South Carolina Nursing Home Blog

South Carolina Nursing Home Blog

Nursing Home Information & Litigation

What Would You Do With $10,000?

Posted in Advocacy

One nursing home is answering that question the same way that they always live their lives: by giving to others. The Randolph County Nursing Home houses a number of residents, including Merlene Brown. Brown had a mastectomy 13 years ago and says she knows how hard it can be to live with and as a survivor of breast cancer. The home has a number of people like Brown who form a support group. The NEA Breast Cancer Survivors Group is composed of 25 giving women who have survived breast cancer. They often engage those outside the home with breast cancer, sending special pillows and roses, writing letters, and holding meetings for survivors and families, says the nursing home’s activities director. The group has made a dance competition video in the hopes of winning $10,000 which they will donate to charity. To watch the group’s video (and maybe vote for them to win the prize), click here.

Texas Failing Those Most Dependent on the State

Posted in Abuse and Neglect

Families for Better Care recently released their second state report card for nursing home rankings. Coming in as the worst state for nursing homes is Texas, for the second consecutive year. Texas failed to meet minimum federal requirements in almost every category including staffing, inspections, and complaints. To combat the complacency of Texas’s long term care facilities and the seemingly inept Department of Aging and Disability Services, the regulatory body in charge of ‘overseeing’ nursing homes in Texas, lawmakers created a ‘three strikes rule’ which would make the DADS shut down violators who had three serious violations placing residents at immediate risk within 24 months. Hopefully, this measure will provide some relief to Texans everywhere who have no choice but to use the worst nursing homes in the country. Texas’ continued lackadaisical attitude towards long term care represents more than two failed report cards, it also represents a failure to each and every resident who lives in a home which doesn’t even meet minimal federal standards.

Caregiver Steals Rings From Residents’ Hands

Posted in Abuse and Neglect

Emerald Health Care received a shock when one of its caregivers woke up a resident. What was unusual was when the resident saw Christina Bazo slipping something on her hand. Bazo had been stealing jewelry from residents at the home, even daring to put lotion on residents’ hands to slip off rings. The resident told the staff who alerted police. Police found jewelry at a pawn shop and traced it back to Bazo.

Nursing Homes Aren’t Addressing Constipation, Fecal Impaction

Posted in senior care

Researchers from several established institutions just released a new study which shows that chronic constipation and fecal impaction are two areas of care where nursing homes aren’t meeting the needs of the residents. The study was conducted in 34 Spanish nursing homes, using surveys, data, and rectal examinations on consenting participants. This study is the first of its kind since other constipation studies have been based on the use of laxatives. What the researchers found is that chronic constipation is not well controlled in nursing homes, even though it’s very common. Almost 3/4 of all residents had chronic constipation, and half of those exhibited signs of fecal impaction. Part of the problem is that laxatives are not as effective in the older population as they are in others, and if a patient is given a laxative, there is no follow up to see if it worked. The researchers cite other studies done outside of Spain, some in the US, which suggest these results can be generalized to nursing homes elsewhere. The full study can be found here.

Put A Registered Nurse in the Nursing Home Act

Posted in Staffing, Trial themes

The New York Times’ fantastic blog “New Old Age” had an article on the lack of registered nurses in nursing homes.  The article explains how the lack of nurses contribute to the poor quality of care in understaffed facilities.  Studies have repeatedly pointed to the importance of registered nurses. With higher registered-nurse staffing, patients have fewer pressure ulcers (aka bedsores) and urinary tract infections and catheterizations. They stay out of hospitals longer. Their homes get fewer serious deficiencies from state inspectors. Their care improves, but it costs less.  Licensed practical nurses are vital to good care, and of course the lowest-paid certified nursing assistants — the aides — provide most hands-on help. But only registered nurses are trained and licensed to evaluate a patient’s care and conduct assessments when his or her condition changes, which can happen rapidly — and at 3 a.m.

“The 1987 federal law intended to reform the country’s nursing homes required a registered nurse on-site only eight hours a day, regardless of the size of the facility. Supporters at the time understood that in a building full of sick and disabled elders, health crises could occur at any hour. But getting the legislation passed required substantial compromises, including in regulations allowing reduced nurse staffing.”

“It’s something advocates have wanted to return to ever since,” said Robyn Grant, director of public policy and advocacy for the National Consumer Voice for Quality Long-Term Care. “I think most people will be both shocked and appalled that there’s not an R.N. on duty around the clock.”

Representative Jan Schakowsky, Democrat of Illinois, responded by introducing on July 31 the bluntly titled Put A Registered Nurse in the Nursing Home Act. It would require that a direct-care registered nurse be present 24 hours a day, seven days a week, in all the nearly 16,000 nursing homes that receive Medicare or Medicaid reimbursement.

Thirteen states (not South Carolina) require 24-hour registered nurse coverage in some cases, but their statutes vary.  The American Association of Nurse Assessment Coordination — one of several nursing organizations backing the bill — rooted through the ratings data on Medicare’s Nursing Home Compare site for 2012.   In the end, 1,777 nursing homes did not, which means that at least 11.4 percent have no registered nurse available around the clock. But that’s a fuzzy percentage, because a home could have two on the day shift and none at night, or have some registered nurses doing administration instead of patient care. Besides, all staffing data is self-reported. The actual proportion of nursing homes without a direct-care registered nurse much of each day could well be higher.

LESS STAFF FOR PATIENTS. POVERTY PAY FOR CAREGIVERS.

Posted in Staffing

Here is an excerpt from Alarisk.com, a public relations plan to increase staffing and improve caregivers’ pay.

When the owners of Omni nursing homes changed their company’s name to Alaris, they thought they were leaving negative news stories and their bad reputation behind.

But despite receiving hundreds of millions of your tax dollars from Medicare and Medicaid to deliver care to elderly and frail patients, Alaris is plagued by the same problems as the old company.

Poverty level wages and short staffing jeopardize patient care. Most Alaris nursing homes have certified nursing assistant (CNA) staffing ratios below both New Jersey and national averages, according to data from Centers for Medicare & Medicaid Services.

When the owners of Omni nursing homes changed their company’s name to Alaris, they thought they were leaving negative news stories and their bad reputation behind.

But despite raking in $376 million of your tax dollars from Medicare and Medicaid, Alaris is plagued by the same problems as the old company.

Despite making more than $41 million in profits in 2012, the overwhelming majority of Alaris nursing home workers earn less than $25,000 a year. Many workers have no choice but to enroll in public assistance just to get their children the healthcare they need.

THE FACTS

  • Omni changed their name to Alaris, but it seems that they haven’t changed their ways.
  • The overwhelming majority of Alaris nursing home workers earn less than $25,000 a year, while the company earns millions in profits.
  • Certified nursing assistant (CNA) staffing levels at a majority of Alaris nursing homes are below both New Jersey and national averages.
  • Hundreds of caregivers at four Alaris facilities are working under expired contracts and have filed unfair labor practice charges against Alaris for refusing to bargain in good faith.
  • Alaris is asking low-wage workers to pay even more for health insurance and seeks to reduce critical benefits including sick leave. Many workers already have no choice but to enroll in public assistance just to get their children the healthcare they need.
  • Unfair labor practices, persistent staffing shortages and management’s proposals to reduce job standards at four nursing homes have prompted hundreds low-wage Alaris caregivers, members of 1199SEIU, to prepare for a strike.
  • Caregivers and concerned community members are demanding answers from Avery Eisenreich, the multimillionaire owner of Alaris Health, as he seeks to demolish a nursing home in Guttenberg to build a luxury high-rise, displacing 100 elderly and frail residents.

Overprescribing Antipsychotics

Posted in Medications

McKnights’ reported that Michael Reinstein, M.D has been stripped of his medical license over charges that he received kickbacks and overprescribed antipsychotic drug clozapine to nursing home residents.   The revocation will last a minimum of three years, at which time he can apply for reinstatement.

Reinstein was the nation’s No. 1 prescriber of clozapine, according to investigative journalism organization ProPublica. In 2012, federal authorities brought a lawsuit against him, charging that he received kickbacks from pharmaceutical companies and submitted “at least 140,000 false claims to Medicare and Medicaid for antipsychotic medications he prescribed for thousands of mentally ill patients in [Chicago] area nursing homes.”  Three deaths have been linked to clozapine prescribed by Reinstein, according to ProPublica and theTribune.

Reinstein tried to defend his overuse of clozapine to treat patients with schizophrenia. The news organizations pointed out that the FDA has approved the risky drug only as a last resort for schizophrenics, and Reinstein at one point admitted to having 75% of the residents at a 400-bed nursing home on the medication.

In March, Teva Pharmaceuticals and IVAX LLC reached a $27.6 million settlement with the Department of Justice over the alleged kickbacks to Reinstein. IVAX, which makes clozapine, became a Teva subsidiary in 2006.

Financial Fraud

Posted in Regulatory enforcement, Trial themes

McKnights reported that Michael A. Horowitz was the criminal mastermind of a financial fraud that victimized nursing home residents.  He has admitted wrongdoing and will only pay $850,000 in a settlement, the Securities and Exchange Commission announced.  Horowitz, a broker, devised a scheme in which wealthy investors bought annuities that paid out when nursing home residents died.

Horowitz and his accomplices allegedly used a fake charity and other means to steal the residents’ identification information, and falsified documentation to get insurance companies to issue the annuities.  These insurance companies might not have sold the products if they knew the annuitants were terminally ill, and that Horowitz’s customers intended to use the annuities as “short-term investment vehicles,” the federal authorities stated.

 

“Worthless Services”

Posted in Trial themes

McKnights had an interesting article about Oxford Health & Rehabilitation Center’s frivolous argument to escape charges that it provided “worthless services,” a federal judge ruled in a False Claims Act case. The Mississippi nursing home, its former owner and certain affiliated organizations are facing charges of billing government health programs for “non-existent, grossly inadequate and materially substandard, worthless, harmful care,” the complaint states.

Medicare and Medicaid do not pay for specific services, but rather pay prospectively for the daily “bundle” of nursing home services, the defendants noted. Therefore, “the United States must plead that the ‘entire bundle of billed-for services had no value to the Government’ to prevail on a worthless services theory,” the defendants argued in court documents.  What a ridiculous argument!

District Judge Carlton W. Reeves rejected that argument in a July 9 ruling.  Reeves cited the government’s “compelling” counterargument that this logic ultimately means that a nursing home should be paid “for doing nothing more than housing an elderly person and providing her with just enough bread and water for short-term survival, even in conditions of filth, mold and insect infestation.”

These conditions were allegedly the norm at the nursing home in question. The ruling includes dozens of examples of neglect, substandard care and unsanitary conditions identified by surveys and other inspections between 2005 and 2012, including a snake discovered in a resident’s bed. These examples are sufficient to sustain the government’s “worthless services” claim, Reeves ruled.

 

 

Diverting Meds

Posted in Medications, Staffing

Violet Thelen, 44, admitted she stole painkillers from a Viroqua nursing home where she worked. She faces ‘multiple counts of possession of schedule II controlled substances and theft”. The Vernon Manor Nursing Home where Thelen worked investigated missing Vicodin and fentanyl patches.