The Chicago Tribune broke with an expose on how some powerful psychotropic medications are being administered to nursing home residents in Illinois without consent and without valid psychiatric diagnoses. Some of these elderly have suffered from a variety of adverse responses that include, said the Tribune, “tremors, dangerous lethargy, and a higher risk of harmful falls or even death.”

Psychotropic medications include antipsychotics, antidepressants, and anti-anxiety medications, explained the Tribune. (more…)

In a horrible report detailing an incident of nursing home abuse, LoHud wrote that a North Salem, New York nursing home aide tied an 83-year-old woman to her wheelchair with a bed sheet, deposited her in a common room, shut the lights out, and napped. The certified nurse’s aide napped for about one hour while the woman was tied to the chair.

According to LoHud, the incident took place at the Waterview Hills Rehabilitation and Nursing Home. Pierre Obas, 72, pleaded guilty to violating public health law involving the abuse, neglect, and mistreatment of a person, said LoHud, a misdemeanor offense. Obas was required to surrender his certification and is not allowed to work in a nurse’s aide capacity for a year from his April 27 sentencing said LoHud, citing court records. (more…)

We’ve been following the widespread issue of nursing home abuse for some time. Last year, the former Bush administration finally published the names of 131 of the nation’s worst nursing homes. Now, says the Wall Street Journal, the federal government is increasing efforts to improve nursing home care by implementing an evaluative Web-based tool.

The Centers for Medicare and Medicaid Services (CMS) will initiate the pilot program this summer to track how cash incentives to nursing homes improve care, specifically in nurse staffing and preventable hospitalizations, said the Journal. The agency also flags those listed as the worst, which has increased to about 135, on the Web site. The most problematic facilities are labeled as “Special Focus Facilities,” noted the Journal.

In a harrowing example of the widespread problem of elder abuse and negligence, last year, the family of a deceased Norwich, Connecticut man filed what is believed to be the first wrongful death lawsuit against officials at Connecticut’s largest nursing home chain: Haven Healthcare. The suit claimed that misappropriation of Haven funds by Chief Executive Officer Raymond Termini contributed to “deplorable conditions.” The family also sought permission to sue the state departments of public health and social services, and Nancy Shaffer, the state’s long-term care ombudsman, for failing to investigate and act on complaints lodged by the family.

The deceased family member was a patient at Haven homes for over two years when he was rushed to a hospital after his wife found him in excruciating pain and his legs gangrenous and in early rigor mortis, allegedly due to an untreated and infected pressure sore on his hip and physical restraints that immobilized him. The man died two days later.

There are roughly 16,400 nursing homes nationwide and taxpayers spend about $72.5 billion annually to subsidize nursing home care. Late last year the CMS began ranking nursing homes “based on government inspection results, staffing data, and quality measures” via the “Nursing Home Compare” system, which is available at medicare.gov/NHCompare, said the Journal.

“We are certainly taking assertive steps to make sure nursing-home residents are adequately protected and to stimulate improvement on the part of various providers,” said Thomas Hamilton, CMS’s survey and certification group’s director, quoted the Journal.

The Journal also pointed out that approximately three million Americans require nursing-home care annually. A costly expense, many elderly and disabled patients must pay for such care themselves because they earn too much to qualify or simply don’t qualify for the benefit. If covered, benefits are limited—up to a mere 100 days following a minimum of three-day hospitalization with a doctor ordering care for the same reason as the hospitalization and for specific treatments, such as physical therapy, said the Journal citing the elder care advocacy group the AARP. After 20 days of full benefits, the patient must pay $133.50 daily, and then the full day’s cost each day after the first 100 days, noted the Journal.

When reviewing the Web site, the Journal warns consumers to conduct additional research, such as in-facility visits, speaking to other residents, data review, and state and other source review. Advocacy group, the National Citizens’ Coalition for Nursing Home Reform, warns some nursing home-provided data may contain errors and that consumers should check regularly for monthly updates, said the Journal.

Two nursing homes in the Rochester, NY area are embroiled in an abuse scandal.  Yesterday, one certified nurse aide at the Kirkhaven Nursing Home in Rochester, and another who worked at the Edna Tina Wilson Living Center in Greece, NY, were arrested as part of a state-wide probe into nursing abuse and healthcare fraud.

According to the New York State Attorney Generals office, the aides arrested were 32-year-old Monique Jones, who worked at Kirkhaven, and 47-year-old Nellie Weller, an aide at the Greece facility. Jones is accused of kicking an 88-year-old resident in his ribs.  Weller allegedly tied a 76-year-old resident’s nightgown around his neck and legs, leaving him unable to move or use his urinal.  Both aides have been fired from their jobs at the facilities. (more…)

Low federal standards and inconsistent state laws have caused lapses in nursing home social workers’ qualifications.  Although social workers are integral to nursing home residents’ quality of care, there are vast differences among workers backgrounds based on the first national study on nursing home social workers, said The Press Citizen.  This, according to the findings of a University of Iowa study that surveyed 1,071 nursing home social service directors.

The study found only half of all nursing home social workers actually have a social work degree; unbelievably, 20 percent do not have a four-year degree of any kind; two-thirds do not belong to any professional organizations; and the vast majority—62 percent—are not licensed in social work said The Press Citizen according to the study.

UI also noted that for-profit nursing homes are 31 percent less likely to hire a degreed social worker.  Mercedes Bern-Klug, study lead and assistant professor of social work at UI’s College of Liberal Arts and Sciences expressed concern over the findings noting that nursing home social workers are responsible for a variety of critical areas of care.  “Nursing home social workers handle very serious emotional issues affecting residents, family members, and other staff members, and they deserve to be educated on how to handle these issues,” Bern-Klug said. “Everyone benefits when nursing homes hire qualified social workers,” she added.

UI noted that nursing home residents struggle with serious disorders such as dementia, and pointed out that the highest suicide rates are among the elderly; worse, older patients are often victimized, “Still, many people in charge of social work in nursing homes aren’t social workers, and the federal government doesn’t require that they be social workers,” Bern-Klug said.  Bern-Klug said 10 states do not address nursing home social worker qualifications, seven state codes seem to be out of compliance with federal standards, only 21 states require a social work degree, and there are loopholes in some state laws.  For instance, in Colorado, if a rurally-located for-profit nursing homes advertises for one week in its local paper for, but is not able to find, a qualified social worker, it is not required to hired such a worker, while in Indiana, a clergy member who completes a 48-hour course and consults with a social worker can deliver social services.

Also, UI said nursing homes with over 120 beds must meet federal regulations requiring one full-time social worker be employed; however, a bachelor degree in any human service area—not specifically in social work—and a year of supervised field experience is considered sufficient.  Because most nursing homes—70 percent—do not meet the 120-bed standard, they are not required to employ a social worker and despite that most do employ one such worker, there are insufficient social workers to provide the individualized care patients need and, often, said, Bern-Klug, social workers are consumed with marketing and activity planning.  “I asked 1,000 social workers, ‘How many residents can you handle?  Federal guidelines say you can do 120.’ An overwhelming majority said fewer than 60,” she said.  “We need legislation to demand well-prepared social workers and to set reasonable social worker-to-resident ratios….  Decades of research has documented the negative consequences of having too few nurses in a nursing home, and still we don’t have strong laws demanding a realistic nursing ratio,” Bern-Klug said.

The Centers for Medicare and Medicaid Services (CMS) has launched a Website ranking nearly 16,000 nursing homes.  Reuters Health reports that this is the first-ever federally-managed Website that ranks nursing home facilities for quality.

“Around three million Americans depend on nursing homes at some point during each year to provide life-saving care,” CMS administrator Kerry Weems said in a statement announcing the website launch.   “Most of those individuals are enrolled in Medicaid or Medicare and we all bear a special responsibility to protect their health and welfare.” (more…)

New York State Attorney General Andrew Cuomo has announced the arrests of nursing home employees over charges of resident neglect and abuse, Business First of Buffalo is reporting.  According to Business First, three employees were arrested and charged and a fourth has been convicted for “abusing elderly and ill patients.”

Cuomo announced the arrests yesterday, following a New York state-wide investigation into institutional care abuse and neglect said Buffalo First.  A prepared release stated that the acts involved “physically attacking and using racial slurs against an 86-year-old Alzheimer’s patient, slapping a 100-year-old patient in the face, and tying an elderly patient with dementia to a chair for two consecutive nights.”  In the release, Cuomo said his “office remains committed to protecting the vulnerable and defenseless by uncovering and prosecuting alleged abuses at nursing homes across the state,” noting that elderly New Yorkers deserve better “than to endure suffering at the hands of those entrusted with their care.” (more…)

Four nursing home workers caught on tape mistreating a patient  were charged yesterday with falsifying records and endangering a resident at a Suffolk County facility familiar with such problems, according to Attorney General Andrew Cuomo.  This case represents the fourth recent nursing home abuse case in the state, it is the first to originate out of the New York City area in which hidden camera technology was used to obtain evidence against nursing home employees, Cuomo says.

Cuomo said the hidden camera technology has been used upstate, producing 26 convictions and forcing one nursing home into receivership.  Cuomo also said that small cameras are installed at facilities across Long Island.  “We’re going to be using this technology aggressively,” he said.  “It gives us a whole new avenue for making these cases,” Cuomo added.  In the recent case, the tiny camera was placed in the room of an 84-year-old man at Long Island’s Medford Multicare Center for Living.  Investigators monitored the camera feed from January to March in 2007, officials said. (more…)

SLS Residential, LLC, a private mental health facility located in Putnam County, NY, has been sanctioned for threatening former patients who are potential plaintiffs in a class actions lawsuit.  SLS runs two residential treatment centers in the town of Southeast, NY  for adolescents and young adults.  In addition to a class action lawsuit, SLS is facing revocation of its state operating licenses for the two facilities.

The class action lawsuit, filed by two former SLS Residential patients, alleges that they were subjected to physical and mental abuse.  The complaint, which was filed on behalf of all SLS patients, seeks  $75 million in compensatory damages, $150 million in punitive damages and an injunction that would bar SLS from further violating patients’ rights. (more…)

Nursing home abuse and neglect continues to be a serious problem in the U.S.  According to a new report conducted by the inspector general of the Department of Health and Human Services, a whopping 94 percent of all for-profit nursing homes were cited last year for violations of federal health and safety standards. In total, 90 percent of all nursing homes – including those owned by non-profit groups and government agencies – were cited last year for violations of health and safety standards.

The violations cited by the inspector general’s report included infected bedsores, medication mix-ups, poor nutrition, and abuse and neglect of patients.  The inspector general also said on Monday that some nursing homes “have systematically failed to provide staff in sufficient numbers and with appropriate clinical expertise to serve their residents.”  In other cases, nursing homes billed Medicare and Medicaid for services that “were not provided, or were so wholly deficient that they amounted to no care at all,” the inspector general said. (more…)