Resident Safety

Nursing Home Maintenance Worker Fired, Arrested for Alleged Sexual Abuse of Resident

January 22, 2013 | Lebowitz & Mzhen

A maintenance worker at an assisted-living facility in Albany, New York was fired and then arrested for the alleged sexual abuse of a 91 year-old resident. Media coverage of the incident has indicated that the man is a registered sex offender with convictions from the 1980’s for rape and other offenses. The owner of the facility reportedly did not know about the maintenance worker’s criminal history or status as a sex offender. The incident also led to the termination of an administrator at the facility and demands by a county official for stricter background check requirements for adult home employees.

An employee at the Loudonville Home for Adults alleged that they witnessed a maintenance worker sexually abusing a 91 year-old female resident on November 30, 2012. The man had reportedly gone to the woman’s room to change a lightbulb, when the employee making the report saw him put his hands down the front of the woman’s shirt without her consent . The nursing home fired the maintenance worker immediately upon hearing of the alleged abuse.

The maintenance worker is a Level 3 sex offender, according to the Times Union. Under the risk levels assigned by the state of New York, Level 3 indicates the highest level of risk for repeat offenses and threats to public safety. The man was reportedly convicted in 1984 for the 1983 rape of a woman in Saratoga County. He spent sixteen years in prison until his parole in 2000. After his community supervision ended in 2008, he was hired at Loudonville.

Police arrested the maintenance worker on December 20, 2012 in connection with the alleged sexual abuse. He allegedly confessed to police after his arrest. He now faces charges for felony endangering the welfare of a vulnerable elderly person and misdemeanor sexual abuse. As of mid-January 2013, he remained at the Albany County Jail, where law enforcement is holding him on $25,000 bond.

Does Quality of Care Differ Between For-Profit and Non-Profit Healthcare Facilities?

January 9, 2013 | Lebowitz & Mzhen

A recent New York Times article examined some of the differences in services between for-profit and non-profit nursing homes. Some research over the past few decades has suggested that for-profit facilities, by seeking to minimize expenses, may be at a disadvantage to nonprofit facilities in terms of quality of care. The article cites a handful of academic papers in support of this argument, which is certain to generate controversy for its criticism of the private sector. As nursing home injury attorneys, we are interested in whether a nursing home’s for-profit or non-profit status affects its duty of care to its residents. Under federal laws and the laws of the state of Maryland, it makes no difference when it comes to a nursing home’s professional obligations.

Eduardo Porter, writing for the New York Times, discussed a study performed in 1984 by two researchers, Bonnie Svarstad and Chester Bond, at the University of Wisconsin-Madison’s School of Pharmacy. The paper, entitled “The Use of Hypnotics in Proprietary and Church-Related Nursing Homes,” is not currently available online, but was cited in a 1988 book, The Nonprofit Economy, by the economist Burton Weisbrod. Svarstad and Bond examined the use of sedatives at for-profit “proprietary” nursing homes and non-profit nursing homes affiliated with churches. They reportedly found that both types of facilities prescribed drugs for their patients at about the same rate, but that the proprietary facilities prescribed doses that were, on average, around four times larger than the dosages at the non-profit facilities. Weisbrod interpreted these figures in stark economic terms, arguing that medications are less expensive than staff, and it is more cost-effective to sedate a patient than to employ caregivers to offer individual attention.

Increasing Numbers of LGBT Seniors May Require Additional Training For Nursing Home Workers

December 11, 2012 | Lebowitz & Mzhen

There is a growing population of lesbian, gay, bisexual, and transgender (LGBT) seniors who face certain challenges in addition to those that come with growing older. Although a growing number of states now have legislation protecting individuals from discrimination on the basis of sexual orientation in areas such as education, employment, and marriage, nursing homes and other assisted care facilities often must decide for themselves how to handle the changing demands.

According to an article in the Boston Globe, 80 percent of LGBT seniors in Massachusetts are afraid to reveal their sexual orientations to care providers, and they are also unlikely to seek continued care for the same reason. These numbers are likely representative of other states, as well.

The problem is complex. While LGBT seniors’ fears are often substantiated, their unwillingness to come out in their assisted living communities makes others unwilling to reveal their sexual orientations either. Providing adequate training to nursing home staff specifically on the issue of LGBT senior care is part of the solution.

It is also important that supervisors be extra diligent in ensuring that LGBT seniors are not subject to abuse or neglect by their supposed caregivers. If an individual wishes not to come out, an abusive employee could use knowledge of their secret to extort the resident or otherwise use it against her. Less obvious would be instances of neglect. A worker might express disapproval of a resident’s sexual orientation by being neglectful of care.

LGBT seniors also face a risk of abuse from their fellow residents. While that risk is present for any resident, LGBT individuals tend to be more susceptible to it. The onus is on the nursing home employees to notice when inter-resident abuse occurs and to stop it.

Study Suggests Norovirus Poses Risk to Nursing Home Residents of Hospitalization or Death

October 26, 2012 | Lebowitz & Mzhen

A recent review of norovirus outbreaks in nursing homes found a correlation between outbreaks and higher rates of both hospitalizations and mortality among residents. While the correlation does not necessarily mean that the norovirus directly causes a greater number of hospitalizations or deaths, the data obtained by the study could prove useful in identifying risks faced by nursing home residents during outbreaks of communicable disease. This can in turn help nursing home administrators enact policies to protect and preserve their residents’ health and safety.

The norovirus is a highly contagious virus commonly associated with the stomach flu. It can affect anyone, regardless of age or general health condition, with symptoms ranging from stomach pain and nausea to acute gastroenteritis. People can contract an infection from other infected people, contact with contaminated surfaces, or ingestion of contaminated food or water. According to the Centers for Disease Control and Prevention (CDC), the norovirus sickens around 21 million people in the U.S. annually, and it is responsible for as many as seventy thousand hospitalizations and eight hundred fatalities per year.

The study, “Hospitalizations and Mortality Associated With Norovirus Outbreaks in Nursing Homes, 2009-2010,” was published in the October 24/31, 2012 online edition of the Journal of the American Medical Association. The researchers reviewed records from Medicare and the CDC for a period from January 2009 through December 2010 from three states: Oregon, Pennsylvania, and Wisconsin. Their review covered 308 nursing homes, with a combined total of 407 reported outbreaks of norovirus. The norovirus outbreaks lasted a median of thirteen days. Twenty-nine percent of the total number of reported hospitalizations and seven percent of the reported deaths occurred during reported outbreaks.

Nurse’s Aide Gets Five Years in Prison for Stealing Nursing Home Residents’ Wedding Bands

October 11, 2012 | Lebowitz & Mzhen

A nurse’s aide at a Virginia veterans’ nursing home received a five-year prison sentence in September 2012 for a scheme that involved stealing residents’ wedding rings and selling them. She pleaded guilty to receiving and selling stolen property in July. She allegedly had a partner who actually stole the rings, then gave them to her to sell. The partner is still awaiting sentencing for grand larceny and selling stolen property. In addition to the prison sentencing, the court ordered both aides never to work in the nursing field again.

According to the Franklin News-Post, Ashley Michelle Sweeney and Brittney Heather Cook worked as contract nurse’s aides at the Virginia Veterans’ Center in Roanoke. Prosecutors described how the two aides worked together to carry out the theft scheme. Cook reportedly stole the wedding bands from nursing home residents. She would reportedly then give the rings to Sweeney, who allegedly sold them at two different pawn shops for a total of $360. The rings’ appraised value totaled about $4,600. In all, the two were charged with stealing and selling five rings. Their alleged victims were veterans of World War II and the Korean War, between 77 and 89 years of age.

Baltimore Nursing Home Closes After Owner Files Bankruptcy; Almost Seventy Residents Must Relocate

September 12, 2012 | Lebowitz & Mzhen

A Baltimore nursing home announced that it will shut its doors by the end of September 2012. The nursing home’s parent company, Ravenwood Healthcare, Inc. of Baton Rouge, Louisiana, filed for bankruptcy earlier this year. The facility lost its Medicare and Medicaid funding, and Ravenwood has been unsuccessful in locating a buyer. Residents received notice to relocate within thirty days, leaving many of them in an extremely difficult situation.

According to the Baltimore Sun, Harborside Nursing and Rehabilitation Center was the first nursing home in Maryland to accept patients suffering from AIDS in 1985. Despite this history, the facility has had difficulties with health and safety inspections over the years. The building was originally a hotel, and it has had difficulties over the years adapting to use as a nursing home and to modern structural standards. Inspectors with the state’s health department reportedly conducted an inspection of the nursing home during the period from February 29 to March 9, 2012. They identified more than thirty deficiencies, many of which were safety problems due to structural issues. As a result, the Sun reported, the Centers for Medicare and Medicaid Services (CMS) cut off Medicare and Medicaid funding to the nursing home, effective in September.

CMS’s “Nursing Home Compare” website gives Harborside one out of five stars, meaning “Much Below Average,” for both its overall rating and its health inspection results. It identifies the nursing home as a “Special Focus Facility,” meaning it has a “recent history of persistent poor quality of care” as determined by CMS inspectors. The last “standard health inspection” at Harborside, according to the website, took place on December 7, 2010. The site states that the facility has twenty health deficiencies, well above the state average of 10.6 and the national average of 7.5.

Nursing Home Could Lose Medicare and Medicaid Funding Due to Multiple Alleged Deficiencies

September 4, 2012 | Lebowitz & Mzhen

A nursing home in Greenwood, Mississippi could lose all of its funding through the Medicare and Medicaid programs if it fails to correct certain problems alleged by the federal government. The Centers for Medicare and Medicaid Services (CMS), the federal agency that administers both programs, recently notified Greenwood’s Golden Age Nursing Home of multiple deficiencies, including allegations of criminal conduct by nursing home staffers. The number and nature of the deficiencies, in large part because of the effect they have on the safety of the nursing home’s residents, put its participation in Medicare and Medicaid in jeopardy.

The Jackson Clarion-Ledger reported that CMS notified the nursing home in late August 2012 of twenty-four deficiencies occurring over the past fifteen months. It stated that it will continue to make payments for the nursing home’s residents until September 29 but will not pay for residents admitted after August 30. This gives the facility thirty days to remedy the deficiencies.

CMS reported that it had conducted three surveys of the facility in response to complaints in the past fifteen months. It compared the total number of deficiencies in the facility, twenty-four, to the national average of 7.5. The average number of deficiencies for facilities in Mississippi is six. The most recent survey of the nursing home, conducted on February 10, 2012, identified deficiencies in eight broad categories based on the regulatory requirements for participation in the Medicare and Medicaid programs:
1. Privacy and confidentiality of residents’ personal and medical information and records;
2. Provision of care that maintains “dignity and respect of individuality”;
3. Adequate housekeeping and maintenance;
4. Safety and cleanliness in food handling;
5. Labeling of drugs and maintenance of drug records in accordance with professional standards;
6. Effective planning to control the spread of infections;
7. Monitoring of nurse aides to ensure they can provide for resident needs; and
8. Recordkeeping on individual residents that meets accepted professional standards.

Nursing Home Locked Down by Police After Receiving Threat Letter

August 13, 2012 | Lebowitz & Mzhen

Police in New Milford, New Jersey put a local nursing home on “lockdown” after the facility received a letter containing threats and references to the recent shootings at a movie theater in Aurora, Colorado. As a precautionary measure for the safety of the nursing home’s residents, police kept residents in their rooms while searching for potential safety threats. No threats were found, and no suspects have been identified. All the residents are safe, and both police and nursing home staff say that they had access to care throughout the crisis.

A letter arrived at the Woodcrest Health Care Center the morning of Wednesday, July 25, 2012. This was less than a week after the shooting incident in Colorado, in which a masked gunman wearing full body armor shot dozens of people during a midnight screening of the new Batman movie. The gunman killed twelve people, injured more than sixty, and terrified the whole nation. The letter received by Woodcrest reportedly included handwritten references to the Aurora shootings and other threats, as well as pasted newspaper headlines. The letter made threats referencing explosives, knives, and guns. Nursing home staffers contacted the police, who arrived at about 11:40 a.m. Although the letter was apparently signed, police have not said by whom.

Police “locked down” the facility, instructing residents to remain in their rooms. They kept the residents there for about two hours. Bomb squad investigators, assisted by canine units, swept the facility and found no trace of explosives. The police chief reportedly requested the assistance of the county prosecutor’s Counter-Terrorism Unit, although it is not clear if they arrived on the scene before the scene was cleared at around 2:00 p.m.

Medical Study of Hip Injuries Placed Over 1,300 Nursing Home Residents at Risk, Government Says

August 7, 2012 | Lebowitz & Mzhen

A study involving researchers affiliated with Harvard and other academic institutions, intended to look into prevention of hip fractures, actually may have exposed over 1,300 participants to increased risk of hip injury. The Office of Human Research Protections (OHRP), part of the U.S. Department of Health and Human Services, ordered investigators to send notifications to the participants, who are elderly nursing home residents, detailing the risks to which they were exposed during the 2002-06 study. This concludes a year-long investigation by OHRP.

The Hip Impact Protection Project (HIP PRO) investigated the effectiveness of padded undergarments known as “hip protectors” in preventing injury to elderly nursing home residents. The study involved thirty-seven nursing homes, testing the efficacy of a type of undergarment that contained a hip pad on either the right or left hip. The researchers found that the single-side protective garments “may have caused unanticipated changes in behavior” among participants. The researchers concluded that hip protectors offered no significant protection against hip fractures. The study was published in the August 2008 issue of Clinical Trials, and it was also included in a 2007 issue of the Journal of the American Medical Association.

Contractor Kickbacks Result in Prison Sentence for Former Nursing Home Executive

July 27, 2012 | Lebowitz & Mzhen

A former executive with a nursing home company based in Roanoke, Virginina has been sentenced to just over five years in prison after pleading guilty to multiple counts involving mail fraud and tax evasion. He was accused of receiving more than half a million dollars in kickbacks from contractors, awarding contracts based on payments rather than on bids, and falsifying tax returns in order to conceal such income. Four contractors have also faced prosecution for payment of kickbacks. The case is important to advocates for victims of nursing home abuse and negligence because of the importance of maintaining adequate facilities for the care of nursing home residents. Kickbacks and other forms of corruption compromise the ability of nursing home administrators to effectively care for their patients.

Roanoke-based Medical Facilities of America (MFA) operates over forty nursing homes located around North Carolina and Virginia. John D. Henderson worked for MFA as its director of maintenance and renovations. According to prosecutors, he demanded and received $541,821 in kickbacks from three or more companies between 1998 and 2006. Those companies then received more than $5 million in contracts from MFA for construction work at its facilities. Henderson allegedly created false records of higher bids from competitors to create the appearance of a competitive bidding process. He was also accused of filing fraudulent tax returns to conceal over $400,000 in income. MFA fired Henderson in 2006 after learning about the kickback scheme.