New Blood Test Predicts Development of Alzheimer's

Alzheimer’s can be a devastating illness that we see in many of our cases.  Good news from the front against this disease is that a new blood test was developed that can accurately predict the development of the disease.  While not yet fully available to the public, when it is it could have wide ranging possibilities. 

Knowing in advance that the disease is a real possibility will give people the ability to plan for a time when they may not be able to care for themselves – to purchase long term care insurance, draft a proper will, and make sure a power-of-attorney is in place.  It will also give patients the ability to take medical steps immediately to prevent or treat the disease as early as possible.

You can read the full VOA article here.


New Study Illustrates Problems with Sedentary Lifestyle

If you’re over 60, the next time someone tells you to “take a hike” it might not be a bad idea.   

A new study shows how problematic a sedentary lifestyle can be.  The study found that adults over the age of 60 spend roughly 9 sedentary hours per day, and that “[e]very additional hour adults over age 60 spend sitting increases by 50% their risk of being disabled for activities of daily living such as bathing, dressing and walking”.

Exercise generally is linked to better health, both physically and mentally.  Turn off the TV and take a walk instead.  You’re far better off. 

To read the full article describing the study, please click here

Pressure Sores are Preventable

There is a great PBS interview of a former CEO who talks quite candidly about preventability of pressure ulcers (bedsores) and the misdirection of health care in America. Please click here to see that interview. 


Elderly Man Dies After Being Left in Burning Sun Due to Understaffing

Many times, when I tell people the facts of our cases they cannot believe them.  Sometimes, the care and neglect the elderly suffer is simply stunning. 

This story from Florida is both horrifying and yet not surprising.  In a ManorCare facility in Florida, an elderly man died with second and third degree burns after being left out in the sun for almost 4 hours.  It is another example of a stressed facility with too many residents to care for.  It’s all about profit.  In a drive for profits, staffing gets slashed because it’s the biggest expense.  While most aides and nurses care about their residents, there is just not enough of workers to get the work done.

This was born out by a former employee of that facility who stated “she watched as conditions got worse over the past six years as budgets were slashed.”

The same employee went on to say “’A nursing assistant who would normally give daily care to eight patients is now up to nine, 10 or 11 patients,’” she said.  The former employee added that if it’s the night shift, an aide could have as many as 20 patients to look after.”

To read the full article, please click here.


A Real Cause of Increased Costs in Health Care is Fraud, Not Lawsuits

Even though lawsuits and litigation comprise only a small portion of the cost of health care – less than 1 percent – attorneys constantly get blamed for the rise in medical expenses.

You can read the statistics, which come from a study done by John Hopkins University School of Medicine and reported in the UPI, here.

A real driver of health care costs is fraud.  A recent L.A. Times article chronicles that the Ensign Group Inc., which operates nursing homes along the West Coast, just settled with the government to reimburse $48 million due to fraudulently inflated Medicare bills.  The facilities were billing for unnecessary work, or work that was never done – mostly in the areas of physical, occupational, and speech therapy. The company would have gotten away with it of not for an employee that spoke up and brought the truth to light.

You can read the full article here.


Florida Attorney General Pursues Billing Fraud

In yet another chilling example of wasting taxpayer dollars and jeopardizing vulnerable nursing home residents, a Florida based owner has allegedly bilked public funds to line his own pockets.

For more information, please click here.


Sleep Shown to Help Prevent Alzheimer's and Dementia

In many ways, what we do when we’re younger affects our health in the future.  Women must get enough Calcium when young in order to prevent osteoporosis in the future.  For men, keeping a healthy weight as a younger man reduces cancer risk and other complications as an elderly person. 

A recent Forbes article recounts a new study, which shows that adequate sleep may assist in the prevention of Alzheimer’s and dementia.  The study explains that during sleep, the brain actually flushes toxins out of the brain – toxins that can contribute to Alzheimer’s and dementia.  You can read the article here.

So, if you’re considering watching your fourth episode in a row of Breaking Bad, at 2 AM on a work night, perhaps going to bed may be a better decision.

South Carolina Hospital Sued for Medicaid Fraud

There has been yet another of a stream of whistleblower cases involving Medicare and Medicaid fraud. A hospital in South Carolina operated by Tenant Healthcare Corp. and Health Management Associates is being sued by the government for having a clinic illegally steer Medicaid patients to their hospital.

The whistleblower, a former chief financial officer, found out about the alleged scheme quickly after he began working at the facility.  After voicing concerns he was abruptly fired without reason.

You can read the full article by clicking here.


The Real Cost of Budget Cuts

You often hear the mantra about cutting the budget when talking about government spending.  We recently had the sequester, which cut significant amounts of money to numerous government agencies.  However few people realize what these cuts truly mean, other than perhaps slightly lowering a person’s or business’s tax bill.

A truly disturbing story from the Sacramento Bee chronicles a lawsuit filed by California against Nevada for the “state-sanctioned practice of improperly transporting indigent psychiatric patients” from Nevada to California.  In effect poor psychiatric patients were given one-way bus tickets out-of-state with no escorts, medication, or food – many of them to California.  California is suing to recoup the cost to their social services programs.

The article points out that the “state’s aggressive busing practices coincide with funding cuts that slashed Nevada’s mental health budget by 28 percent between 2009 and 2012.”

It’s hard to imagine any organization that can operate effectively when their budget is cut by 28% in three years.

The article tells the unfortunate story of a man who turned up at a Sacramento homeless shelter confused and suicidal after a 15 hour bus ride from Las Vegas.  The man knew no one in Sacramento and was told by doctors at the time he was discharged from the Nevada psychiatric facility to dial 911 when he arrived in the city.  This story is almost too terrible to believe.  You can read the full article by clicking here.

As a person who advocates daily for the rights of vulnerable people, this story is particularly angering.  Gandhi once said that “a nation’s greatness is measured by how it treats its weakest members.”  Perhaps this is something to reflect upon in light of this article. 


Assisted Living Facility Operating Without a License Sparks Wrongful Death Lawsuits

A recent article states that an assisted living facility (ALF) in New York is now facing several wrongful death lawsuits after operating for several years without a license.  One of the plaintiffs is the estate of a judge. 

When choosing an ALF, asking specific questions about expected care is important.  Just trusting a facility to accept only those people they can care for is insufficient.  Although they are not regulated as closely as skilled nursing homes, ALFs can accept residents requiring nursing home level of care.  The level of care ALFs can deliver may vary widely within the same county and may be significantly lacking.

Just trusting a doctor is probably insufficient as well.  A doctor that signs off on an admission generally knows little to anything about a particular facility.  The doctor will not meet staff or participate in the plan of care.  Doctors typically trust the facility to accept only who they can care for – many times incorrectly.

In short, proper research is necessary.  Talk to the doctor about specific needs of the resident (like fall prevention measures, mobility, and physical therapy) and question the ALF to be sure they can deliver the care. 

To read the article, click here

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Jersey City Medical Center Fails in its Attempt to Invoke a Mandatory Arbitration Clause After 21 Months of Costly Litigation

In an excellent decision, the New Jersey Supreme Court agreed with the plaintiff in this case who cried foul after the Medical Center decided to wait until nearly two years after litigation was completed before attempting to deprive her of her right to a trial by jury. Mandatory arbitration clauses are anti-consumer and antithetical to our Constitution.

To read the article, click here.  

Preliminary Study Shows Cocoa May Help in Some Dementia Cases

As if you needed another reason to indulge in chocolate, a new study out this week showed people with vascular dementia who drank cocoa for a month did better on memory tests.  However the USA Today article is quick to point out that the study is small and preliminary.

The study found that cocoa improved blood flow to the brain.  The study did not go so far as to suggest that drinking cocoa will prevent dementia.  Another concern is that a cup of cocoa is high in calories, so any cognitive benefits might be outweighed by general health benefits.

However, the study is interesting and promising.  To read the article, click here.


Overworked Aides Can Overlook Dental Care with Catastrophic Results

A recent blog article in the New York Times discussed the fact that in some nursing homes, due to short staffing, many residents are not receiving the proper oral care. 

This can have serious consequences – from the terrible pain of tooth decay and damage, to gum disease, to pneumonia.  Apparently poor oral care can lead to pneumonia, a leading killer of elderly in nursing homes. 

Proper staffing is always at the root of these problems.  Having enough caring and well trained aides is critical to making sure the proper care is given.

To read the article, click here.

Ugly Side of Assisted Living Exposed on Frontline Documentary

I recently wrote an article for the New Jersey Law Journal discussing the shortfalls of some Assisted Living Facilities.  These same problems were discussed in depth in a recent Frontline documentary “Life and Death in Assisted Living.” 

The movie focused on the largest Assisted Living Corporation Emeritus, a very profitable publicly traded corporation.   It chronicled how when one facility was bought by Emeritus, care dropped.  Another ex-employee stated how the company wants to keep residents as long as possible to keep the beds full – keeping residents that should go into a nursing home.

One serious problem with Assisted Living is that there are no overriding Federal Regulations as in nursing homes.  In New Jersey, an Assisted Living Facility by regulation can keep anyone, regardless of how sick or cognitively impaired they are, including residents that require “nursing home level of care.”

Companies take advantage of these regulatory loopholes.  Assisted Living facilities are not staffed like nursing homes, do not have fall and wound preventions like nursing homes, and the staff do not have the same training.  They are cheaper to run and the company can charge almost as much as they want.  In many cases that we handle, the catastrophic results are fatal. 

These problems are not going away.  Assisted Living is a very lucrative business, and the elderly population is growing.  Many corporations that own these facilities are not healthcare companies.  In fact, one facility we litigated with was owned by a real estate corporation with the entire board of directors for the facility being marketers, financiers and attorneys.  Not one of them had a healthcare background.

If you are considering Assisted Living, this video is very important for you to watch.  You can watch here.

Never Events, Upcoding and Medicare Fraud

In October 2008 Medicare introduced a new reimbursement system, based upon 2002 industry standards, otherwise known as “never events.”  This related to a determination by a number of non-profit organizations, at least one physician, multiple insurance companies and health care watch analysts who all concluded that many health care related problems should never occur in the hospital setting.

Seemingly agreeing with this standard of care, Medicare made clear to the hospital community that if any one of the enumerated "never events" occurred in a hospital, the hospital would not be permitted to be paid extra by Medicare for resolving the problem that they caused.  Sadly it appears as though hospitals across the country are learning ways to code around this -  in order that they can still charge taxpayers for fixing the problems that they caused ‑ problems which never should have happened.  A number of articles are beginning to appear indicating that the industry itself is quite concerned about the incentives that hospitals face to inaccurately characterize their bills, in order that they do not need to comply with the nearly 5‑year-old Medicare Never Event reimbursement policy.

If any individual becomes aware of an institutionalized policy by an acute care center to defraud the United States government, there exists a number of whistle-blower laws designed to protect this person from retaliation and assist the government in retrieving monies lost to the fraud.