Articles Posted in End of Life

marylandlogo-300x177It turns out there is more to be said about Maryland’s recently completed, pandemic-related checks on hundreds of nursing homes and long-term care facilities.

Three facilities, indeed, got expensive rebukes from state inspectors, but dozens more were hit with milder fines that also suggest widespread issues in the institutions, notably with the crucial concern of infection control.

In contrast to the Washington Post’s previous coverage of the sizable fines for Collingswood Rehabilitation and Healthcare Center ($275,000) and Potomac Valley Rehabilitation and Healthcare Center ($120,000), and Kensington Healthcare Center ($294,000), the Baltimore Sun said it, too, had obtained Maryland records indicating:

aged-199x300For the old, sick, and injured who are institutionalized, the Covid-19 pandemic and the efforts to halt the spread of the disease into care facilities has created debilitating side-effects: isolation, loneliness, silence, fear, and worries of abandonment.

Facility lockdowns, combined with the relentless governmental bungling of the coronavirus response, are taking a terrible toll that may not soon be eased, the New York Times reported. Dr. Jason Karlawish, a geriatrician at the University of Pennsylvania, told the newspaper this about the situation in all too many nursing homes and other long-term care facilities:

“It’s not just Covid that’s killing residents in long-term care. It’s the isolation, the loneliness.”

hhslogoaug20-300x300In response to the shattering harms of the Covid-19 pandemic, Congress sought to shore up the U.S. health care system with billions of dollars in emergency aid. But the federal agency that helps to oversee the institutional care for the elderly, sick, and injured performed poorly as a steward of taxpayers’ hard-earned money.

The Health and Human Services department, instead, shoveled hundreds of millions of dollars, “no strings attached,” to dubious owners or operators of facilities nationwide. These “for-profit nursing home providers … have faced accusations of Medicare fraud and kickbacks, labor violations or widespread failures in patient care,” the Washington Post reported.

The newspaper said its analysis of HHS allocations of big sums in the Coronavirus Aid, Relief, and Economic Security Act, or Cares Act, also showed that:

Last week the world took note with appropriate solemnity a terrible historic moment: The first military use of nuclear weapons, with explosions 75 years ago of bombs over the Japanese cities of Hiroshima and Nagasaki.

The resulting carnage — which the United States said was needed to end the horrors of World War II, especially by averting a bloody land conquest of Japan — has been seared into the global consciousness ever since, especially with the remarkable writing and reporting of author John Hersey.

The exact toll of the bombings of Hiroshima (a famous site shown above) and Nagasaki has eluded historians and other experts because of multiple factors, including: the scale of destruction, the chaos that ensued, and the uncertainty of the population and infrastructure that existed in the already war-torn cities. Still, by many estimates, tens of thousands died immediately — at least 135,000 in Hiroshima and 64,000 in Nagasaki.

alztest-300x79It isn’t just the testing for the novel coronavirus that has already anxious Americans upset these days. Controversies also are swirling around existing and developing ways for experts to screen older patients for cognitive decline, namely  dementia and its most familiar form,  Alzheimer’s disease.

Alzheimer’s disease, which accounts for 60%-80% of dementia cases, is the sixth leading cause of death in the United States overall and the fifth leading cause of death for those age 65 and older, researchers say. Medical scientists have engaged in furious efforts for a while now to determine the condition’s causes and to create treatments for it — a response that is sorely lacking now.

But the New York Times reported that experts believe they are nearing a better way to screen and diagnose the illness using the blood rather than current “expensive methods like PET scans of the brain and spinal taps for cerebrospinal fluid.” As reporter Pam Belluck wrote:

bookingpicretamays-150x150She was a 46-year-old Army veteran hired by the Louis A. Johnson Medical Center in 2015 with no certification or license to care for patients. Reta Mays worked in the middle of the night, tending to elderly, onetime service personnel, sitting bedside and monitoring their vitals, including their blood sugar levels. Mays went room to room, largely unnoticed for three years on Ward 3A.

But as unexplained deaths mounted on the surgical unit between 2017 and 2018, the bespectacled mother of three — who had served in the Army National Guard and had deployed to Iraq and Kuwait — shifted from being a nurse’s aide to becoming a murder suspect.

She now has confirmed in court that she injected multiple doses of insulin in at least seven patients in the rural Veterans Affairs hospital a few hours away from the nation’s capital, causing the frail victims’ blood glucose levels to plunge in fatal fashion.

cmschiefSeemaVerma-150x150With the calendar pages flying off to the fall presidential elections, why isn’t today an excellent time for President Trump to thank Seema Verma for her service and send her packing as head of the Centers for Medicare and Medicaid Services (CMS) in the Department of Health and Human Services?

Two news organizations — Vox and Politico — have posted detailed and disturbing takedowns of CMS and its oversight failures that have helped to worsen the terrible Covid-19 toll in the nation’s nursing homes and other long-term care facilities.

CMS, for example, halted nursing home inspections as the pandemic broke out — with disastrous consequences, as the Washington Post explains in a separate report. The agency earlier had also acceded to industry bleating about tough regulation, with Verma and her agency relaxing fines on owners and operators for detected problems and easing training requirements for under paid, over worked, and already ill-trained caregivers. The training standards have gotten so lax that a reporter, in 40 minutes of online effort, became certified temporarily to be a 24/7 caregiving aide.

faucipic-150x150To paraphrase the White House press secretary, science denialism is not getting in the way of the rampaging Covid-19 pandemic.

Eighteen states have hit “red zone” status where infections, hospitalizations, and deaths have soared to such dire levels (more than 100 new cases per 100,000 people per week) that a study held in private by the Trump Administration recommends officials impose tough public health measures.

The country now has, at least twice, shattered daily coronavirus case counts, reporting 70,000 new Covid-19 diagnoses. The country, as the New York Times reported, also has “set a record with 75,600 new cases [in one day], the 11th time in the past month that the daily record had been broken.”

covidSEvetcenter-300x200To paraphrase the late, great writer and activist Maya Angelou, nursing homes and other long-term care facilities are showing the public in the middle of this pandemic just truly what they are.

It is hard to believe, still, the shabby way they are treating the aged, sick, and injured. Just consider this sampling of recent news reports:

“Care” facilities — including centers dealing with veterans — have been too willing to subject residents to risky medical experimentation to fight the novel coronavirus, including what appear to be  inappropriate treatments with a much-promoted anti-malarial drug. This echoes a situation involving nursing home residents in Galveston, Texas,  and their facility’s dosing them with hydroxychlorquine without their loved ones’ knowledge and iffy circumstances about their individual capacity to consent to receiving the drug. As the Washington Post reported of a Philadelphia area veterans’ facility (shown in federal photo above):

capnurse-300x169What’s in a name? The Covid-19 pandemic should force a major change in the big misnomer of long-term care institutions: Let’s stop labeling them with the term nursing — as if they provide significant medical services to the elderly, sick, and injured.

Instead, the coronavirus may lead the public to bust the myth put forward by owners and operators of nursing homes, skilled nursing facilities, assisted living centers, and other similar centers about how they treat some of the nation’s most vulnerable people, especially based on growing evidence amassing in news reports.

The care facilities knew they were not hospitals, with extensive equipment and highly trained doctors and nurses. The facilities found they often were sorely lacking gear — especially personal protective equipment. They too many times did not have the staff with the skills or training to treat already fragile residents infected with the novel coronavirus or recuperating from significant bouts with a debilitating illness. They did not have the Covid-19 tests they needed. They struggled to isolate the infected.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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