Documentation & Reporting

How does the role of an MDS Coordinator relate to patient care and Medicare or Medicaid fraud?

A nursing home MDS Coordinator assesses the capabilities of a patient and creates individual care plans—including the level of treatment that must be delivered. A person in this position may be doing their job right but then fall under the pressure from the nursing home to up the ante for more billings or risk losing a well-paying job. It starts out with a fudged physical therapy session here or there. Then the message flows downhill to CNAs and other healthcare staff resulting in more falsified records. This escalates with more and more demands from above to get additional services—and higher value services—added to the bills. In the end, the Government is defrauded.


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A new law will soon take effect requiring nursing home employees to notify police within hours of suspected abuse – or to call 911 if the situation is an emergency. “Peggy’s Law” will provide additional protections to nursing home residents by ensuring that law enforcement is promptly notified of possible criminal abuse cases.

Peggy’s Law was named for 93-year-old Peggy Marzolla, who died following injuries suffered while in the care of a nursing home in 2010. When Peggy Marzolla was taken to the hospital, it was found that she had sustained a broken eye socket, cheekbone, jaw, and wrist, as well as a badly bruised elbow, a gash on her leg, and welts on her back.

Staff members at the nursing home stated that she had slipped on some powder in a bathroom and fallen. Her daughter did not believe the explanation and spent the next several years lobbying lawmakers to better protect institutionalized seniors.

Governor Chris Christie signed Peggy’s Law on August 7, 2017 and it will go into effect 60 days later.


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Special kudos to the Reading Eagle on its recent series on nursing homes – in particular the editorial We Must Demand Better from Nursing Homes, Regulators, published on December 11, 2016. For those of us who work hard to hold nursing home corporations accountable when seniors are neglected, abused, seriously injured, or die, this series of articles is a vindication.

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In recent news in Pennsylvania, the Office of the Attorney General is suing the nursing home chain, Golden Living Center, for allegations that they repeatedly refuse to meet its residents most basic needs. Further allegations reported by WPXI include falsifying records and lying to state inspectors.

It looks like Pennsylvania is beginning to catch on

When deciding whether to place a loved-one into a nursing home, families attempt to determine whether the nursing home is capable of providing the necessary quality care. Most families visit the nursing home, as well as check the U.S. government’s Nursing Home Compare tool at Medicare.gov.

Despite their efforts, some nursing homes have purposefully misrepresented

Harborview, a defendant in a case we took to trial last year, is back in the news.  During the trial, the ownership and management spoke of the facility in glowing terms – terms that were contradicted by state inspections and other testimony.  The article recounts rodent problems – and even chronicles a resident that bought

Many times, in the world of nursing home litigation and medical malpractice, you hear things like “caps on damages,” “tort reform,” of “medical review panels.”  These measures are presented as ways to “Stop the crisis!” or “Reign in out of control juries!”  The reality is, there is no crisis, juries are reasonable, and these measures

As an advocate in New Jersey  for nursing home residents, one of my greatest frustrations has been the lack of oversight for self reported staffing levels.  This has lead to an extraordinarily low incidence of short staffing citations – and worse yet, has allowed some understaffed facilities to crow over their lack of such citations.

I’ve noticed in my practice a dangerous and burgeoning phenomenon. That is, the emergence of non-disparagement clauses for people who know the dangerous secrets of the worst of the worst long-term care facilities. I am finding that the vast majority of these clauses are found in assisted living facilities. These organizations appear to have very

A very convenient tool for concerned families to evaluate nursing homes is the “Medicare Compare” website.  Included within this is a section that designates what are known as “Special Focus Facilities.”  A Special Focus Facility represents the bottom 1% or 2% of all nursing homes in the country which have demonstrated not only under-performance, but