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.
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.
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.’
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.
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.
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.
Kaiser Health News reported on Action Pact, a national consulting firm which specializes in helping retirement communities and nursing homes train staff and design their facilities to feel and be more like living at home. Since beginning work on the “household model” in 1984, Norton has helped design hundreds of these communities.
“The idea is that residents’ rooms are clustered around a common area, with a kitchen and living room. The size varies from four people in a private home to a bigger building with up to 20 people in “household” groups. Nursing assistants and caretakers help with the more traditional side of things, such as helping residents take their medicine and bathing. Norton says the household model is “the new nursing home” that helps focus on “person-centered care” and helps meet the wave of demand for more quality services from aging consumers. Five percent of people over age 65 in nursing home-type facilities – more than 1.3 million.”
Two employees at Genesis Nursing Home are charged with a delivery of a controlled substance, neglect, and abuse to nursing home residents. Charges stem from other members of the staff at Genesis noticing that the medication count was incorrect. After notifying management, staff at Genesis called the police. Jason Watson and Cindy Smith were taken into custody but are got out on bond. No information has been given on the number of residents that were affected and for what amount of time they had been without their prescription medication. Not receiving necessary medication would most likely lead to residents being in unnecessary pain and duress. See article at WVVA.
A survey by the Commonwealth Fund found that 9.5 million fewer adults are uninsured now than at the beginning of the Obamacare enrollment season. The Urban Institute’s Health Reform Monitoring Survey found a similar drop, with 8 million adults gaining coverage. And Gallup-Healthways survey reported that the uninsured rate has fallen to 13.4 percent of adults, the lowest level since it began tracking health coverage in 2008. In recent months, other surveys in the Gallup series have consistently found the same downward trend, and a RAND survey in April estimated that the law extended health coverage to 9.3 million Americans
The New York Times reported that despite the $2.7 trillion spent on health care, evidence shows that lengthy waits to get a doctor’s appointment have become the norm in many parts of American medicine, particularly for general doctors but also for specialists. And that includes patients with private insurance as well as those with Medicaid or Medicare. For example, patients waited an average of 29 days nationally to see a dermatologist for a skin exam, 66 days to have a physical in Boston and 32 days for a heart evaluation by a cardiologist in Washington.
The Commonwealth Fund, a New York-based foundation that focuses on health care, comparedwait times in the United States to those in 10 other countries last year. “We were smug and we had the impression that the United States had no wait times — but it turns out that’s not true,” said Robin Osborn, a researcher for the foundation. “It’s the primary care where we’re really behind, with many people waiting six days or more” to get an appointment when they were “sick or needed care.”
The study found that 26 percent of 2,002 American adults surveyed said they waited six days or more for appointments, better only than Canada (33 percent) and Norway (28 percent), and much worse than in other countries with national health systems like the Netherlands (14 percent) or Britain (16 percent). When it came to appointments with specialists, patients in Britain and Switzerland reported shorter waits than those in the United States.