Articles Posted in Nursing Home Violations

New York State routinely allows nursing home owners with a record of poor care and government fines to operate more long-term care facilities in the state, according to a report by The Buffalo News. Speaking to the upstate newspaper, Toby Edelman at the Center for Medicare Advocacy described the problem as a “disturbing but all-too-familiar pattern” and joins elder advocates in demanding the New York Health Department provide more transparency and stricter scrutiny when selecting nursing home owners. In response to the criticism, the New York Department of Health, the state agency responsible for regulating nursing homes, drafted legislation intended to allow stronger and more effective government oversight of the long-term care industry.

The evidence uncovered during The Buffalo News investigation paints the portrait of a government agency whose incompetence is endangering elderly New Yorkers. Of the 47 nursing homes in the newspaper’s geographical area, sixteen were purchased in the last decade by for-profit nursing home corporations, which have a documented record of provider lower-quality care to their residents.

In one instance, the Department of Health approved the takeover of a nursing home by a group of New York City investors fined almost $90,000 in the last two years. In another example cited by the newspaper, a nursing home corporation with poor ratings and federal and state fines totaling “at least $325,000” was approved to purchase another nursing home in the state. In both cases, the state agency amazingly concluded that it had received “no negative information” about the nursing home owners. The deputy health commissioner told the newspaper that the agency now vets potential nursing home owners more thoroughly.

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In response to the increase in for-profit nursing homes and recent data on nursing staff levels across the state, New York lawmakers plan to introduce a bill establishing minimum levels of nursing staff at long-term care facilities across the state. According to state legislators, under-staffing remains a serious problem at New York nursing homes and directly contributes to a lower quality of care for their elderly residents. Originally drafted two years ago, Republicans in the state legislature blocked the measure. However, with Democrats set to control all branches of government next year, the Safe Staffing for Quality Care Act will likely become law.

The proposed legislation will establish a minimum ratio of nursing staff to patients, which will vary by the level of care required for the patient. For patients undergoing active rehabilitation at a nursing home, there cannot be less than one nurse or nursing assistant for each patient. Further, the bill would require a nurse to spend an average of 291 minutes with each patient every day. According to The Buffalo News, this would be a significant change for most nursing homes. According to the newspaper’s analysis, only 8 percent of New York nursing homes currently satisfy these requirements.

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The nursing home industry continues to reshape itself as small, independent nursing homes focused on providing high-quality care are rapidly replaced with corporate conglomerates seeking to maximize the profits. Predictably, the harmful effects of the profit-seeking model have only amplified in the last year. According to industry analysts, the ownership structure of nursing home conglomerates – where multiple nursing homes are owned and operated by the same owners – combined with riskier financial decisions are causing a slew of bankruptcies and closings across the country. In addition to removing America’s senior citizens from their nursing home, investigations into for-profit care providers have raised serious concerns about the quality of care provided to financially stable nursing homes.

Last November, The Washington Post reported on HRC ManorCare, a massive nursing home chain owned by Carlyle Group, reportedly one of the “richest private-equity firms in the world.” Despite an owner flush with cash, the nursing home chain struggled financially for five years and eventually filed for bankruptcy. The five years of financial instability exposed HRC ManorCare’s 25,000 nursing home residents to increased health risks, according to the newspaper. The number of health code violations at the nursing home chain rose by 26 percent, which includes serious health violations for failing to prevent bedsores, medical errors, and failing to provide proper nutrition and hygienic care for residents. Serious health code violations – violations that either caused “actual harm” or put patients in “immediate jeopardy” – rose 29 percent between 2013 and 2017, the year HRC ManorCare filed for bankruptcy.

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Elder abuse is one of the most widespread and under-reported problems in the country. However, despite the prevalence of elder mistreatment, the federal government does not gather data or require reporting for the crime against America’s senior citizens. With the population of Americans over the age of 65 expected to double by 2050, elder care advocates are urging the federal government to stiffen enforcement and begin tracking elder abuse cases across the country.

Elder abuse encompasses a wide range of illegal behaviors, from sexual abuse and financial exploitation to outright neglect by family members, caretakers, or nursing homes. Unfortunately, the federal government has not provided states with a precise definition of what behaviors constitute “elder abuse” and therefore, the exact definition varies depending on the state. When the federal government attempted to gather data on the subject for the first time this year, federal bureaucrats described the data received from states as incomplete, according to USA Today.

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Over a decade after a scathing article in the New York Post about the low-quality of care provided in many New York City nursing homes, the problem continues unabated at many nursing facilities. In 2006, the New York Department of Health fined 48 nursing homes in the five boroughs – including eight with violations so severe that nursing home residents were in “immediate jeopardy.” These nursing homes included:

  • United Odd Fellow and Rebekah Home. According to the Department of Health, a resident choked to death because the facility lacked adequate staffing. An inspection report from that year concluded that more than half of the staff at United Odd Fellow and Rebekah Home did not know how to perform the Heimlich maneuver.
  • Split Rock Rehab and Health Care. During 2006, this Bronx nursing home allowed a resident to die from lack of oxygen.

Following several scathing investigations and reports, veterans’ groups are demanding better care at the nursing homes run by the beleaguered Department of Veteran Affairs. While public condemnation has mounted for the past few years over the VA’s ability to care for the country’s 20.4 million veterans, criticism of the nursing homes run by the government agency began last summer when a report found that 70 percent of the VA’s nursing homes received failing grades. Perhaps even worse, more than half of these nursing homes received the lowest grade possible. According to news organizations, the government has collected quality reports and grades for each nursing home run by the federal agency each year. Until the rankings leaked this year, the government had chosen not to publish the results.

In a follow-up investigation reported by The Boston Globe this week, news reporters found a VA nursing home filled with sleeping staffers and a closed cafeteria. Other examples the substandard level of care found at VA nursing homes include a veteran with undiagnosed scabies, a veteran who had sat in soiled sheets for hours, and a veteran writhing in pain because he had not received his scheduled medication, according to USA Today. The national newspaper also reported that a nursing home in Alabama declared a Navy Veteran dead after he simply walked out of a supposedly secure nursing home one night and did not return. Rege Riley, national commander of American Veterans, told USA Today that the “stories being reported about the treatment of some individual veterans at these facilities are nothing short of horrifying.”

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A study released by the University of Illinois at Chicago reports that for-profit nursing homes provide lower-quality care to their elderly residents. This study provides further confirmation that the for-profit nursing home industry, which is still growing across the country, is sacrificing adequate care for vulnerable senior citizens in the pursuit of ever-growing profits. Once again, elder care advocates are sounding the alarm about the substandard quality of care and the need for greater government oversight while President Trump’s administration continues to deregulate the industry.

The University of Illinois at Chicago study included more than 1,100 senior citizens living at five different Chicago hospitals between 2007 and 2011. The results showed a stark difference in the quality of life and health of elderly residents depending on whether their nursing home operated as a non-profit or as a profit-seeking business. Overall, residents at for-profit nursing homes were twice as likely to have health problems related to poor or neglectful care. Among other maladies, for-profit residents were more likely to suffer from severe dehydration, develop stage 3 and stage 4 pressure ulcers – the most serious and commonly preventable type of pressure ulcer, or bed sore. Further, the study concluded that broken catheters and dislodged feeding tubes were more common in for-profit nursing homes and their patients were less likely to receive satisfactory care for their chronic health conditions.

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Nursing home residents nearing the end of their lives are increasingly being sent to rehabilitation therapy for their final weeks of life. According to a new study published in the Journal of American Medical Directors Association, senior citizens at for-profit nursing homes are twice as likely to spend their last days at a rehabilitation center instead of a hospice. According to elder care experts, the primary motivation for forcing senior citizens through rehabilitation during their last days involves churning a profit for the nursing home, according to The New York Times. Rehabilitation services, such as physical, occupational, and speech therapy, are a significant source of revenue for nursing homes. Sending a resident to hospice for palliative care, on the other hand, ends the revenue stream for that resident.

The study’s appalling conclusions found that 14 percent of New York nursing home residents received some form of rehabilitation in the month before they passed away. Four percent received a significant amount of therapy each week – between 325 minutes to 12 hours each week – in their final month. Medicare typically covers rehabilitation services and the highest payouts go towards senior citizens receiving 12 hours of rehabilitation each week, or “ultrahigh levels” according to Medicaid. Disturbingly, the number of senior citizens receiving “ultrahigh levels” of rehabilitation in their final month increased 65 percent between 2012 to 2016.

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Medicare recently lowered the overall ratings of almost one-fourth of the country’s nursing homes due to insufficient staff levels. The move comes after Medicare adopted a new, objective measurement for staffing nursing homes. Previously, Medicare relied on unverifiable data submitted by the nursing homes. Medicare ratings, which can range between one and five stars, are provided for several categories of nursing home care, such as its rating of pressure ulcers or slip-and-falls, along with an overall rating for the nursing home. Medicare now gives the lowest rating, a single star, to 1,387 nursing homes across the country, according to The New York Times.

Medicare requires all nursing homes to have a licensed nurse working at all times and a registered nurse working at least eight hours every day. The payroll data submitted to Medicare by the nursing homes show that the registered nurse requirement produced the majority of compliance problems. Registered nurses, who have the highest level of training and education requirements, are typically able to provide medical services, such as diagnosing illnesses or prescribing medicine.

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The reporting at one nursing home in New York is intensifying as more allegations of neglect and abuse continue to surface. A steady drumbeat of news reports has thrust Sodus Rehabilitation and Nursing Center in the Buffalo area and its mistreated residents into the spotlight over the last year. As the dangerous and unhygienic conditions have come to light, outrage in the community has grown and families of the residents say they are scared for their loved ones.

The nursing home, previously named Blossom View, first received attention from the local news last year when one man came to visit his father and found him dead. Admitted only two weeks earlier, the nursing home resident had fallen several times, suffered multiple bruises, head injuries, and even several broken bones during his short stay. The staff told the son they already knew and simply forgot to notify the family or remove the body.

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