Arkansas Nursing Homes

Arkansas Business reported that nursing home profits in Arkansas are up.  "About 70 percent of the nursing homes in Arkansas made a profit in the year that ended June 30, 2013, according to cost reports audited by the Arkansas Department of Human Services."

Net incomes ranged from just over $1.4 million at both the Nursing & Rehabilitation Center at Good Shepherd and Briarwood Nursing & Rehab Center, both in Little Rock and both with 120 beds, to a loss of almost $1.5 million at 140-bed Northridge Healthcare & Rehabilitation in North Little Rock.  The total net income for the profitable facilities was a hair under $56 million, up from $49 million in 2012. The remainder had losses that totaled just under $14 million, including that of Northridge. That’s up from about $9 million.

 

 

14 Year Old Girl Dies After 2 Days in a Nursing Home

14 year old Marie Freyre was suffering from seizures and cerebral palsy. After being denied home health care by the Agency for Health Care Administration, Marie was forced to go to a nursing home in Miami, 5 hours away from her Tampa home. A judge had previously ordered that Marie be returned to her mother to be cared for, but the Agency for Health Care Administration refused to pay for this manner of care. During Marie’s transport to Miami, she was not given food, water, or her seizure medications. Such poor treatment, in her fragile condition, led to Marie’s death 2 days later.

Up until recently, Marie was able to have stabilized care from her mother. Being forced into unfamiliar and incompetent hands ultimately led to her wrongful death. Her case highlights a growing conflict between Florida healthcare regulators and the U.S. Department of Justice. In spite of a binding court order, health care providers has the callous audacity to refuse to comply with federal laws. Large healthcare corporations should not be allowed to break a judge’s official ruling. The Agency for Health Care Administration needs to be held responsible to such a degree that they do not continue to look at the bottom line, rather than what is best for a patient.
 

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Ideas for Caregivers

Emma Banks is a a wife, mother, and one of the primary caretakers of her widowed father. She was kind enough to offer to write an article advising other caretakers.  Hope you enjoy her writing.

Fun for Seniors

As we’re all getting older, our parents are aging as well, and their lives, like ours, are changing in monumental ways. I just got married three years ago, and my mother passed away two years later. It’s been extremely hard on everyone, including my brother and I, but it’s been especially rough for my father. He’s been struggling to adjust to life on his own, without his best friend, and I’m doing everything I can to keep him engaged with everyday life. My brother lives out of state, so it’s just me and my dad now. Here are some of the fun activities I’ve been trying to set him up with in his new ‘senior citizen’ life (he hates to be called that!).

Exercise

My dad has always been big on exercise. He loves the outdoors, so I try to spend a lot of time with him outside whenever I can. We go on long walks together as often as possible. He was also big on biking when he was younger. My dad was the king of mountain biking, and would explore all kinds of trails wherever he went. That’s why when his birthday rolled around this year, I picked up an exercise bike for him! He keeps it in the den and uses it all the time, watching TV or reading a book or magazine while he cycles. It’s great for keeping him in shape—since staying active has always been so important to him, it was definitely something he wanted to keep in his life, even as he ages!

Social Stimulation

You may think I’m crazy, but I also set my dad up on Facebook recently. Yes, it’s true—Facebook is getting more popular with senior citizens. How do you ‘Like’ that? My dad loves it! He has reconnected with tons of his high school buddies from the rugby team, plus tons of his fraternity brothers from Dartmouth. My dad is pretty tech-savvy, but even if your parent is not, Facebook is user friendly and easy to learn! It’s an exciting tool seniors can use to stay in touch and keep some kind of social interaction going. Definitely worth a shot!

Food Freedom

My mother always did most of the cooking, but recently, my dad has been trying to pick up a few tips and tricks so he can cook for himself! I’ve actually signed him up for cooking classes, too, at the local senior center. They offer some basic introductory courses to teach older folks simply, easy-to-make meals. It’s certainly an adjustment cooking for one—I remember having to do that when I first got my own apartment, and it was tough! I also go over to his house as much as I can to help him out with meals. Cooking is always more fun together! I also help him by delivering groceries making sure that he has a nice variety of snack, food for meals, and some treats for now and then.

Being a senior citizen (or having an elder parent!) doesn’t have to be scary. It can certainly be lonely and isolating at first, but there are ways to combat that. Between exercise, socializing, and staying healthy, your elder parent can definitely live a good life! Whether it’s an exercise bike or a group exercise class, making a Facebook account or joining a church group or poker-playing group, there are plenty of ways to fill their time and make things fun as a senior citizen. Plus, don’t forget the senior citizen discount! That’s why I love shopping and going out with my dad.
 

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Refusing to Disclose

MLive reported that Consulate Health Care and two nursing homes it owns and operates are being sued for allegedly refusing to turn over documents during an investigation into the death of one resident and violations that placed three others at risk for serious harm. The Michigan Protection Advocacy Service, during investigations into the incidents, sent requests for records related to the patients which were accepted by the facilities, then ignored.

Consulate Health Care denies that they were aware of the lawsuit against two of their facilities, and declined to comment on any accusations. Consulate was not initially named as a party to the lawsuit, which the complaint states will be fixed as soon as the Michigan Protection Advocacy Service can prove that Consulate is, in fact, the owner of both nursing homes.

You might wonder how the parent company might publicly comment on their facilities, yet the MPAS has struggled to prove that they are indeed the owners of the facilities. Consulate Health Care is a member of The Alliance for Quality Nursing Home Care Inc., which sounds like a warm and fuzzy non-profit, but is actually a powerful lobbying group composed of some of the biggest for-profit nursing home corporations in America. The Alliance gives money to political campaigns and other lucrative avenues of influence in order to push their agenda, which includes damage caps and “tort reform” which ensure that even the most shocking and terrible cases of abuse and neglect can only result in an award that amounts to pocket change for nursing home parent companies raking in millions.

Members of The Alliance for Quality Nursing Home Care are known to be highly creative in their structure in order to shield themselves further from liability. The Alliance was one of the many groups indicted during the exposure of illegal campaign funds which led to the end of former house majority leader Tom DeLay’s political career. To read more, check out our in depth summary of their involvement.

Stolen Pressure Relieving Mattress

Many residents assessed as a high risk for bed sores, also known as pressure ulcers, are given special pressure reducing cushions or mattresses which help to reduce the chances of their skin breaking down. That’s what was recommended and given to Margaret Patterson, a 78-year-old woman with Alzheimer’s. She received the special mattress while in a hospital, and it was transferred with her to her new nursing home. After that, it disappeared. Her daughter noticed it was gone and asked the administrator about it and was told they would “look into it.” During the subsequent month before the mattress was tracked down and returned, Patterson developed a pressure sore.

Patterson is one of four residents alleged to have been neglected or abused while at the facility in a trial that is currently ongoing. See article at The Examiner.
 

Video Surveillance

Last fall, the New York Times posted an informative blog article discussing the pros and cons of families placing hidden cameras to protect loved ones from being abused or neglected in nursing homes. Certainly, many of the most shocking cases of abuse which have been discovered have come to light due to exactly this scenario: The family starts to suspect something is wrong. The clues are not always obvious, but they raise concern. Maybe their mother has a few new unexplained bruises, or grandpa is suddenly fearful of strangers. Trinkets might go missing, or baths or meals might seem to be skipped. Worried, the family reports their concerns, but receives only verbal assurances and no change in care. They can’t prove what happens at night, but they just feel that something is wrong, so they place a camera to verify that their loved one is safe, only to discover that they are being neglected or abused.

Video evidence is certainly powerful when it comes to light. Allegations of abuse can be glossed over as unreliable, a paranoid family, a delusional resident. Physical wounds can be blamed on an innocent fall instead of a physical attack. Psychological trauma can be blamed on medication, mental deterioration, and other diagnoses. Video footage of a resident being abused or neglected by staff however cannot be disputed.

Oklahoma, New Mexico and Texas have explicitly given state residents the right to place hidden cameras in facilities. Others are debating privacy issues, and some are concerned that the workers should be given notice that they may be recorded. The issue remains contested, but hopefully state governments will put in place standards which equally protect both the safety and the rights of nursing home residents. See NY Times Blog.
 

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The Dementia Village

Often this blog focuses on things going wrong in the nursing home and elder care industries. Today though, the focus is on a groundbreaking facility in Holland that seems to be getting a lot of things right. De Hogewayk is a special home built for residents with severe dementia. Dementia patients are known for their tendency to become confused and wander off, looking for something, someone, or just because they don’t understand why they need to stay close to care givers. Due to this, many dementia wards employ lock downs, medications, and alarms to help keep the residents safe.

De Hogewayk, or The Dementia Village, takes a different approach. The facility is set up like a small burg, with streets free from cars and buses, shops like a grocery store and hair salon, and houses, where several residents stay together with a few live in care givers who wear street clothes, not scrubs. It has been compared to a miniature version of “The Truman Show,” a movie where Jim Carrey discovers that he lives in an artificially constructed town. The village is completely self-contained, so the residents may wander as they please and participate in the little tasks, like picking up milk at the store, joining a club or hobby group, or visiting a friend down the street, that make them feel useful and happy. The staff is instructed not to correct the residents as they describe their delusions, but does not lie to them if they ask questions about where they are or how the village runs.

The idea came from a conversation between two workers in a traditional dementia ward, who both agreed that they were glad that their recently deceased mothers had passed on quickly, instead of having to be in a place like the ward where they worked. Once they realized what they had said, the conversation turned to what a dementia facility could be like, should be like, and how to make it happen.

Giving residents freedom and a sense of normalcy has been a big hit within the community and the waiting list for the facility is very long. The project was completed with funds from both the government and the community, and does not cost much more than traditional dementia care options in Holland. Similar facilities are being planned and built in Switzerland and the US. It is encouraging to see a facility striving so hard to treat the residents as normal people who have different needs, instead of as patients who need to be medicated and locked up for their own good. The model won’t work for every community, but forward-thinking innovation like the idea that brought about The Dementia Village is key to changing the landscape of how elder-care facilities are planned and run.

 

For more information, see The Guardian and Gizmodo.

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Repeat Offenders

Government officials in Texas are squabbling over whether to terminate state contracts with nursing homes which repeatedly are found to abuse and neglect residents. The Department of Aging and Disability Services (aka DADS) in Texas has figures that show that severe violations, which put residents in immediate danger, have gone up 35%. Anecdotal evidence of such incidents is unfortunately not hard to come by.

For instance, there is the case of Minnie Graham, a 97 year old who’s family caught three different employees slapping and shoving her by installing a surveillance camera. A review of the DADS records shows that Ms. Minnie Graham’s home had 79 deficiencies from 2010-2013. Meanwhile, the facility received more than $8 million from Medicaid. The Department for Aging and Disability Services did recommend that the facility be cut off from government funds. Twice. However, the termination never happened. Federal law requires the department to reconsider terminations if the facilities come back into compliance within six months, even when the facilities are repeat offenders.

State Representative Elliot Naishtat is on the Human Services Committee, which oversees DADS and he is very concerned with this reality. He worries that there are not enough inspectors (something the DADS spokesperson denies) and has stated that he will push legislation that increases fines and sanctions against substandard nursing homes.

See full article at KHOU.

One Day of Neglect

ValleyCentral.com reported the tragic story of Isidora Martinez. After only one day of being neglected in a nursing home, under deplorable conditions, Martinez had to be rushed off to the hospital in an ambulance.  Upon admission to Valley Grande Manor, Isidora was stable, after undergoing two major surgeries to remove a cancerous mass in her pancreas.

The family went to visit her the next day and found that she had not been changed or bathed. Isidora said that the facility was not taking care of her.  Isidora’s son, Desi, found that his mother was soiled, with her wounds open and unclean, and her incisions from her surgery were infected. To make matters worse, the nurses call button in her room was not working.  Desi stated that the facilities were outdated and the restrooms were filthy. When alerted of Isidora’s condition, the nurses refused to call for help.

When Isidora arrived at the hospital, she was diagnosed with sepsis. Sepsis is a potentially fatal whole-body inflamation, caused by severe infection. It is caused by the presence of microorganisms, such as bacteria, fungi, viruses, and parasites in the blood.  Since her hospitalization, a representative from Valley Grande Manor visited Isidora to apologize.

Luckily Isidora’s family was able to take an active role in her care. Many times, when a loved one is placed in the care of a nursing home, family members are not able to make daily visits. With how quickly Isidora’s health declined, it is scary to think what would have happened if she was left in such a state of neglect for an extended period of time.  When placed into facilites that are in states of disrepair with incompetent, uncaring staff, the life expectancy of a resident decreases significantly. Facilities attempt to defend themselves when untimely deaths of their residents occur by claiming that such persons were dilapidated and were in declining health. In reality, these facilities are responsible for causing the deaths and injuries of residents because of their negligent care practices.

Tort Reform = Corporate Bailout

Mr. Jernigan is a Florence attorney and president of the S.C. Association for Justice, formerly the S.C. Trial Lawyers Association.  He wrote the below article in The State newspaper about additional efforts to "reform" the civil judicial system.

"In a recent guest column (“Lawsuit reforms will promote job growth,” March 9), business leaders Cathy Novinger and Otis Rawl urged lawmakers to pass a pair of “tort reform” bills they claim will “improve the civil lawsuit climate.” They won’t.

I have great respect for Ms. Novinger and Mr. Rawl, but the only legal “climate” those two bills improve is one that serves giant corporations. The ability of ordinary citizens to seek justice would be seriously undercut.

One bill would limit punitive damages that juries could award when people are injured. The other would place an arbitrary cap on compensation for pain and suffering and shield trucking companies from being held accountable for the actions of their drivers.

These bills would, in essence, limit the legal rights of ordinary S.C. citizens. This is nothing more than an effort to protect corporations from the consequences of their reckless actions.

The arguments to support this legislation are the same old claims we always hear: If big companies can’t be sued, then they’ll have so much more money to hire people and grow the economy. But here are the facts.

First, tort cases make up less than 6 percent of the entire civil caseload. Few of these cases ever go to trial, and when they do, the plaintiff only wins about half the time. According to the U.S. Department of Justice, the average jury award is only $24,000. It’s hard to see how limits are needed.

Second, giving trucking companies free reign to put drivers with a history of speeding and wrecks on our state’s roads without consequences endangers us all.  No one should be protected by law from being held responsible for reckless behavior that injures people and endangers lives — especially not big companies.

Third, the state’s business climate is doing just fine without these unnecessary changes. Last year, export growth in our state was 85 percent higher than the national average.  Nearly every week, a new employer locates in South Carolina.  Building permits are on the rise, and recent surveys found S.C. manufacturers and business leaders are their most optimistic in years.

In fact, Site Selection magazine, Development Counsellors International and the Small Business & Entrepreneurship Council all consistently rank our business climate in the top five nationally. That’s good news.

Countless independent studies conducted by consumer groups and nonprofits have shown that economic growth is not enhanced at all by the type of “tort reforms” these bills would create. The opposite is true. There is more evidence to show that hamstringing our civil justice system is likely to slow employment growth.

Ms. Novinger and Mr. Rawl argue that these bills come “at no expense to the taxpayer,” but that claim couldn’t be further from the truth: This legislation is little more than a government bailout for corporate wrongdoers, with taxpayers picking up the tab.

By granting corporations immunity from responsibility, more individuals will be forced to seek financial help for medical bills and lost work from taxpayer-funded programs such as Medicaid and Social Security Disability.

Additionally, these so-called “tort reform” bills infringe upon our Seventh Amendment right to a jury trial in civil cases. And that comes at a tremendous cost to all S.C. citizens, including taxpayers.

The civil justice system exists so that those who are harmed by the actions of others can be compensated fairly for their loss. That right exists so wrongdoers can be punished for their actions. In a free and just society, nothing is more important.

The facts are clear: These “tort reforms” would benefit the few at the expense of the many.

If we continue to allow special interests and corporate lobbyists to use phony arguments to rig our civil justice system, the price we’ll all pay is one no free society can long survive: the loss of our constitutional rights.

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