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More than 1 in 4 cases of possible sexual and physical abuse against nursing home patients went unreported to police, according to a government audit. These unreported cases violate a federal law requiring immediate notification of nursing home abuse.

The Health and Human Services inspector general’s office issued an “early alert” on preliminary findings from a large sampling of cases in 33 states.

Auditors identified 134 cases in which emergency room records indicated possible sexual or physical abuse, or neglect. The incidents spanned a two-year period from 2015-2016.

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Pennsylvania Attorney General Josh Shapiro is part of a coalition of 16 State Attorneys General and the Attorney General from the District of Columbia who sent a letter to the Centers for Medicare & Medicaid Services (CMS) hoping to protect nursing home patients.

These states are recommending that CMS keep in place its current pro-patient rule.  The existing rule protects patients’ rights by prohibiting pre-dispute arbitration clauses in nursing home and other long-term care contracts.  The current regulation was adopted on October 4, 2016, by CMS and a proposed rule would reverse the prohibition on binding pre-dispute arbitration clauses in Long-Term Care facility contracts.  Pre-dispute arbitration clauses require seniors to waive their rights to go to court to resolve any disputes with a nursing home.

In the August 7th letter, the Attorneys General stated in their comments “Pre-dispute binding arbitration agreements in general can be procedurally unfair to consumers, and can jeopardize one of the fundamental rights of Americans; the right to be heard and seek judicial redress for our claims. This is especially true when consumers are making the difficult decisions regarding the long-term care of loved ones. These contractual provisions may be neither voluntary nor readily understandable for most consumers. Often consumers do not recognize the significance of these provisions, if they are aware of them at all, especially in the context of requiring care in a nursing home.”

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The Pennsylvania Department of Health has levied $816,000 in fines against nursing home providers already in the first half of 2017. That is more than double the $407,450 in fines handed out in 2016.  The department also handed out fines of $170,050 in 2015 and $62,000 in 2014.

In 2014, there were 7 cases where the department found a citation that had caused a resident actual harm. So far in 2017, there have been 88 cases.  This vast increase in fines is due mostly to regulators using a more rigorous penalty system.  The rigorousness is coming after receiving criticism for being too lenient on insufficient care.  “When the auditor general looked at our oversight of nursing homes, one of the key recommendations was to be more aggressive in our oversight, and we are,” the department said earlier this year in a statement.  In October 2016, Secretary of Health Karen Murphy announced that the department would be using more discretion in determining how much it would fine facilities.  The department will be taking into account the level of harm, how long it takes for a problem to be fixed, the facility’s track record of compliance, and other factors.

April Hutcheson, a department spokeswoman, said the department has resumed using federally mandated anonymous reporting, which had been discontinued previously. State surveyors also received federal training last year for how to identify the scope and severity of the situation “and, as a result, we have seen an increase in citations of deficiencies at the actual harm and immediate jeopardy level,” said Lorraine Ryan, a CMS spokeswoman.

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In our last blog post we talked a bit about signs that it might be time to consider assisted living for an aging loved one. In this post, we will talk a bit about Nursing Home Abuse and Elder Abuse. How often abuse occurs, what to be on the lookout for, and what to do if you think an aging loved one has been abused or is being abused.

Unfortunately, nursing home abuse and elder abuse are common and take many forms. According to the Office for Victims of Crime, roughly 5 million people over the age of 65 are victims of elder abuse or nursing home abuse each year. Abuse can be physical, psychological or sexual. Abuse can also take the form of neglect and financial exploitation. Abuse can come from anywhere, even friends and family members. Even more frightening is that only 1 in 24 cases of elder abuse or nursing home abuse is reported to authorities.

Continue reading →

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Whether to move a loved one into an assisted living home or hire an in-home caregiver is a difficult decision. Families can feel pressure to continue providing care for an aging adult despite signs that it might be time to explore other options. Other times families may find themselves unsure as to whether a loved one may need around the clock care.

While there is rarely a clear sign that it is time to move an aging family member to an assisted living home or hire an in-home caregiver, Caring.com recently published a list of eleven signs that family members and caregivers can look for to help in making that decision. Here are some highlights from that article: Continue reading →

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When moving a family member into a nursing home you are doing so with the hope that they will be given the utmost care and protection.  Unfortunately, understaffing in nursing homes leads to neglect of its elderly residents.  When there is a shortage of staff members compared to the amount of residents, the staff becomes overworked and stressed and it is the residents that suffer. This leads to increases in malnutrition, unhealthy weight loss, dehydration, infections and bedsores among the nursing home residents.

PennLive analyzed Medicare and Medicaid reimbursement data to compile a list of the 18 most understaffed nursing homes in Pennsylvania based on hours spent caring for each resident. PennLive also compiled how much of that care came from registered nurses (RN), licensed practical nurses (LPN), and certified nurse assistants (CNA).  It is recommended that at least 4.1 staff hours a day be spent on each resident’s care.  The average hours per day spent on each resident is 2.84.  The most understaffed home on the list was Manor Care in Pottsville (2.77 hours of care per day). Manor Care, which is one of the biggest nursing home chains in the United States, occupied 10 of the 18 spots on this list.

The full list can be seen here.

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A resident and her daughter are suing Carrington Place, a nursing home in Chesapeake, Va., after claims of severe abuse by two nurses. Alice Mackey, 84, was allegedly tied to a chair by the nurses and sedated in order to quiet her, as reported by The Virginian-Pilot.

Police have been notified, and the facility is denying such allegation. Neither of the registered nurses accused have been charged. The Department of Health investigated the complaints, and the lawsuit states there was another resident tied down in addition to Mackey. It also mentions that Mackey’s daughter was not informed of the alleged abuse, an attempt by the facility to “cover up” the situation.

The facility has enacted a correction plan, which included better staff training on abusive situations. The Mackey family is seeking $17 million in damages.

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Over the last two decades, 366 Pennsylvania nursing homes were fined almost $5 million for “federal deficiencies in care largely related to the health and safety of residents,” according to the Reading Eagle.

Individually, the average fine was no more than $6,000, which critics have declared too generous.

Marty Kardon, former chairman of the nursing home litigation committee for the American Association of Justice, stated that pulling licenses is the only way to “slap them down,” rather than these small fines.

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golden nursing homeA six-month investigation headed by PennLive revealed dozens of people died at the hands of Pennsylvania nursing home errors and neglect. Those homes, for the majority, were found to have not been punished by the state, and investigators are suspected of not properly reporting misconduct.

Pennsylvania Senator Bob Casey voiced the need for the state Department of Health to execute an internal investigation regarding the cases.

“When our state’s seniors and families make the decision to enter a nursing home, they are placing a life in those homes administrators’ hands,” said Casey in a statement. “If even one life is lost due to the negligence of these facilities, we need to step back, ask why and see what changes are needed.”

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Auditor General Eugene DePasqualeA 91-page audit was recently released by Auditor General Eugene DePasquale regarding the need for Pennsylvania’s Department of Health to buckle down on enforcement in nursing homes.

The audit, as reported by abc27, involved 13 findings and 23 recommendations. The Department was reported to have shirked their duties when it came to documentation, following proper protocol and enforcement. In turn, this carelessness led to the neglect of nursing home residents as well as unsanitary conditions.

In a press conference, DePasquale stated, “What this tells me is the Department of Health was not looking. And when you don’t look, there’s no way to discover problems.”