Nursing Home Information

A significant number of nursing home residents are shorter-term residents who are recuperating from surgery or illness. A recent study centered on the information provided when patients are discharged from hospitals to nursing homes, and they or their families are tasked with choosing a post-acute care facility.

As a result of regulations and incentives imposed by the Affordable Care Act, hospitals began being held partly accountable for Medicare patients’ care after discharge. However, little information has been available about the process of patients choosing a post-acute care facility.

Continue Reading Patients Often Discharged to Nursing Homes with No Information on Quality of Care

As a result of the unstable economy, many adults have been forced to work longer hours or multiple jobs, resulting in less time to care for their elderly parents at home. This is no exception for America’s growing Latino population, who often hold caring for elderly family members in high regard as a cultural tradition.

Government statistics show that Hispanics have a life expectancy of 82 years, longer than non-Hispanic white Americans (78.7 years) and non-Hispanic black Americans (75.1 years). Hispanic women have a life expectancy of 84.3 years. However, according to a poll conducted by Associated Press-NORC Center for Public Affairs Research, fewer than two out of every 10 Hispanics age 40 and older say they are extremely confident that nursing homes and assisted living facilities can meet their needs.

Continue Reading Special Considerations for Latinos Seeking Elder Care

A recent investigation by CNN brought to light the expanding and allegedly inappropriate use of the prescription drug Nuedexta in nursing homes throughout the country. Nuedexta is FDA-approved to treat a rare condition known as pseudobulbar affect (PBA).

What is Pseudobulbar Affect?

Pseudobulbar affect is characterized by sudden and uncontrollable laughing or crying. It is associated with people who have multiple sclerosis (MS) or amyotrophic lateral sclerosis (ALM), known as Lou Gehrig’s disease. Avanir Pharmaceuticals has been aggressively targeting elderly nursing home residents with the drug, the CNN investigation found, although PBA reportedly impacts less than 1 percent of Americans, based on a calculation using the drug maker’s own figures

What the Investigation Revealed

Nuedexta prescription use in nursing homes is rising at a rapid rate, even though Avanir Pharmaceuticals acknowledges that the drug has not been extensively studied in elderly patients, according to CNN.

Continue Reading CNN Investigates Expanding Use of Nuedexta in Nursing Homes

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.

Continue Reading Will Tort Reform Affect Nursing Home Care?

If you are a member of the so-called “sandwich generation” – those people who are simultaneously caring for children as well as their elderly parents – you may be familiar with U.S. News & World Report’s college rankings. But did you know that U.S. News & World Report also has nursing home ratings? In fact, U.S. News recently evaluated more than 15,000 nursing homes across the country, ultimately including approximately 2000 of those facilities (366 in New Jersey) in its list of Best Nursing Homes.

U.S. News began publishing online ratings of nursing homes in 2009. Until its latest release, the tool used a “snapshot” of the star ratings posted on Nursing Home Compare, a consumer website of the Centers for Medicare & Medicaid Services (CMS). CMS assigns an overall rating of one to five stars to nursing homes according to their performance in three areas – state-conducted health inspections, nurse staffing and medical quality measures.

Continue Reading Where Can I Find Nursing Home Ratings?

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

According to Medicare fraud reports by the U.S. Department of Human Health and Services (HHS), the U.S. Department of Justice’s Medicare Fraud Strike Force team has investigated $7 billion in fraudulent billing since 2007 and prosecuted over 2400 medical professionals and administrators. Part of that amount comes from nursing homes that bill for unnecessary services or for services that have not been provided to the residents that depend on them.

And that fraudulent activity harms nursing home residents as well as our government’s bottom line.

Continue Reading How Nursing Home Staff Can Help Prevent Medicare Fraud

As I’ve written before, the real drivers of healthcare costs are not lawsuits, which studies by Johns Hopkins Medicine found are less than 1% of healthcare costs. The big costs are a result of fraud.

Kindred Healthcare, a large chain of nursing homes, will pay $125 million to settle allegations that it billed Medicare for therapy that was either unnecessary or not provided.

The case was brought forward by two whistleblowers – employees of Kindred who knew that what their company was doing was not right.  You can read a full account of the case as reported by the Boston Globe.

Recently, the August 2015 Special Focus Facility List was published by the Centers for Medicare and Medicaid Services (CMS). The CMS regularly visits nursing homes to assure that they are administering the quality of care that Medicare and Medicaid require. With these regular visits, the CMS will identify any deficiencies in the quality of care being provided, as well as if the facility is meeting safety requirements. The CMS will also examine any previous noted deficiencies and how promptly they were or were not handled. These criteria will determine the facility’s overall survey from the CMS.

Additionally, if serious problems are left unchecked in these facilities, the CMS can opt to terminate the special focus facility’s participation in Medicare and Medicaid.

Once the CMS’ “survey” teams gather their data from the facilities, this is submitted to a master list, The Special Focus Facility List. This list includes all facilities with a history of care problems and/or poor surveys, and is updated monthly by the CMS. Every special focus facility must be visited by a CMS survey team at least twice a year.

If you would like to see the whole list, please visit the CMS website.

It is also important to note that if you go to Medicare’s Nursing Home Compare website and look up any individual nursing home, you will immediately be able to tell if that facility is on the Special Focus Facility List. Any facility on the list will have a yellow triangle with an exclamation point next to its name. Additionally, you can use the website to see other ratings for the facility, including health inspections, staffing and quality measures. At the moment, there are several nursing homes in Pennsylvania and New Jersey on the CMS’s most current Special Focus Facility List.

If you have a loved one in a facility on the Special Focus Facility list, you can go to the administration and demand they tell you why the facility on the list and what they plan to do to improve the quality of care provided to be removed from the list. You do not get on this list when you are meeting even minimal standards.

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.