Friday, August 31, 2007
ROANOKE PHARMACIST LOSES HER LICENSE
Read all about it here - http://docwatch.wordpress.com/2007/08/24/roanoke-pharmacist-gives-it-up/
Thursday, August 30, 2007
DEMENTIA LINKED TO OVARIAN SURGERY
My local paper printed an article from the AP yesterday, Early ovarian surgery linked to dementia By MALCOLM RITTER, AP Science Writer. Read the full article here.
Mr. Ritter writes that "women who have their ovaries removed before menopause run a heightened risk of developing dementia or other mental problems later in life - unless they take estrogen until age 50, a new study suggests."
"Hormone therapy has been linked to a greater risk of dementia and heart attacks when given to women after age 65. But recent research indicates that when given before menopause or just afterward, it doesn't raise heart attack risk and may protect against dementia.
The study did not include women who had ovaries removed as part of cancer treatment, and Rocca said the results do not apply to such women. The work was published Wednesday in the online edition of the journal Neurology."
SO - we are now left with a bad option, and another bad option. Run the risk of cancer or dementia, or both.
Overall, the study found impairment or dementia in 150 of 1,489 women who'd had ovaries removed, versus 98 of 1,472 women who hadn't. That indicates nearly a 50 percent increase in risk.
On the Net:
Neurology journal: http://www.neurology.org
Mr. Ritter writes that "women who have their ovaries removed before menopause run a heightened risk of developing dementia or other mental problems later in life - unless they take estrogen until age 50, a new study suggests."
"Hormone therapy has been linked to a greater risk of dementia and heart attacks when given to women after age 65. But recent research indicates that when given before menopause or just afterward, it doesn't raise heart attack risk and may protect against dementia.
The study did not include women who had ovaries removed as part of cancer treatment, and Rocca said the results do not apply to such women. The work was published Wednesday in the online edition of the journal Neurology."
SO - we are now left with a bad option, and another bad option. Run the risk of cancer or dementia, or both.
Overall, the study found impairment or dementia in 150 of 1,489 women who'd had ovaries removed, versus 98 of 1,472 women who hadn't. That indicates nearly a 50 percent increase in risk.
On the Net:
Neurology journal: http://www.neurology.org
Wednesday, August 29, 2007
AARP REPORT ON LONG TERM CARE
The American Association of Retired Persons (AARP) recently published its biennial report covering the many facets of long-term care and independent living in America. Published biennially since 1992 by the AARP Public Policy Institute, the Across the States series was developed to help inform policy discussions among public and private sector leaders in long-term care throughout the United States.
Here are some interesting facts about my home state of Virginia as of 2005:
o 28,652 Virginians resided in nursing homes
o 45% of those residents suffered from dementia
o Staffing was such that each resident was allotted 2 hours of time for CNA care per day
o 17% of Virginia’s nursing homes had deficiencies which caused actual harm or jeopardy to the residents
o 63% of residents depended upon Medicaid to pay the nursing home bill
o Medicaid paid $113 per day for nursing home care
o Medicare paid $264 per day for nursing home care
o Private pay rate was $187 per day for nursing home care (urban areas)
Read the full report here.
Here are some interesting facts about my home state of Virginia as of 2005:
o 28,652 Virginians resided in nursing homes
o 45% of those residents suffered from dementia
o Staffing was such that each resident was allotted 2 hours of time for CNA care per day
o 17% of Virginia’s nursing homes had deficiencies which caused actual harm or jeopardy to the residents
o 63% of residents depended upon Medicaid to pay the nursing home bill
o Medicaid paid $113 per day for nursing home care
o Medicare paid $264 per day for nursing home care
o Private pay rate was $187 per day for nursing home care (urban areas)
Read the full report here.
CENTER FOR MEDICARE AND MEDICAID SERVICES PROHIBITS DOCTOR SELF REFERRAL
On August 27, the Center for Medicare and Medicaid Services (CMS) issued final regulations prohibiting physicians from referring Medicare patients for certain items, services and tests provided by businesses in which they or their immediate family members have a financial interest.
These rules protect beneficiaries from receiving services they may not need and the Medicare program from paying potentially unnecessary costs.
Read the CMS Press Release.
These rules protect beneficiaries from receiving services they may not need and the Medicare program from paying potentially unnecessary costs.
Read the CMS Press Release.
2006 SURVEY OF NURSING HOME WORKFORCE SATISFACTION
We get a magazine called NURSING HOMES, Long Term Care Management - a periodical written for long term care administrators. This month, in their monthly section called A VIEW ON WASHINGTON, the magazine cites a 2006 sruvey done by MyInnerView, taken of current long term care employees, regarding job satisfaction etc. While 60% of employees in nursing homes rate their employment as good or excellent, the survey reflects the following statements by the staff.
Priority items cited by Nursing Aids or Assistants: (1) Help with Job Stress or Burnout; (2) Management Listens; (3) Management cares; (4) Supervisor appreciates; (5) adequate equipment / supplies. Wow. Difficult job, low pay, and if you feel you do not have the proper tools and or corporate support, how long could you last as a CNA in a nursing home? I imagine not very long. And I think my conclusion is correct given the survey also found that 1/3 of all nursing home employees had been employed in long term care for less than two years. This reflects pretty high turnover.
There may be a solution - MORE NURSES AND BETTER PAY. I think it's a good place to start. Sadly, then the coporate owners would make less money for their families or shareholders. Too bad that $ again dictates level of care...
Priority items cited by Nursing Aids or Assistants: (1) Help with Job Stress or Burnout; (2) Management Listens; (3) Management cares; (4) Supervisor appreciates; (5) adequate equipment / supplies. Wow. Difficult job, low pay, and if you feel you do not have the proper tools and or corporate support, how long could you last as a CNA in a nursing home? I imagine not very long. And I think my conclusion is correct given the survey also found that 1/3 of all nursing home employees had been employed in long term care for less than two years. This reflects pretty high turnover.
There may be a solution - MORE NURSES AND BETTER PAY. I think it's a good place to start. Sadly, then the coporate owners would make less money for their families or shareholders. Too bad that $ again dictates level of care...
NURSING HOME AIDE SENTENCED FOR SCALDING INCIDENT
A former Tulsa, Oklahoma nursing home aide has been sentenced to six years in prison for scalding two disabled residents. Paula Drew was a nurse's aide at the Green Park Nursing and Rehab Center. She allegedly placed each resident in an overheated shower last March without checking the water temperature. Both residents suffered severe burns. Read the story here.
Read a more complete report here.
Read a more complete report here.
WHAT'S IN A NAME?
No, I am not talking about Shakespeare... I am talking about the names of various medical diagnosis - Dementia / Alzheimer's Disease / Depression. What to these names mean, and do we use them inappropriately?
Dan and I put on a seminar this Monday with a local Geriactric physician, Dr. Gary Oberlender. Dr. Oberlender shared with the group that yes, these terms may be used inappropriately. He also discussed the very detailed analysis required to diagnose Dementia and/or Alzheimer's Disease correctly. I think you would be amazed at what is required to properly diagnose someone. For more information, check our Dr. Oberlender's website - www.seniorevaluations.com. How can you treat someone correctly, if they haven't been correctly diagnosed? I think you know the answer to that question, you can't.
Dan and I put on a seminar this Monday with a local Geriactric physician, Dr. Gary Oberlender. Dr. Oberlender shared with the group that yes, these terms may be used inappropriately. He also discussed the very detailed analysis required to diagnose Dementia and/or Alzheimer's Disease correctly. I think you would be amazed at what is required to properly diagnose someone. For more information, check our Dr. Oberlender's website - www.seniorevaluations.com. How can you treat someone correctly, if they haven't been correctly diagnosed? I think you know the answer to that question, you can't.
Tuesday, August 28, 2007
FORCING IN DOWN
I have been trying to read a Virginia Blog every week - docwatch - today, the author reports about a south west Virginia nurse who recently lost her license (in June) when she forced liquids into a nursing home resident, while restraining the resident - the result, the resident started vomiting and had to be taken to the E.R. at Carillion Giles Memorial Hospital. Sylvester resigned before she was fired. Her license was revoked two years later - WHAT, IT TOOK THAT LONG?
MICHIGAN NURSING HOME PAYS FINE
Northfield Place, a nursing home in the Whitmore Lake area, was one of four Michigan nursing homes under investigation for allegations of health care fraud and poor patient care, state and federal authorities said this week. Ciena Healthcare Management, the company that owns the four nursing homes and 26 others in Michigan, entered into a settlement agreement announced Monday. It includes repaying $1.25 million to Medicare and Medicaid and agreeing to outside monitoring.
When will nursing homes realize they cannot charge for services they do not provide? I call it fraud!
Read more about the story.
When will nursing homes realize they cannot charge for services they do not provide? I call it fraud!
Read more about the story.
WIDESPREAD NEGLECT LEADS TO MULITPLE CRIMINAL CHARGES
A former nursing home employee in Rochester, New York, became the 12th person to admit neglecting an elderly patient with dementia. Certified nurse’s assistant (CNA) Marguerite Carrington, 49, pleaded guilty to the misdemeanors of second-degree falsifying business records and willful violation of health laws in connection with neglect of a patient at the former Jennifer Matthew Nursing and Rehabilitation Center.
The New York Attorney General’s Office conducted an investigation into complaints of patient neglect and gathered evidence by, among other things, placing a hidden camera in the patient’s room.
Bravo!
Read more on the story.
The New York Attorney General’s Office conducted an investigation into complaints of patient neglect and gathered evidence by, among other things, placing a hidden camera in the patient’s room.
Bravo!
Read more on the story.
TENNESSEE RESIDENT FOUND TO HAVE MAGGOTS
It doesn’t get any more disgusting than this! A Tennessee Health Department investigation has revealed that a 91-year-old patient at Lakebridge Health Care Center in Johnson City had maggots in her ear because of a hygiene problem at the facility. Records show the unnamed woman suffered from dementia and needed assistance with dressing, eating and bathing.
The nursing home’s staff had not washed her hair since July 23…when they found the maggots on August 4. The state Health Department found the home deficient in providing daily hygiene to patients and is requiring a plan of action to fix the problem.
A Lakebridge administrator says that the woman did have her hair washed regularly, but that staff had failed to record it. There is a saying in health care that goes, “if it isn’t charted in the patient’s records it didn’t happen.”
The resident was taken to a local hospital emergency room for treatment. Follow the story.
The nursing home’s staff had not washed her hair since July 23…when they found the maggots on August 4. The state Health Department found the home deficient in providing daily hygiene to patients and is requiring a plan of action to fix the problem.
A Lakebridge administrator says that the woman did have her hair washed regularly, but that staff had failed to record it. There is a saying in health care that goes, “if it isn’t charted in the patient’s records it didn’t happen.”
The resident was taken to a local hospital emergency room for treatment. Follow the story.
Sunday, August 26, 2007
NURSING HOME / LONG TERM CARE SEMINAR TOMORROW - MONDAY, AUG. 27, 2007
Roanoke, VA – Seminar, Open to the public, August 27, 2007 at 2:00pm at the Higher Education Center, downtown Roanoke. Topics to include:
- Resident’s Rights – What rights you loved one has in a Nursing Home;
- The Seven Deadly Sins of Nursing Homes (Common patient errors and what you can do to prevent them); and
- Diagnosing Dementia in Seniors – Essentials of a Complete Medical Evaluation.
The Event is open to the public, refreshments will be served. Sponsored by Gary Oberlender, MD and The Frith Law Firm. Questions, call Frith Law Firm 985-0098.
PLEASE COME - IT SHOULD BE A GREAT AND INFORMATIVE EVENT
Wednesday, August 22, 2007
WHY CAN’T I HAVE ACCESS TO EXPERIMENTAL DRUGS?
On August 20, the Wall Street Journal published letters to the editor addressing a previously published opinion piece by Ronald Trowbridge, an adjunct scholar with the Abigail Alliance, and Steven Walker, co-founder of the Alliance, about a decision earlier this month by the U.S. Court of Appeals for the District of Columbia Circuit. The court held that terminally ill patients do not have the right to obtain access to unapproved experimental drugs that potentially are lifesaving.
According to Trowbridge and Walker, the Abigail Alliance, which filed the lawsuit against the Food and Drug Administration (FDA) in 2003, has pushed for access to 12 experimental drugs that if "available to people denied entry to clinical trials" might have "helped more than one million mothers, fathers, sons and daughters live longer, better lives"
I say bravo to the Abigail Alliance! Can anyone tell me why, when faced with certain death, I should be prohibited from knowingly assuming the risks of unproven treatment which might allow me to live?
According to Trowbridge and Walker, the Abigail Alliance, which filed the lawsuit against the Food and Drug Administration (FDA) in 2003, has pushed for access to 12 experimental drugs that if "available to people denied entry to clinical trials" might have "helped more than one million mothers, fathers, sons and daughters live longer, better lives"
I say bravo to the Abigail Alliance! Can anyone tell me why, when faced with certain death, I should be prohibited from knowingly assuming the risks of unproven treatment which might allow me to live?
Tuesday, August 21, 2007
"I AM SORRY" GOES A LONG WAY!
Apologies Gaining Favor in Medical Community
In a departure from past practices, doctors are increasingly admitting medical errors and making apologies for their mistakes. Advocates of the practice say acknowledging errors helps increase patient satisfaction and may cut back on medical malpractice lawsuits. Still, many hospitals and most insurance companies insist that doctors cease all communication with patients after a mistake has been made. Judith Graham, Chicago Tribune 08/19/2007
Read Article.
In a departure from past practices, doctors are increasingly admitting medical errors and making apologies for their mistakes. Advocates of the practice say acknowledging errors helps increase patient satisfaction and may cut back on medical malpractice lawsuits. Still, many hospitals and most insurance companies insist that doctors cease all communication with patients after a mistake has been made. Judith Graham, Chicago Tribune 08/19/2007
Read Article.
RESIDENT’S DEATH REMAINS UNDER INVESTIGATION
A Pennsylvania nursing home resident who died days after a fall has been identified as a 64-year-old woman. Judith Bliger, of Blair County, fell out of a mechanical lift at Laurel Crest Nursing Home earlier this month. She was treated and released from the hospital immediately following the incident. She died three days later.
Sadly, the Laurel Crest Nursing Home had been operating under a provisional license because of several deficiencies within the facility. One of those deficiencies included the care home's lifting procedures.
Follow the story here.
Sadly, the Laurel Crest Nursing Home had been operating under a provisional license because of several deficiencies within the facility. One of those deficiencies included the care home's lifting procedures.
Follow the story here.
Monday, August 20, 2007
MEDICARE WILL NOT PAY FOR PREVENTABLE INJURIES
This was reported in the New York Times yesterday:
“WASHINGTON, Aug. 18 — In a significant policy change, Bush administration officials say that Medicare will no longer pay the extra costs of treating preventable errors, injuries and infections that occur in hospitals, a move they say could save lives and millions of dollars.
Private insurers are considering similar changes, which they said could multiply the savings and benefits for patients."
Under the new rules, to be published next week, Medicare will not pay hospitals for the costs of treating certain “conditions that could reasonably have been prevented.”
"Among the conditions that will be affected are bedsores, injuries caused by falls, and infections resulting from the prolonged use of catheters in blood vessels or the bladder.”
The whole article can be read at http://www.nytimes.com/ if you have a subscription. Well, our friends across the United States are nervous as to what this means, and with good reason. Does it mean if Medicare won't pay, the patient will be denied care? Will the hospital then have a lein on care provided because they, and not medicare paid for it? Will the hospitals take a reduced amount like Medicare does, or will our personal injury clients have to pay 100% back for care required as a result of someone else's negligence? Will the fact that Medicare refuses, be a statement of negligence, admissible in court? So many questions, yet to be resolved. It certainly means a more complicated system, and much more work for our office - and sadly, it could mean much more!
“WASHINGTON, Aug. 18 — In a significant policy change, Bush administration officials say that Medicare will no longer pay the extra costs of treating preventable errors, injuries and infections that occur in hospitals, a move they say could save lives and millions of dollars.
Private insurers are considering similar changes, which they said could multiply the savings and benefits for patients."
Under the new rules, to be published next week, Medicare will not pay hospitals for the costs of treating certain “conditions that could reasonably have been prevented.”
"Among the conditions that will be affected are bedsores, injuries caused by falls, and infections resulting from the prolonged use of catheters in blood vessels or the bladder.”
The whole article can be read at http://www.nytimes.com/ if you have a subscription. Well, our friends across the United States are nervous as to what this means, and with good reason. Does it mean if Medicare won't pay, the patient will be denied care? Will the hospital then have a lein on care provided because they, and not medicare paid for it? Will the hospitals take a reduced amount like Medicare does, or will our personal injury clients have to pay 100% back for care required as a result of someone else's negligence? Will the fact that Medicare refuses, be a statement of negligence, admissible in court? So many questions, yet to be resolved. It certainly means a more complicated system, and much more work for our office - and sadly, it could mean much more!
35 RESIDENTS DEAD: NEW ORLEANS NURSING HOME TRIAL BEGINS
USA Today reports that owners of the St. Rita nursing home in St. Bernard Parish, a New Orleans-area nursing home, ignored televised and government warnings of the growing strength of Hurricane Katrina and failed to evacuate 59 frail, elderly residents which resulted in the deaths of 35, a prosecutor told a jury last week.
The residents, some strapped to their beds or attached to feeding tubes, drowned when floodwaters poured into the St. Rita nursing home in St. Bernard Parish, just east of New Orleans. It was one of the deadliest events of the Aug. 29, 2005 storm.
Follow the case here.
The residents, some strapped to their beds or attached to feeding tubes, drowned when floodwaters poured into the St. Rita nursing home in St. Bernard Parish, just east of New Orleans. It was one of the deadliest events of the Aug. 29, 2005 storm.
Follow the case here.
NURSING HOME NURSING HOME RESIDENTS AT HIGHEST RISK FOR HEATSTROKE
These are certainly the “Dog Days of Summer!” Temperatures in the 90s and 100s have been common throughout much of the nation the last few weeks. It is important to keep in mind the elderly during these particularly hot days as they are more susceptible than most people to dehydration and other heat-related complications.
Heatstroke can be a serious complication during this period of record temperatures and may be most lethal for people who live in nursing homes or take medication to lower their blood pressure, a French study finds. Heatstroke, which results from exposure to high temperatures, is "defined by an elevated core body temperature above 40 degrees Celsius (104 degrees Fahrenheit), associated with central nervous system abnormalities," the study authors wrote.
They looked at the survival rates and outcomes of 83 heatstroke patients hospitalized in the city of Lyon during a severe heat wave that struck Europe in 2003. Estimates of the death toll ranged from 22,000 to more than 70,000 people.
Read more here.
Heatstroke can be a serious complication during this period of record temperatures and may be most lethal for people who live in nursing homes or take medication to lower their blood pressure, a French study finds. Heatstroke, which results from exposure to high temperatures, is "defined by an elevated core body temperature above 40 degrees Celsius (104 degrees Fahrenheit), associated with central nervous system abnormalities," the study authors wrote.
They looked at the survival rates and outcomes of 83 heatstroke patients hospitalized in the city of Lyon during a severe heat wave that struck Europe in 2003. Estimates of the death toll ranged from 22,000 to more than 70,000 people.
Read more here.
Sunday, August 19, 2007
GOOD RESOURCE
Looking for a nursing home? How do you find one? What do you look for?
AARP has great resources on their website - read more here.
AARP has great resources on their website - read more here.
Friday, August 17, 2007
CASE REPORT: DEATH FROM MRSA RESULTS IN MILLION DOLLAR VERDICT
This case report comes from Maryland. The patient, 27 years old, was taken to the hospital by his mother due to feeling ill. He was admitted to the hospital and the emergency room doctor called the patient’s internist to advise him of the admission and his patient’s condition. A doctor in training at the hospital made a second call to the internist, also advising the doctor of his patient’s condition.
The patient’s parents remained with him throughout his admission. Their son’s condition worsened and, at one point, he lost consciousness while using the bathroom. After six hours passed without their son being examined by a doctor, the parents alerted the nurses to the fact that their son’s fingers and toes were turning blue. A nurse immediately notified 3 physicians who administered intravenous Vancomycin (an antibiotic). This treatment was unsuccessful and the patient died from septic shock due to a MRSA (Methicillin Resistant Staphylococcus Aureus) infection. The internist never came to the hospital.
A wrongful death medical negligence suit (Estate of Adrian Bennett v. Shoaib A. Hashmi, MD) was filed by the parents against the internist and the jury awarded the family a verdict of over $2 million.
What a senseless (and preventable) loss of life!
The patient’s parents remained with him throughout his admission. Their son’s condition worsened and, at one point, he lost consciousness while using the bathroom. After six hours passed without their son being examined by a doctor, the parents alerted the nurses to the fact that their son’s fingers and toes were turning blue. A nurse immediately notified 3 physicians who administered intravenous Vancomycin (an antibiotic). This treatment was unsuccessful and the patient died from septic shock due to a MRSA (Methicillin Resistant Staphylococcus Aureus) infection. The internist never came to the hospital.
A wrongful death medical negligence suit (Estate of Adrian Bennett v. Shoaib A. Hashmi, MD) was filed by the parents against the internist and the jury awarded the family a verdict of over $2 million.
What a senseless (and preventable) loss of life!
GASTROINTESTINAL OUTBREAK AT NORTH CAROLINA NURSING HOME
It seems you cannot go a month without reading or hearing about a widespread outbreak of the norovirus or other gastrointestinal disease in a nursing home. My opinion is that these preventable outbreaks are the result of unclean facilities and a staff/administration not adequately trained to quickly identify an ill resident and how to prevent the spread of the illness to others. Just basic hand washing and use of gloves would help!
Well, here we go again. The Jesse Helms Nursing Center near Charlotte, North Carolina is under a self-imposed quarantine after 13 residents and three staff members fell ill with symptoms of a gastrointestinal virus. The nursing home is operated by the Carolinas Medical Center-Union, which runs the 70-bed facility.
Read the news report here.
Well, here we go again. The Jesse Helms Nursing Center near Charlotte, North Carolina is under a self-imposed quarantine after 13 residents and three staff members fell ill with symptoms of a gastrointestinal virus. The nursing home is operated by the Carolinas Medical Center-Union, which runs the 70-bed facility.
Read the news report here.
GREAT BLOG
I just came across this great blog today - http:// docwatch.wordpress.com - its a Doctor's Watch Blog. One recent post/article, is on nursing home nurses receiving expensive gifts from residents. Hmm, sounds a little fishy to me. Great blog - I would check it out.
NURSING HOME ON TRIAL
Two years later, we still hear about Hurricane Katrina and its lasting effect on so many. Today, I woke up to a news cast on a New Orleans Nursing Home that refused to evacuate residents, despite numerous warnings. The result? Thirty Five elderly residents, unable to leave on their own, drowned in the wheelchairs and beds. Who knows how many civil suits have been filed, but the trial this week, is criminal. Now, the defense will likely argue the facility did not have warning or appropriate tools to evacuate. They may even point the finger to the Federal Government's response, or the Corp's failure to enforce the levys, or FEMA etc. But if other facilities in town knew to evacuate, and did it successfully, will those excuses fly?
We have horrific nursing home cases all the time where residents are killed as a result of negligence - falls, bedsores, malnutrition... but to let 35 people drown. That makes me ill, and hopeful that the New Orleans jury is paying attention. We will keep you posted on the outcome. Read details about the case here.
We have horrific nursing home cases all the time where residents are killed as a result of negligence - falls, bedsores, malnutrition... but to let 35 people drown. That makes me ill, and hopeful that the New Orleans jury is paying attention. We will keep you posted on the outcome. Read details about the case here.
Thursday, August 16, 2007
USA TODAY: AMERICANS HEADED TO MEXICAN NURSING HOMES
I reported several days ago about a family who decided to send their aging parents to India to receive better nursing home care at lower cost. Well, it appears some Americans are just driving across our southern border to Mexico for the same reason.
USA Today reports that more and more elderly Americans are moving to Mexico. An estimated 40,000 to 80,000 American retirees already live in Mexico, many of them in enclaves like San Miguel de Allende or the Chapala area, says David Warner, a University of Texas public affairs professor who has studied the phenomenon.
As millions of baby boomers reach retirement age and U.S. health care costs soar, Mexican nursing home managers expect more American seniors to head south in coming years. Mexico's proximity to the USA, low labor costs and warm climate make it attractive, although residents caution that quality of care varies greatly in an industry that is just getting off the ground here.
Read the article here.
USA Today reports that more and more elderly Americans are moving to Mexico. An estimated 40,000 to 80,000 American retirees already live in Mexico, many of them in enclaves like San Miguel de Allende or the Chapala area, says David Warner, a University of Texas public affairs professor who has studied the phenomenon.
As millions of baby boomers reach retirement age and U.S. health care costs soar, Mexican nursing home managers expect more American seniors to head south in coming years. Mexico's proximity to the USA, low labor costs and warm climate make it attractive, although residents caution that quality of care varies greatly in an industry that is just getting off the ground here.
Read the article here.
Wednesday, August 15, 2007
TENNESSE NURSING HOME SANCTIONED
The state Department of Health suspended admissions at a Hartsville, Tenn., nursing home for numerous violations found during an investigation and annual inspection. Sun Valley Home for the Aged, a 15-bed facility, can no longer admit new patients until the conditions are corrected, according to a release from the Tennessee Health Commissioner, Susan R. Cooper.
Specific deficiencies included the failure of administration and staff to ensure physician's orders were followed for wound care, among other problems. Follow the story here.
Specific deficiencies included the failure of administration and staff to ensure physician's orders were followed for wound care, among other problems. Follow the story here.
SECOND ROCHESTER NURSE PLEADS GUILITY IN NURSING HOME CASE
We wrote a short blog yesterday about a nursing aide pleading guilty to criminal neglect in a Rochester, New York nursing home, the Jennifer Matthew Nursing and Rehabilitation Center. Well… it looks like another former nursing home employee has now pleaded guilty to neglecting a 70-year-old patient with dementia. Sounds like a bad situation to me!
Registered nurse Nada Jadrovska, 53, pleaded guilty to misdemeanors of second-degree falsifying business records and willful violation of health laws for neglecting the patient in the spring of 2005 at the former Jennifer Matthew Nursing and Rehabilitation Center on Portland Avenue.
Read the news report here.
Registered nurse Nada Jadrovska, 53, pleaded guilty to misdemeanors of second-degree falsifying business records and willful violation of health laws for neglecting the patient in the spring of 2005 at the former Jennifer Matthew Nursing and Rehabilitation Center on Portland Avenue.
Read the news report here.
Tuesday, August 14, 2007
DIAGNOSING BIAS IN DOCTORS
Washington Post Staff writer, Shankar Vedantam wrote in yesterday's Washington Post
"Long before word recently broke that white referees in the National Basketball Association were calling fouls at a higher rate on black athletes than on white athletes, and long before studies found racial disparities in how black and white applicants get called for job interviews, researchers noted differences in the most troubling domain of all -- disparities in survival and health among people belonging to different racial groups.
Black babies, according to the federal government's Centers for Disease Control and Prevention, have higher death rates than white babies. Black women are more than twice as likely as white women to die of cervical cancer. And in 2000, the death rate from heart disease was 29 percent higher among African Americans than among white adults, and the death rate from stroke was 40 percent higher.
The trouble with all these numbers, as with the NBA study -- which was conducted by researchers Justin Wolfers and Joseph Price -- is that they do not explain why such differences exist among racial groups.
Some studies have shown, similar to the NBA analysis, that diagnoses and treatments offered by physicians vary between racial groups, for diseases as dissimilar as heart disease and schizophrenia. But does this reflect physician bias, or the possibility that patients from different backgrounds present themselves differently? Could race be a marker for some other variable that really matters, such as health insurance status?
A new study by researchers at Massachusetts General Hospital and other institutions affiliated with Harvard University provides empirical evidence for the first time that when it comes to heart disease, bias is the central problem -- bias so deeply internalized that people are sincerely unaware that they hold it.
Physicians who were more racially biased were less likely to prescribe aggressive heart-attack treatment for black patients than for whites. The study was recently published in the Journal of General Internal Medicine.
The research finding cannot be automatically extrapolated to the NBA or other domains, but it does suggest a mechanism by which disparities emerge. No conscious bias was apparently present -- there was no connection between the explicit racial views of physicians and disparities in their diagnoses. It was only when researchers studied physicians' implicit attitudes -- by measuring how quickly they made positive or negative mental associations with blacks and whites -- that they found a mechanism to explain differences in medical judgment.
"Physicians who had higher biases against blacks were less likely to recommend thrombolysis for blacks," said Alexander R. Green, the study's chief investigator and a faculty member at the Disparities Solutions Center at Massachusetts General Hospital.
Thrombolysis is a clot-busting technique given when doctors suspect that a patient is having a heart attack. It is not to be given lightly, which is why a physician's judgment is crucial in telling patients who are merely having aches and pains apart from patients at death's door.
Green had 287 physicians at four academic medical centers in Boston and Atlanta take a psychological test for bias. He followed it up by providing a case study of a 50-year-old man called "Mr. Thompson," a smoker with a history of hypertension, "who presents to the emergency department with chest pain. He appears to be in a lot of pain describing it as 'sharp, like being stabbed with a knife.' "
The patient was described to some physicians as white and to others as black. Physicians were asked to decide whether the pain was the result of coronary artery disease and whether to prescribe clot-busting drugs.
Doctors were more likely to think "Mr. Thompson" was having a heart attack when he was black than when he was white. But they did not prescribe treatment to reflect this -- physicians who thought a black Mr. Thompson was having a heart attack prescribed thrombolysis less often than when they thought a white Mr. Thompson was having one.
Green said numerous other studies are underway to evaluate the utility of psychological tests for bias to explain disparities in medical domains. "We have reason to suspect you can measure unconscious bias among physicians and show it has an impact on treatment decisions," he said.
Mahzarin Banaji, a co-author and Harvard psychologist who helped develop the Implicit Association Test used in this study, said the racial bias unearthed by the study is at odds with conventional views of bigotry -- and perhaps more insidious. Rather than harboring deliberate ill will, she said, the physicians had apparently internalized racial stereotypes, and these attitudes subtly influenced their medical judgment without their even realizing it.
The study of physicians had one hopeful note, Banaji said: Doctors at least were willing to open their subconscious minds for inspection, which is something that many other professionals -- judges, police officers and NBA referees -- rarely are willing to do."
WOW... That is a bold article, and a sad one.
"Long before word recently broke that white referees in the National Basketball Association were calling fouls at a higher rate on black athletes than on white athletes, and long before studies found racial disparities in how black and white applicants get called for job interviews, researchers noted differences in the most troubling domain of all -- disparities in survival and health among people belonging to different racial groups.
Black babies, according to the federal government's Centers for Disease Control and Prevention, have higher death rates than white babies. Black women are more than twice as likely as white women to die of cervical cancer. And in 2000, the death rate from heart disease was 29 percent higher among African Americans than among white adults, and the death rate from stroke was 40 percent higher.
The trouble with all these numbers, as with the NBA study -- which was conducted by researchers Justin Wolfers and Joseph Price -- is that they do not explain why such differences exist among racial groups.
Some studies have shown, similar to the NBA analysis, that diagnoses and treatments offered by physicians vary between racial groups, for diseases as dissimilar as heart disease and schizophrenia. But does this reflect physician bias, or the possibility that patients from different backgrounds present themselves differently? Could race be a marker for some other variable that really matters, such as health insurance status?
A new study by researchers at Massachusetts General Hospital and other institutions affiliated with Harvard University provides empirical evidence for the first time that when it comes to heart disease, bias is the central problem -- bias so deeply internalized that people are sincerely unaware that they hold it.
Physicians who were more racially biased were less likely to prescribe aggressive heart-attack treatment for black patients than for whites. The study was recently published in the Journal of General Internal Medicine.
The research finding cannot be automatically extrapolated to the NBA or other domains, but it does suggest a mechanism by which disparities emerge. No conscious bias was apparently present -- there was no connection between the explicit racial views of physicians and disparities in their diagnoses. It was only when researchers studied physicians' implicit attitudes -- by measuring how quickly they made positive or negative mental associations with blacks and whites -- that they found a mechanism to explain differences in medical judgment.
"Physicians who had higher biases against blacks were less likely to recommend thrombolysis for blacks," said Alexander R. Green, the study's chief investigator and a faculty member at the Disparities Solutions Center at Massachusetts General Hospital.
Thrombolysis is a clot-busting technique given when doctors suspect that a patient is having a heart attack. It is not to be given lightly, which is why a physician's judgment is crucial in telling patients who are merely having aches and pains apart from patients at death's door.
Green had 287 physicians at four academic medical centers in Boston and Atlanta take a psychological test for bias. He followed it up by providing a case study of a 50-year-old man called "Mr. Thompson," a smoker with a history of hypertension, "who presents to the emergency department with chest pain. He appears to be in a lot of pain describing it as 'sharp, like being stabbed with a knife.' "
The patient was described to some physicians as white and to others as black. Physicians were asked to decide whether the pain was the result of coronary artery disease and whether to prescribe clot-busting drugs.
Doctors were more likely to think "Mr. Thompson" was having a heart attack when he was black than when he was white. But they did not prescribe treatment to reflect this -- physicians who thought a black Mr. Thompson was having a heart attack prescribed thrombolysis less often than when they thought a white Mr. Thompson was having one.
Green said numerous other studies are underway to evaluate the utility of psychological tests for bias to explain disparities in medical domains. "We have reason to suspect you can measure unconscious bias among physicians and show it has an impact on treatment decisions," he said.
Mahzarin Banaji, a co-author and Harvard psychologist who helped develop the Implicit Association Test used in this study, said the racial bias unearthed by the study is at odds with conventional views of bigotry -- and perhaps more insidious. Rather than harboring deliberate ill will, she said, the physicians had apparently internalized racial stereotypes, and these attitudes subtly influenced their medical judgment without their even realizing it.
The study of physicians had one hopeful note, Banaji said: Doctors at least were willing to open their subconscious minds for inspection, which is something that many other professionals -- judges, police officers and NBA referees -- rarely are willing to do."
WOW... That is a bold article, and a sad one.
NURSING HOME WORKER ADMITS NEGLECT
The use of video cameras or “granny cams” to record poor care in nursing homes is a good thing! An ex-employee of a Rochester, New York nursing home has admitted she neglected a patient in a case that included the use of a hidden camera. Tammy Devos, 43, who worked as a certified nurse’s aide at the former Jennifer Matthew Nursing and Rehabilitation Center, pleaded guilty to the misdemeanors of second-degree falsifying business records and willful violation of health laws.
According to court documents, the 70-year-old patient, who suffered from dementia, was not turned regularly, was allowed to lie in his own waste, and was not given adequate food or hydration. False entries were made in the patient’s records to show that proper care was given.
Nine other former employees pleaded guilty to misdemeanors and received probation. The employees were charged after an investigation by the state Attorney General’s Office that involving putting a hidden camera in a patient’s room in the spring of 2005.
Read the news report here.
According to court documents, the 70-year-old patient, who suffered from dementia, was not turned regularly, was allowed to lie in his own waste, and was not given adequate food or hydration. False entries were made in the patient’s records to show that proper care was given.
Nine other former employees pleaded guilty to misdemeanors and received probation. The employees were charged after an investigation by the state Attorney General’s Office that involving putting a hidden camera in a patient’s room in the spring of 2005.
Read the news report here.
Monday, August 13, 2007
EVERY STATE IS DIFFERENT
Most conservatives would say that state, not federal law, should address issues such as tort reform, medical malpractice, legal procedure etc. I agree these issues should not be decided in Washington, but a close examination of state laws reveals how very different we are.
In Virginia, you can file a Medical Malpractice lawsuit without having supporting experts. You cannot however, serve the lawsuit (which means start the clock) without having your experts certify in writing, that the defendant was negligent and that his/her negligence caused harm to your client.
West Virginia and Maryland both go much further and require the plaintiff to provide a written opinion by the experts, before you can even file or serve the lawsuit. This puts the defendant in a great position strategically - they get to see all of the plaintiff's cards before the case even begins.
I read this morning that other states are going in the opposite direction. Arkansas just found that requiring expert certification before one could proceed with a medical malpractice lawsuit, was unconstitutional. The court's reasoning was based on the financial burden on the plaintiff in having to hire experts in order to access the courts. Apparently Oklahoma has done the same thing.
The cost of litigation is a very real consideration for all plaintiffs, and certainly discourages filing even valid lawsuits. Is there a solution? I don't see an easy one. Defense attorneys claim that frivolous lawsuits drive up the cost of healthcare, and that requiring pre-litigation expert certifications is one minor step at weeding out frivolous suits. Plaintiffs however, know all to well that valid cases will never be pursued because average working families don't have $30,000 set aside for malpractice experts.
Just another example of our courts being inconsistent.
In Virginia, you can file a Medical Malpractice lawsuit without having supporting experts. You cannot however, serve the lawsuit (which means start the clock) without having your experts certify in writing, that the defendant was negligent and that his/her negligence caused harm to your client.
West Virginia and Maryland both go much further and require the plaintiff to provide a written opinion by the experts, before you can even file or serve the lawsuit. This puts the defendant in a great position strategically - they get to see all of the plaintiff's cards before the case even begins.
I read this morning that other states are going in the opposite direction. Arkansas just found that requiring expert certification before one could proceed with a medical malpractice lawsuit, was unconstitutional. The court's reasoning was based on the financial burden on the plaintiff in having to hire experts in order to access the courts. Apparently Oklahoma has done the same thing.
The cost of litigation is a very real consideration for all plaintiffs, and certainly discourages filing even valid lawsuits. Is there a solution? I don't see an easy one. Defense attorneys claim that frivolous lawsuits drive up the cost of healthcare, and that requiring pre-litigation expert certifications is one minor step at weeding out frivolous suits. Plaintiffs however, know all to well that valid cases will never be pursued because average working families don't have $30,000 set aside for malpractice experts.
Just another example of our courts being inconsistent.
NEW ORLEANS: CRIMINAL TRAIL AGAINST NURSING HOME OWNERS SET TO BEGIN
This one is going to be interesting! The owners of a nursing home where 35 patients died amid flash flooding during Hurricane Katrina are set to stand trial today on negligent homicide charges.
The owners of St. Rita's Nursing Home, Salvador and Mabel Mangano, are the only individuals charged with the responsibility of deaths from the storm. The Manganos face 35 counts of negligent homicide and 24 counts of cruelty to the elderly or infirm.
Follow the story on ABC News.
The owners of St. Rita's Nursing Home, Salvador and Mabel Mangano, are the only individuals charged with the responsibility of deaths from the storm. The Manganos face 35 counts of negligent homicide and 24 counts of cruelty to the elderly or infirm.
Follow the story on ABC News.
Sunday, August 12, 2007
RESIDENT’S DEATH BRING SANCTIONS FOR MARYLAND NURSING HOME
Here is another sad report of a nursing home elopement. Milford Manor Nursing Home, located in Pikesville, Maryland, has been fined $65,000 and barred from training nurse's aides for two years following the disappearance and death of an 82-year-old Alzheimer's patient.
The resident, Semen Binder, walked away unnoticed on the evening of July 7. Searchers found his body five days later in a wooded area less than half a mile from the home.
A subsequent investigation by the state revealed "multiple unsecured and unsupervised exits as well as multiple residents assessed by the facility to be 'wanderers' and potential elopement risks." Facility administration confirmed they did not have practices in place to prevent residents with cognitive impairments from wandering out of the building. Read the news report here.
Can someone tell me why this problem continues to exist?
The resident, Semen Binder, walked away unnoticed on the evening of July 7. Searchers found his body five days later in a wooded area less than half a mile from the home.
A subsequent investigation by the state revealed "multiple unsecured and unsupervised exits as well as multiple residents assessed by the facility to be 'wanderers' and potential elopement risks." Facility administration confirmed they did not have practices in place to prevent residents with cognitive impairments from wandering out of the building. Read the news report here.
Can someone tell me why this problem continues to exist?
Friday, August 10, 2007
A NEW NURSING HOME FOR PITTSYLVANIA COUNTY, VIRGINIA
The Danville Register and Bee is reporting that a new nursing home has been approved for Chatham, Virginia. The nursing home would house 60 certified beds and would initially bring 55 full-time jobs to the area. Its price tag is approximately $5.8 million. Read the article here.
Pittsylvania County is very under-served in terms of available nursing home beds. However, the company who will design, build, and probably operate the nursing home (West Piedmont Health Investors and Smith/Packett) doesn’t have the best track record in protecting the rights of its residents. One of the company’s developments, Carrington Place in Botetourt County, Virginia requires all of its residents to sign a mandatory arbitration agreement upon admission which prohibits the resident (or their family) from filing a civil lawsuit when the facility is guilty of neglect or abuse. Simply put, the arbitration agreement prevents anyone from holding the facility accountable for its actions.
Word of warning to Pittsylvania County and its residents – Be Careful What You Ask For!
Pittsylvania County is very under-served in terms of available nursing home beds. However, the company who will design, build, and probably operate the nursing home (West Piedmont Health Investors and Smith/Packett) doesn’t have the best track record in protecting the rights of its residents. One of the company’s developments, Carrington Place in Botetourt County, Virginia requires all of its residents to sign a mandatory arbitration agreement upon admission which prohibits the resident (or their family) from filing a civil lawsuit when the facility is guilty of neglect or abuse. Simply put, the arbitration agreement prevents anyone from holding the facility accountable for its actions.
Word of warning to Pittsylvania County and its residents – Be Careful What You Ask For!
Thursday, August 09, 2007
MEDICAL MALPRACTICE LAW IN TEXAS: IS IT COMING TO YOUR STATE?
Doctors and hospitals have been pushing and pushing for tort reform – claiming that “frivolous” lawsuits are putting them out of business! They have been most successful in Texas with dramatic changes in the law. What has been the result?
The Houston Chronicle ran an article this week which might open some eyes. The article, entitled “Malpractice Work Shrinks After Law Tightens Standards,” is a good read.
What do you think?
The Houston Chronicle ran an article this week which might open some eyes. The article, entitled “Malpractice Work Shrinks After Law Tightens Standards,” is a good read.
What do you think?
IS THERE SUCH A THING AS A GOOD NURSING HOME?
We have previously written about what to look for when searching for a good nursing home. The type of home which has enough nurses and aides to provide prompt and timely care to the residents. The type of home which provides proper nutrition and hydration to its residents. The type of home which provides needed physical therapy and regular visits by the Medical Director.
Many people believe that finding the “right” nursing home is a very difficult task. I just read the attached article from a Philadelphia newspaper and he concludes “there is no such thing as a good nursing home. The best you can hope for is to find one of the best homes available and to avoid the many at the middle and bottom of the list.”
Read the article here.
Many people believe that finding the “right” nursing home is a very difficult task. I just read the attached article from a Philadelphia newspaper and he concludes “there is no such thing as a good nursing home. The best you can hope for is to find one of the best homes available and to avoid the many at the middle and bottom of the list.”
Read the article here.
LET'S DO THE NUMBERS - 1 CEO or 2000 NURSES
There is a great NPR show, Market Place, where the host always says "Let's do the numbers." Well, someone has done the numbers for us in the big business corporate nursing home industry. What if you took the money a CEO would make (or shareholder dividends) and put it toward staffing and resident care.
Read the full letter/report here:
"Reports that Manor Care’s CEO Paul Ormond would personally realize between $118 and $186 million when his company, the largest nursing home chain in the United States, is acquired later this year by a private equity group got us thinking about staffing in nursing homes. Knowing that the federal government has reported that more than 90% of nursing homes do not have enough staff to take care of their residents, we wondered how many nurses and nurse aides could be hired for a year at Manor Care’s nursing facilities with that same money.
Using federal wage estimates for nursing home workers, we calculated that Manor Care’s 278 nursing homes could hire an additional 5346 certified nurse aides or an additional 2198 registered nurses if $118,000,000 were spent on staff (19.2 aides or 7.9 RNs at each Manor Care nursing home). If Mr. Ormond’s $186,000,000 windfall were spent on staff, Manor Care could hire an additional 8427 certified nurse aides or an additional 3464 RNs (30.3 CNAs or 12.5 RNs at each Manor Care nursing home).
Like all nursing home chains, most of Manor Care’s revenues come from public programs, Medicare and Medicaid. How should our public health care dollars be spent? One man’s windfall or certified nurse assistants and registered nurses in nursing homes? "
Sincerely,
Toby S. Edelman
Center for Medicare Advocacy
California Advocates for Nursing Home Reform
The John A. Hartford Institute for Geriatric Nursing
National Conference of Geriatric Nurse Practitioners
Solutions: In testimony before the Senate Aging Committee on May 2, 2007 on the 20th anniversary of the federal Nursing Home Reform Law, Professor Charlene Harrington of the University of California, San Francisco, discussed, as one of her key points, the issue of financial accountability for public funds. She described the ability of nursing facilities, under current law, to spend their Medicare reimbursement, once they get it, as they choose, not necessarily as Congress intended. Professor Harrington’s solution is prohibiting nursing facilities from shifting costs across cost centers. Her testimony is at http://aging.senate.gov/events/hr172ch.pdf, pages 9-11.
WHAT A GREAT LETTER - And thank you Professor, for doing the numbers!
Read the full letter/report here:
"Reports that Manor Care’s CEO Paul Ormond would personally realize between $118 and $186 million when his company, the largest nursing home chain in the United States, is acquired later this year by a private equity group got us thinking about staffing in nursing homes. Knowing that the federal government has reported that more than 90% of nursing homes do not have enough staff to take care of their residents, we wondered how many nurses and nurse aides could be hired for a year at Manor Care’s nursing facilities with that same money.
Using federal wage estimates for nursing home workers, we calculated that Manor Care’s 278 nursing homes could hire an additional 5346 certified nurse aides or an additional 2198 registered nurses if $118,000,000 were spent on staff (19.2 aides or 7.9 RNs at each Manor Care nursing home). If Mr. Ormond’s $186,000,000 windfall were spent on staff, Manor Care could hire an additional 8427 certified nurse aides or an additional 3464 RNs (30.3 CNAs or 12.5 RNs at each Manor Care nursing home).
Like all nursing home chains, most of Manor Care’s revenues come from public programs, Medicare and Medicaid. How should our public health care dollars be spent? One man’s windfall or certified nurse assistants and registered nurses in nursing homes? "
Sincerely,
Toby S. Edelman
Center for Medicare Advocacy
California Advocates for Nursing Home Reform
The John A. Hartford Institute for Geriatric Nursing
National Conference of Geriatric Nurse Practitioners
Solutions: In testimony before the Senate Aging Committee on May 2, 2007 on the 20th anniversary of the federal Nursing Home Reform Law, Professor Charlene Harrington of the University of California, San Francisco, discussed, as one of her key points, the issue of financial accountability for public funds. She described the ability of nursing facilities, under current law, to spend their Medicare reimbursement, once they get it, as they choose, not necessarily as Congress intended. Professor Harrington’s solution is prohibiting nursing facilities from shifting costs across cost centers. Her testimony is at http://aging.senate.gov/events/hr172ch.pdf, pages 9-11.
WHAT A GREAT LETTER - And thank you Professor, for doing the numbers!
Wednesday, August 08, 2007
ALLIANCE REVEALED
Dan blogged this week about the Alliance for Quality Nursing Home Care. He spoke about the group, and its financial goals.
Below is a link to an editorial from the Palm Beach Post about the Alliance for Quality Nursing Home Care. They have been very vocal about Medicare payments to nursing homes.
"In newspaper and television ads targeting U.S. Reps. Ron Klein, D-Delray Beach, and Tim Mahoney, D-Palm Beach Gardens, the alliance points out that Congress doesn't have to cut Medicare spending for the elderly to help uninsured children receive subsidized health insurance through the SCHIP program. Congress can do both.
No matter how powerful an advocate, that's a strange position for a group that not so long ago had then-lobbyist Haley Barbour as its chief spokesman. Mr. Barbour, now the governor of Mississippi, is a champion of Republican tax cutting. The alliance's position on the children's health-insurance bill that Congress passed, however, makes the group seem more like the "tax-and-spend" Democrats Mr. Barbour used to vilify as national GOP chairman.
So who is behind this champion of the elderly poor? The alliance is no industry watchdog. It is the industry. The Alliance for Quality Nursing Home Care is 16 of the largest chains. It gave $100,000 to Tom Delay's political action committee that redrew districts for the Texas Legislature, a contribution that figured prominently in criminal charges against the former House speaker. When the alliance needed a lobbyist, it hired Thomas Scully, the Medicare administrator who squelched the true cost of the federal prescription drug plan.
Support for Medicare from the Alliance for Quality Nursing Home Care is like support for Barry Bonds from steroid makers. But just how does the alliance define "quality"?
The alliance claims to have led in adopting quality assurance programs. It boasts that stabilized Medicare spending, due partly to its powerful lobbying, has resulted in continued improvement in nursing home care. And it argues that the one-year, $700 million freeze in Medicare nursing home spending in the children's insurance bill would cost the industry $2.7 billion over five years. Spread over the industry, said alliance President Alan Rosenbloom, that would be the equivalent of two lost staff positions per nursing home.
It's hard to believe, but the industry's arguments amount to a claim of poverty. At 3 percent, profit margins are too slim, Mr. Rosenbloom said, to absorb even a one-year freeze.
Tell that to patients of the nation's largest nursing home owner, HCR Manor Care, an alliance member. Manor Care's chief executive, Paul Ormond, received an $18 million pay package this year. Mr. Ormond is overseeing the public company's $6.3 billion sale to the private Carlyle Group, owner of Dunkin' Donuts, Water Pik and Hertz. If the financials are so dismal, why is Carlyle buying Manor Care?
If the sale goes through, Mr. Ormond stands to make even more. He can cash in stock options valued at between $118 million and $186 million, The Toledo (Ohio) Blade reported last month. Options for other top executives would reach $68 million. That's a third of the proposed Medicare freeze for all nursing homes."
Read the entire article here.
Below is a link to an editorial from the Palm Beach Post about the Alliance for Quality Nursing Home Care. They have been very vocal about Medicare payments to nursing homes.
"In newspaper and television ads targeting U.S. Reps. Ron Klein, D-Delray Beach, and Tim Mahoney, D-Palm Beach Gardens, the alliance points out that Congress doesn't have to cut Medicare spending for the elderly to help uninsured children receive subsidized health insurance through the SCHIP program. Congress can do both.
No matter how powerful an advocate, that's a strange position for a group that not so long ago had then-lobbyist Haley Barbour as its chief spokesman. Mr. Barbour, now the governor of Mississippi, is a champion of Republican tax cutting. The alliance's position on the children's health-insurance bill that Congress passed, however, makes the group seem more like the "tax-and-spend" Democrats Mr. Barbour used to vilify as national GOP chairman.
So who is behind this champion of the elderly poor? The alliance is no industry watchdog. It is the industry. The Alliance for Quality Nursing Home Care is 16 of the largest chains. It gave $100,000 to Tom Delay's political action committee that redrew districts for the Texas Legislature, a contribution that figured prominently in criminal charges against the former House speaker. When the alliance needed a lobbyist, it hired Thomas Scully, the Medicare administrator who squelched the true cost of the federal prescription drug plan.
Support for Medicare from the Alliance for Quality Nursing Home Care is like support for Barry Bonds from steroid makers. But just how does the alliance define "quality"?
The alliance claims to have led in adopting quality assurance programs. It boasts that stabilized Medicare spending, due partly to its powerful lobbying, has resulted in continued improvement in nursing home care. And it argues that the one-year, $700 million freeze in Medicare nursing home spending in the children's insurance bill would cost the industry $2.7 billion over five years. Spread over the industry, said alliance President Alan Rosenbloom, that would be the equivalent of two lost staff positions per nursing home.
It's hard to believe, but the industry's arguments amount to a claim of poverty. At 3 percent, profit margins are too slim, Mr. Rosenbloom said, to absorb even a one-year freeze.
Tell that to patients of the nation's largest nursing home owner, HCR Manor Care, an alliance member. Manor Care's chief executive, Paul Ormond, received an $18 million pay package this year. Mr. Ormond is overseeing the public company's $6.3 billion sale to the private Carlyle Group, owner of Dunkin' Donuts, Water Pik and Hertz. If the financials are so dismal, why is Carlyle buying Manor Care?
If the sale goes through, Mr. Ormond stands to make even more. He can cash in stock options valued at between $118 million and $186 million, The Toledo (Ohio) Blade reported last month. Options for other top executives would reach $68 million. That's a third of the proposed Medicare freeze for all nursing homes."
Read the entire article here.
GOOD NEWS! WV NURSING HOME RESIDENT WHO ELOPED IS FOUND ALIVE!
Just yesterday we reported the elopement of a nursing home resident in West Virginia. Clifford Messer, 80, who was missing since Sunday, was found Monday no more than 1,500 yards away from the Morris Memorial Nursing Home nursing home where he lived. Messer, missing for about 30 hours, was found in a dehydrated state and required medical attention.
We are glad this story has a happy ending. Read the newspaper report.
We are glad this story has a happy ending. Read the newspaper report.
THE ALLIANCE FOR QUALITY NURSING HOME CARE: A WOLF IN SHEEP’S CLOTHING!
Who wouldn’t support a resident advocacy and watchdog group called “The Alliance for Quality Nursing Home Care.” Sounds like another grass roots group out to protect the rights of the elderly and assure good care and treatment in America’s nursing homes. Unfortunately, nothing could be further from the truth.
So who is behind this champion of the elderly poor? The alliance is no industry watchdog. It is the industry! The Alliance for Quality Nursing Home Care is 16 of the largest chains. It gave $100,000 to Tom Delay's political action committee that redrew districts for the Texas Legislature, a contribution that figured prominently in criminal charges against the former House speaker. When the alliance needed a lobbyist, it hired Thomas Scully, the Medicare administrator who squelched the true cost of the federal prescription drug plan.
Read more about this group…whose main goal is to make more money not protect the elderly!
So who is behind this champion of the elderly poor? The alliance is no industry watchdog. It is the industry! The Alliance for Quality Nursing Home Care is 16 of the largest chains. It gave $100,000 to Tom Delay's political action committee that redrew districts for the Texas Legislature, a contribution that figured prominently in criminal charges against the former House speaker. When the alliance needed a lobbyist, it hired Thomas Scully, the Medicare administrator who squelched the true cost of the federal prescription drug plan.
Read more about this group…whose main goal is to make more money not protect the elderly!
Tuesday, August 07, 2007
WV MAN MISSING FROM NURSING HOME
Police are searching for a man from Milton, West Virginia who went missing from the Morris Memorial Nursing Home, a 185 bed facility. Clifford Messer, 80, walked off from the nursing home in Milton about 11 p.m. Sunday, August 5. Read the story here.
Why do these tragedies continue to occur? Today, why aren’t nursing homes using cheap and available door alarms, chair alarms, locater bracelets? It is inexcusable!
Why do these tragedies continue to occur? Today, why aren’t nursing homes using cheap and available door alarms, chair alarms, locater bracelets? It is inexcusable!
Monday, August 06, 2007
CASE REPORT: FAIRFAX VIRGINIA COURT RULES CONSUMER PROTECTION ACT APPLIES TO CLAIMS AGAINST NURSING HOMES
Just about every state in the country has a law designed to protect consumers where they have been harmed or injured as a result of the misrepresentation of products or services. Virginia has such a statute and it can be found at Virginia Code Annotated § 59.1-196. et seq.
In the past, the nursing home industry in Virginia has been fighting the application of this statute to claims of neglect and abuse with some success. Now, a judge from the Circuit Court of Fairfax County, The Honorable Jane M. Roush, has convincingly put this facetious argument to bed! Judge Roush in her May 31, 2007 decision in Humphrey v. Leewood Healthcare Ctr., (2007 Va. Cir. LEXIS 101) held the Virginia Consumer Protection Act does apply to certain types of claims against nursing homes. Not only is Judge Roush’s opinion well-reasoned, it is common sense!
Count Judge Roush’s decision as a “win” for the consumer!
In the past, the nursing home industry in Virginia has been fighting the application of this statute to claims of neglect and abuse with some success. Now, a judge from the Circuit Court of Fairfax County, The Honorable Jane M. Roush, has convincingly put this facetious argument to bed! Judge Roush in her May 31, 2007 decision in Humphrey v. Leewood Healthcare Ctr., (2007 Va. Cir. LEXIS 101) held the Virginia Consumer Protection Act does apply to certain types of claims against nursing homes. Not only is Judge Roush’s opinion well-reasoned, it is common sense!
Count Judge Roush’s decision as a “win” for the consumer!
YOU HAVE GOT TO BE KIDDING ME
This one takes the cake. Today I read a case summary of a Minnesota case where a nurses aid yelled the following at a resident (please note, it is profane):
"I forgot to put my [f___ing] gloves on and it's your fault, now you're going to [s___t] all
over my hands you dumb [f___er].
She was fired, of course. Then the state department of Health cited her for abuse. On appeal the Court of Appeals held the state was required to show conduct which would reasonably produce emotional distress. The Court found that because the aide's statement was not malicious, and was not repeated, it did not meet the stanard of conduct which would reasonably produce emotional distress.
WHAT - ARE YOU KIDDING ME? Screaming at an eldely resident, blaming him for incontinence etc.. That's not likely to cause emotional distress? I sure hope the Court didn't factor in the resident's short term or long term memory problems in determining whether the comment could have caused emotional distress.
Frankly, that one made me mad.
"I forgot to put my [f___ing] gloves on and it's your fault, now you're going to [s___t] all
over my hands you dumb [f___er].
She was fired, of course. Then the state department of Health cited her for abuse. On appeal the Court of Appeals held the state was required to show conduct which would reasonably produce emotional distress. The Court found that because the aide's statement was not malicious, and was not repeated, it did not meet the stanard of conduct which would reasonably produce emotional distress.
WHAT - ARE YOU KIDDING ME? Screaming at an eldely resident, blaming him for incontinence etc.. That's not likely to cause emotional distress? I sure hope the Court didn't factor in the resident's short term or long term memory problems in determining whether the comment could have caused emotional distress.
Frankly, that one made me mad.
"COST" OF LITIGATION
Probably once a week, a family will tell our firm, the "cost" of litigation is too great. What do I mean? Although a family may have what we would call a meritorious case, they do not have the money to pay for experts, court reporters, copies etc. And I understand. I don't have $25,000 sitting in a special "slush - if I want to file a lawsuit fund." But what does that say about our "justice" system if it costs too much money for citizens to access the system? What does it say about our legal system when families are denied their day in court, because they don't have thousands of dollars in cash laying around?
There may be a unique remedy, one I fear Virginia will not take kindly to. CLASS ACTION LAWSUITS in healthcare industry. You hear about class action lawsuits against drug companies, the silicon implant manufactures, etc - well what if all of the residents of a nursing home that had received substandard care, filed a class action lawsuit together? Well, that very situation is currently happening in Arkansas courts. The overreaching allegation that the facility was understaffed so as to violate residents rights (contractual and rights to care) allowed 489 suits to be combined. The result, 489 families get to split the costs - and some families, who may not have even known about their legal rights, now have access to our justice system. I say well done. Seems like a responsible ruling, and one that is better for all sides.
There may be a unique remedy, one I fear Virginia will not take kindly to. CLASS ACTION LAWSUITS in healthcare industry. You hear about class action lawsuits against drug companies, the silicon implant manufactures, etc - well what if all of the residents of a nursing home that had received substandard care, filed a class action lawsuit together? Well, that very situation is currently happening in Arkansas courts. The overreaching allegation that the facility was understaffed so as to violate residents rights (contractual and rights to care) allowed 489 suits to be combined. The result, 489 families get to split the costs - and some families, who may not have even known about their legal rights, now have access to our justice system. I say well done. Seems like a responsible ruling, and one that is better for all sides.
Sunday, August 05, 2007
MEDICATION ERROR CAUSES NURSING HOME RESIDENT’S DEATH
We wrote a short blog just several days ago about medication errors and the problems they create for patients and here is living (or maybe dieing) proof!
The death of an Illinois woman who was given the wrong medication in a nursing home in February was ruled accidental Thursday by a Tazewell County coroner's jury, which also ruled the home was negligent. Sherrie L. Parrish, 64, died Feb. 24 after she was given another patient's medicine while at Washington Christian Village.
Tazewell County Coroner Dennis Conover said a nurse at the facility called Parrish's doctor to report the incorrectly administered medicine and was told by a physician's assistant to monitor Parrish for several hours. Parrish was given the wrong medicine at 8 a.m. Feb. 24 and was dead about two hours later, Conover said.
Follow the story here.
The death of an Illinois woman who was given the wrong medication in a nursing home in February was ruled accidental Thursday by a Tazewell County coroner's jury, which also ruled the home was negligent. Sherrie L. Parrish, 64, died Feb. 24 after she was given another patient's medicine while at Washington Christian Village.
Tazewell County Coroner Dennis Conover said a nurse at the facility called Parrish's doctor to report the incorrectly administered medicine and was told by a physician's assistant to monitor Parrish for several hours. Parrish was given the wrong medicine at 8 a.m. Feb. 24 and was dead about two hours later, Conover said.
Follow the story here.
WV NURSING HOME SUED FOR RESIDENTS DEATH
A Kanawha County, West Virginia man has filed a professional malpractice suit against the nursing home where his mother was a resident when she died. Billy Skiles filed the suit July 18 in Kanawha Circuit Court, on behalf of the estate of his mother, Barbara Skiles. Genesis Healthcare Corporation, HR of Charleston Inc., and Oakridge Center (already on a national watch list for providing substandard care) are the defendants.
Billy Skiles claims his mother suffered falls on various occasions, because of the negligent treatment of the employees at the home. He claims in the suit that the care and treatment his mother received violated the standard of care normally exercised in such circumstances.
Read the full news account.
Billy Skiles claims his mother suffered falls on various occasions, because of the negligent treatment of the employees at the home. He claims in the suit that the care and treatment his mother received violated the standard of care normally exercised in such circumstances.
Read the full news account.
Friday, August 03, 2007
MEDICATION ERRORS: WRITE IT DOWN AND BE CLEAR
Confusion over the similarity of drug names accounts for approximately 25% of all reports to the USP Medication Errors Reporting Program, according to the National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP). The mission of the NCCMERP is to maximize the safe use of medications and to increase awareness of medication errors through open communication, increased reporting and promotion of medication error prevention strategies.
Too many times the ordering physician’s verbal or written orders for medications are confusing or unclear. The result, when well-intentioned nurses provide the wrong medication or wrong dosage to the patient can be deadly.
Read the Council’s recommendations for reducing medication errors.
Too many times the ordering physician’s verbal or written orders for medications are confusing or unclear. The result, when well-intentioned nurses provide the wrong medication or wrong dosage to the patient can be deadly.
Read the Council’s recommendations for reducing medication errors.
Thursday, August 02, 2007
LONG TERM CARE INSURANCE: IT’S NOT ALWAYS THERE FOR YOU!
I am starting to see long term care insurance being pushed everywhere. The insurance carriers play on everyone’s fear that one day we will be alone and without the ability to care for ourselves and how are we going to pay the ever rising costs for assisted living and nursing home care?
With the increasing number of these policies comes the inevitable refusal of the company to pay benefits just when the owner of the policy needs those benefits. Recently in California alone, one out of every four long-term insurance claims was denied. Read a sad story of denial involving Rose Derks in Montana.
I realize insurance companies are businesses. And, business is business, one might say. Maybe it is naive thinking, but an industry formed to provide all of us with some security in our lives should have a sense of honor in the way they do their business. Maybe they should honor their commitment to provide benefits to those in need.
With the increasing number of these policies comes the inevitable refusal of the company to pay benefits just when the owner of the policy needs those benefits. Recently in California alone, one out of every four long-term insurance claims was denied. Read a sad story of denial involving Rose Derks in Montana.
I realize insurance companies are businesses. And, business is business, one might say. Maybe it is naive thinking, but an industry formed to provide all of us with some security in our lives should have a sense of honor in the way they do their business. Maybe they should honor their commitment to provide benefits to those in need.
MALPRACTICE LAWSUIT WINNER DONATES TO RESEARCH
Here is a feel good story! A man left quadriplegic after doctors misdiagnosed his stroke as sinusitis donated $600,000 Wednesday to a Miami spinal cord research center. Allan Navarro won a $217 million verdict against his doctors in October. The two law firms that represented Navarro each donated an additional $200,000 to the center for a total donation of $1 million.
Read the full story here.
Read the full story here.
Wednesday, August 01, 2007
PHYSICIAN SALARIES BIG PART OF EXPENSIVE HEALTH CARE
I don’t begrudge doctors for making a good living. The training is long and difficult and the responsibilities they assume are great! However, many health care economists argue that physician salaries must be examined along with prescription drug prices and the high cost of health insurance in attempting to provide affordable health care to more Americans.
The New York Times reports salaries for U.S. physicians are two to three times higher than salaries for physicians in other industrialized nations. According to surveys conducted by medical practice management groups, U.S. physicians on average have annual salaries of $200,000 to $300,000, and specialists on average have annual salaries of more than $400,000. Physicians in Europe in 2002 on average had annual salaries of $60,000 to $120,000, according to a survey conducted in 2004 by the British government.
Read more about this topic.
The New York Times reports salaries for U.S. physicians are two to three times higher than salaries for physicians in other industrialized nations. According to surveys conducted by medical practice management groups, U.S. physicians on average have annual salaries of $200,000 to $300,000, and specialists on average have annual salaries of more than $400,000. Physicians in Europe in 2002 on average had annual salaries of $60,000 to $120,000, according to a survey conducted in 2004 by the British government.
Read more about this topic.
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