South Carolina Nursing Home Blog

South Carolina Nursing Home Blog

Nursing Home Information & Litigation

Trump’s Bizarre Choice to lead HHS

Posted in Advocacy, Medicare, Regulatory enforcement, Tort Reform

There are plenty of reasons to be worried about Tom Price, President-elect Donald Trump’s choice for secretary of Health and Human Services.  Price is an orthopedic surgeon and U.S. congressman from Georgia with no relevant experience.

Price has often and repeatedly voted to cut Medicaid and Medicare,  and is an ardent opponent of female reproductive rights.  Price also belongs to a truly radical medical organization known as the Association of American Physicians and Surgeons with 4,000 members.

The AAPS statement of principles declares that it is “evil” and “immoral” for physicians to participate in Medicare and Medicaid.  In particular, it urges “non-participation” in the Social Security amendments of 1965 — also known as Medicare — “as the only legal, moral, and ethical means of concretely expressing their complete disapproval of the spirit and philosophy behind these amendments.

Its website features ridiculous unscientific claims that tobacco taxes harm public health and electronic medical records are a form of “data control” like that employed by the East German secret police. An article on the AAPS website speculated that Barack Obama may have won the presidency by hypnotizing voters.

Their views on medicine are controversial to say the least: such as blaming vaccines for autism, including that the “shaken baby syndrome” is a “misdiagnosis” for vaccine injury; denying about HIV/AIDS; that immigrants cause crime and disease; that abortion causes breast cancer to name just a few.

Dr Price’s political agenda is the same self-serving tort reform that does not increase quality, transparency, or accountability including in the Empowering Patients First Act, the bill he has offered as an alternative to the ACA since 2009.  His solution is the same type of ineffective federal tort reform which violates States’ Rights, and includes unconstitutional and arbitrary caps on damages.  The bill would also allow physicians to “balance-bill” Medicare beneficiaries—to charge them more than Medicare’s allowable charge—which is currently illegal.  The bill also proposes a modern day “Star Chamber” or “administrative healthcare tribunals” where a confidential proceeding by anonymous bureaucrats would decide if a jury gets to hear your case.

Be afraid.  Be very afraid.


ObamaCare Report Card

Posted in Advocacy, Tort Reform

The Week had an interesting article on the CDC and other federal health agencies latest report on Americans’ ability to pay medical bills: The last five years has marked a steady decline in the number of people who struggle to pay their medical bills.

“With the help of data from the National Health Interview Survey, a regularly scheduled poll of Americans’ health habits and behaviors, the authors found that, in 2011, 21.3 percent of Americans under the age of 65 reported living in a family that had problems paying their bills. By the first six months of 2016, that figure had dropped to 16.2 percent. This drop held across all racial, gender, and socioeconomic groups, but some of the largest gains, percentage-wise, were among the poor and lower income, those uninsured or with public health insurance (i.e. Medicaid), and Hispanics.”

The Affordable Care Act in 2010 is one of the largest single factors explaining this trend. “Moreover, research from the Kaiser Foundation has shown that nearly 13 million non-elderly previously uninsured adults have obtained a health insurance plan as of the end of 2015, a sharp drop down from the 41 million uninsured in 2013.”

The current uninsured rate, 10.5% percent of non-elderly Americans, is a historic low.  ACA has acted as an economic stimulus while lowering general health care spending. See Commonwealth Report.

Supporting Family Decision Makers for Nursing Home Residents

Posted in Advocacy, Trial themes

JAMA published another study regarding the necessity and effectiveness of communicating with resident’s family members.

The study showed how better training can lead to better communication and improved quality of care. The intervention was conducted at the nursing home level; it involved enrolled family decision makers viewing an 18-minute goals of care video decision aid and the nursing staff at that facility receiving a 1-hour training on the aid and principles for family communication.

Following the delivery of the goals of care video and staff training, the facilities were prompted to meet with family decision makers. Communication was reportedly better which allowed family and care givers consistent goals and approaches to care.

Communication at End of Life

Posted in Advocacy

Reuters had an article on the importance of communication during end of life discussions.  A new study shows better communications leads to less wasteful hospitalizations. “At the end of life, hospital stays for seriously injured or ill nursing home residents typically offer little hope of improving quality of life or changing outcomes for the better, researchers note in JAMA Internal Medicine.”

“Family members want their loved ones to receive quality care, and the responsibility of health professionals is to promote communication about the residents’ care goals in the context of their medical condition and available options,” Dr. Gary Winzelberg, a palliative care researcher at the University of North Carolina at Chapel Hill said by email.

Among other things, patients and families may consider creating a legal document known as an advanced directive that specifies what types of interventions should be done, and which ones should be avoided, at the end of life. This may include opting against ventilators, feeding tubes or other mechanical support.



New Rule for Hospitals

Posted in Advocacy, Choosing a nursing home

NPR reported on what hospitals can and do tell patients looking for information on long term care alternatives.  “For years, many hospitals simply have given patients a list of all the skilled nursing facilities near where they live and told them which ones have room for a new patient. Patients have rarely been told which homes have poor quality ratings from Medicare or a history of public health violations, according to researchers and patient advocates.”

This is how some residents get admitted to bad facilities without the family knowing. Now, new rules will allow and require information to be shared.

Hospitals must provide patients with all nearby options, but the new rule says hospitals “must assist the patients, their families, or the patient’s representative in selecting a post-acute care provider by using and sharing data” about quality that is relevant to a particular patient’s needs for recovery.  The rule was drafted in October 2015.

Canada’s Nursing Shortage

Posted in Staffing, Trial themes

The Ottawa Citizen reported the shortage of nursing staff is affecting the quality of care in Canada’s nursing homes.  “A study by SafeCare BC found 60 per cent of long-term residential care homes that participated in the survey have a worker shortage, and it is particularly acute on Vancouver Island, with 78 per cent of care homes reporting a shortage.”

“We know it’s having a negative impact on workers, so there’s no doubt the shortage of workers is having a negative impact on the quality of care (for seniors in nursing homes),” said SafeCare BC spokesperson David Hurford.

The positions employers are finding the most difficult to fill are care aides and health care assistants, with 66 per cent of nursing homes reporting a need, followed by licensed practical nurses and registered nurses, both at 47 per cent, and food service workers and dietitians at 16 per cent.



S.C. Nurses Can Unionize

Posted in Advocacy, Staffing

The U.S. Court of Appeals for the Fourth Circuit ruled in Palmetto v NLRB that registered nurses (RNs) and licensed practical nurses (LPNs) at a nursing home in South Carolina were not supervisors and could therefore lawfully unionize. The Fourth Circuit focused entirely on whether the nurses used independent judgment.

The NLRB found that “a judgment is not independent if it is dictated or controlled by detailed instructions, whether set forth in company policies or rules, the verbal instructions of a higher authority, or in the provisions of a collective bargaining agreement.” The Fourth Circuit held that the RNs and LPNs lacked such independent judgment. The court held that, at most, the evidence established that the nurses “exercise not independent, but heavily constrained, judgment.”

The RNs and LPNs assessed patients, administered medications, and performed general patient care duties. The CNAs assisted residents with activities of daily living, such as helping them bathe, repositioning them in bed, and aiding them in using the restroom. The nursing home’s handbook described the nurses as the CNAs’ “first line of authority,” and placed the RNs and LPNs above the CNAs on its organizational chart.

The court ultimately concluded, “In every case, the nurses’ responsibility seems to amount to the same thing: making sure the CNAs follow the written instructions. This suggests that the Nurses serve merely as conduits for these instructions.”


Targeting PruittHealth

Posted in Advocacy

The Georgia Supreme Court ruled that a personal injury law firm, McHugh Fuller Law Group of Hattiesburg, Miss., can target a specific defendant in advertising for new clients.  The unanimous opinion reversed the permanent injunction against all advertising targeting nursing homes run by PruittHealth Inc.

The law firm ran a full-page color advertisement for a month in the Moultrie Observer starting in March 2015. At the top is a photo of the nursing home and its sign before it changed its name from UniHealth. The headline said, “Attention!” The copy said the law firm is “currently accepting cases against PruittHealth-Moultrie (formerly known as UniHealth Post-Acute Care-Moultrie) for resident care related issues.” The ad suggested contacting the law firm “if you suspect that a loved one was neglected or abused at PruittHealth–Moultrie.”

Pruitt is a for profit chain which operates in Georgia and South Carolina with a history of issues and problems.

The opinion held that “The ad did not attempt to link PruittHealth’s marks directly to McHugh Fuller’s own goods or services,” The opinion states “McHugh Fuller was advertising what it sells – legal services, which are neither unwholesome nor degrading – under its own trade name, service mark, and logo, each of which appears in the challenged ad.”

The Court went on to say that no one reading the ad “would think that McHugh Fuller was doing anything other than identifying a health care facility that the law firm was willing to sue over its treatment of patients. In short, the ad very clearly was an ad for a law firm and nothing more.”

The case is McHugh Fuller Law Group v. PruittHealth, No. S16A0655.

Dementia Rate Declines

Posted in Dementia Care, Trial themes

Fox News had an article about the declining rate of people suffering from dementia.  A new study released shows the rate of Alzheimer’s disease and other dementias in adults aged 65 and up dropped to about 9 percent in 2012 from nearly 12 percent in 2000, continuing a decline noted in earlier research. Led by University of Michigan researchers, the study was published in JAMA Internal Medicine. Dementia was most common in the oldest adults; in 2012 almost 30 percent of adults aged 85 and up were afflicted versus just 3 percent of those 65-74.

The dementia rate declined amid a rise in diabetes and heart disease. Both increase risks for Alzheimer’s and other dementias but the researchers say better treatment for both diseases may explain the results.

Obesity rates also increased, while dementia was most common among underweight adults. Previous research has shown weight loss may precede dementia by several years and that late-life obesity may be healthier than being underweight.

The Alzheimer’s Association estimates that about 5 million people aged 65 and older have Alzheimer’s, and that is expected to rise to almost 14 million by 2050.



Video Surveillance is a Deterrent

Posted in Abuse and Neglect, Staffing

WFAA reported the horrific case of attempted sexual assault of a resident at Modern Senior Living Nursing Home.  A resident says she woke up to find Ngozi Nwokori groping her. She told police he unzipped his pants, exposed himself and climbed on top of her, trying to rip the bed sheets from her hands. It was a noise in the hallway that she says finally scared him off.

In fact, Modern Senior Living staff say video from a hallway confirmed Nwokori was in the victim’s room when he shouldn’t have been the night of the assault.

Curtis Clinesmith is a Dallas attorney who serves clients of nursing home abuse. He says families placing loved ones should ask about a facility’s video surveillance.

“One of the first things they should ask is if there are cameras available and what their access to that footage is,” he said.

In 2001, Texas became the first state to allow video monitoring in nursing home rooms.

“They can certainly put a camera in their loved one’s room and that sometimes acts as a deterrent,” said Clinesmith.

It could be an extra layer of defense when a family member is the most vulnerable.