Governmental reports

How do I know if a nursing home is safe?

There is no way to be 100% certain that your elderly relative won’t suffer an injury or trauma in a nursing home.

But when it comes to elder care, knowledge is power. If a home has history of abuse or neglect complaints, it’s a sign of serious, systemic problems.

Search for nursing home complaints 

Medicare tracks nursing home violations and deficiencies. Nursing Home Inspect has organized that data: you can search for a specific facility – for example, “Harborview Hospice”; or by location – “Aberdeen, Washington”. The information is updated monthly, and covers the past three years.     

  • How many complaints – or “deficiencies” have residents filed?

For example, Kittitas Valley Health & Rehab Center in Ellensburg, Washington has a shocking 59 verified complaints.

  • How severe are the violations?

Severity ratings range from “A” violations—the least severe, usually the potential for harm, without actual damage— to “L” violations, the most severe incidents, occurring in a pattern.

  • What actually happened?

Medicare’s incident reports are included; you can see the details of specific incidents, and know what to watch for if you have a relative in that facility.

Coluccio_Law_Nursing_Home_Checker

A search for “Seattle, Washington” found 216 elder care facilities, with a total of 913 deficiencies.

 

This is a great resource, but one of the best things you can do to ensure a safe, healthy nursing home experience is to go there often, and on various dates and times.

If the residents generally seem happy and healthy, it’s a good sign.

If you suspect something is wrong, you’re probably right. Request an investigation.

See: How to file a Nursing Home Complaint: 4 easy steps. 

 

Increasing Acceptance of "Granny Cams"

Most of us have heard of nanny cams. Now, the tiny hidden cameras, used for parents who are suspicious of their nannies, are gaining greater acceptance as a way to stop elder abuse or nursing home abuse.

A video still shows a nursing home aide stuffing latex gloves into Eryetha Mayberry’s mouth

A video still shows a nursing home aide stuffing latex gloves into Eryetha Mayberry’s mouth

According to the NY Times’ Well blog, Doris Racher decided to use a granny cam to catch a petty thief who was stealing from her mother, a 96-year-old dementia nursing home patient.

Instead of catching the thief, Doris found an aide stuffing latex gloves into her mother’s mouth, while another taunted her, tapping her on the head, laughing.

Despite concerns about privacy, some state attorney generals have used hidden cameras to go after some suspected of nursing home patient abuse and neglect.

In June, Mike DeWine, the Ohio state attorney general, announced that his office, with permission from families, had placed cameras in residents’ rooms in an unspecified number of state facilities. Mr. DeWine has moved to shut down at least one facility, in Zanesville, where, he said, cameras caught actions like an aide’s repeatedly leaving a stroke patient’s food by his incapacitated side.

As for the Mayberry story, there is now a new Oklahoma law that allows cameras in residents’ rooms if consent forms are filed to notify the facility, according to prior coverage by News9. The law gives the family exclusive rights to the recording and allows it to be used in court.

 

WA State Has a Problem with Caring for Some of its Most Vulnerable Citizens

Two July 31st Washington state audits reveal some significant issues with how our developmentally disabled citizens are inadequately served. Audit findings include:

Washington’s challenge is to make more equitable services available  to all the eligible people who are asking for them.

Washington’s challenge is to make more equitable services available
to all the eligible people who are asking for them.

  • 23 criminally disqualified caregivers were hired. This number is based on a sample pool of 1,400 supported-living workers (out of 40,000 statewide).
  • 12% of caregivers lack safety training certifications. Note that the numbers may actually be much higher, but the state is too understaffed to investigate or cross-check records.
  • There were roughly $500,000 in overpayments. These overpayments were due primarily to errors manually transferring rates into spreadsheets, and then manually transferring again into the payment system.
  • There were about $11.3 million in questionable payments and $5.5 million in unauthorized payments. Mismanagement of funds focused on paying roughly 3,700 individual citizens, while  ~15,000 people eligible for such services as housing, medical care and job planning languish on a waiting list.

The Seattle Times ran a blistering editorial enumerating Washington state’s problems with caring for some of its most vulnerable citizens, calling on lawmakers to do something.

Indeed, what do we need to do to open the eyes to our legislature to address the serious problems that the auditor’s reports call out?!2nd Auditor Rept

As one of the auditor’s reports points out, Washington serves fewer people compared to other states.

In 2012, Washington served 12,722 people with ICF/ID or HCBS services. Based on 2012
population estimates, this is about 186.6 individuals per 100,000 in the general population,
which is still below the 2010 national average.

President Obama Signs Bipartisan Medicare Law

Just a few days ago, President Obama signed H.R. 1845 (112th), the bipartisan Strengthening Medicare and Repaying Taxpayers (SMART) Act, which was introduced by Reps. Tim Murphy (R-PA) and Ron Kind (D-WI) in the House and Sens. Ron Wyden (D-OR), Rob Portman (R-OH), Ben Nelson (D-NE) and Richard Burr (R-NC) in the Senate.

The legislation was a bipartisan solution to streamline the Medicare Secondary Payer (MSP) system, to ensure that seniors and persons with disabilities get timely assistance and taxpayers are repaid millions of dollars every year.

The SMART Act is seen as a victory for senior advocates.

We will see how effective SMART is, as the Centers for Medicare and Medicaid Services (CMS) must still work to eliminate confusion and uncertainty by providing clear, efficient and definitive information to seniors.

Medicare Secondary Payer (MSP):

– The MSP process ensures Medicare is reimbursed for medical bills that are the responsibility of another party – such as an insurer or negligent party.

– A senior or person with disabilities who has been injured, and later obtains recourse through the legal system, often cannot access their settlement until Medicare is reimbursed for all medical cost

– The current MSP system is inefficient and slow to return dollars to the Medicare Trust Fund, which is funded by tax payer money

– It can take years for the Centers for Medicare and Medicaid Services (CMS) to report reimbursement amounts to beneficiaries and CMS can seek multiple reimbursement amounts over time, providing further delay and uncertainty

The SMART Act will:

  • Require CMS to maintain a secure web portal to access claims and reimbursement amounts in a timely fashion.

CMS must upload care payments they disperse within 15 days with the required information about the payment.

  • Streamline the process of obtaining reimbursement amounts.
  • Medicare beneficiaries must notify CMS they are anticipating a settlement no more than 120 days beforehand.
  • CMS then has 65 days to ensure the web portal is up-to-date, but may request an additional 30 days, if needed
  • Reimbursement amounts are reliable if downloaded from the web portal within three days of settlement.
  • Provide a process and timeline for discrepancies and appeals.

Medicare beneficiaries can provide documentation for discrepancies on the web portal to CMS. CMS has 11 days to respond to discrepancies.

– If CMS does not respond in 11 days, the amount calculated by the beneficiary is the correct amount.

– An additional appeal process must be established by CMS for reimbursements it attempts to collect from insurance plans.

– Create a threshold for collecting any payment amounts by CMS that are below the cost it incurs to collect an average claim.

– Readjust the penalty for reporting errors by insurers based on the violation.

– Ensure greater privacy for beneficiaries by no longer requiring use of full social security or health id claim numbers.

– Create a three year limit for CMS to seek any repayments beginning from when they were informed of an anticipated settlement.

Population of 90+ Year Old Tripled Within 3 Decades, Will Quadruple by 2050.

The Census Bureau reports some sobering statistics: The segment of our population that is 9!Cedar Village.jpg0 years old or older has tripled in the past three decades to 2 million. The number is projected to quadruple by 2050.

As the economy continues to limp along and the aging population jumps, an increasing number of elderly people are forced to turn to their younger relatives. Unfortunately, these family members don’t always have their vulnerable elders’ best interest in mind. This is one of the key reasons why elder financial abuse is growing at epidemic proportions.

A recent USA Today article addresses this troubling problem, reporting the opening of the first elder abuse shelter in Ohio. Despite the statistics that point to widespread abuse, the total number of elder abuse shelters in this country are in the single digits, Non profit groups fund all of them.

Word still needs to get out that our the elder abuse problem is cutting across socio-economic lines.

I-1163 Claims to Protect Vulnerable Citizens

Pierce County Prosecutor, Mark Lindquist, writes in today’s News Tribune in favor of I-1163. Lindquist explains that this initiative will require home care workers to pass a federal background check. These are the home care workers who provide identical care in nursing home facilities, but in a setting where they are not supervised closelyI-1163.jpg.

At present, the background checks are at the state level. But this means that such checks will not catch crimes committed outside the borders of Washington State. However, Lindquist does not mention that workers who have lived in the state less than three years are required to undergo an FBI fingerprint check by state law.

The measure also would require more than double the current number of hours of basic training — 75 hours instead of the current requirement of 35 hours. Workers would be paid wages for attending the training classes.

Opponents to the initiative, which had passed three years ago as I-1029, focus on the state’s budget shortfall. Gregoire, who opposes I-1163, explains that cuts will have to be made elsewhere if this measure passes. State analysts estimate that this measure would cost about $18 million over the next two years. Opponents most damning criticism of I-1163 is the fact that the Service Employees International Union (SEIU), a large proponent of I-1163, stands to benefit financially, as it would likely provide much of the instruction. The proposed new 75 hour training mandate would indeed provide a generous income source to SEIU.

Nonetheless, Cindi Laws, executive director of the Washington State Residential Care Council, explains that more training will not effectively prevent caregivers with nefarious intentions from taking advantage of seniors. She says that the state needs to do a better job of investigating places that have repeated and serious violations, and she wants regulators to take swifter action when there is a major problem.


Read more: http://www.thenewstribune.com/2011/10/18/1869787/wa-voters-asked-again-to-boost.html#ixzz1bH2C0mFl

Financial Abuse Costs Seniors $2.6 Billion Per Year

Because I handle claims of Elder Abuse quite frequently, I like to stay abreast of developments in the communities in which I practice. The Senior Focus is a paper that published the latest issues facing Senior Citizens. They recently reported that financial abuse of senior citizens costs vulnerable adults up to $2.6 billion a year. 

The report, by the National Committee for Prevention of Elder Abuse, states that the abuse is often where you least expect it, from those taking care of the elderly. The Committee states the abuse is "most often perpetrated by family members and caregivers."

If you feel you may have been the target of elder financial abuse, you need to take action. Be wary of someone wanting you to place all of your financial assets with them as a trustworthy source if things go wrong. There are ways to structure your assets so that they can be used for your benefit without putting all your trust in one person. Additionally, if you do need to execute a power of attorney, place that power in more than one person. If you have two people who you trust, the second person can act as a check if the first begins to abuse their power over you. 

In addition, the article lays out other forms such abuse can take: marketing and repair scams, brokers, salespersons, loan officials. If something seems too good to be true, it usually is, and you should enlist the assistance of a friend, relative, or even an attorney to help you evaluate the deal. 

A common scam perpetrated not only on the eldery, but on anyone, involves "phishing". Phishing does involve fishing for your personal information through either the phone or the internet. If someone is asking you for your social security number or bank number, get their name and telephone number. After you have verified that they are who they say they are, you can call them back or visit in person. As a general rule, anyone that would call you and ask for such information is someone who shouldn’t be getting that information in the first place — if you’re the one who called them, you probably already know the number you are calling is the right one.

$2.6 billion may seem like a drop in the bucket compared to things like defense spending and the annual budget, but the number should be $0. Learning the signs to watch for is the first step.

About Kevin

Kevin Coluccio was recently named one of the Top 10 Super Lawyers in Washington State. He has long history of successful elder abuse/neglect cases and has a stellar reputation for getting results for his injury clients in serious car crashes, pedestrian accidents, trucking accidents, maritime claims, and asbestos injury cases.