The operator of South Star Ambulance Service alleges that Pruitthealth—Augusta Hills facility repeatedly tapped the ambulance company for inappropriate, non-emergency services over a two-year period, and is asking for more than $150,000 back for those trips. SSAS first filed suit against Pruitthealth—Augusta Hills on April 8 for repeatedly ignoring warnings to more judiciously use its services.

Regional Services, which operates the ambulance company, alleges that since the SNF is a Medicare-eligible provider, it should apply for reimbursement for non-emergency ambulance transport. The alleged inappropriate trips were made between August 2016 and September 2018, according to the lawsuit.

Parent company Pruitthealth is based in Norcross, GA, and operates about 180 facilities in Georgia, Florida, and North and South Carolina.

On June 12, 2019, a report released by the Health and Human Services’ Office of the Inspector General revealed that Nursing Home Abuse remains largely unreported. The report estimates that one-in-five high-risk hospital emergency room Medicare claims for treatment provided during the 2016 calendar year were the result of potential abuse or neglect, including injury of unknown source, of beneficiaries residing in skilled nursing facilities (SNF).

The report revealed that nursing homes are failing to comply with regulations established by the Centers for Medicare and Medicaid Services (CMS). Under these regulations, SNFs are required to report incidents of abuse and neglect to Survey Agencies, who are then required to report the incidents to the CMS or local enforcement agencies. However, both SNFs and Survey Agencies have been failing to meet their federal requirements. Currently, the CMS may not be doing all they can to prevent abuse as it does not require all potential incidents to be tracked in the Automated Survey Processing Environment Complaints/Incidents Tracking System.

The Office of Inspector General (“The Office”) is urging CMS to take action since “preventing, detecting, and combating elder abuse requires CMS, Survey Agencies, and SNFs to meet their responsibilities.”

The Office suggests that CMS work with Survey Agencies to train SNF staff on identifying and recording all potential incidences of abuse or neglect. They also suggest that CMS require Survey Agencies to record and track all incidents of potential abuse or neglect in SNFs, as well as all referrals made to local law enforcement and other agencies. CMS concurred with these recommendations and stated they are creating a plan to ensure more accurate reporting in the future.

James Riley was arrested for allegedly sexually contacting residents at the Good Samaritan Home nursing home he worked at as a Chaplain.  Riley, 58, of Quincy was charged with Aggravated Criminal Sexual Abuse of a Person Over 60.

The police were notified and advised that residents had alleged inappropriate sexual contact by the Chaplain, Riley, who is no longer employed at the home.

 

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.

Kaiser News recently reported that many seniors are so scared of the thought that they will be abused and neglected in nursing homes that some discuss “rational suicide”.  The concept of rational suicide is highly controversial; it runs counter to many societal norms, religious and moral convictions, and the efforts of suicide prevention workers who contend that every life is worth saving. More seniors are weighing the possibility of suicide, experts say, as the baby boomer generation — known for valuing autonomy and self-determination — reaches older age at a time when modern medicine can keep human bodies alive far longer than ever.

Is it better to die on your own terms?  The question itself is taboo. Many want the option to take “preemptive action” before their health declines in their later years, particularly because of dementia. A Kaiser Health News investigation in April found that older Americans — a few hundred per year, at least — are killing themselves while living in or transitioning to long-term care. Many cases KHN reviewed involved depression or mental illness.

Dena Davis is a bioethics professor at Lehigh University who defends “rational suicide” — the idea that suicide can be a well-reasoned decision, not a result of emotional or psychological problems. Davis, 72, has been vocal about her desire to end her life rather than experience a slow decline because of dementia, as her mother did.

Suicide prevention experts contend that while it’s normal to think about death as we age, suicidal ideation is a sign that people need help. They argue that all suicides should be avoided by addressing mental health and helping seniors live a rich and fulfilling life.

Public opinion research has shown shifting opinions among doctors and the general public about hastening death. Nationally, 72 percent of Americans believe that doctors should be allowed by law to end a terminally ill patient’s life if the patient and his or her family request it, according to a 2018 Gallup poll.

If you or someone you know has talked about contemplating suicide, call the National Suicide Prevention Lifeline at 800-273-8255, or use the online Lifeline Crisis Chat, both available 24 hours a day, seven days a week. People 60 and older can call the Institute on Aging’s 24-hour, toll-free Friendship Line at 800-971-0016. IOA also makes ongoing outreach calls to lonely older adults.

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.

Voorhees Care and Rehabilitation Center lost its air conditioning on a hot summer day.  While temperatures rose throughout the day placing residents and caregivers, management refused to do anything about the dangerous and oppressive heat.  A worker said many of the lights in the building were off to try to keep the place cool. Nursing home facilities in New Jersey are required to establish a written heat emergency action plan which mandates the procedures to be followed if the indoor air temperature is 82 degrees or higher for a continuous period of four hours or longer, officials said.

Finally, a visitor was so concerned about the community, the police were called as the heat wave sent temperatures outside to triple digits.  Dozens of first responders began arriving to help evacuate more than 100 residents out of the facility.

Nursing home owners and operators declined to say why they did not alert anyone to the crisis, or what went wrong with their air conditioning system.

The nursing home is rated at the bottom for its quality of care, ranked “much below average,” according to the most recent report by the U.S. Centers for Medicare & Medicaid Services. That report in April 2018 concluded the facility had failed to maintain a clean and sanitary environment that was in good repair.  According to state health officials, the department was never notified by the facility about the deteriorating conditions, and was not involved in the evacuation.

Inside the facility’s lobby, though, it still felt muggy in the early afternoon. A portable air conditioning unit sat on the floor near the entrance, an exhaust tube snaking into the ceiling.

Reuters had an interesting article on a recent study found in JAMA Internal Medicine.  Numerous nursing home residents develop preventable health problems after they are returned from the hospital in stable condition, a new study shows.  More than half of the complications were related to poor residential care resulting in preventable conditions like pressure ulcers, skin tears and falls, the study found.  Another 28% of adverse events involved infections. A total of 38% of the complications were serious.  7.4% were life-threatening. 2.1% were fatal.  About 70% of the adverse events were preventable, researchers report in JAMA Internal Medicine.

“Adverse events are occurring due to transition related issues (such as being released from the hospital too soon as well as deconditioning requiring increased support from nursing home staff including monitoring to prevent falls, turning in bed to prevent/heal pressure ulcers, and gentler handling to prevent skin tears,” said

“Families should advocate for their loved ones and make sure they do not leave the hospital too early,” Dr. Alok Kapoor, lead author of the study and a researcher at the University of Massachusetts Medical School in Worcester said by email.

“It is important to realize that a nursing home patient who was recently hospitalized is at very high risk for problems over the next several weeks,” Bhatt said by email. “So don’t think they are out of the woods yet.”

Landon Terrel has been convicted of elder neglect for his actions against  91-year-old Adam Bennett who died last year. On Aug. 15, 2017, Bennett was found in his room at Sunrise Assisted Living Center with a bruised lip. Bennett told a day-shift caregiver: “He punched me,” while motioning to his face, chest, and groin. Soon after, Bennett became unresponsive.

Caregivers at the facility called for an ambulance. He was rushed to WellStar Kennestone Hospital, where his injuries included facial bruising, multiple rib fractures, and a collapsed lung. He never regained consciousness and died on Aug. 18. Cobb’s Chief Medical Examiner, Dr. Christopher Gulledge, ruled Mr. Bennett’s death resulted from blunt force trauma as a result of assault.

Evidence collected by police showed that Terrel was the only male working the overnight shift at Sunrise that night. Terrel denied hitting Bennett and insisted he saw no facial bruising when he last checked on Bennett just before his shift ended at 6 am. But he told investigators he “caught” Bennett as he fell out of bed the previous evening and Bennett had banged his chest into the bed. Terrel said he checked on Bennett hourly throughout the night and that Bennett repeatedly complained of pain. Terrel admitted he used “poor judgment” in repeatedly ignoring those complaints.

After a week long trial and about three days of deliberations, a Cobb jury convicted Terrel of elder neglect and found him not guilty of two counts of elder abuse and one count of felony murder based on abuse. The jury was unable to reach a unanimous verdict on the charge of felony murder based on neglect. Terrel faces up to 20 years in prison.