WFMZ reported that a lawsuit was filed over the preventable death of a nursing home resident at Cedarbrook Nursing Home caused by a staffing shortage, a federal lawsuit claims. The suit claims the county-owned facility was “intentionally and grossly understaffed” when resident Shirley Liebenguth fell and later died in 2017.

On July 5, 2017, Liebenguth was being moved by a certified nursing assistant when she was dropped, hitting her face and knees and causing major injury, the lawsuit says.  She needed extensive assistance for all activities of daily living including transfers and bed mobility. Cedarbrook medical records note Liebenguth “rolled out of bed while she was being changed,” but the suit says her fall was “due to the CNA’s lack of training, instruction, supervision…”

She was hospitalized with femur fractures and other injuries, but ultimately died nearly 10 hours later after suffering cardiac arrest and being resuscitated several times, the suit says.

The suit claims Cedarbrook was “intentionally and grossly understaffed” causing a “significant decrease in care that should have been provided” in the two years that Liebenguth was a patient.

 

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.

WSBTV reported on another resident being sexually abused. This time it was all caught on a hidden video.  The sexual assaults are alleged to have occurred between June 1 and July 3 at an assisted living health care facility in Seattle.

Nshimiyiana O. Hamzat is accused of  repeatedly raping a disabled victim while he cared for her at the facility. He is charged with first-degree rape, second-degree rape and indecent liberties.  Police said Hamzat was employed at the facility as a nursing assistant and worked as a care provider to multiple vulnerable adults at the time of the sexual assaults.

The victim, a 50-year-old woman, complained to her family that she was being assaulted in the facility, according to prosecutors.

Police said a family member called police on July 2 to report the sexual assaults.

The family member then installed a camera in the woman’s room.

“The camera captured the defendant sexually assaulting her twice a day, on two different days. The videos did not capture the totality of the sexual abuse the victim suffered at the hands of the defendant,” prosecutors wrote in charging documents.

In a probable cause document, police said that when they contacted Hamzat he said he had not had any inappropriate sexual contact complaints and denied having done anything wrong.

When Hamzat was shown video of himself abusing the woman, police said he continued to maintain that he was doing patient care.

 

 

 

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.

 

The Atlanta Journal-Constitution recently reported that the family of a 94-year-old widow offered a $2,000 reward for information that leads to the conviction of an unknown man who they say sexually assaulted her at Governor’s Glen Memory Care and Assisted Living facility.

The Golden family alleges that the home didn’t handle the case properly. The family said police were not called for five hours, and the delay hurt the gathering of crucial evidence.  The day of the incident, Golden told nursing staff she had been inappropriately touched by an unknown man the night before, according to police. She said this around 9:30 a.m., according to Madden.

Governor’s Glen officials deny that Golden was the victim of a sexual assault.

“We believe nothing happened,” said Dennis Stamey, an operating partner with Canopy Lifestyles, which operates Governor’s Glen and five other facilities in Georgia.

 

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.

Oakbrook Health and Rehabilitation Center nursing home in Summerville, S.C. is facing two wrongful death claims. One claims a resident died from neglect and reckless treatment and care.  The suit says the woman suffered harm and died as a consequence of the neglect for failing to supervise and monitor this woman’s vital signs and failed to document and notify physicians of changes in her condition.

In February of 2019, DHEC investigated complaints of residents receiving medication late and there were more than 2,000 pages of documents on late administration and late charting of resident medications.

The suit says Oakbrook Health and Rehabilitation Center failed to notify the nurse until about nine hours later and did not sent her to the hospital. EMS was finally called later that day and the woman was admitted for an accidental overdose along with another infection.

The woman was able to return to the nursing home and then a month later she fell in the bathroom because of poor supervision.

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.”

 

In 1959, the Department of Housing and Urban Development (HUD) created a program that provides loans to start up new nursing homes and assisted living facilities across the US.  This program was meant to keep care for the elderly viable and affordable in rural or lower-income communities which would otherwise be unable to sustain such a facility. Since the program began, however, it’s become an easy way for some business owners to get loans backed on for-profit nursing homes that are practically doomed at the start.

Back in late 2013, Zvi Feiner and a group of investors bought the Rosewood Care Centers, a chain of 13 nursing homes and assisted living facilities in Illinois. The Department of Housing and Urban Development insured the loans for the centers’ creation, so they were automatically implicated when the Rosewood Care Centers went on a downward spiral. Feiner started losing money on the facilities soon after he bought them, with a team of investors, and began diverting Rosewood’s government-backed funds to other businesses. The HUD program eventually had to come to Rosewood’s rescue when their operation ran out of money and the agency had to take it over.

This HUD program is increasingly known for its lack of oversight and its loss of money on these nursing homes and assisted living facilities. Yes, owners like Feiner are at fault for moving those funds and allowing negligence in those facilities, but HUD backed those for-profit facilities and paid little attention to their nefarious activities before it was too late. Not only is the program poorly run and bad for the government financially, it’s also bad for the residents. Some studies are finding these facilities which take government backing, especially the for-profit ones, are more likely to receive bad quality ratings and ultimately endanger their residents.

The families of many Rosewood patients have filed lawsuits due to the facilities’ negligence. Other facilities backed by the HUD program face similar widespread issues. If the program continues the way it is, it might only further the danger surrounding the businesses it backs.

Back in 2015, the drug company Pfizer found a strong possibility that Enbrel, their rheumatoid arthritis medication, could significantly reduce the risk of Alzheimer’s disease. Based on an analysis of insurance claims, researchers from Pfizer found that Enbrel could potentially reduce Alzheimer’s risk by 64 percent.

Researchers in the company wanted to do more research relating to Enbrel’s connection with Alzheimer’s. Pfizer decided against it because it would not be as profitable.  Around the same time Pfizer made its decision not to support Alzheimer’s research with Enbrel, they also decided to shut down their neurology department where the testing would have occurred and lay off 300 employees.  Pfizer also had the option to publish its data for other researchers to use, but decided not to share the important research.

Some outside researchers and scientists think Alzheimer’s might be very closely related to inflammation and the correlation between Enbrel and Alzheimer’s prevention might not be coincidental.