Across the pond we see similar issues we face daily. Getting residents up at 5:30am is considered abuse.

A NURSE was reported to watchdogs after she ordered dementia patients out of their beds at 5.30am.

The Care Commission upheld a complaint that up to 18 elderly residents were taken out of their beds and left to sit in a lounge until breakfast.

Some residents had to wait more than two hours before they could be fed when the kitchen staff arrived for work at 8am.

Joyce Lynn, a district nurse, works part-time at Greenhills Care Home in Biggar, Lanarkshire, where the abuse allegedly took place.

And she works as a nurse attached to Lady Home Hospital in Douglas, also Lanarkshire.

Sounds familiar.

Watchdogs who examined the claims of early starts for patients were told that some of them were taken out of bed and left to doze in their wheelchairs in the residents’ lounge.

One source said: “Some of them just wanted to go back to bed but they were just left in the lounge to sleep there. Sometimes they didn’t even get a cup of tea until breakfast.

“Some were put in baths at that time in the morning. It was ridiculous.”

Lynn was a staff nurse on night shift and sources claim that she maintained there was not enough time for the day shift to get everyone up in time for breakfast.

The source said: “If we protested, we were told to just get on with it.”

The Care Commission gave the home 24 hours to stop disturbing patients at such an early hour.

They ruled: “The practice of disturbing residents at early hours of the morning will cease.

It happens here in the US often. But we don’t think of it as abuse.

Carlyle Group has put in writing that it will not cut back on resources and staffing with the Manor Care buyout.

The Carlyle Group, under siege for weeks by a labor union critical of its $6.3 billion purchase of Manor Care nursing homes, has taken the rare step of putting in writing its promise to provide adequate staffing and resources to the chain.

The District-based buyout giant said it has sent to state regulators across the nation a “patients first” pledge, vowing to provide quality services to patients and proper education and training to staffers who care for them. The private-equity firm also said it will make the investments necessary to “ensure Manor Care’s facilities continue to be . . . state of the art.”

The pledge comes in the wake of concerns over whether the private-equity firm might cut staffing and reduce patient care in pursuit of financial goals.

“We are confident, because we have been doing this for 20 years, that we can provide quality products and services to people that is completely compatible with providing a return to investors,” said Karen H. Bechtel, Carlyle managing director and head of its health care team.

Health-care experts differed on the value of Carlyle’s pledge.

David A. Goldstein, an associate professor of clinical medicine at the University of Southern California Keck School of Medicine, said he considered Carlyle’s pledge “relatively meaningless.” He added, “For-profit companies should not be in the business of health care. Their allegiance is not to patients. It’s to their stockholders.”

But Joseph C. d’Oronzio, associate professor of health policy at Columbia University’s Mailman School of Public Health, called the pledge “a positive and good gesture.” He added that “Carlyle won’t be able to run a nursing home and get Medicaid and insurance funding without toeing that line and answering to state regulators.”

We’ll see. Written words mean little when the excuses start coming in. Census numbers and levels of acuity will be used- just watch. And let’s keep an eye on the profit margins too.

Why it’s so important to maintain professional relationships with residents.

OLYMPIA — A 20-year-old woman has lost her nursing assistant’s license after being accused of accepting $145,000 in gifts — including jewelry, a car, a stock portfolio and a trip to Disneyland — from an elderly man before he died at an Olympia assisted-living facility in 2006.

Lila Guzman collected the gifts from Damiano Buffone from 2004 to 2006, starting when she was 18 and Buffone was a resident of Merrill Gardens on Lilly Road, according court records and a statement of administrative charges filed by the state Department of Health against Guzman this year.
[...]
According to the civil suit filed by Buffone’s daughter:

“Over a period of time from November, 2004 to May, 2006, defendant received approximately $145,000 from the decedent in the form of checks. Additionally, shares of stock managed by Merrill Lynch was transferred to the defendant.”

The suit alleges that before Buffone’s death June 6, 2006, Guzman “coerced” him into giving her stock and money while she worked at Merrill Gardens. Horn’s attorneys were able to freeze Guzman’s stock holdings, as well as at least one of her bank accounts, after Buffone’s death, the complaint states.

Now, Guzman is broke, unable to pay the money she has been ordered to give Horn as part of the judgment, Benjamin said.

“She has no money because all of her assets were frozen and taken away,” he said.

More Congressional fallout for the private equity buyouts of nursing homes.

Private equity firms have been rapidly buying up nursing homes in the last few years, sometimes using complex ownership structures to shield them from lawsuits. Now they have attracted attention in Washington.

Two members of the United States Senate on Thursday asked the federal agency that oversees nursing home inspections to account for what The New York Times described in September as an increase in health and safety violations at nursing homes bought by private investors. The lawmakers, Max Baucus of Montana of Chuck Grassley of Iowa, also sent letters to private equity firms, including the Carlyle Group and Warburg Pincus, seeking information about their nursing home investments.

Mr. Baucus, a Democrat, and Mr. Grassley, a Republican, are the chairman and ranking member, respectively, of the Senate Finance Committee. They have already squared off with some of the biggest players in the private equity industry. Earlier this year, they proposed a bill that would more than double the tax rate on publicly traded investment firms such as the Blackstone Group and the Fortress Investment Group. Such a measure would also likely apply to Kohlberg Kravis Roberts if it goes through with its plan to go public.

On Thursday, the two lawmakers turned their attention to private equity’s role in the nursing home industry. Most nursing home fees are paid by Medicaid and Medicare, two programs overseen by the Senate Finance Committee.

In a press release, Mr. Baucus and Mr. Grassley expressed concern about the findings in the report, by The Times’ Charles Duhigg, that after nursing homes were acquired by buyout firms, their residents were generally worse off than under the previous owners.

“Nursing homes aren’t just investment vehicles,” Mr. Baucus said in a statement. “They’re homes for some of America’s most vulnerable citizens.”

Let’s hope this attention from Congress scares off some of these unethical groups. Sometimes though, these investigations and hearings only serve to create more unscrupulous investing deals- the bad guys learn how to hide themselves even more. We will stay on top of this.

This is fraud.

Some Cuyahoga County nursing homes have become warehouses for the homeless and mentally ill, using millions of taxpayer dollars to house patients who often don’t qualify for the care. Medicaid pays nursing homes to take in hundreds of Cuyahoga patients discharged every year from hospital psychiatric wards. The mentally ill are eligible for admission to nursing homes only if they need 24-hour supervision or hands-on assistance. But 60 percent of the psychiatric patients admitted into Cuyahoga nursing homes, most on Medicaid’s dime, don’t need the care, the state found.

Read the entire article, which is 5 pages long. Ohio needs to figure out where to place their homeless and mentally ill citizens AND keep the elderly and frail safe. It appears as though the nursing home industry is taking advantage of these people and placing the others at risk.

State lawmakers in PA are going to investigate the proposed buy out of Manor Care nursing homes to Carlyle Group:

HARRISBURG - Two northeastern lawmakers called on state health officials Wednesday to investigate a planned corporate takeover of the largest nursing home chain in Pennsylvania.

Reps. Robert Belfanti, D-Northumberland, and Todd Eachus, D-Butler Township, as well as House Majority Leader Bill DeWeese, D-Greene, raised concerns about the future well-being of residents at 46 Manor Care nursing homes in Pennsylvania, including Hampton House in Wilkes-Barre, if the sale to private investment firm Carlyle Group goes through. Manor Care stockholders are scheduled to vote Wednesday on the $6.3 billion deal.

In a joint letter to Gov. Ed Rendell, the lawmakers said the Health Department ought to withhold action on re-licensing the Manor Care homes under new ownership until it has examined the potential impact of the takeover on resident care and has given the public an opportunity to comment.

At a Capitol press conference organized by the Service Employees International Union, Mr. Belfanti said nursing home residents and employees as well as state taxpayers deserve a say on the takeover. Taxpayer Medicaid and Medicare dollars go to support residents in nursing homes, he added.

“These people (residents) depend on nursing home care for their quality of life,” said Mr. Belfanti. “Millions of Pennsylvanians are paying for the care in these nursing homes.”

But it might not amount to much:

The Health Department typically takes a month to review re-licensing applications, said spokeswoman Stacy Kriedeman. The main emphasis is to determine if the new owner is a responsible party. Carlyle has yet to submit any relicensing applications, she added.

But the department has no plans to include a formal public input process, as the lawmakers requested.

“People are free to provide comment,” added Ms. Kriedeman. “Change of ownership is not a public process. It never has been. We can’t alter the rules based on who the company is.”

I say, when government funds are used to pay for services provided by nursing homes, this should be a very public process. It’s OUR money that is very apt to be wasted here- at the expense of elderly nursing home residents who reside in Manor Care
facilities. Somehow the laws need to change on this.

Reactions from that NYT article about nursing home investments vs. quality care:

First:

WASHINGTON, Oct. 2/PRNewswire-USNewswire/ – Concerned that the trend toward private equity ownership of nursing homes is diverting taxpayer money to enriching top executives and buyout firms at the expense of quality care, the nation’s largest healthcare workers union is calling on Congress to take action to improve the quality of care and hold private equity firms accountable for their ownership of nursing homes.

Citing a recent New York Times investigation, the experience of nursing home caregivers, and concern over the pending buyout by the Carlyle Group of the nation’s largest nursing home provider, HCR Manor Care, SEIU sent letters Friday to the Chairmen of the House Committees on Ways and Means, Energy and Commerce, and Oversight and Government Reform, and to the
Chairman and Ranking Member of the Senate Finance Committee.

Then this:

To US Senators want to know if nursing home abuse and neglect are more prevalent in facilities owned by private Wall Street equity firms, and they are asking the Government Accountability Office (GAO) to find out. Their requests come on the heels of a New York Times investigation that found that the quality of care at nursing homes dropped sharply after they were acquired by private investment concerns.

Senators Hilary Clinton (D-NY) and Charles Grassley (R-Iowa) based their requests on the report in the New York Times that said drastic cost cutting measures imposed on nursing homes once they were purchased by private equity firms made nursing home neglect and abuse far more likely. Recently, private investment firms have looked to nursing homes as a possible route to easy money. These firms buy facilities, drastically reduce their costs, then turn around and sell them at huge profits.

Good to see some action coming from the NYT article. The NYT isn’t always accurate with it’s reporting; and they are known to have an agenda that isn’t always friendly towards the business community. In this case though, we KNOW through our own work and experiences that these nursing homes are just bad places. WE know of the staff cutbacks, the supply shortages and neglect forced upon the residents. I hope something good comes of this. Our elderly deserve so much better.

More about nursing homes/assisted living facilities hiring and then firing or HIDING staff who have criminal backgrounds.

NEW PORT RICHEY - A man applied for a job at a home for the elderly. He had pleaded no contest to a violent felony; he was hired nonetheless. One morning last week, police say, he lunged at an 78-year-old Alzheimer’s patient and punched him in the face.

The man went to jail, but he was not the only person with a criminal record on the New Port Inn’s payroll. At least two other caregivers also had records. And before state investigators arrived Tuesday to survey the facility, those caregivers were swept out of view.

Not good. I suspect we will be reading more about this in the coming weeks. (I hope so anyway).

The tales found in the Texas Department of Aging and Disability Service’s disciplinary files can be savage, sad and stomach-turning. But they are intended to serve an essential purpose: protecting Texas grandparents, disabled children and the terminally ill from abusive or dishonest nurse aides and other caregivers.

But dangerous blind spots plague the system that oversees them, a Star-Telegram examination has found. Across the state, caregivers facing discipline for sexual misconduct, theft, abuse — and a fatal case of neglect — were all able to find and hold new jobs.

Consider this: The department has banned about 680 people — for life — from working at any of the facilities it regulates. Yet every two years, the department renews the certifications of some of those same workers as nurse aides. One San Antonio aide, blacklisted for stealing an elderly man’s identity in 2005, has a new certification good through 2009. A Lubbock aide banned for swindling an elderly woman out of more than $100,000 works for a healthcare staffing company and insists she’s not caring for patients — “We do billing,” she said. Another, banned for neglect, was fired from a Plano nursing home only after the Star-Telegram questioned her status in August.

Just how do those workers keep getting recertified? All the state requires for renewal is evidence that an aide is still working.

So if a blacklisted aide continues to hold a job and sends that evidence to the state, no one checks to see whether they should be working before issuing the renewal.

Some have read the article at the NYT about nursing home investors buying up homes, cutting back services to the point of near neglect, and selling the properties for a huge profit. This is an awful horrible thing to read about, but it’s been happening a lot longer than some think. Those of us who have worked for chain owned facilities KNOW of the cutbacks and supply shortages, and many of us learn to work around it. When we do that, we enable this scheme to continue. When we make excuses for these places, when we claim it’s “not that bad”- we are allowing some terrible wrongs to happen. We’re fooling ourselves just a little; but in fact we are fooling the public a lot. One thing about this: We may not even be aware we are employed by one of these nursing homes believe it or not. IF you were hired by an outside group, and IF the facility places limits upon basic supplies AND there are a very few RN’s in house, you probably work at an facility that is being managed under this profit driven scheme.

Nonetheless, the details of the article are ethically wrong and we would all do the entire industry a favor by refusing to work at facilities owned by these groups; families and doctors would be wise NOT to allow an admission and investors would be shocked to know they are party to such neglect- investors are often people like you and me- who buy some stock hoping to make a little profit. Being assured by the holding company of good care and all, and having little real knowledge of the industry, investors continue to buy.

This should also serve as another reason we need to work towards getting people out of nursing homes. The desire to earn a few million bucks on the lives of our most treasured and vulnerable people is inexcusable. But money talks- our elderly often won’t.

We would be very interested in hearing from more aides who believe they are currently or have, in the past, worked for a home managed like this.