Nursing Home Law Blog

New York City Home Health Agency Pays $24 Million for Falsified Medical Claims

David Cohen — Tue, 02 Feb 2010 08:07:48 -0500

Nursing Personnel Home Care, a New York City home health agency, has agreed to pay $24 million in response to allegations that they submitted false claims to the New York Medicaid and Medicare programs, according to the United States Department of Justice. The claims state that Nursing Personnel Home Care knowingly supplied aides with phony training certificates to Extended Home Care and Excellent Home Care, which then billed New York Medicaid for the aides’ services.

The government also alleged that Extended Home Care and Excellent Home Care knowingly billed for aides with phony certificates who were untrained and that Extended and Excellent knowingly submitted claims to the Medicare program for home health aide services purportedly rendered by aides supplied by Nursing Personnel that were not actually provided.

You can read more on this story online here.

Medical Malpractice Reform & Passing the Buck

Stark & Stark — Fri, 29 Jan 2010 09:34:59 -0500

Stark & Stark Nursing Home Litigation Group Chair, David R. Cohen, authored the article, MEDICAL MALPRACTICE REFORM & PASSING THE BUCK: an elder advocate weight in, for the Winter 2009 edition of Injury Board magazine.

In the article, Mr. Cohen discusses the reasons why large corporations, who own and operate nursing homes and assisted living facilities, choose to profit financially rather than provide adequate levels of care to their residents. Additionally, Mr. Cohen provides an overview of the devastating effects these decreased levels of care have on residents who trust these nursing homes and assisted living facilities with their lives.

You can read the full article online here.

Nursing Homes and Assisted Living Facilities: Understanding the Differences and Keeping Your Loved Ones Safe

David Cohen — Thu, 21 Jan 2010 14:47:44 -0500

Dave Cohen, Chair of Stark & Stark's Nursing Home Litigation Group, authored the article, Nursing Homes and Assisted Living Facilities: Understanding the Differences and Keeping Your Loved Ones Safe, for the January 20, 2010 edition of US 1 Newspaper. You can read the full article below:

As a trial attorney for over twenty years and a litigator who has devoted his entire career to protecting the rights and safety of the elderly, I have seen a disturbing trend in recent years in the interplay of nursing homes and assisted living facilities. As many are aware, when our loved ones’ health declines, families are faced with critical and emotionally heart wrenching choices.

Traditionally, nursing homes have been the most common choice in working toward obtaining the highest quality of life and safety for seniors who can no longer care for themselves and for whom family members simply do not have the qualifications to fulfill these needs. More recently, assisted living facilities (ALFs) have been gaining popularity. They fulfill a well needed void in the healthcare continuum and are certainly a welcomed addition to the options available to families.

However,Assisted living facilities are regulated, but not nearly as much as nursing homes. The facilities themselves are generally much more attractive and family members tend to feel better about placing parents or spouses in them. However, ALFs generally have fewer nurses and fewer nurses’ aides. Additionally, they frequently do not have registered nurses on site for significant periods of time. For seniors with lesser needs and who are otherwise much more independent, this is an excellent environment. However, the danger is twofold:

In the first instance, while the majority of ALFs are owned and operated by caring, professional and qualified individuals, many are so focused on filling beds that they often will admit those who simply are an improper fit for that level of care. In my practice, I have seen far too many residents suffer from malnutrition, dehydration, bedsores, fractures and ultimately death based upon a poor fit for a facility which never could or should have let this person through their doors. The second danger faced by families involves situations where the fit was initially appropriate, but when the resident’s health declines, it becomes dangerous to allow that person not to receive a higher level of care. Much like poor admission situations, in my practice I have seen many residents needlessly suffer and die because the tough decision to move them into a higher level of care was overlooked by the staff at the ALF.

In the end, the decision to accept or reject the resident should be based upon the individual’s needs and not by profit. This is the formula by which the vast majority of assisted living facilities operate. It is those who do not operate in this fashion who create the dangers we speak of. Families can and should be vigilant about all of these issues. They should also conduct a significant amount of research into what the particular assisted living facility they are looking into can and cannot do.

Unfortunately, there is not a bright-line rule as to the level of care that assisted living facilities provide. I have seen an incredibly wide variance between the lower levels of care and the higher levels of care. At the lower end, there is very little supervision and medical/nursing staff available, while the higher end of care at some of these facilities is nearly indistinguishable from that provided in nursing homes. Without a clear knowledge as to what these facilities can provide, families are ill advised to take the leap into admitting a loved one. Every bit as important is monitoring the health and cognitive status of your loved one while living in an assisted living facility to ensure that they remain an appropriate fit.

With vigilance, attention and research, families can and should look toward assisted living facilities to provide the best of care and quality of life for their loved ones - but must do so with caution and their eyes open.

Omni Nursing Homes Hit with Violations

David Cohen — Fri, 15 Jan 2010 08:22:55 -0500

In several previous posts I have discussed the mounting problems associated with several Hudson County nursing homes, which are owned and operated by Omni Assets Management. Though reports, TV ads, websites and previous citations have brought these harmful acts to the attention of the public, Omni has done nothing to right these wrongs.

Just last week, Omni was cited by the National Labor Relations Board for violating several labor laws, including refusing to reinstate 14 striking workers and harassing and intimidating workers for participating in lawful union activities, according to a complaint issued by a federal agency.

You can read more on this story online.

Another Charitable Hospital settles Whistleblower Suit for Medicare Fraud

David Cohen — Fri, 18 Dec 2009 10:25:45 -0500

Articles such as these have led many commentators to question whether so-called charitable health care institutions are truly charitable. A recent report online states that Our Lady of Lourdes Medical Center in Camden and Lourdes Medical Center of Burlington County in Willingboro will pay the government $7.95 million in response to allegations that the hospitals defrauded Medicare. This is not the first time Our Lady of Lourdes Health Care Services Inc. has been involved in litigation due to questionable billing practices. In 2005, Lourdes Medical Center was a defendant in a civil suit which stated that the hospital fraudulently inflated its charges to Medicare patients in order to collect enhanced reimbursements.

Stark & Stark Launches New Injury Focused Website

Stark & Stark — Thu, 17 Dec 2009 09:20:01 -0500

I am pleased to announce that Stark & Stark has launched a new website, offering visitors easy access to important legal information for those who have been seriously injured. The new site provides video blogs offering helpful tips, information for family members of those who have been in an accident and blogs discussing changes to laws impacting the field of personal injury.

In addition to the new injury website, the firm has also has redesigned its existing website in order to provide visitors with easier access to information on our attorneys and the many services Stark & Stark provides. The new site features updates on our community involvement, industry specific newsletters and information on all of blogs Stark & Stark provides.

Highly Paid CEO's of Financially Struggling Hospitals

David Cohen — Wed, 16 Dec 2009 10:47:20 -0500

I read an interesting article on the New York Post online earlier this week discussing how even in these tough economic times, hospital presidents & CEOs are collecting large bonuses and incentive payments while the health-care systems continues to struggle. Apparently Wall Street executives aren’t the only ones. Read the full article online here to see what other benefits these top executives are receiving, at the cost of our loved ones.

The Mercer County Geriatric Center To Be Sold

David Cohen — Fri, 11 Dec 2009 08:07:42 -0500

The Board of Chosen Freeholders resolved earlier this week to transfer ownership of The Mercer County Geriatric Center to the Mercer County Improvement Authority. The 240-bed nursing facility is being sold to a private entity in hopes of having the home run more efficiently, after years of monetary losses and poor quality ratings.

In 2008 the facility lost $7.4 million, and over $6.7 million in 2007. Additionally, the losses were expected to continue to rise over the next several years, which would only increase the burden for taxpayers. The facility is staffed by 150 county employees and serves primarily residents on Medicare or Medicaid. Officials said they would try to persuade the new owner not to cut staff, and said that the county hopes to have the sale completed by June 2010, but added that no negotiations have yet been initiated.

Picking a nursing home but don't know where to begin?

Michael A. Brusca — Wed, 09 Dec 2009 09:02:36 -0500

Picking a nursing home to care for a loved one can be difficult and overwhelming. You want the best care, but where to start? What nursing homes are in the area? Have they had any problems? What services do they provide? What are the right questions to ask? Here is a great place to start.

Medicare keeps detailed records of all nursing homes, and rates them on a one-star to five-star scale. Its free, easy to access, objective, simple to read, and you can compare multiple nursing homes at the same time. If your family member or loved one is currently in a nursing home, this website is also a great tool to see how your current nursing home compares to others.

Understaffing Causes Death in Nursing Home

David Cohen — Thu, 03 Dec 2009 08:13:49 -0500

An article out of Minneapolis, Minnesota last week reports of an 89-year old nursing home resident who, even with all of the proper precautions, died after a fatal fall. Despite a bed alarm, a motion sensor, a sound monitor and a perimeter mattress the resident fell in the middle of the night. Due to a severely understaffed wing, the resident died due to complications from the fall.

What You Can Do When You Feel Your Loved One Is Not Being Properly Cared For

Michael A. Brusca — Mon, 30 Nov 2009 08:05:39 -0500

The decision to trust a nursing home to care for a loved one can be a difficult one, even when a family does not have the time or resources to properly care for a elderly family member at home. Conflict between family members and nursing home staff is very common, especially when a family feels their loved one is not being taken care of properly. In this article, there is some great advice on what you can do when you feel your loved one is not being properly cared for.

Profits of people and bedsores

David Cohen — Tue, 24 Nov 2009 09:45:02 -0500

Nursing home employees in New Jersey have launched a campaign informing the public about the rate of bed sores in patients residing at Omni nursing homes. The campaign includes TV ads, radio ads, Google ads, a mobile billboard and a website dedicated solely to informing people of the poor care provided at these homes.

In recent years, Omni nursing homes have been reported to have the worst bed sore rate in New Jersey, and one home in particular, 45% of short-stay residents had bed sores. Due to the severity and possibly deadly side effects of bed sores, this rate is simply unacceptable. Though the care provided is lacking, supplies are limited and homes are often times understaffed, the profits are not. In the past four years alone, Omni executive Avery Eisenreich has earned a personal fortune of roughly $33 million.

You can visit the website online here.

Nursing Home employee steals from resident

David Cohen — Fri, 20 Nov 2009 08:30:53 -0500

Charges have been brought against a nursing home employee in Bayone, New Jersey after he reportedly stole $48,000 by forging employee paychecks, including those of mentally-challenged individuals who worked at the home. You can read more on this story online here.

Falls in nursing homes: A deadly killer of the elderly

David Cohen — Mon, 16 Nov 2009 08:35:18 -0500

Here is an interesting article which addresses the fact that more than 100 Minnesotans die each year after suffering falls in nursing homes. The article questions why so few of these deaths are fully investigated by the state, and how serious penalties for violations are rarely enforced.

Good news on the Nursing Home Transparency Act

David Cohen — Mon, 09 Nov 2009 11:39:44 -0500

Hot off the press is some very good news about generating more accountability for those who choose to profiteer off of the elderly and infirm. Below is an email alert I received from The National Consumer Voice For Quality Long-Term Care detailing the changes the bill will provide:

Nursing Home Transparency Clears Another Round As House Votes on Health Care Reform

The 1990-page health care reform bill passed by the House of Representatives just before midnight Saturday includes not only sweeping health insurance reforms but also nursing home transparency, criminal background checks on long-term care workers, and a voluntary payroll deduction system that would provide benefits for long-term care services. The bill, H.R. 3962, the Affordable Health Care for America Act, can be downloaded here.

As expected, the bill includes-without amendment-nursing home transparency provisions requiring:

Public disclosure of individuals and entities that own, govern, operate, finance, provide services to, and/or control the nation's nursing homes.
Compliance and ethics programs and internal quality assurance programs in nursing homes, and pilot projects to test ways to improve oversight of chains.
Collection and reporting of staffing information based on payroll data, including hours of care per resident day, turnover and retention rates, and facility expenditures for wages and benefits.
A review of Nursing Home Compare and addition of information about sanctions against facilities and the number of adjudicated crimes occurring in them.
A categorical breakdown of expenditures on cost reports to show how much facilities spend on direct care versus other expenses.
An improved state complaint process to help protect complainants against retaliation.
An increase in federal civil monetary penalties and a process to hold CMPs in escrow during appeals (although only after an independent informal dispute resolution process was completed).
Adequate notification when facilities decided to close, including the option for the government to continue reimbursement until relocation was achieved.
Training of nursing assistants in dementia care and abuse prevention.
The bill would authorize a program of national criminal background checks on all long-term care workers who have access to residents or patients--from those who provide in-home long-term care services to nursing home employees.

H.R. 3962 also incorporates the Community Living Assistance Services and Supports (CLASS) Act to create a national voluntary social insurance system through which enrollees who became disabled (after paying into the system for at least five years) could purchase community-based long-term care, services or supports. Nursing home residents who were Medicaid beneficiaries could retain 5 percent of their benefit, in addition to their personal needs allowance, for their personal use while the remainder was applied to the cost of their care. (See page 1562 of the bill.)

Last-minute efforts to add the Elder Justice Act to H.R. 3962 were not successful. The EJA is in the health care reform bill passed by the Senate Finance Committee.

In the coming weeks, the focus of health care reform will be on the Senate, where Senate leaders are trying to meld bills passed by the Finance (S. 1796) and HELP (S. 1679) committees and to find enough votes to pass the resulting bill. Any bill that passes the Senate will have to be reconciled with H.R. 3962 to create a final health care reform bill to be voted on by both houses. Nursing home transparency and other long-term care provisions will remain at risk of being amended or dropped as this delicate and highly political process goes forward.

NCCNHR will provide additional policy bulletins on H.R. 3962, continuing coverage of long-term care issues in health care reform, and Action Alerts to let you know how and when your voice can be crucial.

Preventing Crippling Contractures in Nursing Homes

David Cohen — Mon, 26 Oct 2009 15:34:00 -0500

I found an interesting article online which addresses the recent epidemic of contractures in nursing homes.Contractures are injuries, usually sustained by the elderly in nursing homes, which limit their mobility and range of motion. When residents enter nursing homes with preexisting medical conditions they often times do not receive the proper amount of physical exercise. This decrease in regular movement leads to degeneration and increased stiffness in the joints, and ultimately leads to contractures. The article discusses three common ways nursing home residents can prevent contractures from developing.

You can read the full article online here.

Omni Assets Management Employees Hold March in Hopes of New Contracts

David Cohen — Mon, 19 Oct 2009 09:36:07 -0500

I read an article online last week about nursing home employees in Hudson County who held a “Family Day” march in Jersey City after working the last two years without contracts. The walk was held in hopes of putting pressure on their employers, Omni Assets Management, in hopes of negotiating a fair contract for all Omni employees.

You can read more about the march online here.

Malpractice Reform - Not a Silver Bullet

David Cohen — Thu, 08 Oct 2009 08:15:57 -0500

As we have been saying on this blog for some time, malpractice reforms have no place in the healthcare debate. The real issues should be 98,000 needless deaths every year, unnecessary human suffering, the cost of treatment for injuries caused by carelessness and $68 billion lost annually to medicare and medicaid fraud.

In the end, all studies confirm that malpractice reform would have no impact on any of these issues. I found this article online which reinforces the fact that malpractice reform has no business being included in the nation's healthcare debate.

Nurse abusing patients in Gloucester Manor, Kresson View, Rainbow Nursing Home and Others, Sentenced

David Cohen — Mon, 05 Oct 2009 10:08:47 -0500

In a story that we've been following, nurse Devin Bonsall, has been sentenced for stealing medications and abusing many patients throughout the state at long term facilities across South Jersey. Bonsall plead guilty to theft and two counts of elderly endangerment. She will received a sentence of only three years in state prison. You can read more on the story online here.

The real face of Medical Malpractice - A grieving mother speaks

David Cohen — Fri, 02 Oct 2009 13:09:44 -0500

There is a human side to the nonsense spewed by the insurance industry about malpractice. It's about needless suffering and tragedy. It is the face of many tragic cases that a billion dollar industry and its well funded lobby does not want the public to see.

I found an aticle online which gives insight into the lives of those affected by the most severe cases of negligent care. You can read the article online here.