Articles Posted in Pressure Sores

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A Virginia nursing home is being sued after ignoring one of their former resident’s growing infection and bedsores. The family of the former patient alleges the nursing home’s neglect of Casey Lamont was so severe that it caused his death after just six months at the long-term care facility. The lawsuit seeks damages related to the medical costs incurred by the nursing home’s alleged negligence and Lamont’s pain and suffering.

Lamont was admitted to the nursing home, Envoy of Williamsburg, in November 2013. According to the medical history provided to the nursing home, Lamont would be susceptible to bedsores and pressures and therefore, the nursing home should take preventative measures, which generally include moving the patient around every few hours. Unfortunately, the nursing home appears to have neglected their responsibility to care for Lamont and within two months he developed “life-threatening bedsores,” according to The Virginia Gazette.

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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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New York State is proactively training nursing home staff how to be “better whistleblowers” whenever nursing home abuse or neglect is suspected. Describing the training as “the first of its kind” across the country, The Buffalo News said the New York Department of Health trained nursing home workers on submitting reports with important details, which include the “time and location of the alleged infractions” as well as any possible witnesses or other relevant information. The health department, which is responsible for overseeing nursing homes in New York, encouraged filing these “comprehensive complaints” in certain situations such as when the nursing home lacked adequate staffing, when important medical devices are malfunctioning, or anything else that puts the health and safety of nursing home patients in jeopardy.

Currently, anyone can file an anonymous report with the state health department. While staffers are obligated to report some instances of nursing home abuse under the state’s “mandatory reporter” laws, elder care advocates say this law is difficult to enforce. The state also prevents nursing homes from retaliating against any employee who files a report or cooperates with an investigation against the facility.

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Sen. Chuck Grassley issued a statement demanding that the Centers for Medicare and Medicaid Services (CMS) provide the Senate with a thorough report on the “comprehensive review” the agency plans to conduct on its nursing home oversight. Last month, the Republican Senator held a hearing on nursing home abuse and excoriated the nursing home industry and its grossly inadequate government oversight. In response to the spectacle on Capitol Hill, Administrator Seema Verma announced the agency would perform a “comprehensive review” of its nursing home oversight. In a statement issued by his office, Sen. Grassley described the news as “encouraging” but also directed the government to prepare a report on its planned changes.

After a fiery attack on the nursing home industry, Sen. Grassley does not plan on letting the government-funded industry to continue with its blatant violations. Speaking to McKnight’s Long Term Care News, Sen. Grassley said, “As chairman of the Senate Finance Committee, I’ll continue conducting diligent oversight of the nursing home industry. Once these reports are available and I’ve had time to review their findings, I intend to hold another hearing to learn the facts and find workable solutions.” The Senator from Iowa directed both the Department of Health and Human Services and CMS to prepare reports for a Senate hearing later this year.

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Outrage continues to grow at the poor quality of care being delivered at a New York nursing home. According to an investigation by News10NBC, Sodus Rehabilitation and Nursing Center in Sodus, New York is still violating numerous state regulations about the treatment of its senior citizens. The local news agency began investigating Sodus Rehab several years ago and, unfortunately, it does not appear that the quality of care has improved over time. According to the New York Department of Health, the nursing home received 90 citations for health and safety violations in just the last four years. In New York, the average number of violations per nursing home is approximately 30.

After undercover investigations by News10NBC last year showed unsafe and unsanitary conditions, Sodus Rehab says they “cleaned house” and brought in new administrators. Unfortunately, the new staffers do not appear to have fixed any of the nursing home’s problems. In one particularly egregious example cited by the news, Bill Tanner, a nursing home resident with leukemia, dementia and “other health issues,” developed bedsores that one doctor described as “some of the worst” he had ever seen. Bedsores, also called pressure ulcers, could have been easily prevented in Tanner, according to the doctors. Perhaps even more horrifically, the bedsores were only noticed because a former neighbor visiting Tanner noticed a foul smell in the room. According to the neighbor, she asked for a registered nurse and a licensed practical nurse to attend to the elderly man. Sodus Rehab staff said that neither was on-duty at the time.

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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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The federal government designated New Roc Nursing and Rehabilitation Center as a Special Focus Facility (SFF) after racking up more than five times the average number of violations in the last couple years. According to WHEC, the nursing home has a troubled history dating back to 2014 when an undercover investigation found a “pattern of patient neglect” so horrific that ten nursing home staffers were charged with criminal neglect. Since 2014, the problems have only “continued to pile up,” according to local news agency.

After “a persistent pattern of poor care was identified during its last three inspection surveys,” the New York Department of Health recommended regulators designate the Rochester nursing home as an SFF. An SFF is inspected twice as much as other nursing homes and subject to increased fines and penalties for any violations. According to Jennifer Lewke, spokeswoman for New Roc Nursing and Rehabilitation Center, this creates a “downward spiral.” Money necessary to fix the cause of numerous violations are instead used to pay the fines and penalties. Further, designating a nursing home as SFF sharply reduces the number of residents, who understandably choose facilities with records of better care. This causes a further drain on resources and leads to more violations and poor care.

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State prosecutors charged seven nursing home employees with involuntary manslaughter after a patient died from a bedsore in 2017. The nursing home employees, which includes one nurse, are collectively charged with 37 crimes for their gross mistreatment and neglect of two nursing home patients during their time working at Whetstone Gardens and Care Center in Ohio. Announcing the charges, Attorney General Dave Yost says, “Evidence shows these nurses forced the victims to endure awful mistreatment and then lied about it.”

Yost says first patient “literally rotted to death” after developing a preventable bedsore or “pressure injury” in 2017. The patient, who entered the facility on a short-term basis, developed several bedsores after nursing staff failed to move the patient every few hours. Once the bedsores developed, the staff continued to ignore the nursing home resident and failed to treat the sores, also called pressure injuries or ulcers. Within weeks of developing the bedsore, the patient’s bedsores became infected with gangrene. The nursing home resident passed away just weeks later after the staffers at the nursing home failed to take “any medically appropriate steps.”

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The Centers for Medicare and Medicaid (CMS) announced it will launch a ‘comprehensive review’ of nursing home regulations across the country. According to Health Leaders Media, CMS Administrator Seema Verma announced the new initiative last week in response to mounting criticism by states and federal legislators. Administrator Verma said the government agency will seek $45 million in additional funding from Congress for its review.

CMS says the review will focus on several primary areas. First, CMS will work with state agencies across the country to strengthen oversight of the country’s nursing homes. According to CMS, federal and state agencies will work together to ensure CMS health and safety requirements are being followed and ever nursing home is inspected at least once a year. Second, the federal agency plans to increase enforcement of nursing homes by, according to Administrator Verma, “developing new ways to root out bad actors and repeat offenders.” Administrator Verma says nursing homes with insufficient nursing staff will be targeted will begin receiving more “unannounced inspections” to encourage compliance. Finally, nursing homes will now be more severely penalized for poor patient outcomes and less severely penalized for failing to follow CMS protocols. In addition to improving outcomes for current nursing home patients, the focus on patient outcomes will also be more helpful to prospective nursing home residents by providing a more meaningful metric to judge nursing homes.

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The Department of Veteran Affairs released its first report on the status of its nursing homes this month and the results show widespread neglect and abuse at the government-run facilities, perhaps even worse than the well-documented problems seen in its private-care counterpart. The federal government is responsible for caring for the country’s 40,000 veterans and, according to its own report, is doing a poor job. The report analyzed 99 VA nursing homes across the country and reported the findings of surprise inspections conducted by outside contractors. The VA spokesperson said that releasing the report in its entirety is part of a new push by the agency for transparency and accountability.

The findings of the report are daunting. Eleven of the 99 nursing homes were so unsafe that veteran safety was in “immediate jeopardy.” More than half of the nursing homes (52) were deficient enough to cause “actual harm” to their veteran residents. “That is really bad. It’s really bad,” Richard Mollot, executive director of the Long Term Care Community Coalition, a nursing home advocacy nonprofit told USA Today.

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