South Carolina Nursing Home Blog

South Carolina Nursing Home Blog

Nursing Home Information & Litigation

Less People Are Delaying Treatments

Posted in Advocacy

Los Angeles Times: Fewer Americans Delayed Needed Medical Care In 2014, Survey Says 
From 2012 to 2014, the share of consumers delaying a recommended test or treatment or not filling a prescription fell by nearly a third. And the percentage who reported problems with medical bills fell by almost a quarter. Those are the first declines ever recorded by the biennial national survey by the nonprofit Commonwealth Fund, which began asking Americans about the affordability of medical care a decade ago. (Levey, 1/14)

This is a great advance for the health of the country and the long term costs of health care.  Delaying treatment has been shown to cause more serious health problems and increase overall health care costs.

Sexual Assault of Vulnerable Adult

Posted in Abuse and Neglect, Staffing

ABC7 reported that David Moreno, former maintenance worker for Yorba Linda assisted living senior homes, was charged and sentenced for sexually violating a 69 year old disabled woman. Prosecutors state that Moreno committed the acts from June 1st to July 24 2012, and, took advantage of the woman’s dementia and sexually assaulted her on numerous occasions.  The atrocities of Moreno’s acts were not known until the woman had the courage to tell a close friend what had happened to her.  Traces of Moreno’s DNA were discovered throughout the victim’s room. The charges of his deviant conduct includes 2 felony charges; one for sexual battery of an institutionalized victim and the other is for sexual penetration by foreign object of an incompetent victim.

Moreno’s sentence includes only a three year stint at a California state prison as well as having to register as a sex offender for the rest of his life.  After his release from prison, Moreno will be barred from entering local recreational areas as well as city parks.  Hopefully with Moreno’s lifetime sex offender registration status, companies, corporations, and small businesses may be forewarned of the sexually deviant nature that Moreno exhibits towards individuals, particularly those that are already in a vulnerable position.

“Three Strike Plan”

Posted in Regulatory enforcement, Tort Reform, Trial themes

KLTV had an article on Texas lawmaker Charles Schwertner who is pressing lawmakers to enact a more stringent policy towards nursing homes with established violations of abuse and neglect. Senator Schwertner has proposed legislation that, if enacted, would require the state to revoke licenses of nursing homes that have chronically presented high level deficiencies to the state.

During a Sunset Advisory Commission hearing, the senator listed out seven nursing home facilities within Texas that had a surplus of violations during their duration of service.  One of the nursing homes within the senator’s jurisdiction, Eastwood Care and Rehab, located in Tyler in East Texas, acts as a focal point for how necessary and vital legislative reform can be.  Eastwood recently lost its federal funding and was subject to license revocation after numerous violations were discovered within the facility.  After finding over 70 separate violations from a singular inspection, the former owners of Eastwood Care and Rehab were removed from their positions, and a new company took over the facility.

Senator Schwertner wants to see a better system of enforcement within the nursing home industry.  One of his proposals includes a “three strike plan” in which a facilities’ license would be revoked if three or more high level deficiencies were reported within a two year period.  Additionally, Senator Schwertner emphasizes that the rules, regulations, and policies of the nursing home mandates are too vague and need to be more detail oriented in order to combat the substandard living conditions that are present in some facilities.  Although the proposition has not been formally made into law, the Texas delegation are expected to wrestle with Schwertner’s plan in 2015.

Canadian Study on Use of Anti-psychotics

Posted in Advocacy, Medications

The Star of Ontario conducted an investigation into the usage of potentially lethal pharmaceutical drugs. According to the survey, some doctors are continuing to use the dangerous drugs, despite the fact that many of them come with a “black-box” warning that the patient taking the pill has about a 60 percent increased risk of death after taking it. In 40 Ontarian nursing homes surveyed, more than half of the residents were on the anti-psychotic drugs, and in about 300 homes, more than one third of residents were on them. One of the nursing homes surveyed even uses the pills on 75 percent of its residents.

 The pills used in the nursing homes include olanzapine, quetiapine, and about 10 other dangerous anti-psychotic drugs. These drugs come with serious side effects, including diabetes, hyperglycemia, high fever, intestinal obstruction, and rigid muscles. Though olanzapine and quetiapine were approved by the American Food and Drug Administration (FDA) for use on individuals with schizophrenia, bipolar disorder, mania in 2004 and 2005, the drugs have never been approved by Health Canada for use on people suffering with dementia. Canadian doctors were warned in 2007 by the auditor general of overuse of the anti-psychotic drugs.

One family told The Star that one of their loved ones died after the nursing home she was in administered olanzapine to her to “quiet her down.” The caregivers did so without explaining the risk to her husband who says he never would have consented to it had he known of the drug’s dangerous potential.

So if anti-psychotic drugs like olanzapine and quetiapine are obviously dangerous, and it seems as if doctors are aware of the risks that come with prescribing the pills, what can be done to prevent patients from having the drugs administered to them? Some suggest that doctors should be made to warn the patients receiving the drugs or their substitute decision makers so that they can consent to taking the drugs or refuse them. Others suggest that nursing homes should increase staff numbers and provide their caregivers with in-depth training regarding care for dementia patients. Dr. Andrea Moser says that work has already been done to limit the use of anti-psychotic drugs in nursing homes. She told The Star, “We’re making progress. We still have a long way to go.”

Video Catches Rapist

Posted in Abuse and Neglect, Tort Reform

The New York Daily News reported Laszlo Molnar, the owner of AA Adult Family Home nursing facility has been charged with second degree rape.  He is accused of sexually exploiting an 83 year old dementia patient within his own facility.  The grotesque act was made tangible when the family of the affected resident decided to place video recording equipment in an inconspicuous area within her room.  Soon enough, the assailant was horrifically caught in the act on tape.  The family was forced to bear witness to the owner’s actions by watching the video in an attempt to achieve justice for their mother.

The other 11 residents in the nursing home have been removed and are being checked for sexual assault.  With such depraved acts demonstrated by this nursing home owner, perhaps allowing video cameras in nursing homes will become commonplace.

Occupancy Rate and Staffing

Posted in Advocacy, Staffing

The Indianapolis Business Journal reported that building new nursing homes cost Indiana millions. Since the last nursing home building ban ended in 2008, more than 5,000 new beds for patients needing skilled-nursing services have been added (or are being added) at nursing homes around the state. All that building is costing the state money, according to an analysis by accounting firm Myers & Stauffer, which was issued in December by the Indiana Family and Social Services Administration.  27 new nursing homes that opened or began construction in 2014, plus another 10 expected in the next year or so, will cost the state $24 million in additional payments from the Medicaid program, according to Myers & Stauffer’s analysis.

The roughly 2,200 skilled-nursing beds either opened or started in 2014 represent 4.3 percent of the 50,000 existing skilled-nursing beds in the state. Assisted-living beds, which are also part of nursing homes, are not counted in this total because they do not require nursing staff and do not qualify for Medicaid payments.  The number of Medicare recipients staying at nursing homes has been flat or declining. That’s partly due to the fact that 30 percent of Medicare beneficiaries are in privately run Medicare Advantage plans, which earn higher profits if they reduce the overall cost of care. Also, Medicare has signed accountable care contracts with teams of health care providers, also rewarding them if they reduce the overall cost of care for specific groups of Medicare patients.

Given those larger trends, adding more nursing home beds will almost certainly decrease the occupancy level further at Indiana’s nursing homes. Average occupancy statewide now stands at 76 percent, according to the report published by the Indiana Family and Social Services Administration. That’s actually up 2 percentage points since late 2013, but is still down from 80 percent in early 2011.Nationwide, nursing homes are 83-percent occupied, on average.

Low occupancy is problematic, the state argues, because it will stretch staffing capacity across the industry. And staffing levels are a key indicator of the quality of care residents receive.  Also, lower occupancy actually costs the state Medicaid program money, due to the convoluted way it pays for nursing home care. The Medicaid program sets its payments based on cost data from each nursing home, including costs of care, of administration and of capital.

But the state assumes nursing homes are at least 90-percent occupied. When they are not, nursing homes stretch their fixed costs over fewer patients, which raises the per-patient cost data on which the state bases its payments.

Is a 60 Day Sentence Fair or Unjust?

Posted in Abuse and Neglect, Staffing

The incident occurred on July 9, 2013 when former caregiver, 19-year-old Emily Green, and a co-worker held the 90-year-old victim’s arms over her head and shoved a soapy washcloth into her mouth while they were bathing her in the shower. The victim was a dementia patient at Garden Courte Memory Care Community in Olympia, WA. Green and her accomplice, Cameron Malizio, who is serving a one-year prison sentence for the incident, were caught by a co-worker who witnessed the incident and contacted police. The witness said that the victim was “a small, skinny, malnourished dementia patient…too weak to hurt anyone,” according to court documents. See full article from The Olympian.

 Green pleaded guilty to one count of third-degree assault with aggravating circumstances. She was then immediately sentenced to 60 days in prison by Thurston County Superior Court Judge Anne Hirsh. Deputy Prosecutor Megan Winder asked Hirsh to give Green an exceptional sentence of nine months in prison, but Green argued for a lesser sentence. He said that there was not sufficient evidence that Green knew what Malizio would do, and that she was working a minimum wage job where she was often overworked, after only receiving two months of training to become a Certified Nursing Aide. As part of her sentence, Green will no longer be able to work as a caregiver and will have a felony conviction on her record.

Stealing Pain Medications

Posted in Abuse and Neglect, Medications

A licensed nurse at Villa St. Vincent Nursing Home reportedly stole opiate based painkillers from at least ten residents within the facility.  This act is unfortunately prevalent in the nursing home industry, yet, this specific event carries an additional level of shock and disbelief. The nurse supposedly removed fentanyl pain relieving patches from at least three residents and applied them to his tongue in order to become intoxicated.  Also, he removed the patches from his mouth and placed them back onto residents’ bodies, thus denying residents the pain relieving effects of the patches while also covering his tracks.  In addition to the fentanyl patches, the nurse also stole Tramadol, Percocet, and other powerful opiates.  The nurse admitted to carrying out this malicious act at least three to four times a week for an entire year until he was caught.

The employee has since been fired and is currently under investigation by local law enforcement entities.  To add insult to injury, the residents affected by the nurse’s vice had severe cognitive defects and were by in large unable to communicate their needs.  In short, the residents had useless pain patches on their bodies, most likely resulting in the individuals to experience prolonged periods of pain, perhaps up to an entire year.  Compounded by the fact that the residents could not verbalize what was occurring.   The possible ramifications to the residents’ health could not be determined, but one would be safe to assume that the yearlong ordeal of not receiving adequate pain relieving medicine was simply excruciating for those involved.   See full article here.

Neighbor Love’s Adopt a Senior

Posted in Advocacy

The Charlotte Observer reported during the holidays that Fundamental’s facility in Rock Hill called Magnolia Manor-Rock Hill allows volunteers to come in to provide care and entertainment to the residents. Singing Christmas carols and handing out gift bags, 18 volunteers from across the region paid a visit Dec. 21 to 65 Magnolia Manor residents through Neighbor Love’s annual Adopt-a-Senior for Christmas celebration, according to event coordinator Trisha Bowman. Unfortunately, for the rest of the year they must rely on the staff for these services.

Neighbor Love, a ministry of E Cubed International, is committed to helping people with special needs, senior citizens in nursing homes, orphans and the unemployed or underemployed, according to the ministry’s website.  Neighbor Love brings volunteers to nursing homes where the residents have the most need, he said.

 

 

Rate of Uninsured Drops to Record Low

Posted in Advocacy

The uninsured rate among U.S. adults for the fourth quarter of 2014 averaged 12.9%. This is down slightly from 13.4% in the third quarter of 2014 and down significantly from 17.1% a year ago. The uninsured rate has dropped 4.2 percentage points since the Affordable Care Act’s requirement for Americans to have health insurance went into effect one year ago.

010515Q4Uninsured_1_FINAL

The uninsured rate declined sharply in the first and second quarters last year as more Americans signed up for health insurance through federal and state exchanges. After the open enrollment period closed in mid-April, the rate leveled off at around 13%. The 12.9% who lacked health insurance in the fourth quarter is the lowest Gallup and Healthways have recorded since beginning to track the measure daily in 2008. The 2015 open enrollment period began in the fourth quarter on Nov. 15 and will close on Feb. 15.

The fourth-quarter results are based on more than 43,000 interviews with U.S. adults from Oct. 1 to Dec. 30, 2014, as part of the Gallup-Healthways Well-Being Index. Gallup and Healthways ask 500 U.S. adults each day whether they have health insurance, allowing for precise and ongoing measurement of the percentage of Americans who lack health insurance.

Uninsured Rate Drops Most Among Blacks, Low-Income

While the uninsured rate has declined across nearly all key demographic groups since the Affordable Care Act went into effect a year ago, it has plunged most among blacks and lower-income Americans. The uninsured rate among blacks dropped seven points over the past year, while the rate among Americans earning less than $36,000 in annual household income dropped 6.9 points.

The Hispanic population remains a key target of the healthcare law’s marketing efforts, as it continues to be the subgroup with the highest uninsured rate, at 32.4%. Still, the percentage of uninsured Hispanics is down 6.3 points since the end of 2013.

Across age groups, the uninsured rate dropped the most among 18- to 25-year-olds, falling 6.1 points from a year ago. The rate fell 5.6 points for 26- to 34-year-olds, and 5.2 points for 35- to 64-year-olds. The percentage of uninsured Americans aged 65 and older has not changed over the past year, likely because most were already covered through Medicare.

010515Q4Uninsured_3

Two in Five Americans Under 65 Have Employer-Based Coverage

The uninsured rate among 18- to- 64-year-olds dropped to 15.5% from 20.8% a year ago, with most of the dip reflecting Americans gaining coverage through self-funded plans, Medicaid and Medicare. Those aged 65 and older are excluded from this analysis of health insurance type because most are covered through Medicare.

The 20.6% of U.S. adults under the age of 65 who say they are covered by a self-funded plan is up three points since the fourth quarter of 2013. This is likely because more Americans purchased individual plans through a federal or state health insurance exchange.

The percentage of 18- to 64-year-olds with Medicaid (8.6%) has also increased slightly over the past year, which is not surprising because many states expanded Medicaid eligibility so that more lower-income and lower-middle-income Americans could get affordable insurance. There was also a slight increase over the past year in the percentage of those under 65 with Medicare insurance.

The percentage who get their insurance through a current or former employer declined in the first quarter of 2014, but recovered throughout the year.

Type of Health Insurance Coverage in the U.S. Among 18- 64-Year-Olds

Implications

The Affordable Care Act has accomplished one of its goals: increasing the percentage of Americans who have health insurance coverage. The uninsured rate as measured by Gallup has dropped 4.2 points since the requirement to have health insurance or pay a fine went into effect. It will likely drop further as plans purchased during the current open enrollment period take effect. The Department of Health and Human Services reported that 6.5 million Americans either selected new plans or were automatically re-enrolled into a plan via HealthCare.gov as of Dec. 26, 2014. Prior to this year’s open enrollment period, Gallup found that more than half of those who were uninsured planned to sign up, a positive sign. Gallup also found that most newly insured Americans planned to renew their policy or get a different policy elsewhere.

Furthermore, the uninsured rate may drop because the healthcare law’s provision requiring businesses with 100 or more employees to provide health insurance to 70% of their workers took effect on Jan. 1. In 2016, companies with 50 or more employees will be required to provide health insurance to 95% of their workers.

Other signs also point to the uninsured rate falling more after this open enrollment period ends. HHS continues to focus on the financial assistance available to enrollees and increasing the fine for not having health insurance: currently $325 per person or 2% of an individual’s yearly household income, whichever is greater. Gallup previously found that higher fines would compel more uninsured Americans to sign up.

The uninsured rate could also fall further as more states expand Medicaid. Twenty-seven states and the District of Columbia implemented Medicaid expansion through the Affordable Care Act in 2014, which Gallup found to be a major factor in declining uninsured rates. Pennsylvania expanded Medicaid as of Jan. 1, and Arkansas, Iowa and Michigan approved Section 1115 waivers for expansion, giving the secretary of HHS authority to approve experimental, pilot or demonstration projects that promote the objectives of Medicaid and the Children’s Health Insurance Program.

However, closing the health insurance gap may be more challenging this year than last, as those who did not sign up last year may be harder to reach or more reluctant to get health insurance. Additionally, the open enrollment period will be nearly two months shorter in 2015 than in 2014.

Survey Methods

Results are based on telephone interviews conducted Oct. 1-Dec. 30, 2014, as part of the Gallup-Healthways Well-Being Index survey, with a random sample of 43,016 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia. For results based on the total sample of national adults, the margin of sampling error is ±1 percentage point at the 95% confidence level.

Each sample of national adults includes a minimum quota of 50% cellphone respondents and 50% landline respondents, with additional minimum quotas by time zone within region. Landline and cellular telephone numbers are selected using random-digit-dial methods.