Articles Posted in Nursing Home Violations

After addressing the shortage of nursing staff in hospitals, healthcare advocates have set their sights on implementing “Safe Staffing” policies in New York’s nursing homes. Safe Staffing policies would legislate minimum levels of nursing staff across the state’s nursing homes. Currently, New York State law only requires “sufficient staffing” which grants nursing homes wide discretion to determine whether its facility has sufficient levels of staffing. Elder care advocates lobbied state legislators to include safe staffing requirements in the budget this year. Lawmakers in Albany declined their request.

Instead, lawmakers opted to study the staffing levels at nursing homes. According to The Buffalo News, the budget passed earlier this year in Albany included a directive to the New York State Health Department to begin a study on May 1 analyzing “the range of potential fiscal impacts of staffing levels, other staffing enhancement strategies, and other potential quality improvement initiatives,” according to WHEC. The health department will then issue a final report to lawmakers at the end of the year. Given the timing of the report, it appears unlikely that any legislation will pass this year establishing mandatory staffing levels at nursing homes. Studies in Albany can frequently go in two directions. In some situations, studies are meant to endlessly shelve an unpopular idea. In other circumstances, studies can empower government agencies to develop their own policy proposals that will then be quickly passed into law.

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Employees at an Illinois nursing home stole more than $750,000 from a 96-year-old woman, according to The Chicago Sun Times. After the appalling theft, the thieves are now trying to delay the nursing home patient’s lawsuit trying to recover the stolen funds. According to attorneys for the elderly woman, the former nursing home employees are deliberately stalling in hopes that the woman passes away before the lawsuit’s conclusion. “I think they’re hoping they’ll get off the hook if she dies,” Cook County Public Guardian Charles Golbert told the Chicago newspaper. Because the nursing home resident, whose name is Grace Watanabe, does not have a spouse or any children, the money was willed to two non-profits in the local area. If Watanabe were to pass away before the conclusion of the lawsuit then those organizations would have the legal right to “step in” to her shoes and finish litigating her civil lawsuit.

The judge overseeing the case is to frustrate the nursing home’s attempts at delaying the case. Last week, the judge imposed a $400 fine as part of a contempt order aimed at executives of Symphony Residents of Lincoln Park. These executives are refusing to sit down for a deposition and answer questions about the treatment of Grace Watanabe. The employees who are accused of stealing money from Watanabe, who is diagnosed with advanced stage dementia, have invoked their Fifth Amendment right against self-incrimination when asked about the alleged crimes over the past few months. Criminal charges are expected to be filed against the fraudster in the next few weeks, according to Cook County District Attorneys.
 
The illegal scheme to defraud Watanabe was discovered by federal authorities after the bank alerted them of suspicious withdrawals coming from the nursing home resident’s bank account. Unfortunately, this type of financial fraud is a common form of elder abuse, which has been on the rise across the country and remains sadly under-reported. Employees of a nursing home or caretakers discover the financial information of an elderly person, typically with limited cognitive abilities, and then take advantage of their position of trust by swindling the person out of their money. In this instance, it appears the lowlife criminals will not be able to get away with it, though. In addition to the $400 daily fine, which the nursing home says it will appeal, an entire community of Japanese-Americans have rallied support for Watanabe and promise to keep her case in the spotlight and hold the thieves responsible, whether Watanabe lives to see that result or not.

Webcams are becoming popular in nursing rooms across the country as families see it as an easy way to check on their loved ones and prevent neglect and elder abuse. Driven by the increased use of security cameras across the country and their reduced prices, webcams are popping up across the country and, when used discreetly, can sometimes catch cases of horrific elder abuse. The legality of webcams inside of nursing homes is sometimes questionable. A Minnesota court ruled in 2017 that a family had a right to set up a webcam in their loved one’s room after nursing home staffers kept unplugged and moving the camera – apparently not wanting to be recorded. Since 2017, seven states have passed legislation allowing families to place webcams in nursing home rooms.

While states move to legalize the use of webcams, privacy advocates have some concerns about the widespread use of webcams in elder living facilities. First, since nursing home residents are particularly vulnerable and prone to cognitive impairments then the decision to set up a webcam usually falls on their guardian or family. Given the serious privacy implications of being constantly filmed, family members would hopefully consult their loved one. Unfortunately, studies reported by Medical Xpress show that families tend to value “keeping the peace” over discussing these important matters.

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The Centers for Medicare and Medicaid Services (CMS) announced arbitration agreements would be allowed in nursing home agreements which receive federal funding. Under President Obama’s administration, CMS barred nursing homes from inserting mandatory arbitration clauses into their agreements. Mandatory arbitration agreements bar nursing home residents from bringing any legal grievance against their nursing home in a courtroom. Since nursing home residents are particularly vulnerable and nursing homes have a poor record of abuse and neglect, President Obama’s administration reasoned that mandatory arbitration clauses should be banned in all nursing home contracts.

Predictably, the nursing home chain did not support the federal government’s ban on arbitration clauses. The elder care industry said that arbitration provides a faster, more efficient resolution of claims for everyone involved. When President Trump came into office, his administration took a more industry-friendly approach to regulating nursing homes. In addition to sharp drops in fines on nursing homes, CMS also began deregulating the nursing home industry and appears to have reached a compromise on the mandatory arbitration agreement. Under the rule finalized this month, nursing homes will be allowed to include arbitration agreements in their default contracts with nursing home residents. However, nursing homes cannot deny admission to any resident because of their refusal to include a mandatory arbitration clause in their contract.

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Top ranking nursing homes in New York are less likely to admit poor residents despite a state and a federal ban on discriminating against the ability to pay during admissions. According to a recent analysis by The Buffalo News, New York nursing homes routinely deny admission to poor New Yorkers on Medicaid. A reason for denying admission is typically never provided but elder care advocates say it is not difficult to do the math. Medicare, the government-run health insurance program for the elderly, pays significantly more to nursing homes than Medicaid, the government-run health program for low-income New Yorkers. While the payouts differ depend on the region, an upstate New York nursing home can expect approximately $148,555 annually for each Medicare patient. For Medicaid patients, the reimbursement is almost half – just $86,505, according to The Buffalo News.

The price disparity has incentivized nursing homes to seek out wealthier patients, despite a statewide ban against the practice. Some nursing homes are particularly brazen in their efforts. For example, the five-star rated North Westchester Restorative Therapy and Nursing Center admitted zero Medicaid patients out of its 665 total admissions last year. Unable to gain admission to the state’s five-star nursing homes, Medicaid recipients are now taking a larger share of beds at the state’s worst facilities. At Riverdale Nursing Home in the Bronx, nearly two-thirds of new admissions to the one-star nursing home are Medicaid recipients.

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Nursing home residents may need family members or advocates to report cases of elder abuse. According to The National Elder Abuse Incident Study, only 20 percent of neglect, exploitation, abuse or self-neglect is reported to state authorities. The nonprofit agency which conducted this study, The Center for Elder Abuse, said that an estimated 2.5 million cases of elder abuse occurred at nursing homes across the country in just the last year. This means that 2 million nursing home abuse cases go unreported and unpunished. This eye-wateringly high number indicates a substantial problem on its own but considering the aging population in America, unreported elder abuse could increase to even higher levels.

While victims can be any age, race, gender, or with any kind of diagnosis, the nonprofit elder care group said that common characteristics of nursing home abuse victims include anyone over the age of 80, elderly women, people with cognitive impairments, and people who are physically or psychologically aggressive. Nursing homes are the most common place for unreported elder abuse, although adult day care centers and hospitals are common locations for this horrific crime, too.

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The federal government fined a New Jersey nursing home for $600k after a deadly adenovirus outbreak killed 11 children and infected 37 other residents, according to NJ.com. The nursing home, Wanaque Center for Nursing and Rehabilitation, is a long-term care facility in northern New Jersey with senior citizens and children who require around-the-clock care and monitoring. According to federal regulators, insufficient safety protocols led to the deadly outbreak and permitted its rapid spread across the assisted living facility.

In a scathing report released last week, the federal government cited numerous safety violations that enabled the rapid spread of the virus. The protocols at the retirement home were so insufficient that medical staff did not even realize an outbreak was occurring until the fourth child died. The federal report details violations including a lack of infection control plan, a “void of leadership,” and an off-site medical director who was so disengaged she only checked on the facility weekly.

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Victims of nursing home abuse and industry stakeholders gathered in Washington this month for a Senate hearing on the nursing home industry. In addition to hearing testimony from the families of nursing home abuse, the federal legislators sounded the alarm over a looming fight over Medicaid funding. According to Skilled Nursing News, the Trump administration will propose its plans to convert Medicaid funding into a “block-grant model.”

According to proponents of the new model of funding, Medicaid spending has spiraled out-of-control and the federal health insurance scheme is no longer sustainable. Instead of continuing with the current open-ended model, the federal government will fund a predetermined amount each year for a state’s Medicaid program. The amount will likely depend on the number of Medicaid beneficiaries in the state, among other factors. The idea for overhauling Medicaid’s open-ended funding model into a block grant system has been favored by Republicans for a long time and finally reached a fever-pitch during the Affordable Care debate in 2017.

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In an exhaustive report by Care.com on the current state of America’s nursing home industry, the well-researched guide compiles data from various private studies, data published by the government, and even included a recent analysis of approximately 1,000 Medicare patients. While the detailed and illuminating guide to elder care facilities is worth reading in full, these are the highlights:

  • The Scope of the Nursing Home Industry. According to the report, there are 1.7 million nursing home beds in America and 79 percent of these are occupied each day. Nursing home residents receive an average of four hours of personalized care each day. Of these four hours, only 45 minutes are spent with a registered nurse each day.
  • Nursing Home Visitors. A nursing home resident can expect six visits from their relatives each month and spend an average of 1 hour and 27 minutes each visit. A majority – 55 percent – of nursing home patients wish their family would visit them more frequently. Nursing home patients satisfied with their family’s visitation habits report an average of nine visits each month. Apparently, family members feel guilty about their infrequent visiting habits – 14 percent described feeling “extremely guilty” and 21 percent felt “moderately guilty” for rarely visiting their loved one.

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The Trump Administrations deregulation effort has led to decreased oversight across the country’s nursing home industry. According to The Washington Post, President Trump’s deregulation agenda has indiscriminately removed “essential protections for vulnerable Americans.” Citing the Trump administration’s popular boast of removing 22 regulations for every single regulation added, the newspaper understandably questions the necessity of these regulations and the consequences of their removal.

Sadly, the nursing home industry has never been a priority for many Presidential administrations. Despite the highly regulated nature of the industry, nursing homes have often escaped the scrutiny lodged at hospitals and other healthcare providers. Late in his second term, President Barack Obama attempted to change that and directed the Centers for Medicare and Medicaid Services (CMS) to aggressively pursue nursing homes flouting the law. Beginning in 2014, nursing home violations would not result in a one-time fine. Instead, the nursing home would be fined every single day until the violation was rectified. By 2016, over two-thirds of nursing home violations resulted in a per-day fine. Unfortunately, the Trump administration reversed this change – which was viewed by elder care advocates as broadly effective and necessary.

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