In an effort to increase transparency, the Physician Payments Sunshine Act, a provision of the Affordable Care Act, began August 1. The provision mandates that doctors and medical companies reveal their financial relationships.  This will allow consumers to know if the physician is biased or has a financial incentive in providing certain medications or services.

The provision is helpful in increasing transparency among doctors and large companies. The financial data revealed under the provision can help draw connections which can establish a link between a doctor and a pharmaceutical company, for instance. The provision could cause doctors to meet with pharmaceutical companies less, which would decrease unnecessary meeting and spending, but would also decrease some necessary interactions. For more on the provision and how it could affect doctors, read the full article at Kaiser Health News.

McKnight’s reports that the Centers for Medicare & Medicaid Services (CMS) recently updated their operations. New F-tags mandate that facilities must give notification at least 60 days before closure. Once given, the facility mustn’t admit any new residents and must submit a transfer plan for residents of the facility. Additionally, there were updates on tags F203 and F204. Ftags are the interpretative guidelines used by surveyors to determine if a nursing home is complying with standards from the Federal Nursing Home Act.

In a recent report in Wisconsin, 40 nursing homes have been listed as having a ‘substandard quality of care.’  See article at WAOW.  This tag comes with additional federal scrutiny on the homes, many of which have a history of violations and citations. Some were even on the list in 2011, marking them as consistently below the line when it comes to quality of care. The substandard homes are being watched more closely by the state and federal authorities, prompting a more immediate response to violations and citations than in the past.

Additionally the homes aren’t allowed to train new CNAs for a period of two years after the listing. The list may be a good thing, resulting in extreme watchfulness and immediate action, but if it is such a strong list to be placed on, how come homes have been on the list more than once?   If authorities responded immediately to violations and citations, and the list was a strong deterrent to providing poor quality of care, then something is getting lost in translation, because homes are staying on the list – not improving, not closing, but maintaining a state of care that is substandard.

Is that where you want your loved one to be?

Autumn Healthcare of Zanesville, OH is being shut down by the Ohio Department of Health and Ohio Attorney General, Mike DeWine. The 100 bed facility is being closed because of patient neglect. ODH received several complaints from family members about the facility, and entered into an investigation with the families’ permission. They installed several hidden cameras in the rooms of multiple patients, which revealed that staff were neglecting to provide medical, nutritional, and personal care to at least one patient.

Some staff were falsifying documents so it would appear that correct treatment had been given. After these videos, ODH conducted an inspection, and cited the home for violations of infection control, treatment and care, food and nutrition, and resident rights.

This particular facility has been on the Centers for Medicare and Medicaid Services’ watch list, Special Focus Facilities, for the past 53 months, identifying the home as one with a history of issues. All of the home’s residents are being transferred to other facilities. The move is being coordinated by the Ohio Department of Aging and all patients will be moved after the remaining days of the home’s operation are up.

See article at NBC4i.

In an update about the ongoing battle against DHEC, SC and Greenwood Co. School District 52, WSPA reported that the numbers for the TB outbreak in Greenwood exceeded the previous estimate. 55 students and 18 non-students, a total of 73 individuals have been exposed to TB. The numbers are a stark reality in the ongoing saga, with the reported numbers being much higher than the last DHEC report indicated.

At least five lawsuits are being brought against DHEC for negligence in their treatment of the tuberculosis outbreak. The attorneys say that the main goal of the suits is to force DHEC to respond as any other government agency would, with efficiency and promptness. In the months before the outbreak, DHEC reportedly urged the school to keep quiet about the infectious disease. That cover up and lack of action have transformed what could have been an isolated incident of TB into a full scale outbreak. Details about the exposure and DHEC’s lack of response are still forthcoming. One thing is for sure, this outbreak is not going away anytime soon, it will require medical attention and continued screening to ensure that the TB outbreak doesn’t spread even further than it already has.

The Tennessean had an article on the report recently released by the state of Tennessee detailing serious complaints about the Imperial Gardens Health and Rehabilitation Center in Madison. The 143 page inspection report uncovered many instances of delays of necessary medication, lack of necessary medication, transcription errors which led to overdosing, under dosing, and giving patients wrong medications. In addition to medication mistakes, there were cases cited in the report detailing lab test results which were not sent to physicians or never completed, contrary to physician’s orders. The report also discloses instances where patients were placed in harm through neglect. In one instance, a patient’s head was stuck between his mattress and bed rail. Another patient wandered undetected outside in near-freezing temperatures, concluding with him being picked up by a passing emergency vehicle near a busy street.
The inspection report is the result of a series of complaints from residents and family members. However, complaints come not only from the patient side, but the care side as well. Some facility staff were so discouraged by the conditions that they immediately transferred. In one instance, a family member reports that a staff member encouraged her to file a complaint because the conditions were so bad. The report cites facility records, discovering that the Administrator was aware the facility was not meeting state standards for staffing. This lack of staffing led to the neglect of everyday necessities, such as showers, meals, and waste removal. It was also cited as contributing to the development of several patients’ pressure sores and a delay in necessary treatment.
This report details the serious neglect occurring at the Imperial Gardens Health and Rehabilitation Center. The 143 page report covers the spectrum of nursing home neglect for the facility which had at the time of this report, 118 patients. Because of this report, the state has effectively shut down the facility, refusing new admissions to the home and beginning the transfer process for the residents. Medicare and Medicaid Services have barred funding for new patients and will cover current residents for only 30 days. Spokesman for Vanguard Healthcare, the owner of Imperial Gardens Health and Rehabilitation Center, said that decertification will begin immediately and that a monitor has already been appointed to oversee patient transfers.
With 2 other Vanguard owned homes in the Nashville area alone, the transfer facilities may still be under Vanguard Healthcare, which requires a concern for those facilities’ conditions of care. Since rampant neglect occurred on Vanguard’s watch at Imperial Gardens Health and Rehabilitation Center, who is to say that it isn’t occurring at the other two facilities? And how will the state of Tennessee move forward with that in mind?

Villaspring, a nursing home in Kentucky, will pay $350,000 to the federal government and improve their care after settling a lawsuit over fraudulent charges. The home charged Medicaid and Medicare for services that were never performed; in some cases going against the orders of physicians, neglecting to treat and monitor patients, and being short staffed in their care.

In 2007, Kentucky issued the home a Type A citation, the most severe citation, for the facility’s neglect to treat pressure sores that resulted in an environment of imminent danger, serious physical harm, and death.   This lawsuit settlement has provided not only financial recompense for Medicare and Medicaid spending but has also provided its residents with a commitment to improvements within the institution.

According to the terms of the settlement, the nursing home will hire a third party consultant to help improve the facility. This consultant firm will also be responsible for submitting quarterly reports to the US Attorney’s Office. This settlement is the first of its kind because it demonstrates a commitment not only to justice for those who have been affected by the home, but for justice of those who will be affected.

See article at

Iowa’s Heartland Connection reported that Golden Age Nursing and Rehabilitation Center has been fined $15,000 following the death of two patients.  Inspectors found that the nursing home has repeatedly failed to provide the minimum level of care for residents at the facility.

The home was fined $8,000 in September after the death of a 64-year-old woman.  Now the fine of $15,000 is connected to the death, in November, of a 91-year-old woman. An 89-year-old woman also died around the same time.

The Times News reported the closing of Sava owned and operated Brian Center of Weber City with an extensive history of compliance problems after the federal government finally took action to terminate its ability to accept Medicaid and Medicare reimbursements.  The facility is now known as Continium Care of Weber City.

“According to a nursing home license application filed with the Virginia Department of Health Office of Licensure and Certification in October 2010, the facility is managed by Continium Health Care Management LLC located at 10800 Biscayne Blvd., Suite 810, Miami, Fla. The LLC’s president/chairman is listed as Avi Klein of Miami.”  Klein’s partners include Abraham Shaulson, Murray Forman, and Leonard Grunstein.  I’m sure they bled the facility dry before closing the facility down.  In October 2010, the facility, which was then known as the Brian Center, was investigated by the Internal Revenue Service for possible violations of wire fraud, mail fraud, health care fraud and money laundering.

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The Star Online reported that Nightingale Nursing Home and three others were fined a total of $64,500 for various offenses related to mistreatment of elderly patients and employment standards.  These offenses ranged from failing to provide a patient with quality care consistent with approved standards of nursing practice to withholding overtime pay from staff working more than 8 hours at a time.

In one case, nursing home staff were caught on film throwing an elderly patient onto a bed and slapping her. Judge Hamidah Ibrahim, the presiding Judge in this case, viewed Nightingale Nursing Home’s treatment of its elderly patients as “offensive, unacceptable, and inexcusable,” and hopes to set a precedence through the outcome of the Nightingale Nursing Home case for a zero-tolerance attitude when elderly patients are cared for inappropriately.