Refusing to Disclose

MLive reported that Consulate Health Care and two nursing homes it owns and operates are being sued for allegedly refusing to turn over documents during an investigation into the death of one resident and violations that placed three others at risk for serious harm. The Michigan Protection Advocacy Service, during investigations into the incidents, sent requests for records related to the patients which were accepted by the facilities, then ignored.

Consulate Health Care denies that they were aware of the lawsuit against two of their facilities, and declined to comment on any accusations. Consulate was not initially named as a party to the lawsuit, which the complaint states will be fixed as soon as the Michigan Protection Advocacy Service can prove that Consulate is, in fact, the owner of both nursing homes.

You might wonder how the parent company might publicly comment on their facilities, yet the MPAS has struggled to prove that they are indeed the owners of the facilities. Consulate Health Care is a member of The Alliance for Quality Nursing Home Care Inc., which sounds like a warm and fuzzy non-profit, but is actually a powerful lobbying group composed of some of the biggest for-profit nursing home corporations in America. The Alliance gives money to political campaigns and other lucrative avenues of influence in order to push their agenda, which includes damage caps and “tort reform” which ensure that even the most shocking and terrible cases of abuse and neglect can only result in an award that amounts to pocket change for nursing home parent companies raking in millions.

Members of The Alliance for Quality Nursing Home Care are known to be highly creative in their structure in order to shield themselves further from liability. The Alliance was one of the many groups indicted during the exposure of illegal campaign funds which led to the end of former house majority leader Tom DeLay’s political career. To read more, check out our in depth summary of their involvement.

Politician Uses Influence To Protect His Nursing Home Business

Rep. Eric Turner, a House Republican secretly lobbied colleagues to kill a measure that would have been disastrous for his family's nursing home business. Multiple fellow Republicans with direct knowledge of the discussions told The Associated Press that Turner lobbied to kill legislation that would have temporarily halted construction of new nursing homes and elderly care facilities.

Last year, The Associated Press reported that Turner had pushed a measure to benefit a client of his daughter, who is a Statehouse lobbyist. In light of that, House Speaker Brian Bosma, R-Indianapolis, said last year he'd review how the House handles conflicts of interests. Turner's private lobbying marked an about-face from his public actions during the session, during which he regularly excused himself from votes on the measure and stayed quiet through public hearings.

House ethics rules bar lawmakers from voting directly to benefit themselves. Turner's children and others launched a last-minute campaign at the end of the session, bringing in top-tier Republican  lobbyists to sway lawmakers.  But it was his father's decision to swoop inas the session raced to a close that became deciding factor in defeating the nursing home measure.



Memory and Old Age

The Huffington Post had an interesting article on the German study of memory abilities of older people.  The study likened the memory abilities of older people to full hard drives: They don’t lose cognitive power over time; they just function slower because of an increasing amount of information.

The team of researchers from Tübingen University in Germany used computers to replicate different stages of an adult’s memory recall. The computer models were fed small amounts of information each day (much like young adults), but as the devices gathered more information, their performances mirrored those of older people, according to the study, which was published this month in the journal Topics in Cognitive Science.

Researchers concluded the brains of senior citizens do not deteriorate over time due to aging, as traditionally thought to be the case, but they slow down because they hold more information.


DON Compensated for Retaliation reported that former director of nursing, Darren Coggins, will receive $100,000 after reaching a settlement agreement with his former employer Heartland Employment Services.  Coggins was fired after complaining about understaffing and other unsafe conditions at the facility that put elderly residents at risk of injury.  The facility's management retaliated against Coggins by firing him after he called for the facility to hire more employees and fix its security protocols.

Coggins served as the nursing director at Heartland Health Care Center-Fostrian from January 2011 to September 2012, but his employment was terminated after two patients were able leave the facility by circumventing its security system.  The facility used Coggins as a "scapegoat" and that it violated multiple state statutes, including the Whistleblower Protection Act.

Records show a developmentally-disabled resident was able to leave the building Feb. 4, 2012, despite wearing a device that was intended to alert staff in such a situation, by leaving through an alarmed door on the building. The door alarm sounded as the resident left but another resident, who was given the code to the door by nursing staff so he could smoke outside the facility unsupervised, deactivated the alarm. Staff found the resident alone in the facility's parking lot.

A second resident was able to leave the facility Aug. 21, 2012, less than three weeks after an annual survey by the state revealed more than a dozen areas of concern at the facility. The state Licensing and Regulatory Affairs Bureau of Health Systems cited the facility for seven violations.
In that second incident, a wheelchair-bound resident with a history of dementia was found by a housekeeper in the facility's parking lot, despite also wearing a device to alert staff, after someone on the nursing staff disabled the alarm system.



Preventable Negligence

The Times-News had an interesting article on the recent OIG report finding that one in three nursing home patients were harmed by medication errors, infections or injuries. Doctors who reviewed the report for a news organization, almost six in 10 cases were preventable. "For anyone who has ever had a loved one in a nursing home or is contemplating that possibility, this should be pretty terrifying."

"What that means seems obvious: With a little effort, better training and well-followed procedures, many of those patients wouldn’t have had to suffer additional treatment or re-hospitalization. Pro Publica, a nonprofit journalism website that specializes in investigative reporting, ran a story outlining some of the more salient findings and talked to doctors about what it all means. In short, we’re not doing a very good job when it comes to ensuring the safety and care of our frailest residents."

"This study found that the odds are even worse in nursing homes. Many of these errors are the result of understaffing, inadequate training, negligence and lack of or failure to follow procedures."

Medical experts insist it is possible to reduce the number of preventable injuries and infections in nursing homes. It should be a priority, because doing so is good for the patient, their families, the nursing home and the taxpayers. Preventable accidents, medical mistakes and infections affect more than the patient; they cost our entire health care system by necessitating expensive additional treatment and readmission to the hospital. The study estimated that preventable injuries cost Medicare and patients about $208 million in that single month. Over a year’s time that’s almost $2.5 billion.

Nursing Home Industry Buying Arkansas Judges

The nursing home "king" of Arkansas (Michael Morton) has set up multiple channels by which money was funneled to previously discussed Mike Maggio.  Interestingly, about $18,000 on the day the jury verdict for abuse and neglect was arbitrarily reduced from $5.2 million to $1 million.  See full story at Blue Hog Report.


In February 2012, Estate of Martha Bull v. Greenbrier Care Center, Central Arkansas Nursing Center, and Michael Morton was filed in Faulkner County and was assigned to Judge Maggio. Morton is the owner of Greenbrier Care Center d/b/a Greenbrier Nursing and Rehabilitation Center, as well as Central Arkansas Nursing Center and many, many other nursing-home facilities.

The complaint alleged that Martha Bull, aged 76, had died at the nursing home on April 7, 2008, due to neglect and negligence on the part of Greenbrier Care Center staff. Because Greenbrier was managed by Central Arkansas Nursing, which was in turn owned by Morton, the complaint argued that Central Arkansas Nursing and Morton were also vicariously liable for the death of Ms. Bull. On April 19, 2013, Maggio entered orders that dismissed Morton and Central Arkansas Nursing from the suit.

At trial, the jury heard testimony and saw evidence of neglect and abuse that caused the resident's death. The jury returned a verdict in favor of Ms. Bull’s estate and awarded the estate $5.2 million on May 8, 2013. The order was entered on June 6, 2013.

On July 8, 2013, Judge Maggio granted Greenbrier Care Center’s motion for a remittitur hearing, because he found that the $5.2M award against the nursing home “shock[ed] the conscience of the court. Also occurring on July 8, 2013?

•Sherwood Nursing (owned by Morton) contributed $3,000 to GO Good Government PAC. That PAC was registered by Chris Stewart on July 31, 2013, and the PAC donated $2,000 to Maggio on December 5, 2013, and $250 on January 28, 2014.

•MSM Properties, Inc. (owned by Morton) contributed $3,000 to Thomas Group In PAC. That PAC was registered by Chris Stewart on July 31, 2013, and the PAC donated $2,000 to Maggio on December 5, 2013, and $250 on January 28, 2014.

•Quapaw Care & Rehabilitation Center (owned by Morton) contributed $3,000 to Judicial Reform PAC / Citizens for Judicial Reform. That PAC was registered by Chris Stewart on July 31, 2013, and the PAC donated $500 to Maggio on December 31, 2013, and $1,000 on January 28, 2014.

•Briarwood Nursing (owned by Morton) contributed $3,000 to Citizens for Information Technology PAC. That PAC was registered by Chris Stewart on July 31, 2013, and the PAC donated $1,450 to Maggio on January 28, 2014.

•Central Arkansas Nursing Centers (owned by Morton, and previously a defendant in the case above) contributed $3,000 to DBH 2 PAC. That PAC was registered (late) by Chris Stewart on August 8, 2013, and the PAC donated $2,000 to Maggio on December 5, 2013, and $1,000 on January 28, 2014.

•Michael Morton contributed $3,000 to Conservative Persons in PAC. That PAC was registered by Chris Stewart on July 31, 2013, and the PAC donated $500 to Maggio on December 31, 2013, and $1,000 on January 28, 2014.

•Good Shephard (owned by Morton) contributed $3,000 to Taxpayers for Change PAC. That PAC was registered by Chris Stewart on July 31, 2013, and the PAC donated $1,000 to Maggio on — wait for it — January 28, 2014.

Seven PACs, none of which existed prior to July 31, 2013, and all of which received the same amount of money from Michael Morton (or a Morton-owned entity) on the exact same date, which also happens to be the date that Maggio agreed to a remittitur hearing, some 32 days after the order was entered.  And, most damning, the PACs all gave money directly to Maggio on the same dates. Five of the seven gave money only to Maggio, and a sixth gave only $250 to one other candidate.

It appears that Mike Maggio let Michael Morton buy his way out of full responsibility for the death of Martha Bull for less than one cent on the dollar.

The real reason Maggio reduced the jury award to $1M was because Morton carried $1M in insurance coverage, so a $1M award wouldn’t actually cost Morton anything. Which means that Morton was apparently able to remove any personal liability in the case for the low, low price of $21,000. If that doesn’t make you angry, you aren’t paying attention.

 And what is even MORE interesting….following this money trail has led us to a land where the nursing home industry appears to be trying to buy influence in courts. There's $100,000 accounted for in donations from Michael Morton/nursing home entities to a three Supreme Court judges/candidates and one Court of Appeals candidate. See article in the Arkansas Times.

Court of Appeals Judge Robin Wynne has recently reported $7,000 from Morton’s companies and $7,000 from entities under Victoria Healthcare Inc., owned by Joshua and Ken Kilgore.

Associate Justice Karen Baker of the Supreme Court is another recipient of about $18,000 in nursing home industry money that links back to Morton.

Past Circuit Judge Rhonda Wood, of Conway, who now sits on the Court of Appeals and is running unopposed for the Supreme Court, has recently reported more than $60,000 in campaign contributions from entities linked to Reliance Healthcare Management and Morton.




Duty to Monitor Sexual Predators

A nursing home in Iowa was only fined $2,150 while mismanaging the care of a registered sex offender and placing the community of residents at risk.  Facilities should put in place measures to protect the safety of innocent residents and their visitors.

The 80 year old man was supposed to be closely monitored. The staff was under orders to check on him every half hour at least.  When he was stopped from approaching a young boy who was there to visit, the facility should have doubled down on precautions. Instead, since they were fined for not adhering to their plan, they just changed the plan, eliminating the precautions, so that they wouldn’t be violating it by failing to monitor the sexual predator.

Unsurprisingly, his behavior did not stop. He was found in bed with another resident. This time the facility decided to change his room and restart the twice an hour checks. When a state inspector came by however, the new room was adjacent to his alleged victim’s. The director of nursing even admitted that he had made several attempts to enter it. A better solution may be needed to separate the sheep from the wolves, and keep sex offenders and violent criminals away from the vulnerable populations inside long-term care facilities.

Until then, facilities must make do with the tools available to keep everyone safe. This facility obviously failed that test, and jeopardized the well-being of their residents by giving this known sex offender access to his victims and failing to properly monitor and restrain him.  See article at Newton Daily.

1500 Deaths Per Month

A study on the high incidence of “preventable adverse events” in skilled nursing facilities was published by the Inspector General of DHHS. Among other things, the report concludes that approximately one of three residents in skilled nursing facilities suffer a medication error, infection or some other type of harm related to their treatment, and that nearly 60 percent of the errors and injuries are preventable. Projected nationally, the study estimated that 21,777 patients were harmed and 1,538 died due to substandard skilled nursing care during August 2011, the month for which records were sampled. The report further concludes that more than half of those harmed have to be readmitted to a hospital, amounting to about 2% of Medicare's total inpatient spending.

The injuries and deaths were caused by substandard treatment, inadequate monitoring, delays or the failure to provide needed care, the study found. The deaths involved problems such as preventable blood clots, fluid imbalances, excessive bleeding from blood-thinning medications and kidney failure. Here is a good article on the report from Pro Publica.

"Substandard Living Conditions"

The L.A. Times reported that L.A. City Atty. Mike Feuer has filed a lawsuit against two assisted-care facilities for allegedly abusing their disabled patients in "deplorable, overcrowded and substandard living conditions."   “These residents are among the most vulnerable in our society and they were forced to live a daily nightmare,” Feuer said. “We are bringing that nightmare to a close." 

The two facilities, Agape Mission House and Agape Home Church are unlicensed. A judge appointed a receiver to immediately begin relocating those being cared for at the two facilities with the assistance of state and county officials.

According to court documents, residents at the facilities would be punished for failure to attend religious services twice a day, despite their individual beliefs. The punishments allegedly included being made to stand by a tree for up to four hours, being required to translate Bible verses for an entire day and sleeping outside at night.

From January 2011 to October 2013, Los Angeles police reported receiving more than 180 calls related to the properties, including a dozen attempted suicides, numerous assaults and batteries, assault with a deadly weapon, narcotics activity, indecent exposure and burglary from a motor vehicle.

Rape Victim was a "flirt"

This incident was so disgusting and outrageous, it was difficult to write about it. A Minnesota nursing home, Edgewood Vista, attempted to deny and then cover-up the rape of an 89-year-old victim even after the nursing home employee confessed to the rape. The home’s head nurse, Marilyn Moore, called her a "flirt" who harassed her attacker "mercilessly”.

"Did she tell you that this was consensual?" Moore told a nurse examiner who inspected the victim. "Did she tell you that she flirts with this boy mercilessly?" Nurse examiner Theresa Flesvig said she was shocked when Moore suggested the sex was "consensual." When she performed a full rape examination on the woman -- days after the attack -- she found the "biggest tear" she'd ever seen.

The victim told a nurse examiner that Merzwski sat down to watch a movie with her, but then took his clothes off. She tried to repel the younger man’s advances by pointing to a picture of her husband. “It’s not right,” she reportedly said. “This wouldn’t be right." The woman told her daughter what happened the next day, and the daughter called police.

While her claims were investigated, she was locked in a psych ward for three days while administrators tried to downplay the crime. “The room was dark and cold ... and they locked her in at night and all she had was a blanket,” Flesvig testified.

Once the victim was back in the nursing home, she was placed in the same room where the attack had occurred. This left her so panicked, she moved her furniture in front of the door for protection. The way the nursing home lied, manipulated, and tried to cover up the rape was appalling. Thankfully the police, summoned by the victim's fraught daughter, had no time for their deception.