Articles Posted in Nursing Home Neglect

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.”

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.

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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.

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.

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.”

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.”

Nurse Abuses Patient in Nursing Home
The Pennsylvania Department of Health has significantly buckled down on its penalty enforcement for nursing home violations over the last year after enduring much criticism.

The department released data showing that from July to December of 2015, fines and violations across the 700 nursing homes in Pennsylvania more than tripled compared to the earlier six months.

The Pittsburgh Post-Gazette reported that The Department of Health was receiving criticism in the form of a lawsuit filed not against the department directly, but rather nursing homes under their supervision. Back in July, the Pennsylvania attorney general’s office filed a lawsuit against nursing home chain Golden Living Center, which controlled 36 homes across Pennsylvania. The lawsuit pointed out that the homes had errors in the care of its residents, which went unpunished by the Department of Health.

Cops outside of Voorhees Center in New Jersey
A nursing home in New Jersey has been under investigation by FOX 29 for serious abuse accusations to the home’s residents. The charges, as reported by FOX 29 reporter Jeff Cole, include cover-up and neglect, and they have the family members of the residents completely enraged.

One of the licensed practical nurses of Voorhees Center nursing home, Nikki Thompson, was fired after her eight-year stint with the home. After reporting abusive and negligent behavior within her workplace, Thompson received a threatening note in relation to a specific image taken in the facility. The picture was of one of the female residents with dementia, 85-year-old Eleanor Hallowell, who was tied to her wheelchair with a bed sheet.

“I guess because they felt like they couldn’t deal with her, they tied her to a wheelchair,” Thompson told FOX 29.

The Pennsylvania Department of Health has put together a task force that will work to find new ways to advance quality improvement in Pennsylvania’s long-term care facilities. In the wake of allegations of inadequate care in 14 nursing homes operated by Golden Senior Living between 2008 and 2014, Secretary of Health Karen Murphy, said the state will take “immediate steps” to address the issue in her announcement about the task force earlier this month. “I am pleased to announce the Department of Health has formed a task force to determine what additional measures can be taken to ensure enhanced quality in these facilities.”

Nursing home abuse is all too common across the United States. A study done by the staff of the Special Investigations Division of the House Government Reform Committee found that 30 percent of nursing homes in the United States — 5,283 facilities — were cited for almost 9,000 instances of abuse over a recent two-year period, from January 1999 to January 2001. Types of abuse demonstrated in nursing homes includes physical, sexual, emotional & psychological, neglect, abandonment, self-neglect and resident-to-resident abuse.

Today there are about 1.4 million residents spread across 17,000 nursing homes across the United States. Pennsylvania is home to about 700 of these nursing homes. According to Nursing Home Report Cards, a Families for Better Care non-profit project that analyzes, compares and ranks state’s nursing home quality by utilizing staffing data compiled by the Kaiser Health Foundation, performance measures from the Center for Medicare and Medicaid Services’ Nursing Home Compare, and the Office of State Long-Term Care Ombudsman complaint data, PA’s nursing homes were ranked as 26th best in the nation in 2013. In 2014, PA fell 6 spots down to 32nd in the nation with an overall grade of D. However, PA ranked among the best in the nation in Severe Deficiencies with only 14 severe deficiencies in 2014.

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