Articles Posted in Certification and Licensure

bauchner-150x150dredlivingston-150x150While the federal Centers for Disease Control and Prevention has declared racism a serious threat to the nation’s health, establishment medicine finds itself mired in an angry scandal over doctors’ inability to recognize the term, much less its existence, or its considerable harms.

An uproar at a leading medical journal might seem a tempest in an ivy-covered tower. But patients will want to track even a little the professional furor falling on the leaders of the respected Journal of the American Medical Association.

Its website recently featured a podcast, for which doctors could get continuing professional education credit, in which host Ed Livingston (photo above left), JAMA’s deputy editor for clinical content and “a white editor and physician, questioned whether racism even exists in medicine,” Usha McFarling, a Pulitzer Prize-winning journalist reported for Stat, the medical-science news site.

stop-150x150Although state licensing boards have taken more than their fair share of criticism for failing to discipline bad doctors as quickly and severely as circumstances merit, regulators appear to be trying to get ahead of a problem that especially plagues women patients and women health staff: doctors’ sexual misbehavior.

This inappropriate conduct can encompass a range of bad acts — all of which are unacceptable and should result in serious consequences for offenders, a viewpoint in the Journal of the American Medical Association argues. The article describes a review and consensus reached by the Federation of State Medical Boards, representing the 71 state medical and osteopathic regulatory boards — commonly referred to as state medical boards — in the United States, its territories, and the District of Columbia.

The authors wrote this:

cmsnursinghomecompare-300x139Federal regulators, by allowing owners and operators to self-report quality and safety data and failing to audit vital information with diligence, have “broken” the national nursing-home rating system — what was supposed to be an invaluable tool for consumers to make life-and-death decisions about where to place vulnerable loved ones needing round-the-clock care.

Instead, the New York Times reported, the popular and convenient star rankings have become little more than an inaccurate means for facilities to advertise and market themselves, even while keeping from the public their serious problems — including abuse, neglect, over medication, sexual assault, and killings of the aged, injured, and ailing.

The system’s glaring shortcomings were exposed even more by the coronavirus pandemic, the newspaper reported. It launched its deep dig into the ratings when it became clear that highly rated homes, when the pandemic struck, did not fare notably better, as might be expected.

chartnytnhomedeaths-300x213Nursing home owners and operators have pleaded “poor us” through a lethal 2020. But profit-seeking players in the industry clearly still see rapacious opportunity in long-term care facilities — with residents suffering the consequences.

NPR and the Washington Post both have dug into the results when investment groups or chains acquire and operate nursing homes, and, as the media organizations reported, resident care declined.

The newspaper focused one of its deep digs on long-term care on New Jersey-based Portopiccolo Group, and how it “buys troubled nursing homes and tries to make them profitable,” paying “hundreds of millions of dollars to acquire facilities in Maryland, Virginia and elsewhere,” with little federal, state, or local oversight of its acquisitions.

countylahospicegrafic-300x139With coronavirus infections and deaths rising anew in worrisome fashion from coast to coast, matters could not get worse with the nation’s long-term care, right? Guess again. Profit-mongering and “audacious, widespread fraud” apparently has run amok in hospice care in the Golden State.

Because California, alas, too often serves as a trend-setting locale, patients, their loved ones, clinicians, regulators, and politicians may wish to take heed of an investigation published by the Los Angeles Times. The newspaper reported that too many older, sick, and injured patients have been gulled into signing up for unneeded and undelivered services meant for folks at the end of their lives:

“[M]any [hospice patients] are unwitting recruits [of] unscrupulous providers who bill Medicare for hospice services and equipment for ‘terminally ill’ patients who aren’t dying. Intense competition for new patients — who generate $154 to $1,432 a day each in Medicare payments — has spawned a cottage industry of illegal practices, including kickbacks to crooked doctors and recruiters who zero in on prospective patients at retirement homes and other venues … The exponential boom in providers has transformed end-of-life care that was once the realm of charities and religious groups into a multibillion-dollar business dominated by profit-driven operators. Nowhere has that growth been more explosive, and its harmful side effects more evident, than in Los Angeles County. The county’s hospices have multiplied sixfold in the last decade and now account for more than half of the state’s roughly 1,200 Medicare-certified providers, according to a Times analysis of federal health care data.”

covidnrsnghomenovdeaths-300x149While untold Americans tried to do right by older and more vulnerable friends and family members by taking extra precautions and even canceling Thanksgiving gatherings, the nation crossed a ghastly threshold for the aged, sick, and injured in late November: The coronavirus has killed at least 100,000 residents and staff in nursing homes and other long-term care facilities.

The number of deaths is likely under-reported in federal and other data sources, as several states lag in providing information about problems in the facilities. The deaths of those institutionalized also is spiking as Covid-19 cases have, too, from coast-to-coast. “Community spread” poses grave risks to those in institutions.

If these figures are not already bleak, the Wall Street Journal reported that its research finds that there also are “more than 670,000 probable and confirmed Covid-19 cases in long-term care, affecting both residents and staff members.”

govhogan-283x300Maryland will take the lead among states in the area in re-opening nursing homes and other long-term care facilities from months of coronavirus-related closures to family members, guests, and other visitors.

Gov. Larry Hogan (shown, right) acted as the state, for the first time in months, reported that October started with zero Covid-19 fatalities and 76 of Maryland’s 227 nursing homes had active coronavirus cases — down from 130 on Aug. 5, the Washington Post reported.

After struggling through some of the worst outbreaks in long-term facilities in the area, Maryland will put significant resources into safeguarding nursing homes as they reopen, Hogan said.

wyden-150x150https://www.protectpatientsblog.com/wp-content/uploads/sites/69/2020/09/Bob_Casey_Jr._official_photo-150x150.jpgThe White House and Senate Republicans have failed to protect more than 1.3 million Americans in nursing homes and other long-term care facilities, with persistent inaction contributing to the rising toll of Covid-19 deaths and infections among the institutionalized — months after the crisis in long-term care exploded into the public consciousness.

Those are the new findings of Bob Casey and Ron Wyden, two ranking Democratic U.S. senators serving on the Aging and Finance committees, respectively. They issued their harsh criticisms and a minority staff report they requested and based on information from the Trump Administration. The Washington Post quoted Casey:

“This report lays bare the devastating cost that American families have paid as a result of the Trump administration’s incompetency and Republican inaction. The crisis in our nursing homes, which residents and workers and their families are experiencing every day, demands immediate action.”

dementiadiagram-300x204Even as news organizations reported that the coronavirus pandemic has taken a grievous toll on seniors institutionalized with dementia, a presidential panel on nursing home care split over common sense but limp recommendations on how the nation might reduce Covid-19’s savaging of the old, sick, and injured in long-term care facilities.

The unsurprising, 180-plus pages of recommendations from the Coronavirus Commission on Safety and Quality in Nursing Homes to the Trump Administration and specifically its long-term care facility watchdog Centers for Medicaid and Medicare Services (CMS) included calls for: “More money for testing, for personal protective equipment (PPE), for registered nurses, for infection control training and staff salary increases,” the Washington Post reported.

Seema Verma, the CMS chief who has led a calamitous federal response in long-term care that has left at least 77,000 vulnerable residents dead — 40% of all the coronavirus fatalities in the nation — and not quite a half million infected, tried to spin the commission’s findings.

demattos-150x150Maryland officials have wrapped up pandemic-prompted inspections of 226 nursing homes with a pricey rebuke to long-term care facilities that have failed still to safeguard the elderly, sick, and injured from Covid-19, putting them at “immediate jeopardy,” instead.

Three facilities were slapped with six-figure fines after state inspectors faulted them in June and July for improperly isolating potentially contagious residents, including new admissions: Collingswood Rehabilitation and Healthcare Center ($275,000) and Potomac Valley Rehabilitation and Healthcare Center ($120,000), and Kensington Healthcare Center ($294,000).

Inspectors also asserted that a patient died at Potomac Valley after a nurse failed to provide basic life support, and the Washington Post reported, based on state data, that “at least 78 residents from the three facilities have died since the spring of Covid-19 … and more than 270 have been infected with the virus.”

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