Falsification of Records

The Duluth News Tribune reported that two nursing home employees were fired after falsifying medical records.  Two nurses at Cook Nursing Home failed to conduct blood sugar tests on seven residents, and then filed reports on insulin levels with made-up numbers, according to Minnesota Department of Health documents. Insulin was then withheld or given to residents based on the falsified numbers.  No criminal charges were filed yet.

This type of willful falsification typically is a result of inadequate staffing.  Not enough staff to get everything done so they take shortcuts.  A full investigation into the staffing data at the facility is necessary.

 

Debt Collectors at Hospitals

The N.Y. Times reported the horrible practice of debt collection agencies interrogating and intimidating emergency room visitors and others recovering at the hospital.  "This and other aggressive tactics by one of the nation’s largest collectors of medical debts, Accretive Health, were revealed by the Minnesota attorney general, raising concerns that such practices have become common at hospitals across the country."

The harsh tactics include "embedding" debt collectors as employees in emergency rooms and demanding that patients pay before receiving treatment, and discouraging them from seeking emergency care at all.  These methods were disclosed in hundreds of company documents released by the attorney general.  The company’s workers had access to health information in violation of federal privacy laws.  Accretive last year reported $29.2 million in profit, up 130 percent from a year earlier.

 "Concerns are mounting that the cozy working relationships will undercut patient care and threaten privacy, said Anthony Wright, executive director of Health Access California, a consumer advocacy coalition. “The mission of these companies is in direct opposition to the supposed mission of these hospitals.”"

Employees were told to stall patients entering the emergency room until they had agreed to pay a previous balance, according to the documents. Employees in the emergency room, for example, were told to ask incoming patients first for a credit card payment. If that failed, employees were told to say, “If you have your checkbook in your car I will be happy to wait for you,” internal documents show.   In March 2011, doctors at one hospital complained that such strong-arm tactics were discouraging patients from seeking lifesaving treatments.

 

Money Tied to Standards

The News-Messenger had a good article on how new regulations in Ohio will require nursing homes to show that they're providing quality and comfortable care for their residents or risk losing  funding.  Future funding for nursing homes could be tied to whether they reduce the number of times their residents go to the hospital, for instance, or increase the number of bathrooms that are wheelchair accessible.

For now, effective July 1, nursing homes must meet any five out of 20 standards or risk losing nearly 10 percent -- $16 per patient per day -- of their full Medicaid payments for services they provide.  Some of the standards are based on staffing levels, facilities and resident satisfaction.

Political Donations

The nursing home industry is donating large amounts of money to politicians who protect their interests especially their profits.  Several articles have mentioned the $175,000 given to Republican Utah Senator Orrin Hatch. If he wins reelection, Hatch may be chair of the committee that has jurisdiction over the tens of billions of Medicare and Medicaid dollars that flow annually to nursing homes.   Maybe they should use that money to hire staff.

A political action committee representing radiologists has spent about $77,000 supporting his candidacy through print ads and other activities conducted. The contributions show how some interest groups are demonstrating their support for Hatch beyond the $10,000 limit that political action committees must abide by when contributing directly to a candidate’s campaign.

Nursing homes rely heavily on federal reimbursements for profits. The federal government’s Medicare program is projected to spend about $31 billion on nursing home care in 2012. Medicaid, a federal-state partnership, will spend about $45 billion with nursing homes, according to Health and Human Services Department projections.

The nursing home industry's lobbying group, The Alliance for Quality Nursing Home Care, represents 12 companies owning about 1,400 properties throughout the county. The Alliance for Quality Nursing Home Care provided the largest donation of the year, $100,000, records show. The group then kicked in another $75,000 this year already.

Although the money was given with no strings attached, according to Republican party officials, there is little illusion as to its real purpose: to buy influence.

See articles at McKnight's, CBS, and Business Week.

 

Criminal Neglect

Charleston South Carolina's "Count on News 2" covered a story involving the arrest of Andrea Magwood.  Magwood is the owner of Fair Haven Manor assisted living facility.  She is accused of neglecting residents.  The Friday before her release, new pictures were presented to the bond court judge revealing the deplorable conditions of Magwood's facility.  Papers from court helped condemn the building of Magwood's facility with reports of a roach infestation, moldy food and malnourished residents.

Magwood's neglect charges are not the first accusations she faces concerning poor treatment of residents. In 2004 she was charged with stealing from and beating an elderly resident. To avoid facing trial on these charges, Magwood consented to pay a $4,000 fine.  Incredibly, Magwood was then allowed to reopen her establishment under a new name: Genesis Care Community. However, keep-out notices condemning the buildings as unsafe, unfit or abandon posted by the North Charleston Building department and a DHEC food quality stamp baring a large "C" suggests the facility's new clean title cannot erase a multitude of problems.
 

Ruby Weston Settlement

The NY Daily News had a great article on the case of nursing home Administrator Ruby Weston.   After years of delays, was justice served?   Ruby Weston operated two "non-profit" nursing homes that were funded by taxpayers' money in Brooklyn, New York.  Despite the facade of non-profit, Ruby Weston and her family profited from these homes by robbing the facilities of the funds needed to properly care for the residents.

After years of this hoax, her fraudulent and questionable financial dealings were revealed by the press in 2004.  Finally, after charges were brought against her eight years ago, she is finally paying only $871,000 in a settlement. Of this settlement, $821,000 will go to supplement the Marcus Garvey Home and $50,000 will go to paying the state for legal expenses.  Pretty good deal considering she paid herself personal paychecks of upwards of $380,000 in 2009, a bonus of $500,000 after construction of the Ruby Weston Manner in 1995, an annual salary of $500,000 to herself and upwards of $1 million to her son.

“It is inexcusable for someone to profit at the expense of elderly, frail and vulnerable New Yorkers in nursing homes,” Attorney General Eric Schneiderman said.

“I'm glad to hear about the money, but what it comes down to is that residents were cheated for years and years from the care they deserved,” said Richard Mollot, executive director of the Long Term Care Community Coalition and a longtime advocate for nursing home residents. “It's sad.”

See articles at North Country Gazette and Legal News Line.
 

"Worthless Services" Conviction

The Polk County Crime Examiner reported the conviction of nursing home owner/operator George Dalyn Houser of Atlanta on charges of conspiring with his wife to defraud the Medicare and Medicaid programs by billing them for “worthless services” in the operation of three deficient nursing homes.   The nursing homes suffered from food shortages bordering on starvation, leaking roofs, virtually no nursing or housekeeping supplies, poor sanitary conditions, major staff shortages, and safety concerns,  As hundreds of residents were neglected, Houser spent taxpayer money on real estate, vacations, and other luxuries.  Evidence proved that Houser diverted at least $8 million of Medicare and Medicaid funds to his personal use. Staffing shortages, employee injuries, high tunrover rate, and poor employee benefits were a major problem as it is in most for profit facilities.

The conviction is the first time that a defendant has been convicted after a federal court trial for submitting claims for payment for worthless services. The court found by clear evidence that the evidence showed “a long-term pattern and practice of conditions at defendant’s nursing homes that were so poor, that, in essence, any services that the defendant actually provided were of no value to the residents.”

The Medicare and Medicaid programs require nursing homes to provide sufficient dietary, pharmaceutical, and environmental service to care for their residents’ needs.  Leaky roofs, foul odors and mold were common.  Flies, mosquitoes and other insects, as well as rodents easily entered the homes through ill-fitting screens and doors.   Employees spent their own money to buy milk, bread, and other groceries so that residents would not starve. Employees also bought nursing supplies for the residents, cleaning supplies for the homes. Some employees also washed the residents’ laundry in laundromats or in their own homes.

“It almost defies the imagination to believe that someone would use millions of dollars in Medicare and Medicaid money to buy real estate for hotels and a house while his elderly and defenseless nursing home residents went hungry and lived in filth and mold,” said United States Attorney Sally Quillian Yates. “We will continue to aggressively protect our most vulnerable citizens and hold accountable those who prey on the elderly and steal precious healthcare dollars.”

"According to an FBI press release, between July 2004 and September 2007, Houser billed Medicare and Medicaid approximately $39.4 million, and they paid him $32.9 million based on his certifications and promises that he was providing the residents of the nursing homes with a safe,clean environment with nutritional meals, medical care, and services that would promote or enhance the residents’ quality of life."

Nursing Home Industry's "Astonishing" Profits

The Wall Street Journal's Market Watch reported the "astonishing" profits of the nursing home industry.   Nursing homes remain highly profitable.  Year-end earning statements for publicly traded nursing homes show a thriving enterprise with companies reporting “strong balance sheets” and “better than expected operating results.” One company’s annual revenues spiked nearly 200%.  

Brian Lee is the Executive Director of Families for Better Care.  Families for Better Care, Inc. is a citizen advocacy organization dedicated to quality resident care in nursing homes and other long-term care settings. Executive Director Brian Lee served as Florida’s State Long-Term Care Ombudsman for most of the past decade.

“The industry’s analysts framed the Medicare adjustment as an eventual doomsday for the nation’s nursing home market. But the industry’s own reports show quite the opposite, revealing surging revenues, strong profits, and expansion through acquisitions,” said Lee. “The industry is wallowing in strong profits while failing to consistently provide quality care.” 

The reason care declines in nursing homes is that executives unnecessarily target labor costs to offset any reimbursement adjustments,” Lee said. “While this obviously maintains a robust bottom line for investors and cushy CEO salaries, the decline in frontline staff puts residents in jeopardy for harm while simultaneously creating dangerous working conditions for employees.”

“Lawmakers must demand greater transparency and disclosure from nursing home companies and their affiliates. This will allow payment systems to be restructured, guaranteeing taxpayer dollars go directly to resident care and safety,” Lee commented.

A recent study by the University of California-San Francisco shows a steady decline in nursing hours for Medicare-licensed facilities and an unacceptably high level of deficiencies.

 

 

For Profits: Less staff, less care

 A new study conducted by researchers at the University of California at San Francisco has determined that the ten largest for-profit nursing home chains administer a lower quality of care to residents and accrue more deficiencies in federal inspections than their non-profit and government-run peers. These deficiencies potentially place residents' health in jeopardy when they are the result of negligent patient care or other nursing home malpractice.

In the United States, nursing homes typically fall into three different categories: government-run, non-profit and for-profit. The former two do not make money by filling their beds with residents that need skilled medical care; the latter does. In 2008, over half of all the nation's nursing homes were owned by for-profit chains like HCR ManorCare, Golden Living, SavaSenior Care, LLC, and Skilled HealthCare, LLC, to name half of the ten chains studied by the University of California researchers.

The study found that though these and the five other chain nursing home facilities had better growth and a higher market share than their non-profit and government-run peers, they also had 36 percent more total deficiencies and 41 percent more deficiencies that were harmful to residents. For-profit nursing homes had the highest bed numbers in the industry and the sickest patients, yet employed less staff and had 30 percent less total nursing hours than non-profit and government-run facilities.

Arrest for Kickback Scheme

LoanSafe.org reported the guilty plea of John D. Henderson, nursing home director of corporate maintenance and renovations at Medical Facilities of America Inc. (MFA), to accepting kickbacks and evading taxes.  MFA operates health care and nursing home facilities throughout Virginia and North Carolina.   Henderson conspired with others to steer contracts for repair, maintenance, and renovations at MFA facilities to co-conspirator contractors in return for kickbacks.   Henderson was also charged with evading taxes on his 2005 and 2006 federal tax returns. 

As the director of corporate maintenance and renovations at MFA, Henderson was responsible for overseeing maintenance, repairs and renovations of the various MFA locations throughout Virginia and obtaining quotes from contractors for capital improvements and equipment purchases. Henderson participated in a conspiracy with contractors to defraud MFA  in return for monetary payments amounting to millions.

 

Poliakoff & Associates, P.A., is one of South Carolina’s most respected and distinguished law firms. The Poliakoff firm began nearly 60 years ago by three attorney brothers: Matthew, J. Manning, and Bernard. With a history of believing the justice system...More...