Saturday, December 2, 2017

Local nursing homes agree to pay up to $6.9 million to settle kickback and fraud allegations

A room at Brighton Place in San Diego
Four San Diego nursing homes have agreed to pay up to $6.9 million to settle civil allegations that employees paid kickbacks for referrals and submitted fraudulent bills to government healthcare programs, the U.S. Attorney’s Office announced Thursday.

The nursing homes, all owned by Los Angeles-based Brius Management Co., were accused of paying kickbacks to hospital staffers in violation of anti-kickback laws, the U.S. Attorney’s Office said in a news release.

The four nursing homes were Point Loma Convalescent Hospital, Brighton Place in San Diego, Brighton Place in Spring Valley and Amaya Springs Health Care Center in Spring Valley, according to the news release. Brius Management could not be reached for comment.

The settlement resolves a lawsuit brought by a former employee of one of the nursing homes under federal whistleblower laws, the statement said. The employee, Viki Bell-Manako, will receive 20 percent of each settlement payment.

In a deferred prosecution agreement with the U.S. Attorney’s Office last year, the four nursing homes admitted employees conspired to pay kickbacks, and did so without the owner’s knowledge, the statement said.

The nursing homes also admitted employees used corporate credit cards to buy gift cards, massages, tickets to sporting events and a cruise for hospital staffers in exchange for referrals, according to the statement.

The settlement announced Thursday calls for Brius Management Co. to pay $1,785,967 to the United States over three years, and a single payment of $240,950 to California, the statement said.

It also agreed to pay $4.9 million to the U.S. government if certain “operational contingencies” are met and to enter into a corporate integrity agreement with the U.S. Department of Health and Human Services, the statement said.

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Local nursing homes agree to pay up to $6.9 million to settle kickback and fraud allegations

Circuit judge accused of not paying taxes agrees to resign

LITTLE ROCK, Ark. (AP) — A suspended Arkansas judge accused of not filing or paying his taxes for several years has agreed to resign from the bench.

The Arkansas Judicial Discipline and Disability Commission said Friday that Saline County Circuit Judge Bobby McCallister will resign, effective Dec. 15. The panel says it unanimously accepted McCallister’s agreement to step down.

Prosecutors say McCallister failed to pay or file taxes from 2012 to 2014 and in 2016. He’s been charged with four felony counts of failing to pay or file taxes.

The Judicial Discipline and Disability Commission said McCallister was “candid” and cooperative with the panel during its investigation.

Gov. Asa Hutchinson will appoint a replacement to the position.

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Circuit judge accused of not paying taxes agrees to resign

Seniors, leaving the house daily may help you live longer

We've all been there: confined to our homes for days, or even weeks, thanks to the dreaded flu or some other ailment. When you're finally able to go outside, there's no feeling quite like it. And for older adults, this seemingly simple pleasure could be life-saving.

New research finds that older people who leave their homes every day are likelier to live longer than those who remain indoors, regardless of their health status or functional capacity.

Lead study author Dr. Jeremy Jacobs, from the Hadassah Hebrew-University Medical Center in Israel, and colleagues recently reported their findings in the Journal of the American Geriatrics Society.

According to a 2015 study, approximately 2 million older adults in the United States never or rarely leave their homes, primarily due to functional difficulties.

Not only does this have implications for their physical health — due to lack of exercise, for example — but it can harm their psychological health, too. Research has shown that those who are confined to their homes are more likely to develop depression, anxiety, and other mental illnesses.

For their study, Dr. Jacobs and colleagues set out to investigate whether or not the frequency with which an older adult leaves their home might be associated with mortality.

Staying indoors linked to greater death risk

The research included 3,375 adults aged between 70 and 90 years. All adults were enrolled in the 1990–2015 Jerusalem Longitudinal Study.

As a part of the study, participants completed questionnaires about how often they left their homes each week. They were divided into three groups, based on their answers: daily (six to seven times weekly), often (two to five times weekly), and rarely (less than once per week).

Mortality among the participants was assessed from 2010 to 2015.

The researchers found that older adults who left their homes on a daily basis were at the lowest risk of death, while those who rarely left their homes had the highest mortality risk.

"What is interesting is that the improved survival associated with getting out of the house frequently was also observed among people with low levels of physical activity, and even those with impaired mobility," says Dr. Jacobs. "Resilient individuals remain engaged, irrespective of their physical limitations."

These findings also remained after accounting for the participants' social status and other medical conditions, including visual impairment, diabetes, heart disease, high blood pressure, and chronic kidney disease.

While the precise reasons behind these findings were not explored in the study, the scientists note that getting out of the house frequently gives older adults the chance to engage with the outside world.

Previous research has shown that people who spend more time outdoors — particularly in natural environments — may experience lower levels of stress and improved physical and mental health.

What is more, going outdoors provides greater opportunity for social interaction, which studies have linked to better overall health and well-being in seniors.

So, it seems that simply going outside to chat with the neighbor or taking a quick trip to the local grocery store could do the world of good for older adults' health.

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Seniors, leaving the house daily may help you live longer

Friday, December 1, 2017

Lengthy terms, discipline process cloak Maryland judges from scrutiny

Baltimore’s highest-ranking judge faces removal for misconduct. City judges are criticized for their handling of gun cases during a record spike in violent crime. And landlord-tenant judges are undergoing retraining after multiple studies found them misapplying housing laws.

Amid the recent string of bad news about the bench, calls are intensifying for Maryland to establish a program to evaluate judges — a method endorsed by the American Bar Association and recommended nearly two decades ago by the state’s leading legal minds.

Maryland judges serve what are believed to be the longest terms in the nation — 15 years for elected Circuit Court jurists, a decade for appointed District Court justices. But unlike 17 states and the District of Columbia, Maryland does not routinely evaluate the performances of judges with the type of program that watchdogs say is essential to maintaining public trust, informing voters and helping judges improve.

“Judges in Maryland are kings and queens in their own courtrooms, so it’s hard to enforce best practices,” said Laurie Duker, executive director of Court Watch Montgomery, which examines judges in domestic violence cases. “They don’t like to be told what to do.”

Six states post evaluations publicly, according to the Quality Judges Initiative at the University of Denver’s Institute for the Advancement of the American Legal System. Others publish summaries, or give the reports privately to judges or those who appoint them to improve performance.

Jennifer Yim is executive director of Utah’s Judicial Performance Evaluation Commission. The state agency’s program is considered one of the nation’s most exhaustive.

“Most voters don’t see the inside of a courtroom, so it’s hard for them to have information they can know and trust about judges’ performance,” Yim said.

That’s true in Maryland, Johns Hopkins political scientist Matthew Crenson said, where jokes abound every election year about how to cast ballots for judges whom no one seems to know.

“Those who do vote have no information whatsoever,” Crenson said.

The Maryland State Bar Association expressed opposition last year to contested elections for Circuit Court judgeships, in part, the organization said, because voters have a “a lack of familiarity” with jurists that may lead them to vote based either on party or, worse, the alphabetical order in which they appear on the ballot.

Such a process, the association said, is “a poor formula, to be sure, for a fair and impartial judiciary.”

The association convened a committee in 1998 to study judicial performance evaluation programs.

The panel was co-chaired by Steven I. Platt, a retired Circuit Court judge, and attorney Nell B. Strachan, and included two of the state’s most accomplished jurists: former Court of Appeals Chief Judge Robert M. Bell and current Court of Appeals Judge Sally D. Adkins. Members recommended establishing a mandatory evaluation program to be run by the Administrative Office of the Courts.

The recommendation went nowhere.

“We’re coming up on 20 years,” Platt said recently. “I do think it’s needed. We’d be better with it than without it. Judges should be as subject to as much criticism as anyone else.”

Circuit Court judges in Maryland are appointed by governors from lists developed by the state’s judicial nominating commissions. They then face voters in the next election.

District Court judges are appointed by a similar process, but never face election.

Platt said the nominating commissions expend tremendous amounts of time, effort and money to vet candidates for the bench — but they never formally follow up on their performance.

“Is anyone watching them?” Platt asked.

Strachan, Platt’s co-chair on the bar association committee, said an evaluation program would give the public more confidence in judges.

“There’s plenty of room for improvement,” she said. “But a project like that requires commitment of time, energy and money — and a lot of follow through.

Utah spends $400,000 annually on its Judicial Performance Evaluation Commission over the past five years, according to budget documents. To understand how the 13-member commission works, consider the case of Utah District Court Judge Su Chon.

Before election day last year, the commission posted reviews of all judges up for re-election. Chon was subjected to a scathing 10-page review in which survey respondents called her a “rude” and “indecisive” judge who had “failed to meet the minimum performance standard for legal ability.”

The opinions were developed through extensive surveys with lawyers, courthouse staff, jurors and litigants. Volunteer observers with no legal training watched judges for basic etiquette.

The commission’s advice to voters: remove Chon from the bench.

Chon countered in the report that she had been vetted and appointed by Utah’s governor in 2012, and none of her rulings had been reversed on appeal.

When the ballots were tallied, Chon ended up keeping her job. The victory did not bother Yim. The commission’s executive director was satisfied that voters had an exhaustive report to use when they cast their ballots.

Some in Maryland say the vetting by the state’s nominating commission, elections and disciplinary process are sufficient.

“Currently, the delivery of justice is guided by strict ethical rules for judges and attorneys,” Maryland Public Defender Paul DeWolfe wrote in an email. “These rules are more than minimum standards but rather stringent guidelines. Granted they are not a measure for concepts like ‘quality’ and ‘effectiveness,’ but they demand of judges (and attorneys) that they behave with integrity and impartiality.”

Some warn an evaluation of a sitting Circuit Court judge could give an advantage to an opponent who had no record on the bench to evaluate. That would chip away at how the system, they say, and the lengthy 15-year terms, help insulate circuit judges from politics.

A lengthy term “protects the independence of the judiciary from political influence,” said Russell McClain, a professor at the University of Maryland’s Carey School of Law.

“We want to have independent decision-makers,” McClain said. “We don’t want them to be worried about being reappointed or re-elected.”

“Oversight is hard unless someone is sitting in the courtroom monitoring how decisions are being made.”

That’s exactly what Court Watch Montgomery does. Duker, the group’s co-founder, said a statewide evaluation program with courtroom observers as in Utah would improve the administration of justice.

The judiciary is “such a closed process,” she said. “There is a lot of clubbiness to it.”

Court Watch Montgomery deploys 70 volunteers to observe 500 protective order cases and 500 domestic violence criminal cases each year.

In 2011 and again in 2015, the group reported that judges were not using staggered exits out of courtrooms that are meant to keep victims from encountering abusers in hallways or parking garages. The District Court quickly enacted a new policy six years ago and issued a reminder in 2015.

The group also pushed judges to stop ordering parental visitations and exchanges of children in areas where victims could easily be abused again. In response, this month Montgomery County is opening a “safe passage” center for supervised visits and exchanges.

Duker said judges now appreciate the feedback, and will go to her with tips about colleagues.

The Quality Judges Initiative at the University of Denver has found that judges do not view the programs as a “threat or a challenge to their competence.” Instead, they see the process as an effective way to improve.

Recent research has shown that some surveys used in evaluation programs can be “systematically biased against minority and women judges,” according to the National Center for State Courts. “States must remedy weaknesses in their [Judicial Performance Evaluation] surveys if they wish to preserve the credibility of JPE programs in the public’s eye and within the court community.”

A spokesman for the Maryland Judiciary said the courts are not considering an evaluation program. The judiciary is using a data-collection process developed by the National Center for State Courts as part of an “approach to continuous improvement and quality service.”

The process, called CourTools, examines closure rates of cases and time management, not judges’ performance.

The last time the Maryland Judiciary conducted the system’s “statewide user survey at every court location” was in 2008, the judiciary said in a report. A new one is scheduled for next year.

Others say Maryland’s Commission on Judicial Disabilities is an effective process for rooting out problematic judges.

The commission ruled in October that Baltimore Chief Judge Alfred Nance should be removed from the bench for misconduct stemming from his “persistently disrespectful and unprofessional” interactions with a public defender. The commission had investigated Nance at least twice before during his 20-year career, and publicly reprimanded him in 2001 after female prosecutors complained that he had an explosive temper and commented on their appearance.

The commission’s recommendation now goes to the Court of Appeals for a decision.

Complaints filed with the commission — which come mostly from the public — are considered “confidential and not available to the public” unless the panel takes action.

Complaints to the commission have doubled over the past decade, from 117 in the fiscal year 2007 to 234 in fiscal 2017. Of the 234 verified complaints in 2017, three ended in charges. One ended in a public reprimand, and another resulted in an extension of probation.

Most complaints are dismissed because the commission finds them to be unsubstantiated or the actions reported do not amount to “sanctionable conduct.”

Among complaints that ended in warnings, judges were found to be “demeaning,” “threatening,” “condescending,” “irritable,” “short-fused,” “snide,” “rude,” and “racist,” or to have lacked impartiality.

Critics of the process say it can take too long, and does not always change behavior.

The commission held a hearing Thursday on charges filed against District Court Judge Mary C. Reese of Howard County. Duker said the case is a perfect example of how long complaints can take.

The Women’s Law Center of Maryland filed two complaints with the commission in July 2015. The commission ruled in April, nearly two years later, that Reese’s actions were “manifesting bias.”

Reese rejected the request of a 17-year-old girl for a temporary peace order against a man who had left her with a black eye visible in the courtroom. The girl told the judge she had blocked the man’s phone number to avoid contact with him.

“It looks to me like she’s taking care of it,” Reese said in court transcripts.

In a different domestic violence case, Reese told a woman that if she picks a fight with her abuser “you’ve got to expect to lose it,” according to transcripts.

In a response to the complaint, Reese called the allegations “a targeted attack on Judge Reese by an advocacy group with a political agenda.” She said she ruled correctly in both cases.

Michelle Daugherty Siri, executive director of the Women’s Law Center of Maryland, said she would not comment because the case is still pending.

The commission said its investigation “revealed sanctionable conduct by Judge Reese with regard to her unprofessional comments and behavior.”

A decision by the commission can take weeks or months.

Duker called the process inadequate.

“We need far better — and swifter — judicial accountability,” she said.

Full Article & Source:
Lengthy terms, discipline process cloak Maryland judges from scrutiny

Who is the patient at the center of the Connecticut Valley Hospital abuse allegations?

MIDDLETOWN - Investigations into alleged patient abuse at the Whiting Forensic Division of Connecticut Valley Hospital are continuing.

In the meantime a close family friend and the co-conservator to the patient at the center of the abuse shared insight into who the patient is with FOX61.

“He was fun, he had a sense of humor and he had a sense of purpose,” Dr. Karen Kangas, the co-conservator of the patient and a mental healthcare advocate, said.  She told FOX61 she’s know the man at the center of abuse allegations for decades.

“He once said in a letter that he wrote, he said I don’t know that I have any friends and I’ve never had a girlfriend, so much of what he’s missed in life,” Kangas said.

Along with the patient’s brother, Kangas says she’s the only person left to advocate for the 59-year-old man who remains in the care of the Whiting Forensic Division of CVH.  The Whiting Forensic Division is the maximum security unit of the hospital whose patients are most often court ordered to be there.

Kangas told FOX61 the patient was court ordered to Whiting Forensic back in the 1990’s when he was charged with killing his elderly father.  He was found not guilty by reason of insanity.

Kangas also said the patient served out his court ordered sentence, but remained at the hospital for the last 10 years due to a lack of improvement in his mental health and a concern for his ability to be able to reintegrate back into society.

The abuse that allegedly went on over at least in a one month period involved taunting, antagonizing, physical, and abuse sexual in nature, according to police arrest warrants of the accused staff members.  The police investigation and an inspection by the Department of Health and Human Services states the alleged abuse was all captured on surveillance video used in the patient’s room.  Those cameras were intended for 24 hour a day patient monitoring, according to the reports.

This abuse surfaced in April.  Since then, a total of 10 workers from Whiting Forensic have been arrested and charged with multiple counts of cruelty to a person.  A total of 37 workers have been suspended from the hospital as well.

FOX61 obtained transcripts of the bi-annual, state mandated hearings held for the patient.  In these hearings doctors for Whiting Forensic are required to present a patient status update to the state’s Psychiatric Review Board.

The transcripts included conversations about the patient’s “aggressive behavior” and “self-injury” triggering an order for two-to-one patient care with 24 hour monitoring.

The transcripts also reveal the patient was put in restraints 157 times over one two-year period.

The initial report of abuse triggered a full unit inspection by the Department of Health and Human Services this past spring. In that report,the inspectors claim the hospital had a long list of “failures” including a failure to “ensure the restrain and seclusion rooms were free from dirt, debris, or maintained safety.” Another “failure” cited was that the hospital and its workers did not properly report abuse or harassment.

FOX61 received an anonymous letter on the issue that makes claims workers in the hospital tried to report abuse but were disregarded or retaliated against.

"I've learned it recently.  I met with the staff at Whiting and with some of the patients and that is something that they talk about so that is very concerning,” responded Miriam Delphin-Rittmon, Commissioner of the Department of Mental Health and Addiction Services who oversees the hospital.

"We investigate all instances of abuse and then act accordingly,” she added.  She said the department is actively responding to the allegations and working on making a wide-range of improvements.

“This is something that we are taking very seriously, I take this very seriously.  The fact that this happened is just … is just beyond words really, that somebody in our care could be treated so inhumanely,” Delphin-Rittmon said.

She also said she is working on a task force made up of people within the department at all levels to try to assess the changes needed within the hospital.

“Certainly the fact that this abuse happened and it wasn’t reported, that’s something that I’m trying to better understand.  That’s a central question in our HR investigation, that how is it that this could happen and people didn’t come forward,” Delphin-Rittmon said.  She added the department continues their own internal investigations into the matter.

In the meantime, Kangas said she and the patient’s brother are looking into what options they have to move the patient out of Whiting.

The patient is currently in a new unit on the Whiting Forensic floor, but under care of new staff, according to Kangas,

This is a really difficult time, a really difficult time in history to think that this goes on and I don’t think anyone would look back and want this to ever happen again,” Kangas said.

Connecticut Valley Hospital is a state-run facility which was $174 million to operate in fiscal year 2016.

Since the abuse allegations surfaced, the state leaders heading the Connecticut Public Health Committee launched their own investigation into the matter.  They will hold a public hearing Monday at the State’s Legislative Office Building.

Full Article & Source:
Who is the patient at the center of the Connecticut Valley Hospital abuse allegations?

Wells pastor accused of exploiting elderly

Peter Leon of Wells
A Wells man who is listed as a senior pastor at the Wells Branch Baptist Church, also known as Trinity Coastal Community Church, faces multiple charges in connection with the alleged exploitation of an incapacitated elderly Kennebunk woman in May.

Peter Leon, 66, is scheduled to make a first appearance at York County Superior Court in Alfred on Dec. 18. The grand jury this month handed up indictments charging Leon with felony and misdemeanor counts of endangering the welfare of a dependent person along with misdemeanor criminal restraint, criminal trespass, criminal mischief and theft.

Police said Leon befriended the elderly woman while he was volunteering as a pastor at Atria Senior Living where she lived.

Kennebunk Police Detective Steve Borst said the elderly victim had been determined to be incapacitated by the state and had been assigned a guardian and conservator. Borst said police became involved when the conservator called to make inquiries about keeping Leon away from the woman through a protection order.

“Her attorney told me he actually took her from the [senior residence] — to the bank, and withdrew some money,” Borst said. The amount was not disclosed.

Police allege Leon used the money to have the locks changed on the woman’s Kennebunkport home, which was on the market, and took the “for sale” sign down.

According to Borst, Leon allegedly told the woman he’d help her return to her home, even though the property was not equipped for wheelchair access which she required, and suggested his daughter would live with the woman.

“His goal was to ingratiate himself and have access to her accounts and property,” Borst alleged.

It is unclear if Leon remains pastor of the church.

On Sept. 15, Leon filed an appeal of his Sept. 1 conviction for misdemeanor assault that involved touching a 15-year-old girl on the back while in a line at a Sanford fast food restaurant in the fall of 2016. Leon also allegedly made a suggestive remark to the girl. He was sentenced to 60 days in jail, which were suspended, and placed on one-year administrative release, with the conditions that he refrain from criminal conduct, not possess or use any unlawful drugs, notify the District Attorney’s Office of any contact with law enforcement within 96 hours and to have no contact with the victim, among other conditions. He was fined $300.

Leon ran an unsuccessful campaign for the Republican nod for the Maine House of Representatives in the June 2014 primary. His resume includes a stint as a president of the Wells Rotary Club.

According to his LinkedIn profile, Leon has been a tennis coach, a volunteer firefighter, and was a special education teacher for the Calais School Department for 10 years, as well as a recreation director for the eastern Washington County city. The LinkedIn profile lists Leon as the owner-instructor at Leon’s International Tennis Center. No telephone listing could be found for the center.

Leon, according to his LinkedIn profile, graduated with a bachelor’s degree in theology from New England Bible College in 1984.

Borst said court papers ordering Leon to stay away from the woman were issued within a few days of the conservator’s initial inquiry, and he advised family members or friends of the elderly who feel someone may be taking advantage of them to contact authorities.

Full Article & Source:
Wells pastor accused of exploiting elderly

Thursday, November 30, 2017

Kansas nursing homes have ‘become far too dependent’ on mind-altering meds

Allen Wagner used to light up when his granddaughter entered the room, but when she visits him at his nursing home in Overland Park now, he hardly reacts. He’s sleepy and uncommunicative.

He’s sedated.

Wagner, 78, has Lewy Body Dementia and Parkinson’s disease. But his wife, Charlene, said it’s hard to tell how much of his lethargy is due to that and how much is due to the anti-psychotic medications he was first given during an extended hospital stay and has continued taking in nursing homes.

“I’ve seen a change since he went to the nursing homes,” Charlene Wagner said. “Not because of the care. The care is good. I believe it’s the medicines.”

Anti-psychotics are contraindicated for people with dementia and include a U.S. Food and Drug Administration warning that they increase the risk of falls, stroke and other potentially fatal side effects.

The federal government started tracking the off-label use of such medications in nursing homes in 2011. Since then, Kansas has always ranked at or near the top in percentage of medicated residents, suggesting there are thousands of residents in the state’s certified nursing facilities who have been given drugs that aren’t medically indicated for them, and could actually harm them.

“There’s something about that dementia coupled with the anti-psychotics,” said Margaret Farley, a board member for Kansas Advocates for Better Care, a group that represents nursing home residents. “This is not just us saying, ‘Gee, that’s not very good, you’re robbing them of their personality, they won’t talk, they’re not active, etc, etc.’ This is hardcore. This is a 1.6 to 1.7 times increase in deaths that most of the time is related to cardiovascular changes or it’s related to the development of pneumonia.”

Kansas also led the nation last year in percentage of skilled nursing facilities cited by the federal government for a broad slate of medication-related violations, some of which relate to anti-psychotic use.

Kathy Greenlee, a former Kansas Secretary of Aging who was appointed to U.S. Assistant Secretary of Aging under President Barack Obama, said the overuse of anti-psychotics is an unintended consequence of removing physical restraints from nursing homes in the 1980s and 1990s.

Now when people visit nursing homes they’ll no longer see residents strapped to beds and wheelchairs. But they will likely see some under “chemical restraint,” through the use of anti-psychotic medications like Haldol and Seroquel, which Charlene Wagner said have caused her husband to deteriorate.

Greenlee said she knows Kansas nursing homes are not the worst in the nation overall. But the rate at which they use anti-psychotics should cause some soul-searching about how they deal with difficult or disruptive behavior of residents with dementia.

“They can be overprescribed to sedate people and then mask the need to deal with these underlying causes (of disruptive behavior),” said Greenlee, who is now vice president of aging and health policy for the Center for Practical Bioethics in Kansas City, Mo.

Groups that represent Kansas nursing homes say the state’s anti-psychotic use ranking is unfairly skewed by a handful of homes that specialize in mental illness and that they face a number of challenges that are outside their control.

It’s hard to find enough qualified staff in many parts of the state. Some facilities rely heavily on Kansas Medicaid and payments under that program have been delayed for years due to bureaucratic changes. There’s also a shortage of psychiatrists in Kansas, especially those who specialize in treating older people.

“All of those I believe do factor into our ability to continue to really tackle this issue,” said Debra Zehr, the president and CEO of LeadingAge Kansas.

Cindy Luxem, the president and CEO of the Kansas Health Care Association, said Kansas homes have brought rates down, but they need help to reduce them further.

“We’re going to take a lot of responsibility on this topic, but at the same time we look at it as something where we really better start getting family members involved,” Luxem said. “Physicians, pharmacists, you name it.”

Zehr said that when doctors and nursing home workers use anti-psychotics on people who don’t have a mental illness, it’s not ideal, but it’s done with good intentions.

“Anybody who’s spent time with people in the throes of dementia and has seen the kind of internal anguish and volatile behaviors of people with dementia at certain stages, they’re trying to help,” Zehr said.

But some facilities have found better ways to handle those behaviors. Farley said more should follow their example.

“It’s not an easy thing to be able to take care of bad behaviors without these medications, but we’ve become far too dependent upon them,” Farley said.

The fight over the rankings

On average, 20 percent of all Kansas long-term nursing home residents received an anti-psychotic medication at some point in 2016, tying it for the highest rate in the country with Oklahoma and Mississippi. The national average is 16 percent. Missouri ranked near the top at about 19 percent.
Kansas has dropped from a high of about 26 percent in 2011, but other states’ rates have fallen more since then.  (Click to Continue)

Read more here:

Full Article & Source:
Kansas nursing homes have ‘become far too dependent’ on mind-altering meds

Webinar focuses on guardianship

ESCANABA — The Michigan Alliance for Families is collaborating with Pathways to host a free live webinar workshop called Rethinking Guardianship-Facilitating Life-Long Self Determination with Dohn Hoyle of The Arc Michigan on Nov. 30 from 1 to 4:30 p.m. at Pathways, 2500 7th Ave. S., Suite 100, Escanaba.

The workshop will discuss the implications of guardianship as well as alternatives to guardianship that can be utilized as a student reaches the age of majority on their 18th birthday.

Parents and relatives of children with a disability, professionals who work with individuals with disabilities, and teenagers learning to advocate for themselves may all find this workshop helpful. Pre-registration to Lisa@michiganallianceforfamilies or (906) 483-0442 is appreciated so organizers can plan for materials, etc.

Full Article & Source:
Webinar focuses on guardianship

Nursing home worker charged with harassment

WATSONTOWN – A nursing home worker is being charged with harassment after slapping a resident. Watsontown police say 21-year-old Caitlyn Rogers of Milton has been charged with harassment for allegedly striking the 86-year-old woman at the facility.

According to police, the incident took place around 6pm November 21, the charges have been filed at the office of the Magisterial District Judge Michael Diehl.

Full Article & Source:
Nursing home worker charged with harassment

Wednesday, November 29, 2017

Elder caregiving law comes into focus with Edith and Eddie

Elder caregiving law comes into focus with Edith and Eddie

New Mexico man pleads guilty in guardianship fraud case

ALBUQUERQUE, N.M. (AP) — A New Mexico man accused of embezzling more than $4.8 million from trust accounts he managed for elderly and disabled clients has pleaded guilty to federal wire fraud and money laundering charges.
Authorities said Paul Donisthorpe entered his plea Monday, acknowledging that he looted his clients' accounts for personal gain.

As part of an agreement with federal prosecutors, the 62-year-old Bloomfield resident faces eight to 12 years in prison and will have to pay restitution and forfeit property in New Mexico and Texas. Sentencing has yet to be scheduled.

"This was a heartbreaking case of an individual stealing millions of dollars from elderly, disabled and other New Mexicans with special needs who depended on him to make sure their rent, medical bills and living expenses were paid," said FBI Special Agent in Charge Terry Wade.

The FBI, federal tax agents and state regulators teamed up to investigate the case.

Donisthorpe, a former Albuquerque resident and owner of Desert State Life Management, was accused of using the money he transferred from his clients' accounts to support a lavish lifestyle and concealed the theft by having his employees report incorrect balances.

In his plea agreement, Donisthorpe acknowledged that he provided trustee services and representative payee services to more than 75 clients. Court documents show the fraudulent transfers were done from at least 2009 through 2016.

In one case, he used the proceeds from the scheme to pay the mortgage for property related to his cattle business. He also spent money on business ventures, vehicles, credit card bills and a vacation home in northern New Mexico.

Full Article & Source:
New Mexico man pleads guilty in guardianship fraud case

Lawmakers, advocates bicker over updated regulations for nursing homes: A Critical Choice

(Lisa DeJong/The Plain Dealer)
CLEVELAND, Ohio - Federal regulations designed to protect residents in the nation's nursing homes are facing mounting pressure from Congress.

A group of 146 lawmakers has urged federal government officials to re-evaluate  revised standards in care centers, claiming some of the measures are excessive and are financial burdens for facility owners.

Advocates for residents have blasted the move. They said the regulations are needed, as the measures will expand care plans, offer greater freedom for residents, increase the amount of training for nurses and aides caring for residents with dementia and provide grievance officers to help handle complaints.

"This is a very concerted effort to undermine the basic protections for residents of nursing homes," said Richard Mollot, the executive director of the Long Term Care Community Coalition, a national nonprofit based in New York City that aims to improve the care of residents in nursing homes.

A vast majority of the nation's more than 15,000 nursing homes accept some form of Medicare or Medicaid. To obtain it, the facilities must comply with the regulations in the Nursing Home Reform Law. The law went into effect in 1991.

Last year, the Centers for Medicare and Medicaid Services revised the regulations, the first reworking of the standards in 25 years. Some of the changes went into effect last year, and others are to be completed over the next two years.   (Click to Continue)

Full Article & Source:
Lawmakers, advocates bicker over updated regulations for nursing homes: A Critical Choice

Tuesday, November 28, 2017

Probate public officials terminated, resign after 7 Action News investigation

LANSING, Mich. (WXYZ) - The 7 Investigators continue to get results for grieving families in Michigan.  The Attorney General is terminating one of the public officials accused of cashing in on a controversial probate practice, and another public official has resigned.

And even though new legislation has been introduced because of our investigation, the Attorney General is now telling the 7 Investigators that he wants the changes to the law to go even farther.

“They’re messing with my home -- where I live! How dare they,” said Joanne Zaremba.

Several local families say they nearly lost their late relatives’ homes after some Attorney General-appointed lawyers called Public Administrators teamed up with real estate agent Ralph Roberts to cash in on probate estates.

“I find properties.  I believe there’s a benefit, so I then tell a public administrator, here’s the benefit there,” Ralph Roberts told 7 Investigator Heather Catallo in November 2016.

The Public Administrators bill the estates for thousands of dollars in fees.  Court records show that Roberts’ company, Probate Asset Recovery, often tried to take 1/3 of the value of the assets, plus Roberts earned real estate commissions (often 4% instead of the typical 3%).

Oakland County Sheriff’s investigators and federal agents recently raided Ralph Roberts offices as part of an ongoing criminal probe.  (Click to Continue)

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Probate public officials terminated, resign after 7 Action News investigation

Wellness: Three ways to help with mental health and addiction in lawyer discipline proceedings

Darryl Singer
For all the law society’s talk about harassment, discrimination and Statements of Principles — laudable as these are — there remains one group that is left out of the discussion and as a result faces unduly harsh treatment in law society discipline proceedings: those with addiction and mental health (AMH) issues.

It might seem trite to suggest that AMH issues have an impact on one’s ability to run a law practice in an organized and ethical manner. And yet the law society investigators and discipline counsel typically take the same approach to licensees with AMH issues as they do to lawyers whose bad behaviour is deliberate and calculated.

In reality there is a major difference between deliberate misdeeds  — Javad Heydary, who calculatingly disappears with $3 million of a client’s money or the lawyer who uses his trust account to assist in laundering money — and where AMH issues result in misconduct. Lawyers with undiagnosed depression whose disorganized docketing and billing inadvertently leads to overbilling legal aid or lawyers whose drug addiction results in missed court appearances do not belong in the same deliberate and calculated category.

It has been said by some that the biggest problem caused by AMH issues among lawyers is underservice. A lawyer suffering from such an illness will be unable to carry out even the most basic tasks associated with successful lawyering, such as being organized, punctual and reliable, let alone address with clarity such ethical issues as confidentiality and trust.

The results, as I have seen in many cases where I have represented lawyers in law society matters, include: failure to communicate with clients and opposing counsel; failure to appear in court as scheduled; failure to meet court imposed deadlines; lack of civility toward opposing counsel and candour toward clients; and on the extreme end, defalcation of trust monies. More than half of all lawyers I represent in law society matters are there for infractions that would not have been committed, but for their AMH issues.

In last month’s column, I quoted some statistics regarding AMH issues in the legal profession. The main takeaway from the studies is that lawyers are approximately three times as likely as non-lawyers to suffer from AMH issues. Studies suggest that about 60 per cent of discipline cases and 85 per cent of trust account theft cases involved AMH issues.

What can the law society do about this issue? I have three concrete solutions to propose:

1. At the intake and investigative stage, when it is apparent the lawyer has AMH issues, the focus should be on getting the lawyer help and ensuring the lawyers’ clients are protected.

In most cases, this should not mean seeking an interlocutory suspension to take away the lawyer’s right to practise.

Instead, the society should provide proper guidance and assistance so the lawyer is able to manage his or her affairs while accessing the help that is necessary. Our entire penal system in Canada is built upon the notion of rehabilitation; somewhere along the way, the profession that guarantees to fight for those rights forgot to ensure its members had the same protections within their profession.

2. The tribunal itself must take AMH issues into consideration not just in terms of a mitigated penalty (as is the case now), but in the actual determination of misconduct.

Most Rules of Professional Conduct and bylaws are viewed at the tribunal as something approaching strict liability offences, which generally means the lawyer pleads to the misconduct and then gets a reduced penalty based on the AMH issues.

Furthermore, the tribunal ought not to be simply handing out an interlocutory suspension because the law society prosecutor comes in to the motion waving the flag of “protection of the public.” Interlocutory suspensions ought to be reserved for the most obvious and egregious breaches of trust.

3. A task force or working group needs to be established by the law society to determine exactly what percentage of discipline cases involve addiction and mental health issues and to make recommendations that would allow the society to address the disciplinary process within this context in a manner that protects the public while maintaining the integrity of the profession and the professional involved in the proceeding.

The long-term goal of such a study would be to ensure an investigatory and disciplinary framework that need not result in careers being destroyed.

Full Article & Source:
Wellness: Three ways to help with mental health and addiction in lawyer discipline proceedings

She spent five nights in jail. She was actually a victim of the crime, sheriff says.

Hancock County - A Saucier woman accused of stealing identities and exploiting an elderly man will not face criminal charges after all.

The five charges on which Lynda Wolfe was arrested have been dismissed, Sheriff Ricky Adam confirmed Wednesday.

Shara Faye Leon, the neighbor arrested with Wolfe, now faces a new charge of identity theft.

“Ms. Wolfe was indeed a victim of identity theft herself,” Adam said.

“Early on, it appeared she was involved because her name was on some paid receipts. In actuality, after further investigation and looking at her information, she was indeed a victim herself.”

Deputies arrested Wolfe, 55, on five charges Nov. 14.

She spent five nights in jail on bonds that totaled $55,000.

Both women initially were accused of stealing identities and paying bills with other people’s money. One of the victims was an elderly man, the sheriff said.

Leon, 39, has remained in custody at the Hancock County jail on the same bonds set for Wolfe.

An investigator presented Leon with an arrest warrant Tuesday for the new charge. She has no bond on that charge pending an initial court appearance, the jail docket showed Wednesday.

The original charges filed are exploitation of a vulnerable adult, identity theft, wire fraud, conspiracy to commit wire fraud and conspiracy to commit identity theft.

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She spent five nights in jail. She was actually a victim of the crime, sheriff says.

Monday, November 27, 2017

Abolishing Probate #8: Euthanizing the Disposables

5:00 pm PST … 6:00 pm MST … 7:00 pm CST … 8:00 pm EST

Tonight we will be talking with Carly Walden of "HOSPICE PATIENTS ALLIANCE".

What to Look For:
Whatever your particular situation, if your loved one is NOT getting the services needed, if the hospice is trying to talk you into transferring your loved one to their facility against his or her will, if your loved one is NOT being kept comfortable, if there is inadequate staff and you are getting exhausted while caring for your loved one, you must demand that the hospice provide the services needed to meet the needs of the family and patient, whether living at home or in any facility. The law requires the hospice to meet the needs of the patient and the family!

 What to Do:
It is crucial that you read all the printed literature, documents and contracts you have with the hospice. These pamphlets, brochures, contracts and papers must (by law) inform you of your rights to the various services available through the hospice. Most patients and families do NOT read all this literature, and thereby they lose their greatest protection from exploitation...KNOWLEDGE OF THE REQUIRED SERVICES. Knowing what services are required to be provided will allow you to make informed decisions about the care your loved one receives. Knowing what services are required will help you protect your loved one from exploitation. If you are not getting the services needed to meet the patient's and the family's needs, you need to speak with the RN case manager. If you get the runaround or sophisticated excuses, you must demand to speak with the hospice's Medical Director and Manager. If you still do not quickly get proper action to correct the problem, put a complaint in writing and send it to your State's Bureau of Health Systems (which is responsible to inspect the hospice) immediately and also give a copy to the hospice.

LISTEN to the show live or listen to the archive later

Failing Care: Ensuring crimes against nursing home residents are reported

For decades, the federal government has attempted to address concerns over the quality of nursing home care in the U.S. It was only recently, though, that federal law included reporting requirements with sanctions for crimes against the elderly.

Since 2010, federal law has required nursing home providers to report the reasonable suspicion of a crime against residents to police and state oversight agencies, which in Pennsylvania includes the departments of Health, Aging and Adult Protective Services.

Reports to the state Health Department are confidential to encourage self-reporting. But a Reading Eagle review of state inspections over the past three years found many suspected abuse cases go unreported.

With 10,000 Americans turning 65 each day and studies showing as many as 1 in 10 seniors nationally have been a victim, elder abuse is a problem that is only expected to grow.

Advocates worry unreported crimes will likely be repeated, putting nursing home residents at greater risk. And industry leaders expressed concern that police don't investigate when nursing homes do report suspected abuse to law enforcement.

The pressing question then, is: Can anything be done about it?

Although single solutions alone are unlikely to significantly improve reporting, generally accepted strategies include greater oversight and enforcement, police training and better state laws that make the entire process more open and transparent.

But it all starts with nursing homes complying with federal law.

"If facilities aren't reporting these events immediately, it ties the hands of the police," said Sam Brooks, an attorney with Community Legal Services in Philadelphia.

'Something terrible is going on'

The penalties for not reporting are already stiff, with fines up to $300,000 and exclusion from federal participation in health care programs.

However, neither the Centers for Medicare and Medicaid Services, CMS, nor the state Health Department have penalized nursing homes for failing to report abuse.

The reason?

In August, the U.S. Department of Health and Human Services' Office of the Inspector General determined that CMS "has inadequate procedures to ensure that incidents of potential abuse or neglect of Medicare beneficiaries residing in (Skilled Nursing Facilities) are identified and reported."

Advocates for the elderly found the report troubling and called into question the Health Department's oversight role.

"The magnitude of this report is just stunning," Brooks said. "CMS has done nothing to enforce it. This is scandalous."

The Inspector General's report identified more than 100 incidents of potential neglect and abuse nationally. To do so, auditors matched emergency room data with Medicare reimbursements to find suspected nursing home abuse cases hidden in medical payments.

Five cases were flagged in Pennsylvania and referred to the state attorney general's office. Joe Grace, spokesman for Attorney General Josh Shapiro, did not respond to multiple calls and emails seeking comment about the referred cases.

"They haven't taken any enforcement actions because the DHHS secretary didn't delegate the authority yet," said Dave Lamir, a regional inspector general who worked the team of auditors that produced the report. "They didn't identify anything because they don't conduct a data match like we did."

The report determined that CMS needs to beef up procedures that identify potential abuse and neglect, specifically using a data match similar to the one their auditors employed.

Because the entire process in Pennsylvania - from the initial report through the investigation - is undisclosed, it cannot be independently scrutinized to know whether the system is protecting nursing home residents.

Researchers and advocates alike said it was unconscionable that state regulations could shield information on nursing home abuse from the public.

"They don't want to release the data because it's going to be obvious when you get the data that something terrible is going on," said Charlene Harrington, a University of California at San Francisco professor emeritus of sociology and nursing who has studied the industry for decades.

Harrington added, "They're trying to hide the fact that they're not doing their job."

'A right to know'

While state Health Department officials here worry that without confidentiality nursing homes won't comply with federal law, California has posted the outcomes of its substantiated investigations online since 2015.

The agency has not ever had "a concern that facilities would stop self-reporting incidents" if made public, according to the California Department of Public Health.

Many of the biggest nursing home chains in Pennsylvania - Genesis Healthcare, ManorCare and GoldenLiving - also operate in California, where this information is released to the public.

Retired California state Sen. Elaine Alquist sponsored much of the legislation that overhauled nursing home oversight in the Golden State, including the creation of a system for timely reporting, stiffer penalties and public access.

"In the law, there needs to be a more defined link between nursing home abuse and public safety," Alquist said. "The public needs to know who the bad apples are."

In Pennsylvania, state law doesn't permit releasing information on abuse reports - even aggregated tallies - effectively leaving the public in the dark about what nursing homes are and are not doing to protect residents.

For Alquist, statewide aggregated report totals aren't enough.

"You need actionable information," Alquist said. "The public has a right to know. We're talking about an extremely vulnerable population."

Neither Acting Pennsylvania Health Secretary Rachel Levine nor Aging Secretary Teresa Osborne would comment for this story on whether they favored greater transparency and supported changes in state law.

In speaking for both agencies, Health Department spokeswoman April Hutcheson, though, said in statement to the newspaper that they support the General Assembly updating laws that better protect seniors.

"Wholesale culture change begins with education, enforcement of regulations and evaluating our current regulations, all which is underway," Hutcheson said in an email to the Eagle. "Legislation and regulation alone will not improve nursing homes, but working together will."

Last year, the nursing home task force and auditor general both recommended revising current regulations, which haven't been updated in nearly four decades. Despite being pressed on its status, Hutcheson declined to elaborate.

State Sens. Judy Schwank of Ruscombmanor Township and Art Haywood of Montgomery County, both Democrats who sit on the state Senate Health and Human Services Committee, said the reporting and transparency issues the Eagle has raised deserve further investigation.

State Rep. Mark M. Gillen, who is a co-sponsor of a House bill this session that would amend the statute addressing neglect of a care-dependent person, said any reform effort would require collaboration and resources for more effective deterrence, reporting and prosecution.

"Pennsylvania is graying," the Robeson Township Republican said. "I think we're long overdue for a more surgical examination of our caregiver facilities so that the tragedies of yesteryear don't repeat themselves."

'Shake the trees'

When it comes to protecting elders from abuse, there are a number of impediments at each step in the process, but none more frustrating than police inaction.

"The police don't do anything when we call," said Eric Kiehl, a spokesman for the Pennsylvania Health Care Association, a statewide member organization for nursing homes. "We can't do the investigation."

Although the Berks County district attorney's office does not have a designated elder abuse unit, per se, it does have two detectives and an assistant DA working these cases.

Fewer than 10 cases a year in Berks stem from elder abuse investigations. Most referrals, Berks DA John T. Adams said, come through the Berks County Area Agency on Aging.

The reason more are not prosecuted - advocates and those in law enforcement agree - are the inherent challenges that come with elder abuse cases.

"Many times we're dealing with individuals who may have been found not to be competent or have a guardian appointed," Adams said. "Those are very difficult cases."

Because the district attorney's office is not the responding agency, mounting a prosecution hinges on the decisions made by local law enforcement, some of which are not 24-7 responders, let alone trained in how to handle elder abuse cases.

The San Diego County district attorney tapped Paul Greenwood, now a nationally recognized expert and in-demand speaker on elder abuse, to head up an elder abuse unit in 1996. He started first by talking to police officers and sheriff's deputies, asking why they didn't refer any cases for prosecution.

Before long, a familiar refrain emerged: the elderly just don't make good witnesses.

After two decades and 500 felony prosecutions, Greenwood blames police reluctance on a lack of training and laziness. Police and prosecutors often find other cases more attractive.

"I think this is where the elected district attorneys of Pennsylvania need to become much more proactive and not just expect these cases to fall in their lap, because they don't," Greenwood said.

The way Greenwood sees it, combating this requires prosecutors to take the initiative."We've got to be the ones to shake the trees," he said.

Full Article & Source:
Failing Care: Ensuring crimes against nursing home residents are reported

Commission suspends Clark County judge who exploded in anger

LAS VEGAS (AP) — The Nevada Commission on Judicial Discipline has suspended a Clark County District Court judge for two months without pay and ordered him to undergo a psychiatric exam.

The Las Vegas Review-Journal reports that Family Court Judge William Potter ordered a lawyer handcuffed in court, commented on cases during his re-election bid and exploded in anger during the commission’s own hearing.

The commission’s decision Wednesday says the panel questioned Potter’s “mental stability and capacity to control his anger.”

Potter watched video of the hearing when the attorney was put in handcuffs and said he didn’t violate judicial conduct rules but cringed when he saw his behavior.

The commission ordered Potter to submit the psychiatric exam’s results, write letters of apology, perform community service with an anti-bullying group and pay it $5,000.

Full Article & Source:
Commission suspends Clark County judge who exploded in anger

Jerry Lewis' wife Patty threatened with eviction by nursing home

Jerry Lewis' children from first marriage fighting famous father's will calling it a fraud

Late comedian #Jerry Lewis' first wife and mother to six of his children Patty Lewis has been threatened with eviction by the nursing home where she resides. Since Jerry's death last August it has been one struggle after the next for Lewis' first family. Following Lewis' passing funds that had been provided for Patty since the couple's divorce in 1980 were suddenly cut off according to Hollywood News Daily reports.

Jerry Lewis intentionally left six children out of his will

Jerry and Patty Lewis were married for 36 years and had six children together, one which is deceased. #Gary Lewis is fighting to keep mom safe and taken care of and has set up a GoFundMe page in hopes of doing so.

Not only is the family fighting for their mom's rights, they are also fighting their father's estate and have claimed that Jerry's will is a fake.

San Dee Lewis and daughter inherit $75 million

Gary Lewis claims that Jerry's signature on the has been forged and that he has proof. Gary had the signature examined by a professional forensic graphologist who has declared the signature a fraud. The family is also in the process of contesting the will which states that Jerry Lewis purposely excluded his six children and their descendants from inheriting one cent from his $75 million estate.

Coincidentally, the entirety of the estate was left to Jerry's second wife San Dee and their daughter Danielle. The entire situation is a painful and ugly battle for the family. Gary Lewis has told the family's story to authors Richard Lertzman and William Birnes for a new biography book that will detail Jerry Lewis' life with Patty and their six children.

Jerry's sons have revealed that growing up with their father was sheer "hell" stating that he was verbally and physically abusive to them. It looks as if the battle over Jerry Lewis' estate could be a long and fierce battle, it also has all the makings to rank along the same lines as Casey Kasem and #Glen Campbell's estate battles, making it one of the nastiest celebrity family battles of the decade.

As previously reported, Casey Kasem and Glen Campbell's families are currently fighting amongst themselves over their famous father's estates and last wishes. Kasem passed away in 2014 and the battle continues within the courts between Kasem's children and Kasem's widow Jean Kasem. Glen Campbell, who passed away in August after a long battle with Alzheimer's Disease family continues to battle over the estate and their father's care during the time of his illness.

With the exception of Jerry Lewis, who purposely disowned the majority of his children, the long nasty drawn-out court battles are very sad. These types of celebrity family legal cases over money are not the first and will surely not be the last. When it comes to money, sadly, in a lot of cases it will drive a wedge between even the closest of families.

Full Article & Source:
Jerry Lewis' wife Patty threatened with eviction by nursing home

Sunday, November 26, 2017

Nothing stopped doctor from paying health care fraud fine, then buying a nursing home

Dr. Jack Michel (Courtesy)
When Florida regulators went to approve new ownership of a Hollywood nursing home in 2015, they had before them a Miami doctor trained in internal medicine who controlled a major hospital.

He also had been a key figure in a civil suit brought by the U.S. Department of Justice alleging massive health care fraud.

That, however, was not a deal breaker. The state allowed Dr. Jack Michel to take over the Rehabilitation Center at Hollywood Hills even though he’d been hit with a $15.4 million fine years earlier to settle claims that he and others swindled Medicare and Medicaid.

It’s a common practice in the health care industry, where people and institutions accused of fraud are allowed to write large checks to the U.S. government then continue operating.

Now the Hollywood Hills nursing home is the subject of a criminal investigation into the deaths of 12 people left for days without air conditioning after Hurricane Irma. The medical examiner has ruled them homicides caused by heat exposure. The deaths of two other nursing home patients, previously suspected as storm-related, are no longer part of the criminal investigation.

There’s no indication that Michel was at the nursing home during the crisis. Yet he is a main character in the matter because he owns the Hollywood Hills facility, through a limited liability company.

Why was he allowed to take over the nursing home after having been accused in federal court of bilking Medicare and Medicaid?

Had he been convicted of a crime, Michel would not have been able to own the nursing home. But the federal government brought a civil suit, not a criminal one, and then settled it with Michel and his colleagues.

A civil settlement with no admission of wrongdoing does not preclude purchasing a nursing home. There is no law or statute that precludes it,” Michel’s lawyers, Julie W. Allison and Geoff Smith, said in a statement to the Sun Sentinel.

Also typical: Michel and his companies agreed to five years of special monitoring, but were never expelled from participating in Medicaid or Medicare -- a vital element to running a nursing home.
Had Michel been banned from the programs, he would not have been able to operate the Rehabilitation Center at Hollywood Hills.

In fiscal 2007, the year of Michel’s settlement, the government barred more than 3,300 service providers from federal health insurance programs for misconduct, usually criminal, according to statistics from the U.S. Health Care Fraud and Abuse Control Program. That same year it collected $1.8 billion in civil settlements. By fiscal 2016, it was up to $2.5 billion.

Why some people are arrested and others aren’t, and why some are excluded from Medicare and others aren’t, isn’t always obvious. Lawyers who have handled such cases say the decisions can hinge on the scope and complexity of the fraud.

“It’s a case by case decision,” said Don White, spokesman for the U.S. Department of Health and Human Services’ Office of Inspector General.

The more money stolen and the greater the number of victims, the more likely the case will be filed criminally, experts said. Patient harm is also a key factor. In recent years, the government has made increased efforts, especially in South Florida, to bust organized criminal networks engaged in health care fraud.

Harvard health care Professor David Grabowski, who’s researched the economics of long-term care, said policy makers in Florida and other states should consider tightening the criteria for owning a nursing home, given the approval of Michel.

He had been accused by the government of taking kickbacks for hospitalizing elderly patients when they didn’t need to be hospitalized.

“Would any of us want to send a parent or grandparent to a nursing home owned by somebody like that?” Grabowski asked.

Elderly exploited

Now 52, Jack Jacobo Michel earned a medical degree in 1989 from the University of Miami and later developed a busy gerontology practice.

In a publicity video for the University he says he became close to the owners of Larkin Community Hospital in South Miami and was invited to become a minority owner, with a 10 percent interest, in the 1990s. By 1998, he had bought a majority stake in Larkin. And in 2004, the 146-bed hospital became the focus of a federal fraud case.

The Justice Department filed a civil case against Michel, his brother, and five other people for their roles in several “interlocking schemes” in the late 1990s to defraud Medicaid and Medicare.

The suit accused Larkin’s main owner, Dr. James Desnick, of paying Michel kickbacks for admitting patients to the hospital from his private practice and from Oceanside Extended Care Center, a Miami Beach nursing home where Michel was the medical director.

Once he became the majority owner of the hospital, Michel allegedly arranged with business partners Morris and Philip Esformes, father and son nursing home operators from Chicago, to buy numerous assisted living facilities in Florida and then transfer residents to Larkin for unnecessary treatment, court records state.

The legal drama continued until just before Thanksgiving 2006 when Larkin hospital, Michel and Desnick, and the Esformes men agreed to pay a $15.4 million penalty.

The attorneys for Michel told the Sun Sentinel that he “did not engage in any illegal conduct” but settled “rather than continue with the costs, expense and uncertainty of litigation.”

The lawyers said it is not uncommon for companies in today’s highly regulated health care environment to settle with the government over allegations of filing “false claims” against Medicaid or Medicare. They noted that Tenet Healthcare, HCA, Baptist Health System and Broward Health have all been subjects of civil settlements.

“Many health care professionals -- including those who have gone on to hold elective office -- have served in companies that have settled claims with DOJ,” the attorneys said in the statement released to the Sun Sentinel. They were referring to Florida Gov. Rick Scott, who founded HCA but left in 1997 in the midst of a federal investigation that led to a $1.7 billion health care fraud settlement.

When the government enters into such settlements, it expects the defendants will follow all laws and regulations in the future – and not fleece U.S. taxpayers. Officials commonly force greater monitoring, reporting and accountability requirements on the defendants and did so for Michel and Larkin Hospital. As of mid-November, the federal government had about 380 of these “Corporate Integrity Agreements” ongoing nationwide with hospitals, hospices, pharmaceutical firms, nursing homes, diagnostic imaging centers, doctors and others, according to the U.S. Health and Human Services Office of Inspector General’s web site.

Michel and Larkin were no longer on the monitoring list in the summer of 2015 when a company tied to Larkin bought the building housing the Hollywood nursing home in a bankruptcy auction.

Ironically, Michel and Larkin took over the nursing home after the building went into foreclosure when its owner went to prison for health care fraud. That case was egregious for endangering patients.

Karen Kallen-Zury and three other executives were imprisoned for defrauding Medicare of more than $70 million at a psych hospital in the same building. They were accused of paying bribes to recruiters to find Medicare beneficiaries, including drug addicts, from as far away as Maryland and bus them to the psych hospital, where they were forced to attend bogus “treatment sessions” or be evicted from nearby halfway houses where many stayed. The drug abusers desperately needed substance abuse help but instead got “day care sessions in which their life-threatening illness went untreated,” according to prosecution documents. Others who actually needed psychiatric treatment did not get it and “their lives were put at risk as a result,” the government argued.

As a result of the bankruptcy proceeding, the state awarded the nursing home’s operating license to a company owned by Michel.

He had hired Fort Lauderdale lobbyist William Rubin, a campaign supporter and former business associate of the governor, to facilitate the process, paying him at least $100,000, state records show.

Mallory McManus, communications director for the Florida Agency for Health Care Administration, said the change of ownership request from Michel went through the normal review practice, including background checks.

“There was no disqualifying offense based on Florida statutes,” she said.

Full Article & Source:
Nothing stopped doctor from paying health care fraud fine, then buying a nursing home

Hidden cameras show apparent abuse inside South Florida nursing homes

POMPANO BEACH, Fla. - More and more family members are placing hidden cameras inside rooms to monitor the quality of care of their loved ones at nursing homes.

Local 10 News obtained disturbing images of what can happen inside the walls of a nursing home. There is renewed debate over the issue following the deaths of 13 people from a nursing facility in Hollywood during Hurricane Irma.

Video recorded inside a Pompano Beach room of a 94-year-old man with dementia who is unable to speak are cringe-worthy.

It shows a certified nursing assistant forcefully trying to get the man off the bed. She sends him free-falling into a chair and then hits him on the head.

In another clip, the nursing assistant is seen dousing him with mouthwash.

"Mouthwash has alcohol in it. Guess what? He's going to end up with ulcers and bedsores from dried out skin, and that's exactly what happened to this man when he had stage three ulcers, that ultimately proved to be fatal," Blake Dolman, who represented the man's family in a lawsuit against the nursing home, said.

The hidden camera was placed in the elderly man's room by a concerned daughter, who said it caught her worst fears.

"Ninety-nine percent of the time, the nursing home says, 'No, that didn't happen,'" Dolman said.

The video in that case was so valuable, Dolman said, because it made what happened unquestionable.

"It saved the judicial system time," Dolman said. "It saved the attorneys time."

A hidden camera video taken inside a South Florida nursing home shows a worker sleeping as an alarm indicating something is wrong in a patient's room is clearly blaring.

In another hidden camera video, a patient's breathing tube appears to be removed by a nursing assistant. She appears to do nothing, despite alarms going off. She even reenters the room again after leaving. Five minutes go by until another employee comes in and sees the tube is disconnected.

That nursing assistant claims she knew nothing about what happened, even though the video shows otherwise.

Could cameras have alerted someone to do something faster in Hollywood after Hurricane Irma?

Six states -- Illinois, Maryland, New Mexico, Oklahoma, Texas and Washington -- allow the use of video monitoring.

"I believe that the state of Florida require that residents be presented with the option or the right to have cameras in their rooms," Dolman said.

Attorney Don Fann has spent more than 20 years representing and defending nursing homes.

"I know how nursing homes operate from the inside out," Fann said.

Fann now uses his expertise to sue them.

"The staff didn't want to be observed," he said. "They didn't want to have that pressure, and that is ridiculous."

In 2012, a bill in the Florida Legislature that would allow the use of cameras died in committee.
"If they're not doing anything wrong, why be against the camera?" Dolman said.

The Florida Health Care Association, which represents 550 of the state's 683 nursing homes, is against cameras.

Local 10 News asked and had several interviews set up with some of its members. They were all canceled. 

"The use of surveillance cameras carries a number of challenges, and we must remember that cameras observe, they do not protect," association spokeswoman Kristen Knapp said in a statement to Local 10 News. "Cameras provide access to footage of residents in their most intimate moments. Even if proper consent is obtained by one resident, the issue becomes complicated when there are roommates involved."

Several state legislators said they are researching the issue, but at this point, no bills have been filed for the upcoming legislative session.

The state of Florida revoked the license of the the certified nursing assistant who was accused of abusing the 94-year-old man. Family members said they didn't want to pursue criminal charges against her.

Full Article & Source:
Hidden cameras show apparent abuse inside South Florida nursing homes

INOVA Gate IV: Anastasia Broken & Bruised

This 16:30 minute video chronicles the alleged neglect my beautiful and precious sister Anastasia Adams suffered at the hands of Inova Fairfax Hospital designated guardians Kenneth Labowitz and Anne Heishman and the alleged abuse and neglect of the nursing facilities in which they placed her, Dulles Health and Rehab in Herndon, Virginia; Golden Living Centers Sleepy Hollow in Annandale, Virginia, and theEnvoy of Alexandria in Alexandria, Virginia; that led to her untimely unnatural death.

INOVA Gate IV: Anastasia Broken & Bruised