South Carolina Nursing Home Blog

South Carolina Nursing Home Blog

Nursing Home Information & Litigation

CMS Requests a Refund

Posted in Advocacy, Medicare, Trial themes

The Telegraph reported that Ronnie Rollins, CEO of Macon-based Community Health Services of Georgia, was “speechless and stunned” when CMS demanded he return more than $100 million in improper payments made to his nursing homes.  The company nursing homes had received the “extra” Medicaid funding in question for more than a decade. This past December, a federal ruling declared the funding to be inappropriate.

A Dec. 8 letter and report from the federal Centers for Medicare and Medicaid Services said the “unallowable” payments to more than 30 nursing homes were made in fiscal years 2010 and 2011.  The Centers for Medicare and Medicaid Services report targeted 35 Georgia nursing homes that were owned by local development authorities and were the source of “intergovernmental transfers” to get “upper payment limit dollars”.  But the Centers for Medicare and Medicaid Services report to state officials said “these nursing facilities are actually privately owned” — not owned by a public agency as required.


Nursing Home Ratings and Surveys

Posted in Choosing a nursing home, Ombudsman, Regulatory enforcement

WDTN reported on the sad state of nursing homes in Ohio.  Nursing homes are supposed to be a place of care, rehabilitation, and cleanliness but many are not living up to that standard.

Bev Laubert is Ohio’s Long Term care ombudsman. She’s an expert on nursing homes. She says these surveys can tell you if nursing homes follow the rules. “These are minimums, so if a nursing home isn’t meeting the minimums it calls into question how high do they go. How high of quality do they provide?” said Long-term Care Ombudsman Bev Laubert. CMS tries to answer that question for families. It even has a rating system in place.  “A one star home is a problem,” said Laubert.

Before you put your loved one in a nursing home, do your homework, visit the facility and ask questions.

“You just intuitively pick up stuff. It tells you, look at the residents. Look at how their hair is combed, look at whether they are shaved. Are they out of their rooms? Simple little things,” said Jones.

Abuse and Cover-Up

Posted in Abuse and Neglect, Staffing, Trial themes reported that a certified nurse’s aide named Renee Geloso has been charged with hitting a nursing home resident while another person is accused of trying to cover the incident up.  The state attorney general’s office said that Geloso was working as a certified nurse’s aide at the Valley Health Services in Herkimer when she hit a resident of the nursing home after becoming frustrated with the resident.  Geloso was charged with first-degree endangering the welfare of an incompetent or physically disabled person and willful violation of the Public Health Law.

While investigating, authorities charged a second person. Jordan Gonzales was charged with first-degree falsifying business records and willful violation of the Public Health Law.  Gonzales is accused of making a false statement to protect Geloso and of not quickly reporting the incident as required by law.  illful violation of the Public Health Law carries a maximum punishment of a year in jail or three years of probation. Endangering the welfare of a disabled person and falsifying business records can carry a penalty of up to three years in prison or five years probation.

“Caregivers are entrusted with an important responsibility to keep our loved ones healthy and safe,” Attorney General Eric T. Schneiderman said in a statement. “Those who violate this trust by deliberately harming a nursing home resident must be held accountable.”



Should NH Employee Wages Be $15 an hour?

Posted in Advocacy, Staffing, Trial themes

The Times Online reported that raising the minimum wage even beyond a proposed $10.10 per hour would help the state’s nursing home workers care not only for themselves and their families, but also older residents, according to a new report from the Keystone Research Center.  The economic think tank in Harrisburg has called for the minimum wage for nursing home workers to be raised to $15 — a number backed by the Service Employees International Union Healthcare Pennsylvania, which represents health care workers.

In “Double Trouble: Taxpayer-Subsidized Low-Wage Jobs in Pennsylvania Nursing Homes,” the KRC says that low wages force many of the state’s nearly 87,000 nursing home workers to rely on public assistance or hold multiple jobs, and also contribute to high turnover at facilities across the state.

About 52 percent of nursing home workers who were surveyed by KRC said they could not support their families on their wages, and 16 percent said they work more than one job.  The nursing home industry received about $5.9 billion in public funding from Medicare and Medicaid in 2013, and 14 percent of nurse aides and 28 percent of dietary workers employed by the facilities said they or their family members receive public assistance, according to the report.

That means taxpayers are “double subsidizing” nursing homes in some cases, the report’s author, KRC Executive Director Stephen Herzenberg, said in a news release.  “If we hope to strengthen the state’s economic recovery, rebuild the middle class and ensure that the commonwealth’s aging population receives the consistent, quality care it deserves, caregivers need to make a living wage of at least $15 per hour,” he said.

The report said nursing home costs would only increase about 4 percent with a $15 minimum wage, and the KRC suggested reigning in CEO salaries to adjust for it.  The report also said that raising the minimum wage would reduce staff turnover and associated costs, while generating 1,500 jobs and more than $30 million in new tax revenue for the state and its municipalities. It would also benefit more than 50,000 workers and put nearly $300 million in their pockets, according to the KRC.

Grannycam Bill in South Carolina

Posted in Advocacy

The State reported on the ongoing saga of increasing quality of care in South Carolina nursing homes.  Sen. Paul Thurmond, R-Charleston, introduced a bill allowing video cameras in resident’s rooms to help reduce abuse or neglect in nursing homes. Thurmond compared it to equipping police vehicles with video cameras. Placing a video camera in a nursing home room could help track the care given family members.  He has been frustrated by the pushback by the powerful nursing home industry and lobbyists.

The Senate medical affairs subcommittee voted to adjourn debate on what some refer to as the grannycam bill, giving the bill’s advocates more time to address alleged concerns. AARP has made the bill, S.257, one of its priorities. Video cameras can be “a tool to assist family care givers, especially care givers from other states, in checking on their loved ones,” said Coretta Bedsole, associate state director for advocacy at AARP.

The nursing home industry is flexing its considerable muscle to stop the bill.  It will be interesting to follow the money via campaign contributions to those who oppose the measure.  Those in favor of the bill noted that similar laws have been passed in Texas, Oklahoma and New Mexico, and recent regulatory changes in Maryland allow the cameras.

The S.C. legislation would allow families at their own expense to set up the cameras in rooms, with consent from the room’s resident. The S.C. Department of Health and Environmental Control would be responsible for developing consent forms and procedures. The bill also would allow the captured video to be used in court proceedings, and would make it illegal to tamper with the cameras.


Why Video Cameras Are Needed

Posted in Abuse and Neglect, senior care, Staffing, Trial themes

Ozarks First reported that John Carrier is accused of sexually assaulting a woman described by the Nixa Police Department as being under legal guardianship and of diminished mental capacity.  The Christian County prosecutor has charged Carrier with sodomy and rape of a resident in the nursing care facility where he worked.  A probable cause statement in the case states that Carrier, a caregiver at the Life Enhancement Village in Nixa, had sexual intercourse and deviate sexual intercourse with the woman, despite her resistance.

During interviews with investigators, Carrier admitted to having sex and oral sex with the woman, the court document states.  The victim told investigators that she had told Carrier to stop and that she didn’t want to have sex with him, but that she was afraid of him and followed his instructions because he was a staff member and was telling her what to do. I wonder if he would have done this if there had been a video camera in the room?

Illinois To Allow Video Cameras

Posted in Advocacy

The Illinois House has passed a proposal to allow families to install video or audio devices to monitor their loved ones in nursing homes. The goal is quality care for residents and peace of mind for family members.  Attorney General Lisa Madigan said complaints of negligence sparked the legislation. She said there’s an increasing need for additional safety measures in nursing homes across the state.

Madigan proposed legislation that would give families and nursing home residents the option of installing video or audio devices in their rooms.

Attorney General Lisa Madigan today applauded the members of the Illinois House of Representatives after it passed her proposal to allow nursing home residents and their families to place video or audio monitoring devices in their rooms to help ensure their safety and well-being. House Bill 2462 sponsored by Rep. Greg Harris (D-Chicago) passed with 85 votes in support and now heads to the Senate for consideration.

“Placing a loved one in a nursing facility is a difficult decision that many families will face,” Madigan said. “This measure provides an extra layer of security for nursing home residents, while giving their families peace of mind knowing that their loved ones are receiving safe, quality care.”

The initiative stems from complaints Madigan received from nursing home residents and families who are concerned for their relatives’ care and security. Madigan’s proposal would allow residents of nursing homes and rehabilitation facilities or their family members to purchase and install video or audio monitoring devices in their rooms.

Madigan cited an increasing need for additional safety measures at Illinois nursing homes as the state’s population continues to age. Currently, Illinois has over 1,100 nursing home facilities with over 76,000 residents. The U.S. Census Bureau also estimates that by 2030, 22.3 percent of Illinois’ population will be aged 60 and older, an increase of more than 28 percent from 2012.

Madigan noted that video and audio surveillance could be used as an added tool to help resolve disputes about suspected abuse or negligence. The Illinois Department of Public Health (IDPH) receives more than 21,000 calls annually and responds to approximately 5,000 complaints. In 2013, the IDPH found 106 allegations of abuse, neglect, or misappropriation of property against residents by facility staff to be valid.

The main provisions of Madigan’s proposal would:

Allow for audio and video electronic monitoring devices;
Require resident and roommate consent;
Make nursing home residents or their representatives responsible for the purchase, installation and maintenance expenses of the devices;
Prohibit facility retaliation for the use of the devices;
Provide for recordings to be admissible into evidence in administrative, civil and criminal proceedings; and
Provide misdemeanor and felony penalties for any person or entity that intentionally hampers, obstructs, tampers with, or destroys a recording or an electronic monitoring device.
If enacted, Illinois would become the fourth state to explicitly allow electronic monitoring devices to be installed in resident rooms in nursing home facilities.


Using Webcams to Communicate With Residents

Posted in Advocacy

This story was originally published at  Stuart Sanderson’s connection to the world outside his Philadelphia nursing-home room was severed because of anxiety over a simple webcam.  A compact video camera on his computer monitor allowed him to speak to family even without a voice. Stu, as he prefers to be called, has cerebral palsy, but video calls put him in touch with his ailing father and his brother, who would take the time to read his lips.

But to Inglis House, the camera was a watchful eye, scrutinizing its staff’s every move and potentially capturing images of people whose privacy they’re responsible to protect.  Even when Inglis House returned the electronics, tension lingered. Signs warning of advanced surveillance were plastered on the walls of Stu’s room. Caregivers covered or moved the webcam and “forgot” to reposition it.

Stu’s computer equipment was abruptly removed in mid-December, and he was asked to write a note defending his access to it. Family members called it a “cruel hurdle” for a man with limited mobility who selects each letter by pushing the back of his head against a switch.

In a note pleading for his webcam to be returned, Stu wrote: “WE ARE NOT SPYING ON ANYBODY!”  The Sandersons unwittingly became part of a splintered national debate about the role of video cameras in longterm care facilities.  The conversation includes webcams used for video calls, clocks with hidden pinhole cameras, and motion-activated cameras that broadcast live video feeds to laptops and smartphones.

At a time when police officers wear body cameras and average citizens check video feeds of their children and pets at daycare, the long-term care industry is being forced into a game of catch-up.  The facility is now drafting a policy to address cameras for communication needs and those used to monitor care, either visibly or covertly, said Gavin Kerr, president and CEO of Inglis House, a nursing home that serves about 300 people with complex disabilities and health care needs. He said the policy will support residents’ rights to cameras as long as they notify staff.

Pennsylvania, like south Carolina, doesn’t have regulations pertaining to cameras in nursing homes. A state wiretapping statute forbids audio recording without the consent of all parties; video is fine, though. Federal guidelines prioritize residents’ rights, but there are conflicting interpretations.

A handful of states took that decision out of their hands. In 2001, Texas became the first state to expressly allow electronic monitoring in long-term care facilities.  New Mexico, Washington, Illinois, and Oklahoma followed suit. Maryland gave its nursing facilities guidance on how to properly allow cameras, but left it up to them if they will permit it.  No state has passed a law banning cameras in nursing facilities.

The laws generally require that administrators are notified of the camera and that consent forms are signed by the resident and any roommates. Signs notifying staff, residents and visitors of the cameras are required at the resident’s door or the facility’s entrance.

Hidden cameras have caught abuse at Pennsylvania long-term care facilities.  In three notable cases out of Bucks and Delaware counties between 2011 and 2014, families had suspicions and set up cameras. The recordings captured mocking, manhandling and slapping. Collectively, six caregivers were arrested, one nursing home was closed and another operated on a provisional license until it made state-mandated corrections.

Attorneys general in New York and Ohio have used hidden cameras in similar cases. The Pennsylvania Attorney General’s Office has not used hidden cameras to investigate long-term care facilities, “but that doesn’t mean we wouldn’t,” said spokeswoman Carolyn Myers.

The cameras are easy to come by with a basic online search: A hidden-camera alarm clock equipped with night vision and motion-activated recording starts at $99. A $400 air purifier has a tiny camera that can store recordings for up to a month.  The hidden variety also come in coat hooks, picture frames and tissue boxes. Some people opt for visible security cameras to let the staff know they’re watching.

Too many family members decide to use video cameras because they feel the duty to protect a frail loved one, said Nina Kohn, a Syracuse University law professor who specializes in elder law and the civil rights of senior citizens.

Several elder advocacy organizations support the use of video technology when the resident wants it and privacy safeguards are in place.

“You’re dealing with a vulnerable population and if a resident wants that to feel more comfortable, we certainly think they have right to have that type of monitoring,” said Amity Overall-Laib, a manager at The National Consumer Voice for Quality Long-Term Care.

AARP has a national policy supporting the use of cameras for communication and surveillance, said Ray Landis, advocacy manager for AARP Pennsylvania.

More and more nursing facilities and retirement communities, he said, are using video conferencing for caregivers to meet with family and are also offering personalized calendars and email updates to show what residents do all day.



Covering Up Sexual Abuse

Posted in Abuse and Neglect, Advocacy, Staffing, Trial themes

KOMO News reported the disturbing story of one nursing home’s attempts to cover up sexual abuse of its residents.  The KOMO 4 Investigators uncovered reports that detail nurses and staff at Cashmere Convalescent Center witnessing a number of cases of a patient in the dementia ward sexually abusing other residents.  The abuse started in mid-January between a man known as “Resident One” in the documents and “Resident Three.” Both were patients in the center’s dementia ward. The report said that a housekeeper saw Resident One standing over Resident Three with his jeans around his legs, holding onto her hand and forcing her to touch his genitals. She wasn’t able to call for help, fight back, or even move.

The report said the housekeeper only “hollered at him to stop.” The Director of Nursing was told, but no one outside Cashmere Convalescent Center knew that it happened. The report says the Director of Nursing Services viewed what was going on as nothing more than consensual activities between dementia patients.  Prominent elder law attorney Mark Kosieradzki dismisses any talk of dementia patient consent. After reading the reports, he believes failing to report this was deliberate. “The choice here was to cover it up, not report it and pretend it’s not happening,” he said.  “What you have is a culture over there that it’s okay to abuse these people and that’s just not right,” Kosieradzki said.

This wasn’t an isolated case either, according to the investigation report. The report from state and federal surveyors found that a patient in the dementia ward had repeatedly sexually abused other dementia patients and staff did little to stop it or prevent it from happening again.  On Feb. 2, a staff member saw Resident One take the key to the dining room and followed him there and found him fondling another dementia patient’s breasts. Deputies with the Chelan County Sheriff’s Office were called because Resident One was being unruly.

Cashmere staff witnessed Resident One pull another patient’s hands to his groin, but that a nurse did nothing other than make “eye contact” with him to get him to stop.  He also tried to get into Resident Threer’s room two more times until she was finally able to get staffers to understand that Resident One was sexually abusing her.

A joint report by Federal and State investigators found the center violated mandatory reporting rules and that it “failed to recognize the behaviors as sexual abuse” and “did not act to protect” residents there. DSHS ordered Cashmere to write proper policies for recognizing sexual conduct and consent, something that the law already requires. The center promised to increase staff training and that Cashmere had to pay a $6,300 fine that is less than the rate to live one month in the Cashmere Convalescent Center.

The Department of Health’s Marqise Allen said the Board has launched its own investigation into the owner of the facility Bill Dronan.  DOH also confirmed that the Board of Nursing was not aware of what occurred at Cashmere until notified by the KOMO 4 Investigators earlier in April. It appears the focus has now turned to Dronan and not the nursing staff.  That Board did its own investigation and concurred with Department of Social and Health Services investigation that the problems at Cashmere were so “systemic” and “facility-wide,” that no one nurse should be sanctioned.

Cheating in Arbitration

Posted in Arbitration

Saint Peters Blog reported that a lawsuit was filed in Hillsborough County, Florida accusing arbitrators in a nursing home dispute of improperly allowing lawyers for the nursing home, John Knox Village of Tampa Bay, to cheat in the proceedings.  The claim on behalf of Geraldine Green-Young who passed away April 30, 2014 at Kindred Hospital in Tampa as a result of sepsis resulting from several open pressure ulcers or bedsores.

As part of the arbitration process, Green and her attorneys as well as attorneys for the nursing home were required to submit through discovery any documents they planned to present during arbitration proceedings.  However, attorneys for John Knox Village also submitted a “secret document” written by an outside medical expert outlining an alternative cause of Young’s death.  This document was not shared with the Plaintiff’s lawyer and would be considered an unethical and improper “ex parte” communication with the arbitrator. The arbitrator improperly relied upon the “secret document” and refused to compensate the Plaintiff for the neglect suffered by Geraldine.

The lawsuit alleges that John Knox Village attorney Kelly Jo Lamb broke procedural rules by submitting the document to arbitrators and that arbitrators broke the rules by accepting it.  She is seeking damages to pay for arbitration costs and to have the arbitration ruling in favor of John Knox Village overturned.