A federal jury awarded $1.75 million to a woman who said her sister lost her dignity in the last days of her life because of unhygienic conditions and improper care at a Charleston nursing home.

Tammy Rectenwald, 44, lived at Meadowbrook Acres on Greenbrier Street from March 1999 until October 2003.

On Oct. 8, 2003, she had chest congestion and other signs of pneumonia, but nursing home staff did not call her family or an ambulance.  When the nursing home called Taylor 12 hours later, she insisted that Rectenwald be sent to the hospital.

Rectenwald died a week later at Saint Francis Hospital, where doctors found evidence that she had been neglected, such as an infected catheter site and dirty nails and skin. 

Taylor sued Harrell Memorial Nursing Home Inc., which owns the nursing home, and Nursing Care Management of America Inc., which manages it. Both companies are based in Ohio. The jury found on April 20 the company failed to provide adequate care for Rectenwald.

The award is West Virginia’s second-highest nursing home verdict. “The only way to punish a facility and make them clean up their act is financially,” he said.

I ran across a sad but interesting article discussing the difficulties in choosing the right nursing home for a loved one.

The author was looking for the right place for his wife who suffered from Alzheimer’s Disease. He used the federal database (the Nursing Home Compare Database) that is supposed to help in choosing a nursing home for our loved one. This can be found at: www.medicare.gov/NHCompare.

He visited dozen facilities, making a careful inspection of each, before finally deciding on one that seemed just right.  Afterwards he realized, after reading an editorial in the Boston Globe, that he could easily have made a really bad choice.

The Boston Globe April 27 piece entitled, “Enforce Quality Care for Elders,” the Globe points out that the Department of Health and Human Services (DHHS) is failing in its duty to make sure that nursing homes correct their shortcomings and then continue to meet quality standards. That is the conclusion of an April 23 report Congress mandated from the Government Accountability Office (GAO). Here’s a quote from that report, referring to the Centers for Medicare and Medicaid Services (CMS):

In general, the effectiveness of CMS’s management of nursing home enforcement is hampered by the overall complexity of its immediate sanctions policy, intended to deter repeated noncompliance, and by its fragmented data systems and incomplete national reporting capabilities.”

You’ll find this report at: www.gao.gov/htext/d07241.html.

According to the Globe, the U.S. has more than 16,000 nursing homes, caring on an average day for about 1.5 million patients. Another report that Congress mandated dated Feb. 21, 2002 — more than five years ago — begins: “HHS Nursing Home Compare Website Has Major Flaws.”

This report said: “The report finds that ‘Nursing Home Compare’ has major flaws that can mislead families seeking to find a safe nursing home.”

Here’s what they’re hiding from consumers: the data on ‘Nursing Home Compare’ does not include tens of thousands of recent violations of federal health standards, including nearly 60 percent of the violations involving death or serious injury. 

Tthe Nursing Home Compare Web site is being used by millions of familiest. The Web site receives approximately 100,000 visits a month and is one of the most popular destinations for individuals who view the Medicare homepage. HHS says, “the most important information on this site is the searchable database that allows the public to determine the compliance status of virtually any nursing home in the United States.”

Despite this talk of compliance, the report shows that the HHS Web site in fact excludes information on many documented health violations in these nursing homes. Information is missing because Nursing Home Compare does not include the results of complaint investigations conducted by state inspectors.

You can read the whole thing. Just search on: “Nursing Home Compare Website Has Major Flaws.”

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

Oklahoma Governor Brad Henry has vetoed a tort reform bill that would have changed the way medical malpractice cases were litigated in the state.  Governor Henry said he found the bill unconstitutional and restrictive of citizen’s rights. 

One example he cited was a $300,000 cap on non-economic damages such as pain and suffering.  The bill would also restrict punitive damages in several circumstances.  Governor Henry says he will work with lawmakers to address some of his issues with the bill.

Read the article at :  http://www.insurancejournal.com/news/southcentral/2007/04/30/79077.htm

 U.S. Medicare Monday proposed a $690 million increase in payments to nursing homes. The 3.3-percent increase would go to nursing facilities that provide skilled nursing and rehabilitation care to Medicare beneficiaries, according to the Centers for Medicare & Medicaid Services.

Under the new payment schedule, called the skilled nursing facility prospective payment system, the daily rate for room, board, medical care and other expenses would be increased. Current payments are based on a 1997 market basket, but the proposal would update rates using a 2004 market basket.

Hopefully, this increase will lead to more staff who are better trained.

It is horrible how the U.S government treats war veterans.  This article discuss how a Phoenix, Az nursing home for veterans was cited for negligence because of mismanagement and understaffing.

State review blames staffing shortage for nursing home troubles.  A state government-run nursing home for veterans suffered from staffing shortages, poor morale and mismanagement.

The Governor’s Arizona State Veteran Home Review Team report said the Phoenix nursing home had problems with nursing shortages, high personnel turnover, poor organization and lack of direction from state administrators.   The vets home has been fined by federal regulators for poor care and some cases of patient negligence.

When two residents at a nursing home in Santa Cruz got eviction notices last March, they decided to fight them. They called Linda Robinson of Advocacy Inc., a Santa Cruz nonprofit, to help them file appeals with the state Department of Health Services. A little more than a year later, the issue is being resolved according to an April 11 memo signed by Kathleen Billingsley, deputy director of the state health department.

The April 11 memo affects nearly 900 nursing home patients in Santa Cruz County as well as 1,400 nursing homes statewide with more than 133,000 beds.

"In a year, dozens, maybe hundreds, of [eviction] notices are sent," Connors said. "They get issued way too often in my experience. Patients have the right to be protected from arbitrary transfers"

Billingsley’s April 11 memo to district managers covered policy and procedures for appealing eviction notices. It also said staff must receive training to make sure policy and procedures are followed.

Last year, a lawsuit was filed, complaining about a backlog of nursing-home complaints. This month, a state auditor, reporting on 17,000 complaints filed over two years, said the department had not completed about 60 percent of its investigations in a timely fashion.

See article here.

I have been surfing around on the internet today, and was looking at one of David Swanner’s most recent blog posts, where he talks about Stephanie Mencimer’s blog, The Tortelinni.  That led me to a post on there about tort reform and nursing homes.  That got me thinking . . .

This is an issue we deal with a great deal, and that we fight against every day – the idea that "frivolous lawsuits" are increasing insurance premiums for nursing homes to the point that they might have to close their doors.  Never mind the evidence the feds are not providing the oversight needed to prevent abuse and neglect in nursing homes in the first place.  Nevermind the amount of money some nursing homes are making.  Just look at this example.  $959 million in one quarter?!

What no one is talking about is the actual lawsuits being filed against these nursing homes.  What no one thinks about is what if it was your mother, your father, your husband or wife who lived in a nursing home where staff wouldn’t answer the call bell to take them to the bathroom, forcing them to lie in their own feces or urine for hours – add to that pressure sores without bandages, so that urine and feces soak into open wounds.  What no one thinks about is what if your family member was given the wrong medication which led to brain damage or even death?  This is not made up stuff, these are the kinds of cases we see all too often.  Put yourself in that position, and then lets talk about "frivolous lawsuits."

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Drug-maker freebies can lead to harm for patients, a new report from the highly respected New England Journal of Medicine warns. Consumers have reason to be concerned about the study’s findings.

Gifts (bribes?) showered upon doctors by drug- and medical device-makers have become so pervasive that they are a standard part of every physician’s practice. 94 percent physicians have a  relationship with the drug industry, according to a study scheduled to be published Thursday in the New England Journal of Medicine.

Consumers should care about such relationships because drug companies market the most expensive brand names; gift-giving influences prescribing behavior and therefore how much patients spend on prescriptions.

The study proves that many doctors do not follow the AMA voluntary guidelines. It notes, for example, that 35 percent of respondents accept reimbursement for continuing medical education or for travel, food or lodging for medical meetings.

A National Survey of Physician–Industry Relationships
E. G. Campbell and Others

I saw this article about a nursing home resident with dementia who killed his roommate and thought "how could this happen?" but then I read an article where a murder suspect was moved to a nursing home.  The suspect was charged in connection with a quadruple homicide. See story here

With the graying of the population and the incarceration of so many citizens on Medicaid, nursing homes will need to adapt at receiving dangerous criminals into facilities. This may lead to violence and tragedy in many nursing homes.

On a related note, there have also been issues with registered sex offenders becoming residents of nursing homes.  More often than not, neither family members nor residents are aware that this is occurring.  We found a website recently that family members and residents can use to search by facility, city or state to see which nursing homes sex offenders are currently living in, and I thought that was a great thing to have – for more information, click here.

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