Archive for September, 2005

Michigan Attorney General Charges CNA & Administrator with Abuse, Failure to Report

Family suing nursing home- claim mother died of neglect

It was only a matter of time before this happened. I hope they really look at these deaths, and if they find any foul play or neglect issues, people need to be held accountable.

Attorney General Charles Foti said Wednesday that 13 nursing homes and four hospitals in area’s hardest hit by Hurricane Katrina are under criminal investigation by his office.
Foti told a Senate panel more arrests could come. His office already arrested St. Bernard nursing home owners on nearly three dozen negligent homicide charges in the deaths of nursing home patients and others.

“We are investigating every death that happened,” Foti said. “We have filed charges against one institution and there may be other charges.”

News of the criminal investigations caught top nursing home and hospital industry officials by surprise.

Louisiana Nursing Home Association executive director Joe Donchess said later Wednesday he was aware the attorney general’s office investigators visited nursing homes and asked questions.

Read the rest of this article—>

This isn’t funny.

Frankfort (AP) — Attorney General Greg Stumbo announced Tuesday the indictment of two nursing assistants for multiple counts of abuse after it was discovered that they allegedly gave elderly and medically fragile patients laxatives as a prank in order to harass staff that worked shifts after them.

The incidents allegedly occurred at the Irvine Health and Rehabilitation Center in Irvine, Kentucky. Lisa Kilburn, 27, and Kim Congleton, 30, both certified nursing assistants, were employed at the nursing home, providing care for residents, when the abuse occurred. Their employment has since been terminated.

The investigation, conducted by Stumbo’s Medicaid Fraud and Abuse Control Division, disclosed that on October 18, 2004, Kilburn and Congleton, while working as caretakers at the facility, abused elderly and medically fragile residents by administering laxative suppositories that were not medically necessary and had not been ordered as part of the residents’ treatment. The acts were apparently done to harass next shift nursing assistants. Some of the patients suffered pain and rectal bleeding as a result of the nursing assistants’ actions.

Staff of the Irvine Health and Rehabilitation Center assisted in the investigation.

“These defendants treated the residents of Irvine Health and Rehab as nothing more than objects for their own amusement as a means to play pranks on fellow staff members,” said Stumbo. “This conduct is an outrage to human decency and dignity. I will not allow this callous abuse of our elderly citizens. This conduct is criminal and will be punished.”

Kilborn and Congleton are scheduled to be arraigned in Estill Circuit Court on October 6. If convicted, each face up to five years in prison for each count.

Additional indictments resulting from this investigation may be forthcoming.

This nursing home has lost it’s federal funding due to poor care. I think the owners want it this way too. From the sounds of it, they want only private paying residents. Problem is, the care isn’t going to change. Who is in charge of oversight when there are no federal funds coming in? The customer. The resident and family.

Dozens of Iowa seniors are being forced to move out of Oskaloosa’s only remaining nursing home because of poor resident care.

Fifty-eight of the 89 residents at Pleasant Park Estates rely on Medicaid to pay for their care. Those Medicaid-dependent residents will have to move by Nov. 8, which is when the home will lose all Medicaid and Medicare funding because of the poor care.

The home has been fined $350 per day since April 8 for failing to meet minimum standards of care. Those fines now total $60,200. Federal officials decided to cut off the Medicaid and Medicare funding because the home recently failed another inspection.

That decision will leave Oskaloosa, a town of 10,600 people, with no nursing homes to care for Medicaid-dependent seniors. The state shut down two other Oskaloosa facilities in 2004.

Since January 2004, at least five Iowa homes for seniors have been closed to Medicaid-dependent seniors because of similar concerns over resident care.

Iowa Long-Term Care Ombudsman Jeanne Yordi said she and her staff were at Pleasant Park on Saturday to help prepare for the relocation of residents.

“We’re trying to make the transition as calm as possible, with as little trauma as possible,” she said. “It’s sad. Very sad. But this is a home that has chosen not to come into compliance with the regulations, and that’s scary when a home can’t meet even the minimum standards.”

The minimum standards are not that hard to reach. If this place cannot get to that point with federal funds, what makes the owners think they will reach it without the money? Private paying customers are going to expect a lot.

State inspection reports from the past five months allege a wide range of problems at Pleasant Park: insufficient staffing; inadequate and overcooked food; unsanitary conditions; residents lying in their waste; a failure to train workers as mandatory reporters of abuse; and neglect that resulted in residents’ call lights going unanswered.

The home is run by Total Quality Care Management, a for-profit company owned by Steven and Clarice Wright of Oskaloosa. Steven Wright said Monday that the problems at the home were minor and that he expected the facility to remain open to serve private-pay residents after Medicaid money is shut off.

“All of the problems there have been addressed, and there were just a couple of minor deficiencies,” he said. “There was no immediate jeopardy to residents.”

They don’t just stop funding for no reason. There is a lot more going on here than meets the eye.

Among the problems alleged by inspectors since April:

• Inspectors found several instances of the home ignoring physicians’ orders for special diets, medical treatment or lab tests.

• Workers repeatedly failed to observe good-hygiene practices when feeding and cleaning residents. In some instances, residents with open wounds were dressed by the staff in clothing that was soiled with urine or excrement.

• Two residents were seriously injured after workers ignored guidelines on physically moving residents. One resident sustained a fractured hip, and the other suffered a broken shoulder.

• During a May inspection, the home had five nurse aides on duty to serve 89 seniors. Residents complained that when they switched on their call lights, workers would come to their room, turn off the light and leave without providing assistance.

Typical items many nursing homes have problems with. But most correct the problems and do not lose funding.

Read the rest of this article—>

Now the feds are entering the investigation into the LA nursing home deaths.

WASHINGTON — Federal investigators said Thursday that they have joined a Louisiana probe of nursing home deaths during Hurricane Katrina, as the government begins considering stronger requirements to protect patients in health-care facilities during natural disasters.

Industry officials, however, say the deaths were tragic exceptions in chaotic circumstances under which most facilities carried out their duties, some heroically.

The inspector general’s office in the U.S. Department of Health and Human Services said it was assisting the investigation of 34 deaths at St. Rita’s Nursing Home in St. Bernard Parish. State authorities have charged the owners of the home with 34 counts of negligent homicide for allegedly ignoring requests to evacuate.

“This office is tremendously concerned about the possible abuse and neglect of hospital patients and nursing home residents,” Inspector General Daniel Levinson wrote to Sen. Charles Grassley (R-Iowa) in a letter released Thursday. Grassley has also asked for a Justice Department investigation.

Every nursing home has to have disaster plans in place. Detailed plans. It’s part of the Life Safety Code each facility must pass in order to continue receiving federal funds.

Separately, officials of the department — which, through Medicare and Medicaid, is the nation’s largest payer for hospital and nursing home care–said they would consider a broad range of actions to prevent such deaths in the future.

“I think only Rip Van Winkle would be able to ignore the wake-up call that Hurricane Katrina offers with regard to emergency preparedness,” said Thomas Hamilton, director of the Health and Human Services office that sets standards for health-care facilities.

Responsibility for oversight of health-care facilities is shared by state and federal agencies as well as by independent professional organizations that issue accreditation. Washington generally plays a secondary role to state regulators.

In the St. Rita’s probe, federal investigators will be examining whether the nursing home fulfilled its duty of care under Medicaid regulations. Possible penalties include barring the nursing home owners from billing Medicaid and Medicare, which is tantamount to exile from the health-care marketplace.

Federal regulations require nursing homes to have an evacuation plan tailored to local conditions, to train their staffs and to periodically practice the plan. Nursing homes say they often have to bear the cost of evacuations, which can run to tens of thousands of dollars. But the government says many have insurance to cover it and Medicare also helps pay ambulance transportation for residents.

Yet another article about how unions can save nursing homes. I’m going to look around to see if there are other sites that can show both sides of this issue. I do not believe unions are good for employees, nursing staff and residents. For all the benefits you might get, you could end up losing a place to work for.

LONG BRANCH –– Nursing home employees demonstrated here Saturday to advocate for improved conditions for healthcare workers and the people they care for at facilities statewide.

“This is really a chain-of-hope type of get together to raise public awareness about conditions at nursing homes in the state,” Roy Garcia, spokesman for the Service Employees International Union (SEIU), said last week.

“[Nursing home] workers and caregivers want to express the hardships involved in providing quality care when [nursing facilities] are so understaffed.”

The demonstration was held outside Monmouth Care Center on Bath Avenue from noon to 2 p.m. Workers from Monmouth Care, Victoria House in Matawan, Pinebrook in Englishtown, and several other nursing homes participated.

Workers at Monmouth Cares are members of the SEIU local 1199 New Jersey and their contract expired March 31. The workers are currently negotiating for a contract that offers “equal pay for equal work,” Garcia said.

“Workers are having a hard time providing quality care to residents when they are understaffed,” Garcia said.

“Almost 80 to 90 percent of the staff at [Monmouth Care Center] provides hands-on care to residents and when you are short-staffed, that can be a real problem.”

The average state nursing home caregiver earns $7 to $10 an hour, said Garcia, adding that they are working at these wages in facilities that are under-staffed.

According to Garcia, Monmouth Cares is the third lowest staffed nursing home facility in Monmouth County, with workers there able to spend an average of 2.7 hours per resident per day.

In Monmouth County, which has 32 nursing homes, the average is 3.69 hours per resident, he said, and in New Jersey, which has 356 nursing homes, the average is 3.7 hours.

The recommendation by the government agency the Center for Medicaid, is 4.1 hours per resident per day, according to Garcia.

I’m not against better working conditions and better wages. I just think there are better ways to go about getting these things. We can make a huge difference ourselves, with our working conditions. Good team work, good supervison and support can make the world of difference. Pay is something that we earn; when you consider that our pay is based upon what the government issues for payments, we can’t blame the nursing home. It’s really our own tax dollars that pay us.

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Anticipating the effects of Hurricane Rita, Texas nursing homes are evacuating. But it’s not going as smoothly as they would like, appearently.

AUSTIN – Nursing home operators along Texas’ Gulf Coast are finding that even with evacuation plans in place, they’re having trouble moving the frail and elderly out of Hurricane Rita’s path.

Private bus companies canceled promised service, saying they had agreed to help evacuate more nursing homes than they could. Two nursing home owners said state emergency management officials had taken control of ambulances that their homes had counted on to transport their sickest residents.

A spokeswoman for Gov. Rick Perry denied that the state seized ambulances but said the Federal Emergency Management Agency “is contracting with a number of ambulance companies to move resources around as they are needed.”

FEMA spokesman Ross Fredenburg said the agency had no role in evacuations, and he knew of no contracts for ambulances.

After nightmarish accounts of failed evacuations of New Orleans nursing homes after Hurricane Katrina, the agency that regulates long-term care in Texas said last week that it checked not only that homes had transportation plans but that contractors could carry out such plans.

Still, many of the arrangements were falling through.

“We just got bad news,” said Matt Robinson, owner of a home with 120 residents in southeast Harris County. “Our ambulance service that was going to transfer eight of our critically ill patients, those ambulances have been commandeered by the state to go to Matagorda. And so we’re in search of an ambulance company at the moment.”

Let’s hope things get better down there, and fast. Read the rest of this article—>

From the September 22nd edition of Nursing Assistant Trainer: Ambulation 2

Ambulation provides a range of physical and mental benefits to residents, who vary in the degree of assistance they require. Some residents are able to ambulate by themselves, some need assistance from CNAs, and some require assistive devices. CNAs should always make the resident’s safety their number one priority. The following is a general procedure for assisting residents before, during, and after ambulation.

Before ambulation

Obtain needed information from the resident’s care plan.
Check with your immediate supervisor for specific instructions.
Wash your hands.
Assemble necessary equipment and bring it to the bedside.
Identify the resident, introduce yourself, and tell him or her what you plan to do.
Provide for the resident’s privacy.
Make certain that the resident’s bed is lowered and locked in place.
Assist the resident to a sitting position on the side of the bed.
Let the resident sit on the side of the bed for a few minutes.
Take the resident’s pulse.
If pulse rate is outside the normal range for that resident, return him or her to a lying position and notify your supervisor.
Encourage the resident to take a few deep breaths and ask whether he or she feels dizzy or faint.
If resident does not feel dizzy or faint, help put on his or her robe and sturdy shoes.

During ambulation (without assistive devices)

Place one hand under the resident’s arm and the other hand around his or her waist.
Move slowly, at the resident’s pace.
If the resident starts to fall, step quickly behind and allow his or her body to slide slowly down the front of your body. Trying to hold up the resident may result in injury to both of you.

After ambulation

Assist the resident to a chair and make him or her comfortable.
Place a call light within reach.
Leave the area neat and clean.
Clean and return any equipment to its proper place.
Report any significant observations.

Source:
from LTC Nursing Assistant Trainer. Property of HcPro, Inc.

From the September 15th edition of Nursing Assistant Trainer: Ambulation

Ambulation provides a range of physical and mental benefits to residents, who vary in the degree of assistance they require. Some residents are able to ambulate by themselves, some need assistance from CNAs, and some require assistive devices such as gait belts, canes, and walkers. CNAs should always make the resident’s safety their number one priority. Before you ambulate a resident, you should bear in mind the following:

The number of staff members required to assist
The type of assistive device, if one is required
The distance the resident is to ambulate
The resident’s normal pulse rate
Any possible problems you might encounter

Benefits of ambulation

It helps strengthen the muscles, especially those of the abdomen and legs
It helps joint flexibility, especially that of the hips, knees, and ankles
It stimulates circulation, which helps prevent phlebitis and the development of stroke-causing clots
It helps prevent constipation because the movement of the abdominal muscles stimulates the intestinal tract
It helps prevent osteoporosis due to the mineral loss from the bones when they do not bear weight
It stimulates the appetite
It helps prevent urinary incontinence and infection—when residents are able to go to the bathroom on their own, incontinence is reduced
It relieves pressure on the body and skin, helping to prevent pressure ulcers
It improves self-esteem and the resident’s feelings of independence
It improves the resident’s ability to socialize

Source:
from LTC Nursing Assistant Trainer. Property of HcPro, Inc.

From the September 8th edition of Nursing Assistant Trainer: Infection Control 3

CNAs should always be aware of the potential for infection transmission. In last week’s LTC Nursing Assistant Trainer, we discussed how frequent handwashing and changing gloves help CNAs lower that potential.

If and when a resident contracts a communicable disease, isolation precautions become necessary to prevent transmission to other residents and staff. There are three major types of precautions, described below in this last piece of a three-part series on infection transmission.

Contact precautions

Contact precautions require CNAs to wear gloves when entering a resident’s room to provide care. You should always remove your gloves and wash your hands with an antimicrobial agent before leaving the area. You should also wear a gown when entering the room if you anticipate that your clothing could come into contact with the resident, equipment, or contaminated surfaces.

Droplet precautions

Droplet precautions call for wearing a mask when working within three feet of a resident. The policies at some facilities dictate that a CNA must wear a mask whenever entering a resident’s room.

Airborne precautions

When airborne precautions are ordered, the resident should be placed in a room with a special ventilation system—one that changes the air in the room frequently by ventilating it through special filters to the outside. CNAs should always keep the door to that resident’s room closed to prevent the room air from circulating into hallways.

Special respiratory equipment that filters the air should be worn by anyone entering the room. If at all possible, CNAs who have developed an immunity to the disease should be assigned to thosespecific residents.

Source:
from LTC Nursing Assistant Trainer. Property of HcPro, Inc.