Nursing Home Law Blog : Nursing Home Lawyer & Attorney : Stark & Stark Law Firm : Elder Care, Senior Care

The Centers for Medicare and Medicaid Services (CMS) have recently designated certain injuries in hospitals “never events” – or injuries that should not happen. These injuries include Stage III and IV bed sores and falls with fractures. The penalty to hospitals when these injuries happen is that CMS will not pay for treatment rendered for these injuries. The result is that many hospitals are reporting the incidence of these events has gone down, and in some places tremendously.

Now, the Obama administration is doing a similar thing to nursing homes according to an article in Forbes magazine.

According to the article, a recent study showed that 25% of nursing home hospital admissions may be preventable. A further congressional review panel estimates that 14% of hospital patients sent back to nursing homes return to a hospital for a preventable condition. The Obama administration wants to penalize nursing homes that have unnecessarily high hospital admissions for preventable conditions by reducing their Medicare payments.

So, why are these residents being sent to the hospital to be paid for with your tax money? The author of the article documents that, “I’ve seen hospital emergency rooms filled with very frail seniors on Friday afternoons. Why? Because nursing homes know they won’t have enough weekend staff to care for their sickest residents, so they simply send them back to the hospital. The new rules could stop those practices.”

Perhaps hitting substandard nursing homes in the pocketbook will force them to take better care of their residents. 

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A recent article in The Bergen Record, New Jersey ranks poorly on long-term nursing care, discusses the fact that New Jersey nursing-home care is less affordable and patients are more likely to suffer bedsores or need trips to the hospital than in many other states. New Jersey ranked in the second tier of states — 22nd — for choice, affordability, quality of care and support for family members who take care of the elderly and disabled at home.

I recently wrote a post on my firm’s Facebook page discussing the implications this article, and these new findings, could have on the health care industry in New Jersey.  

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David R. Cohen, Chair of Stark & Stark’s Nursing Home Litigation Group, authored the article, The Role of Physicians in Nursing Home Litigation, for the September 12, 2011 edition of the New Jersey Law Journal.

The article discusses a common mistake made my personal injury attorneys when litigating nursing home cases: discussions with the physician. Although federal regulations concentrate on the role of the medical director in relation to the care of and operation of the nursing home, these standards are often times far from the truth. In the article, Mr. Cohen states, “72% of all medical directors spent less than one to four hours per week at facilities, and 70% indicated that the role of medical director constituted somewhere between 1 and 10% of their medical practice.”
 

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We have noted many times on this blog the importance of screening employees of nursing homes before they are placed in the role of caring for elderly and infirm residents. In this story, a nursing home employee with what appears to be a long and difficult history, along with multiple aliases, was somehow given the highest position in the facility.  

All studies show, and regulations confirm, that nursing homes have a responsibility not only to check the criminal background of employees, but also to ensure that they are of good moral character. This is a critical step in protecting our most vulnerable citizens. 

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Many times I’ve written about the over-medication of the elderly – especially with anti-psychotics. Despite the fact that anti-psychotics are supposedly only for a small percentage of the elderly, many nursing home residents with dementia are given these drugs even though some have FDA warnings of an increased risk of death.  This overuse of anti-psychotics was confirmed in a recent government audit.

It appears that the message is finally being heard.  A recent article reports that nursing homes are beginning to reduce the use of anti-psychotic drugs. This is a positive development. Instead of chemically controlling people, nursing homes are beginning to use alternative methods to treat Alzheimer’s and dementia. These therapies are in many cases reported to be more effective.

Chemically controlling residents for the sake of convenience or punishment is illegal in New Jersey.  Knowing what medications a resident is taking is important. 

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Picking a nursing home or assisted living facility can be a very difficult process.  Most people know very little about these facilities, how they are regulated, and how they operate.  Some people find themselves turning to free referral or placement agencies for their expertise.  These agencies are businesses that allege to help people find the right facility for their loved one.

This recent New York Times article points out the problem with some of these agencies. While some of these agencies are free to the users, they may get paid by the facilities they refer to – in some cases sub-standard facilities. 

Another enlightening article in the Seattle Times reports that some “[p]lacement companies, which rely on commission-only sales people, funnel the aged only to facilities that have agreed to pay thousands of dollars in finders' fees.

In addition, most placement companies do not screen homes for past violations. As a result, many have referred seniors to facilities with documented histories of substandard care, including fatal neglect.”

The decision of where to place a mom or dad is a very important one.  It’s laudable to seek assistance with this important decision.  However, be careful of whom you are getting your information from, and how they are getting paid.  

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