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Sen. Chuck Grassley issued a statement demanding that the Centers for Medicare and Medicaid Services (CMS) provide the Senate with a thorough report on the “comprehensive review” the agency plans to conduct on its nursing home oversight. Last month, the Republican Senator held a hearing on nursing home abuse and excoriated the nursing home industry and its grossly inadequate government oversight. In response to the spectacle on Capitol Hill, Administrator Seema Verma announced the agency would perform a “comprehensive review” of its nursing home oversight. In a statement issued by his office, Sen. Grassley described the news as “encouraging” but also directed the government to prepare a report on its planned changes.

After a fiery attack on the nursing home industry, Sen. Grassley does not plan on letting the government-funded industry to continue with its blatant violations. Speaking to McKnight’s Long Term Care News, Sen. Grassley said, “As chairman of the Senate Finance Committee, I’ll continue conducting diligent oversight of the nursing home industry. Once these reports are available and I’ve had time to review their findings, I intend to hold another hearing to learn the facts and find workable solutions.” The Senator from Iowa directed both the Department of Health and Human Services and CMS to prepare reports for a Senate hearing later this year.

Last week, the Government Accountability Office (GAO) published more disheartening information about nursing home oversight. According to the GAO, CMS failed to collect comprehensive data on nursing homes in Oregon for more than 15 years. The report overstated the obvious when it said that this may “indicate a potentially larger problem.” Sen. Grassley was unequivocal, “Incomplete data means an incomplete picture of a facility’s ability to care for its elderly residents.”

A long-time critic of the nursing home industry, Sen. Grassley’s criticisms have only mounted in the last couple years as the Trump Administration has chipped away at regulations and elder rights. The Senator from Iowa says once the comprehensive review of nursing home regulations is presented to the Senate then, depending on the results, it may begin drafting nursing home abuse legislation.

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Outrage continues to grow at the poor quality of care being delivered at a New York nursing home. According to an investigation by News10NBC, Sodus Rehabilitation and Nursing Center in Sodus, New York is still violating numerous state regulations about the treatment of its senior citizens. The local news agency began investigating Sodus Rehab several years ago and, unfortunately, it does not appear that the quality of care has improved over time. According to the New York Department of Health, the nursing home received 90 citations for health and safety violations in just the last four years. In New York, the average number of violations per nursing home is approximately 30.

After undercover investigations by News10NBC last year showed unsafe and unsanitary conditions, Sodus Rehab says they “cleaned house” and brought in new administrators. Unfortunately, the new staffers do not appear to have fixed any of the nursing home’s problems. In one particularly egregious example cited by the news, Bill Tanner, a nursing home resident with leukemia, dementia and “other health issues,” developed bedsores that one doctor described as “some of the worst” he had ever seen. Bedsores, also called pressure ulcers, could have been easily prevented in Tanner, according to the doctors. Perhaps even more horrifically, the bedsores were only noticed because a former neighbor visiting Tanner noticed a foul smell in the room. According to the neighbor, she asked for a registered nurse and a licensed practical nurse to attend to the elderly man. Sodus Rehab staff said that neither was on-duty at the time.

Thankfully, the neighbor kept pushing staffers to help identify the source of the putrid smell. When Tanner was finally rolled over, photographs taken by the neighbor show deep, open sores. Tanner was immediately admitted into the hospital and doctors say that waiting much longer would have likely been fatal for the elderly man. Tanner remains in the hospital in critical condition.

Sodus Rehab declined to comment to NBC about the story, citing patient confidentiality laws. Although Tanner’s former neighbor did say that last summer when she raised concerns about news articles on the nursing home’s poor care, staffers shrugged off her worries and said local news stations had a “vendetta” against the senior living facility. The New York Department of Health also declined to comment and instead provided a hotline to report nursing home abuse in the state.

Please contact us to discuss your potential case.

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While most states continue ignoring the widespread nursing home abuse problem in America, Kansas recently passed legislation cracking down on nursing homes and exploitative nursing home operators. The legislation passed unanimously by a Republican legislator in response to a particularly dire situation in the state. According to The Kansas City Star, the state took over operations of 22 financially troubled nursing homes just last year. According to the newspaper, the out-of-state nursing home operators had fallen behind on basic bills like food and medication. With the health and safety of the nursing home residents at risk, the Kansas Department of Aging and Disability Services had “no choice” but to take over the beleaguered elder care facilities.

The new law requiring extensive financial disclosure for any person or business entity hoping to own a nursing home hopes to solve this problem. Any prospective buyers will also need to show a “12-month operating budget” for the facility and a sufficient amount of funds to follow through on the budget, according to Skilled Nursing News. “It gives us a better opportunity to maybe know in advance if somebody coming in is maybe in financial difficulties,” Rep. Brenda Landwehr told The Kansas City Star. The new state law will also make it easier to remove negligent or financially irresponsible nursing home operators and create a “blacklist” of operators with a record of poor care in other states.

The new law, which was passed and signed into law by Republicans controlling both the legislature and the governorship, stems from the collapse of Skyline Health in 2017. Skyline Health had a history of financial difficulties – owing almost $2 million – when it applied for nursing home licenses in Kansas. Despite the nursing home company’s poor record, Kansas still granted it licenses to operate the nursing homes. Within a year, the nursing home company was faltering on its financial obligations with overdue bills on “laundry, housekeeping, and food.” At the time Skyline Health was granted licenses, Kansas only required prospective nursing home operators to provide proof of enough income to operate the nursing home for a single month, a shockingly low standard.

The new law will hopefully tackle the serious problems that have developed in Kansas and across the country as more nursing homes are operated by large and complex corporate structures. As discussed on this blog, these conglomerates are routinely linked to providing a lower quality of care in the search for higher profits. More states should follow Kansas lead and pass legislation to “ensure the health, safety, welfare and continuity for [nursing home residents].”

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The Trump Administrations deregulation effort has led to decreased oversight across the country’s nursing home industry. According to The Washington Post, President Trump’s deregulation agenda has indiscriminately removed “essential protections for vulnerable Americans.” Citing the Trump administration’s popular boast of removing 22 regulations for every single regulation added, the newspaper understandably questions the necessity of these regulations and the consequences of their removal.

Sadly, the nursing home industry has never been a priority for many Presidential administrations. Despite the highly regulated nature of the industry, nursing homes have often escaped the scrutiny lodged at hospitals and other healthcare providers. Late in his second term, President Barack Obama attempted to change that and directed the Centers for Medicare and Medicaid Services (CMS) to aggressively pursue nursing homes flouting the law. Beginning in 2014, nursing home violations would not result in a one-time fine. Instead, the nursing home would be fined every single day until the violation was rectified. By 2016, over two-thirds of nursing home violations resulted in a per-day fine. Unfortunately, the Trump administration reversed this change – which was viewed by elder care advocates as broadly effective and necessary.

The Trump Administration has not just reduced the fines for nursing homes across the country, it has even reduced the number of violations. After entering office, President Trump halted a series of safety requirements set to go into effect. The Trump administration said it needed to delay the new health and safety code for 18 months. According to The Washington Post, this was “a giveaway” to the nursing home industry.

Finally, and equally as brazen, the Trump administration also rolled back a ban on “mandatory arbitration clauses.” Mandatory arbitration clauses force nursing home residents to pursue any grievance against a nursing home using a private, third-party. These arbitrators often limit damages and the right to appeals. Further, numerous studies have shown they tend to favor companies when compared to public trials and juries.

Overall, the Trump administration has made the regulatory system more favorable to nursing homes and enabled its violators in the process. While previous administrations merely ignored the nursing home industry, President Trump appears to be actively making things worse for America’s elderly population. In a brazen desire to “cut the red tape,” the Trump administration should focus on what tape is actually being cut.

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The federal government designated New Roc Nursing and Rehabilitation Center as a Special Focus Facility (SFF) after racking up more than five times the average number of violations in the last couple years. According to WHEC, the nursing home has a troubled history dating back to 2014 when an undercover investigation found a “pattern of patient neglect” so horrific that ten nursing home staffers were charged with criminal neglect. Since 2014, the problems have only “continued to pile up,” according to local news agency.

After “a persistent pattern of poor care was identified during its last three inspection surveys,” the New York Department of Health recommended regulators designate the Rochester nursing home as an SFF. An SFF is inspected twice as much as other nursing homes and subject to increased fines and penalties for any violations. According to Jennifer Lewke, spokeswoman for New Roc Nursing and Rehabilitation Center, this creates a “downward spiral.” Money necessary to fix the cause of numerous violations are instead used to pay the fines and penalties. Further, designating a nursing home as SFF sharply reduces the number of residents, who understandably choose facilities with records of better care. This causes a further drain on resources and leads to more violations and poor care.

Lewke says that the New York nursing home fills a unique niche in the area. The majority of nursing home residents suffer from mental health disorders and are often rejected from other nursing homes in the area. Responding to the 132 violations issued in the last few years, Lewke says the majority relate to “maintenance and cleanliness” and not the quality of care. While the nursing home administrators are promising to turn the facility around, the New York Department of Health is warning the facility that unless “significant improvements are made” then it will face additional enforcement, including a loss of all Medicaid and Medicare funding.

Contact our office if you or a loved one was neglected in a nursing home.

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State prosecutors charged seven nursing home employees with involuntary manslaughter after a patient died from a bedsore in 2017. The nursing home employees, which includes one nurse, are collectively charged with 37 crimes for their gross mistreatment and neglect of two nursing home patients during their time working at Whetstone Gardens and Care Center in Ohio. Announcing the charges, Attorney General Dave Yost says, “Evidence shows these nurses forced the victims to endure awful mistreatment and then lied about it.”

Yost says first patient “literally rotted to death” after developing a preventable bedsore or “pressure injury” in 2017. The patient, who entered the facility on a short-term basis, developed several bedsores after nursing staff failed to move the patient every few hours. Once the bedsores developed, the staff continued to ignore the nursing home resident and failed to treat the sores, also called pressure injuries or ulcers. Within weeks of developing the bedsore, the patient’s bedsores became infected with gangrene. The nursing home resident passed away just weeks later after the staffers at the nursing home failed to take “any medically appropriate steps.”

The criminal charges also stemmed from a second patient where the nursing home staff’s actions were even more flagrant and reprehensible. According to prosecutors, the indicted nursing home staffers falsified medical information and forged signatures for a patient that resulted in “physical harm as a result of inadequate care.” Ohio prosecutors say the staffers recorded treating the patient and administering medication when the patient was not even at the nursing home.

“These victims were completely dependent on others for day-to-day care, which their families trusted [the nursing home] to provide. Instead of providing that care, evidence shows these nurses forced the victims to endure awful mistreatment and then lied about it,” Yost told CNN. In addition to criminal charges filed against the neglectful and fraudulent staff, the families of the two alleged victims have filed civil lawsuits against the nursing homes.

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The Centers for Medicare and Medicaid (CMS) announced it will launch a ‘comprehensive review’ of nursing home regulations across the country. According to Health Leaders Media, CMS Administrator Seema Verma announced the new initiative last week in response to mounting criticism by states and federal legislators. Administrator Verma said the government agency will seek $45 million in additional funding from Congress for its review.

CMS says the review will focus on several primary areas. First, CMS will work with state agencies across the country to strengthen oversight of the country’s nursing homes. According to CMS, federal and state agencies will work together to ensure CMS health and safety requirements are being followed and ever nursing home is inspected at least once a year. Second, the federal agency plans to increase enforcement of nursing homes by, according to Administrator Verma, “developing new ways to root out bad actors and repeat offenders.” Administrator Verma says nursing homes with insufficient nursing staff will be targeted will begin receiving more “unannounced inspections” to encourage compliance. Finally, nursing homes will now be more severely penalized for poor patient outcomes and less severely penalized for failing to follow CMS protocols. In addition to improving outcomes for current nursing home patients, the focus on patient outcomes will also be more helpful to prospective nursing home residents by providing a more meaningful metric to judge nursing homes.

The federal agency will also improve several of its own processes. Administrator Verma announced an increased push for transparency during her discussion on nursing home oversight. Going forward, CMS will now publicize whenever it “terminates agreements with nursing homes due to poor quality” on its website. Previously, CMS announced the changes in local newspapers. Further, CMS also plans to decrease the amount of paperwork required by nursing homes. The nursing home industry has long complained about what it views as excessive paperwork and bureaucracy.

While the details are still scarce, the planned overhaul of nursing home regulation is long overdue. Describing the ambitious overhaul, Administrator Verma succinctly described the efforts as “developing our regulatory strategy in a way that puts patient quality and safety first while removing burdens on providers that create staffing challenges and increase cost without increasing quality.” Hopefully, the “comprehensive overview” of regulations at the agency finally leads to improved care for nursing home patients.

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The Department of Veteran Affairs released its first report on the status of its nursing homes this month and the results show widespread neglect and abuse at the government-run facilities, perhaps even worse than the well-documented problems seen in its private-care counterpart. The federal government is responsible for caring for the country’s 40,000 veterans and, according to its own report, is doing a poor job. The report analyzed 99 VA nursing homes across the country and reported the findings of surprise inspections conducted by outside contractors. The VA spokesperson said that releasing the report in its entirety is part of a new push by the agency for transparency and accountability.

The findings of the report are daunting. Eleven of the 99 nursing homes were so unsafe that veteran safety was in “immediate jeopardy.” More than half of the nursing homes (52) were deficient enough to cause “actual harm” to their veteran residents. “That is really bad. It’s really bad,” Richard Mollot, executive director of the Long Term Care Community Coalition, a nursing home advocacy nonprofit told USA Today.

Almost one-third of the nursing homes had patients with preventable bedsores. In one particularly horrific case, the inspector noted that a “resident [with a bedsore] moaned throughout the wound care and moaning increased during wound cleansing and measuring.” The resident was at least getting treated for his bedsore, though. In one case, an inspector noted that a patient had developed five to six bedsores in the previous six months. Despite developing these painful sores, the nursing home still failed to follow basic protocols to treat the resident or prevent any further bedsores.

Failing to follow basic protocols was a theme of the federal government’s report. Three facilities were cited for failing basic sanitary practices, such as washing hands or wearing sterile gowns and gloves. At many nursing homes run by the Department of Veteran Affairs, washing and bathing was a dangerous activity. Several residents were scalded by hot water while being bathed. In other instances, the nursing home staffers were simply incompetent at cleaning and bathing residents. Almost a third of facilities had residents with recurring infections that should not have occurred with basic sanitation practices.

A mere seven nursing homes out of the 99 appeared to “pass” the surprise inspections. Despite this shockingly low number, Veteran Affairs Secretary Robert Wilkie offered justifications and excuses by stating, “Overall, VA’s nursing home system compares closely with private-sector nursing homes, though the department on average cares for sicker and more complex patients in its nursing homes than do private facilities.” While Wilkie’s statements may be true, they should only mean that the private sector has just as much work to do on improving care for the nation’s elderly population. With government spending on VA nursing homes at $3.8 billion, America’s veterans and taxpayers both deserve much better from the government agency.

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New York’s Department of Health appears unable to adequately monitor the nursing homes across the state and hold poor performers accountable. Elder care advocates say the state agency must reform to protect senior citizens from poor care and nursing home abuse. Thankfully, legislators in Albany appear to finally be listening.

According to The Buffalo News, Assembly Majority Leader Crystal Peoples Stokes is co-sponsoring a bill regulating the number of nurses at each assisted care facility in the state. The appropriately named Safe Staffing for Quality Care Act would mandate that each nursing home have RNs (registered nurses) and that practical nurses and CNAs (certified nursing assistants) spend a minimum of 291 minutes with each resident. According to federal data, nursing staff levels are the largest indicator of whether a nursing home is providing quality care to its residents. Unfortunately, the same federal data shows that most nursing homes are grossly deficient when it comes to staffing. According to a study released in January 2019, only 7.5 percent of nursing homes across the state currently satisfy the requirements laid out in the Safe Staffing for Quality Care Act.

Unsurprisingly, nursing home operators are against the proposed legislation which they say will cost an extra $1 billion each year. The industry says these costs will likely be passed on to consumers through higher Medicaid payments. Opponents of the legislation also describe the proposed law as too narrow and short-sighted, reasoning that the law does not consider nurse practitioners or physical and occupational therapists. Moreover, it imposes a strict nursing quota on some nursing homes that already provide excellent care to their residents. Instead of an expensive, one-size-fits-all law, opponents of the Safe Staffing for Quality Care Act say that legislation focused on reforming the New York Department of Health and targeting nursing homes with a record of low-quality care would be more effective and cost-efficient.

Opponents of the law correctly point out that New York should do more to overhaul the ineffective nursing home regulator and prioritize nursing homes that are neglecting or abusing their residents. However, this does not necessarily mean the legislation introduced last month should be so easily disregarded. Currently, the Department of Health can only cite a nursing home for insufficient staffing if the level is so low that it “places residents at risk.” Considering the correlation between nursing staff and quality of care, New York’s nursing home patients deserve a bar set much higher.

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Outrage continues to grow at the poor quality of care being delivered at a New York nursing home. According to an investigation by News10NBC, Sodus Rehabilitation and Nursing Center in Sodus, New York is still violating numerous state regulations about the treatment of its senior citizens. The local news agency began investigating Sodus Rehab several years ago and, unfortunately, it does not appear that the quality of care has improved over time. According to the New York Department of Health, the nursing home received 90 citations for health and safety violations in just the last four years. In New York, the average number of violations per nursing home is approximately 30.

After undercover investigations by News10NBC last year showed unsafe and unsanitary conditions, Sodus Rehab says they “cleaned house” and brought in new administrators. Unfortunately, the new staffers do not appear to have fixed any of the nursing home’s problems. In one particularly egregious example cited by the news, Bill Tanner, a nursing home resident with leukemia, dementia and “other health issues,” developed bedsores that one doctor described as “some of the worst” he had ever seen. Bedsores, also called pressure ulcers or pressure injuries, could have been easily prevented in Tanner, according to the doctors. Perhaps even more horrifically, the bedsores were only noticed because a former neighbor visiting Tanner noticed a foul smell in the room. According to the neighbor, she asked for a registered nurse and a licensed practical nurse to attend to the elderly man. Sodus Rehab staff said that neither was on-duty at the time.

Thankfully, the neighbor kept pushing staffers to help identify the source of the putrid smell. When Tanner was finally rolled over, photographs taken by the neighbor show deep, open sores. Tanner was immediately admitted into the hospital and doctors say that waiting much longer would have likely been fatal for the elderly man. Tanner remains in the hospital in critical condition.

Sodus Rehab declined to comment to NBC about the story, citing patient confidentiality laws. Although Tanner’s former neighbor did say that last summer when she raised concerns about news articles on the nursing home’s poor care, staffers shrugged off her worries and said local news stations had a “vendetta” against the senior living facility. The New York Department of Health also declined to comment and instead provided a hotline to report nursing home abuse in the state.

Contact our New York attorneys to discuss your potential case.

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