Articles Posted in Nursing homes

umc-pic-300x111Health officials caught expectant mothers, local politicians, and the D.C. community off guard by ordering the only full-service hospital in the southeast part of the District of Columbia to stop delivering babies and to shut its nursery for 90 days.

Details weren’t provided as to why D.C. regulators slapped restrictions on United Medical Center’s obstetrics and nursery care license. The hospital itself has acknowledged that at least three incidents, which it says it cannot discuss due to rigorous federal patient privacy rules, prompted the official rebuke.

This shutdown provides a harsh reminder just how little the public gets to know about important issues affecting doctors, hospitals, and patient safety and quality care.

Nursing-home-holding-hands-300x200Federal regulators need to ramp up their oversight of nursing homes, big time, with recent news reports and studies finding persistent abuses of elderly patients, including during crackdowns on problem operators, and facilities failing to care for vulnerable charges so they don’t lapse into emergency or hospital care.

Jordan Rau and the independent Kaiser Health News Service deserve kudos for digging into Uncle Sam’s “special focus status,” in which the nation’s “most dangerous” nursing homes get an ultimatum to correct major and continuing harms to patients or they may lose crucial Medicaid and Medicare funds from the federal government.

Rau found that more than half of the 528 homes deemed since 2014 to require the supposedly stringent “special focus” from regulators and that still are operating have since harmed patients or put them in jeopardy in the last three years.

Donald_Trump-1-225x300Republicans in the U.S. Senate will spend a long Fourth of July break trying to figure if they can repeal and replace the Affordable Care Act, aka Obamacare, with their Better Care Reconciliation Act, aka Trumpcare. Their bill, drafted in large part by just 13 GOP senators, some of the most conservative in the Senate, failed to win sufficient support so Majority Leader Mitch McConnell even could get it up for a vote before the holiday recess.

Lots of negotiations are under way.

In case you missed it, the Congressional Budget Office provided its independent analyses, scoring the cost and effects of the bill. The CBO estimated it would save the nation $321 billion in health-related expenditures in the next decade but would strip 22 million Americans of coverage, slightly fewer than would lose health insurance under the House-approved Trumpcare.

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Look out Baby Boomers and Gen Xers: Just when you or your elderly loved ones may be most vulnerable and needing nursing home care, the government is going back to allowing nursing home administrators to push a pile of documents for you to sign at you at admission time. And when you put your John Hancock on some of these, you will give away important legal protections.

The Centers for Medicare and Medicaid, overseer of 1.5 million nursing home residents and more than $1 trillion in Medicare and Medicaid funding, has posted notice that, under Trump Administration leadership, it soon will reverse its predecessors’ plan to halt agreements that forced patients and their families to give up their right to sue. Instead, Trump officials will push them to the alternative legal process known as arbitration. Officials insist they will require nursing homes to make arbitration requirements simpler, and to ensure they’re written in plain English.

But, in keeping with a recent U.S. Supreme Court ruling in a Kentucky case, regulators are yielding to the nursing home industry’s aggressive lobbying and point of view that arbitration is simpler, easier, and will keep down costs.

oregon-300x198For policy-makers and politicians who seek to offer robust, transparent information about the quality and safety of all too often troubled nursing homes, a newspaper investigation in Oregon underscores how poor execution guts good intentions.

The Oregonian deserves praise for discovering that a highly praised public health initiative in the Pacific Northwest foundered due to weak oversight and follow-up by regulators and others involved.

The project started with a great idea that many in health care discuss often: Taking public data about nursing homes and posting it online on a website targeted at families in desperate need for information to decide which care facilities are best for their ailing, infirm loved ones.

Medicaid-300x225Republicans have long fumed about the federal government’s role in health care, ever since Medicare for the elderly and Medicaid for the poor were both passed in 1965. Now, though, we’re at a crossroads, where a frontal assault on Medicaid could cause big damage to both programs.

The temptation for too many Americans, as I’ve written before, may be to skip over the Medicaid-related parts of the GOP proposals to repeal and replace the Affordable Care Act, aka Obamacare. That would be wrong because those parts of the American Health Care Act, aka Trumpcare, may be the most radical and will be detrimental to the poor, working poor, children, sick, disabled, and seniors. They will hit many millions more middle-class Americans than might be thought.

Opponents also say that Trumpcare and its Medicaid and health insurance changes will harm Medicare, the linchpin of health care coverage for seniors.

goodlatte-300x256We all know how con artists work the streets. One might bump into you in a train or in a crosswalk, while the other grabs your wallet. Or one might smile and chat with a mom at a playground, while her partner nabs the purse.

Patients and consumers may want to watch carefully for the congressional version of the distraction scam, a series of stealth bills that aim to strip them of valuable legal rights and protections they’ll need if harmed by big hospitals, rich doctors, big insurance companies, or giant corporations. With so much commotion under way with the new administration, Republicans sneakily have launched a furious, multi-pronged so-called “tort reform” campaign. They’ve wanted it for a long time. They insist it is needed to curb excess and frivolous lawsuits, to save money for Uncle Sam (who often is a defendant), to make the economy work better, and to add jobs, and to make life in general more wonderful.

Their arguments are counter-factual and lacking in evidence.

elder-abuse-awareness-300x210It’s one of the more disturbing, revolting, and painful health care investigations put out by a news organization in recent times. It’s disheartening but it also demands action: So, what steps will federal, state, and local authorities take now that CNN has reported that thousands of sick, disabled, and defenseless patients, most of them women, have been sexually abused and assaulted in nursing homes in the last decade?

The broadcast network said that data, collected by the U.S. Health and Human Services Department’s Administration for Community Living, show 16,000 sexual abuse complaints have been filed since 2000 over conditions at long-term care facilities (both nursing homes and assisted living facilities). Experts say there may have been more cases because sexual assault and abuse, due to stigmatization, often is un- or under-reported.

CNN, which turned up more than 380 sexual assault allegations in Illinois and more than 250 in Texas between 2013 and 2016, said it had analyzed U.S data in the same period, finding that “the federal government has cited more than 1,000 nursing homes for mishandling or failing to prevent alleged cases of rape, sexual assault and sexual abuse at their facilities … And nearly 100 of these facilities have been cited multiple times during the same period.”

prescription-bottles-1-300x170Some diligent, grown-up sons and daughters may want to check in on mom, dad, and grandma, grandpa, all the aunties and uncles, too. That’s because there’s yet another warning that too many doctors are whipping out their prescription pads all too readily and writing scripts for retirement-age Americans, who now take on average three psychiatric drugs without any mental health history.

Research published in the JAMA Internal Medicine shows that over-prescribing of powerful psychotropic drugs, including sleeping pills, painkillers, and anti-depressants may be more common than believed. The study was based on an analysis of data from a big number of doctors’ office visits, with researchers finding the number of “polypharmacy” incidents (cases in which seniors received scripts for multiple drugs) increased between 2004 and 2013 from 1.5 million to 3.68 million.

This doubling resulted from seniors’ greater openness in talking with their doctors about mental health issues, and, in instances where visits were related to “anxiety, insomnia, or depression,” the researchers write. But, in disturbing fashion, a high number of women and rural patients were involved in cases where multiple psychotropics were prescribed, and many of the prescriptions were for painkillers.

harlanYes, there can be progressive steps in health care—and with all the controversy and change going on in the sector it’s worth spotlighting some of these:

Patients should get access to own health records, researchers say

  • Three researchers—Dr. Harlan Krumholz of Yale Medical School (photo right), Connecticut lawyer Jennifer L. Cox, and Yale student Austin W. Jaspers—deserve credit for publishing a pointed opinion piece in the JAMA Internal Medicine detailing the costs and needless obstacles patients confront when they want copies of their own health records. As Krumholz told Reuters of the study’s message about excessive records fees charged by doctors and hospitals:  “Higher costs are a higher barrier for people to get their own information. Without that information it is not possible to correct errors in the record, get informed second opinions, donate your data to research – or share with others what is happening with your care.”  That’s spot on, doctor, as I have written recently and in my book,  The Life You Save: Nine Steps to Getting the Best Medical Care, and Avoiding the Worst. Uncle Sam has stepped in and tried to make it easier and more affordable for patients to get their own records, which Krumholz and company point out should be even more available now that they are digitized (he’s working on software to help, too). But states aren’t doing enough to help, except for Kentucky, which requires a free first copy on request, he and his colleagues say. My firm’s site contains information that may be helpful to those struggling to get their records. Here’s hoping that doctors, hospitals, and other caregiving facilities read the Jaspers, Cox, and Krumholz viewpoint, and, because it appears in one of their publications and Krumholz is a physician-researcher of growing influence, they heed it more.

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