Friday, December 19, 2014

Avoid the guessing game in search for nursing home

Ron Clark of Davidsville visits with his mother, May Clark, 88
The responsibility of finding the right long-term care facility for his mother, whose memory is clouded by dementia, gnawed at Ron Clark.

Though he sometimes asks 88-year-old May Clark if she remembers him, she seems to know when her son needs consoling. She grips his thick palm, weathered from years as a power plant mechanic, and the familiar touch evokes a smile of relief.

“It’s a shock when you realize you have to put your mother in a nursing home,” he said, pausing to corral his emotions. “You know you have to do it, you don’t know where to turn …. It’s one of the most excruciating things to do, but you have to make a decision.”

Most people will face this responsibility for a friend or family member at some point in their lives as people live longer. It’s particularly likely in Pennsylvania, which has the fourth largest percentage of residents 65 and older in the country.

Often, the search leaves people dizzy with choices and worried that their selection could end up being harmful to a loved one. The horror stories of mistreatment or worse are well known.

But now there are more helpful tools than ever as government agencies face the need for improved systems of looking at care and help for families making these decisions.

The federal government is improving its ratings system of nursing homes throughout the country. In January, staffing information and quality measures that used to be self-reported by nursing homes for the Nursing Home Compare tool will instead be pulled from auditable reports.

That information will expand on the full text of inspection reports that the Centers for Medicare and Medicaid Services [CMS] began releasing in 2012.

However, elder-care advocates and long-term care officials caution consumers against using only online tools to choose a facility. They say the No. 1 priority should be to visit a facility, not just once during the day, but a few more times, during meals and at night.

It can become a job on its own, and it has for some people, like Eileen Graham, an elder-care adviser in Southwest Pennsylvania who helped the Clarks of Davidsville find a personal-care home for their mother.

Ron Clark and his wife, Rosalyn, told Graham they valued safety and cleanliness, and hoped for a nearby facility that had the comforts of home. They also wanted it to specialize in working with residents with dementia.

Graham considered the pros and the cons of several facilities, took tours and then shared her notes with the Clarks. She also helped them access benefits for spouses of veterans. She charges $85 to $125 an hour.

Together, they decided on the Amber Hills unit of the Cambria Care Center in Ebensburg, about 25 minutes away from their Somerset County home.

“There’s a lot of stigma, that nursing homes are dark and gloomy,” Graham said. “It’s never going to be perfect ... but there are really great facilities out there.”

Where Pennsylvania stands

The most comprehensive tool to determine what nursing home may be suitable is the online Nursing Home Compare.

Users can see what health violations nursing homes have had, how many hours of care they provide daily to each resident and how many residents develop pressure sores or use antipsychotic medication.

The data also tell a story about Pennsylvania nursing homes in general.

For instance, the news website ProPublica used the data to show that Pennsylvania nursing homes have one of the lowest average rates of serious deficiencies per home in the country. In addition, 28 states have had more Medicare or Medicaid payments suspended because of violations.

On the other hand, CMS data show more than half of long-term residents become incontinent, which surpasses the national average, and Pennsylvania is home to the facility with the second-highest fine amount in the country, according to CMS.

That title is held by the Golden LivingCenter in Lancaster, which was fined more than $582,000 between January 2013 and February 2014 for persistently poor care.

For two years, it has been a Special Focus Facility, meaning it’s subject to more frequent inspections and escalating penalties, according to CMS. In November, CMS listed it among facilities that have shown improvement.

Executive Director Stephen McShane wrote in an email that the home takes “immediate action” when deficiencies are found, and he has hired additional staff and new leaders. The home is currently in compliance with all standards, he said.

With 699 nursing homes in Pennsylvania, according to Nov. 19 data, each home has averaged eight deficiencies per year over three years and three months of mandated annual inspections and complaint investigations.

The national average is six to seven deficiencies per inspection, according to CMS.

Five Harrisburg nursing homes had the highest average rate of deficiencies among the state’s 10 most-populous cities, at 16 violations per nursing home per year. It is followed by Lancaster and Scranton with averages of 10 deficiencies per home annually.

Pittsburgh matched the statewide average of eight, and Philadelphia was slightly higher with each nursing home cited with an average of nine violations a year.

PublicSource used federal data that reports the city based on the nursing home’s postal code to determine this.

While the number of deficiencies can show a pattern, it’s the type of deficiency that truly matters to Ron Barth, president and CEO of LeadingAge PA, a trade association that represents 365 not-for-profit senior service providers.

“You can get a deficiency because literally there were three burnt-out light bulbs in the facility, or you can have a deficiency because people aren’t getting fed,” he said.

The deficiencies are rated on a scale of A to L, with L being the most severe. About 85 percent of Pennsylvania violations were graded as Ds and Es, meaning there was no actual harm, just the potential for it.

Eight nursing homes were responsible for the 11 most severe violations in the state.

Forbes Center for Rehabilitation and Healthcare of Pittsburgh accounted for three Ls, and Harrison Senior Living of Christiana, Pa., in Lancaster County got two scarlet letters. An L grade means the violation put several or all residents in immediate jeopardy.

Forbes earned its Ls in June for fire safety violations: Not inspecting or testing generators, not maintaining sprinkler systems, and there was no approved program for fire alarm systems. The home reported it made corrections in July.

Eric Dudik, the current administrator, declined to comment because he wasn’t at the home at the time.

In March, inspectors reported that Harrison Senior Living failed to supervise residents at risk of wandering off the premises and neglected to take action after noticing a strong gas odor. It was also cited for not having a current emergency plan. The home told inspectors it updated procedures by May.

“Our mission is to provide a high level of care for our residents,” said Harrison Saunders, chief operating officer of Harrison Senior Living. “We’re thankful to have the light shed on these deficiencies so we can correct them and turn them around, and we certainly have.” (Continue reading)

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Avoid the guessing game in search for nursing home

Business owner charged with financial exploitation

GRAND RAPIDS — A Nashwauk man is being accused of swindling more than $1 million from his late uncle who suffered from dementia.

Patrick V. Pecchia, 55, made his first appearance Monday in Itasca County District Court in Grand Rapids on one felony count of financial exploitation of a vulnerable adult.

He obtained power of attorney for his ailing uncle, Joseph L. Pecchia, in 2007 after Joseph began suffering from dementia.

Patrick Pecchia used the money to gamble, buy a new car and pay hundreds of thousands of dollars in credit card bills from 2007 until Joseph, a longtime Nashwauk resident, passed away in 2011 at age 79, according to the criminal complaint.

The complaint includes copies of canceled checks, purchases and payments made by Pecchia through his uncle’s accounts, including:

• $10,700 to purchase a new snowplow that Pecchia used to clear snow at his businesses.
• $29,295 to purchase a new Chrysler 300 car.
• $48,000 in transfers from the uncle’s account to his bank account.
• $40,844 in VISA bill payments.
• $107,062 to himself in cashier’s checks.
• $119,501 in checks for “questionable gambling.”
• $146,207 to Discover Credit Card.
• $203,701 in counter checks.
• $258,993 to Capital One Credit.
• $50,000 to an account in the name of Pecchia Boys, Inc.

The complaint also details that upon his uncle’s death, Pecchia wrote checks from his uncle’s account to accounts Pecchia had set up under the names of his sons. Investigators said Pecchia’s sons seemed “shocked” and apparently knew nothing about the uncle’s checks, according to the complaint.

Several other checks from his uncle’s account were cashed with many of them noted as gambling money. Pecchia said that he would take his uncle gambling, and that he would cover the cost of his own expenses during the trips.

Medical records clearly show that the uncle would not have benefited from traveling to a gambling location to the extent of the withdrawals that were made or that he would have been physically capable of traveling, according to the criminal complaint.

Pecchia is the owner of Pecchia Boys, Inc, according to the Minnesota Secretary of State website. He is also listed as the owner of the Nashwauk Bottle Shop, Pecchia Clean Car Wash and Nashwauk Little Store.

Judge Jon Maturi Monday released Pecchia on conditions that he stay in contact with his attorney, report for booking at the Itasca County Jail and remain law abiding. His next appearance is scheduled for Jan. 26.

Phone messages left Tuesday for both Pecchia and his attorney, John Undem, were not returned.
The crime is a felony that could bring a fine of up to $100,000 and up to 20 years in prison.

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Business owner charged with financial exploitation

Newton woman charged with elderly exploitation

Houston County Sheriff’s investigators recently arrested a woman, charging her with financial exploitation of the elderly.

Court records show sheriff’s investigators arrested Terri Reeves Doughtie, 51, of Newton, on Tuesday, and charged her with felony exploitation of the elderly.

Records show investigators charged Doughtie with allegedly committing exploitation of the elderly by taking $4,685.19. Records show deputies charged Doughtie with stealing the money from the victim between Dec. 21, 2011 and Dec. 10 of this year.

Doughtie was released from custody at the Houston County Jail after posting $30,000 bail.

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Newton woman charged with elderly exploitation

Thursday, December 18, 2014

Congratulations to 2015 duPont Award Winner WFTS Tampa for: Incapicated: Florida's Guardianship Program

WFTS-TV, Tampa

Incapacitated: Florida's Guardianship Program

An investigative team uncovers rampant abuse and fraud by court appointed guardians

WFTS-TV’s ABC Action News I-Team zealously followed up on a tip by launching an in-depth
Incapacitated_florida_s_guardianship_program-_dupont_awardsinvestigation into Florida’s court-appointed guardianship program, which affects tens of thousands of people. The resulting series of reports exposed astonishing stories of elderly people stripped of their rights and property by self-serving “guardians.” Their homes, personal property and vehicles were often sold for a small percentage of their actual worth and then resold by guardians’ friends for huge profits. The team first followed 99-year-old Willi Berchau, who had been locked into a dementia ward after being determined “incapacitated’ three times by panels hired by the court. It was immediately clear that Berchau was not incapacitated, but was an intelligent, alert remarkable man. The reporters searched through records, spoke with family members and confronted some of the guardians with clear evidence of their misdeeds. As a result, this summer a new guardianship reform bill led to legislative changes to help protect others. 
Adam Walser, investigative reporter; Fran Gilpin, investigative producer; Randy Wright, I-Team photographer; Doug Iten, executive producer of Special Reports.

2015 DuPont Awards
Note:  NASGA congratulates Investigative Reporter Adam Walser and the fantastic staff of the ABC Action News I-Team for this prestigious award and we extend our deepest gratitude for their hard-hitting investigative series on the subject of guardianship abuse.   

The power of the press not only freed wrongfully guardianized  Willi Berchau, but it informed the unwary public who may not have ever heard of adult guardianship abuse, and now - thanks to this fine reporting, can take measures to protect themselves.  Thank you, ABC Action News I-Team!

Governor to discuss financial exploitation law

CONCORD, N.H. (AP) — Gov. Maggie Hassan is going to be discussing a measure she signed into law that strengthens the penalties for financially exploiting the elderly and other vulnerable New Hampshire citizens.

The bill establishes clearer definitions of the crime of financial exploitation, which includes intentionally abusing the trust of an elderly or impaired adult to gain access to their money and assets.

The law, which takes effect Jan. 1, 2015, makes it a crime to use the person's money or assets for personal gain rather than to provide them with food, clothing, shelter and other care.

Penalties range from a misdemeanor to a felony depending on the amount of money diverted. The law also requires anyone convicted to make restitution.

Hassan was scheduled to discuss the law Monday morning at the Statehouse.

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Governor to discuss financial exploitation law

Personal injury lawyer is indicted, accused of stealing $600K in client settlements

A 62-year-old New York City personal injury lawyer has been indicted on charges that he stole more than $600,000 from client settlements in less than six years, the Manhattan district attorney announced Monday.

Stephen Krawitz is charged with a scheme to defraud and grand larceny after allegedly providing no money at all to 16 clients for whom he negotiated settlements and wrongfully withholding money from at least two other clients. The indictment and filed court documents also say there was a shortfall in his attorney trust account, according to a press release from the DA’s office.

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Personal injury lawyer is indicted, accused of stealing $600K in client settlements

Wednesday, December 17, 2014

Florida’s chief justice hunts for goof-off judges

Florida’s chief justice has ordered the state’s 20 chief judges to monitor the work of each judge in their circuit looking for goof-offs — a move that’s unnerved judges in South Florida and elsewhere.

In a Dec. 1 administrative order, Chief Justice Jorge Labarga directed each chief judge to “separately communicate” with each trial court judge in their circuit “the importance of a professional work ethic and accountability to the judiciary as a full-time commitment.”

“Neglect of duty” offenses “shall be reported by the chief judge to the chief justice of this court,” Labarga’s order says.

Labarga turned down an interview request to discuss what prompted the order.

“The Chief Justice simply wants to make sure that the chief judges and the judges they supervise understand that there are consequences for violations of the public trust,” Supreme Court spokesman Craig Waters said. “We certainly realize that most of our judges honor their duties, but we feel it is a healthy thing to remind everyone of their ethical obligations.”

Broward, where judicial misbehavior has made national headlines and County Court Judge Gisele Pollack and Circuit Judge Laura Marie Watson are defending ethics charges brought against them by the Judicial Qualifications Commission (JQC), is among a number of circuits thought to have motivated Labarga’s order.

“The Supreme Court has to have a statewide perspective,” Waters said. “The people in the 18th Circuit [Brevard and Seminole counties] are convinced that the order is aimed at them.” Three judges from the 18th Circuit have disciplinary cases pending before the JQC.

Still, over the years Broward has had its fair share of concern about judges allegedly shirking their duty.

Larry Seidlin, the weepy probate judge who gained notoriety presiding over the high-profile Anna Nicole Smith case, had a reputation for paying more attention to his backhand than his caseload before his 2007 retirement. And this fall’s election included allegations that defeated incumbent Judge Stephen Feren was frequently absent from the courthouse.

Chief judges are elected to two-year terms by their fellow judges and serve as the administrative officer in their circuit, with supervisory authority over all judges and court personnel.

The new administrative order obliges chiefs to ensure accountability by the judges they oversee.

“Until this order came out, the chief judge, at least in Broward, was largely a ceremonial title where you went to rubber chicken lunches and you cut ribbons at the courthouse,” said Broward Public Defender Howard Finkelstein. “I was told by at least four chief judges that, whether a judge was intoxicated on the bench or was violating people’s rights by not following the law, they had no authority to do anything. … This order, as I read it, puts it clearly on the chief judges.”

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Florida’s chief justice hunts for goof-off judges

Death in Bronx Shows Vulnerability of State’s Nursing Home Residents

University Nursing Home in the Bronx is part of a large consortium of rehabilitation and home health companies called Centers Health Care. Credit Edwin J. Torres for The New York Times

Unable to see clearly and afflicted with dementia, Frank Mercado, 77, depended completely on the care provided by the small nursing home in the Bronx where he had lived for four years. But last Monday, as Mr. Mercado cried for help, a veteran employee beat him to the ground, where he was impaled on a sharp metal protrusion from an overturned table, according to prosecutors.

Mr. Mercado died hours after the beating, and on Monday, the Bronx district attorney’s office said the employee, Cherrylee Young, 41, had been charged with negligent homicide, fatal assault and endangering the welfare of an adult.

The death, which was ruled a homicide by the medical examiner, underscores the vulnerability of frail nursing home residents in New York State, where rates of substandard care, neglect and abuse are high, according to national studies. Advocates for elderly and disabled residents complain that state enforcement has dwindled in recent years, even as private companies have been on a buying spree, acquiring nonprofit facilities and often cutting staff to enhance profit margins.

The nursing home, University Nursing Home on Grand Avenue, is small, with only 46 beds, but it is part of a large consortium of rehabilitation and home health companies called Centers Health Care.

Kenneth Rozenberg, the consortium’s chief executive, is an owner or director of 17 nursing homes, including University. It has scored high in federal rankings, though the integrity of those rankings was called into question in a recent investigation by The New York Times, and in recent years state officials found numerous violations there.

Thomas McCartin, a spokesman for Centers Health Care, said Ms. Young, who has worked at the nursing home for 14 years, had been suspended. A lawyer for Ms. Young, Jacob Lemon-Strauss, could not be reached for comment.

Mr. McCartin said University Nursing Home had an exemplary health care history, including a five-star rating from He said the company was assisting the Police Department in its investigation but declined to comment further.

Only one-fifth of the country’s 15,000 nursing homes have received the top rating from Medicare, but The Times this year reported that the ratings rely heavily on self-reported data from nursing homes that the government does not verify, and that can be incomplete and misleading. Medicare has since made changes to its rating system, which will take effect in January.

Over the last four years, the state has found 19 life safety code deficiencies at University, compared with a statewide average of 11 over the same period. A State Health Department inspection in 2011 cited the nursing home for filthy rooms, for broken equipment — including over-the-bed meal tables — and for failing to properly report or investigate resident injuries for possible abuse.

In one case, an 86-year-old woman’s hand was lacerated on nails sticking out from a wardrobe; in another, an 81-year-old man with dementia complained of shoulder pain and then developed large bruises on his arm that went uninvestigated.

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Death in Bronx Shows Vulnerability of State’s Nursing Home Residents

Eleven Texas lawyers & four judges disciplined

Disciplinary Actions — December 2014 State Bar list (verbatim from the State Bar of Texas)

General questions regarding attorney discipline should be directed to the Chief Disciplinary Counsel’s Office, toll-free (877) 953-5535 or (512) 453-5535. The Board of Disciplinary Appeals may be reached at (512) 475-1578. Information and copies of actual orders are available at The State Commission on Judicial Conduct may be contacted toll-free, (877) 228-5750 or (512) 463-5533. Please note that persons disciplined by the Commission on Judicial Conduct are not necessarily licensed attorneys.

Houston area discipline:

On Sept. 4, 2014, the Hon. Denise Pratt [#16238500], former judge of the 311th District Court, Houston, Harris County, was issued a public reprimand by the State Commission on Judicial Conduct for failing to be diligent and failing to timely execute the business of the court in violation of Article V, Section 1-a(6)A of the Texas Constitution. The commission found that Judge Pratt’s decisional delays, which inclu-ded a failure to timely issue orders, renditions, and findings of fact in numerous family law cases pending before her court, were unreasonable and unjustified; that Judge Pratt’s frequent tardiness and cancelation of hearings and trials contributed to the court’s enormous backlog; and that her dismissal for want of prosecution of more than 600 cases on Dec. 30-31, 2013, without notice to the parties or their attorneys, failed to comply with the law under Canon 2A, demonstrated a lack of professional competence in the law under Canon 3B(2), and deprived litigants of their right to be heard under Canon 3B(8). The commission noted that prompt disposition of cases is critical to the parties appearing in court, especially when vulnerable children are involved, and necessary to prevent backlogs that interfere with the administration of justice. The commission also noted that a judge who fails to show up for court hearings, appears late to court, or delays making decisions and signing orders in cases involving the rights of parents and the best interests of children, causes harm and a great disservice to parties, lawyers, witnesses, jurors, and other judges.

On Sept. 15, 2014, Melonie Dwan Jones [#24032483], 49, of Sugar Land, was disbarred in three separate disciplinary actions composed of multiple cases. An evidentiary panel of the District 5 Grievance Committee found that in all three disciplinary matters, Jones failed to keep her clients reasonably informed about the status of their legal matters; failed to promptly comply with reasonable requests for information from the clients about their legal matters; failed to explain the status of the legal matters to the extent reasonably necessary to permit the clients to make informed decisions regarding the representation; engaged in conduct involving dishonesty, fraud, deceit, or misrepresentation; failed to timely furnish to the Office of Chief Disciplinary Counsel a response or other information as required by the Texas Rules of Disciplinary Procedure; and engaged in the practice of law when her right to practice had been administratively suspended for failure to timely pay required fees and assessments or for failure to comply with Article XII of the State Bar rules relating to mandatory continuing legal education. The panel found that, upon receiving funds in which some of the clients had an interest, Jones failed to promptly notify the clients; failed to promptly deliver to the clients funds that they were entitled to receive; failed to hold funds, belonging at least in part to the clients, that were in Jones’s possession in connection with the representation separate from her own property; and distributed funds, belonging at least in part to the clients, that were in Jones’s possession in connection with the representation to persons or entities who were not entitled to receive them by virtue of the representation or by law. The panel found that Jones failed to abide by some clients’ decisions of whether to accept an offer to settle the clients’ legal matters and that she knowingly disobeyed a ruling by a tribunal and committed a serious crime or other criminal act that reflects adversely on her honesty, trustworthiness, or fitness as a lawyer. Jones violated Rules 1.01(b)(1), 1.02(a)(2), 1.03(a), 1.03(b), 1.14(a), 1.14(b), 1.14(c), 3.04(d), 8.04(a)(2), 8.04(a)(3), 8.04(a)(8), and 8.04(a)(11). She was ordered to pay $60,955 in restitution and $3,944.99 in attorneys’ fees and direct expenses.

On Oct. 9, 2014, Ty Alexander Gibson [#24083069], 28, of Houston, agreed to a 28-month, 15-day partially probated suspension effective Nov. 1, 2014, with the first four months and 15 days actively suspended and the remainder probated. An evidentiary panel of the District 4 Grievance Committee found that Gibson ordered, encouraged, or permitted conduct by a non-lawyer that would have been a violation of the Texas Disciplinary Rules of Professional Conduct if engaged in by Gibson; paid a non-lawyer to solicit and refer prospective clients; accepted or continued employment in a matter when that employment was procured in a manner contrary to the disciplinary rules; committed a criminal act that reflects adversely on his honesty, trustworthiness, or fitness as a lawyer; and engaged in conduct that involves dishonesty, fraud, deceit, or misrepresentation and that constitutes barratry as defined by the law of this state. Gibson violated Rules 5.03(b)(1), 7.03(b), 7.06(a), 8.04(a)(2), 8.04(a)(3), and 8.04(a)(9). He agreed to pay $2,000 in attorneys’ fees and $620.80 in direct expenses.

On Sept. 15, 2014, Charles L. Thorn [#19963700], 61, of Webster, received a two-year probated suspension effective Oct. 1, 2014. An evidentiary panel of the District 7 Grievance Committee found that complainant hired Thorn for representation regarding two traffic citations. In representing complainant, Thorn neglected the legal matters entrusted to him by failing to provide legal services for complainant and failing to keep complainant reasonably informed about the status of the legal matters. Thorn violated Rules 1.01(b)(1) and 1.03(a). He was ordered to pay $100 in restitution and $1,300 in attorneys’ fees and direct expenses.

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Eleven Texas lawyers & four judges disciplined