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

According to the Justice Department, two East Coast nursing home chains agreed to settle a whistle-blower lawsuit law week which alleged that they committed Medicare and Medicaid fraud.This high profile kickback case recently settled for $14 million and resolved the many allegations of medicare and medicaid fraud.

This settlement comes just a few months after Omnicare Inc. paid $19.8 million to settle several additional suits. Friday's settlement arises from government allegations that the Atlanta-based Mariner Health Care Inc. and SavaSeniorCare Administrative Services LLC nursing home chains solicited kickback payments from Omnicare in exchange for agreements by Mariner and Sava to continue using Omnicare's pharmacy services for 15 years.

You can read the full article online here.

• Email This
• Print
• Comments
• Trackbacks

Leaders from Democracy for America, Blue Wave NJ and the Anakbayan Filipino Youth Group and other community groups collected over 3,600 signatures for a petition which was sent to the administrators of four area nursing homes in support of workers who have been in contract negotiations for nearly three years.

More than 300 workers at three Hudson County facilities - Harbor View Health Care Center in Jersey City, Castle Hill Health Care Center in Union City, and Palisade Nursing Home in Guttenberg - plus a fourth in Bergen County, have been without a contract since July 2007.

The workers went on strike in August for three days, held several days of protests in October, and have run an extensive campaign of television, radio and billboard ads against Avery Eisenreich and Mendel Gold, top executives at the Jersey City-based Omni Health System, which owns the facilities. You can read more on this story online here.

• Email This
• Print
• Comments
• Trackbacks

• Email This
• Print
• Comments
• Trackbacks

Nursing home care is proving to be a growing priority.  After being faced with alarming delays in investigating nursing home complaints, the Texas Department of Aging and Disability Services avows to speed up scrutiny to ensure safety and avoid resident harm. Read more on this story online here.


 

• Email This
• Print
• Comments
• Trackbacks

A Delton, Florida man died last month due to horrendous care provided by the University Center West nursing home. Anthony Digiannurio, 82, was transported in November from University Center West to Florida Hospital DeLand where staff members found maggots in one of his eyes, an infected breathing tube, a partially inserted catheter and bed sores. You can read more on this story online here.

• Email This
• Print
• Comments
• Trackbacks

Dave Cohen, Chair of Stark & Stark's Nursing Home Litigation Group, authored the article, Nursing Homes and Assisted Living Facilities: Understanding the Differences and Keeping Your Loved Ones Safe, for the January 20, 2010 edition of US 1 Newspaper. You can read the full article below:

As a trial attorney for over twenty years and a litigator who has devoted his entire career to protecting the rights and safety of the elderly, I have seen a disturbing trend in recent years in the interplay of nursing homes and assisted living facilities.  As many are aware, when our loved ones’ health declines, families are faced with critical and emotionally heart wrenching choices.

Traditionally, nursing homes have been the most common choice in working toward obtaining the highest quality of life and safety for seniors who can no longer care for themselves and for whom family members simply do not have the qualifications to fulfill these needs.  More recently, assisted living facilities (ALFs) have been gaining popularity. They fulfill a well needed void in the healthcare continuum and are certainly a welcomed addition to the options available to families. 

However,Assisted living facilities are regulated, but not nearly as much as nursing homes.  The facilities themselves are generally much more attractive and family members tend to feel better about placing parents or spouses in them. However, ALFs generally have fewer nurses and fewer nurses’ aides.  Additionally, they frequently do not have registered nurses on site for significant periods of time.  For seniors with lesser needs and who are otherwise much more independent, this is an excellent environment.  However, the danger is twofold:

In the first instance, while the majority of ALFs are owned and operated by caring, professional and qualified individuals, many are so focused on filling beds that they often will admit those who simply are an improper fit for that level of care.  In my practice, I have seen far too many residents suffer from malnutrition, dehydration, bedsores, fractures and ultimately death based upon a poor fit for a facility which never could or should have let this person through their doors.  The second danger faced by families involves situations where the fit was initially appropriate, but when the resident’s health declines, it becomes dangerous to allow that person not to receive a higher level of care.  Much like poor admission situations, in my practice I have seen many residents needlessly suffer and die because the tough decision to move them into a higher level of care was overlooked by the staff at the ALF.

In the end, the decision to accept or reject the resident should be based upon the individual’s needs and not by profit.  This is the formula by which the vast majority of assisted living facilities operate.  It is those who do not operate in this fashion who create the dangers we speak of.  Families can and should be vigilant about all of these issues.  They should also conduct a significant amount of research into what the particular assisted living facility they are looking into can and cannot do.

Unfortunately, there is not a bright-line rule as to the level of care that assisted living facilities provide.  I have seen an incredibly wide variance between the lower levels of care and the higher levels of care.  At the lower end, there is very little supervision and medical/nursing staff available, while the higher end of care at some of these facilities is nearly indistinguishable from that provided in nursing homes.  Without a clear knowledge as to what these facilities can provide, families are ill advised to take the leap into admitting a loved one.  Every bit as important is monitoring the health and cognitive status of your loved one while living in an assisted living facility to ensure that they remain an appropriate fit.

With vigilance, attention and research, families can and should look toward assisted living facilities to provide the best of care and quality of life for their loved ones - but must do so with caution and their eyes open.   

• Email This
• Print
• Comments
• Trackbacks

Articles such as these have led many commentators to question whether so-called charitable health care institutions are truly charitable. A recent report online states that Our Lady of Lourdes Medical Center in Camden and Lourdes Medical Center of Burlington County in Willingboro will pay the government $7.95 million in response to allegations that the hospitals defrauded Medicare. This is not the first time Our Lady of Lourdes Health Care Services Inc. has been involved in litigation due to questionable billing practices. In 2005, Lourdes Medical Center was a defendant in a civil suit which stated that the hospital fraudulently inflated its charges to Medicare patients in order to collect enhanced reimbursements.

• Email This
• Print
• Comments
• Trackbacks

The Board of Chosen Freeholders resolved earlier this week to transfer ownership of The Mercer County Geriatric Center to the Mercer County Improvement Authority. The 240-bed nursing facility is being sold to a private entity in hopes of having the home run more efficiently, after years of monetary losses and poor quality ratings.

In 2008 the facility lost $7.4 million, and over $6.7 million in 2007.  Additionally, the losses were expected to continue to rise over the next several years, which would only increase the burden for taxpayers. The facility is staffed by 150 county employees and serves primarily residents on Medicare or Medicaid. Officials said they would try to persuade the new owner not to cut staff, and said that the county hopes to have the sale completed by June 2010, but added that no negotiations have yet been initiated.

• Email This
• Print
• Comments
• Trackbacks

Picking a nursing home to care for a loved one can be difficult and overwhelming.  You want the best care, but where to start?  What nursing homes are in the area?  Have they had any problems?  What services do they provide?  What are the right questions to ask?  Here is a great place to start.

Medicare keeps detailed records of all nursing homes, and rates them on a one-star to five-star scale. Its free, easy to access, objective, simple to read, and you can compare multiple nursing homes at the same time.  If your family member or loved one is currently in a nursing home, this website is also a great tool to see how your current nursing home compares to others.

 

• Email This
• Print
• Comments
• Trackbacks

Here is an interesting article which addresses the fact that more than 100 Minnesotans die each year after suffering falls in nursing homes. The article questions why so few of these deaths are fully investigated by the state, and how serious penalties for violations are rarely enforced.

• Email This
• Print
• Comments
• Trackbacks

I read an article online last week about nursing home employees in Hudson County who held a “Family Day” march in Jersey City after working the last two years without contracts. The walk was held in hopes of putting pressure on their employers, Omni Assets Management, in hopes of negotiating a fair contract for all Omni employees.

You can read more about the march online here.
 

• Email This
• Print
• Comments
• Trackbacks

Families of residents in New Jersey nursing homes have joined the picket lines in support of the health care workers at their family members’ facilities. The strike began last Friday, August 7, 2009, against the Omni Corporation, owned and operated by Avery Eisenreich, and include Castle Hill, Harbor View, Palisade and Bristol Manor. Family members are supporting the caregivers who have dedicated years to their family members. Reports state that Eisenreich and his management have intimidated and harassed many caregivers—creating a difficult environment for both workers and residents.  He even tried to get an injunction to close down one of the four picket lines, but the judge ruled against him and in the workers’ favor.

You can read more on this story online here.
 

• Email This
• Print
• Comments
• Trackbacks

I found an article online last week  which reports that the Centers for Medicare & Medicaid Services has issued quality ratings for 15,800 nursing homes throughout the USA which participate in Medicare or Medicaid. Each nursing home was assigned a star rating, from one to five - with five being the best. The ratings are based on health inspection surveys, staffing information, and quality of care measures.

Alaska had the best record with 0.0% of all nursing homes have a 1-star ranking, and 26.7% of all nursing homes have a 5-star ranking. While Louisiana had the worst record with 39.3% of all nursing homes have a 1-star ranking, and 2.8% of all nursing homes have a 5-star ranking. New Jersey was in the middle of the pack with 22.2% of all nursing homes have a 1-star ranking, and 12.7% of all nursing homes have a 5-star ranking,

You can read the full article and the complete list of rankings by state online here.

• Email This
• Print
• Comments
• Trackbacks

I read an article online recently which reports on the plan initiated by the Dubuque Retirement Community to give up its state license in order to avoid state regulation. Dubuque is treating the initiative as a pilot program which may be expanded to other Iowa care facilities. Dubuque, Iowa's largest assisted living center, will give up its license September 14, 2009 and become an unregulated retirement home. The residents' medical services will be provided by home health agencies, one of which is unregulated and owned by the facility's parent company.

The move concerns industry officials and senior citizen advocates because the move allows the company to deliver the same care to the same residents but without annual inspections, state oversight or sanctions for inadequate care.

You can read the full story online here.

• Email This
• Print
• Comments
• Trackbacks

I found an interesting article on NYDailyNews.com this week entitled, Hospital records were sometimes falsified to cover up medical mistakes. The article discusses the recent report that doctors, nurses and support staff at New York City-run hospitals have falsified documents in hospital records in order to cover up medical mistakes. The records were either deleted altogether or were doctored in order to omit specific details of certain cases in order to mislead investigators. The state issued 16 citations between 2004 and 2008.

You can read more on the story online here.
 

• Email This
• Print
• Comments
• Trackbacks

I read an article online last week which reported of a recent case in which a nursing home owner and operator stole pension funds from a resident. On June 30, 2009 Michael D. Berg, 72, the owner of an Ocean Township nursing home, plead guilty to stealing approximately $39,000 from one of his home's residents. Berg plead guilty to one count of third-degree theft by deception.

 

The Prosecutor's Office had been investigating the allegations that Berg was stealing from his residents, and found that from January 1, 2005 through March 31, 2008, Berg began stealing pension funds which belonged to a resident of the home. Berg will face sentencing by Superior Court Judge Edward M. Neafsey in Freehold on July 31, 2009.

 

You can read more on this story online here.

• Email This
• Print
• Comments
• Trackbacks

According to US News & World Report, In a typical year, about 3.2 million Americans will spend at least some time in a nursing home. To help find a good choice from among the nation's more than 15,500 homes, U.S. News created America's Best Nursing Homes - a list of the roughly 15,000 best nursing homes from throughout the country. You can search by name of the nursing home, by state, city or by zip code.

Once the search has been conducted, a report is generated with all of the homes which fit your search criteria. Each home is given an overall rating, a rating for health inspections, nursing staff and quality measures. The report also provides a link to a full, more detailed report of each home. You can access the search online here.

• Email This
• Print
• Comments
• Trackbacks

The nation's crisis in patient care stems from routine understaffing of registered nurses in hospitals--and that understaffing, say nurses unions, leads to thousands of unnecessary patient deaths a year.

To read the full article Click Here. (PDF)

 

• Email This
• Print
• Comments
• Trackbacks

Toms River Township sued Dover Woods Health Care Center because of abnormal conduct at the facility. There are over 20 calls a month to the police according to township officials. On Wednesday June 17, 2009 Township Officials asked a judge to force the adult home's owners to improve security at the facility.

To read the full story Click Here. (PDF)

• Email This
• Print
• Comments
• Trackbacks

National Nurses Movement Launches Ad Campaign for Nurse TV Shows

By: PR Newswire
Jun. 16, 2009 02:17 PM

RN SuperUnion Uses "Pop Culture Moment" to Advocate for Safe RN Staffing Levels Bill and Nurse Rights

OAKLAND, Calif., June 16 /PRNewswire/ -- The three nursing organizations at the heart of the newly announced national RN Super Union today announce a new television and internet advertising campaign in conjunction with the debut of HawthoRNe, one of the new TV shows debuting this season that features nurse characters. The ad can be viewed here:www.YouTube.com/CalNurses or at www.RNVoices.net. (Click Here to read the full article) PDF

• Email This
• Print
• Comments
• Trackbacks

Saturday June 13, 2009 Providence Nursing & Rehab Center located on Bellevue Avenue in Trenton, NJ sent a group of its residents on an outing to the Casinos in Atlantic City. The residents were monitored by two activity aides. One male resident described as a Hispanic male in his 50s to 60s, did not return with the group later on that day. Providence Nursing & Rehab Center did not confirm or deny the allegations.

Click Here to read the full artice. (PDF)

• Email This
• Print
• Comments
• Trackbacks

Kindred, PharMerica to pay $1.3 million settlement
By Gregg Blesch
Posted: June 12, 2009

Kindred Healthcare and PharMerica, a company formed in part from Kindred’s spun-off institutional pharmacy division, have entered a $1.3 million settlement to resolve allegations that Kindred’s Knoxville, Tenn., nursing home billed Medicaid for more pharmaceuticals than were actually used or delivered to the facility from 2003 to 2006.

The settlement does not constitute an admission of liability by either company, both based in Louisville, Ky. The allegations originated in a whistle-blower lawsuit filed in 2005 by former billing clerk Jeanne Mayes and subsequently investigated by the U.S. attorney’s office in Knoxville and the Tennessee attorney general’s office. “Kindred Healthcare is pleased with the settlement announced today which puts an old pharmacy dispute to rest,” the company said in a written statement. “The parties settled to avoid the distraction, time and expense of further litigation.”

Mayes, the whistle-blower, is set to receive about $220,000 from the settlement payments PharMerica will make to the U.S. and Tennessee governments.

• Email This
• Print
• Comments
• Trackbacks

A former female employee is suing Cimarron Pointe Care Center and one of its contractors for wrongful termination after she reported abuse and neglect of the nursing facility's residents.

To read the full article click here. (PDF)

 

• Email This
• Print
• Comments
• Trackbacks

Dr. Lewis A. Rogatnick is a attending physician at Golden Living Center- Rose Hill in Berryville. Dr. Rogatnick is also the medical director at Heritage Hill Nursing Home. Doris Critzer, whose mother, Lorena Virginia Tumblin, former resident at Heritage Hill Nursing Home has serious issues with the facility's medical director, Dr. Lewis A. Rogatnick because of his failure to disclose his background.

To read the full article click here. (PDF)

• Email This
• Print
• Comments
• Trackbacks

The family of an elderly Bridgeton woman claims a Millville nursing home intentionally misled them by promising she could remain in the facility after she depleted her personal savings, and then threatening her with eviction when she did, according to a lawsuit.

To read the full article click here. (PDF)

• Email This
• Print
• Comments
• Trackbacks

Omnicare, Inc., paid $283,000 to settle Medicaid fraud charges by the State of Delaware. Delaware alleged that the pharmacy had committed Medicaid fraud by illegally switching the drugs of senior citizens in nursing homes and other facilities.

To read the full article click here. (PDF)

• Email This
• Print
• Comments
• Trackbacks

A recent report from the House Committee on Oversight cites 8 states--New York, Michigan, Virginia, West Virginia, Kansas, Indiana, Florida, and Nevada--that are likely to use medicaid stimulus funding to fill budget gaps rather than to care for seniors.  See the full report  CLICK HERE

• Email This
• Print
• Comments
• Trackbacks

New Jersey's Public Advocate today accused a national assisted living company of "breaking its trust" with customers by trying to evict dozens of frail and elderly South Jersey residents who sought Medicaid assistance when they ran out of money.

To read the full article click here. (PDF)

• Email This
• Print
• Comments
• Trackbacks

Golden Living Center Mountain View, a 120-bed licensed nursing home in Winchester, was ordered Tuesday not to admit new residents.

To read the full article click here. (PDF)

• Email This
• Print
• Comments
• Trackbacks

Government public records are becoming more available or "Transparent" to citizens. This article talks about public records  including  nursing home inspection documents and many others.

To Read More click here. (PDF)

• Email This
• Print
• Comments
• Trackbacks

Here is an editorial about Monmouth County based Nursing Home :

Think for a moment about 85-year-old Mary and 90-year-old John, who live at the J.L. Montgomery and Geraldine L. Thompson nursing facilities. They've lived all their lives in Monmouth County, and were productive and law-abiding citizens. Now they face a difficult future, suffering from any number of serious medical conditions that require 24-hour nursing care.

At this point in their lives, Mary and John cannot eat, bathe or go to the bathroom without assistance. Fortunately, the nurses and aides at J.L. Montgomery and Geraldine L. Thompson are there when they need them.

Mary and John see less and less of their relatives and friends, and have come to view their caregivers as family. They are there for them each morning with a smile of reassurance. They bake cakes on their birthdays; they make sure they have a gift at the holidays. These caretakers, all public employees, do this even though they have more and more Marys and Johns to care for each day, and less and less time to spend with these vulnerable patients.

These caregivers are the same Monmouth County employees the Asbury Park Press criticized for being "intransigent" and trying to "extort wage hikes from fellow citizens" ("Unions remain intransigent," editorial, Jan. 31). Many have worked at J.L. Montgomery and Geraldine Thompson for 25 years or more, and yet earn barely enough to make ends meet. Their annual salaries are less than $29,000 per year.

Like the rest of us, these employees are struggling to pay rent, make car payments, support their families and stay out of bankruptcy. Their reward is the smile they get back from Mary or John once in a while, and the "thank you, dear," when they tuck them in at night.

But Monmouth County's administrators and freeholders, as well as the Asbury Park Press, have a different reward in mind for nursing home employees and other county workers. Their "thank you" is to blame the employees and their unions for the county's fiscal woes, as if the real causes of the present predicament weren't decades of patronage, corruption and overspending, most of which has been well-chronicled during the past few years in the Press.

Make no mistake about it: The measures being proposed by the administrators and freeholders are designed to get headlines (which the Press gladly will provide) and get them re-elected (we'll see). The county has taken a divide-and-conquer approach to these labor matters. Our members are being asked to give up their negotiated raises in order for the county not to consider laying off their fellow workers.

However, there is nothing preventing Monmouth County from accepting the wage concessions from workers and then turning around and laying off employees for financial reasons.

Our union also represents library workers in Monmouth County, who earn on average $31,000 per year and have advanced degrees. Our members' work in the libraries has been lauded by the public and their good deeds have been well-documented in the Press.

AFSCME Council 73 represents the lowest-paid groups of workers in Monmouth County. We are committed to speaking up not only for our members but also for Mary, John and the other citizens of Monmouth County who rely on county services.

Quick fixes got us into the current mess. Thoughtful solutions and responsible decision-making are what we need from our elected officials. But all we are getting are sound bites, sloganeering and politics as usual.

No one likes to be barked at and told that we are the cause of all the county's ills. We still are waiting for true discussions to take place in Monmouth County.

By Gerard J. Meara, APP.COM

 

• Email This
• Print
• Comments
• Trackbacks

Here's a website link critical of the use of the drug, Zyprexa, for nursing home residents

Please click here to view website.

• Email This
• Print
• Comments
• Trackbacks

Please see attached article on the strikes at two Innova Facilities in South Jersey

To read the full article click here. (PDF)

• Email This
• Print
• Comments
• Trackbacks

The Senate Special Committee on Aging convenes tomorrow to discuss inclusion of improvements in long term care as a part of national heath care reform.  In advance of the hearing, the American Assn. of Homes and Services for the Aging has organized a call-in day today.  Healthcare workers and members of the public are being urged to call their representatives and tell them of the importance of reform in the long term care system as part of a broader reform platform.  If you wish to participate, call 800-958-5374 between 8:00 a.m. and 5:00 p.m. Eastern Time.

http://www.mcknights.com/Funding-issues-hit-the-spotlight-as-nursing-home-advocates-gear-up-for-Aging-Committee-hearing/article/128165/

• Email This
• Print
• Comments
• Trackbacks

New Jersey Bill Would Require Pressure Redistribution Mattresses in all Nursing Homes

Legislation that would require all New Jersey nursing homes to use pressure redistribution mattresses to reduce the incidence of pressure ulcers is headed to the Governor’s desk for signature. Th e bill, S-1517, would require nursing homes, beginning one year after the enactment of the legislation, to purchase pressure redistribution mattresses when replacing the mattresses used by nursing home residents. The bill would also require that all mattresses within a nursing home be switched to pressure redistribution mattresses within three years aft er the enactment of the bill.

Source: www.politickernj.com, February 5, 2009

• Email This
• Print
• Comments
• Trackbacks

In one of  his last acts in public office, President Bush changed a significant number of federal regulations designed to help the consumer public. One of those was the set of regulations which allowed consumers access to the results of nursing home inspections. Undoing the damage caused by the former President is no small task, but it is an essential one.

Don't limit access to nursing home inspections

Monday, February 02, 2009


A new rule limiting public access to nursing home inspection reports is a prime example of bureaucracy run amok. Because administrators say requests for information have become too burdensome, the Department of Health and Human Services now says you can't have copies of inspection reports that might explain how your loved one came to have a broken bone, or bruises.

The requests "divert employees from their federal survey, certification and enforcement responsibilities," said Michael Leavitt, HHS secretary. Under the rule change, state employees who inspect nursing homes for the federal government are reclassified as federal employees who aren't allowed to provide "privileged" information or documents to the public without approval from the head of the Centers for Medicare and Medicaid Services. We rely on the government to provide services we cannot provide for ourselves, and policing an industry that has had more than its share of shady operators is one of those jobs. But HHS seems to have the idea that the inspections themselves are the end result, and that the public is willing to trust it to do the right thing by our loved ones.

- The News-Enterprise, Elizabethtown, Ky.

• Email This
• Print
• Comments
• Trackbacks

Last month, it was reported that four nursing home employees were arrested for abusing resident...one of them actually tying a resident to a chair for two straight nights.

http://www.newsinferno.com/archives/4335

• Email This
• Print
• Comments
• Trackbacks

• Email This
• Print
• Comments
• Trackbacks

Here is a story about a nursing home social worker who claims to have been fired for telling the truth about problems with a nursing home and for cooperating with investigators.  If this is true, it's illegal - AND ACTIONABLE.

To read the full article click here. (PDF)

• Email This
• Print
• Comments
• Trackbacks

Today, Medicare officially released its nursing home ”5-star” ranking system. Take a look to see how the nursing home(s) you are interested in hold up.

Click Here for Medicare's Official Website.

• Email This
• Print
• Comments
• Trackbacks

Here is a recent informative article in USA Today. It rates nursing homes across the nation and offers some tips in how the select the right one for your loved one. 
 

Click Here to read the full article.(PDF)

 

 

• Email This
• Print
• Comments
• Trackbacks

Here is an article about the recent Bush administration's change in federal rules on nursing home inspection records.

 

To read the full article click here. (PDF)

• Email This
• Print
• Comments
• Trackbacks

Here is a recent article about the Nursing Home Industry and the new federal government rating system.

To read the full article click here.(PDF)

• Email This
• Print
• Comments
• Trackbacks

David R. Cohen, Shareholder of Stark & Stark’s Nursing Home Litigation group, will be a speaker at the New Jersey Institute for Continuing Legal Education Seminar Dealing with The Surge in Nursing Home Litigation with A Special Presentation on Pressure Ulcers.

This seminar deals with learning how to deal with the recent surge in Nursing Home litigation, including: medication errors, medical directors, pressure ulcers, physical abuse, failure to address fall downs/broken bones, financial abuse , a discussion on the distinction between attending physicians and medical directors , elderly abuse, Assisted Living Evictions,and a review of the Fairness in Nursing Home Arbitration Act of 2008.
 

Date: Thursday, December 4, 2008

Time: 5:00 pm to 8:30 pm

Location: Law Center in New Brunswick, NJ

Click here for more info.

• Email This
• Print
• Comments
• Trackbacks

As reported in this blog, most studies confirm that publicly owned nursing homes typically provide a higher quality of care than those driven by profit.  Here is a story about a quality facility in Warren County, NJ, which resisted the temptation to privatize.

You can read the full story here (PDF)

• Email This
• Print
• Comments
• Trackbacks

The National Citizens' Coalition for Nursing Home Reform is a prominent national organization effectively utilizing consumer voices to fight for quality long term care. It is pro-actively defining and achieving a new standard of quality for long term care residents. If you feel you want to do more to help reduce neglect and abuse in long term care facilities, this is a great place to start!

Click here for more information.

 

• Email This
• Print
• Comments
• Trackbacks

I am slated to soon speak before the Tennessee Trial Lawyers Association on the topic of corporate ownership of nursing home facilities and the means by which many, though certainly not all, corporations will underfund the facilities and undertrain their employees. Sadly, we are seeing more and more of this practice these days where the front line healthcare workers simply are not provided with the tools that they need to provide the care that they desperately want to provide for nursing home residents. I am thrilled to enjoy the panel with a number of very distinguished speakers from whom I am confident I will learn a great deal.

• Email This
• Print
• Comments
• Trackbacks

We have written in this blog before about the major problems caused by the Byzantine and mind-dizzying fashion by which corporate ownership has been altered in recent years in the nursing home industry. All of this started as a result of a number of articles printed in healthcare law journals which literally provided a step-by-step recipe through which unscrupulous nursing home owners could hide behind multiple corporations to avoid accountability for injuries and even deaths which occur in their nursing homes. As I negotiate a number of very significant cases, many owners seem to feel a false sense of security that their conduct is immune from consequence because of the so called “corporate walls” placed between them and the very people harmed by underfunded, poorly staffed and systemically failing homes. The reality is that we cannot and will not allow this lack of accountability to occur. More and more we are uncovering evidence to demonstrate that the so called “investors” of these homes also operate them and cause them to be dramatically underfunded. The Supreme Court of Illinois provided an excellent ruling in allowing for direct liability of owners of an enterprise which underfunded its franchisees and thus allowed two people to be killed as a result of worker safety violations. Although the Illinois Supreme Court case did not involve a nursing home, the concepts are no different. Owners who intentionally allow profits to be placed over the welfare of people cannot and will not escape responsibility for their conduct.

• Email This
• Print
• Comments
• Trackbacks

David R. Cohen, Shareholder of Stark & Stark’s Nursing Home Litigation, was quoted in the article Nursing home suits face new litigation hurdles published by LawyersUSA on October 9, 2008.

Mr. Cohen comments on the number of obstacles for Plaintiffs lawyers seeking negligence claims against nursing homes. Mr. Cohen discusses how nursing home owners often elect not to insure the nursing home. Many states do not require nursing homes to carry insurance, which can affect how plaintiffs’ attorneys bring suits.

You can read the full article here (PDF).

• Email This
• Print
• Comments
• Trackbacks

The center for Medicare and Medicaid services released the 54 worst nursing homes in November, but homes that were showing signs of improvement were left off the list. After bowing to pressure from Democratic lawmakers, the Feds have released the first full list.

• Email This
• Print
• Comments
• Trackbacks

Americas Watchdog's Corporate Whistleblower Center is releasing its annual report on Medicare & Medicaid fraud, and according to the group things have never been worse.


The report focuses on nursing homes, drug/medical device companies, not for profit, and boutique hospitals. The group referred to its findings as grim with respect to Medicare and Medicaid over billing & fraud. You can read the full report online here.

• Email This
• Print
• Comments
• Trackbacks

Below is a general overview of nursing homes' responsibility to abide by federal and state law.  Nursing homes that receive medicaid and or medicare are required to comply with federal legislation. Federal legislation calls for a high quality of care. All states must comply with the federal regulations and some states have adopted even tougher laws.


In 1987, Congress enacted legislation requiring nursing homes participating in the Medicare and Medicaid programs to comply with certain requirements for quality of care. This law is included in the Omnibus Budget Reconciliation Act of 1987 (OBRA 1987), also known as the Nursing Home Reform Act. According to OBRA, a nursing home "must provide services and activities to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident in accordance with a written plan of care..."


To participate in the Medicare and Medicaid programs, nursing homes must also be in compliance with the federal requirements for long term care facilities as prescribed in the U.S. Code of Federal Regulations (42 CFR Part 483).


Below is a list of some regulations with which the nursing home must comply:

• Sufficient nursing staff to meet the needs of the residents. (42 CFR §483.30)
• Conduct comprehensive and accurate assessments of each resident's functional capacity. (42 CFR §483.20)
• Develop a comprehensive care plan for each resident. (42 CFR §483.20)
• Prevent the deterioration of a resident's activities of daily living (the ability to bathe, dress, groom, transfer and ambulate, toilet, eat) (42 CFR §483.25)
• Provide activities of daily living such at toileting, grooming, feeding and person hygiene if a resident assessment determines . (42 CFR §483.25)
• Ensure that residents receive proper treatment and assistive devices to maintain vision and hearing abilities. (42 CFR §483.25)
• Ensure that residents do not develop pressure sores and, if a resident has pressure sores, provide the necessary treatment and services to promote healing, prevent infection, and prevent new sores from developing. (42 CFR §483.25)
• Provide appropriate treatment and services to incontinent residents to restore as much normal bladder functioning as possible. (42 CFR §483.25)
• Ensure that the resident receives adequate supervision and assistive devices to prevent accidents. (42 CFR §483.25)
• Maintain acceptable parameters of nutritional status. (42 CFR §483.25)
• Provide each resident with sufficient fluid intake to maintain proper hydration and health. (42 CFR §483.25)
• Ensure that residents are free of any significant medication errors. (42 CFR §483.25)
• Maintain dignity and respect of each resident. (42 CFR §483.15)
• Ensure that the resident has the right to choose activities, schedules, and health care. (42 CFR §483.40)
• Provide pharmaceutical services to meet the needs of each resident. (42 CFR §483.60)
• Be administered in a manner that enables it [the nursing home] to use its resources effectively and efficiently. (42 CFR §483.75)
• Maintain accurate, complete, and easily accessible clinical records on each resident . (42 CFR §483.75)

• Email This
• Print
• Comments
• Trackbacks

One of the greatest obstacles to helping victims of abuse and neglect is the failure of nursing homes to self police. More often than not, we see a complete lack of investigation - even in light of serious allegations against staff. One way for families to overcome this is to immediately call the Ombudsman's office for their state.


The work doesn't end there, though. Families should remain in constant communication with the investigator. DO NOT ALLOW THE INVESTIGATION TO BE LIMITED TO THE NURSING HOME OR ASSISTED LIVING'S SIDE OF THE STORY. MAKE SURE THAT THE INVESTIGATOR GETS BOTH SIDES.


Our office has had great success over the years in utilizing these investigations to both improve the quality of care and help our clients achieve justice.


Here is a link to a helpful site which provides phone numbers for the Ombudsman's office for each state. And here is a direct link to New Jersey's Ombudsman's home page.

• Email This
• Print
• Comments
• Trackbacks

Here is an article I recently read, which outlines not only allegations of abuse, but also retaliation against a whistle blower who reported the abuse. The article contains helpful links for families looking to research nursing homes.

• Email This
• Print
• Comments
• Trackbacks

One of the most important responsibilities of nursing home owners is to treat their employees well.  This leads to a positive environment, which fosters good care and enthusiasm among staff.  As may be seen, the opposite is alleged here in an article stating that the Union City's Manhattan View Nursing Home is being sued by the United States Department of Labor. The suit is seeking unpaid overtime wages for employees of Manhattan View over the past several years.

• Email This
• Print
• Comments
• Trackbacks

After receiving tremendous pressure from advocacy groups, CMS has released its expanded list of the most troubled nursing homes in the country.  These are known as "Special Focus Facilities." 
 
Acting CMS Administrator Kerry Weems disclosed at a special media briefing Thursday that the “Special Focus Facilities” list had actually grown to 131 nursing homes with poor survey records. The list will continually be in flux, noting the next public update will be in April.

In response to a McKnight's reporter's question, Weems also clarified that from now on providers would be given brief advance notice of their inclusion on the dubious list but no others would learn of list contents until results are refreshed online. When CMS went public for the first time ever, but with just the partial list, in November, consumer advocates loudly complained that nursing home lobbyists and associations had been given the full list, while the general public had not.
 
In New Jersey, there are currently only three facilities on the list.  Two of these are listed under the category, "Improving," while the other, sadly, is now a veteran of the listing, in the list of "Facilities That Have Not Improved."
 
It will interesting to see if inclusion on this list will provide extra incentive for these troubled homes to improve the quality of care - and thus reduce the unacceptable quantity of  nursing home injuries and abuse.

• Email This
• Print
• Comments
• Trackbacks

• Email This
• Print
• Comments
• Trackbacks

I recently found a great website for families looking to investigate nursing homes.  The website offers a list of nursing home throughout the country that are in danger of harming it's residents. The site breaks down the potentially harmful home into three categories:

- a red code equals actual harm and/or immediate jeopardy
- a yellow code equals the potential for more than minimal harm
- a blue code equals the potential for minimal harm

In this link, there exist some significant problems at a facility known as Plaza Regency at Park Ridge, in Park Ridge, New Jersey.  I strongly urge our Blog readers to explore this helpful site.

You can access the website here.

• Email This
• Print
• Comments
• Trackbacks

David Cohen, Shareholder and Chair of Stark & Stark’s Nursing Home Litigation Group, was quoted in the January 16, 2008 edition of US 1 Newspaper, in the article, Choosing the Right Assisted Living Home.

The article discusses the importance of research and careful planning when selecting a nursing home for you and your loved ones, in order to prevent further injuries. Cohen advises families to be aware of the specific statewide and national regulations in place in order to prevent nursing home abuse in under-funded facilities providing inadequate care.

You can read the full article here.

• Email This
• Print
• Comments
• Trackbacks

As recently reported in the Courier Post, New Jersey faces a critical nursing shortage.  As is frequently revealed in investigations of nursing home negligence and abuse, there is much more that Nursing home owners and the industry should be doing to provide greater support for this very important profession.

You can read more on the nursing shortage in New Jersey here.

• Email This
• Print
• Comments
• Trackbacks

Serving as an example of how regulators can effectuate change, the Altoona, Pennsylvania nursing home, Laurel Crest, is not only undergoing tremendous scrutiny for surveyors to ensure quality, but outside consultants are being brought into the facility to make sure that the right changes are made.

These changes could have a huge effect on the level of care to be provided to its residents. You can read more about these changes here.

• Email This
• Print
• Comments
• Trackbacks

• Email This
• Print
• Comments
• Trackbacks

After being bought out by private investors in 2002, along with 48 other nursing homes in Tampa, Florida, Habana Health Care Center began to suffer, and so did it's residents. Within the first few months the number of clinical nurses at the facility had been cut by half in an effort to cut costs by the facility's new management.  And, according to Florida’s Agency for Health Care Administration, budget cuts were made for nursing supplies, resident activities and other services.

Meanwhile, the investors and operators of the 49 homes throughout the state were making millions. As if that wasn't bad enough, over the three years of budget cuts, 15 Habana residents died from what their families feel was negligent care and since have filed suits in state court. In addition to a severely understaffed team of caregivers, reports found malfunctioning fire doors, unhygienic kitchens and a resident using a leg brace that was broken.

Due to the ever-increasing number of Americans needing elder care, nursing home facilities across the country are being bought out by large investors, who can only see dollar signs as our baby-boomers enter through their doors. The more people admitted to each facility should mean increased support and resources for the home. However, more and more this is not the case.

The severely neglected residents of these homes need more attention and care than ever. Federal and state regulators also said in interviews that budget cuts help explain why serious quality-of-care deficiencies — like moldy food and the restraining of residents for long periods or the administration of wrong medications — rose at every large nursing home chain after it was acquired by a private investment group from 2000 to 2006, even as citations declined at many other homes and chains.

While the suit is still in the beginning stages for the 15 families at Habana Health Care Center, similar cases continue to arise across the country. You can read more on the Habana and other facilities' stories in the New York Times article, At Many Homes, More Profit and Less Nursing.

• Email This
• Print
• Comments
• Trackbacks

I found an alarming report on a New Jersey nursing home in the Star Ledger recently. A surprise inspection by Senator Richard Cody (D-Essex) revealed an astounding level of neglect at the New Vista Nursing and Rehabilitation Center in Newark, NJ.

Patients had been left alone for days in stifling heat, with broken facilities and unsanitary bathrooms. Senator Cody was disgraced by the level of care at the nursing home. I think an increased number of surprise inspections will enable us to keep an eye on nursing home neglect and will shed light on the need for higher standards and care for our loved ones.

You can read the full story here.

• Email This
• Print
• Comments
• Trackbacks

Carlyle Group, a District-based private equity firm, has reached an agreement to acquire nursing home operator Manor Care for $6.3 billion, the companies said in a statement on July 2.

Manor Care runs more than 500 nursing homes and assisted living centers across the United States and employs more than 60,000 people. The company, which was founded in 1959 by Stewart Bainum Sr., has deep roots in the Washington region and for years was based in Montgomery County.

In 1998, Manor Care merged with rival Health Care and Retirement Corp. in a $2.9 billion stock swap, and moved its headquarters to Toledo, Ohio.

Stewart Bainum Jr., the founder's son, stepped down as chairman in 2002. He is chairman of Choice Hotels International, a Silver Spring hospitality firm that was a unit of Manor Care before being spun off as a separate company in 1996.

• Email This
• Print
• Comments
• Trackbacks

Nursing home neglect and abuse is occurring at an alarming rate in the state of New Jersey. This neglect and abuse is to blame for most of the instances of bedsores, dehydration, malnutrition, fractures, infections, as well as physical, emotional, and psychological trauma. Although these injuries are largely preventable, they persist because nursing homes are often understaffed and care providers are inadequately trained. This reality makes finding a nursing home that provides quality care challenging work. However, having a basic understanding of the substandard care presently found in nursing homes and employing the tips provided below will make it significantly easier for you to find the quality care your loved one needs and deserves.

Many nursing homes routinely fail to provide enough staff to meet the needs of the residents. Often residents wait long periods of time for even the most basic necessities. These delays can have horrific consequences. For instance, a significant delay in providing residents with food and water can quickly lead to life-threatening malnutrition and dehydration complications. Also, delays in repositioning of immobile residents can result in very painful wounds, severe infections, and amputations.

In addition to under staffing, nursing home personnel, particularly certified nursing aides, are often inadequately trained. CNAs have the most contact and provide the most care to the residents. However, administering quality care to frail elderly individuals is complicated. It can only be done properly after considerable training. Unfortunately, CNAs are overworked and underpaid. As a result, their turnover rate is high causing nursing homes to regularly scramble to train new employees. The unfortunate consequence is that residents are continuously left at risk of neglect and abuse.

The good news is that there are nursing homes within the State of New Jersey that are providing quality care to their residents but they have to be sought out. If you are considering placing a loved one in a nursing home, visit the State of New Jersey Department of Health and Senior Services web site. There you will find the DHSS report cards for nursing homes. Each year, the department conducts on-site inspections called "surveys", of all New Jersey nursing homes. State surveyors evaluate the quality of care and services provided, as well as the appropriateness of the facilities, building, equipment, staffing, policies, procedures, and finances. The surveys are a "snap shot" of the facilities' performance at that point in time.

If you find a nursing home that you believe will provide quality care, don't stop there. Go to the nursing home web site and read up on facility. Then visit the nursing home and meet with its administrator. Inquire about the staffing levels and turnover rates. While you are there make some observations: Do the residents appear to be well taken care of? Is the building well maintained? Do the residents appear active? Is the staff respectful to the residents? What do staff members think of their work? Ask the residents if they like the nursing home. The more time you take and the more questions you ask the better your chance of developing an accurate assessment of the facility.

Nursing homes should be a place where you can trust your loved ones' needs will be met and quality care administered. This is not always the case and in order to insure that it is for your loved one, it will be up to you to do the research and make certain the nursing home you choose provides quality care.

• Email This
• Print
• Comments
• Trackbacks

A major concern with both nursing homes and assisted living facilities (ALF) is short staffing. In our practice, we routinely find the plaintiff’s injuries are directly related to inadequate staffing. If you have a loved one who is in a nursing home or ALF and are concerned about the staffing speak with the facilities administrator and/or a social worker. If you are unsuccessful contact the Ombudsman’s Office (this is an independent state-run office who advocate for the rights of elderly residents).

• Email This
• Print
• Comments
• Trackbacks

In evaluating a nursing home for a loved one, it is advised that you go and visit the nursing home and ask yourself some of the following questions:

(1) Do the residents appear to be well taken care of?

(2) Is the building clean?

(3) Is the building well maintained?

(4) Are there any foul odors in the building?

(5) Do residents seem active or are they sitting around and appear ignored and bored?

(6) Does the food look appetizing?

(7) Do the staff members interact with you and especially the residents in a pleasant manner?

(8) Does the facility seem to be adequately staffed?

(9) Do the linens look clean?

(10) Does the staff seem to interact in a respectful manner with the residents?

(11) What is the lighting like?

(12) Ask staff members what they think of their work.

(13) Ask staff members if they are ever short-staffed.

(14) Ask the residents if they like the nursing home.

(15) Ask the residents if the staff is helpful and caring.

(16) Ask the residents what they think of the food.

• Email This
• Print
• Comments
• Trackbacks

When deciding on a nursing home for a loved one, it is recommended that you do a pre-visit investigation. Consider doing some of the following suggestions:

(1) Make a list of nursing homes that are close enough for family and friends to conveniently visit the resident;

(2) If your loved one will need assistance from Medicaid and/or Medicare in paying for their stay, list only those nursing homes that participate in the Medicare and Medicaid programs;

(3) Learn as much as possible about nursing homes by talking with:

(a) Others with loved ones in nursing homes;

(b) Clergy;

(c) Doctors;

(d) Social workers;

(e) Nurses;

(f) Nursing home employees; and

(g) Long-term care ombudsmen;

(4) Review state survey inspection reports. These reports are conducted by the state on an annual basis and can give you a good sense of what, if anything, the nursing home is failing to do in terms of care and treatment of its residents. These surveys should be posted in each facility that you visit. This is required by Federal Law. This information is also available on the internet at the Medicare website.

• Email This
• Print
• Comments
• Trackbacks

Finding the right assisted living or residential care facility for you or a loved one is an important decision. After you have determined the kind of services you or your loved one need, you should obtain or develop a list of assisted living facilities in your area offering those services. Your hospital discharge planner, social worker, personal physician and clergy may be familiar with facilities in your area. Additionally, you may want to contact New Jersey’s Department of Health and Senior Services.

• Email This
• Print
• Comments
• Trackbacks

According to the 2006 MetLife market survey of assisted living costs, the rate of private pay averaged approximately $35,616.00 yearly. This represented a 2.2% increase from 2005 and more significantly, a 17.6% increase from 2004.  As we have posted on this site in the past, assisted living is increasing in popularity as an alternative to other forms of long-term nursing care.

• Email This
• Print
• Comments
• Trackbacks

Assisted living facilities provide relatively independent seniors with assistance and limited healthcare services in a homelike atmosphere. Assisted living services include twenty-four hour protective oversight, food, shelter and a range of services that promote the quality of life of the individual. The philosophy of assisted living emphasizes the right of the individual to choose the setting for care and services. Assisted living customers share the risks and responsibilities for their activities and well-being with a staff geared toward helping them enjoy the freedom and independence of private living. Assisted living facilities are licensed by state governments and can be known by several different names including residential care, board and care, congregate care and personal care. Assisted living is not a substitute, but rather a compliment to nursing facility care.

• Email This
• Print
• Comments
• Trackbacks

Poor work conditions represents one of the most significant hurdles facing nursing home residents today. Workers who lack job satisfaction and who feel a sense that the management company is not providing them the support they need simply cannot deliver the level of care that our elderly deserve. When conditions reach a critical level, workers will literally leave the job. This happened as recently as August of this year at a Veterans home in Menlo Park, New Jersey. A union representative noted “people don’t want to come to work anymore, it’s so bad…we just want to be able to do our job in peace.” One worker claimed that she was on suspension for utilizing six work days, even though her contract authorized fifteen sick days. This represents a classic example of management failing to protect nursing home residents through fair and equitable treatment of its own employees.

• Email This
• Print
• Comments
• Trackbacks

Assisted living facilities offer a special combination of housing, personalized support services and healthcare design to accommodate those who need help with the activities of daily living, but may not require the type of care provided in a nursing home. In selecting an assisted living facility in New Jersey, consult the State of New Jersey Department of Health and Senior Services website. There you will find a checklist of issues to be concerned with, including contracts, cost and finances, medication and healthcare, services, recreational activities, food and dining, and atmosphere. Assisted living facilities in the State of New Jersey are regulated by the New Jersey Department of Health and Senior Services. They are licensed facilities and are, therefore, held to a higher standard. The New Jersey Department of Health and Senior Services regularly inspect assisted living facilities throughout the state.

• Email This
• Print
• Comments
• Trackbacks

For those considering moving a loved one to an assisted living facility in the State of New Jersey, Chelsea Senior Living in Summit, New Jersey, has been named one of the top forty assisted living chains in the country. This, according to a survey found on the website for the National Center for Assisted Living. This survey takes into consideration the following factors: occupancy rates; revenue sources; and services offered.

• Email This
• Print
• Comments
• Trackbacks

According to the September 2, 2006 Wall Street Journal, the average assisted living center cost rose approximately one-third from 2002 up to $35,000.00 a year in 2005. That same article noted that assisted living centers are reaching a near saturation point, with a 95% occupancy rate. Many of these facilities have extensive waiting lists. Despite its popularity, the allure of the assisted living option represents a number of dangers to the unwary consumer. As I have lectured across the country, many assisted living facilities accept patients that they are not capable of properly protecting, while others are simply too slow in discharging those who are more appropriate for nursing home residency. It is essential to assure that a qualified physician not only performs an assessment upon a potential admission into an assisted living facility (ALF), but also that reassessments occur on a regular basis to ensure that the combined deteriorating effects of age and disease processes do not make ALF residency problematic. We will have many more entries on this emerging issue in the weeks and months to come.

• Email This
• Print
• Comments
• Trackbacks

Assisted Living Facilities and Nursing Homes cannot offer the same level of care. Assisted Living Facilities do not offer specialty care. They have fewer nurses, fewer CNAs, and less overall oversight of the individual resident. Thus, Assisted Living Facilities generally have residents who are more independent. However, due to desire to fill beds and generate more revenue, Assisted Living administrators sometimes take residents they cannot necessarily care for. Such is the case with a matter our firm is currently handling. In this particular case, the resident was brought into an Assisted Living Facility even though there was documentation that showing the resident had fallen thirty seven times at a previous nursing home. This resident was clearly a high risk for falls. Assisted Living Facilities are simply not equipped to provide the kind of care that this individual needed. Consequently, within three days after being admitted to the Assisted Living Facility, this resident fell and severely fractured her wrist.

• Email This
• Print
• Comments
• Trackbacks

I recently returned from a speaking engagement at the Association of Trial Lawyers of America's Annual Nursing Home Litigation Conference (now known as the American Association for Justice). Although I have attended many of these conferences of the years, I am continually impressed by the continued devotion of all of the hardworking attorneys who have chosen this specialty to protect our most vulnerable of citizens. Throughout the two days of seminars and interactions, the group continually talked about the unwavering goal of protecting the elderly and improving the quality of care for nursing home residents across the country. The devotion of this group, of which I am proud to say I am a member, never fails to inspire on this mission. In broad posts to follow, we will talk about a number of organizations that concerned citizens can join to serve as advocates for the elderly in long term care.

• Email This
• Print
• Comments
• Trackbacks