What’s wrong with Illinois’ plan to prevent nursing home abuse

A new law proposed in Illinois would permit the use of cameras in nursing homes to monitor patient care.

The use of the cameras would be voluntary, although there are questions about obtaining consent from elderly residents, their visitors, and the nursing home staff.

Nursing home safety (if you can afford it)

Patients and their families would have to purchase and set up the equipment themselves, and then monitor the footage.

In this plan, a patient’s safety is contingent upon their ability to finance and install an expensive surveillance system. Many senior citizens in long-term care facilities (which are hugely expensive) can’t afford that.

Additionally, this plan assumes that there are family members who are willing and able to watch hours of video footage on a regular basis.

Who’s in charge here?

Families should be allowed to monitor the care of elderly relatives. “Granny cams” have recorded elder abuse in other cases.

And there’s a good argument that the mere presence of a camera would decrease the risk of nursing home abuse: surveillance in itself changes behavior.

But should the State of Illinois place the burden of ensuring nursing home safety on the patients themselves?

Nursing home abuse and neglect is a big problem. Illinois received a failing grade in a national study released in May 2014. Voluntary surveillance captured and monitored by those who can afford it may help, but overall, this plan does not come close to solving the problem.

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.

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.

Elder Abuse Results in $2.9 Billion Loss Per 2011 Report

A June 2011 by the MetLife Mature Market Institute (MMMI) reports that older Americans lost $2.9 billion as the result of elder abuse. This is a whopping 12% increase from the previous year. Financial Elder Abuse.jpg

A common practice among banks is to allow older customers to use signature stamps (especially for those clients who find it more difficult to sign their names on forms, etc.)

The MMMI report is a sobering reminder that elder abuse comes in many forms–not only physical and emotional, but also financial. However, if a signature stamp fall in the wrong hands, it can do much more than wreak more than a little havoc to one’s finances. Case in point: Ms. Isenberg.

Ms. Isenberg’s daughter, Liz Sanders, hired a caregiver for her bedridden mother. This caregiver, Ms. Wofford, slowly drained over 3/4 of $1 million from Ms. Isenberg’s accounts. Wofford wrote herself checks and withdrew from Wofford’s life insurance. In addition to racking up tens of thousands of dollars in debt at various department stores, Ms. Wofford treated herself to a Mercedes courtesy of Ms. Isenberg–unbeknownst to Ms. Isenberg and her daughter.

When Liz Sanders found out about how Wofford had victimized Ms. Isenberg, she also learned that restitution was not a reality. However, she was determined to make it less easy for such financial abuse to occur to other elderly Californians. She went to her state senator, Fran Pavley (D-Agoura Hills), and put together California Senate Bill 586, which would have doubled the penalties for elder and dependent adult abuse in California. It added new provisions for the issuing of signature stamps by state-organized banks and credit unions.

The legislation passed easily, backed by the AARP along with other advocates for seniors and the CA Senior Legislature. Yet, Gov. Jerry Brown vetoed the bill last week. His message with the veto was that he did not believe that the bill would prevent fraudulent use of stamps. Brown pointed to another bill that increases penalties for elder abuse embezzlement, forgery, and identity theft as sufficient.

Liz Sanders says she pursued the legislation to find justice for her mother, and also to protect other seniors who might be at risk. The process helped spread the word about this problem throughout California and the United States.

Please heed Sanders’ plight and stay mindful of common signs of financial elder abuse:

  • Unusual financial activity, abnormal purchases, unpaid bills
  • An individual seems neglected physically or his/her home seems neglected
  • An elderly person asks to add a new name to bank accounts or seeks other co-signing arrangements
  • An individaul is granted power of attorney, although the senior may not have known that person for a long period of time
  • Increasing isolation of a senior along with decreasing contact with family members/friends
  • The emergence of a sudden “new best friend,” especially of someone who is much younger than the senior.

Better to err on the side of caution and report any suspicions to local authorities, which often have a division that focuses on assisting seniors.

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

Obama Tries to Improve Quality of Nursing Home Care

Today, Medicare pays the costs for hospital admission regardless of the reason. But Obama’s recent proposal includes a provision that addresses this issue as it relates to the quality of nursing home care.Nursing Home Patient.jpg

If you ever wonder why emergency rooms are often filled with elderly patients on Fridays, it is because a number of nursing homes homes send their sickest residents to the hospital as their facilities don’t have sufficient weekend staff. Obama’s deficit reduction plan targets those nursing home facilities.

Some of the new rules in his proposal penalizes nursing facilities by reducing up to 3% of their Medicare payment. For some operations running on thin margins, this could make or break their business.

These new rules apply only to patients receiving rehabilitation or recovering from a hospital stay– not those longer term residents receiving Medicare.

If Congress approves this plan, elder care facilities will have to retool their practices and do better at lowering hospital readmission rates for their residents.

State of WA: Let's Crack Down On Elder Care Referrals

I applaud an editorial in today’s Seattle Times that urges Gov. Christine Gregoire to sign legislation that will clamp down on so-called “free” referrals for elder care referrals.Gregoire.jpg 

According to a Seattle Times report, providers that assist families by guiding through an array of options for their loved ones can include assisted living or other senior housing that best fits their needs for free. What is often not disclosed is that in return, these providers are paid as much as $3,500 per person by the facilities for providing them with a client.

Legislation sent to Governor Chris Gregoire demands referral companies to follow strict standards, including written disclosures of their commission rates.  

Washington is the first state to pass a comprehensive law to rein in elder-care referral companies, according to research by AARP, a senior organization that supported the bill.

I’m hopeful that Chris Gregoire will perservere with this incredibly important issue and sign the bill. We must impose a minimum set of rules on those who target this vulnerable group of citizens to for a profit. 

Check out this Seattle Times report for more details about the bill.

Family Councils Improve Quality of Care

California seems to be on the forefront of legislation aimed at improving the lives of nursing home residents. The legislature recently approved AB 1457, which provides transparency in the shell game of nursing home ownership and operation. 

California also has legislation in place which improves on the idea of Resident Councils by creating Family Councils. Resident Councils can have any number of residents as members, and are usually facilitated by the facility. The downside of a Resident Council is that there is no check on the accountability of the system. A problem may get reported to a Resident Council but not acted on. A Family Council allows two extra prongs of accountability. First, the Family Council involves not just residents, but family members external to the nursing home. These family members can push back without worry of the inherent power dynamic that is involved in an elder care relationship. Second, the concerns of the Family Council must be addressed by law. According to Walton Barber, the law in California provides improved protections not available in other states:

California law allows the creation of "family councils" by relative of a nursing home resident to help influence the quality of care given to a resident. Not merely gripe sessions, these councils can facilitate communications between families and residents with the nursing home staff and caregivers, and also offer peer support for friends and relatives of the resident, and help prevent substandard care.

A nursing home may not prohibit the formation of a family council, and must allow the council to meet on the grounds of the facility at least once a month. In addition the home must designate a staff member who is responsible for assisting the council, and to respond to all written requests made by the council.

Maybe its time to look at these types of protections in Washington. Below is a short video on Family Councils.

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.