What do you do when your aging parents need responsive and attentive nursing home care but cannot afford it? How about outsourcing them to India!
Steve Herzfeld was exhausted and faced with spending his family's last resources to put his parents in an affordable Florida nursing home – so he decided to ship them to India. Today his 89-year-old mother, who suffers from advanced Parkinson's disease, gets daily massages, physical therapy and 24-hour help getting to the bathroom, all for about $15 a day. His father, 93, an Alzheimer's patient, has a full-time personal assistant and a cook who has won him over to a vegetarian diet healthy enough that he no longer needs his cholesterol medication.
Although the costs are lower and the care as good or better, it is a sad day when nursing homes in America cannot provide quality care at a reasonable expense.
Follow the story here.
Tuesday, July 31, 2007
CORPORATE OWNER OF NURSING HOME INDICTED FOR MANSLAUGHTER
For the first time in history a nursing home corporation has been arraigned on manslaughter charges. Massachusetts Attorney General Martha Coakley says Tennessee-based Life Care Centers of America is charged with manslaughter, abuse and neglect in the 2004 death of a woman who lived in their Acton facility.
Most states have laws that make it a crime to abuse and neglect the elderly. In Virginia, most Commonwealth Attorneys will not prosecute these cases as they believe a civil action for money damages is sufficient to punish the wrong doers. Unfortunately, the nursing home industry sees paying damages for abuse and neglect of their residents as just a “cost of business” and rarely change their mode of operation. Maybe a few criminal prosecutions in Virginia would get their attention!
Read the news report here.
Most states have laws that make it a crime to abuse and neglect the elderly. In Virginia, most Commonwealth Attorneys will not prosecute these cases as they believe a civil action for money damages is sufficient to punish the wrong doers. Unfortunately, the nursing home industry sees paying damages for abuse and neglect of their residents as just a “cost of business” and rarely change their mode of operation. Maybe a few criminal prosecutions in Virginia would get their attention!
Read the news report here.
CASE REPORT: 88 YEAR OLD ALZHEIMER’S PATIENT FALLS TO HER DEATH
An 88-year-old resident of the brand-new St. Barnabas Nursing Home facility located in Chattanooga, Tennessee died after a fall down a stairwell on Sunday. The resident, Frona Baxter, was found dead at the bottom of a stairwell after she rolled her wheelchair down a flight of six steps.
Police said Mrs. Baxter, who suffered from Alzheimer’s, "was allowed to roam the 3rd floor hallway where she lived in the newly-opened facility."
Why was a resident, who suffered from Alzheimer’s disease, allowed to wander the hallways? Read the report here.
Police said Mrs. Baxter, who suffered from Alzheimer’s, "was allowed to roam the 3rd floor hallway where she lived in the newly-opened facility."
Why was a resident, who suffered from Alzheimer’s disease, allowed to wander the hallways? Read the report here.
Monday, July 30, 2007
TAKE THE MEDS OFF THE SHELF
Today's Washington Post has a great article from the AP:
By ANDREW BRIDGES
The Associated Press
Monday, July 30, 2007; 9:51 AM
WASHINGTON -- The widely used diabetes drug Avandia should be pulled from the market because of heart risks, a federal scientist said Monday.
Those risks, combined with no unique short-term benefits in helping diabetics control blood-sugar levels, fail to justify keeping Avandia on the market, according to a copy of a slide presentation by Food and Drug Administration scientist Dr. David Graham.
The document was distributed at the onset of a daylong meeting of a joint panel of outside experts convened to consider whether the drug should be restricted to use in select patients and branded with prominent warnings or removed altogether from sale. Previously, the FDA said information from dozens of studies of the GlaxoSmithKline PLC drug points to an increased risk of heart attack.
Glaxo officials, meanwhile, disputed that claim, citing their own analyses of studies of Avandia, also called rosiglitazone.
"The number of myocardial infarctions is small, the data are inconsistent and there is no overall evidence rosiglitazone is different from any other oral antidiabetes agents," said Dr. Ronald Krall, the company's senior vice president and chief medical officer.
The FDA isn't required to follow the advice of its advisory committees but usually does.
The FDA moved up the date of Monday's meeting following the May publication of a study by The New England Journal of Medicine that generated new concerns about Avandia's safety. The pooled analysis of 42 studies revealed a 43 percent higher risk of heart attack for those taking Avandia compared with people taking other diabetes drugs or no diabetes medication.
Glaxo, meanwhile, says its own data show no increase in heart risks with Avandia compared with other diabetes drugs, including Actos. The FDA's Graham, in his presentation, said Avandia does increase heart risks _ something Actos, from Takeda Pharmaceuticals, does not do.
About 1 million Americans with Type 2 diabetes use Avandia to control blood sugar by increasing the body's sensitivity to insulin. That sort of treatment has long been presumed to lessen the heart risks already associated with the disease, which is linked to obesity. News that Avandia might actually increase those risks would represent a "serious limitation" of the drug's benefit, according to the FDA.
By ANDREW BRIDGES
The Associated Press
Monday, July 30, 2007; 9:51 AM
WASHINGTON -- The widely used diabetes drug Avandia should be pulled from the market because of heart risks, a federal scientist said Monday.
Those risks, combined with no unique short-term benefits in helping diabetics control blood-sugar levels, fail to justify keeping Avandia on the market, according to a copy of a slide presentation by Food and Drug Administration scientist Dr. David Graham.
The document was distributed at the onset of a daylong meeting of a joint panel of outside experts convened to consider whether the drug should be restricted to use in select patients and branded with prominent warnings or removed altogether from sale. Previously, the FDA said information from dozens of studies of the GlaxoSmithKline PLC drug points to an increased risk of heart attack.
Glaxo officials, meanwhile, disputed that claim, citing their own analyses of studies of Avandia, also called rosiglitazone.
"The number of myocardial infarctions is small, the data are inconsistent and there is no overall evidence rosiglitazone is different from any other oral antidiabetes agents," said Dr. Ronald Krall, the company's senior vice president and chief medical officer.
The FDA isn't required to follow the advice of its advisory committees but usually does.
The FDA moved up the date of Monday's meeting following the May publication of a study by The New England Journal of Medicine that generated new concerns about Avandia's safety. The pooled analysis of 42 studies revealed a 43 percent higher risk of heart attack for those taking Avandia compared with people taking other diabetes drugs or no diabetes medication.
Glaxo, meanwhile, says its own data show no increase in heart risks with Avandia compared with other diabetes drugs, including Actos. The FDA's Graham, in his presentation, said Avandia does increase heart risks _ something Actos, from Takeda Pharmaceuticals, does not do.
About 1 million Americans with Type 2 diabetes use Avandia to control blood sugar by increasing the body's sensitivity to insulin. That sort of treatment has long been presumed to lessen the heart risks already associated with the disease, which is linked to obesity. News that Avandia might actually increase those risks would represent a "serious limitation" of the drug's benefit, according to the FDA.
WAY TO GO JOE
My daily ritual (no matter where I am) is reading the Roanoke Times, my local paper. This morning I was sort of delighted - a call to action in Roanoke. Healthcare where profit is the goal - is that really the best we can do?
Joe Kennedy writes "We've read story after story about the political influence that drug companies buy, and about politicians who accept money, vote a certain way and assure themselves of more campaign contributions -- and maybe even a splendid job at a splendid salary with companies that benefited from their votes.
Watching the Canadians, the English and the French laud their national health systems, with their free care, and their countries' we-not-me mentality, made me yearn for a time that used to exist in America, before greed took over." Read his entire article here.
I agree Joe. My first job in Law School was working for a wonderful non-profit in Richmond Virginia, called LINC - Legal Information Network for Cancer (check out their website here). My first summer there I attended numerous health care insurance appeals - trying to convince the most wealthy insurance companies to cover cancer treatment for folks, who were denied coverage becuase they had "pre-existing conditions." We heard time and time again that chemo would not be covered, or some other treatment. Do you have $20,000 sitting around for chemo? Me neither, and I wouldn't want to dig my family into debt either.
I think it is sad when profit wins out over care. Anyone agree?
Joe Kennedy writes "We've read story after story about the political influence that drug companies buy, and about politicians who accept money, vote a certain way and assure themselves of more campaign contributions -- and maybe even a splendid job at a splendid salary with companies that benefited from their votes.
Watching the Canadians, the English and the French laud their national health systems, with their free care, and their countries' we-not-me mentality, made me yearn for a time that used to exist in America, before greed took over." Read his entire article here.
I agree Joe. My first job in Law School was working for a wonderful non-profit in Richmond Virginia, called LINC - Legal Information Network for Cancer (check out their website here). My first summer there I attended numerous health care insurance appeals - trying to convince the most wealthy insurance companies to cover cancer treatment for folks, who were denied coverage becuase they had "pre-existing conditions." We heard time and time again that chemo would not be covered, or some other treatment. Do you have $20,000 sitting around for chemo? Me neither, and I wouldn't want to dig my family into debt either.
I think it is sad when profit wins out over care. Anyone agree?
WHAT EVERY FAMILY SHOULD KNOW ABOUT LONG TERM CARE AND DEMENTIA
We are happy to announce the above seminar, free to the public, in Roanoke, Virginia on Thursday, August 22 from 3:00 to 5:00 PM at the Higher Education Center in Downtown Roanoke (Room 212). The seminar, sponsored by the Frith Law Firm, will cover the following important topics:
§ Residents’ Rights
§ The Seven Deadly Sins Committed by Nursing Homes
§ The Diagnosis of Dementia
The first two topics will be presented by our firm’s attorneys, Dan Frith and Lauren Ellerman, and the last topic will be presented by Gary H. Oberlender, MD, a board certified geriatric specialist licensed in Virginia.
Please mark your calendars and plan to attend this informative program. Call the Frith Law Firm at 540.985.0098 with questions
§ Residents’ Rights
§ The Seven Deadly Sins Committed by Nursing Homes
§ The Diagnosis of Dementia
The first two topics will be presented by our firm’s attorneys, Dan Frith and Lauren Ellerman, and the last topic will be presented by Gary H. Oberlender, MD, a board certified geriatric specialist licensed in Virginia.
Please mark your calendars and plan to attend this informative program. Call the Frith Law Firm at 540.985.0098 with questions
SENATOR GRASSLEY PROPOSES “WATCH LIST” FOR BAD NURSING HOMES
Kudos to Iowa Senator Charles Grassley for proposing a new "watch list" for nursing homes that aren't meeting federal health and safety standards. "That would include nursing homes that yo-yo in and out of compliance by using grace periods to correct deficiencies, but only then on a temporary basis," Grassley says. "We never seem to get consistency of safety and quality at these nursing homes." Read the news report here.
The public would be better able to judge whether a nursing home is the right place for their loves one if a "watch list" disclosed which homes aren't up to snuff, according to Grassley.
What does your US Senator have to say about this important issue?
The public would be better able to judge whether a nursing home is the right place for their loves one if a "watch list" disclosed which homes aren't up to snuff, according to Grassley.
What does your US Senator have to say about this important issue?
Friday, July 27, 2007
THE GREAT MEDICAL MALPRACTICE HOAX!
Come on we have all heard it – lawsuits against doctors are driving up the cost of health care and driving good doctors out of the practice of medicine. It would be a bad thing – if it were true! The “Big Three” comprised of corporate medicine, pharmaceuticals, and health insurers are driving the dramatic rise in the cost of healthcare.
Read what the consumer advocacy group, Pubic Citizen, has to say about this issue before you believe the story that lawyers filing medical malpractice cases are the source of the problem.
Here is the report.
Read what the consumer advocacy group, Pubic Citizen, has to say about this issue before you believe the story that lawyers filing medical malpractice cases are the source of the problem.
Here is the report.
NEW ADMISSIONS PROHIBITED AT TENNESSEE NURSING HOME
The Tennessee Department of Health has suspended new admissions of patients to Hermitage Health Center located in Elizabethton, TN. The state imposed a civil monetary penalty of $1,500 and recommended a federal civil penalty be imposed at $3,550 a day until the violations are corrected. A special monitor will be appointed to review the center's operations.
The fines and suspensions were based on conditions found during an annual survey conducted July 17 – 20, 2007. During the investigation, surveyors found violations of quality of care, nursing services, resident protection, physician's orders and performance improvement standards. Specifically, the deficiencies related to failure of staff to ensure physician's orders were followed; failure of the staff to obtain in a timely manner laboratory services; and failure of facility's performance improvement committee to identify staff's problems following physician's orders and obtaining laboratory services.
Read the news report here.
The fines and suspensions were based on conditions found during an annual survey conducted July 17 – 20, 2007. During the investigation, surveyors found violations of quality of care, nursing services, resident protection, physician's orders and performance improvement standards. Specifically, the deficiencies related to failure of staff to ensure physician's orders were followed; failure of the staff to obtain in a timely manner laboratory services; and failure of facility's performance improvement committee to identify staff's problems following physician's orders and obtaining laboratory services.
Read the news report here.
ABUSE AND NEGLECT IN DC HOSPITAL
If you can dig through all the Michael Vick articles in the Washington Post, you will run across an article published yesterday by Jenna Johnson, Post staff writer, entitled "Youth Hospital Faulted for Abuse." Read the full article here.
Ms. Johnson cites a report published this week by district mental health officials, that states
'Children at Riverside Hospital in Northwest Washington are at risk from "serious and persistent abuse and neglect."'
'The psychiatric hospital for youths up to age 21 stopped accepting new long-term patients last week. But Riverside lawyers say the temporary halt in admissions has nothing to do with the report and was a "completely voluntary" way to provide patients with quality treatment as the hospital completes an "intensive program and plant renovation initiative." The lawyers said they did not know how long this initiative will take.'
The article continues: "University Legal Services Inc., a federally designated advocacy group for District children with developmental disabilities, produced the 13-page report summarizing its observations, interviews and investigations at the hospital since April 2006. There have been previous allegations of abuse at the private, for-profit hospital, including one into the death in December of a teenage resident. In 1997, federal regulators threatened to cut Riverside, which opened in 1995, from the Medicaid program."
"The latest report, obtained under the Freedom of Information Act, provides a grim description of Riverside: Youths were punched, choked, slapped, pushed and threatened by staff members. Children were highly medicated as a form of restraint or placed in seclusion for reasons such as "being playful with his roommate."
Did you catch that? The report states youths were assaulted by staff members. I am certainly not a psychiatrist, but how is physical abuse going to help mental illness? It makes me sick to read about this. More sick when I ponder what if anything will be done.
In our practice, we have unfortunately seen similar abuse - and state and local authorities are hesitant to revoke facility licenses because there are no alternative facilities. Well I for one think being at home, would be a far better alternative than being abused by staff. Anyone agree?
The article also states "a lack of supervision led to patients attacking fellow patients, grabbing bottles of medicines from nurses' stations and cutting themselves with shards of glass. Treatment plans were not fulfilled. The facility had broken windows and mold. It was too hot in summer and too cold in winter.
The report, dated June 6, offered several specific examples of abuse. It said that on April 24, a University Legal Services staff member witnessed a hospital worker punching a male resident "two times in the eye, calling him a racial epithet." The child was taken to nearby Georgetown University Hospital for treatment."
I would sue the hospital, and the staff - press criminal charges of assault. Something drastic needs to be done.
Please read the article - it is upsetting, but you need to read it. Ms. Johnson - we would love to hear what needs to be done now!
The article concludes, stating "This month, the Mental Health Department increased its monitoring of the hospital, Baron said. During weekly visits of at least five hours, a department representative talks with senior staff members and patients, reviews records and recommends improvements.
When asked whether children were safe at the hospital, Baron replied, "All that I can tell you is that we have not seen the need to decertify them."
Baron said the department hopes the hospital improves rather than loses its certification."
I can't say I agree with Mr. Baron.
Ms. Johnson cites a report published this week by district mental health officials, that states
'Children at Riverside Hospital in Northwest Washington are at risk from "serious and persistent abuse and neglect."'
'The psychiatric hospital for youths up to age 21 stopped accepting new long-term patients last week. But Riverside lawyers say the temporary halt in admissions has nothing to do with the report and was a "completely voluntary" way to provide patients with quality treatment as the hospital completes an "intensive program and plant renovation initiative." The lawyers said they did not know how long this initiative will take.'
The article continues: "University Legal Services Inc., a federally designated advocacy group for District children with developmental disabilities, produced the 13-page report summarizing its observations, interviews and investigations at the hospital since April 2006. There have been previous allegations of abuse at the private, for-profit hospital, including one into the death in December of a teenage resident. In 1997, federal regulators threatened to cut Riverside, which opened in 1995, from the Medicaid program."
"The latest report, obtained under the Freedom of Information Act, provides a grim description of Riverside: Youths were punched, choked, slapped, pushed and threatened by staff members. Children were highly medicated as a form of restraint or placed in seclusion for reasons such as "being playful with his roommate."
Did you catch that? The report states youths were assaulted by staff members. I am certainly not a psychiatrist, but how is physical abuse going to help mental illness? It makes me sick to read about this. More sick when I ponder what if anything will be done.
In our practice, we have unfortunately seen similar abuse - and state and local authorities are hesitant to revoke facility licenses because there are no alternative facilities. Well I for one think being at home, would be a far better alternative than being abused by staff. Anyone agree?
The article also states "a lack of supervision led to patients attacking fellow patients, grabbing bottles of medicines from nurses' stations and cutting themselves with shards of glass. Treatment plans were not fulfilled. The facility had broken windows and mold. It was too hot in summer and too cold in winter.
The report, dated June 6, offered several specific examples of abuse. It said that on April 24, a University Legal Services staff member witnessed a hospital worker punching a male resident "two times in the eye, calling him a racial epithet." The child was taken to nearby Georgetown University Hospital for treatment."
I would sue the hospital, and the staff - press criminal charges of assault. Something drastic needs to be done.
Please read the article - it is upsetting, but you need to read it. Ms. Johnson - we would love to hear what needs to be done now!
The article concludes, stating "This month, the Mental Health Department increased its monitoring of the hospital, Baron said. During weekly visits of at least five hours, a department representative talks with senior staff members and patients, reviews records and recommends improvements.
When asked whether children were safe at the hospital, Baron replied, "All that I can tell you is that we have not seen the need to decertify them."
Baron said the department hopes the hospital improves rather than loses its certification."
I can't say I agree with Mr. Baron.
Thursday, July 26, 2007
MEDICAL GROUP REPORTS SUCCESS IN PREVENTING PRESSURE ULCERS
In our law practice we hear nursing home representatives, and their paid trial experts, take the position that pressure (or decubitus) ulcers just can’t be prevented in the elderly. This is a bunch of baloney and a recent study from New Jersey supports our view!
The New Jersey Hospital Association's (NJHA) Pressure Ulcer Collaborative announced a 70% reduction in the incidence of new pressure ulcers in its 150 participating healthcare facilities over a two year period. The NJHA tracked pressure ulcers from September 2005 until May of 2007 in hospitals, nursing homes, and home health agencies.
The most helpful techniques for improvement included complete skin evaluations within eight hours of a patient's admission, skin breakdown evaluations using the Braden scale, prevention strategies such as positioning, and regular monitoring of patients' skin conditions.
The New Jersey Hospital Association's (NJHA) Pressure Ulcer Collaborative announced a 70% reduction in the incidence of new pressure ulcers in its 150 participating healthcare facilities over a two year period. The NJHA tracked pressure ulcers from September 2005 until May of 2007 in hospitals, nursing homes, and home health agencies.
The most helpful techniques for improvement included complete skin evaluations within eight hours of a patient's admission, skin breakdown evaluations using the Braden scale, prevention strategies such as positioning, and regular monitoring of patients' skin conditions.
Wednesday, July 25, 2007
PICK AN EXPERIENCED SURGEON
Brian Williams of the NBC Nightly News reported yesterday on the results of a recent study published in the Journal of the National Cancer Institute. The article on the study is entitled, “The Surgical Learning Curve for Prostate Cancer Control After Radical Prostatectomy.”
The study concludes that as a surgeon's experience increases, cancer control after radical prostatectomy improves, presumably because of improved surgical technique. In other words – the more experienced your surgeon the better the outcome!
Whether you are facing a prostatectomy or any other surgical procedure, ask you doctor what their experience is in regard to the procedure and how many times they have performed the surgery. If they are offended or refuse to answer….find another surgeon!
Read an abstract of the article.
The study concludes that as a surgeon's experience increases, cancer control after radical prostatectomy improves, presumably because of improved surgical technique. In other words – the more experienced your surgeon the better the outcome!
Whether you are facing a prostatectomy or any other surgical procedure, ask you doctor what their experience is in regard to the procedure and how many times they have performed the surgery. If they are offended or refuse to answer….find another surgeon!
Read an abstract of the article.
HIP PROTECTORS DON’T WORK
We see many cases where a nursing home resident suffers multiple falls without significant injury. Finally, they have the inevitable “bad fall” and fracture a hip resulting in hospitalization and surgery. The resident often never recovers to their previous level of function.
Now for the bad news, a recent study published in the Journal of the American Medical Association followed residents for 20 months and concluded that energy-absorbing/shunting hip protectors currently available in US nursing homes were not effective in preventing hip fractures. My reaction is that we should design and manufacture better hip protectors!
Read an abstract of the report.
Now for the bad news, a recent study published in the Journal of the American Medical Association followed residents for 20 months and concluded that energy-absorbing/shunting hip protectors currently available in US nursing homes were not effective in preventing hip fractures. My reaction is that we should design and manufacture better hip protectors!
Read an abstract of the report.
IMMIGRATION AND HEALTH CARE
Last month I was surprised to find a nursing home trade magazine advocating open immigration policies to fulfill staffing needs in nursing homes. Apparently, extensive lobbying efforts have been initiated in Washington to allow these "much needed" workers ways to enter the counrty. Please, do not misunderstand my reaction. I am actually pro-immigration and want many to have the opportunities that the United States provides. I am just amazed that the educational differences, as well as obvious language barriers do not cause alarm for healthcare providers - and today, I learned it is not just nursing homes, the idea is industry wide.
An article in BlueHNews, a hospital administration paper says "Current Immigration Reform is Not Nurse Friendly." The article cites Michael Lodge, President and CEO of VisionQwest Healtcare. Mr. Lodge says it is a "big problem" when "we can't hire more nurses because we do not have the visas to apply for and we get bombarded everday for requests for nurses from medical and skilled nursing facilities and we can't provide." Well - here is an idea Mr. Lodge. PAY YOUR NURSES MORE, and there will not be a need to recruit from counrtries that do not provide a living wage for their workers.
I spent a wonderful week in the Dominican Republic with my church this month, and it was very clear that absent the ability to speak Spanish, I was not going to be able to connect with the people I met on anything but a very shallow level. How is a CNA that does not speak the language of her patient, or her supervisor, going to be able to effectively treat and provide? That is where my fear comes in, and frankly my surprise that hospitals and nursing homes would be so pro-immigration, that they would direct money towards Washington for lobbying. Anyone think immigrants are desired because they will take less for the same work? I do, and that upsets me on MANY levels.
An article in BlueHNews, a hospital administration paper says "Current Immigration Reform is Not Nurse Friendly." The article cites Michael Lodge, President and CEO of VisionQwest Healtcare. Mr. Lodge says it is a "big problem" when "we can't hire more nurses because we do not have the visas to apply for and we get bombarded everday for requests for nurses from medical and skilled nursing facilities and we can't provide." Well - here is an idea Mr. Lodge. PAY YOUR NURSES MORE, and there will not be a need to recruit from counrtries that do not provide a living wage for their workers.
I spent a wonderful week in the Dominican Republic with my church this month, and it was very clear that absent the ability to speak Spanish, I was not going to be able to connect with the people I met on anything but a very shallow level. How is a CNA that does not speak the language of her patient, or her supervisor, going to be able to effectively treat and provide? That is where my fear comes in, and frankly my surprise that hospitals and nursing homes would be so pro-immigration, that they would direct money towards Washington for lobbying. Anyone think immigrants are desired because they will take less for the same work? I do, and that upsets me on MANY levels.
STAFF SHORTAGES PLACE ELDERLY AT RISK
Somehow, we came across a publication called BlueHnews - a publication for hospital administration. One of the lead articles cites a published study from the June issue of the Journal of Medical Care, that found a direct corelation between staffing levels (nurses) and infections among elderly. High staffing levels, lower the number of infections (often a cause of mortality in intensive care settings). Lower staffing levels, and the opposite was true. The study also found the same corelation between staffing levels and pressure ulcers, as well as over all mortality rates.
In conclusion, the Columbia University study stated "improvements in nurse working conditions are necessary for the safety of our nation's sickest patients." My thoughts - way to go Columbia, and way to go BlueHNews for telling their readership about such a relevant study.
In conclusion, the Columbia University study stated "improvements in nurse working conditions are necessary for the safety of our nation's sickest patients." My thoughts - way to go Columbia, and way to go BlueHNews for telling their readership about such a relevant study.
Tuesday, July 24, 2007
YIKES - CONGRESS SLIPS ONE PAST US AGAIN!
KEVIN FREKING, writer for The Associated Press reported on a new Medicaid provision will go into effect Oct. 1 - read complete article here:
Tamper-Resistant Pads Could Prove a Pain
WASHINGTON -- Millions of Medicaid patients and their pharmacists could be in for a nasty surprise Oct. 1. A tiny provision tucked into a spending bill for Iraq requires that prescriptions for Medicaid patients be written on "tamper-resistant" pads. But most doctors do not use such pads.
The law is designed to make it harder for patients to obtain controlled drugs illegally and easier for the government to save money. The quick start date leaves little time to educate doctors and pharmacists.
"Our members are absolutely flabbergasted that they're going to be put on the hook for denying prescriptions if something is not on a tamperproof pad," said Paul Kelly, vice president of government affairs for the National Association of Chain Drug Stores. "Our biggest fear is the negative impact this could have on patient care and access to prescriptions."
Pharmacists' groups have asked lawmakers and the Centers for Medicare and Medicaid Services to delay putting the law in place.
"Millions of Medicaid beneficiaries may not be able to obtain their medications after Oct. 1," they said in a recent letter to lawmakers. "This could lead to higher Medicaid costs for emergency room visits, hospitalizations and physician office visits if medication cannot be obtained in a timely manner."
Steve Hahn, a spokesman for the centers, said the agency has no plans now to change the Oct. 1 date. In the interim, it is consulting with health care providers and preparing guidance on how to comply with the law.
Several states already require tamperproof prescription pads, Hahn noted. They usually require them only for controlled drugs, those easily subject to abuse.
But health care providers in those states often had more than a year to prepare, Kelly said. New York, for example, had 18 months.
In this instance, many doctors are not even aware of the law.
Dr. Edward Langston, chairman of the board of trustees for the American Medical Association, said the organization is also concerned the new law may threaten some Medicaid patients access to medicine.
"The implementation timetable is too short to educate prescribing physicians about the new law and is also likely too short to produce and distribute the enormous quantity of new prescription pads that will be needed," Langston said.
The tamper-resistant pads often contain a chemical that reveals when efforts have been made to alter the paper. For example, the heat from a copier may cause the word void to appear. Sometimes, the pads contain serials numbers that are entered into a computer by the pharmacist so that they can be matched against a doctor's order.
Medicaid is the federal-state partnership that provides health coverage to about 55 million poor people. President Bush had recommended the requirement for tamperproof prescription pads in his 2008 budget. The Congressional Budget Office projected that the requirement would save taxpayers $355 million over the coming decade, mainly through preventing fraudulent prescriptions.
Some lawmakers say they are starting to hear concerns from pharmacists back home. Rep. Charles Wilson, D-Ohio, and Reps. Marion Berry and Mike Ross, both Democrats from Arkansas, circulated a letter to colleagues Wednesday that urged them to contact Medicaid officials.
The lawmakers want a clear definition of tamper-resistant prescription pads. They want to know who is responsible for the costs of the pads and where they can be obtained. They also want to know what will happen when customers show up with prescriptions on regular paper.
Wilson is worried that some pharmacies in rural areas "may end up forced to close up shop if they're not getting reimbursed by Medicaid because their clients' prescriptions aren't on tamperproof pads."
Tamper-Resistant Pads Could Prove a Pain
WASHINGTON -- Millions of Medicaid patients and their pharmacists could be in for a nasty surprise Oct. 1. A tiny provision tucked into a spending bill for Iraq requires that prescriptions for Medicaid patients be written on "tamper-resistant" pads. But most doctors do not use such pads.
The law is designed to make it harder for patients to obtain controlled drugs illegally and easier for the government to save money. The quick start date leaves little time to educate doctors and pharmacists.
"Our members are absolutely flabbergasted that they're going to be put on the hook for denying prescriptions if something is not on a tamperproof pad," said Paul Kelly, vice president of government affairs for the National Association of Chain Drug Stores. "Our biggest fear is the negative impact this could have on patient care and access to prescriptions."
Pharmacists' groups have asked lawmakers and the Centers for Medicare and Medicaid Services to delay putting the law in place.
"Millions of Medicaid beneficiaries may not be able to obtain their medications after Oct. 1," they said in a recent letter to lawmakers. "This could lead to higher Medicaid costs for emergency room visits, hospitalizations and physician office visits if medication cannot be obtained in a timely manner."
Steve Hahn, a spokesman for the centers, said the agency has no plans now to change the Oct. 1 date. In the interim, it is consulting with health care providers and preparing guidance on how to comply with the law.
Several states already require tamperproof prescription pads, Hahn noted. They usually require them only for controlled drugs, those easily subject to abuse.
But health care providers in those states often had more than a year to prepare, Kelly said. New York, for example, had 18 months.
In this instance, many doctors are not even aware of the law.
Dr. Edward Langston, chairman of the board of trustees for the American Medical Association, said the organization is also concerned the new law may threaten some Medicaid patients access to medicine.
"The implementation timetable is too short to educate prescribing physicians about the new law and is also likely too short to produce and distribute the enormous quantity of new prescription pads that will be needed," Langston said.
The tamper-resistant pads often contain a chemical that reveals when efforts have been made to alter the paper. For example, the heat from a copier may cause the word void to appear. Sometimes, the pads contain serials numbers that are entered into a computer by the pharmacist so that they can be matched against a doctor's order.
Medicaid is the federal-state partnership that provides health coverage to about 55 million poor people. President Bush had recommended the requirement for tamperproof prescription pads in his 2008 budget. The Congressional Budget Office projected that the requirement would save taxpayers $355 million over the coming decade, mainly through preventing fraudulent prescriptions.
Some lawmakers say they are starting to hear concerns from pharmacists back home. Rep. Charles Wilson, D-Ohio, and Reps. Marion Berry and Mike Ross, both Democrats from Arkansas, circulated a letter to colleagues Wednesday that urged them to contact Medicaid officials.
The lawmakers want a clear definition of tamper-resistant prescription pads. They want to know who is responsible for the costs of the pads and where they can be obtained. They also want to know what will happen when customers show up with prescriptions on regular paper.
Wilson is worried that some pharmacies in rural areas "may end up forced to close up shop if they're not getting reimbursed by Medicaid because their clients' prescriptions aren't on tamperproof pads."
Monday, July 23, 2007
Why Bed Sores or Pressure Ulcers Should Concern You
Lauren Ellerman has written and posted a new article on our firm's website, www.frithlawfirm.com.
This article will provide you with a broad picture of what pressure ulcers and bed sores are, and why you should be concerned about them. While it is an unpleasant topic to discuss, it is much worse to witness the development of bed sores on a loved one which can lead to infection and death.
See the full article here.
See the full list of articles written by our attorneys here.
This article will provide you with a broad picture of what pressure ulcers and bed sores are, and why you should be concerned about them. While it is an unpleasant topic to discuss, it is much worse to witness the development of bed sores on a loved one which can lead to infection and death.
See the full article here.
See the full list of articles written by our attorneys here.
NURSING SHORTAGE IS THREAT TO PUBLIC HEALTH
In this video on MSNBC, they discuss the shortage of nurses in the United States. 118,000 nurses are needed today to fill the vacant spots across the US. Within the next decade (2017), that number will increase to 300,000.
St. Joseph’s Hospital in Phoenix, Arizona is always busy. The hospital employs more than 1300 nurses but actually needs about 10% more, or another 130 nurses. In the state of Arizona there are more than 1000 job openings for nurses.
The starting salary for registered nurses is on average $38,000 per year. The average salary overall is $68,000 per year. Many people see those numbers and want to go to nursing school. So, why is there still a shortage? The nursing schools cannot handle the numbers of applicants. Arizona State University recently doubled its class size but still turns away about 110 qualified applicants per year. Nursing schools cannot handle larger class sizes due to a lack of qualified teachers. Experienced nurses working as executives for hospitals or insurance companies can make 2 to 3 times what they can make teaching at a nursing school.
Bernadette Melnyk is the Dean at the College of Nursing at Arizona State University. She is quoted, “We are looking at not only a greater number of medical errors and complications that go on with patients, but also the percentage of patients that actually die from not having good nursing.”
In addition to the money issue, many nurses find that their jobs are too stressful and decide to leave the profession. To me, it seems like this is a never ending circle. We already have a shortage which causes present nurses to be busier and more stressed, and then they decide to quit and that only increases the shortage.
Nurses are a huge factor in the care that anyone receives at a hospital or clinic. Maybe we should start addressing this shortage and we can hopefully improve the medical system at the same time.
St. Joseph’s Hospital in Phoenix, Arizona is always busy. The hospital employs more than 1300 nurses but actually needs about 10% more, or another 130 nurses. In the state of Arizona there are more than 1000 job openings for nurses.
The starting salary for registered nurses is on average $38,000 per year. The average salary overall is $68,000 per year. Many people see those numbers and want to go to nursing school. So, why is there still a shortage? The nursing schools cannot handle the numbers of applicants. Arizona State University recently doubled its class size but still turns away about 110 qualified applicants per year. Nursing schools cannot handle larger class sizes due to a lack of qualified teachers. Experienced nurses working as executives for hospitals or insurance companies can make 2 to 3 times what they can make teaching at a nursing school.
Bernadette Melnyk is the Dean at the College of Nursing at Arizona State University. She is quoted, “We are looking at not only a greater number of medical errors and complications that go on with patients, but also the percentage of patients that actually die from not having good nursing.”
In addition to the money issue, many nurses find that their jobs are too stressful and decide to leave the profession. To me, it seems like this is a never ending circle. We already have a shortage which causes present nurses to be busier and more stressed, and then they decide to quit and that only increases the shortage.
Nurses are a huge factor in the care that anyone receives at a hospital or clinic. Maybe we should start addressing this shortage and we can hopefully improve the medical system at the same time.
NURSING HOMES, MEDICAID, AND YOUR ASSETS
More than a year has passed since the federal government changed the rules for qualifying for Medicaid assistance for long-term care, and experts in the field are still sorting out the implications for those who want to pass assets on to their children.
The new rules made it tougher, for example, to give gifts to children or grandchildren to help pay for their college education. Individuals who make such gifts can find themselves ineligible for Medicaid benefits after they're already in a nursing home.
Read this article from the Wall Street Journal which discusses this important issue in detail.
The new rules made it tougher, for example, to give gifts to children or grandchildren to help pay for their college education. Individuals who make such gifts can find themselves ineligible for Medicaid benefits after they're already in a nursing home.
Read this article from the Wall Street Journal which discusses this important issue in detail.
Sunday, July 22, 2007
NURSING HOME SUED IN RESIDENT DEATH
The daughter of an 82-year-old woman who died in a Chicago area nursing home in May filed a lawsuit Wednesday alleging that the facility did not provide adequate supervision to prevent a fall that she claims led to her mother's death.
Teresa Thorp alleged in the lawsuit that Lemont Nursing and Rehabilitation did not properly assess the risk of a fall or devise a plan for supervising Minnie Burger, who fell May 11 and died three days later. Burger had previously suffered injuries from a fall in the facility in September, the suit said.
We see these types of cases in Western Virginia all the time! These tragedies are preventable with sufficient staffing and training.
Read the Chicago Tribune article.
Teresa Thorp alleged in the lawsuit that Lemont Nursing and Rehabilitation did not properly assess the risk of a fall or devise a plan for supervising Minnie Burger, who fell May 11 and died three days later. Burger had previously suffered injuries from a fall in the facility in September, the suit said.
We see these types of cases in Western Virginia all the time! These tragedies are preventable with sufficient staffing and training.
Read the Chicago Tribune article.
Friday, July 20, 2007
NONPROFIT HOSPITALS - I TOLD YOU THERE WAS AN ISSUE HERE!
This week I posted a very simple blog on why the "charitable" status of a health care provider should matter to you. Miss it? Read it here. Today, the Wall Street Journal published an article, Nonprofit Hospitals Scrutinized on Care to Needy, wherein the Journal reports "federal and state officials are increasingly questioning whether nont-for-profit hospitals provide enough care to uninsured patients to warrant the sizeable tax breaks they get for charitable work."
Well, as I commented earlier, at least they are not trying to make a profit for shareholders, but the article has a point. You get tax breaks, why - because you are performing a public service, preventing the government (theoretically) from picking up the tab. But the IRS just published a report noting that many hospitals spend 3% or less on care for poor. Should there be rules on how much charity care to provide? Republic Senator Chuck Grassley thinks so, and has suggested such a regulation. Grassley asks the obvious question - "when nonprofit hospitals sit on big cash reserves, I wonder how much public service they're offering."
In my area of the world, most health care is operated by Carilion, a large and local not-for profit hospital. They are the largest employer in the region. Last I heard, they had over $400 million in reserves. They don't pay real estate taxes at the same rate, and so our fair city losses millions each year on their not-for-profit hospital. I don't know the amount of charity care they provide - but I know that our general district court is overwhelmed with hospital collection agents - squeezing payment for services out of our City's poor.
The article ends with a statement from a Chicago attorney who works for not-for-profit hospitals, who says the industry "clearly has a legislative fight on their hands." Well, shouldn't we the tax payers also be prepared to fight? I pay higher local taxes because they don't pay as much; my insurance indirectly pays for their un-insured - and, I care about my neighbors that cannot afford insurance, so yes, I want the non-profit hospital to be a leader in indigent care. A healthy neighbor is a healthy neighbor - so I say, way to go Senator Grassley - and good luck!
Well, as I commented earlier, at least they are not trying to make a profit for shareholders, but the article has a point. You get tax breaks, why - because you are performing a public service, preventing the government (theoretically) from picking up the tab. But the IRS just published a report noting that many hospitals spend 3% or less on care for poor. Should there be rules on how much charity care to provide? Republic Senator Chuck Grassley thinks so, and has suggested such a regulation. Grassley asks the obvious question - "when nonprofit hospitals sit on big cash reserves, I wonder how much public service they're offering."
In my area of the world, most health care is operated by Carilion, a large and local not-for profit hospital. They are the largest employer in the region. Last I heard, they had over $400 million in reserves. They don't pay real estate taxes at the same rate, and so our fair city losses millions each year on their not-for-profit hospital. I don't know the amount of charity care they provide - but I know that our general district court is overwhelmed with hospital collection agents - squeezing payment for services out of our City's poor.
The article ends with a statement from a Chicago attorney who works for not-for-profit hospitals, who says the industry "clearly has a legislative fight on their hands." Well, shouldn't we the tax payers also be prepared to fight? I pay higher local taxes because they don't pay as much; my insurance indirectly pays for their un-insured - and, I care about my neighbors that cannot afford insurance, so yes, I want the non-profit hospital to be a leader in indigent care. A healthy neighbor is a healthy neighbor - so I say, way to go Senator Grassley - and good luck!
Thursday, July 19, 2007
SENATE HEARINGS ON ELDER ABUSE
Patient Safety Act? Sound familiar? United States Senate began informal hearings yesterday on elder abuse and how to prevent future abuse. What ideas does the Bill contain? A national registry to prevent criminals from being employed by long-term care facilities.
The Bill is based on laws that exist in 7 states, which deny employment in long term care facilities to those with criminal backgrounds. Want to listen to the hearings? I think it will be worth your time - Listen Here.
The first witness is remarkable - please listen to Jennifer Coldren, Witness #1.
Think her story is unique? You would be surprised and shocked her story is not unique.
The Bill is based on laws that exist in 7 states, which deny employment in long term care facilities to those with criminal backgrounds. Want to listen to the hearings? I think it will be worth your time - Listen Here.
The first witness is remarkable - please listen to Jennifer Coldren, Witness #1.
Think her story is unique? You would be surprised and shocked her story is not unique.
ILLINOIS NURSING HOME SUED IN DEATH
The Chicago Tribune reports that the daughter if an 82 year old woman who died in a Lemont, IL nursing home has filed a lawsuit alleging that the facility did not provide adequate supervision to prevent a fall that she claims led to her mother’s death.
Other allegations in the suit include neglect, failure to identify and treat and infection and failure to protect Minnie Burger from physical abuse inflicted by another patient. Teresa Thorps’ attorney, Steven Levin, of Levin & Perconti, is quoted “It is crucial that nursing homes that accept elderly residents who are at risk for falls come up with a plan to prevent falls.” Thorp is seeking in excess of $50,000 in damages.
The Illinois Department of Public Health is also investigating the case against Lemont Nursing and Rehabilitation due to a complaint that Thorp filed with their office.
Other allegations in the suit include neglect, failure to identify and treat and infection and failure to protect Minnie Burger from physical abuse inflicted by another patient. Teresa Thorps’ attorney, Steven Levin, of Levin & Perconti, is quoted “It is crucial that nursing homes that accept elderly residents who are at risk for falls come up with a plan to prevent falls.” Thorp is seeking in excess of $50,000 in damages.
The Illinois Department of Public Health is also investigating the case against Lemont Nursing and Rehabilitation due to a complaint that Thorp filed with their office.
POLICE REPORT: NURSING HOME OWNER TAKES $60K FROM RESIDENT
In a report released by police in Anderson, South Carolina, it is announced that the owner of Connie’s Residential Home cashed two social security checks totaling $60,000 written to a resident in the home. Connie McCurry, 63, was charged with unlawful exploitation of a vulnerable adult. The family of the man whose checks were taken has moved him to another nursing home.
ARIZONA SURGEON SUSPENDED
In an article on Medical News Today, consumers are warned to check their physicians credentials due to the suspension of an Arizona doctor.
On July 10, the Arizona Medical Board announced that it had suspended the license of an internal medicine doctor due to several liposuction procedures that had resulted in his patients’ deaths. The doctor is not named in the article.
The American Society of Plastic Surgeons (ASPS) would like to make the public aware of the requirements for certification by the American Board of Plastic Surgeons:
- Graduate from an accredited medical school
- Complete a combination of at least five years of general surgery and plastic surgery residency training
- Pass comprehensive oral and written exams.
Doctors that are ASPS certified are also required to attend continuing education classes and adhere to a strict code of ethics.
Always do your homework and check out your doctor, especially if you are having elective surgery and have time to check them out even more thoroughly! Be in charge of your own care and those that are performing services for you. When it comes to your health, there should be no shortcuts!
On July 10, the Arizona Medical Board announced that it had suspended the license of an internal medicine doctor due to several liposuction procedures that had resulted in his patients’ deaths. The doctor is not named in the article.
The American Society of Plastic Surgeons (ASPS) would like to make the public aware of the requirements for certification by the American Board of Plastic Surgeons:
- Graduate from an accredited medical school
- Complete a combination of at least five years of general surgery and plastic surgery residency training
- Pass comprehensive oral and written exams.
Doctors that are ASPS certified are also required to attend continuing education classes and adhere to a strict code of ethics.
Always do your homework and check out your doctor, especially if you are having elective surgery and have time to check them out even more thoroughly! Be in charge of your own care and those that are performing services for you. When it comes to your health, there should be no shortcuts!
NEW SURVEY - HOW MISTAKES CAUSE STRESS IN DOCTORS
The AP published results of a new survey yesterday - read here:
Survey Finds Many Docs Stress Mistakes
By LINDSEY TANNER
CHICAGO -- Patients aren't the only ones harmed by medical errors, according to a survey released Wednesday that found many doctors who make mistakes _ and even those who come close _ suffer stress, sleep problems and loss of confidence.
Job stress related to medical errors potentially could make some doctors prone to depression, quitting or even making additional mistakes, underscoring the need for helping them cope, said Washington University psychologist Amy Waterman, the study's lead author.
Most doctors surveyed said they would have liked counseling or other help after making mistakes, but that hospitals and other health care organizations didn't offer much assistance.
The survey involved 3,171 doctors in St. Louis, Seattle and Canada who answered mailed or e-mailed questionnaires. Most _ 2,909 of them _ said they had been involved with a near miss, minor medical error or serious error, which includes mistakes causing permanent or potentially life-threatening harm.
The results appear in the August edition of The Joint Commission Journal on Quality and Patient Safety, published by an affiliate of The Joint Commission, a hospital regulatory group involved in nationwide efforts to reduce medical errors.
Many of those efforts stem from an influential 1999 report that estimated that at least 44,000 Americans die each year from medical mistakes.
While the survey's scope was limited, the results echo smaller studies and likely apply to doctors elsewhere, the authors and experts not involved in the research said.
Dr. Donald Berwick, a Harvard professor who runs the Institute for Healthcare Improvement, said even more doctors might be adversely affected in regions where reforms aimed at reducing medical errors haven't taken hold.
"Nobody thinks that this excuses or should minimize" the suffering of patients harmed by errors, but it's important to emphasize that doctors suffer, too, Berwick said.
Of surveyed doctors involved in errors, 61 percent said they felt increased anxiety about the potential for future mistakes, 44 percent said they became less confident in their job abilities, 42 percent experienced sleep problems and 42 percent had a loss in job satisfaction.
Only 10 percent said hospitals offered them adequate resources for dealing with mistake-related stress.
Doctors involved in serious errors were most likely to report increased job-related stress. Still, increased stress also was reported by one-third of those involved in near-misses."
Survey Finds Many Docs Stress Mistakes
By LINDSEY TANNER
CHICAGO -- Patients aren't the only ones harmed by medical errors, according to a survey released Wednesday that found many doctors who make mistakes _ and even those who come close _ suffer stress, sleep problems and loss of confidence.
Job stress related to medical errors potentially could make some doctors prone to depression, quitting or even making additional mistakes, underscoring the need for helping them cope, said Washington University psychologist Amy Waterman, the study's lead author.
Most doctors surveyed said they would have liked counseling or other help after making mistakes, but that hospitals and other health care organizations didn't offer much assistance.
The survey involved 3,171 doctors in St. Louis, Seattle and Canada who answered mailed or e-mailed questionnaires. Most _ 2,909 of them _ said they had been involved with a near miss, minor medical error or serious error, which includes mistakes causing permanent or potentially life-threatening harm.
The results appear in the August edition of The Joint Commission Journal on Quality and Patient Safety, published by an affiliate of The Joint Commission, a hospital regulatory group involved in nationwide efforts to reduce medical errors.
Many of those efforts stem from an influential 1999 report that estimated that at least 44,000 Americans die each year from medical mistakes.
While the survey's scope was limited, the results echo smaller studies and likely apply to doctors elsewhere, the authors and experts not involved in the research said.
Dr. Donald Berwick, a Harvard professor who runs the Institute for Healthcare Improvement, said even more doctors might be adversely affected in regions where reforms aimed at reducing medical errors haven't taken hold.
"Nobody thinks that this excuses or should minimize" the suffering of patients harmed by errors, but it's important to emphasize that doctors suffer, too, Berwick said.
Of surveyed doctors involved in errors, 61 percent said they felt increased anxiety about the potential for future mistakes, 44 percent said they became less confident in their job abilities, 42 percent experienced sleep problems and 42 percent had a loss in job satisfaction.
Only 10 percent said hospitals offered them adequate resources for dealing with mistake-related stress.
Doctors involved in serious errors were most likely to report increased job-related stress. Still, increased stress also was reported by one-third of those involved in near-misses."
FUTURE OF HEALTHCARE IN AMERICA
I logged on to Washingtonpost.com today - and read the following article by Christopher Lee, Post Staff Writer
Bush: No Deal On Children's Health Plan - President Says He Objects On Philosophical Grounds
"President Bush yesterday rejected entreaties by his Republican allies that he compromise with Democrats on legislation to renew a popular program that provides health coverage to poor children, saying that expanding the program would enlarge the role of the federal government at the expense of private insurance.
The president said he objects on philosophical grounds to a bipartisan Senate proposal to boost the State Children's Health Insurance Program by $35 billion over five years. Bush has proposed $5 billion in increased funding and has threatened to veto the Senate compromise and a more costly expansion being contemplated...
"I support the initial intent of the program," Bush said in an interview with The Washington Post after a factory tour and a discussion on health care with small-business owners in Landover. "My concern is that when you expand eligibility . . . you're really beginning to open up an avenue for people to switch from private insurance to the government."
The 10-year-old program, which is set to expire on Sept. 30, costs the federal government $5 billion a year and helps provide health coverage to 6.6 million low-income children whose families do not qualify for Medicaid but cannot afford private insurance on their own.
About 3.3 million additional children would be covered under the proposal developed by Senate Finance Committee Chairman Max Baucus (D-Mont.) and Republican Sens. Charles E. Grassley (Iowa) and Orrin G. Hatch (Utah), among others. It would provide the program $60 billion over five years, compared with $30 billion under Bush's proposal. And it would rely on a 61-cent increase in the federal excise tax on cigarettes, to $1 a pack, which Bush opposes.
Grassley and Hatch, in a joint statement this week, implored the president to rescind his veto threat. They warned that Democrats might seek an expansion of $50 billion or more if there is no compromise.
They also said that Bush should drop efforts to link the program's renewal to his six-month-old proposal to replace the long-standing tax break for employer-based health insurance with a new tax deduction that would help people pay for insurance, regardless of whether they get it through their jobs or purchase it on their own.
"Tax legislation to expand health insurance coverage is badly needed, but there's no Democratic support for it in the SCHIP debate," said Grassley, the ranking Republican on the finance panel. "In the meantime, our SCHIP initiative in the Finance Committee takes care of a program that's about to expire in a way that's more responsible than current law and $15 billion less than the budget resolution calls for."
But Bush said he was not persuaded.
"I'm not going to surrender a good and important idea before the debate really gets started," Bush said. "And I think it's going to be very important for our allies on Capitol Hill to hear a strong, clear message from me that expansion of government in lieu of making the necessary changes to encourage a consumer-based system is not acceptable."
The Senate committee is scheduled to consider the compromise legislation today, and the House is expected to try to pass its own version before the congressional recess in August.
Rep. Rahm Emanuel (Ill.), the House Democratic Caucus chairman, said he is "bewildered" that Bush is fighting the expanded funding for a program supported by Republicans and Democrats alike. "This is the chance for him to finally be a uniter and not a divider," Emanuel said. "You have consensus across party and ideology, and a unity on the most important domestic issue, health care -- except for one person."
A recent analysis by the Congressional Budget Office concluded that the program would require about $14 billion in new money over five years -- on top of the current $5 billion in annual funding -- merely to keep covering the same number of children, in part because of rising health-care costs. Secretary of Health and Human Services Mike Leavitt, accompanying Bush yesterday, said: "We disagree with that number."
In the 15-minute interview, Bush also rejected the charges by former surgeon general Richard H. Carmona that the administration's political appointees routinely rewrote his speeches, blocked public health reports for political reasons and screened his travel.
"I can't speak to some of the complaints the surgeon general made," Bush said. ". . . He worked energetically in his job. And, obviously, at some point in time, he became very disgruntled and spoke out about it. But ours is an administration that attracts very smart, capable people. I'm very interested in their points of view, and I expect people to speak out. I also have my own points of view and feel very strongly about a lot of issues."
Bush said he is opposed to a bipartisan legislation that would allow the Food and Drug Administration to regulate the manufacturing, marketing and sale of tobacco products, which could lead to stronger warning labels and limits on nicotine and other ingredients.
"We've always said that nicotine is not a drug to be regulated under FDA," Bush said.
Leavitt added that one danger is that the FDA could be seen as giving its stamp of approval to a product "that will never be safe."
Bush: No Deal On Children's Health Plan - President Says He Objects On Philosophical Grounds
"President Bush yesterday rejected entreaties by his Republican allies that he compromise with Democrats on legislation to renew a popular program that provides health coverage to poor children, saying that expanding the program would enlarge the role of the federal government at the expense of private insurance.
The president said he objects on philosophical grounds to a bipartisan Senate proposal to boost the State Children's Health Insurance Program by $35 billion over five years. Bush has proposed $5 billion in increased funding and has threatened to veto the Senate compromise and a more costly expansion being contemplated...
"I support the initial intent of the program," Bush said in an interview with The Washington Post after a factory tour and a discussion on health care with small-business owners in Landover. "My concern is that when you expand eligibility . . . you're really beginning to open up an avenue for people to switch from private insurance to the government."
The 10-year-old program, which is set to expire on Sept. 30, costs the federal government $5 billion a year and helps provide health coverage to 6.6 million low-income children whose families do not qualify for Medicaid but cannot afford private insurance on their own.
About 3.3 million additional children would be covered under the proposal developed by Senate Finance Committee Chairman Max Baucus (D-Mont.) and Republican Sens. Charles E. Grassley (Iowa) and Orrin G. Hatch (Utah), among others. It would provide the program $60 billion over five years, compared with $30 billion under Bush's proposal. And it would rely on a 61-cent increase in the federal excise tax on cigarettes, to $1 a pack, which Bush opposes.
Grassley and Hatch, in a joint statement this week, implored the president to rescind his veto threat. They warned that Democrats might seek an expansion of $50 billion or more if there is no compromise.
They also said that Bush should drop efforts to link the program's renewal to his six-month-old proposal to replace the long-standing tax break for employer-based health insurance with a new tax deduction that would help people pay for insurance, regardless of whether they get it through their jobs or purchase it on their own.
"Tax legislation to expand health insurance coverage is badly needed, but there's no Democratic support for it in the SCHIP debate," said Grassley, the ranking Republican on the finance panel. "In the meantime, our SCHIP initiative in the Finance Committee takes care of a program that's about to expire in a way that's more responsible than current law and $15 billion less than the budget resolution calls for."
But Bush said he was not persuaded.
"I'm not going to surrender a good and important idea before the debate really gets started," Bush said. "And I think it's going to be very important for our allies on Capitol Hill to hear a strong, clear message from me that expansion of government in lieu of making the necessary changes to encourage a consumer-based system is not acceptable."
The Senate committee is scheduled to consider the compromise legislation today, and the House is expected to try to pass its own version before the congressional recess in August.
Rep. Rahm Emanuel (Ill.), the House Democratic Caucus chairman, said he is "bewildered" that Bush is fighting the expanded funding for a program supported by Republicans and Democrats alike. "This is the chance for him to finally be a uniter and not a divider," Emanuel said. "You have consensus across party and ideology, and a unity on the most important domestic issue, health care -- except for one person."
A recent analysis by the Congressional Budget Office concluded that the program would require about $14 billion in new money over five years -- on top of the current $5 billion in annual funding -- merely to keep covering the same number of children, in part because of rising health-care costs. Secretary of Health and Human Services Mike Leavitt, accompanying Bush yesterday, said: "We disagree with that number."
In the 15-minute interview, Bush also rejected the charges by former surgeon general Richard H. Carmona that the administration's political appointees routinely rewrote his speeches, blocked public health reports for political reasons and screened his travel.
"I can't speak to some of the complaints the surgeon general made," Bush said. ". . . He worked energetically in his job. And, obviously, at some point in time, he became very disgruntled and spoke out about it. But ours is an administration that attracts very smart, capable people. I'm very interested in their points of view, and I expect people to speak out. I also have my own points of view and feel very strongly about a lot of issues."
Bush said he is opposed to a bipartisan legislation that would allow the Food and Drug Administration to regulate the manufacturing, marketing and sale of tobacco products, which could lead to stronger warning labels and limits on nicotine and other ingredients.
"We've always said that nicotine is not a drug to be regulated under FDA," Bush said.
Leavitt added that one danger is that the FDA could be seen as giving its stamp of approval to a product "that will never be safe."
Wednesday, July 18, 2007
SECOND TRIAL BEGINS FOR NOTRE DAME COACH CHARLIE WEIS
USA Today reports that the second medical malpractice trial for Charlie Weis, the head football coach for Notre Dame is underway. Weis underwent gastric bypass surgery in 2002 and then suffered from complications that left him in a coma for several weeks.
The first trial ended in a mistrial when a juror collapsed and the two defendants rushed to his aid. Many thought that after that trial, Weis and the doctors would settle before a second trial, but they are all now sitting in a courtroom for the second time.
Weis’s complaint alleges that the doctors negligently allowed him to bleed internally for 30 hours before performing a second operation to stop the bleeding. The doctors hold that internal bleeding is a known complication of gastric bypass, and in many cases the bleeding stops on its own. Weis now suffers from pain in his feet even after a long and painful rehabilitation.
See the full article here.
The first trial ended in a mistrial when a juror collapsed and the two defendants rushed to his aid. Many thought that after that trial, Weis and the doctors would settle before a second trial, but they are all now sitting in a courtroom for the second time.
Weis’s complaint alleges that the doctors negligently allowed him to bleed internally for 30 hours before performing a second operation to stop the bleeding. The doctors hold that internal bleeding is a known complication of gastric bypass, and in many cases the bleeding stops on its own. Weis now suffers from pain in his feet even after a long and painful rehabilitation.
See the full article here.
RECOGNIZING NURSING HOME ABUSE AND NEGLECT
Many of our posts are about abuse and neglect that happen in nursing homes. You may be wondering, “How do I know if my loved one is being abused or neglected?” We have an article that may help. Among the many articles written by our attorneys, there is an article entitled “Recognizing Nursing Home Abuse and Neglect.” While this article cannot include all forms of abuse and neglect, it can be a good starting point for realizing what is going on with your loved one.
You can find this article here.
Find other articles written by the attorneys of Frith Law Firm here.
You can find this article here.
Find other articles written by the attorneys of Frith Law Firm here.
TRIAL OVER DOCTOR’S CREDENTIALING BEGINS IN WEST VIRGINIA
An article in the Charleston Daily Mail covers the beginning of a trial against the former Putnam General Hospital.
Dr. John L. King practiced at Putnam General for about six months and is now at the center of about 122 medical malpractice lawsuits, from Putnam General and other hospitals where he practiced. However, this trial deals with whether or not the hospital can be included in the trial due to the fact that they granted King temporary credentials.
The former patients or their survivors claim that the hospital overlooked many red flags about King when they granted his credentials. The lawyer for Putnam General claims that the hospital followed a seven-step screening process before granting his credentials. The hospital in their investigations found that King was licenses and in good standing in none other states, he was insured and former colleagues and professors spoke highly of him. What they didn’t find out was that he was suspended from an Alabama hospital in 1989, he abruptly left several other hospitals and did not complete internships. The hospital was also unaware of at least five pending malpractice claims against King as well as his 1999 arrest for removing log books from a Florida hospital.
The hospital at that time was owned by HCA, Inc. but sold the hospital last year to Charleston Area Medical Center, which renamed the hospital CAMC Teays Valley. King surrendered his West Virginia medical license and left that state after Putnam General suspended his privileges in 2003. He returned to the Alabama area and changed his name to Christopher Wallace Martin.
What do you think? Do you think the hospital should be held liable to credentialing a doctor whose track record had previously been so poor? What lengths should a hospital go to to research the past of doctors applying to their hospital? Please feel free to leave your comments.
Dr. John L. King practiced at Putnam General for about six months and is now at the center of about 122 medical malpractice lawsuits, from Putnam General and other hospitals where he practiced. However, this trial deals with whether or not the hospital can be included in the trial due to the fact that they granted King temporary credentials.
The former patients or their survivors claim that the hospital overlooked many red flags about King when they granted his credentials. The lawyer for Putnam General claims that the hospital followed a seven-step screening process before granting his credentials. The hospital in their investigations found that King was licenses and in good standing in none other states, he was insured and former colleagues and professors spoke highly of him. What they didn’t find out was that he was suspended from an Alabama hospital in 1989, he abruptly left several other hospitals and did not complete internships. The hospital was also unaware of at least five pending malpractice claims against King as well as his 1999 arrest for removing log books from a Florida hospital.
The hospital at that time was owned by HCA, Inc. but sold the hospital last year to Charleston Area Medical Center, which renamed the hospital CAMC Teays Valley. King surrendered his West Virginia medical license and left that state after Putnam General suspended his privileges in 2003. He returned to the Alabama area and changed his name to Christopher Wallace Martin.
What do you think? Do you think the hospital should be held liable to credentialing a doctor whose track record had previously been so poor? What lengths should a hospital go to to research the past of doctors applying to their hospital? Please feel free to leave your comments.
Tuesday, July 17, 2007
CHARITABLE STATUS IN HEALTH CARE - WHY DOES IT MATTER
News in my fair City today, is whether a local retirement home community can claim charity status, in order to be exempt from various taxes. Read about the Glebe in Roanoke here. We hear all the time that some hospitals and nursing homes are "non profit" - but what does that mean?
On the surface, a non-profit healthcare provider will likely look the same as one that is for profit, but consider the differences.
Non-Profit Healthcare providers, often have a legal duty to provide some level of indigent care
(that means reduced rate or free services). In addition, they are limited to how they can compensate their Board of Directors and employees. Without shareholders, there is no duty to maximize profits - only the legal duty to provide care according to local standards. Non- profit health care providers do however, continue to charge governmental programs full price for services - so Medicaid will pay nursing home A that is non-profit, the same it pays nursing home B that is for profit.
The difference is usually the bottom line. A for-profit health care provider, has a legal duty to maximize profits. Well, as any good business man or woman will tell you, the way to maximize profits in an industry where prices are regulated, is to decrease expenses. Hire fewer nurses; pay your staff less; try to find a deal on bandaids and hospital beds; Provide food that costs $1.45 a day, rather than expensive, healthy meals that cost $5.00 a day. I am not making this up, this is how nursing homes especially, turn a profit. And for many, it is a rather large profit.
In past blogs we have discussed what a lucrative business nursing homes can be - so the lesson today, is ask whether the nursing home your aunt betty lives in is non-profit, and if not, dig around - find out if they are making a profit, and where they are skimping to do so.
On the surface, a non-profit healthcare provider will likely look the same as one that is for profit, but consider the differences.
Non-Profit Healthcare providers, often have a legal duty to provide some level of indigent care
(that means reduced rate or free services). In addition, they are limited to how they can compensate their Board of Directors and employees. Without shareholders, there is no duty to maximize profits - only the legal duty to provide care according to local standards. Non- profit health care providers do however, continue to charge governmental programs full price for services - so Medicaid will pay nursing home A that is non-profit, the same it pays nursing home B that is for profit.
The difference is usually the bottom line. A for-profit health care provider, has a legal duty to maximize profits. Well, as any good business man or woman will tell you, the way to maximize profits in an industry where prices are regulated, is to decrease expenses. Hire fewer nurses; pay your staff less; try to find a deal on bandaids and hospital beds; Provide food that costs $1.45 a day, rather than expensive, healthy meals that cost $5.00 a day. I am not making this up, this is how nursing homes especially, turn a profit. And for many, it is a rather large profit.
In past blogs we have discussed what a lucrative business nursing homes can be - so the lesson today, is ask whether the nursing home your aunt betty lives in is non-profit, and if not, dig around - find out if they are making a profit, and where they are skimping to do so.
Monday, July 16, 2007
TEXAS NURSING HOME LOCKS WOMAN OUT AFTER RAPE
According to an article in the Houston Chronicle, a nursing home in Texas City kicked out a mentally disabled woman after she made a rape charge against an employee of the home. The man was later charged with sexual assault.
The lawsuit, filed by the mother of the woman (named Jane Doe 1 in the lawsuit), accuses HRA Village of locking the woman out of the nursing home facility after a rape kit administered by the University of Texas Medical Center came back positive. The lawsuit says that Henry Lewis Jones, 54, targeted the daughter (named Jane Doe 2 in the lawsuit) after she reported other sexual assault acts she witnessed. He assaulted Jane Doe 2 several times between march and July 2006. Jane Doe 2 was only taken to UTMB for an examination after her mother insisted. The suit also claims that HRA Village failed to report the allegation of abuse to the Texas Department of Aging and Disability Services. The HRA Village Executive Director said she had not seen the lawsuit and could not comment. The Texas Department of Aging and Disability Services’ website shows that HRA Village was cited for failing to report abuse incidents and for failing to prevent the use of seclusion and restraint as forms of punishment.
See the full article here.
The lawsuit, filed by the mother of the woman (named Jane Doe 1 in the lawsuit), accuses HRA Village of locking the woman out of the nursing home facility after a rape kit administered by the University of Texas Medical Center came back positive. The lawsuit says that Henry Lewis Jones, 54, targeted the daughter (named Jane Doe 2 in the lawsuit) after she reported other sexual assault acts she witnessed. He assaulted Jane Doe 2 several times between march and July 2006. Jane Doe 2 was only taken to UTMB for an examination after her mother insisted. The suit also claims that HRA Village failed to report the allegation of abuse to the Texas Department of Aging and Disability Services. The HRA Village Executive Director said she had not seen the lawsuit and could not comment. The Texas Department of Aging and Disability Services’ website shows that HRA Village was cited for failing to report abuse incidents and for failing to prevent the use of seclusion and restraint as forms of punishment.
See the full article here.
JUDGE RULES AGAINST MAYOR IN MALPRACTICE SUIT
In Amite, Louisiana, a Judge ruled against their mayor, Dr. Reggie Goldsby, who doubles as a general practitioner in Amite. The suit was file by Tanya Hendry Sparks on behalf of her father, Marion Hendry, who passed away November 28, 2003.
The suit alleges that Goldsby’s care of Hendry was below applicable standards of care. Records say that Goldsby failed to properly monitor and treat Hendry’s high blood sugar levels, prescribed high doses of steroids to a diabetic, failed to properly work up and follow his patients, failed to monitor and treat Hendry’s dehydration, failed to monitor and treat his Coumadin levels and in general, permitted Hendry’s condition to deteriorate to the point of death.
Hendry was a retired high school teacher who was independent, lived on his own and suffered from no confusion. He was admitted for Goldsby’s diagnosis of “cellulitis” and osteoarthritis on his right wrist. Hendry’s daughter had him transferred to North Oaks Medical Center after his blood pressure dropped so low that Hendry became brain damaged. North Oaks Medical Center also found that Hendry’s wrist was actually fractured. Because of the brain damage, Hendry was institutionalized and later died.
The jury award Sparks $814,079 on behalf of her late father.
See the full article here.
The suit alleges that Goldsby’s care of Hendry was below applicable standards of care. Records say that Goldsby failed to properly monitor and treat Hendry’s high blood sugar levels, prescribed high doses of steroids to a diabetic, failed to properly work up and follow his patients, failed to monitor and treat Hendry’s dehydration, failed to monitor and treat his Coumadin levels and in general, permitted Hendry’s condition to deteriorate to the point of death.
Hendry was a retired high school teacher who was independent, lived on his own and suffered from no confusion. He was admitted for Goldsby’s diagnosis of “cellulitis” and osteoarthritis on his right wrist. Hendry’s daughter had him transferred to North Oaks Medical Center after his blood pressure dropped so low that Hendry became brain damaged. North Oaks Medical Center also found that Hendry’s wrist was actually fractured. Because of the brain damage, Hendry was institutionalized and later died.
The jury award Sparks $814,079 on behalf of her late father.
See the full article here.
VEIN CLOTS HIGH RISK FOR HOSPITAL PATIENTS
In an article from the Washington Post, the author states “A surprisingly large number of hospital patients run the risk of a potentially fatal vein clot, but half of them aren’t getting preventative treatment.”
The condition is called venous thromboembolism (VTE) and involves the formation of blood clots inside a vein. VTE may be a bigger threat than anyone has previously realized. VTEs can block blood vessels in the leg (deep vein thrombosis) or in the lungs (pulmonary embolism). Dr. Frederick A. Anderson, Jr. is the director of the Center for Outcomes Research at the University of Massachusetts Medical School and the lead researcher for a project that studied the risk of patients in the hospital for VTE.
He is quoted “We looked at 38 million discharges in a database for US hospitals and found that about one of every three people in a hospital bed in the United States arguable should be protected against VTE because they have a risk.” His team published their report in the July issue of the American Journal of Hematology. “The risk is highest for people undergoing orthopedic surgery, such as hip or knee replacement…About 9 of every 10 orthopedic surgery patients are at risk.”
The author ends the article with Dr. Anderson’s quote, “Preventing VTE after hospital stays could have a significant public health impact. Here we have a preventable cause of death in hospital patients, and we should be trying to prevent it.”
Find more information about pulmonary embolism at the U.S. National Library of Medicine.
The condition is called venous thromboembolism (VTE) and involves the formation of blood clots inside a vein. VTE may be a bigger threat than anyone has previously realized. VTEs can block blood vessels in the leg (deep vein thrombosis) or in the lungs (pulmonary embolism). Dr. Frederick A. Anderson, Jr. is the director of the Center for Outcomes Research at the University of Massachusetts Medical School and the lead researcher for a project that studied the risk of patients in the hospital for VTE.
He is quoted “We looked at 38 million discharges in a database for US hospitals and found that about one of every three people in a hospital bed in the United States arguable should be protected against VTE because they have a risk.” His team published their report in the July issue of the American Journal of Hematology. “The risk is highest for people undergoing orthopedic surgery, such as hip or knee replacement…About 9 of every 10 orthopedic surgery patients are at risk.”
The author ends the article with Dr. Anderson’s quote, “Preventing VTE after hospital stays could have a significant public health impact. Here we have a preventable cause of death in hospital patients, and we should be trying to prevent it.”
Find more information about pulmonary embolism at the U.S. National Library of Medicine.
Friday, July 13, 2007
SHOULD MEDICARE PAY WHEN HOSPITALS MAKE ERRORS?
In a blog article on the Wall Street Journal, Jacob Goldstein discusses a new Medicare rule that deny Medicare payments for errors that are commonly caused by less than perfect care. Many times, these errors actually benefit the hospital by increasing the care needed to treat the problem, including longer hospital stays.
The new rule would go into effect in October 2008 and would cover the following:
A. Pressure ulcers
B. Two types of hospital acquired infections; and
C. Three “never events” (events that should never happen under any circumstance): blood incompatibility: when a patient is given the wrong type of blood; air embolism: when bubbles of air or gas enter the bloodstream during a procedure; and leaving an object inside a patient during surgery.
The American Hospital Association’s response supports ending payments for the three “never events”, but argues that some hospital acquired infections and pressure ulcers can happen even if the patient receives the best care possible.
I certainly hope that some version of this rule passes. Perhaps when these mistakes start affecting the hospitals’ bottom line they will start working harder to avoid them. Just as importantly, the new rule needs to be written so that patients who are victims of medical errors are not made victims again by having to pay what Medicare will not.
The new rule would go into effect in October 2008 and would cover the following:
A. Pressure ulcers
B. Two types of hospital acquired infections; and
C. Three “never events” (events that should never happen under any circumstance): blood incompatibility: when a patient is given the wrong type of blood; air embolism: when bubbles of air or gas enter the bloodstream during a procedure; and leaving an object inside a patient during surgery.
The American Hospital Association’s response supports ending payments for the three “never events”, but argues that some hospital acquired infections and pressure ulcers can happen even if the patient receives the best care possible.
I certainly hope that some version of this rule passes. Perhaps when these mistakes start affecting the hospitals’ bottom line they will start working harder to avoid them. Just as importantly, the new rule needs to be written so that patients who are victims of medical errors are not made victims again by having to pay what Medicare will not.
ILLINOIS RIPS NURSING HOME
Why can’t Virginia get tough with bad nursing homes around our Commonwealth?
It doesn’t appear the State of Illinois has any problem getting after them!
Peoria Gardens Healthcare Center, a troubled nursing home located in East Peoria, and state health officials are gearing for battle after authorities fined the home $100,000 -- one of the largest such fines ever -- for neglect and faulty care of mentally ill and elderly patients. In a report obtained by the Chicago Tribune, state health officials detailed violations at the nursing home that are unusual in scope and severity, according to state officials and watchdog groups.
A fine of $100,000 might just get the attention of the “fat cat” owners!
Read the Chicago Tribune article here.
It doesn’t appear the State of Illinois has any problem getting after them!
Peoria Gardens Healthcare Center, a troubled nursing home located in East Peoria, and state health officials are gearing for battle after authorities fined the home $100,000 -- one of the largest such fines ever -- for neglect and faulty care of mentally ill and elderly patients. In a report obtained by the Chicago Tribune, state health officials detailed violations at the nursing home that are unusual in scope and severity, according to state officials and watchdog groups.
A fine of $100,000 might just get the attention of the “fat cat” owners!
Read the Chicago Tribune article here.
CHILD WINS HUGE DAMAGES OVER POOR MEDICAL CARE
The Los Angeles Times reports a Glendale Superior Court civil jury awarded $15 million in damages in the case of a child who developed a rare but serious neurological disorder caused by untreated jaundice shortly after his birth four years ago at Verdugo Hills Hospital.
The child was born March 24, 2003 at Verdugo Hills Hospital. According to the lawsuit, the child exhibited several risk factors for kernicterus, a neurological disorder that can cause mental retardation, cerebral palsy and hearing loss, when he developed jaundice shortly after birth. The jaundice was a sign of the buildup of bilirubin, a yellow bile pigment, produced in greater quantities than a baby's liver can excrete.
The preventable injuries suffered were catastrophic! "He has normal intelligence, but he can't walk. He can't talk, can't feed himself. He can't control a single muscle and it was all preventable," according to his attorney.
Was this verdict unfair or unreasonable? I don’t think so!
Read the LA Times article here.
The child was born March 24, 2003 at Verdugo Hills Hospital. According to the lawsuit, the child exhibited several risk factors for kernicterus, a neurological disorder that can cause mental retardation, cerebral palsy and hearing loss, when he developed jaundice shortly after birth. The jaundice was a sign of the buildup of bilirubin, a yellow bile pigment, produced in greater quantities than a baby's liver can excrete.
The preventable injuries suffered were catastrophic! "He has normal intelligence, but he can't walk. He can't talk, can't feed himself. He can't control a single muscle and it was all preventable," according to his attorney.
Was this verdict unfair or unreasonable? I don’t think so!
Read the LA Times article here.
Thursday, July 12, 2007
PEER ABUSE A PROBLEM IN NURSING HOMES
While elder abuse is usually the abuse of residents by staff, it can also include abuse of residents by their peers (meaning other residents). An article on MSNBC quotes Dr. Mark Lachs of Cornell University “I personally think…that it’s far more prevalent than any other form of interpersonal aggression that you see in older people.”
Dr. Lachs is the lead author of the study about this type of abuse. While he has seen plenty of evidence of the problem, and the nursing home workers can attest to it, for some reason it is not “on the radar screen.” Most cases involve two residents physically assaulting each other, and most times, it is not malicious but due to dementia and confusion in one or both parties.
More research needs to be done regarding peer abuse and its triggers but the problem raises the question of whether people with dementia should be housed together in the general nursing home population.
See the full article here.
Dr. Lachs is the lead author of the study about this type of abuse. While he has seen plenty of evidence of the problem, and the nursing home workers can attest to it, for some reason it is not “on the radar screen.” Most cases involve two residents physically assaulting each other, and most times, it is not malicious but due to dementia and confusion in one or both parties.
More research needs to be done regarding peer abuse and its triggers but the problem raises the question of whether people with dementia should be housed together in the general nursing home population.
See the full article here.
NURSING HOME EMPLOYEE ACCUSED OF RAPING 85-YEAR-OLD PATIENT
This disgusting news comes to us from Utah! Read the article from the Salt Lake Tribune about the allegations involving St. Joseph Villa nursing home.
My biggest question is: Did the nursing home really investigate this employee’s past record (criminal?) before hiring him? Shouldn’t all nursing homes take extra precautions when hiring employees who will be responsible for caring for the aged and infirm?
My biggest question is: Did the nursing home really investigate this employee’s past record (criminal?) before hiring him? Shouldn’t all nursing homes take extra precautions when hiring employees who will be responsible for caring for the aged and infirm?
Wednesday, July 11, 2007
“AMERICA’S BEST HOSPITALS” GOOD FOR HEART ATTACK SURVIVAL
Each year, U.S. News & World Report publishes lists of “America’s Best Hospitals.” Now a study from Yale University affirms some of those rankings.
According to an article on MSN, heart attack patients are more likely to survive the month if they go to a hospital which is ranked as “America’s Best” by U.S. News & World Report. Dr. Oliver Wang and his colleagues at Yale University analyzed 30-day death rates for patients of 50 hospitals ranked on the US News list as compared to death rates for patients admitted to hospitals which did not make the list.
The authors concluded, “The U.S. News & World Report ranking, which includes many of the national’s most prestigious hospitals, did identify a group of hospitals that was much more likely than non-ranked hospitals to have superb performance on 30-day mortality after acute myocardial infarction. … However, our study also revealed that not all ranked hospitals had outstanding performance, and that many non-ranked hospitals performed well.”
See U.S. News’ reaction to this study here.
HOW GOOD IS YOUR HOSPITAL?
Are you getting ready to go to the hospital? Have you chosen elective surgery at Carilion Roanoke Memorial Hospital, Danville Regional Medical Center, Carilion New River Valley Hospital, Memorial Hospital of Martinsville and Henry County, Alleghany Regional Hospital, Montgomery Regional Hospital, Wellmont Bristol Regional Hospital or any other hospital in Virginia? Better do your homework first to determine just how good that hospital really is.
Take a quick look at these resources for hospital-quality data:
§ Hospital Compare
§ Leapfrog Group
§ National Association of Health Data Organizations
§ Agency for Healthcare Research and Quality
§ Health Grades
§ Dartmouth Atlas
Take a quick look at these resources for hospital-quality data:
§ Hospital Compare
§ Leapfrog Group
§ National Association of Health Data Organizations
§ Agency for Healthcare Research and Quality
§ Health Grades
§ Dartmouth Atlas
FAMILY MEMBER GUIDE TO NURSING HOMES
Not all complaints against a nursing home are best solved through litigation. Litigation is very expensive and often results in hard feelings and unresolved issues on one or both sides. We receive many calls from family members who are frustrated with the care their loved one is receiving that fit into this category.
Lauren Ellerman has written an article to address the concerns of these family members and give them some advice on what they can do to help their loved one. Some of her tips are as follows:
Be organized. Keep a diary or log of every visit.
Document your complaints. Write everything down and take pictures.
Complain to State/Local authorities. You can file a complaint with the Department of Social Services or the Virginia Department of Health.
Work with attending physicians. Yes. You can talk to them. Ask them questions and write down the answers.
What to do if a fall occurs. If a fall occurs, immediately get all the details – again write them down and make sure they are taking steps to prevent another fall.
If your resident stops eating – Review their chart yourself and help determine why they are not eating. Make sure the physician is aware and that they are taking steps to avoid malnutrition.
There are too many circumstances and situations to go into here. The best thing that you can do is to visit your loved one often and unannounced. As Lauren ends her article, “A supportive family can mean the difference between good care and poor care.”
See the full article here.
See a list of articles by Dan Frith and Lauren Ellerman here.
Lauren Ellerman has written an article to address the concerns of these family members and give them some advice on what they can do to help their loved one. Some of her tips are as follows:
Be organized. Keep a diary or log of every visit.
Document your complaints. Write everything down and take pictures.
Complain to State/Local authorities. You can file a complaint with the Department of Social Services or the Virginia Department of Health.
Work with attending physicians. Yes. You can talk to them. Ask them questions and write down the answers.
What to do if a fall occurs. If a fall occurs, immediately get all the details – again write them down and make sure they are taking steps to prevent another fall.
If your resident stops eating – Review their chart yourself and help determine why they are not eating. Make sure the physician is aware and that they are taking steps to avoid malnutrition.
There are too many circumstances and situations to go into here. The best thing that you can do is to visit your loved one often and unannounced. As Lauren ends her article, “A supportive family can mean the difference between good care and poor care.”
See the full article here.
See a list of articles by Dan Frith and Lauren Ellerman here.
Tuesday, July 10, 2007
1 IN 4 STROKE PATIENTS NOT TOLD TO CALL 911
In a study by Dr. Brett Jarrell from Cabell Huntington Hospital in West Virginia, he found that about 1 in 4 potential stroke patients who called a hospital operator were told to call their primary physician rather than 911. This is especially alarming considering the well-established link between fast treatment of strokes and improved outcomes.
Dr. Jarrell and his team called 46 healthlines in the US and presented the operator with the following stroke scenario: a 65 year old man experiencing weakness in the left arm and leg and having trouble speaking, both of which are common stroke symptoms. The operator was then asked to choose from four options: wait for the symptoms to go away, call their primary care doctor, go to a local urgent care center, or call 911 for an ambulance.
In 22 percent of the calls, the operator told the caller to contact their primary care doctor rather than to seek emergency treatment. In 78 percent of the calls, the operator did recommend emergency treatment. This is outrageously bad medical advice!
Even more alarming is the fact that 24 percent of operators could not name even one stroke symptom or sign!
See the full MSNBC article here.
See more information about strokes and their symptoms at these sites:
National Stroke Association
American Heart Assocation Stroke Warning Signs
American Stroke Association
WebMD Stroke Center
Dr. Jarrell and his team called 46 healthlines in the US and presented the operator with the following stroke scenario: a 65 year old man experiencing weakness in the left arm and leg and having trouble speaking, both of which are common stroke symptoms. The operator was then asked to choose from four options: wait for the symptoms to go away, call their primary care doctor, go to a local urgent care center, or call 911 for an ambulance.
In 22 percent of the calls, the operator told the caller to contact their primary care doctor rather than to seek emergency treatment. In 78 percent of the calls, the operator did recommend emergency treatment. This is outrageously bad medical advice!
Even more alarming is the fact that 24 percent of operators could not name even one stroke symptom or sign!
See the full MSNBC article here.
See more information about strokes and their symptoms at these sites:
National Stroke Association
American Heart Assocation Stroke Warning Signs
American Stroke Association
WebMD Stroke Center
WHAT IS A “MEDICAL HOME?”
“Medical Home” is a new term being used by medical practices to help attract and keep patients. According to this article on MSN, patients have a “medical home” when they have a regular health care provider or place of care, have no difficulty contacting a provider by phone, have no difficulty getting advice or medical care when needed on weekends or evenings, and find office visits well-organized and efficiently run.
Research is showing that when people have a medical home their health is better and they are more likely to follow through with the doctor’s advice and treatment. A regular provider improves preventive care, chronic care, and overall health care. A survey released by the Commonwealth Fund, a private foundation focused on improving healthcare practice and policy, shows that only 27% of adults between the ages of 18 and 64 reported having all four elements of a medical home.
This concept is part of the move toward “collaborative care” where doctors and their staff all work together for the good of the patient. They focus not only on when the patient is sick, but also managing their everyday health and following up on treatment and the patient’s progress and overall health. Collaborative Care is one of the things to look for when choosing a doctor, according to the article entitled “How to Find a Good Doctor” in the LA Times.
Find more about medical homes on the Commonwealth Fund’s website here.
Research is showing that when people have a medical home their health is better and they are more likely to follow through with the doctor’s advice and treatment. A regular provider improves preventive care, chronic care, and overall health care. A survey released by the Commonwealth Fund, a private foundation focused on improving healthcare practice and policy, shows that only 27% of adults between the ages of 18 and 64 reported having all four elements of a medical home.
This concept is part of the move toward “collaborative care” where doctors and their staff all work together for the good of the patient. They focus not only on when the patient is sick, but also managing their everyday health and following up on treatment and the patient’s progress and overall health. Collaborative Care is one of the things to look for when choosing a doctor, according to the article entitled “How to Find a Good Doctor” in the LA Times.
Find more about medical homes on the Commonwealth Fund’s website here.
EYE EXAMS OVERLOOKED FOR NURSING HOME RESIDENTS
Two-thirds of nursing home residents in Alabama did not receive regular eye exams despite the fact that 57% of the residents had evidence of visual impairment. Moreover, about 90% had insurance that would have covered eye care, according to findings published in the July issue of Archives of Ophthalmology. I will assume Alabama treats its nursing home residents no better or worse than any other state.
Read the article from Medpage Today.
Read the article from Medpage Today.
Monday, July 09, 2007
IS HIPAA PROTECTING PATIENTS OR PROVIDERS?
An article in the New York Times explains that because the HIPAA laws are so technical, they are being misunderstood and misinterpreted.
The article tells the story of Gerard Nussbaum was told he could not stay with his father-in-law while he was being treated after a stroke. He was then threatened with arrest while looking through his father-in-law’s chart to prove to the nurse she was about to administer a dangerous second round of sedatives. Both nurses claimed that access to his father-in-law and his father-in-law’s records were prohibited under the Health Insurance Portability and Accountability Act, more commonly known as HIPAA.
Many providers do not understand the law, have not trained their staff members to apply it judiciously and many are afraid of the fines and jail terms threatened by the Act, although no penalty has been levied in four years. Susan McAndrew, deputy director of health information privacy at the Department of Health and Human Service believes healthcare providers are hiding behind the HIPAA law. She states “Either innocently or purposefully, entities often use this as an excuse…They say ‘HIPAA made me do it’ when, in fact, they chose for other reasons not to make the permitted disclosures.”
Many experts distinguish between “good faith nondisclosures,” such as when a random person calls in for information about a patient and they cannot verify they should disclose the information and “bad faith nondisclosures,” like using HIPAA as an excuse to refuse to gather needed records to help public investigators with a child abuse case. Ms. McAndrew explains some of the do’s and don’ts of sharing medical information:
"Medical professionals can talk freely to family and friends, unless the patient objects. No signed authorization is necessary and the person receiving the information need not have the legal standing of a health care proxy or power of attorney. As for public health authorities or those investigating crimes like child abuse, HIPAA defers to state laws, which often require such disclosure. Medical workers may not reveal confidential information about a patient or case to reporters, but they can discuss general health issues."
Most on the spot decisions are made by staff who are more comfortable saying “no” than “yes” when they are not sure of the law.
So, if you need information about a friend or family member, unless that person objects, you have every right to that information. Don’t let the staff hide behind the HIPAA law and prevent you from helping a loved one manage their care.
Download a copy of the HIPAA Act here.
See the simplifications made here.
The article tells the story of Gerard Nussbaum was told he could not stay with his father-in-law while he was being treated after a stroke. He was then threatened with arrest while looking through his father-in-law’s chart to prove to the nurse she was about to administer a dangerous second round of sedatives. Both nurses claimed that access to his father-in-law and his father-in-law’s records were prohibited under the Health Insurance Portability and Accountability Act, more commonly known as HIPAA.
Many providers do not understand the law, have not trained their staff members to apply it judiciously and many are afraid of the fines and jail terms threatened by the Act, although no penalty has been levied in four years. Susan McAndrew, deputy director of health information privacy at the Department of Health and Human Service believes healthcare providers are hiding behind the HIPAA law. She states “Either innocently or purposefully, entities often use this as an excuse…They say ‘HIPAA made me do it’ when, in fact, they chose for other reasons not to make the permitted disclosures.”
Many experts distinguish between “good faith nondisclosures,” such as when a random person calls in for information about a patient and they cannot verify they should disclose the information and “bad faith nondisclosures,” like using HIPAA as an excuse to refuse to gather needed records to help public investigators with a child abuse case. Ms. McAndrew explains some of the do’s and don’ts of sharing medical information:
"Medical professionals can talk freely to family and friends, unless the patient objects. No signed authorization is necessary and the person receiving the information need not have the legal standing of a health care proxy or power of attorney. As for public health authorities or those investigating crimes like child abuse, HIPAA defers to state laws, which often require such disclosure. Medical workers may not reveal confidential information about a patient or case to reporters, but they can discuss general health issues."
Most on the spot decisions are made by staff who are more comfortable saying “no” than “yes” when they are not sure of the law.
So, if you need information about a friend or family member, unless that person objects, you have every right to that information. Don’t let the staff hide behind the HIPAA law and prevent you from helping a loved one manage their care.
Download a copy of the HIPAA Act here.
See the simplifications made here.
IS YOUR SURGERY REALLY SAFE? HOW ABOUT YOUR SURGEON?
An article in the New York Times brings up a surprising realization. Surgeons and their teams are not tested for blood borne viruses. And those who have blood borne viruses are not prohibited from practicing medicine.
The article tells of two people from Long Island who met in a support group for people with Hepatitis C. The two patients realized they both had become infected after open-heart surgery – by the same surgeon! Investigators discovered the surgeon, Dr. Michael Hall, was infected and was the source of the infections in these two patients, and at least one other. Dr. Hall was never found legally liable and he continues to perform open heart surgeries. His attorney stated “he did absolutely nothing wrong and operated in a perfectly reasonable manner.”
The problem arises when the surgeon, or a patient, has a blood borne virus. Doctors often cut or nick themselves, and if it happens while the doctor’s hands are inside the patient’s body, both parties are at risk of picking up viruses from the other.
There are no procedures in place to protect patients, like there are in place to protect health care workers. If a health care worker in exposed to a patient’s blood, they are required to report it and the patient then must be tested for viruses. However, a patient may never know they were exposed to the surgeon’s blood, since they are under anesthesia. You should not put off any important procedures due to the fear of contracting a virus, but you should definitely ask your surgeon if they are infected with any blood borne viruses such as hepatitis B, hepatitis C, or HIV.
However, it is more likely than not that your surgeon will reply “I don’t know” because they have not been tested and they are not required to be tested. Janine Jagger, director of the International Health Care Worker Safety Center at the University of Virginia and her colleagues are calling for testing physicians before they begin residencies in high-risk specialties, and for informing patients when they have been exposed to health care worker’s blood.
I think testing and reporting this information is a great idea, don’t you?
The article tells of two people from Long Island who met in a support group for people with Hepatitis C. The two patients realized they both had become infected after open-heart surgery – by the same surgeon! Investigators discovered the surgeon, Dr. Michael Hall, was infected and was the source of the infections in these two patients, and at least one other. Dr. Hall was never found legally liable and he continues to perform open heart surgeries. His attorney stated “he did absolutely nothing wrong and operated in a perfectly reasonable manner.”
The problem arises when the surgeon, or a patient, has a blood borne virus. Doctors often cut or nick themselves, and if it happens while the doctor’s hands are inside the patient’s body, both parties are at risk of picking up viruses from the other.
There are no procedures in place to protect patients, like there are in place to protect health care workers. If a health care worker in exposed to a patient’s blood, they are required to report it and the patient then must be tested for viruses. However, a patient may never know they were exposed to the surgeon’s blood, since they are under anesthesia. You should not put off any important procedures due to the fear of contracting a virus, but you should definitely ask your surgeon if they are infected with any blood borne viruses such as hepatitis B, hepatitis C, or HIV.
However, it is more likely than not that your surgeon will reply “I don’t know” because they have not been tested and they are not required to be tested. Janine Jagger, director of the International Health Care Worker Safety Center at the University of Virginia and her colleagues are calling for testing physicians before they begin residencies in high-risk specialties, and for informing patients when they have been exposed to health care worker’s blood.
I think testing and reporting this information is a great idea, don’t you?
NEUROSURGEONS ATTEMPT TO INTIMIDATE EXPERTS
I have always thought that neurosurgeons, although very smart, are human and as humans make mistakes. However, it doesn’t appear that neurosurgeons believe they can make mistakes!
In order to prevail in a medical malpractice case the patient must present testimony from an expert in the medical field involved in the claim. In other words, you must have an orthopedic surgery expert if you are suing your orthopedic surgeon…a pediatrician if you are suing your pediatrician.
Well, neurosurgeons have decided to put a stop on suits against neurosurgeons. How? The American Association of Neurological Surgeons (AANS) has decided that any expert who testifies against one of its members should have their testimony subjected to review by their organization. In the 20 years this policy has been in effect, 24 of the 27 cases the AANS reviewed were brought by AANS members who had been defendants in malpractice cases.
What is the effect of this policy? Well, neurosurgeons who are asked to review cases against other neurosurgeons in cases of substandard care are hesitant to get involved. They don’t want their national association to come after them! In our own practice, finding honest and willing neurosurgeons to review potential cases is next to impossible. Wonder why!
In order to prevail in a medical malpractice case the patient must present testimony from an expert in the medical field involved in the claim. In other words, you must have an orthopedic surgery expert if you are suing your orthopedic surgeon…a pediatrician if you are suing your pediatrician.
Well, neurosurgeons have decided to put a stop on suits against neurosurgeons. How? The American Association of Neurological Surgeons (AANS) has decided that any expert who testifies against one of its members should have their testimony subjected to review by their organization. In the 20 years this policy has been in effect, 24 of the 27 cases the AANS reviewed were brought by AANS members who had been defendants in malpractice cases.
What is the effect of this policy? Well, neurosurgeons who are asked to review cases against other neurosurgeons in cases of substandard care are hesitant to get involved. They don’t want their national association to come after them! In our own practice, finding honest and willing neurosurgeons to review potential cases is next to impossible. Wonder why!
Friday, July 06, 2007
AMERICAN MEDICAL ASSOCIATION WANTS TO TAKE AWAY PATIENT’S RIGHT TO SUE
I bet the American Medical Association (AMA) is okay with allowing its members to sue house builders, suppliers, vendors, car dealerships, and lawyers but it is not okay with allowing those same people the constitutional right to sue them in court.
The American Medical Association this week adopted new principles for establishing health courts, or special courts with judges trained in medical standards that it says could lead to a fairer and more expedited resolution of medical liability claims. I read that statement to mean “fairer” only to the doctors…not the victims of medical negligence! Read about the AMA’s position.
Like we have said in this blog before…the corporate medical industry in the US is taking away your right to hold healthcare providers accountable for preventable injuries and death!
The American Medical Association this week adopted new principles for establishing health courts, or special courts with judges trained in medical standards that it says could lead to a fairer and more expedited resolution of medical liability claims. I read that statement to mean “fairer” only to the doctors…not the victims of medical negligence! Read about the AMA’s position.
Like we have said in this blog before…the corporate medical industry in the US is taking away your right to hold healthcare providers accountable for preventable injuries and death!
MEDICAL ERROR IS THE 5TH LEADING CAUSE OF DEATH IN THE US
Millennium Research Group (MRG), the global authority on medical technology market intelligence has conducted a detailed and thorough analysis of the acute care clinical information systems (CIS) market and finds that a major driver in the US is the demand for improvement in patient safety. CIS is a computer-based inpatient information system designed for collecting, storing, manipulating, and making available clinical information that is important to the health care delivery process.
Medical errors are the fifth-leading cause of deaths in the US, with up to 98,000 deaths annually. According to the new report entitled “US Markets for Acute Care Clinical Information Systems,” hospitals are adopting CIS to help them provide adequate, timely care and reduce the frequency of preventable errors.
“Medical errors in the healthcare system arise from miscommunication, physician order transcription errors, adverse drug events, or incomplete patient medical records," says David Plow, Senior Analyst at MRG. "Generally, medical errors are caused by overcrowded, understaffed clinical areas with complex workflow patterns, and incomplete or inefficient communication between clinical areas.
For more information.
Medical errors are the fifth-leading cause of deaths in the US, with up to 98,000 deaths annually. According to the new report entitled “US Markets for Acute Care Clinical Information Systems,” hospitals are adopting CIS to help them provide adequate, timely care and reduce the frequency of preventable errors.
“Medical errors in the healthcare system arise from miscommunication, physician order transcription errors, adverse drug events, or incomplete patient medical records," says David Plow, Senior Analyst at MRG. "Generally, medical errors are caused by overcrowded, understaffed clinical areas with complex workflow patterns, and incomplete or inefficient communication between clinical areas.
For more information.
“CHASING LIFE” BY SANJAY GUPTA, MD
I know this is a different type of post for me but I wanted to share my thoughts on a recent book I read entitled “Chasing Life.” The book was written by Dr. Sanjay Gupta, a practicing neurosurgeon at Emory University Hospital and the Chief Medical Correspondent for CNN.
Dr. Gupta’s book will revolutionize the way you think about your health and the aging process. He writes in depth about advances in medical treatment, health, and nutrition which should make us all live longer and fuller lives.
It is a great read!
Dr. Gupta’s book will revolutionize the way you think about your health and the aging process. He writes in depth about advances in medical treatment, health, and nutrition which should make us all live longer and fuller lives.
It is a great read!
Thursday, July 05, 2007
YOUR PHYSICIAN’S HANDWRITING CAN AFFECT YOUR HEALTH
Doctors are notorious for their bad handwriting. But, how can your physician’s bad writing affect you? In many ways, including a huge problem shown in this MSNBC video.
Bad handwriting makes it more difficult for pharmacists to be sure they are giving you the correct medication. For instance, there are many drugs that are very similar in name, such as Celebrex, which is a pain reliever, and Celexa, which is an anti-depressant. Pharmacists also have a hard time reading the dosage that the doctor prescribes, resulting in you getting a dosage that is either more or less than what you actually need.
A study by the University of Minnesota shows that of those facilities that have switched to computers from handwritten notes, errors have been reduced by 66%. Although the usefulness of computers is definitely proving itself, only 9% of hospitals nationwide have adopted computers as the main way for doctors to prescribe medicine and treatments.
Again, we must suggest, be in charge of your own care. Be sure to know what your doctor prescribes so that if you get the wrong drug or dosage, you will realize it before its too late!
Bad handwriting makes it more difficult for pharmacists to be sure they are giving you the correct medication. For instance, there are many drugs that are very similar in name, such as Celebrex, which is a pain reliever, and Celexa, which is an anti-depressant. Pharmacists also have a hard time reading the dosage that the doctor prescribes, resulting in you getting a dosage that is either more or less than what you actually need.
A study by the University of Minnesota shows that of those facilities that have switched to computers from handwritten notes, errors have been reduced by 66%. Although the usefulness of computers is definitely proving itself, only 9% of hospitals nationwide have adopted computers as the main way for doctors to prescribe medicine and treatments.
Again, we must suggest, be in charge of your own care. Be sure to know what your doctor prescribes so that if you get the wrong drug or dosage, you will realize it before its too late!
CASE REPORT: IV INFILTRATION LEADS TO AMPUTATION
Many people have experienced being stuck in the arm with a catheter (or needle) in order that a health care provider can administer needed fluids, antibiotics, etc. Pretty simple process right? Not always as this report from Minnesota shows us in great detail.
The patient was 55 years old and was hospitalized at the Mayo Clinic in Rochester, MN. She alleged that, while a patient in the ICU, the nursing staff failed to assess the infiltration of an IV (intravenous) line in her arm, which caused swelling and pain in her arm and hand. Ultimately, the patient’s right arm and hand lost circulation for over 8 hours, became necrotic, died, and ultimately required a mid-forearm amputation. The case was tried before a jury which found the nursing staff negligent and awarded the patient $450,000.
If you are hospitalized and an IV line is placed, watch closely for swelling and discoloration of the area around the catheter. Infiltration injuries occur when the tip of the catheter is outside of the vein and the solution being administered is being forced into the soft tissue and muscle and not into the vein as designed.
The patient was 55 years old and was hospitalized at the Mayo Clinic in Rochester, MN. She alleged that, while a patient in the ICU, the nursing staff failed to assess the infiltration of an IV (intravenous) line in her arm, which caused swelling and pain in her arm and hand. Ultimately, the patient’s right arm and hand lost circulation for over 8 hours, became necrotic, died, and ultimately required a mid-forearm amputation. The case was tried before a jury which found the nursing staff negligent and awarded the patient $450,000.
If you are hospitalized and an IV line is placed, watch closely for swelling and discoloration of the area around the catheter. Infiltration injuries occur when the tip of the catheter is outside of the vein and the solution being administered is being forced into the soft tissue and muscle and not into the vein as designed.
CASE REPORT: FAILURE TO TREAT PULMONARY EMBOLISM CAUSES DEATH
A pulmonary embolism is a blood clot in an artery in the lung. Once the artery is blocked oxygen levels in the blood drop, and blood pressure in the lungs rises. It is a life-threatening condition which is demonstrated by this case report from New York.
The patient was 42 years old and had a history of hypertension (high blood pressure) and asthma. In January of 2001 he submitted to knee surgery which was successful. However, two weeks after surgery he went to an emergency room with complaints of shortness of breath and a pulmonary embolism was suspected. The treating doctor ordered a CT of the chest and, after some delay, ordered the administration of Heparin (an anticoagulant). Unfortunately, the Heparin was not promptly given and the patient suffered a cardiac arrest from the pulmonary embolism and died. The suit against the ER physician was reportedly settled for $1.5 million.
The patient was 42 years old and had a history of hypertension (high blood pressure) and asthma. In January of 2001 he submitted to knee surgery which was successful. However, two weeks after surgery he went to an emergency room with complaints of shortness of breath and a pulmonary embolism was suspected. The treating doctor ordered a CT of the chest and, after some delay, ordered the administration of Heparin (an anticoagulant). Unfortunately, the Heparin was not promptly given and the patient suffered a cardiac arrest from the pulmonary embolism and died. The suit against the ER physician was reportedly settled for $1.5 million.
NURSING HOME LOBBY ON IMMIGRATION?
We receive a monthly magazine called Nursing Homes, Long Term Care Management. The magazine is written for long term care businesses and administrators - to discuss the pressing issues affecting the industry. In the June 2007 issue, there is an article by Michael Stoil - entitled, "View on Washington: Will immigration reform solve staffing woes?" Mr. Stoil begins, "Research repeatedly confirms that the quality of long-term care depends on staffing levels." He then goes on to say that America's anti-immigration policies have harmed nursing homes, such that "lobbyists for the nursing home industry" have "become reliable advocates for policies that will increase the availability of workers in Asia, Central America, Mexico" etc.
He continues to state that "nursing homes face a systemic shortages of nurses and other clinical staff; they cannot compete with the salaries offerred by hospitals," and then he lists other health care providers.
I found this article to be VERY interesting. Someone admitting that low staff numbers leads to low care, coupled with the excuse that facilities can't find anyone else willing to work.
I would love for someone to do a study on how long it takes to fill a CNA position at a Nursing Home, or an LPN position. Months? I seriously doubt it. In smaller towns, these are good jobs. YES, we hear over and over again that wages are an issue, but so is level of staffing. This week alone I have heard at least three nursing home employees tell me their facilities were understaffed, and not because no one was responding to the Want Ads - rather, the facility was not looking to hire.
So, I will leave it up to you - do you think the nursing home industry is really hampered by immigration laws, or are big nursing home businesses looking to capitilize on a work force that typically accepts challenging jobs for less money? You decide. But in the meanwhile, check out the Classified section - are there thousands of CNA, LPN or RN jobs available?
He continues to state that "nursing homes face a systemic shortages of nurses and other clinical staff; they cannot compete with the salaries offerred by hospitals," and then he lists other health care providers.
I found this article to be VERY interesting. Someone admitting that low staff numbers leads to low care, coupled with the excuse that facilities can't find anyone else willing to work.
I would love for someone to do a study on how long it takes to fill a CNA position at a Nursing Home, or an LPN position. Months? I seriously doubt it. In smaller towns, these are good jobs. YES, we hear over and over again that wages are an issue, but so is level of staffing. This week alone I have heard at least three nursing home employees tell me their facilities were understaffed, and not because no one was responding to the Want Ads - rather, the facility was not looking to hire.
So, I will leave it up to you - do you think the nursing home industry is really hampered by immigration laws, or are big nursing home businesses looking to capitilize on a work force that typically accepts challenging jobs for less money? You decide. But in the meanwhile, check out the Classified section - are there thousands of CNA, LPN or RN jobs available?
Tuesday, July 03, 2007
HELP! MY DIABETIC MOM IS IN A NURSING HOME
Have you ever felt this way about a member of your family who is diabetic and resides in a nursing home? Well, a reader of the Diabetes Health magazine certainly felt this way and you need to read the recommendations from Mary M. Sullivan RN, and a Diabetes Clinical Nurse Specialist/Nurse Practitioner. Read Nurse Sullivan’s advice here.
Diabetes Health magazine, published continuously for 14 years, provides objective, sometimes controversial, but always balanced articles about living with diabetes. Consumers and medical professionals alike recognize the value of this niche magazine that treads where no other is willing to go.
Diabetes Health magazine, published continuously for 14 years, provides objective, sometimes controversial, but always balanced articles about living with diabetes. Consumers and medical professionals alike recognize the value of this niche magazine that treads where no other is willing to go.
NURSING HOME ADMISSION AGREEMENTS
Many nursing homes will want you to sign an admission agreement, either before or after the resident moves in. Please take your time and read the agreement fully before signing. If possible, consult with an attorney. Obviously, if you can wait until the resident has already moved in, you will have more leverage.
Here is an article that gives some important pointers about nursing home admission agreements.
Two things that you need to pay very close attention to in the agreement are:
- Responsible Party: You should not sign the agreement as the responsible party. This means that you may be agreeing to be responsible for payment if the resident is unable to pay. You can sign as the resident’s agent, but you should pay close attention and cross out any language that implies that you will be personally responsible.
- Arbitration Provision: Nursing homes cannot legally require you to sign an arbitration provision, thus giving up your right to go to court against the nursing home if the need arises.
Other things that you should be aware of:
- Nursing homes cannot require a Medicare or Medicaid recipient to pay the private pay rate, even for a short time. They also cannot require that you confirm that you are not eligible for Medicare or Medicaid.
- Nursing homes cannot evict anyone for anything other than the following reasons: the home cannot meet the resident’s needs, the resident’s health has improved, the resident is a danger to others, lack of payment, or the nursing home is closing.
- Any provision that waives the nursing home’s liability for lost or stolen personal items is illegal. The nursing home also cannot waive their liability for the resident’s health.
For more information on elder law, please visit ElderLawAnswers.com.
Here is an article that gives some important pointers about nursing home admission agreements.
Two things that you need to pay very close attention to in the agreement are:
- Responsible Party: You should not sign the agreement as the responsible party. This means that you may be agreeing to be responsible for payment if the resident is unable to pay. You can sign as the resident’s agent, but you should pay close attention and cross out any language that implies that you will be personally responsible.
- Arbitration Provision: Nursing homes cannot legally require you to sign an arbitration provision, thus giving up your right to go to court against the nursing home if the need arises.
Other things that you should be aware of:
- Nursing homes cannot require a Medicare or Medicaid recipient to pay the private pay rate, even for a short time. They also cannot require that you confirm that you are not eligible for Medicare or Medicaid.
- Nursing homes cannot evict anyone for anything other than the following reasons: the home cannot meet the resident’s needs, the resident’s health has improved, the resident is a danger to others, lack of payment, or the nursing home is closing.
- Any provision that waives the nursing home’s liability for lost or stolen personal items is illegal. The nursing home also cannot waive their liability for the resident’s health.
For more information on elder law, please visit ElderLawAnswers.com.
ADMISSIONS SUSPENDED AT TENNESSEE NURSING HOME
According to an article by the Jackson Sun, The Tennessee Department of Health has suspended new admissions to Bells Nursing Home and imposed a monetary penalty of $1,500. The state has also recommended that the nursing home be charged a federal penalty of $3,050 per day until the violations are corrected.
The violations include:
o failure of staff to follow through with recommendations of a physician and contract dental service,
o failure of the medical director, administrator and social services to provide outside resources to alleviate medical need; and
o the failure to protect a resident from harm.
The Commissioner of the Department of Health can suspend admissions to a nursing home when conditions are detrimental to the health, safety or welfare of its residents. The order remains effective until all violations are corrected. The nursing home has a right to a hearing before the Board for Licensing Health Care Facilities or a judge.
The violations include:
o failure of staff to follow through with recommendations of a physician and contract dental service,
o failure of the medical director, administrator and social services to provide outside resources to alleviate medical need; and
o the failure to protect a resident from harm.
The Commissioner of the Department of Health can suspend admissions to a nursing home when conditions are detrimental to the health, safety or welfare of its residents. The order remains effective until all violations are corrected. The nursing home has a right to a hearing before the Board for Licensing Health Care Facilities or a judge.
THE RISING COST OF NURSING HOME CARE
I just finished reading an article in Virginia Business magazine about the ever increasing costs for nursing home care. The article’s title, “Retirement Dream Could Become a Nightmare” says it all!
The article reports the average daily rate for a private room in a Virginia nursing home is $133 while the maximum average daily rate is $205. The average annual rate for a private room in a Virginia nursing home is $61, 174. The national average rate is even higher at $74,806 per year.
Remember Medicare rarely pays for nursing home care and if it does pay, the payment period is less than 100 days. The lesson to be learned: BETTER START SAVING YOUR MONEY!
The article reports the average daily rate for a private room in a Virginia nursing home is $133 while the maximum average daily rate is $205. The average annual rate for a private room in a Virginia nursing home is $61, 174. The national average rate is even higher at $74,806 per year.
Remember Medicare rarely pays for nursing home care and if it does pay, the payment period is less than 100 days. The lesson to be learned: BETTER START SAVING YOUR MONEY!
CARLYLE TO PURCHASE MANOR CARE NURSING HOMES
The Washington Post newspaper reported yesterday that the Carlyle Group will purchase Manor Care, a nursing-home operator, for $6.3 billion, the latest in a recent string of multibillion-dollar deals involving the DC private-equity giant.
Manor Care, which traces its roots to a single nursing home in Wheaton 48 years ago, has grown into one of the largest providers of long-term care and services in the country, with nearly 60,000 employees in more than 500 facilities under the Heartland, ManorCare Health Services and Arden Courts brands.
My take on this purchase is that Carlyle, whose principals reportedly include George Bush, Sr., James Baker and a host of other conservative republicans, has no clue about health care much less the nursing home industry. Carlyle is out to make money and it will make a lot! So don’t believe it when your nursing home administrator tells you that he cannot hire more nurses because the money is just not available.
Read the Washington Post article.
Manor Care, which traces its roots to a single nursing home in Wheaton 48 years ago, has grown into one of the largest providers of long-term care and services in the country, with nearly 60,000 employees in more than 500 facilities under the Heartland, ManorCare Health Services and Arden Courts brands.
My take on this purchase is that Carlyle, whose principals reportedly include George Bush, Sr., James Baker and a host of other conservative republicans, has no clue about health care much less the nursing home industry. Carlyle is out to make money and it will make a lot! So don’t believe it when your nursing home administrator tells you that he cannot hire more nurses because the money is just not available.
Read the Washington Post article.
Monday, July 02, 2007
NURSING NEGLIGENCE: CASE REPORTS
Nurses Service Organization (NSO) is the nation's largest provider of nurses professional liability insurance coverage, with over 650,000 nursing professionals insured in the program today.
Take a look at this collection of paid claims involving nursing negligence or malpractice and reported by NSO.
Take a look at this collection of paid claims involving nursing negligence or malpractice and reported by NSO.
CASE REPORT: 45 YEAR OLD CALIFORNIA MAN AWARDED $11.7 MILLION
According to the LA Times, Joey Crumes, a 45 year old Californian, was awarded $11.7 million dollars in a lawsuit against ER physician, Andrew Lawson and radiologist Charles Aucreman. Crumes went to the emergency room at Mission Hospital complaining of a severe headache. Crumes told the doctors that several years before he had been operated on for cancer in his sinuses. The doctors ordered a CT scan but sent Crumes home with painkillers and told him to come back if his condition worsened. Five days later, Cumes collapsed into a coma and doctors discovered an infection that had spread to his brain. Crumes spent 11 months in the hospital after suffering a stroke.
In his lawsuit, a treating physician is quoted as saying that Crumes “was sent home with a time bomb in his head.”
See the full article here.
In his lawsuit, a treating physician is quoted as saying that Crumes “was sent home with a time bomb in his head.”
See the full article here.
NURSING HOMES MAKE MONEY?
We have written about it before, the difference between for-profit and non-profit health care. If your nursing home is "for profit" you have a legal duty towards your shareholders, to maximize profits. But what does that duty, do for your residents and staff?
Many for-profit nursing homes will tell us in depositions and discovery in a case, that they don't make that much money. Well - that may be true, but someone is making money. Here is an article I read this morning, about one Fortune 500 company (that owns and operates nursing homes) buying 22 under performing nursing homes from another facility.
As the article states,
"As previously announced, Kindred had entered into definitive agreements with Ventas to acquire 21 nursing centers and one long-term acute care hospital (collectively, the “Facilities”) for $171.5 million. In addition, Kindred paid a lease termination fee of $3.5 million. The current annual rents for the Facilities are approximately $10.3 million.
The Facilities, which contain 2,634 licensed nursing center beds and 220 licensed hospital beds, generated pretax losses of approximately $10 million for the year ended December 31, 2006. Upon closing, Kindred will account for the operations of the Facilities as discontinued operations.
Kindred expects to generate between $80 million and $90 million in proceeds from the sale of the Facilities and the related operations. Kindred expects to record a net loss of approximately $60 million to $70 million in the second quarter of 2007 relating to these divestitures. Kindred expects a total net (after tax) cash outlay of approximately $46 million to $52 million.
“We are focused on disposing of these facilities as soon as possible,” said Paul J. Diaz, President and Chief Executive Officer of the Company. “Completing this transaction allows us to divest of these operating losses and reposition our portfolio to focus on our cluster market strategic growth opportunities.”
WOW - what a business opportunity. Anyone ever think of the people that actually live there?
Many for-profit nursing homes will tell us in depositions and discovery in a case, that they don't make that much money. Well - that may be true, but someone is making money. Here is an article I read this morning, about one Fortune 500 company (that owns and operates nursing homes) buying 22 under performing nursing homes from another facility.
As the article states,
"As previously announced, Kindred had entered into definitive agreements with Ventas to acquire 21 nursing centers and one long-term acute care hospital (collectively, the “Facilities”) for $171.5 million. In addition, Kindred paid a lease termination fee of $3.5 million. The current annual rents for the Facilities are approximately $10.3 million.
The Facilities, which contain 2,634 licensed nursing center beds and 220 licensed hospital beds, generated pretax losses of approximately $10 million for the year ended December 31, 2006. Upon closing, Kindred will account for the operations of the Facilities as discontinued operations.
Kindred expects to generate between $80 million and $90 million in proceeds from the sale of the Facilities and the related operations. Kindred expects to record a net loss of approximately $60 million to $70 million in the second quarter of 2007 relating to these divestitures. Kindred expects a total net (after tax) cash outlay of approximately $46 million to $52 million.
“We are focused on disposing of these facilities as soon as possible,” said Paul J. Diaz, President and Chief Executive Officer of the Company. “Completing this transaction allows us to divest of these operating losses and reposition our portfolio to focus on our cluster market strategic growth opportunities.”
WOW - what a business opportunity. Anyone ever think of the people that actually live there?
MEDICAL ERRORS
Did you listen? The People's Pharmacy, a weekly NPR feature had a great show on this week about medical errors. To listen, and or order a copy of the show, click here.
The show's guests were Janet Lynn Mitchell, a patient’s right’s advocate and author of Taking A Stand. Her Web site is http://www.janetlynnmitchell.com/ and Pierce Scranton, MD, an orthopedic surgeon in private practice in Seattle, Washington. He has been team physician for the Seattle Seahawks and president of the American Orthopedic Foot and Ankle Society. He is author of a novel, Death on the Learning Curve. His Web site is: http://www.piercescranton.com/
The Surgeon on the show gave a great top ten list for what to ask your physician before accepting medical treatment. Here it is - I thought it was very helpful:
Here are Dr. Scranton's questions:
Top 10 Questions to Ask Your Doctor Before Accepting Medical Treatment
1. How long have you been in practice?
2. What is your experience in treating this condition?
3. What are the treatment options, and what other options are available that you or the health plan are not offering?
4. If you don’t understand the doctor’s basic explanation of your condition and treatment, then by all means ask him or her for more information.
5. What are the possible complications of the proposed medical treatments or surgeries?
6. If there are any complications, how will you correct the problem?
7. Aside from your own partners, who would you go to for medical treatment if you had this condition?
8. Are you personally going to perform the surgery?
9. Will others assist and participate, in a major way, in this medical treatment?
10. Can I ask your bookkeeper what my financial responsibility will be?
Click here to order a copy of this or any radio show from their secure online store.
The show's guests were Janet Lynn Mitchell, a patient’s right’s advocate and author of Taking A Stand. Her Web site is http://www.janetlynnmitchell.com/ and Pierce Scranton, MD, an orthopedic surgeon in private practice in Seattle, Washington. He has been team physician for the Seattle Seahawks and president of the American Orthopedic Foot and Ankle Society. He is author of a novel, Death on the Learning Curve. His Web site is: http://www.piercescranton.com/
The Surgeon on the show gave a great top ten list for what to ask your physician before accepting medical treatment. Here it is - I thought it was very helpful:
Here are Dr. Scranton's questions:
Top 10 Questions to Ask Your Doctor Before Accepting Medical Treatment
1. How long have you been in practice?
2. What is your experience in treating this condition?
3. What are the treatment options, and what other options are available that you or the health plan are not offering?
4. If you don’t understand the doctor’s basic explanation of your condition and treatment, then by all means ask him or her for more information.
5. What are the possible complications of the proposed medical treatments or surgeries?
6. If there are any complications, how will you correct the problem?
7. Aside from your own partners, who would you go to for medical treatment if you had this condition?
8. Are you personally going to perform the surgery?
9. Will others assist and participate, in a major way, in this medical treatment?
10. Can I ask your bookkeeper what my financial responsibility will be?
Click here to order a copy of this or any radio show from their secure online store.
Subscribe to:
Posts (Atom)
