A list of nursing homes around the country flagged by federal lawmakers for persistent health issues has now been made public, and 11 of them are in New Jersey.

The government would previously not disclose the official list of the nursing homes with serious ongoing health, safety, or sanitary problems found by inspectors. The silence cracked on June 4th when Sens. Bob Casey and Pat Toomey from Pennsylvania released the list of over 400 nursing homes the Centers for Medicare & Medicaid Services (CMS) flagged with persistently poor survey inspection results.


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Last month, the Centers for Medicare & Medicaid Services (CMS) revised their Nursing Home Compare 5-Star Quality Rating System, giving 29 New Jersey nursing facilities a one-star rating. These updates intend to give consumers clearer information about the quality of care residents receive at different nursing centers. The changes also aim to promote quality improvement within the facilities.

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The federal government imposed a $600,331 fine on the New Jersey nursing center where a viral outbreak left 11 children dead and 36 sick last year. Investigators reported Wanaque nursing home’s poor infection controls, lack of administrative oversight, and slow response from medical staff “directly contributed” to the rapid spread of the virus and its related death toll.

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The latest tort reform measure, H.R. 1215, the Protecting Access to Care Act of 2017, would place caps on medical malpractice damages, limit attorney fees, and modify statutes of limitations. Among other changes to current law, non-economic damages in medical malpractice lawsuits would be limited to $250,000 – and juries would not be informed of this cap on damages. H.R. 1215 would apply to health care lawsuits where coverage for the care was provided or subsidized by the federal government, including through subsidies or tax benefits.

H.R. 1215 would preempt state laws governing health care litigation in several areas, including statutes of limitation, joint and several liability, product liability, and attorney contingency fees.

Proponents of the bill claim that the bill would lower medical liability insurance premiums, and by extension, reduce the incidence of so-called “defensive” medical treatments and lower costs associated with federal health care programs such as Medicaid.


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A caregiver may face the overwhelming decision to place a loved one in a nursing home after a sudden event such as a fall or a stroke. Sometimes, there is more time to prepare, as in cases where the loved one suffers from a chronic or debilitating disease, including diseases where the patient is expected to deteriorate over time.

Once a loved one is safely tucked into a nursing home bed, a caregiver may feel a sense of relief. However, nursing home staff members are notoriously overburdened with the everyday tasks involved in caring for their elderly patients. Nonetheless, it is the responsibility of nursing home staff and management to ensure that each resident receives the care he or she needs.


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In its five-part “Failing the Frail” series, a PennLive investigation reveals the 18 most understaffed Pennsylvania nursing homes. The series includes an interactive map to search for staffing levels of individual nursing homes.

Based on PennLive’s analysis of 559 facilities, nursing homes in Pennsylvania provided residents with an average of only 3.6 hours of care per day, well below the minimum 4.1 hours recommended for safe care, although within Pennsylvania’s minimum staffing requirement of 2.7 hours of care per day. The analysis found 477 homes, or 85 percent, provided less than the recommended level. The analysis further found that 183 homes, or 33 percent, were dangerously understaffed because they provided less than 3.5 hours of care per day and, less than 32 minutes of care from registered nurses.


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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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During much of the 20th century, hospitals did not have a duty to treat patients who entered emergency departments. Without any given reason, they could refuse to treat certain patients. The practice of “patient dumping” arose from that lack of duty.

Patient dumping refers to situations when hospitals deny emergency medical screening and stabilization services. It also refers to instances when a hospital transfers an individual to another hospital after discovering that the individual does not have insurance or a means to pay for treatment.

To correct that wrong and in an effort to ensure that individuals received needed emergency care, in 1986 Congress enacted EMTALA, which was designed to protect all individuals seeking evaluation or treatment at hospital emergency departments that participate in Medicare.
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I was recently speaking with someone about a woman who worked for a non-profit nursing home for many years. She liked it there and the facility provided good care. Then the facility was sold to a for-profit corporation. Overnight, staff hours were cut, pay was cut, and care declined. The person I was speaking with could not believe this could happen–I was not surprised as sadly I’ve seen this occur many times.

If an administrator at a non-profit tells her board of directors she made a little money that year and gave great care, she’s applauded. However, if that same administrator tells the same thing to a for-profit board, she’s getting fired. The replacement knows that staffing is the biggest expense and that’s where you will see the cuts.


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Often, many of the problems that occur in nursing homes are a direct result of terribly insufficient staffing. This knowledge is born out in studies that show a direct correlation between staffing ratios and quality of care.

Despite all of this clear evidence, many facilities only meet the bare minimum hours required under state regulation. Some aides have told me the ratio on their day shift at a nursing home was as high as 1 aide to 14 residents. For those unaware, aides are the people who feed, bathe, and transfer residents, and they are also responsible turning and repositioning any residents who are at risk for developing bed sores. Having only 1 person in charge of caring for 14 patients at the same time is a catastrophe waiting to happen.


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