Nursing Home Abuse Advocate

Better Economic Times Are Not Necessarily Good For Nursing Home Residents

John R Kormanik — Fri, 13 Apr 2012 13:21:07 -0700

In a recent paper published by the Center for Retirement Research at Boston College poses an interesting hypothesis. When the economy improves, nursing home deaths increase due to the simple reason nurses and health aides caring for the elderly decrease during economic booms. Frankly, this hypothesis is not at all surprising to me.

According to the authors: "[T]ight labor markets constrain the already scarce number of workers available for hire by nursing homes.... A greater scarcity of these front-line caregivers may have a direct impact on the elderly, causing them to die in greater numbers when the unemployment rate is declining."

In my experience, nursing homes pay their staff relatively poorly. They recruit less-than-stellar job candidates. As I often explain to my potential nursing home abuse and neglect clients: "Your aide can be flipping burgers at a McDonald's one day and caring for you the next." Although this may be an exaggeration, it is not much of one.

I believe, based upon my experience in pursuing justice on behalf of those injured by the negligence of nursing homes and their employees that staffing levels and quality of staff have a direct impact on nursing home residents' safety and well being. Honestly, who would argue otherwise.

If you or a loved one has suffered an injury in a nursing home you should contact an attorney who has experience in this area of the law in order to protect your rights. As I tell people, you don't have to hire me or my Firm, but you do need to hire an attorney to ensure the playing field is level with the facility...heaven knows it has an attorney on its side!

Nursing Home Profits: "Astonishing"

John R Kormanik — Wed, 11 Apr 2012 16:34:58 -0700

According to a recent Wall Street Journal Market Watch press release, the nursing home industry is doing just fine, thank you very much. This is true despite the fact Medicare reimbursements were reduced back in 2011.

Families for Better Care, Inc. is a citizen advocacy organization dedicated to quality resident care in nursing homes and other long-term care settings. Executive Director Brian Lee served as Florida’s State Long-Term Care Ombudsman for most of the past decade. According to Mr. Lee: “The industry’s analysts framed the Medicare adjustment as an eventual doomsday for the nation’s nursing home market. But the industry’s own reports show quite the opposite, revealing surging revenues, strong profits, and expansion through acquisitions. The industry is wallowing in strong profits while failing to consistently provide quality care.”

The release goes on to note: "A recent study by the University of California-San Francisco shows a steady decline in nursing hours for Medicare-licensed facilities and an unacceptably high level of deficiencies."

Do not let the nursing home industry fool you by crying poverty due to funding cutbacks. The numbers don't lie. In 2011, one company, Adcare Health Systems posted record annual revenues of $151.4 million, which is an increase of 198% over the previous year. Another company, Kindred Health Care, reported an increase in consolidated revenues of 27% to $5.5 billion compared to $4.4 billion in previous year. If that's "hard times" ...don't we all wish our times were that hard?

Staffing cutbacks effect nursing home residents every day. No matter what the industry says, those cutbacks are not because of a lack of funding. They are nothing more than a business decision...a decision that puts profits over people.

Poor Conditions Lead To Nursing Home Residents' Deaths - Is A Fine Enough??

John R Kormanik — Thu, 22 Mar 2012 11:38:34 -0700

Let me get this straight: The California Department of Public Health performed investigations into the deaths of residents at the following facilities: Fountain View Subacute and Nursing Center in Los Angeles; Motion Picture and Television Hospital in Woodland Hills; and Downey Care Center in Downey. The Department found conditions at the facilities contributed to the deaths of three residents. So what did the Department do? It imposed fines on the facilities. FINES?!

According to an article in the Los Angeles Times, The resident at Fountain View: "The patient, who had a history of falls, was not properly supervised at the nursing home. When he was found on the floor, no one knew how long he had been there, according to the department." For this, the Department levied a fine of $75,000.00.

The Motion Picture and Television Hospital was fined $80,0000.00 when "a 90-year-old Alzheimer's patient who was in a wheelchair died a week after falling down a stairwell, according to a report. She had previously fallen down the same set of stairs."

Downey Care Center received a $75,000.00 fine for for "failing to monitor a patient's blood glucose level after she was released from a hospital in 2010. The woman died from a diabetic coma."

Each and every one of these deaths was preventable. Each and every one of the families of the residents were irreversibly and unnecessarily harmed by the facility's negligence. Each and every one of these families likely has grounds for a lawsuit against the facility.

In this era of personal accountability, I hope the fines imposed by the California Department of Public Health were just the beginning of holding the facility accountable for its negligence. Making sure nursing homes and assisted living facilities are accountable for their negligence in caring for their residents is what I do. I do it because I believe when a loved one's care is entrusted to a Nursing home or assisted living facility, they have a duty to make sure they do every reasonable thing to ensure no harm comes to that resident.

Drinking In Assisted Living Facilities - Is There A Problem?

John R Kormanik — Mon, 13 Feb 2012 08:00:00 -0700

In a recent New York Times "The New Old Age" post, author Paula Span broached the subject of drinking problems in assisted living facilities. Ms. Span references a study performed by a University of Pittsburgh "team" to determine whether there is, indeed, a problem. The short answer remains: No one really knows.

The "study" referenced by Ms. Span was conducted by interviewing "[m]ore than 800 aides working in assisted living facilities in Pennsylvania." Why weren't the actual residents interviewed? First, funding was insufficient to conduct such a study. Second, there's a little thing called denial! The specter of alcohol abuse in assisted living facilities is certainly raised in article, however. Consider these statistics:

Nearly 70 percent of assisted living residents drank alcohol.
More than a third drank daily.
Twelve percent had abused alcohol (defined as drinking enough to cause “physical or psychosocial harm”) in the past three months.
Almost 20 percent had experienced an apparent influence on their health from alcohol use in the past three months.

Ms. Span also points out the fact that, because so many assisted living facility residents are on medications, the interaction between alcohol and medicine is a real problem. Finally, the research reveals what we all know...as you age, you can no longer drink as much as you used to be able to drink without adverse affect.

As Ms. Span says: "So might the two or three beers with friends that caused no harm 30 years ago be contributing to your father’s falls now that he is in assisted living? Guess who has been elected to start that conversation."

It is up to you! Check on your loved one. Just because an assisted living facility allows drinking, does not mean it is the right thing to do! On the other hand, it may not be as bad as you think!

Keeping Your Loved One Out Of A Nursing Home

John R Kormanik — Wed, 08 Feb 2012 08:30:00 -0700

In an article in yesterday's Los Angeles Times, Karen Ravin provides some helpful information for those of us who have aging parents or loved ones. As Ms. Ravin correctly points out: Our desire for our loved ones to be safe (possibly in an assisted living facility or nursing home) must compete against our loved one's desire for independence. Ms. Ravin has some great ideas in ensuring the "competition" between these two forces can still result in our loved one living at home. Here are a few recommendations:

Hire an occupational therapist to perform a safety assessment of the home. This will ensure that things which we may never think of as being a danger, such as throw rugs or slippery shower floors, are addressed. Remember...an ounce of prevention is worth a pound of cure.
Stay connected. As I have talked about before, regular phone calls or visits to your loved one are invaluable. If hearing or sight is impaired, you can look into getting a phone with amplified speakers or large buttons to dial.
Food. Sure, we presume our loved ones are eating properly because they tell us they are, right? Well, that may not be the case. If food and nutrition are a concern, look into having a program like Meals on Wheels deliver to the house. In the Treasure Valley, Elks Meals on Wheels provides such a service.
Housekeeping/chores. Let's face it: there are few, if any, people who really enjoy housekeeping and/or chores. If it will help your loved one maintain their independence, why not look into hiring professional help for this? It certainly does not have to be an every-day sort of thing...perhaps a few times a week is all that is needed.
Take care of yourself. According to Myra Hyatt, a specialist clinical social worker at the Landon Center on Aging at the University of Kansas Medical Center in Kansas City, caring for a loved one can just flat wear you down. "You can become isolated yourself and find yourself thinking, 'I want my life back.'" That's where a support group can help you continue to live your life while helping your loved one maintain his or her independence.

Of course, this list is not the be-all-end-all to resources. In fact, if you have some other ideas, please share them with me. I will, in turn, share them with my readers. After all, we want the picture above to remain true with our loved one maintaining her or his independence.

New Office Location

John R Kormanik — Tue, 07 Feb 2012 14:43:32 -0700

You may have wondered where we've been. First, please accept my apologies for not posting information in quite a while. I will be here regularly from here on.

I wanted to let you know Kormanik Hallam & Sneed, LLP, has relocated. We have purchased an old house on the east side of downtown Boise. The house, located at 206 W Jefferson Street in Boise is fully handicap accessible for your convenience.

As I said, my apologies for not posting useful information for you in a while. I look forward to doing so again in the very-near future.

Pre-Litigation Screening - The First Step In The Legal Process

John R Kormanik — Mon, 14 Nov 2011 08:00:00 -0700

Although I am a lawyer, I do not typically write on "ins-and-outs" of nursing home or assisted facility law. Frankly, the laws can be complicated and do not typically lend themselves to a relatively "short" (for a lawyer, anyway) post on this site. I'm going to change it up a little today, though, because I think there is something you need to know.

Did you know that, unlike many other matters, in order to bring a lawsuit against a licensed nursing home or assisted living facility in the state of Idaho, you must first jump through a hoop? This hoop is known as a "Prelitigation Screening Panel."

As defined by Idaho law, and in the context of a claim against a license nursing facility, the prelitigation screening process generally can be described as follows:

Any claim for "alleged negligence or wrongful death" against a "licensed nursing facility," must go through the process;
A panel serves in the nature of a "special civil grand jury";
The panel consists of 3 people: 1 person who is a licensed administrator of a nursing facility in the state of Idaho; 1 person who is an attorney, appointed by the commissioners of the Idaho State Bar; and a layperson selected by the two members listed above;
The process is "informal" and, other than the panel's final decision, there are no records of the proceedings kept;
The process is nonbinding;
The process is compulsory, which means you cannot sue a licensed nursing facility for its wrongful acts unless and until you have gone through this process.

You might ask, if the process is nonbinding, what happens if I "loose" -- get an unfavorable result from the prelitigation screening panel -- to my case? Does that mean I cannot proceed? The answer is an emphatic "no." Because the process is nonbinding, you simply are required to go through it, whatever answer you receive from the panel, you can still choose to proceed with litigation against the licensed nursing facility.

Should you decide you would like to hold a nursing home or assisted living facility accountable for its wrongful acts, there are some steps you should take. First, contact an experienced nursing home abuse lawyer, like the lawyers at Kormanik Hallam & Sneed LLP. Second, remember, you need to go through the prelitigation screening process prior to filing a lawsuit against a licensed nursing facility.

Green Houses - Putting The "Home" Back Into A Nursing Home

John R Kormanik — Tue, 01 Nov 2011 08:17:39 -0700

Imagine walking into a traditional nursing home for the first time. There is a reception area at the front door. Turn right and walk down a hallway - there are resident rooms on both sides. There is typically a nurse's station. in amongst the rooms. There may be medication carts in the hallway. There may even be food carts for those residents who cannot make it to the dining hall. Imagine walking into this traditional nursing for the first time...and being told: "This is your new home." Well, that ain't like any home I've ever lived in...it's a hospital...it's an institutional facility...it is definitely NOT a "home."

In a article in yesterday's New York Times, Laurie Tarkin explains a relatively new movement in the nursing home industry - Green Houses. These "green houses" are not the kind you grow plants in. They are not even particularly "green" as in environmentally sound. Instead, the Green House theory of nursing home care places residents in real, honest-to-goodness (although slightly modified) homes on the property of the main facility. The article describes the Green Houses as:

Front door opening into a large living and dining area;
A hearth surrounded by upholstered chairs;
A long communal dining table where meals are served;
Kitchens that open to the dining table so caregivers can chat with residents while preparing meals;
Private bedrooms and bathrooms;
Front porch and back deck with tables and chairs.

Perhaps, more importantly, are the items not present in a Green House. There are no: corridors, nursing stations, medicine carts, trays of food delivered to residents in their rooms.

In this environment, staff actually gets to know their residents. They spend more time, on average, with their residents and, according to the article, are more able to build a personal bond with their residents.

There are approximately 117 of these Green Houses across the country. I wonder if there are any here in Idaho? I haven't heard of any such facilities here. If you know of one, I'd like to hear from you.

Imagine walking into a Craftsman-style bungalow. You walk up the porch and notice the rocking chairs. You walk in the front door and notice a hearth ablaze in a warming glow and your new housemate seated in a nice chair in front of it. You see a friendly staff member cooking your first meal in the kitchen. You drop your belongings off in your room and return to the main living room. Your loved one, maybe your son or daughter, reaches over to you and says: "This is your new home." You smile and say: "Yes it is."

Will the Green House movement accelerate? Will it fall by the wayside as an expensive experiment? Who knows. Is the care received as good or better than that provided in a traditional nursing home? The studies referred to in the article seem to indicate it is.

If you or a loved one is in such a facility, I would love to hear from you about the experience. What are the pluses or minuses? I can't wait to hear from you!

Relocating From A Nursing Home Facility Can Be Harmful To Nursing Home Residents

John R Kormanik — Tue, 25 Oct 2011 11:25:00 -0700

Did you know: Changing nursing home or assisted living facilities can be hazardous to a resident's health? That would certainly appear to be the case and now there is science to back that fact up.

A recent article in the Science Daily, describes the results of a study by the University of Pennsylvania School of Nursing. The study concerned nursing home residents who required evacuation from their facilities and who were relocated to another facility. Of course, because the residents were relocated, they received care from different people than they were otherwise used to.

"The displaced participants experienced delirium, cognitive changes, hospitalizations, and death." Although the study sample size was small-17 long-term care residents-its results are still worth noting. "The study, published in September 2011 issue, found that more than half the residents were negatively affected by evacuation and showed signs of delirium within the two weeks immediately following -- two participants were hospitalized and one died."

According to Pamela Cacchione, PhD, APRN, GNP, BC, the lead author of the study: "Older adults often have visual and hearing deficits, making it more difficult to interpret their environments and precipitating increased stress," which can also "exacerbate chronic illnesses, further precipitating delirium."

It would seem to me, no matter the reason for a nursing home resident's relocation--evacuation due to natural disaster or a simple change of facilities--the concerns would be the same. If the decision has been made to change facilities, make certain extra care is taken at the new facility so that your loved one is properly cared for during and following the oftentimes difficult transition.

Dementia And Antipsychotic Medications In Nursing Homes

John R Kormanik — Fri, 30 Sep 2011 11:53:27 -0700

A recent story by Matt Sedensky, addresses the use of antipsychotic medications in treating dementia in nursing home residents. The story begins with the story of Hazel Eng, a resident of the Ecumen home in North Branch, Minn. "Day after day, Hazel Eng sat on her couch, a blank stare on her face. The powerful antipsychotics she was taking often cloaked her in sedation. And when they didn't, the 89-year-old lashed out at her nursing home's aides with such anger and frequency her daughter wondered if her mother would be better off dead." When Ms. Eng was transferred to another section of the facility and was removed from her antipsychotic medications, there was a dramatic change. "She now beams as she ambles the hallways, reads the newspaper, tells stories and constantly laughs."

According to Mr. Sedensky: "Antipsychotics are meant primarily to help control hallucinations, delusions and other abnormal behavior in people suffering from schizophrenia and bipolar disorder, but they're also given to hundreds of thousands of elderly nursing home patients in the U.S. to pacify aggressive and paranoid behavior related to dementia."

The use of antipsychotic medications to treat dementia is an "off-label" use. According to a 2007 government audit, approximately 83% of Medicare claims for antipsychotic drugs were for purposes including the treatment of dementia.

So what, you might ask. Isn't it better to medicate a resident suffering from dementia so they do not harm themselves or others? The answer is an absolute and resounding: NO! Use of antipsychotic medicine to "treat" the symptoms of dementia creates its own set of issues. "The drugs can limit seniors' ability to effectively communicate, socialize or participate in everyday life."

Thankfully, according to the article, the off-label use of antipsychotic medications to treat dementia in the nursing home setting has decreased over the past decade.

If you have a loved one who suffers from dementia and is receiving antipsychotic medicine, you should speak with your physician. Make sure the medications are necessary and are being used correctly. If your loved one seems "out-of-it" during visits, it may very well be the result of the medications he or she is receiving. It is up to you to make sure each and every medication prescribed to a loved one is absolutely necessary.

September 21 - Today Is World Alzheimer's Day

John R Kormanik — Wed, 21 Sep 2011 07:19:13 -0700

According to the Center for Disease Control's website, September 21 is World Alzheimer's Day. Here are some disturbing facts about Alzheimer's disease:

It is currently estimated that approximately 2.6 million to 5.2 million Americans currently have Alzheimer's disease, depending upon the approach used for identifying individuals with dementia.
If no cure is developed and present population trends continue, as many as 16 million individuals may have Alzheimer's disease by the year 2050.
Alzheimer's disease ranks as the 6th leading cause of death among adults aged 18 years and older, and is the 5th leading cause of death for adults aged 65 years and older.
For people with Alzheimer's disease and other dementias, the total payments for health care, long-term care, and hospice are projected to increase from $183 billion in 2011 to $1.1 trillion in 2050 (in 2011 U.S. dollars).

Indeed, Alzheimer's disease is "the most common form of dementia among older adults.

If you or someone you know has Alzheimer's, take a look at the CDC website. It has more interesting and informative information and links to other sources.

Therapy Dogs - Does Your Nursing Home Have Them?

John R Kormanik — Wed, 14 Sep 2011 09:01:52 -0700

I am a dog person. I love dogs. I believe they bring joy into our lives like few other things. That is why over the past 20 or so years, I have owned a dog. Pictured here is my dog Maggie May. As you can see, she is very patient with me.

When I first moved to Idaho, I was looking for some public service work I could perform. One of the services I became involved in was a "therapy dog" program at St. Luke's Regional Medical Center in downtown Boise. As a dog owner/lover, it seemed like a perfect fit, and it was. Now, my dog at the time, Sherwood, a yellow lab was not a therapy dog, although she possibly could have been. Instead, I would arrive at the hospital and take the therapy dog and its human around to different parts of the hospital to visit patients, both young and old. The interaction between the therapy dog and patient was something I will never forget.

A recent piece in the Los Angeles Times discussed the use of therapy dogs in "senior communities." According to the piece: "There is a growing body of medical research that shows how interacting with dogs (and other pets) improve seniors' emotional and physical well-being." After reading the piece, it got me thinking...why not have pet therapy in nursing homes in Idaho?

There are resources out there for just such services. One I stumbled upon, called "Idaho Paws for Effect" has a website. According to the website, the organization already apparently already visits several nursing homes in the Treasure Valley area. Another resource, "Heart to Heart: Pets With a Purpose, also apparently provides therapy dogs for long-term care facilities. (I am in no way affiliated with either of these organizations, nor am I stating they are the only resource out there.)

Does your nursing home or assisted living facility provide pet therapy? If not, and you are interested in having having a visit from a therapy dog, you should ask your facility to look into arranging for such a visit.

There are few things in the world that make you feel as good as just petting a dog. But, that view comes from a dog lover.

Selecting The Right Nursing Home - Kick The Tires

John R Kormanik — Wed, 31 Aug 2011 11:59:55 -0700

At one of my previous employers, we had a saying: "It is important to do some 'ground-truthing' before drawing any conclusions." Ground-truthing is, of course, going out into the field and seeing the place with your own eyes because you cannot take as gospel what you are told by others. A recent article from Reuters Money applies this principle to selecting a nursing home.

It is true: According to a GAO study, for-profit nursing homes "more frequent and serious deficiencies than non-profit homes." You need to "peek behind the curtain" and look behind the numbers when selecting an appropriate facility for you or a loved one.

In a previous post, I discussed the Medicare "Nursing Home Compare" website and the excellent information it provides. The NHC, however, should be a starting point for your research, not the "be-all-end-all" of it.

As suggested in my prior posts, and as reiterated by my colleague Jonathan Rosenfeld and others in the Reuters' article, in-person visitation to a nursing home during the selection process is just as important as the "numbers." Go to various facilities. Go unannounced if you would like. Look around. Is the facility clean no matter what time of day or night you visit? Do the residents look neat and clean or disheveled? Do the residents seem happy or over-medicated? Visit at meal-time; try out the food.

Choosing the right nursing home is a big decision. Do not rely upon "numbers" alone. Do not simply take the recommendation of someone, whether they are a friend or not. You wouldn't buy a car based on MPG and recommendations, would you? You need to "kick the tires" to make sure the car you are considering is the right one for you. You take it for a test drive. Shouldn't you do the same when making the decision of which nursing home is right? The answer is undoubtedly: Yes!

Can An Assisted Living Facility Kick You Out Because Of Your End Of Life Wishes?

John R Kormanik — Thu, 25 Aug 2011 08:15:01 -0700

I came across an interesting article by Paula Span in the New York Times about a couple's end-of-life decision and a New Mexico assisted living facility's reaction to it. Honestly, the title says it all: "Deciding to Die, Then Shown the Door. The story is about Armond and Dorothy Rudolph and their decision to voluntarily stop eating and drinking in order to legally hasten their death without drugs or violence. According to one source this act results in death in usually about two weeks.

The corporate owner of the facility, Fundamental Long Term Care, apparently upon the advice of legal counsel, called 911 and informed Armond and Dorothy they would be evicted. A physician came and spoke with the Rudolphs and determined they were more than capable of making the decision they did. At the end of the day, the Rudolphs were not evicted; instead, their family removed them from the facility and placed them in a private home where they died less than 2 weeks later, surrounded by family who loved them.

According to the article, what the Rudolphs chose to do is legal in every state under federal law. The fact that it is legal, however, does not answer the question of whether an Idaho assisted living facility could evict a resident under the same circumstances.

Every resident of an assisted living facility in Idaho has certain rights; they are set forth in Idaho Code § 39-3316. Among these rights is: "The right to refuse medical services based on informed decision making." The Rudolphs presumably had similar rights. That did not stop the facility from trying to evict them.

You have rights as a resident of an assisted living facility. Make certain you exercise them. Remember, though, just because you have the right to make a decision, does not mean the facility will make it easy for you.

If you have questions about your rights, you should contact an attorney who is well versed and knowledgeable in this area of the law.

More Evidence Nursing Homes Do Not Pay Staff Enough - Homes Want Exemption From Health Care Law's Requirements

John R Kormanik — Mon, 16 May 2011 08:55:58 -0700

In an article in today's New York Times, Robert Pear describes the efforts the nursing home industry is undertaking to escape from the requirements of the new Affordable Care Act. The first sentence in Mr. Pear's article says it all: "It is an oddity of American health care: Many nursing homes and home care agencies do not provide health insurance to their workers, or they pay wages so low that employees cannot afford the coverage that is offered."

Why is it important that nursing home workers have access to affordable health care? According to Ms. Charlene A. Harrington, a professor at the School of Nursing at the University of California, San Francisco: "If employees have health insurance, they are more likely to be treated for illnesses, less likely to pass on infections to nursing home residents and more likely to get early treatment for occupational injuries.” Unfortunately: "Among workers who provide hands-on care to nursing home residents, one in four has no health insurance."

Shouldn't the people responsible for caring for nursing home residents be paid a living wage and, thus, be able to afford health insurance? Shouldn't these same people have access to affordable healthcare? Aren't nursing home residents safer if staff can afford to see a physician when they are ill or injured? The answer to all of these questions is: "Yes."

If you think nursing homes should have to abide by the new Affordable Health Care Act by offering staff affordable health care beginning in 2014, as the law requires, do not remain silent. Contact your congressperson. Let them know your thoughts. Nursing home residents would be safer if all staff had access to affordable healthcare.

Elderly For Sale: Placement Services Run The Gamut In Quality And Approach To Placing Seniors

John R Kormanik — Mon, 21 Mar 2011 08:49:46 -0700

In yesterday's Seattle Times, Michael J. Berens wrote an article entitled: "Senior-care Placement Companies Scramble For Cash." In the article, Mr. Berens does an excellent job of pitting two competing business models for elder-care placement against each other: One is a nationwide internet-based service; the other is a locally based provider. Although both providers charge facilities the same amount for their service -- one month's rent -- that is where the similarities end. The differences between the two are both stark and disconcerting.

The nationwide internet-based company, A Place For Mom, is allegedly the nation's largest senior placement firm. The company never meets face-to-face with any senior it is placing; instead all contact is either via telephone or internet. It sends mass facsimile transmissions to its list of approved homes which contain potential residents and urges the facility to call the potential resident. Although they supposedly visit each facility in which they attempt to make a placement, that does not always happen. In fact, according to the article, A Place For Mom placed a resident at a facility which had been cited for hiring caregivers with felony convictions that should have disqualified them from working with vulnerable adults; lying to state investigators and fabricating records; and failing to provide proper care for 32 days to an 88-year-old woman who died from untreated pressure sores. Only after this fact was brought to A Place For Mom's attention by Mr. Berens, did it remove the facility from its list of approved homes.

On the other end of the spectrum is Careful Placement Adult Home Agency, which is a "one-man show" run by Brandon O'Larey. Mr. O'Larey visits each home he places residents in. He visits all potential residents. According to the article, Mr. O'Larey even visits people after he places them to make sure they are doing well and to check up on them. Perhaps this is not the best "business" model; isn't it, however, a more comfortable and caring process?

The moral of the story: Be careful when it comes to placement agencies; they may not always have your best interests in mind. There is no substitute for your own research and site visits to make certain the place you or your loved one is going is all it needs to be. Do not become just another "number" to a placement agency.

Politics And Florida Office Of Ombudsman...Does Industry Hold Too Much Sway?

John R Kormanik — Thu, 10 Mar 2011 08:41:48 -0700

I found a story in today's Tampa Bay Online (Florida) interesting, disturbing and, unfortunately, unsurprising. According to the article, Brian Lee, Florida's long term care ombudsman resigned after "butting heads" with Florida's new governor, Rick Scott. Mr. Lee indicated the "last straw" which lead to his forced resignation was a letter he sent out to Florida's nursing homes "directing them to submit information on their ownership, as permitted under the new federal health care legislation." This is a contentious issue because, according to critics of the nursing home industry, "facilities are often broken into multiple businesses to make lawsuits against them more difficult."

Florida's ombudsman program is funded, in part, by the federal government. Idaho's Commission's on Aging's ombudsman's program receives similar funding. The federal government is looking into Mr. Lee's situation; a representative of the federal government is quoted as stating: "We expect that Florida will make every effort to avoid even the appearance of a conflict of interest" in the appointment of a new ombudsman.

In Idaho, the Ombudsman is hired by the administrator of the Idaho commission on aging. Currently, Ms. Kim Toryanski is the administrator of the commission. Ms. Toryanski was appointed by the governor, and confirmed by the state senate.

Let's hope the Idaho ombudsman program is not politicized. The Ombudsman serves as a critical advocate for those who need it the most, residents of long-term care facilities and persons 60 years' or older living in the community.

Do you have questions about the Idaho ombudsman? Submit them to me and I will try to find answers and post them in the future on this blog.

Does Your Nursing Home Hire Criminals? Chances Are Pretty Good It Does!

John R Kormanik — Wed, 09 Mar 2011 09:00:00 -0700

In a recent New York Times' article, Robert Pear writes about a disturbing fact: More than 90% of nursing homes in the United States "employ one or more people who have been convicted of at least one crime." Frankly, I find that disconcerting.

Mr. Pear's story is based upon a report issued by Daniel R. Levinson, inspector general of the Department of Health and Human Services, who obtained the names of more than 35,000 nursing home employees and then checked with the Federal Bureau of Investigation to see if they had criminal records.According to Mr. Levinson: “Our analysis of F.B.I. criminal history records revealed that 92 percent of nursing facilities employed at least one individual with at least one criminal conviction.” He went on to say: “Nearly half of nursing facilities employed five or more individuals with at least one conviction. For example, a nursing facility with a total of 164 employees had 34 employees with at least one conviction each.

The rules that govern Idaho nursing homes and assisted living facilities require criminal background checks be performed. There are also certain "disqualifying crimes" which prohibit a person from working in a nursing home such as abuse or neglect of a vulnerable adult, among many others. Although the potential employee must "self-report" any criminal convictions, they must also provide finger prints for their criminal background investigation.

No system is fool-proof, however. Make sure to report any suspicious activity to your nursing home or assisted living facility. As the Department of Health and Human Services' survey reveals, nursing homes and assisted living facilities are hiding a "dirty little secret": they employ some unsavory characters.

Nursing Home Staff Have Important Responsibilities; Informing A Resident's Physician Of A Change In Condition Is One Of The Most Important

John R Kormanik — Thu, 24 Feb 2011 07:38:11 -0700

In a story in today's Orange County Register, Courtney Perkes writes about the death of a 93 year-old Donald Bodkin. Mr. Bodkin died of an undetected ruptured intestinal ulcer and infection. Courtney's story reveals the nursing home facility, Victoria Healthcare and Rehabilitation Center, "received the most severe penalty under (California) state law" - $75,000 for violations that led to Mr. Bodkin's death. Victoria Healthcare and Rehabilitation Center is a for-profit facility.

Mr. Bodkin was in the facility for a short time to recover from surgery for a broken hip. A few weeks into his stay, Mr. Bodkin developed signs and symptoms that should have led staff at the facility to call his doctor: a distended, painful abdomen, low urine output and loss of appetite. Incredibly, these symptoms were documented by staff. Also, an occupational therapist and Mr. Bodkin's own family told nursing home staff he was lethargic and in pain. Despite all of this information, no one with the facility contacted Mr. Bodkin's doctor. Five days after his first symptoms, Bodkin was found without a pulse. He died soon after at a hospital Sept. 13.

Victoria Healthcare and Rehabilitation Center is contesting the fine. The facility's argument: It does not believe anything it did contributed to Mr. Bodkin's death.

The fact of the matter is the staff at the facility had lots of information which should have been communicated to Mr. Bodkin's doctor. He suffered needlessly for 5 days after his symptoms were first reported. He died from a ruptured ulcer in the small intestine that led to a bloodstream infection.

The moral of the story: Even though nursing home staff have a responsibility to contact a resident's physician, they cannot always be counted on to do so. If you or a loved one is a nursing home resident and believe your physician should be contacted, be sure to hound the staff to do so. If they will not, take it upon yourself to contact the physician. It may very well save a life.

Nursing Home Abuse: Younger Residents Have Their Own Needs

John R Kormanik — Thu, 20 Jan 2011 10:58:36 -0700

In a recent post on his law firm's blog, my friend Randy Walton discussed a Washington Post story about younger nursing home residents and their needs. The WP story, by Matt Sedensky, reveals "about one in seven people now living in such facilities in the U.S. is under 65. But the growing phenomenon presents a host of challenges for nursing homes." In fact: :The number of under-65 nursing home residents has risen about 22 percent in the past eight years to about 203,000, according to an analysis of statistics from the Centers for Medicare and Medicaid Services."

Many of the "younger" nursing home residents have suffered some type of traumatic injury which rendered them unable to care for themselves. The injuries, be it a gunshot wound or a car wreck, may have resulted in paralysis or a traumatic brain injury. "For young people who find themselves newly disabled, the psychological and social needs are often even more challenging than their physical demands. That presents a challenge for nursing homes that are used to serving people near the ends of their lives."

Nursing homes and assisted living living facilities need to do a better job at caring for all segments of their populations.