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A nursing home in Memphis, Tennessee, is losing patients and staff members as it is being cut off from Medicare and Medicaid reimbursement funding for patient services. The nursing home is Signature HealthCARE at St. Francis, which also has been fined over $1.2 million for failing to meet certain minimum standards. This nursing home received poor grades on multiple Medicare surveys, leading to an overall rating of two out of five stars.

Of the areas surveyed, the nursing home performed worst in health and fire safety inspections. In its most recent health inspection in September 2016, 15 health deficiencies were noted. This number was far above the average number of deficiencies for Tennessee facilities, 5.1. It is also more than two times the national average of 7.2.

Signature is a large nursing home chain. It is based in Louisville, Kentucky. Overall, Signature operates more than 120 nursing homes in the United States, including five in the Memphis area. According to reports, nursing home residents began to transfer to other facilities when news broke that Medicare and Medicaid would no longer be reimbursing the nursing home for services performed for the residents. As of March 2017, around half of the facility’s beds were not being used. This has prompted the nursing home to lay off staff members. The nursing home has said it will appeal the reimbursement decision.

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A sudden death in a Michigan nursing home has sparked a statewide investigation with potentially significant consequences for the nursing home. The nursing home in question, Medilodge of Grand Blanc, has been providing long term skilled nursing care and short term rehabilitation services to the Eastern Michigan area for years. Recently, a male patient was found unresponsive, and investigators are wondering why.

The male resident, who has not been named in reports, was found unresponsive at Medilodge in late 2016. He was rushed to a nearby hospital where he was pronounced dead. The cause of death was not disclosed but is under heavy speculation. The suspicious circumstances surrounding the sudden death have led to an investigation by the Michigan Protection and Advocacy Service (MPAS). The MPAS is a state-appointed group assigned to investigate cases of abuse and neglect against the state’s disabled population.

MPAS also has the authority to file lawsuits on behalf of the state, which is precisely what was done in this case. The lawsuit filed by MPAS alleged that the deceased had physical and neurological disabilities and that he was not receiving adequate care in light of his circumstances. Lawyers for the group requested records from Medilodge in January 2017 but its request went unanswered. MPAS then, for the second time, requested records roughly two weeks later, also to no avail. After the second request, a lawyer for Medilodge stated he was in the process of complying with these requests but pleaded that he needed more time. The case is currently in the early stages of litigation.

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Elder abuse is a widespread but often under-reported problem. Studies show that only 1 out of every 14 cases of elder abuse are ever reported to the proper authorities. This statistic comes at the heels of data showing that citizens of the United States, and the world, are getting older. Worldwide, the percentage of adults aged 65 years or older is expected to triple to 1.5 billion people by 2050. In a recent survey, over 25% of Americans polled agreed that the growing number of aging adults is a major problem.

Currently, the elderly make up 15% of our nation’s population, and as mentioned above that number is expected to keep rising. If the trend of elder abuse and neglect continues to go unchecked, coupled with our growing population of elderly adults, more Americans will be subject to abuse in their lives. Abuse can take many forms including physical, financial, or sexual abuse.

Lawmakers in Tennessee and throughout the United States recognize the troubling trend of increased elder abuse are taking steps to ensure that our older adults are receiving the protection they deserve. In 2016, Tennessee lawmakers introduced legislation that created Vulnerable Adult Protective Investigative Teams in Tennessee, whose goal is to protect elderly and vulnerable adults. One way of accomplishing this goal is to promote information sharing between government agencies across the state.

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Healthcare fraud, specifically through programs like Medicare and Medicaid, is a major problem in the United States. In fact, it is one of the most prevalent types of insurance fraud committed each year. It is estimated that Medicaid fraud amounted to approximately $140 billion in 2016, while Medicare fraud was very close behind. So who foots the bill and gets hurt when fraud is perpetrated? In the situation of health insurance fraud in nursing homes, the victims are our loved ones.

Medicare coverage is broken into sections, starting with Medicare Part A. Part A covers inpatient hospital care, skilled nursing facilities (i.e. nursing homes), home health care services, and hospice care. Medicare is designed to assist persons over 65 years old and those who are disabled pay for medical expenses. For instance, an individual in a nursing who must undergo a procedure would only pay a percentage of the total cost. The remainder is billed by the medical provider to Medicare, who pays the provider an amount negotiated in advance for the specific procedure performed.

Medicare fraud can occur in a number of different ways. Some of the most common occurrences of fraud include phantom billing and kickback fraud. Phantom billing is probably the most obvious and widely committed type of fraud. This type occurs when healthcare providers bill Medicare for unnecessary medical procedures or procedures that are never performed. Unnecessary procedures can cause side effects that cause complications with a patient’s existing medical conditions. Billing for unnecessary medical equipment or tests also constitutes phantom billing. Kickback fraud refers to when another individual or facility receives some form of “kickback” for assisting in Medicare fraud. This could be criminals who steal patients’ Medicare numbers and data or medical providers receiving money for making false diagnoses or needlessly recommending a patient to another facility that will engage in financial fraud.

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Imagine being attacked by creatures with no way of escaping. The feeling of lying helpless as thousands of tiny insects attack your body, bite after bite. This nightmare became a horrific reality for one 84-year-old nursing home patient in East Alabama. According to reports, the patient was left unattended for over 11 hours, during which time she suffered over 100 painful ant bites. The victim, who was bedridden, was unable to move on her own or call for help, and she required constant care from nursing home staff. This incident led to an investigation by the Alabama Office of the Attorney General as well as three employees being criminally charged with elder abuse.

One nurse and two nursing assistants were responsible for caring for the patient on the night of the attack. All three were licensed to practice in Alabama and employed by Cherokee County Health and Rehabilitation Center, the nursing home where this occurred. A status chart for the patient showed that all three staff members had entered the patient’s room multiple times throughout the night, but surveillance footage revealed that none of the three ever actually entered the room for over 11 hours.

Following the investigation, the three employees were fired from the facility and charged with second degree elder abuse/neglect. Further, Cindy Cline, an Administrator for Cherokee County Health and Rehabilitation Center, confirmed that the incident was reported to the state and the board of nursing immediately.

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Elder abuse and neglect can take many forms. Abuse can occur physically, verbally, psychologically, or financially, while neglect can be reckless or intentional. Unfortunately, the news these days seems to be filled with reports of nursing homes abusing and neglecting their elderly residents. What may come to mind are the images of nursing home staff members physically assaulting the elderly or performing unnecessary and dangerous chemical restraints to subdue patients.

While many nursing home abuse cases involve caregivers harming patients, one particular incident in New York involved one patient abusing another. This occurrence took place last August in a nursing home in Buffalo, New York. According to reports, 82-year-old Ruth Murray was assaulted and beaten to death by another nursing home patient at Emerald South Nursing and Rehabilitation Center.

The tragic event occurred after Murray wandered into the room of an 84-year-old dementia patient. According to medical records, the attacker suffered from extreme dementia and, as part of his care plan, was supposed to be checked on every 15 minutes by nursing home staff.  At the time of the incident, however, both the victim and her attacker were unsupervised, which allowed the attack to take place. The New York State Department of Health cited the nursing home for failing to provide adequate care and fined the facility $10,000, its harshest fine.

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Nursing homes are meant to be places of safety and comfort for elderly adults, meaning they should feel assured at all times that they are receiving proper medical care, including specialized medical treatment when needed. It is natural for everyone to require more medical attention as they age. We trust that when we place our elderly loved ones in these homes that they will receive just as much care and attention from their healthcare providers as they would from their own family, if not more. Further, we trust that the physicians and nurses who treat our loved ones are adequately trained and proceed with the highest degree of skill and caution.

However, unfortunately, physicians and nurses do make mistakes. Due to the frail physical nature of many nursing home residents, these mistakes could lead to unwanted diseases that can ultimately cost them their lives. Medical malpractice is a complex branch of personal injury law whereby injured patients can recover against doctors, nurses, or medical facilities for their action or inaction in causing the patients’ injuries. In order to prevail on a medical malpractice claim, the injured party must prove that the healthcare provider breached the relevant standard(s) of care while treating or diagnosing him or her. Within the context of the medical field, the standard of care can comprise accepted practices and procedures of the medical community within a medical provider’s geographic area when treating similar patients with similar medical histories.

In order to recover compensation, just like in all personal injury claims, the injured party must prove that the breach of the standard of care caused his or her injuries. Common types of medical malpractice claims within the context of nursing homes can include misdiagnosis, prescription errors, ignoring patients’ medical needs, or an abuse of medical restraints. Qualified expert witnesses can review medical records and provide testimony needed to meet the plaintiff’s legal burden of proof in court.

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A nursing home in Idaho is facing a lawsuit and severe penalties following findings of neglect. Holly Lane Rehabilitation and Healthcare Center in Nampa, Idaho is one of the latest nursing homes to be hit with allegations of gross neglect of its residents. According to findings by state inspectors in 2016, residents of the home were dehydrated, left to sit in their own feces and urine, and frequently battled infections brought on by the neglect of the nursing staff.

87-year-old Jerry Carr has filed a lawsuit against Holly Lane and its parent company, Orianna Health Systems, which is based out of Bartlett, Tennessee. Carr is seeking undisclosed damages in excess of $100,000. In 2015, Carr had been living at Holly Lane for 12 years when he suffered a serious fall that required surgery and left him hospitalized for two months before he could return to Holly Lane. Upon returning to the home, Carr required constant and detailed attention from nursing staff. The lawsuit alleges many complaints of inadequate care from the facility and its employees.

Among his claims, Carr alleges that the nursing home and its employees did not change his clothes when he soiled himself, did not provide him with his prescribed pain medication, failed to keep him hydrated, and failed to take steps necessary to prevent the fall that caused his severe disabilities. As a result of the neglect, Carr contracted a MRSA infection, which to elderly adults like Carr, can be a death sentence.

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An Oklahoma woman has been charged with 17 different counts of elder abuse. Robyn McKinney owns and operates Branding Brook, an assisted care living facility in Vinita, Oklahoma. The facility specializes in caring for patients with extreme limitations or disabilities. Due to the extreme nature of many of the patients’ disabilities, they are unable to communicate or move effectively, essentially rendering them helpless and completely reliant on McKinney and her staff to take care of them.

This makes it all the more unsettling to hear reports that McKinney had been abusing these residents for years. McKinney, who was responsible for keeping track of residents’ finances and medications, had been psychologically and physically abusing residents by withholding their money and verbally attacking them, according to complaints made by residents. Reports further claim that McKinney had even put a padlock on the facility’s refrigerator. This knowledge comes at the heels of a 911 call placed by someone who reportedly witnessed McKinney attack and bite a resident on the nose.

One of the only ways to stop nursing home abuse from happening is to report it. Reporting can come from a resident, a resident’s family member, or an employee who witnessed the abuse or neglect of a patient. Reporting nursing home negligence is critical because it only becomes more of a problem the longer it is allowed to continue. Unfortunately, facilities that neglect patients continue to operate daily. Elder abuse is all too prevalent, and often under reported. A study found that 30% of nursing homes in the United States were cited for almost 9,000 instances of abuse over a two year period. This same study also found that the percentage of nursing homes cited for abuse has increased every year since 1996.

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The transition to living in a nursing home can be overwhelming and stressful. A change from independent life to assisted living often makes our elderly loved ones angry, frustrated, and anxious. It is no surprise that before nursing homes were so heavily regulated, the use of sedatives as a means to calm rowdy patients was a widespread practice. Using sedatives to calm an elderly nursing home resident is referred to as “chemical restraint,” and it involves the use of potent antipsychotic and other psychoactive drugs to involuntarily sedate unruly patients.

Common types of sedatives are benzodiazepines and antipsychotics, which tend to produce a calming effect. Around 300,000 nursing home patients are receiving some kind of antipsychotic drug to combat the anxiety and aggression frequently found with dementia as a byproduct of Alzheimer’s disease. Drugs like Seroquel and Risperdal are effective in the fight against dementia and other psychotic disorders, but should only be used as a last resort. Additionally, Federal and state laws prohibit the use of chemical restraint for the convenience of nursing home staff. Chemical restraint may only be used if patients pose a threat to themselves or others. Federal and state regulations have done wonders to prevent doping of healthy patients, but cases of unwarranted chemical restraint are all too common.

For example, a lawsuit was recently filed in Chesapeake, Virginia, accusing nursing home staff members of practicing chemical restraint. 84-year-old nursing home patient Alice Mackey claims that she was tied down by two nurses and injected with a heavy sedative. Mackey claims that the restraint was purely to “silence” her. After she was sedated, Mackey was left bound to a wheelchair for the remainder of the night, where she ended up urinating on herself and was left to sit in her own filth.

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