Saturday, August 13, 2016

New Medicare law to notify patients of loophole in nursing home coverage

WASHINGTON — In November, after a bad fall, 85-year-old Elizabeth Cannon was taken to a hospital outside Philadelphia for six and a half days of “observation,” followed by nearly five months at a nearby nursing home for rehabilitation and skilled nursing care. The cost: more than $40,000.

The hospital insisted that Ms. Cannon had never been formally admitted there as an inpatient, so under federal rules, Medicare would not pay for her nursing home stay. The money would have to come from her pocket.

The experience of Ms. Cannon and thousands like her inspired a new Medicare law — in force as of Saturday — that requires hospitals to notify patients that they may incur huge out-of-pocket costs if they stay more than 24 hours without being formally admitted. Because of the Notice Act, passed by Congress last year with broad bipartisan support, patients can expect to start receiving the warnings in January.

“It was extremely distressful to my mother, who was frugal her whole life,” said Cynthia Morgan of Chadds Ford, Pa., Ms. Cannon’s daughter. “She asked, ‘How can I pay into Medicare for so many years, and now Medicare won’t help pay for my care?’ ” Ms. Cannon died in April.

Hospitals have been keeping patients like Ms. Cannon in limbo — in “observation status” — for fear of being penalized by Medicare for inappropriate admissions. While under observation, patients can be liable for substantial hospital bills, and Medicare will not pay for subsequent nursing home care unless a person has spent three consecutive days in the hospital as an inpatient.

Time spent under observation does not count toward the three days, even though the patient may spend five or six nights in a hospital bed and receive extensive hospital services, including tests, treatment and medications ordered by a doctor.

Under the new law, the notice must be provided to “each individual who receives observation services as an outpatient” at a hospital for more than 24 hours. Medicare officials estimate that hospitals will have to issue 1.4 million notices a year.

“The financial consequences of observation stays can be devastating for seniors,” said Sen. Susan Collins, R-Maine and the chairwoman of the Senate Special Committee on Aging.

Sen. Benjamin Cardin, D-Md., the chief sponsor of the Senate version of the legislation, said it would “save seniors from the sticker shock that comes after they are discharged from the hospital and realize that Medicare will not cover the cost of care in a skilled nursing facility.”

The median cost for a private room in a nursing home is roughly $92,000 a year, according to a survey by Genworth Financial, an insurance company. Medicare covers up to 100 days of skilled nursing home care at a time.

The text of the standard “Medicare outpatient observation notice” is subject to approval by the White House Office of Management and Budget. In its current form, the notice to beneficiaries says:

“You’re a hospital outpatient receiving observation services. You are not an inpatient.” And it explains that Medicare will cover care in a skilled nursing home only if the beneficiary has had an inpatient hospital stay of at least three days.

Patients can then consult their doctors and may ask to be reclassified as inpatients.

Hospitals have found themselves in a squeeze. They increased their use of “observation status” in response to close scrutiny of their billing practices by Medicare auditors — private companies hired by the government to review claims. In many cases, these companies challenged decisions by doctors to admit patients to a hospital, saying the services should have been provided on an outpatient basis.

The auditors then tried to recover what they described as improper payments.

Doctors and hospitals said the auditors were like bounty hunters because they were allowed to keep a percentage of the funds they recovered.

But patients now will at least be better informed. The Senate Finance Committee explained the reason for the law this way:

“The number of Medicare beneficiaries receiving outpatient observation care over the last several years has been steadily increasing. Some beneficiaries are surprised to learn that although having received treatment overnight in a hospital bed, the beneficiary was never formally admitted as an inpatient but was instead a hospital outpatient.”

Federal officials acknowledged that Medicare beneficiaries sometimes had to pay more as outpatients under observation than they would have paid if they had been formally admitted to the hospital and received the same services as inpatients.

The administration issued rules last week to carry out the new law. The purpose, it said, is “to inform beneficiaries of costs they might not otherwise be aware of.”

“Even if you stay in a hospital overnight, you might still be considered an outpatient,” the administration said in a publication for beneficiaries.

Consumer advocates and nursing homes support the new requirement.

“Medicare beneficiaries are spending more and more time in the hospital without being formally admitted,” said Joyce Rogers, a senior vice president of AARP, the lobby for older Americans, adding that this “can expose beneficiaries to unexpectedly high out-of-pocket costs amounting to thousands of dollars.”

Mark Parkinson, the president and chief executive of the American Health Care Association, a trade group for nursing homes, said, “Patients often have no idea what their status is in a hospital.”

Observation stays impose a “financial burden on seniors,” he said, and increase the likelihood that they will have to turn to programs like Medicaid, the federal-state program for low-income people.

“The new law is an important first step, but Congress and the administration need to do more to protect beneficiaries,” said Judith Stein, the executive director of the nonprofit Center for Medicare Advocacy.

Under the law, hospitals can still keep Medicare patients in observation status, and some of the patients will be responsible for nursing home costs. Twenty-four senators and more than 120 House members are supporting bipartisan legislation to address that concern. Under that bill, time in a hospital under observation would count toward the three-day inpatient stay required for Medicare coverage of nursing home care.

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New Medicare law to notify patients of loophole in nursing home coverage

Former lawyer indicted for stealing $600,000 from clients

SHAKER HEIGHTS, OH (WOIO) - A former Shaker Heights attorney has been indicted for stealing more than $600,000 from his clients.

Paul Kaufman, 67, has been charged with one count of theft, 20 counts of identity fraud and 20 counts of forgery, according to Cuyahoga County Prosecutor Timothy J. McGinty. The offenses took place between 2009 and 2014.

The indictment names 15 victims, but prosecutors and investigators believe there may be more. 

"Attorneys like Paul Kaufman are why so many people look down on the legal profession," said Assistant County Prosecutor James A. Gutierrez. "He chose to ignore his responsibilities as a lawyer and to cheat his clients, and now he is going to have answer for those crimes."

Investigators say Kaufman’s schemes worked like this: The attorney would win judgments or settlements for his clients, then forge their names on checks and pocket the funds. Sometimes, he eventually paid his clients some or all of their money — though usually only after repeated complaints — and sometimes he never gave them anything.

Kaufman resigned from the practice of law in 2015 with discipline pending.

The investigation continues and more charges may be added.

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Former lawyer indicted for stealing $600,000 from clients

Volunteering is supposed to be a sacrifice, but it's a two-way street that feels so good

While painting a slew of model ponies this week, I concentrated on how each pony should look and how to make it look its best. The model ponies are for a charity auction that is held each year on Chincoteague Island during Pony Penning week, just a week away. They are painted to look like favorite ponies among the wild ponies that reside on the Chincoteague Wildlife Refuge on Assateague Island. Money raised at the auction helps The Feather Fund, a nonprofit organization that buys pony foals for deserving youth.

As I painted, I wondered when to start dinner, since I didn't know what time my husband would get home. He was mowing grass at our community park with another volunteer. That set my chain of thought off in another direction, thinking about all the friends we've made through volunteerism.

I hope my grandchildren become volunteers one day. Their parents set a good example of that. If I could, I would shout from the rooftops so my grandkids could hear of the rewards that come with a volunteering spirit.

During his Points of Light speech as part of his inauguration in 1989, President George Bush spoke of "all the individuals and community organizations spread like stars through the nation, doing good." That speech resonated with many.

He was piggybacking on the sentiments of Ronald Reagan, who once said, "The greatest leader is not necessarily the one who does the greatest things. He is the one that gets the people to do the greatest things."

Throughout my lifetime I have heard our nation's leaders speak of volunteerism, but I didn't realize how good it felt to volunteer until I first pitched in as a teen, volunteering with my church group.

Leaders of both parties have encouraged Americans to get involved and to do good for others.

In one of his speeches, Barrack Obama said, "The best way to not feel hopeless is to get up and do something. Don't wait for good things to happen to you. If you go out and make some good things happen, you will fill the world with hope, you will fill yourself with hope."

And I remember, as a very small child watching John F. Kennedy speak on the black-and-white television screen. My grade school self didn't understand the meaning when he said, "Ask not what your country can do for you, ask what you can do for your country." But I understand it now.

My parents did not volunteer. With seven kids and a hard work life I think they were so focused on keeping us fed that they couldn't think past that. If only they could have reaped those feelings of self-worth and personal growth that come with doing things for others.

I don't do nearly as much as I should but I make an effort, keeping a website and putting out a newsletter for my Lions Club, helping care for our community park and working for the Feather Fund. I often think of the other charities I wish I had time for. There are so many ways to volunteer. When I was a kid I was in awe of the candy stripers working at the hospital — youth volunteers who were not only learning the value of doing good things, but also learning about a trade.

Volunteers often gain professional experience that they can use in future jobs. They find personal growth and a sense of purpose. I used to feel guilty for feeling so good about helping out. I thought, isn't volunteering supposed to be a sacrifice? So why does it feel so good?

I have since learned that volunteerism truly is a two-way street. While volunteers help others and make positive changes, their own lives can be transformed. I have gained a new family through my volunteer work with the Feather Fund.

Our Feather Fund is like a family. More than 30 kids have received ponies from all over the United States. These kids keep in touch on Facebook and through email and phone calls and once a year they get together on the island. They all volunteer at our charity auction, they hang together, they share stories about their ponies and training tips with each other, and they always welcome the two new kids who will be getting their foals at the Pony Penning auction that year. They develop a huge sense of responsibility toward each other and they all value the concept of giving back.

I love this Feather Fund family. We have a picnic each year at Pony Penning with all returning families. Sometimes more than 70 people turn out to share potluck food in the community park. But the Feather Fund is not an exception. It is the rule. Those who join groups to volunteer frequently find opportunities to network. They find friends, forging strong relationships and bonds that enhance their lives. They find self-worth and the happiness that can only be found in giving.

I am passionate about the Chincoteague ponies and I am even more passionate about the Feather Fund because I have seen the change that these foals bring into young lives. They teach kids about love and acceptance, giving them a soft shoulder to cry on and share secrets when needed. They teach about hard work. A pony needs to be cared for and that includes shoveling a path to the barn during snowy seasons, watering, feeding and grooming and the backbreaking work of shoveling out the barn daily to keep a clean stall. I've seen Feather Fund kids get involved in their communities, strive for better grades, feel good about themselves and develop lifelong friendships.

I once read that volunteers live longer and I believe that. Volunteering fills your soul and when you feel good you stay healthier. While strengthening your community you gain extra years. That is a win-win situation.

I've learned that my Feather Fund family makes me smile a lot. I think that every smile we pass on lights up the day for another person. That could even start a viral chain, with folks passing smiles on and on. If it feels this good to volunteer, why would I ever quit? Everyone should give it a try.

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Volunteering is supposed to be a sacrifice, but it's a two-way street that feels so good

Friday, August 12, 2016

I-Team Update: Justice for Pauline

KFVS12 News & Weather Cape Girardeau, Carbondale, Poplar Bluff

I-Team Update: Justice for Pauline

Colorado lacks transparency on judicial discipline

Re: “Ala. judge in spotlight,” Aug. 7 news story.

It’s fascinating that The Denver Post chose to run a story about a judge being disciplined in another state. Do you realize that if that judge was in Colorado, the story would not be possible?

In Alabama, as in most other states, judicial discipline proceedings are public.  But in Colorado, judicial discipline proceedings are confidential.  Even if a judge is ultimately disciplined in Colorado, that discipline almost always remains private and not even the judicial performance commissions, which make recommendations to the public regarding whether to retain a judge, know about the discipline.

The confidentiality regarding judicial discipline is written into our state constitution. And if voters make it more difficult to amend the state constitution this fall, they will essentially forever enshrine Colorado in darkness regarding judicial discipline. Colorado needs sunshine on judicial discipline.

We shouldn’t make it harder to get that sunshine.

Chris Forsyth, Wheat Ridge
The writer is executive director of the Judicial Integrity Project.

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Colorado lacks transparency on judicial discipline

Coroner: 95-year-old dies after being shoved, breaking hip at Denver nursing home

DENVER — A 95-year-old woman died Thursday from complications of a broken hip that police said she suffered when she was pushed by another nursing home patient.

It happened at Manor Care Health Services (290 S. Monaco Parkway). The Denver Office of the Medical Center said someone pushed Nina Rosenfeld, causing her to fall and break her left hip.

She was taken to Rose Medical Center where she later died.  Police are investigating the death as a homicide.

Manor Care said in a statement the resident who pushed Rosenfeld no longer lives at the nursing home.
The safety and well-being of our residents is our primary concern. We have a long standing history of delivering quality care to our residents and our staff is deeply committed to their emotional and physical well-being.

In accordance with federal and state laws and regulations, we are not permitted to discuss individual residents who reside or have resided in the facility due to our commitment to residents’ confidentiality and rights.

Regarding the recent altercation by one of our residents, we have a zero tolerance for any behavior that could cause injury or harm to our residents, staff or visitors. Our staff followed our protocols. We extend our appreciation to our staff for acting immediately last week.

The resident who initiated the incident is no longer in the center. We were saddened to learn that one of our residents passed away while in the hospital. Our thoughts go out to her family.
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Coroner: 95-year-old dies after being shoved, breaking hip at Denver nursing home

Thursday, August 11, 2016

'Failing the Frail' shows lethal errors, poor oversight of Pa. nursing homes

Pennsylvania is growing old.

By 2030, the number of Pennsylvanians over 60 is predicted to reach four million – making up nearly a third of the state's population.

(Illustration by Sue Santola)
And as Pennsylvania grows older, it's expected to become increasingly reliant on nursing homes: facilities tasked with taking care of the state's frailest and most vulnerable citizens.

But as a six-month investigation by PennLive reporters Daniel Simmons-Ritchie and David Wenner found, too many of the state's 700 nursing homes are failing in that duty. Pennsylvania has one of the highest rates of bad nursing homes in the nation and dozens of people have died due to care-related mistakes in recent years.

Furthermore, after poring over federal data and searching through thousands of nursing home inspection reports, they found that state investigations into those incidents appear to be flawed and that punishments are typically weak or non-existent.

The results of that investigation are in PennLive's "Failing the Frail" series, consisting of three major stories and an array of smaller, related stories. You can read the full project here:

PART ONE: Deadly care
PART TWO: Oversight failures
PART THREE: Unpenalized homes
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'Failing the Frail' shows lethal errors, poor oversight of Pa. nursing homes

Greene County probate judge to quit over ethics charges

MONTGOMERY, Ala. (AP) — A west Alabama probate judge is resigning after being charged with violating rules for judicial ethics.

Greene County Probate Judge Earlean Isaac agreed to quit for improperly handling her father's estate in court. In another case, Tallapoosa County Probate Judge Leon Archer got an unpaid, six-month suspension for sending sexually charged messages to a woman. reports the Alabama Court of the Judiciary approved settlements in both cases Monday. The Judicial Inquiry Commission filed charges against Issac and Archer last week.

The commission accused Isaac of violating judicial canons by presiding over a case involving the probate of her father's estate. The commission says Isaac and her siblings were heirs to the estate.

Archer was accused of sending improper messages to a woman he married as probate judge.

Full Article & Source:
Greene County probate judge to quit over ethics charges

States Look To Help Aging Parents Of Those With Disabilities

Emily Criss, who has developmental disabilities, with her mother Elizabeth.
ROCKVILLE, Md. — Ever since she was 4, when a caregiver force-fed her with a spoon, Caroline Munro has not let anyone feed her but her mother.

The 22-year-old has cerebral palsy and an intellectual disability. She doesn’t speak and functions at a preschool level. Her mother, Beth Munro, feeds her with a fork or her hand.

As Beth ages — she’ll be 68 in October — she wonders who will care for Caroline when she’s no longer around. But she may never know. Caroline is on a Maryland waiting list for additional Medicaid services for people with disabilities. The list is thousands of names long, and as in many states, names often stay on it until a caregiver falls ill or dies.

About 860,000 people over 60 nationwide are in Beth’s place, caring for someone with intellectual or developmental disabilities in their home. And many are waiting, sometimes for years, for state-provided Medicaid help for their child, sister or brother, such as placement in a group home, day services, or transportation or employment programs. If they can’t afford to pay for these services on their own, under the federal-state Medicaid system, their relative could end up in an institution.

As the number of older caregivers grows, and their need for help becomes more dire, a few states have passed laws to give older caregivers a chance to help decide where, and how, the person they care for will live. Tennessee passed a law in 2015 to ensure that anyone with an intellectual disability and a caregiver over 80 got the services they needed, and this year the state expanded the law to those with caretakers over 75. And in 2014, Connecticut passed a similar law that is helping about 120 people with a caregiver over 70.

But the waiting lists for needed services in these states and many others are still thousands of names long. In recent years, states such as Maryland, Virginia and Pennsylvania have put money into their budgets to try to chip away at the lists, and they get federal matching dollars to help pay for it. Some states are prioritizing people with urgent needs, while others are prioritizing students as they age out of school.

Yet advocates for people with disabilities, such as Nicole Jorwic, director of rights policy at The Arc, a national nonprofit, say there needs to be a federal fix.

“Something that pumps money into the system,” Jorwic said. “And that’s just not going to happen in the current climate in Congress.”

In Maryland, Beth Munro realizes that unless she becomes seriously ill or dies, her daughter might not be placed in a group home.

“I’ve worked really hard at the issue over the years,” Munro said, “and you get nowhere.”  (Click to Continue)

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States Look To Help Aging Parents Of Those With Disabilities

Wednesday, August 10, 2016

Feds probing illegal strip searches of mentally disabled by CDHS

KUSA - A federal agency is examining actions of the Colorado Department of Human Services that date back to March 2015, when the DHS sanctioned a strip search of mentally disabled residents in their care.

Three reports, two by state agencies and one by an advocacy group, say CDHS performed what amounted to illegal strip searches of at least 50 people who live in their group homes and at a day program at Pueblo Regional Center.

One report says 62 residents were strip searched, another says 50 were fully examined and 12 either refused or received partial examinations.

Attorney Mari Newman, with Killmer, Lane & Newman, LLP, represents some of the people who were searched. She said what happened is a violation of their rights.

“This is one of the most outrageous abuses of a vulnerable population, people with mental disabilities who don’t have the legal capacity to consent to searches, and who said ‘no, we do not want to take off our clothes, we do not want to show you our naked bodies and genitals,’” Newman told 9Wants To Know. “There is no legitimate justification for the searches being done, how they were done and when they were done.”

The searches were conducted at the end of March 2015 and immediately the Colorado Department of Public Health and Environment received ten complaints from guardians and residents of Pueblo Regional Center.

CDPHE investigated and found the DHS “failed to ensure individuals’ rights to personal privacy, dignity and respect. The DHS also failed to allow the individuals or their guardians the opportunity to give informed consent to inspections of their bodies.”

The CDPHE report went on to say, “body inspections were completed by DHS governmental employees without the persons served [by PRC] being adequately informed about the purpose of the inspection, what it would entail, and without obtaining informed consent from either the individuals or their appointed guardians.”

CDPHE found the searches caused significant distress to some of the people. In addition, 40 people affected were incompetent to make their own decisions and had a legal guardian appointed by the court.

“Yet no guardians were contacted to give consent to the inspections, nor were any guardians informed within 24 hours of the suspected abuse,” stated one of the CDPHE reports. (Click to Continue)

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Feds probing illegal strip searches of mentally disabled by CDHS

Federal Health Officials Seek to Stop Social Media Abuse of Nursing Home Residents

This story was co-published with NPR's Shots blog.

Federal health regulators have announced plans to crack down on nursing home employees who take demeaning photographs and videos of residents and post them on social media.

The move follows a series of ProPublica reports that have documented abuses in nursing homes and assisted living centers using social media platforms such as Snapchat, Facebook and Instagram.  These include photos and videos of residents who were naked, covered in feces or even deceased.  They also include images of abuse.

The Centers for Medicare and Medicaid Services, which oversees nursing homes, said in a memo to state health departments on Friday that they should begin checking to make sure that all nursing homes have policies prohibiting staff from taking demeaning photographs of residents. The memo also calls on state officials to quickly investigate such complaints and report offending workers to state licensing agencies for investigation and possible discipline. State health departments help enforce nursing home rules for the federal government.

“Nursing homes must establish an environment that is as homelike as possible and includes a culture and environment that treats each resident with respect and dignity,” said the memo signed by David Wright, director of the CMS survey and certification group. “Treating a nursing home resident in any manner that does not uphold a resident’s sense of self-worth and individuality dehumanizes the resident and creates an environment that perpetuates a disrespectful and/or potentially abusive attitude towards the resident(s).”

CMS said that nursing homes have a responsibility to protect residents’ privacy, to prohibit abuse, to provide training on how to prevent abuse, and to investigate all allegations of abuse. If homes fail to do so, they can face citations, fines and theoretically even termination from the Medicare program.

Also last week, Sen. Charles Grassley, R-Iowa and chairman of the Senate Judiciary Committee, called on other federal agencies to take action on the problem. He sent letters to the U.S. Department of Justice and to the Office for Civil Rights within the U.S. Department of Health and Human Services asking whether “rules and protections are in place to prevent and punish these types of abuses.” He also has sent letters to social media companies, calling on them to pay more attention to this. The Office for Civil Rights is working on its own guidance related to social media but hasn’t released it yet.

In a statement to ProPublica, Grassley praised the new CMS memo. “This guidance is welcome and necessary,” he wrote. “Nursing homes are obligated under the law to keep their residents free from abuse. Exploitation on social media is a form of abuse, and the agency memo makes that clear. We need to prevent it, and we need to punish it when it happens.”

ProPublica has identified 47 instances since 2012 in which workers at nursing homes and assisted-living centers shared photos or videos of residents on social media networks. This includes three discovered in recent weeks. At one Los Angeles nursing home, an employee took video of a coworker “passing gas” on the face of a resident and posted it on Instagram, according to a May inspection report.

“An interview was conducted with Resident 1 and the resident stated that facility employees pass gas in his face as often as every month,” the report said. One employee resigned and a police report was filed.

While some states have taken harsh steps against nursing homes at which social media abuse occurs, other states have not. We reported last month that Iowa health officials recently discovered it wasn’t against state law for a nursing home worker to share a photo on Snapchat of a resident covered in feces because his genitals weren’t visible. Officials are trying to change the law when the Iowa Legislature reconvenes early next year.

The federal government memo sets uniform standards for how such abuse should be written up by inspectors and the severity of sanctions that should be levied. In the past, there was great variability.

Last month, the industry’s trade group issued its own suggestions for dealing with such situations, encouraging training and swift responses by these facilities when allegations are brought to light. The group also is holding training events around the country. While many facilities ban the use or possession of cell phones by employees when in resident areas, some have also found such rules impractical to enforce.

Greg Crist, a spokesman for the American Health Care Association, the trade group, said the CMS memo dovetails with the industry’s effort to stop social media abuse.

“The two words in that CMS directive that stand out most to me are ‘privacy’ and ’responsibility,’” Crist wrote in an email Monday. “That’s why we have taken responsibility and made a concerted, nationwide effort to educate and share best practices with our centers not only on how to detect and root out this abuse, but also proactive steps to ensure it doesn’t happen in the first place.

“It’s not an issue that is conquered overnight, but every day, we get smarter about it."

Full Article & Source:
Federal Health Officials Seek to Stop Social Media Abuse of Nursing Home Residents

For advocate, mistreated kin fuel life's work

Martha Deaver
CONWAY -- Martha Deaver has not forgotten the times her mother, grandmother and mother-in-law spent in nursing homes and is determined to help others get better treatment.

As president of the nonprofit Advocates for Nursing Home Residents since 2008, Deaver has been honored over the years by organizations, including the FBI and more recently the Arkansas Trial Lawyers Association.

The Ladies Home Journal wrote about Deaver's experiences in 2006, and she worked with Consumer Reports on a 2006 article about the country's nursing homes. Most importantly, Deaver offers consumers a mountain of research on nursing-home conditions at no charge through the advocacy group's website, a̶a̶n̶h̶.̶o̶r̶g̶*

Deaver works from an office in her Conway home. As a volunteer, she is not paid. When she goes somewhere related to her advocacy work, she wears a large button with a picture of her mother, Helen Steger, who died in a nursing home in 2001. A large green-and-white magnet on her vehicle says, "Protect the Rights of Nursing Home Residents."

"I've been doing advocacy for years, and I get calls daily from family members who are hysterical," Deaver said. "They don't know what to do, don't know where to go. They don't know there's an oversight agency. Their loved ones have been found with broken bones ... bed sores ... gangrene. ... I have dealt with thousands of complaints."

Asked for comment on Deaver and her work, Rachel Davis, executive director of the Arkansas Health Care Association, said in an email Friday that the association had no comment. The association has 212 member facilities, or 93 percent of the state's nursing-home and long-term care facilities, according to its website.

Deaver said she gets calls from relatives of nursing-home residents, whistleblowers and others. She said she never gets used to the problems. She still has pictures, more than a decade old, of one resident who was covered with ant bites.

"I turn over information from whistleblowers in abuse cases that come across my desk to state and federal investigators," she said. "I give them detailed information. They're always receptive."

Sometimes her information has led to government action.

In awarding her the 2010 FBI Director's Community Leadership Award for Arkansas, the FBI said it based her selection on "her diligent and dedicated work to not only improve the lives of the nursing home residents in Arkansas, but also across the United States, by protecting them from crimes and abuses committed against these elderly and infirm citizens, as well as to raise the public's attention to this tragedy."

Deaver, whose late father, Edward Steger, was an Air Force colonel, also advocates for veterans. She helped expose problems with the Fayetteville Veterans Home in recent years and now serves on a committee working on the development of a new veterans nursing home at Fort Roots in North Little Rock.

Deaver said her mother, grandmother and mother-in-law all received substandard care or were abused while in nursing homes. Deaver began filing complaints with the state's oversight agency, the Office of Long Term Care.

Little Rock attorney Bob Edwards, a past president of the Arkansas Trial Lawyers Association," said Deaver "truly cares."

"What happened to her mother -- she's going to do her best not to let that happen to anyone else," said Edwards, who met Deaver in 1999 when he worked for the Arkansas attorney general's office.

Praise also came from Thomas Buchanan, the attorney who represents the family of Martha Bull, a Perryville woman whose 2008 death in a Greenbrier nursing home led to a negligence lawsuit and later the federal conviction of Michael Maggio, the former judge who admitted taking a bribe to lower the lawsuit judgment. Maggio has since appealed to withdraw that plea.

Buchanan called Deaver "a tireless advocate for the elderly and all folks who are in nursing homes."

"I have a great deal of respect for Martha Deaver and the work that she's done to bring about change and to bring issues to light that the public is either unaware of or doesn't want to think about," he said.

Among the people Deaver has helped is Virginia Brown, whose 41-year-old son has been in a nursing home since a car wreck in 2008 left him paralyzed.

Brown said Deaver has helped her "mentally and every other way to deal with his situation."

"She's gotten me help for him, whereas any other time it would be like a brick wall for me to ... get the resources for him that he needs," said Brown, who lives in Redfield.

Such resources, she said, have included wheelchairs and a computer on which her son can communicate with others.

"I just know if she was not there to educate me on a lot of things, I wouldn't know what to do and how to do" some things for him, Brown said. "She's educated me to better assist him."

Deaver said the federal government's ratings have many of Arkansas' 228 nursing homes as average or worse.

"They're not all bad," Deaver said of the Arkansas facilities. "But too many of them are forced by the owners to cut costs to the detriment of the residents."

"It's important for me to let the public know what's really happening out there," she said.

The memory of her own family members' problems keeps her going. "I had nobody to help me," she said.

"Don't think for a minute that I don't make a difference in people's lives and save lives. In many, many cases, I'm able to stop the abuse, help the family member, stop the death from occurring."

She said she looks at her ability to bring about change as a blessing. The same can be said about her strength.

"I'm not weak," said Deaver, who wore big, silver, hoop earrings, a large necklace and colorful bracelets during a recent interview. "I may wear lipstick and earrings and all that, but do not take me for granted. It will be your worst mistake, and a lot of people have found that out the hard way."

"You have to be strong, you have to be tough, you have to be very outspoken to get things done," she said.

State Desk on 08/08/2016

*CORRECTION: The website address for Arkansas Advocates for Nursing Home Residents is The address was listed incorrectly in this article. 

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For advocate, mistreated kin fuel life's work

Tuesday, August 9, 2016

New Brunswick Man Tricked Elderly Woman Into Giving Up Her Home, Prosecutors Say

New Brunswick, NJ - A New Brunswick man is accused of tricking a senior citizen into signing over the title to her home, and then withdrawing several thousands of dollars from her checking account, the Middlesex County Prosecutor's Office said.

The investigation began after an anonymous tip was placed to state authorities at Adult Protective Services of the Division of Family and Children’s Services. Fady Chedid, 52, of New Brunswick, was arrested Friday after police said he convinced the older woman to first sign over the deed to her home. He then wrote several checks from her bank account between September 4, 2013 and June 2014. The checks were for various amounts, but in total they added up to several thousand dollars withdrawn from her account.

After the anonymous call tip was made, a legal guardian assigned by the state subsequently notified the Middlesex County Prosecutor’s Office.

“The Middlesex County Prosecutor’s Office remains committed to investigating and prosecuting instances of elder fraud, abuse and exploitation.” Prosecutor Andrew Carey said.

Chedid was charged with two counts of theft and is being held at the Middlesex County Adult Corrections Center in North Brunswick in lieu of $50,000 bail.

Full Article & Source:
New Brunswick Man Tricked Elderly Woman Into Giving Up Her Home, Prosecutors Say

Tallapoosa Co. probate judge suspended over sexually charged messages

MONTGOMERY, Ala. (AP) — An Alabama probate judge accused of sending sexually charged messages and nude photos to a woman he met when she went to his office to wed another man has agreed to a six-month unpaid suspension, his lawyer said Thursday.

Tallapoosa County Probate Judge Leon Archer regrets his actions and cooperated fully with a probe that resulted in charges filed Wednesday by the Alabama Judicial Inquiry Commission, said Randy Haynes, an attorney for Archer.

The complaint said Archer met a woman in 2013 when she was 34 and went to the probate office to wed a 68-year-old man. Archer performed the ceremony and noted the large age difference between the two, the complaint said.

The wedding was soon annulled, according to the complaint. In January, Archer began sending the woman sexually explicit messages and nude photos on Facebook, investigators alleged.

The complaint includes more than 60 pages of printed messages between Archer and the woman, including ones in which he allegedly wrote: "I want to hear you moan" and "what happened to us hooking up."

The messages ended after an east Alabama newspaper, The Alexander City Outlook, reported on them. The newspaper reported that Archer had admitted his actions at the time and apologized.

"Judge Archer made some bad mistakes with a person who admitted having an agenda to discredit him," Haynes said.

Archer, who has been married more than four decades, never had any physical contact with the woman, Haynes said.

"It was all on Facebook," said Haynes.

The judge, who is not a lawyer, reached a settlement with judicial investigators in which he agreed to a six-month suspension without pay, Haynes said. The suspension will begin Monday provided the Alabama Court of the Judiciary, which hears administrative cases against judges, approves the settlement during a hearing, Haynes said.

"He will go back on full status in February," said Haynes.

Archer, a Republican who took office in January 2013, is among the Alabama probate judges who quit performing marriages last year rather than allow same-sex couples to wed in his office. His staff does issue wedding licenses for same-sex couples, however.

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Tallapoosa Co. probate judge suspended over sexually charged messages

Farms and hospitals coming together in Pennsylvania to provide patients with fresh, disease-fighting foods

If you or a family member has been in a hospital as a patient, or visitor, you’ve experienced the cafeteria. The menu is frightening – GMO fed beef burgers with a slab of nitrate bacon, canola oil drenched French fries, sugar laden ice cream and chemical pudding, soy oil fried GMO fed chicken steak, mashed potatoes with glazed gravy or white toast and eggs from chickens who never saw a day of sun in their short lives. And if the children want a snack, parents can cough up the change for M&Ms and a soda. Yuck. The healthy options are pesticide laden apples and conventional rotting bananas in a basket next to the Snickers.

There is a straight line between the subsidized corporate industrial food system and the local hospital cafeteria. So when a Western trained hospital institution announces that healing a body requires organic, robust, nutrient filled food, that’s really good news. And that’s exactly what has happened in Easton, Pennsylvania’s St. Luke’s Hospital’s Anderson campus.

The hospital created an employee organic community garden on a 20,000 square feet of land adjacent to the hospital. And then they took it a step further, teaming up with The Rodale Institute, one of the premier organic farming support and training centers in America. The Anderson Campus of the hospital now boasts about its own organic farm, run by Rodale employee and farmer, Lynn Trizna.

This ten acre farm includes a hoop house and produces a wide variety of organic foods, including 45,000 pounds of produce with plans to double the variety and the output. Bees, bats and flowers also dot the landscape. It’s a triple bonus to all who come to the hospital – lower prices, improved health and saying no to industrial agriculture.

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Farms and hospitals coming together in Pennsylvania to provide patients with fresh, disease-fighting foods

Monday, August 8, 2016

When choosing a nursing home, use your eyes and nose

If there are two bits of advice for choosing a nursing home that everyone agrees on, it's these:

1) Don't wait until you need one fast and have no time to be choosy.

2) Then visit the homes that are under consideration and give them a good looking over.

Having to find a nursing home fast, unfortunately, is a common situation. An older person's condition can change abruptly. He or she might be managing well alone or with help of family. But a bad fall or the onset of dementia can change everything. And it used to be that people were given time to recover in the hospital.

That's no longer true. Hospitals are now under pressure to discharge people as soon as they are medically stable, even though they might need significant nursing care and be far from able to care for themselves, or be cared for by family.

Often they are discharged to a nursing home and their families are put in the position of having to select one in a day or two.

The best nursing homes often have waiting lists. That could mean someone ends up in a poorly rated nursing home. And the family might not know the home is poorly rated until it's too late.

But people who know what they're doing can fare better. Here are some tips:
  • With people living longer and hospitals discharging patients sooner, the odds are high any older person will eventually spend time in a nursing home. Don't let it be a matter of "I would never put mom in a nursing home." Talk about the potential need for a nursing home and decide what home you would prefer.
  • Use Medicare Nursing Home Compare, which rates nursing homes according to a five-star scale and provides other measures of quality. It's not wise to base the decision entirely on Nursing Home Compare or any single source. But it can help weed out the bad homes and focus on the better ones. The Pennsylvania Department of Health also offers a guide. It provides basic information on all the homes in each county – things like number of beds, whether it's for-profit or nonprofit, and whether it accepts Medicaid. It also gives the status of the home's license – poor quality can lead to a provisional license – and provides links to inspection reports, which can give insights into quality of care.
  • Ask friends and people at work or church about their experiences with local nursing homes, and which ones did a good job or bad job for their loved ones.
  • Visit the home or homes under consideration. Virtually every expert says this is essential. Walk around the home. Is it fresh smelling or does it smell of urine. Visit during meal time. Does the food look appetizing? Do the residents seem to be enjoying their meals? Are residents who need help with eating getting it, or are they staring at their food? Watch how staff interacts with residents. Talk to the home's administrator. Ask about staffing levels. Ask about the level of staff turnover. Ask about the use of agency staff, knowing that agency staff might not be able to become familiar with your loved one, and have less of a state in providing the best possible care. Ask about activities offered to residents. Ask if the facility has a high vacancy rate. If it does, ask why. Ask if there's a waiting list. Ask if there is a volunteer program and get a description.
  • Consider whether the home is for-profit or nonprofit. This is a contentious subject, with critics arguing that for-profit homes skimp on staffing to maximize profits. Some studies have found that nonprofit homes have higher staffing levels – probably the single most important factor in providing good care, safety and high quality of life for residents. But don't assume all for-profit homes are bad. If it's a nonprofit home, find out its affiliation. Nonprofit homes are often affiliated with churches or religious organizations. These are sometimes more "mission" focused, and more inclined to channeling resources toward higher staffing levels and the highest possible level of care. They also might be better positioned to obtain volunteer help, and have a charitable fund to help residents cover their costs.
It's worth knowing that the best nursing homes often have waiting lists. That means a preferred home might not have an opening when you need it. At the same time, many homes provide a continuum of care, including personal care, assisted living and home health services. People who are already associated with the home often are guaranteed a spot when they need skilled nursing.

Dr. Linda Rhodes, a former Pennsylvania Secretary of Aging, offers a useful guide. The guide provides advice on questions to ask over the phone, using Nursing Home Compare and other surveys, and what to look for when you visit the facility. It's free and can be downloaded from this link.

If you want to know more about nursing homes in central Pa., check out PennLive's list of the best and worst homes in the region. You can also use this map, created by PennLive using data from Nursing Home Compare, to quickly find the best rated nursing homes near you: (Click to Continue)

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When choosing a nursing home, use your eyes and nose

Judge: Estate of Eagles’ Randy Meisner should pay for psych exam

The Eagles in 1972

A judge ruled the estate of Eagles co-founder Randy Meisner should pay an $8,000 advance sought by a psychiatrist appointed to examine the musician in response to a longtime friend’s concern about the musician’s medical care.

Los Angeles Superior Court Judge William Barry’s ruling, issued Tuesday, also states that the examination should be limited to whether Dr. David Trader believes Meisner was mentally sound when he chose his temporary conservators, Arthur Ford and Thomas DeLong.     Under the current temporary conservatorship that Barry established on April 1, the judge named Ford, a longtime Meisner friend, as the temporary conservator of the musician himself.

The 70-year-old Meisner’s accountant, Thomas DeLong, was appointed temporary conservator of his business affairs.

Meisner sought to be placed under a conservatorship shortly after his 63- year-old wife, Lana, suffered a fatal gunshot wound March 6 when she lifted a rifle that accidentally discharged in the couple’s Studio City home.

Another longtime acquaintance of Meisner, James Newton, has filed a competing petition asking that Donna Bogdanovich be appointed as the bassist’s conservator.  Bogdanovich is a former social worker and case manager who specializes in mental health issues.

Newton said he has been in contact with the guitarist’s children regarding their father’s health. A non-jury trial of the competing conservatorship petitions is scheduled for Oct. 14.

Barry’s ruling came over the objections of the current temporary conservators and their lawyer, Sanford Passman. Passman said during a hearing on Tuesday that the estate should not have to pay for the services of an expert witness whose testimony is being sought by Newton and not the temporary conservators.

The Eagles were founded in 1971 by Meisner, the late Glenn Frey, Don Henley and Bernie Leadon. Meisner co-wrote and sang the hit, “Take it to the Limit.”

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Judge: Estate of Eagles’ Randy Meisner should pay for psych exam

Lafayette police: Woman pretended to be doctor, exploited elderly

Lafayette police are looking for a woman accused of exploiting an elderly woman under the guise of being a doctor practicing neurofeedback therapy after police received six referrals from Adult Protective Services.

An arrest warrant affidavit indicates Julie Steenhoek, 53, is wanted on one count of felony at-risk exploitation. She does not appear to have a prior criminal record in Colorado, but police found several online complaints regarding her neurofeedback services.

Police said Steenhoek convinced the woman to go out of state to visit family, then placed her husband in an assisted living facility and moved her own family into the home, which she then put on the market.

Family members began reporting Steenhoek — who went by “Dr. Julie” — after they believed she was preventing them from speaking to the woman, even sending an email purportedly from the woman saying that she was “of sound mind and body,” the affidavit said.

One family member also called Adult Protective Services after attending an elder abuse seminar put on by the Jefferson County District Attorney and thinking that an example case sounded like what was happening to the couple, according to police.  (Click to Continue)

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Lafayette police: Woman pretended to be doctor, exploited elderly

Sunday, August 7, 2016

Dementia 101 in 101 Seconds

Dementia 101 in 101 Seconds

What is a Guardian Supposed to Do, Anyway?

by Erica Wood, JD, Assistant Director, American Bar Association Commission on Law and Aging August 1, 2016

We’ve all heard of good, bad and mediocre guardians. We’ve seen the press stories raging about exploitive guardians. There are no statistics, yet we know that guardian practice ranges from the heroic to the sufficient to the deficient to the abusive – it’s the proportions that are not clear.  But encountering a guardian up close and personal – or being one, or having one – makes you want to reach for a yardstick to see how well the guardian measures up.  Or at least to have a framework for thinking about it. 

Of course, there’s usually some guidance in your state’s guardianship statute.  But that’s often pretty general – provide care and custody, make personal and financial decisions, turn in annual reports.  Sometimes courts require or provide initial training, or maybe a handbook or video, and a few states have certification for professional guardians. 

That’s not enough, and often there’s nothing at all.  Guardians perform one of society’s most difficult roles.  Stepping into someone else’s shoes is an arduous task. Guardians constantly have to negotiate the tension between safety and self-determination.  They are “fiduciaries” with a high duty of care and accountability.  They have duties both to the person and the court.  They may be caught in the crosshairs of high conflict family situations.  They have to know – or know where to find out – about health care, affordable housing, accessibility, long-term supports and services, mental health, public benefits, investments, tax, community services, assistive technology, accounting, supported decision-making, ethics and conflict of interest and more.  And the players and rules are constantly changing.  In short, being a guardian is a job for a super hero, yet most family or lay guardians come to it unprepared, and even professional guardians need more guidance. 

What ultimately is needed is a source of ongoing support and technical assistance, so as questions come up, guardians have somewhere to turn for timely and practical guidance at the local level. 

But short of that, there is at least a set of standards that offers a sound framework.  It is the National Guardianship Association’s 2013 Standards of Practice, at .  Some states have similar standards or have adopted or adapted the NGA Standards.  The NGA standards originally were high quality professional standards – but they became quite remarkable with the incorporation of the 2011 Third National Guardianship Summit standards.  This means the thinking of some of the nation’s key judicial, legal, aging and disability, and elder justice experts and advocates is threaded throughout. 

Suppose you are a care manager or APS staff, and you find out the guardian is restricting the visits of the person’s sister because “they always fight and it upsets her.”  You look in the Standards and it says “The guardian shall encourage and support the person in maintaining contact with family and friends, as defined by the person, unless it will substantially harm the person” and “The guardian may not interfere with established relationships unless necessary to protect the person from substantial harm.”  So you first ask the person subject to guardianship, if she can communicate, whether she wants to see her sister, and you try to find out the pattern of their relationship.  Maybe you suggest the guardian start with a short or supervised visit if there is risk.  When you talk with the guardian, you have something substantial to back you up. 

Suppose you are a guardian who is thinking of selling the person’s home because she is in assisted living, and needs the money to pay for the care. We’ve all heard stories of someone returning from an institution or residential setting to the shock of finding their home and belongings are gone.  Your jurisdiction may require court approval, and the Standards call for “judicial, administrative, or other independent review.”  But the Standards also say that “the guardian shall have a strong priority for home or other community-based settings, when not inconsistent with the person’s goals and preferences,” and they offer a list of 11 specific practical factors to consider in selling a person’s property of any kind -- including of course the person’s previously expressed or current desires, but also including the benefits, tax consequences, effect on entitlements, maintenance and more.  This kind of due diligence, “person-centered” checklist is what guardians need to shape their thinking and to help them document their decision. 

Each of these specific standards is backed up throughout the overall document with more general standards on decision-making that promote self-determination to the extent possible, as well as continued evaluation of options. 

Unless so designated by your state’s law or your court’s rules, the NGA Standards are not legally enforceable, but they offer a solid measure as to what “good guardianship” – short of a less restrictive option including supported decision-making – should mean.  The NGA Standards are a too little known gem.

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What is a Guardian Supposed to Do, Anyway?

Years later, wreck victim forgotten by most

Mark Doehne & Patrick Davis
Patrick Davis was a popular football player at Lee High School in 1980 when, one winter night, he was riding in a friend’s Trans Am after a party and the car careened into a telephone pole.

The pole snapped. It fell on the car roof. And Davis — an all-district wide receiver at school — suffered permanent brain damage.

This is the story of an irrevocably injured young man who made headlines in the 1980s, but was quickly forgotten by the media and most San Antonians.

It’s also a story about a former classmate who stood by Davis and became his legal guardian — but then was accused of rarely visiting him, even as the guardian earned fees from Davis’ estate.

The early chapters of Davis’ struggles were widely covered by the San Antonio media in the early 1980s. Davis’ lawyers sued General Motors for $50 million, claiming the Trans Am was unsafe and had been marketed as a stunt vehicle seen in the movie “Smokey and the Bandit,” starring Burt Reynolds as a wisecracking cowboy.

One of Davis’ lawyers, the flamboyant Pat Maloney Sr., threatened to subpoena Reynolds. Fans deluged the Bexar County Courthouse with phone calls, wanting to know when the movie star would testify — he never did.

Davis’ 15 minutes of fame soon faded. His lawyers reached a settlement with General Motors in August 1984. While the terms were secret, Davis’ lawyers said he received enough money to guarantee a life of rehabilitation and independence.

At the time, Davis seemed happy about his prospects. Able to speak slowly after his injury, he told the media he planned to become an architect.

A photograph from his last news conference shows him with a wisp of a mustache, shaggy hair and mutton-chop sideburns.

“I have my whole life to live,” a hopeful Davis told reporters.

What did life have in store for him?

Friends drift away

Mission Road Developmental Center is a pleasant, tree-lined campus of homes near Stinson Municipal Airport. The nonprofit organization serves people with mental retardation and other disabilities.

For the past 13 years, this tranquil setting has been Davis’ home.

The reality for Davis — and many people who suffer traumatic brain injuries — was not a life of independence.

The injury to Davis’ brain stem left him unable to take care of himself. He was coherent but suffered from seizures, and he was paralyzed on the left side of his body. He mostly stayed in a wheelchair.

After the wreck, classmates rallied behind Davis, who was hospitalized for nearly a year. But as time passed, it became clear the strapping athlete wasn’t going to fully recover. Many people drifted away. Friends and family visited sporadically or moved on with their lives.

For many years, Davis had no legal guardian — someone who visited, made sure he had new clothes and made important decisions on his behalf.

A few people remained in Davis’ life. A former classmate named Mark Doehne and his family visited Davis and did what they could to help. It was a difficult time for Doehne, who watched his friend waste away from 190 to 95 pounds.

“He was my best friend,” a soft-spoken Doehne said when asked why he stuck around when most people moved on. Coming close to tears as he reflected on those hard days, he said: “I guess somebody had to do something.”

The Doehne family is well known in Texas political circles. Doehne’s mother, Dorothy, once served as vice chairwoman of the Republican Party of Texas. In 1996, then-Gov. George W. Bush appointed Doehne’s sister, Diane Rath, as a commissioner of the Texas Workforce Commission. Rath served as chairwoman from 1998 until she stepped down in 2008.

“Overall, there’s been one family that’s been there for (Davis),” said lawyer Pat Maloney Jr. “It says a lot about that family. Very few people hang around long when you’re injured that seriously.”

Fending for himself

While the Doehne family members stayed close to Davis, they weren’t responsible for making decisions on his behalf. Davis’ father, Ellsworth, also had no say in where his adult son lived.

Ellsworth Davis said Pat8rick had been declared a competent adult as part of the court settlement, so he did not ask a judge to appoint him as a legal guardian.

Father and son had been close — Ellsworth Davis enjoyed watching his son play football and went to all the games he could. But after the wreck, it was heart-wrenching every time he visited his shattered boy.

“To lose an 18-year-old son like that, it’s quite traumatic,” said Davis, 78.

Davis still talks to his son by phone, but he can’t remember the last time he visited in person. Doehne said he understood why the visits were so painful.

“It was like peeling the scab off,” Doehne said. “I’m in no position to judge the father.”

With no one ultimately responsible for Davis, he mostly lived in nursing homes throughout the 1980s and early 1990s. He was rarely challenged or living with people his own age.

Davis’ situation hardly was an anomaly. Nursing homes are brimming with vulnerable residents who can’t speak for themselves — and have no one to speak for them.

“It’s a very dysfunctional system,” said Lora Butler, executive director of Mission Road.

In the mid-1990s, Doehne said Davis moved to a group home, where Davis essentially was left to “fend for himself.” Doehne said Davis was hospitalized after becoming dehydrated. When Doehne visited Davis at the hospital and tried to find out how his friend was doing, hospital staffers were reluctant to give out that information to Doehne.

Doehne thought to himself, “I gotta do something about this.”

(Continue Reading)

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Years later, wreck victim forgotten by most