Nursing Home Law Blog

Call your state's Ombudsman's office if your loved one has been abused in a nursing home or assisted living facility

dcohen@stark-stark.com (David Cohen) — Mon, 21 Apr 2008 08:05:16 -0500

One of the greatest obstacles to helping victims of abuse and neglect is the failure of nursing homes to self police. More often than not, we see a complete lack of investigation - even in light of serious allegations against staff. One way for families to overcome this is to immediately call the Ombudsman's office for their state.

The work doesn't end there, though. Families should remain in constant communication with the investigator. DO NOT ALLOW THE INVESTIGATION TO BE LIMITED TO THE NURSING HOME OR ASSISTED LIVING'S SIDE OF THE STORY. MAKE SURE THAT THE INVESTIGATOR GETS BOTH SIDES.

Our office has had great success over the years in utilizing these investigations to both improve the quality of care and help our clients achieve justice.

Here is a link to a helpful site which provides phone numbers for the Ombudsman's office for each state. And here is a direct link to New Jersey's Ombudsman's home page.

Nursing Home abuse and whistle blowers in New York state

dcohen@stark-stark.com (David Cohen) — Mon, 14 Apr 2008 08:53:00 -0500

Here is an article I recently read, which outlines not only allegations of abuse, but also retaliation against a whistle blower who reported the abuse. The article contains helpful links for families looking to research nursing homes.

Nursing Home Sued by U.S. Department of Labor for unpaid Wages

dcohen@stark-stark.com (David Cohen) — Tue, 01 Apr 2008 11:16:26 -0500

One of the most important responsibilities of nursing home owners is to treat their employees well. This leads to a positive environment, which fosters good care and enthusiasm among staff. As may be seen, the opposite is alleged here in an article stating that the Union City's Manhattan View Nursing Home is being sued by the United States Department of Labor. The suit is seeking unpaid overtime wages for employees of Manhattan View over the past several years.

Tracy bill pushes more options for elderly healthcare

dcohen@stark-stark.com (David Cohen) — Thu, 13 Mar 2008 08:11:34 -0500

I found an article the other day relating to recent legislation that passed in Tennessee to increase options for elderly health care. Two bills sponsored by Tennessee Sate Senators passed the Senate aimed at helping elderly or disabled Tennesseans receive more options in their health care, including staying in their homes for as long as possible.The long term care legislation is part of a series of bills aiming to help citizens “age in place.”

The two bills will broaden the definition of assisted living to include hospice services and make it clear that any assisted-care living facility resident who qualifies for hospice care under Medicare can continue those services and also receive reimbursement for assisted living services.

I think this is a wonderful piece of legislation that I hope will make its way across the country in order to provide increased assistance for our elderly. You can read more on the bills here.

Prevention of Inhumane Care

dcohen@stark-stark.com (David Cohen) — Fri, 07 Mar 2008 09:26:37 -0500

I took a deposition of a nurse yesterday who was charged with the care of my client toward the end of her life. My client was fitted with a leg brace that was significantly too tight. She complained of pain. Her leg was bleeding. No one responded.

To make matters worse, no pain medication was given. This is not humane and it is not acceptable.

Thankfully, many good people are working hard to make the final days of terminally ill patients more comfortable.

I recently found a website which offers tips on how to prevent this sort of inhumane treatment from occurring again.

Special Focus Facilities

dcohen@stark-stark.com (David Cohen) — Fri, 29 Feb 2008 08:06:22 -0500

After receiving tremendous pressure from advocacy groups, CMS has released its expanded list of the most troubled nursing homes in the country. These are known as "Special Focus Facilities."

Acting CMS Administrator Kerry Weems disclosed at a special media briefing Thursday that the “Special Focus Facilities” list had actually grown to 131 nursing homes with poor survey records. The list will continually be in flux, noting the next public update will be in April.

In response to a McKnight's reporter's question, Weems also clarified that from now on providers would be given brief advance notice of their inclusion on the dubious list but no others would learn of list contents until results are refreshed online. When CMS went public for the first time ever, but with just the partial list, in November, consumer advocates loudly complained that nursing home lobbyists and associations had been given the full list, while the general public had not.

In New Jersey, there are currently only three facilities on the list. Two of these are listed under the category, "Improving," while the other, sadly, is now a veteran of the listing, in the list of "Facilities That Have Not Improved."

It will interesting to see if inclusion on this list will provide extra incentive for these troubled homes to improve the quality of care - and thus reduce the unacceptable quantity of nursing home injuries and abuse.

Forced Overtime Shifts for Nurses Facing Ban in PA

dcohen@stark-stark.com (David Cohen) — Tue, 26 Feb 2008 08:09:11 -0500

I read an interesting article this week in the Philadelphia Inquirer that truly encapsulates much of what we've been trying to say on this blog since its inception. The management and owners of nursing homes, must treat their front-line worker with dignity, respect and compassion. Otherwise, patients in nursing home get injured and sometimes die.

New Jersey has passed good legislation to protect nurses...and in turn, patients. Pennsylvania should follow this lead.

Resource for Families Investigating Nursing Homes

dcohen@stark-stark.com (David Cohen) — Fri, 22 Feb 2008 08:07:42 -0500

I recently found a great website for families looking to investigate nursing homes. The website offers a list of nursing home throughout the country that are in danger of harming it's residents. The site breaks down the potentially harmful home into three categories:

- a red code equals actual harm and/or immediate jeopardy
- a yellow code equals the potential for more than minimal harm
- a blue code equals the potential for minimal harm

In this link, there exist some significant problems at a facility known as Plaza Regency at Park Ridge, in Park Ridge, New Jersey. I strongly urge our Blog readers to explore this helpful site.

You can access the website here.

Nursing Home Quality Twenty Years After the Nursing Home Reform Act

bmurphy@stark-stark.com (Brian Murphy) — Mon, 18 Feb 2008 08:03:10 -0500

I found this article which I feel is a very informative article on the improvements and continuing problems of nursing home care 20 years after the Nursing Home Reform Act. Although some changes have come about, there is still much work to be done.

The Kaiser Family Foundation that examines the progress nursing homes have made over the past 20 years since the Omnibus Budget Reconciliation Act of 1987 (also known as the Nursing Home Reform Act) became law reports that though the new act has been in place for over 20 years, there has not been a significant enough change.

You can read more the Nursing Home Reform Act and the Kaiser Family Foundation's study here.

Potential Treatment for Alzheimer's Disease

dcohen@stark-stark.com (David Cohen) — Thu, 14 Feb 2008 08:03:15 -0500

Below is an extraordinarily promising article involving a potential treatment for Alzheimer's disease. A very significant component of nursing home and Assisted Living populations includes physically healthy individuals with developing Alzheimer's.

The drug, Enbrel - commonly used to treat arthritis, in recent tests has shown to reverse the effects of Alzheimer's Disease in just minutes. Enbrel is believed to assist those with Alzheimer's by delivering the same relief the drug offers arthritis patients. The drug, which is used to relieve the inflammation in joints of people suffering from arthritis, researchers now believe can reduce the inflammation in the brain of people suffering from Alzheimer's.

This article offer some hope for the many families and patients suffering from this devastating illness.

Oldest resident in Massachusetts dies at age 111

dcohen@stark-stark.com (David Cohen) — Wed, 06 Feb 2008 08:07:17 -0500

I recently found an inspiring story about the recent passing of the world's 22nd oldest person and the oldest resident in Massachusetts, Mary Marques. She died peacefully in her nursing home, Julian J. Leavitt Family Jewish Nursing Home in Longmeadow, at the age of 111. She was believed to be the world's 22d-oldest person, according to the Gerontology Research Group, which validates birthdates of those over 110, who are known as supercentenarians

Much of the credit for her longevity was given to unprocessed foods for the first 40 years of her life, an active lifestyle and red wine. You can read more on Mary Marques and her remarkable life here.

Durable Powers of Attorney

dcohen@stark-stark.com (David Cohen) — Fri, 01 Feb 2008 08:10:56 -0500

Here is a link to good work being done to encourage families to obtain a durable powers of attorney for elderly family members.

Very often nursing home residents begin their residency with all of their mental faculties. Sadly, these frequently diminish over time. Once a person lacks the mental capacity to designate an individual to serve as a power of attorney, the process becomes extremely complicated, slow and expensive. Most importantly, necessary actions and decisions for NH residents often cannot take place without Court intervention.

The simple solution is to get a power of attorney early on. It is simple, inexpensive and the smart thing to do.

Home Health Care

dcohen@stark-stark.com (David Cohen) — Tue, 22 Jan 2008 08:08:24 -0500

As we've been saying for many years now, under the right circumstances home care provides a well needed alternative to nursing homes and assisted living facilities.

This is not to say that it is a fit for everyone, but of the one-million plus nursing home residents in this country, many do not need that level of care - and many gave up their homes, all of their savings and their lifestyle for a higher level of care than they really needed.

We have reported on this blog legislation which is aimed at making funds more available to seniors to help widen the array of options available to them. Obviously, the business community sees this opportunity and is acting upon it.

You can read more on home health care here.

New Jersey Safe Patient Handling Act

dcohen@stark-stark.com (David Cohen) — Thu, 17 Jan 2008 08:08:10 -0500

New Jersey has recently passed the Safe Patient Handling Act, which will hopefully help reduce the number of fall down incidents which occur in long term care facilities.

Many residents who have been assessed to need what is known as a two person assist for all transfers are injured when employees of understaffed facilities make the tragic decision to attempt this alone.

An interesting article in the Philadelphia Inquirer recently discussed the Safe Patient Handling Act, and the requirements which will assist in the decrease of injuries at New Jersey nursing facilities. You can read more on this article here.

Choosing the Right Assisted Living Home

rdeluca@stark-stark.com (Stark & Stark) — Wed, 16 Jan 2008 17:25:04 -0500

David Cohen, Shareholder and Chair of Stark & Stark’s Nursing Home Litigation Group, was quoted in the January 16, 2008 edition of US 1 Newspaper, in the article, Choosing the Right Assisted Living Home.

The article discusses the importance of research and careful planning when selecting a nursing home for you and your loved ones, in order to prevent further injuries. Cohen advises families to be aware of the specific statewide and national regulations in place in order to prevent nursing home abuse in under-funded facilities providing inadequate care.

You can read the full article here.

Pharmacy Records Play Crucial Role in Administration of Medication

dcohen@stark-stark.com (David Cohen) — Fri, 11 Jan 2008 08:05:16 -0500

Pharmacy records are critically important in the evaluation of claims involving improper administration of medication. They also provide a means by which advocates can effectively fact check whether medications that nursing homes claim are delivered actually are.

Our office has uncovered many instances wherein nursing home claim to have provided medications to our clients (and billed for them) when they weren't even in the facility. It is only though careful review of detailed records that these deeds can be uncovered.

Attached is an interesting article which highlights the importance of proper monitoring of pharmaceuticals for our burgeoning nursing population, which is now approximately 1.8 million. As the needs of the geriatric population increase, so must the support that we provide.

New Jersey Faces Nursing Shortage

dcohen@stark-stark.com (David Cohen) — Thu, 03 Jan 2008 08:18:32 -0500

As recently reported in the Courier Post, New Jersey faces a critical nursing shortage. As is frequently revealed in investigations of nursing home negligence and abuse, there is much more that Nursing home owners and the industry should be doing to provide greater support for this very important profession.

You can read more on the nursing shortage in New Jersey here.

Laurel Crest to go under microscope

dcohen@stark-stark.com (David Cohen) — Mon, 12 Nov 2007 08:42:12 -0500

Serving as an example of how regulators can effectuate change, the Altoona, Pennsylvania nursing home, Laurel Crest, is not only undergoing tremendous scrutiny for surveyors to ensure quality, but outside consultants are being brought into the facility to make sure that the right changes are made.

These changes could have a huge effect on the level of care to be provided to its residents. You can read more about these changes here.

Granny Farming

bmurphy@stark-stark.com (Brian Murphy) — Mon, 05 Nov 2007 08:09:18 -0500

By Ben Whitford

Posted Sunday, Sept. 23, 2007, at 3:31 AM ET

The New York Times leads with a report on profiteering at nursing homes; thousands of institutions have been bought up by private investment companies, often to the detriment of care standards. The Washington Post leads with news that the Bush administration's $150 million campaign to tackle human trafficking has produced remarkably few arrests, suggesting that the extent of the problem—at least in the United States—may have been significantly overestimated. The Los Angeles Times leads local, with a look at the financial troubles plaguing many L.A.-area hospitals.

In recent years, Wall Street investors have snapped up thousands of nursing homes across the United States, cutting costs and slashing staffing levels in the hope of reselling at a hefty markup. That's led to plummeting standards, according to government data, with elderly residents receiving less care than they need and increasingly suffering from bedsores and preventable infections. Worse still, the companies' Byzantine corporate structures make it hard for disgruntled residents to sue—or for regulators to impose meaningful fines.

Clinton Calls for GAO Investigation to Examine Long-Term Care Ownership Structures

bmurphy@stark-stark.com (Brian Murphy) — Mon, 29 Oct 2007 08:07:03 -0500

Call Comes as a Result of New York Times Analysis of Nursing Homes Across the Country

Washington, DC – Citing a September 23 New York Times article that reviewed more than 15,000 nursing homes across the country, Senator Hillary Rodham Clinton today called for a Government Accountability Office (GAO) investigation to examine the nation's long-term care infrastructure. In a letter to Comptroller General of the United States, David M. Walker, Senator Clinton expressed her concern over accountability and the ability of the states and federal government to provide appropriate oversight and sanctions, and highlighted the decline in the quality-of-care related to the purchase of nursing home facilities by private investment groups.

"I am deeply concerned that these new ownership structures may allow private investment firms to effectively control, and profit from, the operations of nursing homes without taking a formal ownership or management stake in the nursing home itself. As a result, these hybrid structures may make it difficult, if not impossible, for federal and state regulators to identify and effectively penalize repeat offenders," Senator Clinton wrote.

"The vast majority of the nation’s nursing homes provide quality care to their residents,” Clinton emphasized. "But the abuses cited in the story are intolerable and we must do all that we can to weed them out and shut them down."

[A copy of Senator Clinton’s letter to the GAO follows]

The Honorable David M. Walker
Comptroller General of the United States
United States Government Accountability Office
441 G Street, N.W.
Washington, D.C. 20548

Dear Mr. Walker:
An article in the September 23rd edition of The New York Times on the abhorrent conditions in a number of nursing homes across the country reinforces my concern that we are not doing enough to protect and care for our seniors living in long-term care facilities. The article documented a troubling trend— that facilities which are purchased by private investment groups experience marked declines in the quality-of-care, alongside cuts in nursing staff and other resources. A review of more than 15,000 nursing homes since 2000 revealed that despite sub-standard conditions, these nursing homes and the private investment firms that purchased them have gone largely unsanctioned by federal and state regulators because they have employed complex hybrid ownership structures.

I am deeply concerned that these new ownership structures may allow private investment firms to effectively control, and profit from, the operations of nursing homes without taking a formal ownership or management stake in the nursing home itself. As a result, these hybrid structures may make it difficult, if not impossible, for federal and state regulators to identify and effectively penalize repeat offenders. As The New York Times analysis highlighted, regulators may be unaware that the same private investment firm is responsible for many seemingly unconnected nursing home operations. In addition, such ownership structures may obscure how Medicare and Medicaid dollars are being used, enabling nursing homes to inflate their own profits at the taxpayers’ expense.

These revelations come at a time of crisis in our nation’s long-term care infrastructure. Just last year, nearly one in every five nursing homes that received federal funds was cited for serious deficiencies in care. And earlier this year, we learned that, over the past five years, nearly half of the nursing homes that regulators had identified as having an established history of serious medical deficiencies continued to repeatedly fail federal requirements and still receive federal funds.

The vast majority of the nation’s nursing homes provide quality care to their residents. I believe the “bad apple” practices cited in The New York Times story are the exception, not the norm. Having said this, the abuses cited in the story are intolerable and we must do all we can to weed them out and shut them down.

I am confident that the long-term care industry can continue to flourish while ensuring our seniors receive the care they deserve. Private investment firms can have a constructive role to play in this market, helping restructure, retool and improve profitability at struggling nursing homes. However, this newly-released data linking hybrid ownership structures with serious quality-of-care deficiencies in our nation’s nursing homes raises important questions about accountability and the effectiveness of our existing regulatory framework. It also raises the critical issue of how inadequate staffing and a substandard commitment to health professional and paraprofessional recruitment and retention can decrease quality as well as patient and family confidence in the nation’ s nursing home industry.

For this reason, I would ask that you investigate the link between hybrid ownership structures of federally-funded nursing homes and poor quality of care. In particular, I would appreciate an assessment of the ownership structures of the 63 nursing homes that the GAO identified in March 2007 as having a history of serious deficiencies in care. Finally, I would ask that you make recommendations on any needed changes to the Centers for Medicare and Medicaid Services’ regulatory framework or other federal laws to bring greater transparency and accountability to federally-funded nursing homes.

I thank you for your attention to this matter. Please keep me apprised of the status of this request.

Sincerely yours,

Hillary Rodham Clinton