South Carolina Nursing Home Blog

South Carolina Nursing Home Blog

Nursing Home Information & Litigation

Medicare Spending Declines

Posted in Medicare

Medicare Costs

Sarah Kliff is impressed by the above chart:

This simple, four-line chart is amazing news for the federal budget. It shows that the government is expected to spend about $50 billion less paying for the Medicare program this year than it had expected to just four years ago. What this chart shows is how much the Congressional Budget Office expects we’ll need to pay for each and every Medicare beneficiary. And over the past four years, the forecasting agency has consistently downgraded the price of covering one senior’s health care costs.

Saving $1,000 per patient adds up quickly in a program that covers about 50 million people. More precisely, it adds up to about $50 billion in savings this year. The reduction in expected costs grows to $2,369 in 2019. With an expected 60 million seniors enrolled in Medicare that year, it would work out to more than $120 billion shaved off the total cost of the program.

Tricia Neuman and Juliette Cubanskigo go into more detail on the factors at play:

In addition to scheduled reductions in Medicare’s more formulaic payment rates, providers may be tightening their belts and looking to deliver care more efficiently in response to financial incentives included in the ACA, and it is possible that these changes are having a bigger effect than expected. For example, CMS recently reported that hospital readmission rates dropped by 130,000 between January 2012 and August 2013. It is also possible that hospitals and other providers are using data and other analytic tools more successfully to track utilization and spending and to reduce excess costs. Another more straightforward factor is that several expensive and popular brand-name drugs have gone off patent in recent years, which has helped to keep Medicare drug spending in check.

Whatever the causes may be, the slowdown in spending is good news for Medicare, the federal budget and for beneficiaries—at least for now, and as long as it does not adversely affect access to or quality of care.

Measuring Body Mass Index

Posted in Nutrition

The Mini Nutritional Assessment, a short questionnaire which is used to determine a resident’s nourishment, relies on body mass index to assess residents. However, for the elderly and those with underlying conditions such as dementia, it can be incredibly difficult to measure BMI, or height and weights of bedridden patients. A new study shows that calf circumference may be a suitable alternative to BMI and height/weight measurements. The study was conducted with ~240 residents in seven Turkish nursing homes. Calves were measured at the widest point. Measurements of more than 31 cm received three points. A score of 12 or higher means someone is well nourished. In a situation like a nursing home, which is full of bedridden, frail, and sometimes impaired residents, using calf circumference can be a useful alternative to taking BMIs.

See full article at McKnights.

Lightening Strikes Golden Living Center

Posted in Uncategorized

Fox11 reported that 41 residents of the Golden Living Center facility got an unwelcome surprise when a lightning strike caused a fire in the eastern ward. The home instituted emergency protocol and evacuated all of the residents. But the place the residents were placed wasn’t a community center or a hospital, but a school gym! The local elementary school gym was an ideal place to temporarily house 31 of the residents, while 10 stayed with family members. The Red Cross provided blankets, cots, and other assistance. The Florence community also played a large role in providing assistance to the home and its residents. Their stay in the gym will be a short one, but the easy transition, the outreach, and support demonstrate how the community can be just as important in helping in emergency situations as the corporate management companies which organize protocols.

Keeping active pays off in your 70s and 80s

Posted in Advocacy

Older people who undertake at least 25 minutes of moderate or vigorous exercise everyday–such as walking quickly, cycling or swimming– need fewer prescriptions and are less likely to be admitted to hospital in an emergency, new research has revealed. Such physical activity leads to a higher metabolism and better circulation, reducing the risk of conditions and diseases common in older age such as high blood pressure, type 2 diabetes, coronary heart disease and strokes. Exercise should be targeted and tailored to those in their 70s and 80s, aiming to increase muscle strength, balance, coordination and aerobic fitness to prevent falls. In the first study of its kind looking at this age group, researchers from the Universities of Bath, Bristol and UWE-Bristol looked at data from 213 people whose average age was 78.  The findings, published in the journal PLoS ONE, reinforce the need for exercise programms to help older people stay active.  It could also reduce reliance on health care services and potentially lead to cost savings.

Professor Ken Fox, from Bristol University’s Centre for Exercise, Nutrition and Health Studies who led the study said: “Until now, very little has been known about the value of physical activity in later life, particularly when people are in their 70s and 80s. This research underlines that keeping older people active brings a whole range of health benefits, as well as reducing reliance on the NHS and potentially leading to major cost savings.”

To access the latest research papers see http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0097676.


Medicare Fraud in Lab Billing

Posted in Medicare, Trial themes

The Wall Street Journal had an article about Medicare Lab Billing.  Medicare allowed $1.7 billion in 2010 payments to clinical laboratories for claims that raised red flags, according to a report to be released, the latest example of how the federal insurance program for the elderly and disabled is susceptible to fraud and abuse.  The report, by the Department of Health and Human Services’ Office of Inspector General, found that more than 1,000 laboratories showed five or more measures of questionable billing during that year, the latest available when the office began compiling the data. That includes various metrics signifying higher-than-average billing, using ineligible physician identification numbers and administering duplicate tests, among other things.

Epidemic of Malnutrition in LTC

Posted in Nutrition

Malnutrition, deprivation, inanition. These words may not sound that familiar, but they all mean the same thing: starvation. So why are we writing about starvation? Because it’s a problem that still persists in nursing homes today. A whistleblower in the UK came forward in an article with The Mirror after the paper ran a story on seven people who died of hunger. In hospitals.

Unfortunately, the epidemic doesn’t end there. It is all too easy to get caught up in the ideal of helping people which naturally leads to the question of how nursing homes can get so bad that a resident could drop from a size 16 to a size 12 in two to three weeks, as in the case the whistleblower details. But nursing homes are businesses, and too often, it seems, those in charge care less about the personal and more about profits.

The whistleblower says that much of the problem arises from the food schedule, lack of options, and lack of assistance necessary from staff.  At the facility where she works, the portions are small, and the schedule has residents eating a small meal for dinner at 4:45 pm. Their next meal isn’t until 9:00 am the next morning, and the only snack they can have is a piece of toast and a cup of tea. She has 40-50 residents which are being fed at once, and about ten of them need to be fed, and many more need assistance with feeding.  There’s no way one person can assist all those who require it during a timely manner.

She says, ‘By the time you help three or four, the food is cold for everyone else.’ Another issue is that there are no options for residents. If they don’t like what’s being served, they can only have a piece of toast as a substitute. Additionally, the workers have to deal with a climate that seems hostile to those who raise complaints or threaten to blow whistles. See article at The Daily Mirror.

Delay in Treatment for Stroke

Posted in Trial themes

My Fox Tampa Bay reported that Rachel Mobley, administrator of Grace Manor at Lake Morton allegedly refused to allow a staffer at the facility to call 911 for an elderly resident suffering severe eye pain. She is charged with neglect of an elderly person, which is a second degree felony.

Kristal Stowell, a worker at the home, wanted to call emergency services when Charles Burrows told her he was suffering from eye pain. Due to an ‘unwritten rule’ at the facility, no one can call 911 without getting a supervisor’s approval.  When Stowell called Mobley to ask if she could call 911, Mobley allegedly told her she couldn’t, and to give the man a prescription Tylenol. Stowell called repeatedly, as Burrows’ pain became more severe, but each time, Mobley said she couldn’t call 911. Stowell eventually called 911 even though Mobley never approved it.  Unfortunately, Burrows died ‘after having a stroke’.  The nursing home released a statement supporting Mobley and denying the claim of neglect.  The family declined to comment other than the loss ‘is painful.’

 

Resident Funds Stolen

Posted in Staffing

A Massachusetts nursing home offering peaceful seclusion, as described on their website (http://www.lcca.com/183/), saw their serenity shattered when a nursing home employee stole almost $10,000 from residents at the home where she worked. Sandra DosAnjos, accounts receivable clerk at The Oaks Nursing Home in New Bedford  stole a large sum from various residents ranging from 66-90 in age.

Detective Capt. Steven Vicente explained the details of the case, including how DosAnjos perpetrated the crimes. It’s believed that she used patients’ debit cards to make unauthorized transactions, used personal checks from their accounts and made checks to petty cash, or diverted funds. He further says that there are five instances of theft. The Oaks has cooperated fully with the investigation, and DosAnjos no longer works there, but the home declined to comment further on the story.  See article at South Coast Today.

Indecent Exposure

Posted in Staffing

Marlo Santos Quinton has been arrested and charged with elder abuse and indecent exposure.  Two elderly residents at Auburn Senior Care told police that Quinton, a nursing assistant at the facility, exposed himself to them and kissed them.  With such alarming allegations, Quinton was taken into custody. He is currently out on bail.  Luckily, the women who were assaulted were able to communicate the wrongs that had been done against them.  Frequently, sexual abuse in nursing homes goes unreported because the victims are unable to explain what has happened to them.  See article at CBS.

Investigation into Incident

Posted in Abuse and Neglect

Sons of 68-year-old Violet Ferreri claim that their mother was attacked at Deer Park nursing home.  The attack resulted in Violet sustaining extensive bruising and a broken arm. The nursing home denies these charges, claiming that they were only negligent in allowing Violet to fall out of her wheelchair at 1:28 in the morning.

Kevin Farmer investigated and saw a video that showed Violet with an oxygen cord wrapped around her neck after the incident occurred.  However, Violet’s sons remain unconvinced, sure that this was not an accident, but an act of malice.  The Ferreri brothers remained in the dark, concerning the investigation.  Since then, Violet has been moved to a safer facility where she is highly functioning and embracing her range of capabilities in her golden years. See full article at WCPO.