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.

Continue Reading Rights of Whistleblowers: MDS Coordinators

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.

Continue Reading Peggy’s Law Protects Elderly Nursing Home Residents

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.

Continue Reading Newspaper Highlights Problems with PA Nursing Homes

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 to what those of us that practice in this area have long known: some nursing home companies are willing to put residents in jeopardy in order to increase profits.

The vast majority of the claims we prosecute are not about individual care givers; they are about business wrongdoing. When we prosecute these claims, we prosecute companies, not people. Most of the problems are the result of board room decisions, not individual failings. Most aides and nurses are doing the best with what they have – unfortunately, what they have is oftentimes not enough.

You can read the full article here.

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 their ability to care for its residents.

Overstating Staffing Levels

According to the latest updated report from the Center for Public Integrity, over 80% of nursing homes have consistently overstated their staffing levels to Nursing Home Compare in an apparent bid for higher rankings at the site. The report explained that staffing overstatements occurred for all types of nursing positions, but were particularly high for registered nurses—the most skilled and highest paid workers.

Our nursing home negligence and abuse attorneys have long since understood that the amount of care, especially by registered nurses, is strongly connected to the quality of care provided to nursing home residents. For example, my associate Eric D. Dakhari, Esq. explained in a recent blog article that for understaffed facilities, evidence shows increased incidents of—among other critical issues—pressure ulcers, catheterized patients, urinary tract infections; as well as an increased likelihood of death.

As a nursing home lawyer, I have too frequently litigated nursing home negligence and abuse cases where the low levels of care were associated with a resident’s severe injury or death.

Nursing Home Compare: The Goal

The government website’s goal is to assist families in evaluating a nursing home’s ability to provide adequate “skilled-nursing” care, which is care given when you need skilled nursing or rehabilitation staff to manage, observe, or evaluate your care.

A Flawed Self-Reporting Process

The Nursing Home Compare website explains that each nursing home must self-report its staffing hours to its state survey agency and that the reported staffing hours reflect the staffing of RNs, LPNs, CNAs, and PTs from a two-week period just before the state inspection.

The government website displays the self-reported nursing home staffing hours as the number of staff hours per resident per day, which is the total number of hours worked divided by the total number of residents.

It is important to note that the website does not necessarily show the number of nursing staff present at any given time, or reflect the amount of care given to any one resident.

Our nursing home attorneys know that many nursing homes commit additional human and financial resources to prepare for the state inspections, and as a result, the self-reported staffing levels do not accurately reflect the typical staffing levels in the nursing home. This is particularly important because some nursing homes must provide more nursing staff due to the conditions of their residents, and other factors.

Recommendation to Families

Our nursing home negligence and abuse lawyers understand the difficulty that families face in selecting a nursing home based on false data. My partner, has previously recommended that families ask the nursing home about its CNA-to-Residents ratio. He explained that determining that ratio—as opposed to the RN or LPN ratio—is important because the CNAs are the frontline workers that provide the majority of the hands-on-care to residents.

If you or someone you know has been involved in a nursing home negligence or abuse incident, I recommend that you consult with an attorney immediately to discuss your rights.

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 his own glue traps.

You can read the full article here.

 

 

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 are usually promulgated by nursing home companies solely to avoid liability.

A recent article from WFPL in Louisville, KY, recounts the story of Hazard Health and Rehab Center.  Within the walls of that facility, among other issues, two residents sexually abused a 91 year-old resident and another resident suffered a “gaping pressure ulcer.”  For the sex abuse, the facility paid a fine of $20,000, and for both incidents the facility was sued in civil court.

The nursing home industry in that state backed by among others state Republicans and the Kentucky Chamber of Commerce, want to make-up a law that will require a board of three “healthcare providers” that screen cases for merit – before a plaintiff can even file a lawsuit. This is designed to be yet another hurdle to achieving timely justice.   Helping to bankroll this idea?  Hazard Health and Rehab.

The article goes on to state that it’s the poor state of health care in KY is what’s causing the legal problems, not the law.  According to the article KY has more below average nursing homes than all but 8 other states.  “That just shows there’s widespread abuse, neglect, mistreatment of residents occurring in far too many nursing homes,” said Brian Lee, executive director of Families for Better Care.

You can read the full article here.

Be cautious whenever you hear of measures that limit a person’s ability to hold anyone person or company accountable in court.  There’s usually a lot of money behind the idea, and very little consideration for the good of the population. If you have any questions about a Nursing Home situation, contact Stark & Stark today.

 

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.

The reality on the ground is that an alarmingly high number of long term care facilities CHOOSE to short staff their facilities to increase profit levels.  By falsifying staffing numbers, they can often evade scrutiny on this extremely important issue.  That is, nursing homes rarely have their payroll records cross referenced against their reported staffing numbers – leaving them free to fudge the math.  In our cases, we have uncovered such records, but I am fearful that this is just the tip of the iceberg.  Indeed, this fear is supported by the confounded families who see barely a foot on the ground, a complete lack of care for their loved ones – yet no citations from the State for failing to meeting staffing requirements.

Recognizing this problem, the White House just announced additional funding to assist authorities in preventing this type of dangerous conduct.  In the end, residents will benefit – as will overworked staff who need a helping hand to protect these vulnerable folks. If you or a loved one has been impacted by an understaffed nursing home, contact the New Jersey Nursing Home Abuse Attorneys at Stark & Stark today.

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 organized corporate structures and, upon the termination, retirement or resignation of high-level personnel, they sign legal separation agreements, which also include aggressively enforced non-disparagement language within them.

I first began to notice this phenomenon when I would take depositions and find that people who were fired under very questionable circumstances absolutely afraid to say anything negative about their former employer. It became apparent to me that they feared corporate retribution if they still worked in the healthcare facility and even worse with regard to whatever amounts of money they were paid upon their termination.

Finally, as I began to look more deeply into this, I got witnesses to agree that upon leaving either assisted living facilities, or at times, nursing homes, they would sign legal separation agreements which would not permit them to say anything at all negative about their former employer. With the exposure of these stifling contracts, the truth became self-evident.

Still, these are people are the guardians of our most frail and vulnerable citizens. These are people who know the secrets of poor facilities that could be remedied. These are people who can help folks like me who advocate for nursing home residents to hold wrong-doers accountable. It is a corporate philosophy that through the use of payoffs, chills the speech of the most important people who can shed light on the growing problem of corporate greed being placed over the welfare of nursing home residents.

As we have said in prior blogs, we have uncovered false employees in nursing homes being paid by taxpayer dollars. We have found exorbitant rent being paid by  nursing home owners to themselves for the property they own, while complaining that Medicare and Medicaid dollars are not enough to take care of residents. They do this while paying off in full their investment properties multiple times over.  Now, with this new corporate philosophy, the only people who can truly tell the truth are being silenced.

Former employees should know that there are laws in place to protect them from retribution for being honest.  Also, there are powerful whistleblower laws empower people to get the truth out about fraud and abuse of our most vulnerable citizens.  If in doubt about such agreements, people should obtain representation before signing and think long and hard before allowing their silence to be bought. Contact the Nursing Home Attorneys at Stark & Stark with any questions.

 

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 whose corporate practices have demonstrated a significant danger to members of our community who entrust them to care for their loved ones. http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/Downloads/SFFList.pdf

In order to become a Special Focus Facility, a nursing home must demonstrate a significant period of time of a failure to comply with all the safety rules and regulations promulgated by the Federal government to protect their elderly residents and a failure to address concerns expressed by State and Federal surveyors. Currently, New Jersey has two special Focus facilities.  These are Water’s Edge Rehabilitation in Trenton, New Jersey and Liberty Royal Rehabilitation and Health Care Center, in Tinton Falls, New Jersey.

Consumers should carefully think twice before entrusting a loved one with a facility with this dangerous designation, although many of the better nursing homes in New Jersey have been Special Focus Facilities and have ostensibly cleaned up their act. That is, the Special Focus Facility program is one which works.  Many well meaning organizations take this designation quite seriously and improve their conduct.  However, some facilities have been forced to close their doors because of this designation.  As bad as that seems to many of the residents, it is unquestionable that the Special Focus Facility designation and the hard work of surveyors protects residents whose lives are placed at risk because of dangerous corporate conduct.