

Nursing home partners in the ownership and operation of hundreds of nursing homes are fighting and suing each other for the fraud they have perpetuated for the last decade.   New York real estate investor and nursing home owner/operator Rubin Schron is suing his partners (in fraud) Troutman Sanders, Leonard Grunstein, and Murray Forman.  See Complaint here.

Schron accuses Troutman, Grunstein, and Murray Forman of breaching their fiduciary duties to benefit themselves at Schron’s expense, according to this report by Bloomberg.  The Am Law Daily reported on federal charges against Schron, Grunstein, and Forman over their involvement in a $50 million kickback scheme with nursing homes and pharmaceutical providers. In February all three reached a $14 million civil settlement with federal prosecutors in Boston. 

"This case is about the systemic exploitation by self-interested attorneys and bankers of clients who entrusted them to devise and implement the terms of complex business deals that these defendants arranged and advocated for their clients," states Schron in his 97-page complaint.  Grunstein served as principal outside legal adviser to the real estate investor and his companies from the 1980s until late last year. The suit accuses Grunstein of causing "hundreds of millions in dollars of damages" to Schron.  Also named as defendants are Grunstein’s brother and business associate, Harry Grunstein, and Troutman M&A and project finance partner Lawrence Levinson. 

"Grunstein facilitated his tortious conduct by his association with these firms," states Schron’s complaint. "Grunstein frequently used their letterhead for his schemes, and he was assisted by the active complicity of several partners, including defendant Levinson. In reward for facilitating Grunstein’s misdeeds, these law firms received tens of millions of dollars in legal fees from Schron and the Schron Entities."

The complaint further claims that Grunstein and Forman brought investment opportunities to Schron that they themselves took stakes in without contributing cash or assuming risk. Schron claims that he alone bore the risk from these transactions, with Grunstein and Forman later becoming involved in a series of deals in the nursing home business that drew the attention of federal prosecutors.

The trio have been caught up in a tangle of litigation. Grunstein and Forman filed suit against Schron in March, claiming he misappropriated funds from entities created by the two business partners and failed to keep and maintain audited financial statements.  "Underlying all of the claims in this action is Schron’s pattern of betraying the trust placed in him," state Grunstein and Forman in their 38-page complaint,. Grunstein and Forman are seeking $100 million in damages from Schron, several of his relatives, and their affiliated holding companies. 
 

 

The Business Journal reported an incredible story about Sunrise Senior Living giving bonuses to executives who have lost $16 million in the last year.  This is what is wrong with Corporate America.  Sunrise takes taxpayer money through Medicaid and Medicare; provides poor care while stuffing their pockets, and then before declaring bankruptcy siphon the rest of the money by paying themselves bonuses for poor performance.. 

Sunrise Senior Living, Inc., is paying 2010 bonus payments to its executive officers, equal to one-third of their respective target annual bonus amounts, according to a filing with the Securities and Exchange Commission. The compensation committee of the company’s board will pay CEO Mark Ordan $325,000, while CFO Julie Pangelinan and CIO Gregory Neeb will receive $133,333 each.

 

As stated in the SEC filing, the "compensation committee" awarded the bonuses to these executive for their “extraordinary work” during the recession. Sunrise reported a net loss of $16 million during the first quarter of 2010. The company is also in default on $241 million of debt.

 

All three executives remain eligible to receive the remainder of their 2010 bonuses at the discretion of the compensation committee.

 

Milwaukee-Wisconsin Journal Sentinel had an article about the horrible care and fraudulent documentation at Mount Carmel Health and Rehabilitation including 35 violations of regulations for minimum care.  "Records also show, however, that the 35 citations issued so far this year to Mount Carmel are close to the 40 citations issued in all of 2009 and more than the 25 issued in 2008, according to the state Department of Health Services."

Staff at the state’s largest nursing home recorded on charts that a 41-year-old brain-damaged resident was in his bed watching TV when he was sitting in jail. The man spent five days in custody,  Staff had continued to mark on charts that he was at the facility through the night and into the morning of May 17. 

The man wandered away from Mount Carmel and was arrested for "prowling" more than four miles away.  The nursing home was aware that he was a wandering risk and were ordered by phyisicians to check on him every 15 minutes. The other violations cited this year include failing to communicate with a recent amputee and failing to provide for five residents at risk of falling, including one who was hospitalized for a broken jaw after falling out of his wheelchair.

Licensed for 473 beds, Mount Carmel is the largest of the 397 nursing homes in Wisconsin, according to the Department of Health Services. In January 2009, Kindred Health Care, a Louisville, Ky., for-profit company resumed operation of Mount Carmel. After operating with a probationary license for one year, Kindred was given a full license in January of this year.

The citations issued this year include two identifying "actual harm" to residents and five for violations that constitute a "direct threat to health, safety and welfare," state records show.

Other citations
Among other things, Mount Carmel was accused of:

• Failing to provide appropriate supervision and assistive devices to five out of 10 residents identified by Mount Carmel as being at risk for falls.

Three of the five had fallen since last December, including one who suffered a broken jaw and an eye socket "blowout." A hospital that treated the woman reported the incident to the state but Mount Carmel, which was required to report the incident, did not.

• Failing to assess and treat pain, depression and other problems experienced by a 51-year-old woman.

• Sixteen of 32 residents reviewed were not treated "in a manner that maintained their dignity."

Two were kept in a small alcove near an exit; at least six were kept in an old nursing station or in a hallway for extended periods; and an incontinent resident said staff turned off his call light four times after he sounded it and had a bowel movement before any staff took him to the toilet.

The September inspection also found that after a resident complained of hip pain, Mount Carmel did not notify a physician for two hours and 15 minutes. The doctor ordered an X-ray, but the order was not relayed by a nurse for 2 1/2 hours. The X-ray revealed a broken hip.

The article had a Summary of violations Mount Carmel Health and Rehabilitation Center in Greenfield was cited for 35 state and federal violations so far this year. Among them:

March 2010: A 51-year-old resident who had her right leg amputated below the knee in December 2009 did not have staples removed as of March and no adequate assessment or treatment of the resident’s "phantom pain" in the leg had been done.

Mount Carmel also was cited for failing to communicate with the resident, who did not speak English, in Spanish. Among other things, staff was not aware that the resident experienced phantom pain and that she had been dropped by staff. A registered nurse told an investigator she didn’t need a Spanish interpreter because relied on documents and the resident’s gestures and facial expressions.

Also in March, an investigator found that 16 of 32 residents reviewed were not treated "in a manner that maintained their dignity." Two had been transported in shower chairs with bare legs or buttocks exposed; two were kept in a small alcove near an exit; at least six were kept in an old nursing station or in a hallway for extended periods; an incontinent resident said staff turned off his call light four times after he sounded it and had a bowel movement before any staff took him to the toilet.

January 2010: A federal investigator finds that, going back to December, five out of 10 residents identified by Mount Carmel as being at risk for falls did not receive appropriate supervision and assistive devices, and that three of them fell. A 92-year-old resident who needed supervision was dropped off at a medical appointment by herself. .

Dec. 3, 2009: A resident who lacks the ability to move in bed, is found on the floor next to her bed. She suffers a broken jaw and an eye socket "blowout," according to a federal investigator. The hospital reported the injuries to the state Office of Caregiver Quality, but Mount Carmel, which is required to make a report, did not. When the investigator asked a Mount Carmel administrator on Jan. 11, five weeks after the incident, whether Mount Carmel had reported the incident to the state, the administrator said no report had been made because Mount Carmel "felt they knew how the incident occurred."

Nov. 5, 2009: Resident suffers laceration to left palm requiring sutures in a hospital emergency room. Hospital reports the injury to the state, but Mount Carmel did not. Mount Carmel could not determine how the incident occurred.

 

Happy Father’s Day! 

A friend recently sent me an insightful article written by Anna Mae Halgrim Seaver in 1994 called My World Now (Life in a nursing home, from the inside).  Her son found these notes in her room after her death.
Ms. Seaver does an incredible job of explaining her life and the life of too many residents in nursing homes.  What is also amazing is that things have not improved much since 1994.

 

Business Week had an article about National Healthcare Corp. (NHC).   Nursing home and assisted-living center operator National Healthcare Corp. said Tuesday that its fourth-quarter profit rose 80 percent on a boost in patient revenue.

The company earned $5 million, or 37 cents per share, compared with profit of $2.8 million, or 21 cents per share, in the same quarter a year before. Revenue rose 4 percent to $168.5 million from $161.8 million. For the full year, the company earned $31.4 million, or $2.31 per share, up from $27.7 million, or $2.11 per share, in 2008. Revenue rose to $668.2 million from $633.2 million.

National Healthcare and its affiliates operate 76 long-term health care centers, along with 33 home care programs, 7 independent living centers and 15 assisted living communities. Other services include Alzheimer’s units, long-term care pharmacies, hospice, a rehabilitation services company, and management and accounting services to third parties.

National Healthcare shares rose 19 cents to $37.64 in morning trading.  See NHC’s press release here.

 

Mary Fridley at Gero-Resources wrote the following for The Capital. 

DEAR MARY: I just lost my dear husband of 65 years to Alzheimer’s disease. Mary, you would hardly believe the many times I thought about you during his stay in the hospital and nursing home. I am so glad we had the experiences of the wealth of knowledge you shared through the many workshops and seminars we attended together.

During this difficult period there were many times I thought how much the staff would benefit from your depth and detail of knowledge of dementia care. I was horrified by how they handled him; like he was a piece of meat. One time two aides were moving him up in the bed and slammed his head into the headboard. No one talked to him like he had any sense at all. Even the doctor dismissed him as if he should just die.

He was capable of following directions if they took the time to tell him what to do. Instead, they just did things without warning, which frightened him. I think they could learn a lot by being in bed for a day and having someone tend to all their needs. They would discover how humiliating and degrading an experience it is.

My husband was a person and the love of my life, and I would do anything to have him with me today – even in his Alzheimer’s state. He was a gentle, loving soul who would never hurt anyone. I am heartbroken over this experience.

DEAR READER: Please accept my sincere condolences on the loss of your husband. And I am sorry your final days together were so dreadful. No matter how often I hear this story (and I’ve heard it many times), it never fails to outrage me. The staff broke the most basic rule of care: to see the person, not just the disease.

It should be required that people take a sensitivity course before they work with the elderly. They should be put through the rigors of daily care, such as you suggested, experiencing first hand what it’s like to be on the receiving end. I hope your letter sparks discussion among staff to do better.

I know you are grieving, but I encourage you to write a letter to the administrators of the offending facilities. They need to know about your experience. Peace be with you.

___________

I like that.  See the person, not just the disease.  Nursing home employees especially unqualified CNAs do not get enough training on how to take care of demented residents.  It is a shame and a disgrace.

Auburn Pub had a great article on the increase of family caregivers, and the problem of burn out, frustration, and exhaustion that naturally arises.  The article is based on information from New York but the results and demographics apply nationwide.

2.2 million New York residents are the caretakers of a parent, spouse, grandparent or friend. Their work is worth about $25 billion, which reduces state and federal health care costs, according data from the AARP, and allows the sick to remain at home.  T he emotional cost for caregivers is immeasurable. Many caregivers have only a few hours to themselves a week, become secluded from their community because those they care for cannot leave home or be left alone, and neglect their own health from being so focused on the health of someone who will not get better.

More than half of caregivers live with the person they care for, and spend with that person anywhere from 10 hours a week to 24 hours day, according to a study by the state Office for the Aging that surveyed 1,109 caregivers between May and June 2008. The study, which aimed to identify New York’s caregivers and their needs, found that the average caregiver is a white female caring for a parent or a husband.

The study, “Sustaining Informal Caregivers,” shows that a majority of caregivers, 75 percent, care for someone who has been diagnosed with Alzheimer’s disease or another form of dementia. About half say the person they care for cannot be left alone. They reported an average of 10.3 hours a day spent providing care – more than a full-time job.

Guilt, isolation and physical exhaustion are only a few of the side effects of full-time care giving. The job can have serious health consequences, said Dr. David Strickland, director of the Center for Behavioral Health at Auburn Memorial Hospital.

Full-time caregivers commonly experience clinical depression, sleep deprivation and inadequate nutrition. The frustration that builds while caring for another person day in and day out can turn into anger, and anger can lead to depression or thoughts of harming the person receiving care, Strickland said. He said the guilt of feeling negatively toward someone whom they still love often leads caregivers to ignore mental health problems, such as suicidal feelings.

“Accept these things do occur and are not to be ashamed of,” Strickland said, rather than ignoring – and exacerbating – the problem.

Caregivers should contact a doctor with any serious health problems, but interaction with others, especially other caregivers, can help manage the daily stress, Strickland said.

Cayuga County’s Office for the Aging networks caregivers, educates them about the diseases they deal with and helps them find ways to cope, by connecting them to aids, recommending day programs or just lending an open ear. The decision to make the move to a nursing home is among the hardest decisions caregivers make.  But it is a move Strickland advises caregivers to see as an opportunity. Nursing homes can manage the daily hygiene and medication that are among the most stressful tasks of caring for someone, making time spent together enjoyable again, he said.

“You don’t have to be a caregiver,” Strickland said. “You can be a sibling, a child, a relative.”

The fear that nursing home staff will not be able to provide adequate personalized care available at home is a major reservation for people considering the move.

Coping strategies

Tips for stressed caregivers from Dr. David Strickland, director of the Center for Behavioral Health at Auburn Memorial Hospital:

Recognize you are not alone – join a support group. Resources such as the county Office for the Aging and the Alzheimer’s disease Web site can direct you to groups for caregivers that meet regularly.

Take time for yourself – write it in your schedule. Even if you can spare only an hour, spend a little time every week doing something you enjoyed doing before you became a full-time caregiver.

Build a relief system. Keep in touch with friends and family who can lend a hand in caretaking or lend an ear to listen when you need to talk.

Look into respite care. Many facilities offer overnight stays for both you and the person you care for that allow you to take a break without being far away.

Do not ignore your mental health. Know the signs of depression – sleeplessness, guilt, hopelessness, and suicidal thoughts – and consult a doctor if you recognize them in yourself.

Palm Beach Post had an article about the incredible compensation given to an absent CEO of a  group of nursing homes. Most of the money comes from taxpayers.  Chief Executive Officer Maxcine Darville, a former dress shop owner with a nursing license, has taken home $404,000 in annual compensation from the Okeechobee Council on Aging Inc. and the Council on Aging of Florida Inc.. That’s more than double the state and U.S. averages for CEO pay at nursing-home nonprofits of comparable revenue, according to survey data.  Various nursing homes in Pahokee, Gainesville and Bradenton are funneling more than $1 million a year through a maze of nonprofit corporations that benefit a CEO, along with her daughter and son, a Palm Beach Post investigation shows.

Among The Post’s findings:
Darville’s daughter, Assistant CEO Joanne "Jody" Watson, was paid more than $200,000 plus $23,000 in expenses from the two councils. She received $160,000 a year later. Darville’s son, Gary Watson, the director of maintenance, was paid nearly $118,000. Darville has spent more than $30,000 on annual expenses. She took out a $50,000 loan from the parent council. She gets $1,200 a month to board an unnamed "visiting executive" in a residence she owns.

One member of the board of directors that the Okeechobee Council on Aging lists in 2009 state corporate records, Martha Stoner, died two years ago. Another, Johnie Blevins, said she was "forbidden" to talk to The Post.

Other allegations include nonprofit funds have paid for cars – including a BMW 325ci with a base price of $32,300 and a Cadillac Escalade with a base price of $57,465 – or a $1,708 whirlpool tub with Roman Tub Faucet ordered from a Home Depot in Johnson City, Tenn., and delivered to a Newland, N.C., address where Jody Watson is a part-time resident.

Receipts show the daughter writing checks to herself and other family members on an account for the Okeechobee Council on Aging Inc., doing business as Big Lake Housing – an apartment complex the nonprofit owns next to Glades Health Care Center in Pahokee. On the same day in March 2005, for example, Jody Watson signed checks of $1,000 to herself and her mother and one for $1,200 to her brother without a notation for the purpose, receipts show.

Checks on that account also have paid for tens of thousands of dollars in credit card charges over several years at businesses such as Kahootz Draft House in Okeechobee, Cloud 9 Spa Salon in Gainesville, Burdines, Dillard’s and hotels in North Carolina and Tennessee, receipts show.

The executive compensation saddens and baffles the family of Doris Bullock, a patient at Glades Health Care Center who died last year at age 88 from internal bleeding after an unexplained blow to the head.  The family is still seeking answers about how a frail woman who needed help getting into a wheelchair could sustain a traumatic head injury, and wind up back in her bed with no one the wiser.

"It’s frustrating," Bullock’s granddaughter Felisha Whitehurst said. "That’s taxpayers’ money, and it’s not being spent sufficiently where it should be."

Darville’s $30,385 expense allowance works out to $14.60 per hour in a standard work year – more than the $11.43 median hourly salary of a nursing aide, orderly or attendant in the state, according to research by Florida International University.

In a separate investigation, a Glades Health Care worker was convicted of elder abuse in 2007 for slapping an 89-year-old patient in the face and saying "I can’t stand you," according to state records. A year earlier, the nursing home had rehired the certified nursing assistant months after she got out of jail on charges related to forgery, investigators found.

Riverfront Nursing and Rehabilitation Center in Bradenton was placed on a watch list with a conditional license from the state last year. AHCA inspectors cited 31 violations since July 2007, faulting management for, among other things, its handling of a suspected abuse case. In records filed in January of this year, Darville signed a settlement as CEO of the Bradenton Council on Aging LLC agreeing to pay $13,500 in fines and fees. The facility has been removed from the watch list but maintains a one-star rating, as does a sister facility, the Gainesville Health Care Center.

Meanwhile, patient advocate Anna Spinella of Tampa has a word for hefty executive pay and perks at nursing homes with troubled records: "Obscene. The purpose of a nursing home is to care for residents."

 

Somebody sent me this article from Cityfile.com.  It is about The Carlyle Group having to sell their corporate jets.  The Carlyle Group owns and operates the ManorCare nursing homes throughout the country.  They are notorious for under-staffing and neglect.  Below is part of the article although the Cityfile website has additional information.

You can add The Carlyle Group to the long, long list of financial firms looking to cut back on their private jet budgets. The Washington-based private equity giant that counts members of the Bush family as investors is now looking to unload its 2004 Gulfstream G450. Like its rivals, it’s been a challenging few months for Carlyle, which was ranked the largest private equity firm last year by Private Equity International. In December, the firm announced plans to slash 10 percent of its staff—the first layoffs in Carlyle’s 20-year history—and it also said it planned to close down its Silicon Valley office. The jet broker responsible for selling the G4 didn’t indicate how much Carlyle is hoping to get for the plane. (Similar models run about $30 million.) But if you’re in the market for a jet that’s made its fair share of trips to Kennebunkport and Crawford, you may want to set aside a little extra to replace all the gaudy gold plating in the bathroom and kitchen. Photos and detailed specs after the jump.