Settlement in Maryland Class Action

Several media outlets have reported the $16 million settlement between Maryland and the nursing home industry including Consumer Affairs, The Baltimore Sun and the Washington Post.  Nursing homes sued Maryland for more money.  The average monthyl rate Medicaid pays for nursing home care is over $6,000.  The class action lawsuit, filed in August 2005, claimed that the state's Department of Health and Mental Hygiene erroneously concluded that nursing home residents could afford co-payments for their care. That determination failed to take into account the debt that patients accrued while waiting to be approved for Medicaid coverage, according to the suit. Federal and state law requires states to consider patients' debt when calculating their income.

Maryland taxpayers will provide $8 million of the settlement funds, with the federal government paying the other half. Nursing homes claimed that the state owed $64 million for incorrect calculations made since 2002.

The settlement could serve as precedent for other states that fail to take patients' old debt into account when determining their Medicaid eligibility. In order to qualify for Medicaid, the federal-state program for the poor, an individual must deplete his or her assets to reach a $2,000 threshold. Often, that patient needs care before reaching that limit and can accumulate thousands of dollars in nursing home bills.

Consumers can obtain information at the official settlement website

 


 

Class Action for Understaffing goes to Mediation

The Times-Standard had an article about the decision by Plainitff's attorneys in their successful class action case against understaffing in California nursing homes to participate in mediation to resolve the dispute despite the recent verdict in their favor.

The Humboldt County District Attorney's Office and lawyers for both sides signed a stipulation and order -- essentially an agreement to begin mediation -- with the purpose of reaching a settlement.  The agreement was reached the day before the trial was set to continue before the jury with the punitive damages phase.

The stipulation and order mandates that a stay be enacted in the case, which postpones any further court action. The trial is currently scheduled to resume on Aug. 9, at which time any remaining issues will be tried in a court trial with a judge rather than a jury.

In the meantime, the plaintiffs have agreed not to seek any relief of the previously announced jury verdict (some $677 million in statutory damages and restitution). The defendants, in turn, agreed to not file for bankruptcy or seek any relief from a court under Chapter 11 of the United States Bankruptcy Code, which would allow for a reorganization of assets.

The mediation negotiations are slated to begin July 25. The stock market responded immediately to the agreement, with shares spiking at $3.21 Thursday morning after Skilled Healthcare released a statement acknowledging the stipulation before closing at $2.78, well above the Wednesday closing value of $2.25.

 

 

 

Class Action on Staffing heads to the jury

Contra Costa Times had an article about the class action lawsuit against Skilled Healthcare Group Inc that has been in trial for 7 months.  The case is to insure proper staffing in nursing homes which benefit the residents and the overworked employees of the nursing home.  The main issue in the trial is how to properly count the number of hours a person works.

Skilled Healthcare, along with its subsidiary Skilled Healthcare LLC, owns 22 nursing homes currently under scrutiny.  Whether the nursing homes maintained staffing levels required by the state is at the heart of the trial, which lasted more than 100 days. California law mandates that nursing homes provide a minimum of 3.2 hours of care per resident, per day.

One of the plaintiffs' attorneys, Michael Thamer, who specializes in corporate abuse, said that the case is not about documents, but a matter of patients getting their needs met. Thamer said that if one thing controls the activities of a major corporation, it is the budget.

”The message from the top is simple: Stay beneath the budget,” Thamer said in his closing argument before making way for Wroten. “This corporate greed is what has kept the defendant from adequately staffing their facilities.”

Skilled Healthcare, which filed for bankruptcy in 2001, has been growing steadily over the past five years. The company has since bought up nursing homes in Texas, Kansas, Illinois, Missouri, New Mexico, Nevada and California.


 

Class Action against Skilled Healthcare Group, Inc.

The Fresno Bee reported a class action lawsuit regarding short staffing at Valley Nursing Home.  The lawsuit claims the obvious--that a group of for-profit nursing homes have put elderly residents at risk and skirted state law by skimping on staff to make more money.  Nursing home residents say staffing problems have plagued homes operated by Skilled Healthcare Group Inc., the 10th-largest nursing home chain in the country.  More than 32,000 nursing home residents are represented by the class action.  They hope to improve care.

Industry and advocates for nursing-home reform are watching the case closely. It's not the first class-action case nursing homes have faced for staffing problems, but the size of the case means it could have a far-ranging effect on how nursing homes are staffed.

Millions of dollars could be at stake. In addition to seeking punitive damages, the plaintiffs are suing for statutory damages for each day the nursing homes are found out of compliance with staffing laws. The plaintiffs contend the California homes were under-staffed thousands of days over the six-year period -- 2003 to 2009 -- covered by the lawsuit. Penalties can be up to $500 per resident for each day the law was violated.

Lawyers for the nursing-home residents say they hope not only to win restitution for residents, but also to spur reforms in the industry. "We want to change the corporate culture of the for-profit nursing operators to have them start paying more attention to the nursing of the residents and less attention to shareholders," said Michael Crowley, lead trial counsel for the plaintiffs.

Skilled Healthcare Group of Foothill Ranch was the nation's 10th-largest nursing home chain in 2009, based on the number of nursing beds, according to the trade journal Provider Magazine.

 

 

 

 

Skilled Healthcare Group Inc.: A holding company based in Foothill Ranch. It owns 78 skilled-nursing facilities and 22 assisted-living facilities in California, Texas, Kansas, Missouri, New Mexico, Nevada and Iowa.

*Total nursing home beds: More than 10,500.

*Employees: More than 14,000

*Revenue in 2009: $760 million. (The company posted a loss of $133 million.)

*Chairman and CEO: Boyd W. Hendrickson. He received $1.02 million in salary and bonuses in 2009.

Sources: Skilled Healthcare Group Inc., Yahoo Finance
 

Lack of disciplinary action against Administrators

Chicago Sun-Times had a great article about how administrators in Illnois (like most states) do not get disciplined when  the administrators allow or permit abuse, neglect, or poor care at nursing homes.  Illinois nursing home administrators are rarely disciplined even though the state Health Department, which investigates nursing home care, refers dozens of cases a year to the agency in charge of meting out punishment.

From 2005 through 2009, the Illinois Department of Financial and Professional Regulation received 407 complaints from the state's health department. Only three resulted in discipline for nursing home administrators.  THREE OUT OF 407 COMPLAINTS. 

Advocates for nursing home residents say that's a sign of a broken system.  "Less than 1 percent is ridiculous," said Toby Edelman, an attorney with the nonprofit Center for Medicare Advocacy. "There should be more accountability on the part of the administrators."

The numbers were put together by a task force Gov. Pat Quinn formed after a series of assaults, rapes and murders in Illinois nursing homes. The task force is looking into why so few cases result discipline, said Michael Gelder, Quinn's senior health adviser. "We're absolutely very concerned about that," he said.

Advocates for nursing home residents are now watching to see whether Jamie L. Lloyd, administrator of Maplewood Care in Elgin, will be disciplined after a 21-year-old mentally ill resident sexually assaulted a 69-year-old woman at the home. Lloyd did not do a proper background check.  Had Lloyd checked, he would have discovered the former resident had an outstanding arrest warrant on felony battery charges.

 

 

 

OBRA recognized as creating a private right of action

In a landmark opinion that recognizes a new cause of action for nursing home residents, the 3rd U.S. Circuit Court of Appeals has ruled that the Federal Nursing Home Reform Amendments give residents of county-run nursing homes the right to bring claims to challenge the quality of their treatment.   This is a huge victory for consumers of nursing homes.  Hopefully, other Courts will follow the sound reasoning and adopt the holding.

"The language used throughout the FNHRA is explicitly and unambiguously rights-creating," U.S. Circuit Judge Richard L. Nygaard wrote in his 23-page opinion in Grammar v. John J. Kane Regional Centers.   "These provisions make clear that nursing homes must provide a basic level of service and care for residents and Medicaid patients," Nygaard wrote.

"The FNHRA are replete with rights-creating language. The amendments confer upon residents of such facilities the right to choose their personal attending physicians, to be fully informed about and to participate in care and treatment, to be free from physical or mental abuse, to voice grievances and to enjoy privacy and confidentiality," Nygaard wrote.

Under the law, Nygaard said, nursing homes "are required to care for residents in a manner promoting quality of life, provide services and activities to maintain the highest practicable physical, mental and psychosocial well-being of residents, and conduct comprehensive assessments of their functional abilities."

Nygaard also found that the statute "specifically guarantees nursing home residents the right to be free from physical or mental abuse, corporal punishment, involuntary seclusion, and any physical or chemical restraints imposed for the purposes of discipline or convenience and not required to treat their medical symptoms."

Congress also chose key phrases that Nygaard found to be clear indications that private lawsuits should be allowed. "The repeated use of the phrases 'must provide,' 'must maintain' and 'must conduct' are not unduly vague or amorphous such that the judiciary cannot enforce the statutory provisions," Nygaard wrote.

As further evidence that Congress intended to create a private right of action, Nygaard noted that the FNHRA "use the word 'residents' throughout," and their provisions "are constructed in such a way as to stress that these 'residents' have explicitly identified rights, such as 'the right to be free from physical or mental abuse, corporal punishment, involuntary seclusion, and any physical or chemical restraints imposed for the purposes of discipline or convenience and not required to treat the resident's medical symptoms.'"

In the case of the FNHRA, Nygaard said: "[O]ur independent examination and assessment of the Medicaid Act disclosed no evidence of congressional intent to preclude enforcement of the rights created by the various provisions of this statute. This is so because no provision contains express terms to that effect and no comprehensive remedial scheme is established by the provisions at issue."

 

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...