Nursing Home Abuse Advocate

Nursing Home Abuse Advocate

News and updates on issues concerning nursing homes and assisted living facilities

Overmedicating Nursing Home Residents – Part 1

Posted in Abuse/Neglect, Family Resources, Nursing Home Abuse, Nursing Home Resident Safety

Recently, National Public Radio (NPR) has done a series of stories on the problem of overmedication of nursing home residents and what some facilities are doing right in this area. I thought I’d take the opportunity to share with you these stories, give you the links to the themand the audio of the original stories so you can be educated on this very serious issue. Part 1 of this series of posts deals with a story titled: “Old and Overmedicated: The Real Drug Problems in Nursing Homes,” reported by Ina Jaffe and Robert Benincasa.

A brief refresher: According to Bradley Williams, who teaches pharmacy and gerontology at the University of Southern California, “antipsychotics should only be used as a last resort, and just for a month or so, before gradually being eliminated.” Professor Williams also told NPR antipsychotics ”blunt behaviors. They can cause sedation…[and] increases [the]risk for falls.” Commonsense, right?

What I found most shocking about this story was not the fact over 300,000 nursing home residents are still being overmedicated by facilities using drugs which are not supposed to be used to treat Alzheimers. After all, I posted in September 2014 and October 2014 about this issue. What shocked me was the total disregard the physicians who worked for the nursing homes had for their patients’ rights.

Jody Moore, a California attorney who specializes in elder law, was interviewed by NPR as well. Ms. Moore brought a class-action lawsuit against a nursing home for using chemically restraining its residents without informed consent. “Informed consent” means the patient or their decision-maker is fully informed of the risks and benefits of a medical procedure, including the prescribing of antipsychotic medications. Indeed, the law requires a nursing home facility to obtain informed consent. According to Ms. Moore: ”We learned that the families really weren’t told anything other than, ‘The doctor has ordered this medication for you; please come sign a form,’ ” says Moore. “And families did.” During the lawsuit, Ms. Moore had the chance to question a physician under oath about informed consent and whether his practice was to get it from the resident or resident’s medical decision-maker. The doctor…that’s right…the DOCTOR, testified: “not only do I not get informed consent, but I don’t know of any doctor who does, and you’re crazy to think that that’s my job.” NOT YOUR JOB??!! I’m sorry to tell you, sir, but it is your job. Of course, the facility settled the lawsuit.

At the end of the day, residents need to protect themselves. If they cannot, loved ones must do so. You must demand nursing home residents are protected and appropriately cared for. If you believe you or a loved one is being chemically restrained, or is being given antipsychotics improperly, inform the facility of your concerns, in writing. Contact the state Ombudsman and the Idaho Department of Health and Welfare. And, finally, if you are so inclined, contact Kormanik Hallam & Sneed LLP for a consultation.

 

A Timely Reminder: Visit A Nursing Home…It Will Brighten Someone’s Day!

Posted in Miscellaneous

As we enter the holiday season, it is important to remember: Although we may be able to spend time with our families and loved ones, some nursing home residents are not so fortunate.

As pointed out so eloquently in an article by Ashley Roten of the Athens Banner-Herald: “Giving even just an hour or two of your time participating in activities such as assisting [residents] with their gift wrapping, singing carols with them or just having a friendly conversation with them could make all the difference in the world” to nursing home residents who are not visited by family or friends during the holiday season.

There are several facilities within walking distance of the offices of Kormanik Hallam & Sneed LLP, including the Idaho State Veteran’s Home. I hope to spend time in a few places in the coming weeks, making friends with some residents and, hopefully, making my, and the residents’ day a little brighter.

From all of us at Kormanik Hallam & Sneed, we wish you and yours a happy, healthy and peaceful holiday season.

Another “Record” Broken…Fine of $38 Million Dollars For Substandard/Unnecessary Care

Posted in Uncategorized

Recently, Extendicare Health Services Inc. agreed to pay $38 million to the U.S. government and eight states to settle allegations that it billed Medicare and Medicaid for substandard nursing care and unnecessary rehabilitation therapy. According to Reuters, this is a record: “The settlement is the largest paid by a nursing home chain to the government over failure to provide care.” The company, which operates more than 140 facilities in 11 states, of course, denied any wrongdoing…but you have to ask yourself: If the company is paying $38,000,000.00 to the federal government and some states…isn’t that a tacit admission of wrongdoing? After all, there’s no way it would cost that much to defend against legal action, right?

According to its website, Extendicare “operates 156 senior care facilities in the United States with approximately 15,000 beds. EHSI offers a continuum of health care services, including nursing care, assisted living and related medical specialty services, such as subacute care and rehabilitative therapy on an inpatient and outpatient basis.”  Although Extendicare operates two facilities in northern Idaho (Ivy Court and La Crosse Health & Rehabilitation, both in Coeur d’Alene), the investigation, thankfully, apparently did not find any fault with facilities in Idaho.

A total of $28 million of the settlement will cover claims that Extendicare billed Medicare and Medicaid for substandard services from 2007 to 2013. Another $10 million will cover claims that the company billed them for unnecessary rehabilitation therapy through its subsidiary Progressive Step Corp. According to Assistant Attorney General Joyce Branda, the investigation found that the facilities employed too few skilled nurses and that patients suffered injuries from falls, malnutrition, dehydration and infections, which in some cases required amputations.

What I found interesting is the settlement with the federal government also resolves two “whistle-blower” claims. What this means is staff or other employees stepped up and informed the proper authorities of the wrongful actions occurring at the facilities. To those two individuals, I say: “Thank you.” If only others would have done the same, perhaps a resident or two would not have suffered an injury.

Make no mistake, nursing homes are big business. In my experience, many large companies will stop at nothing to prevent the truth from getting out. That’s why it is so important for residents and family/friends to be watchful and, when something seems amiss, to report it. You might just save a life.

Nursing Home Arbitration Agreements – A Light At The End Of The Tunnel?

Posted in Uncategorized

After last week’s somewhat lighthearted post about pet owners, it’s back to something more important. Something that may effect a majority of nursing home and assisted living residents and their families. That something is forced arbitration of disputes with facilities.

What is “forced arbitration”? Well, oftentimes when a resident enters a nursing home or assisted living facility, they are required to sign contracts, which often contain a clause which says, in essence, you cannot bring a lawsuit against the facility in any court of law. Instead, you have to utilize a private “judge,” otherwise known as an arbitrator (sometimes there will be a panel of 3 arbitrators) to hear your case. Even people who are not parties to the agreement, namely, the surviving members of a resident’s family, who claim their loved-one’s death is because of a nursing home’s negligence or neglect, or worse, may be forced to utilize this arbitration procedure.  In theory, this procedure should afford swifter justice at a reduced cost. In practice, the resident’s family usually comes out with the short end of the stick. A recent case out of Oklahoma, however, may prove useful in fighting against forced arbitration.

The Oklahoma Supreme Court issued a decision on September 30, 2014, in a case called Boler v. Security Health Care, L.L.C.,  in which it held because the next of kin of Cleo Bolder, a deceased nursing home resident, did not sign a contract with the nursing home in their personal capacities and their claim was not wholly derivative of their loved-one’s claim, the arbitration agreement did not apply to the next-of-kin. Now that is a mouthful; let’s unpack that a little bit.

(1) The next-of-kin did not sign the nursing home contract in their “personal capacities” means: Sure, Cleo’s next-of-kin signed the nursing home contract, but only on behalf of Cleo. They didn’t sign it for themselves. The Court held that because this was the case, the contract could not be enforced against the next-of-kin.

(2) The next-of-kin’s claim was not “wholly derivative” of Cleo’s claim means: Recovery under Oklahoma’s wrongful death statute is for the benefit of the surviving spouse and children or next-of-kin. It does not go to the person who died’s estate. That makes it not “wholly derivative” in the Oklahoma Supreme Court’s view.

In the past, nursing home arbitration agreements seemed like a long, dark tunnel to family members trying to get just compensation for a loved-ones’ death. The Boler case gives loved-ones a light at the end of that tunnel.

 

Who Says Pets Aren’t Members Of The Family

Posted in Uncategorized

Maggie

Any one who knows me will tell you I am an animal lover. My chocolate Labrador Retriever, Maggie, comes to the office most days with me. (That’s Maggie’s picture.) At first, I was concerned how potential clients would view the fact I have my dog at the office with me. Then I figured: Hey, this is who I am. Also, I’ve found having Maggie around tends to put people at ease. In fact, there are days at Kormanik Hallam & Sneed when there are 3 dogs at the office!

Since I am an animal lover, the story about Cleo the cat and her owner Ms. Nancy Cowen. It seems Ms. Cowen had to move from her home to a nursing home facility; Cleo was left in the care of neighbors. Well, shortly after Ms. Cowen arrived at the home, staff noticed a cat hanging around the place. It wasn’t until a few weeks later that Ms. Cowen finally had the chance to see the cat and, of course, she recognized Cleo! Thankfully, the nursing home allows pets and Ms. Cowen and Cleo have been reunited.

Who says pets aren’t members of the family?

California Enacts A 100-Fold Increase In Assisted Living Facility Fines…That Just Tells You The Fines Were Too Small To Begin With

Posted in Abuse/Neglect, Nursing Home Abuse, Resident and Family Resources

In a recent San Diego Union Tribune article, Deborah Schoch noted California has just raised the fine the state can impose for violations which cause the death of an assisted living facility resident 100-fold. Sounds GREAT…doesn’t it? Well, dig a little deeper and you’ll find although it is a remarkable increase…the reason is that the fines were so low to begin with. Prior to the enactment of the current law, the most the State of California could fine a facility when it caused the death, thorough abuse or neglect, of a resident was $150.00. Unbelievable! Now, California can fine a facility $15,000.00. While that is a more respectable number…is it really enough?

In Idaho, according to the most recent Idaho Department of Health and Welfare regulations, the fines imposed on assisted living facilities are tied to the number of beds and the length of the alleged violation. Also, if the violation “places the health or safety of its residents in danger,” the state has the ability to remove all residents from the facility and appoint temporary management.

At the end of the day, it us up to the families of assisted living facility residents to protect the resident’s safety. If a resident dies due to abuse or neglect in an assisted living facility, the family should contact an attorney to be sure just compensation is obtained.

Infections In Nursing Homes – On The Rise…But Easily Preventable

Posted in Family Resources, Nursing Home Resident Safety, Resident and Family Resources, Resident Resources

A recent article on MedicineNet.com talks about a study performed by the Columbia School of Nursing shows infection rates at nursing homes are “on the rise,and that trend will continue until better hygiene practices are put in place.” The story, by Robert Preidt, contains important and useful information and some “simple” ways to decrease infection rates.

First, the bad news: The researchers analyzed data submitted by nursing homes to the U.S. Centers for Medicare and Medicaid Services between 2006 and 2010. According to the analysis, the data showed “rising rates of pneumoniaurinary tract infections, viral hepatitis, septicemia (blood infection), wound infections and multiple drug-resistant bacterial infections such as methicillin-resistant Staphylococcus aureus (MRSA).”

Now, the “good” news: There are simple steps which, if taken, could easily reduce the chance of infection. One example, cut the use of uniary cathaters and, instead, have residents use the bathroom on a regular basis. Sounds simiple, right? Well, nursing home facilities would need to hire sufficient staff to make this happen.

A second, universally recognized, method of reducing infection rates is even more simple: hand washing! The article quotes  the study’s author Carolyn Herzig, of the Columbia University School of Nursing: “When you walk into a nursing home for the first time, you should easily spot hand sanitizer dispensers or hand-washing stations. If you don’t see this, it’s an indication that infection control and prevention may be lacking at the facility.”

At the end of the day, it is up to all of us to prevent infections in nursing home facilities. If you do not see hand sanitizer dispensers or hand-washing stations, say something!

Big Pharma – Follow Up

Posted in Abuse/Neglect, Nursing Home Resident Safety, Nursing Home Resources, Resident and Family Resources, Resident Resources

In a recent post, I wrote about how “Big Pharma,” or pharmaceutical companies, have been pushing antipsychotic medications on nursing home residents as a method of making individuals who suffer from dementia more “manageable” for facilities who don’t have adequate staff or properly trained staff. Apparently, nursing homes are worried about the bad publicity.

In an article in The Hill: “Nursing homes are promising to reduce their use of antipsychotic medications on dementia patients 25 percent by 2016 and 30 percent by 2017.”  The questions are: (1) Is that “enough” of a reduction; and (2) With the amount of money involved, can we actually trust the nursing home industry to make the cuts?

The Hill article quotes Patrick Conway, chief medical officer with Medicare and Medicaid: “We know that many of the diagnoses in nursing home residents do not merit antipsychotics, but they were being used anyway.” If even one redident suffereing from dementia receives antipsychotic medication in an effort to control their behavior…that is too many. Shouldn’t the goal be “Zero tolerance”?

The amount of money made by Big Pharma in this area is staggering. My original post mentioned the $2.2 billion fine leveled by the federal government against Johnson & Johnson in 2013 for pushing antipsychotics to nursing homes to use on residents suffereing from dementia. Although not mentioned in my original post, this was not the first time Big Pharma had been fined. In fact, the AARP reports: “Back in 2009, Eli Lilly did the same thing with its antipsychotic Zyprexa, marketing to older people in nursing homes and assisted living facilities, federal prosecutors charged. In a settlement, the company agreed to pay $1.4 billion. At the time, Patrick Doyle, special agent in charge of the Office of Inspector General for the U.S. Department of Health and Human Services in Philadelphia, said: ”This case should serve as still another warning to all those who break the law in order to improve their profits.”

I may have a very jaded view, but here it is: There’s simply too much money to be made by Big Pharma for companies to give up this lucrative albeit illegal market. A $1.4 billion fine on a competitor wasn’t enough of a fine to prevent Johnson & Johnson from going down this path. Big Pharma is in the business of making money…the companies will do anything to improve their bottom line.

I do not expect this is the last you will hear from me about this issue.

 

Idaho Nursing Homes Are More Dangerous Than Last Year

Posted in Abuse/Neglect, Nursing Home Abuse, Nursing Home Resources, Resident and Family Resources, Resident Resources

Families for Better Care is a “non-profit citizen advocacy group dedicated to creating public awareness of the conditions in the nation’s nursing homes and other long-term care settings and developing effective solutions for improving quality of life and care.” According to Families, Idaho no longer ranks in the top-ten states for nursing home care.

Families “Nursing Home Report Card” uses data compiled by the Kaiser Family Foundation, performance measures utilized in Medicare and Medicaid’s Nursing Home Compare and the Office of State Long-Term Ombudsman complaint data. Basically, Families looks at lots of data and comes up with letter grades for the states. This link will take you to the page describing exactly how Families does its evaluation.

Let’s look at Idaho’s Report Card. In 2013, Idaho received an overall grade of “A” and was in the top ten states in the nation with a rank of 8th. In 2014, Idaho receives an overall grade of “B” and therefore is no longer in the top ten states, instead, Idaho now ranks 15th in the nation.

I think Families’ most disturbing findings are that “Severe deficiencies in Idaho nursing homes swelled 11 percent over the last year, pushing the number of potentially dangerous nursing homes to nearly one in every two” and “Verified ombudsman complaints increased 10 percent over the previous year, indicative of growing problems in nursing homes.”

What does this say about Idaho nursing home facilities? It says they are not as safe as they were. If you or a loved one is injured in an Idaho nursing home or assisted living facility, consider contacting the attorneys of Kormanik Hallam & Sneed LLP to discuss your potential options.

 

Surveillance In Nursing Homes: Shouldn’t The Facility Foot The Bill?

Posted in Abuse/Neglect

A recent article by Wes Venteicher in the Chicago Tribune caught my eye. The story is about some legislation in Illinois, which, if enacted, would allow cameras or audio recording devices in nursing home resident’s rooms, if the resident consents and the cost is covered. The legislation would also allow the recordings to be used in court and would include penalties for anyone who tried to obstruct or disable the device.

Illinois Attorney General Lisa Madigan announced the legislation and is quoted as follows: "The work that I have done … as attorney general has unfortunately proven that too often when our loved ones are in a nursing home they are not always safe and they are not always well cared-for." 

My question is this: If the nursing home or assisted living facility is responsible for providing a safe and caring environment…why should the residents or their families bear the cost of monitoring? It doesn’t seem appropriate to shift the cost away from the facility to the family who, quite frankly, may not be able to bear the cost. What do you think?