The Trump Administration has recently adopted new limits on the use of guidance documents for federal agencies. Guidance documents are the government’s interpretation of rules and laws that apply to agencies and related businesses.

Federal agencies have issued hundreds of guidance documents on a host of laws which cover issues like healthcare, civil rights, and labor.

These changes will most likely have a significant impact on the agencies which oversee healthcare industries, like the Centers for Medicare and Medicaid and the Department and Health & Human Services, because these agencies rely heavily on these documents to operate.

Continue Reading Recent Government Actions May Impact the Healthcare Industry and Affect Nursing Home Residents

According Kaiser Health News, an analysis of nursing home financial records revealed that nearly three-quarters of all nursing homes in the U.S. are owned by people who also have vested interest in companies that in turn sell services and goods to these same nursing homes.

These business dealings are known as “related party transactions.” These transactions enable a nursing home owner to arrange contracts with their related businesses above a more competitive price, allowing them to turn around and siphon off the extra profit.

Continue Reading When Nursing Homes Feed Into Corporate Web, Patient Care Fails

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

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

The most recent attempt to overhaul the nation’s health care system would fundamentally alter Medicaid and jeopardize home and community-based services, according to www.DisabilityScoop.com. A chart outlining the proposed bill is available here.

After a prior Republican plan to repeal and replace the Affordable Care Act failed, this new effort in the U.S. Senate again seeks to upend the Obama-era law.

The proposal introduced last week by Sens. Lindsey Graham, R-S.C., Bill Cassidy, R-La., Dean Heller, R-Nev., and Ron Johnson, R-Wis. runs into a deadline of September 30. After that date, a simple majority will not suffice to pass the measure – rather, 60 votes would be needed to do so.

Thus, Republicans have until Sept. 30 to repeal Obamacare with only 51 votes in the Senate under the current budget resolution.

Continue Reading New Healthcare Bill Would Impact Medicaid Services

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

The current administration has set its sights on another federal rule, seeking to eliminate the ban on pre-dispute arbitration agreements for nursing home residents. Pre-dispute arbitration agreements require elderly adults and individuals with disabilities, as well as their families, to waive their right to file a lawsuit in the courts – before admission to a nursing home. As a condition to entering the nursing home, the prospective resident and his or her representative would be required to submit any dispute, including claims of egregious abuse or neglect, to mandatory arbitration proceedings.

The Current Rule

As the rule currently stands, a nursing home resident cannot be required to waive his or her right to access to the court system. This rule preserves the right of vulnerable nursing home residents to sue for injuries caused by nursing home negligence, abuse, and neglect, including pressure sore infections, suffocation caused by restraints, choking, dehydration-related conditions, gangrene, and even sexual assault. Continue Reading Nursing Home Residents Deprived of Right to Sue for Abuse and Neglect

Mandatory Arbitration in Nursing Home Admission Contracts

A proposed rule change introduced by the Trump administration would authorize mandatory, pre-dispute arbitration in long-term care admissions contracts. The proposed rule is in response to an Obama administration rule that prohibited federal funding for long-term care facilities that required residents to resolve disputes through arbitration.

ABA Writes Letter Opposing Rule Change

In a recent letter, the American Bar Association (ABA) advocates for the Centers for Medicare and Medicaid Services (CMS) to retain its current rule prohibiting long-term care facilities from entering into binding arbitration agreements with residents until after a dispute arises. In the letter sent to CMS administrator Seema Verma, the ABA writes that implementing the proposed rule would harm residents’ rights and interests.

Continue Reading ABA Resists Mandatory Arbitration Clauses in Nursing Home Admissions Contracts