‘Nothing short of horrifying:’ Veterans' groups demand fixes at VA nursing homes

WASHINGTON – Six veterans’ groups are calling on the Department of Veterans Affairs to improve the quality of care at its nursing homes following a story by USA TODAY and The Boston Globe detailing “blatant disregard for veteran safety” at a VA nursing home in Massachusetts.

“Anybody who respects veterans should be angered by this,” American Legion National Commander Brett Reistad said. “America’s veterans deserve better.”

The groups, who together represent nearly 5 million members, said veterans who risked their lives for our country shouldn’t have to risk their lives in VA nursing homes.

In Brockton, Massachusetts, investigators found two nurses asleep during their shifts, even though the facility knew it was under scrutiny and inspectors were coming to visit, looking for potential signs of patient neglect. A whistleblower had reported that nurses and aides did not empty the bedside urinals of frail veterans, they failed to provide clean water at night and didn’t check on the veterans regularly. The VA said the napping nurses no longer work at the facility.

The story was the latest in an investigation by USA TODAY and the Globe that revealed care at many VA nursing facilities was worse than at private nursing homes in the agency’s own internal ratings, kept secret from veterans for years.

The stories detailed disturbing examples of substandard care – a veteran with undiagnosed scabies for months, another struggling to eat in Bedford, Massachussetts; and a third sitting for hours in soiled sheets and another writhing in pain without medication in West Palm Beach, Florida.

A Navy veteran was declared dead after he walked out of a supposedly secure VA nursing home and was never found in Tuskegee, Alabama. An Army vet landed in intensive care suffering from malnutrition, septic shock and bed sores after a stay at a VA nursing home in Livermore, California.

“The stories being reported about the treatment of some individual veterans at these facilities are nothing short of horrifying,” said Rege Riley, national commander of American Veterans, known as AmVets. He called on VA Secretary Robert Wilkie to “take swift and transparent action to fix this.” 

   

Veterans of Foreign Wars, Disabled American Veterans, Paralyzed Veterans of America and Vietnam Veterans of America joined AmVets and the Legion in calling for action. Together, the groups are known as the “big six” and wield considerable clout in Washington.

“The VA must address and correct these issues,” said Garry Augustine, executive director of Disabled American Veterans.

VA 'striving to improve'

VA spokesman Curt Cashour said the residents the VA typically cares for are sicker than those in private nursing homes, making “achieving good quality ratings more challenging.” He said that overall, VA nursing homes “compare well” with the private sector.

“We look forward to briefing each of these groups in the near future regarding these crucial facts,” Cashour said, adding that the VA is “continuously striving to improve all of its health care facilities.”

The VA has 133 nursing homes across the country that serve 46,000 veterans annually.

Newly released VA data show that 95 of them – about 71 percent – scored worse than private nursing homes on a majority of quality indicators, such as rates of infection, serious pain and bed sores.

Roughly the same number, 93, received only one or two stars out of five for quality in the agency’s own ratings.

In a scathing statement declaring those facilities “failures,” VFW National Commander Vincent “B.J.” Lawrence said the VA “must improve its delivery of quality care at these facilities.”

"(Veterans') families deserve to know that their loved ones – their heroes – are not being abandoned or abused, and America needs to be reassured that the VA is honoring our nation's promise to those who have borne the battle," he said.

Call for transparency

Reistad, the Legion's commander, added, “We not only expect VA to fix these problems immediately, but we want transparency.” On Sunday, after his group met with VA officials, he said he is confident they will work with the Legion and the other groups to “institute needed improvements.”

The VA released the quality information on its nursing homes only after learning in June that USA TODAY and the Globe planned to publish it. The agency still has not released the results of inspections.

“Why not?” asked Rick Weidman, co-founder of Vietnam Veterans of America. He said his group often has to “fight like hell with VA in order to get information.”

The reports can include instances of neglect or poor conditions that can be a tip-off to current and prospective residents about problems at a facility.

“I don’t see how veterans are best served by the VA not being open about the level of care it’s providing,” AmVets spokesman John Hoellwarth said.

Cashour said the VA is working with an outside contractor who conducts the inspections, Wisconsin-based Long Term Care Institute, to remove patient information from its reports before they are released, maybe by the end of the year.

Private nursing homes have three years’ worth of inspection reports posted on a federal website, Nursing Home Compare.

Lawmakers demand answers

In September, Congress passed and President Donald Trump signed into law legislation requiring the VA to publish quality ratings going forward. The law does not mention inspection reports.

The Republican-led House VA Committee launched an investigation of VA nursing home care after the initial USA TODAY and Globe reports, but a spokeswoman, Molly Jenkins, said the probe won’t be finished in time to hold a hearing this year as anticipated. The Democrat poised to take over the committee in January, Rep. Mark Takano of California, said it is a “critical issue that will continue to be a priority.”

In Massachusetts, home to two, one-star VA nursing homes – in Bedford and Brockton – lawmakers are demanding to know what steps the VA has taken to improve patient care there and at other facilities around the country.

“The continued care lapses at VA facilities raise questions about whether concrete, lasting measures are being implemented to prevent misconduct from occurring again – or whether certain VA facilities are unable to institute changes necessary to provide our veterans with the care befitting their service to the country,” Sens. Ed Markey and Elizabeth Warren, both Democrats from Massachusetts, wrote in a letter to Wilkie.

They demanded the most recent report from the Long Term Care Institute inspection of the Brockton VA nursing home.

“The fact that we can’t treat Americans who put their lives on the line with dignity when their lives are on the line here at home later in life is disgusting,” said Rep. Seth Moulton, D-Mass, a veteran who receives his medical care at  the Bedford VA.

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‘Nothing short of horrifying:’ Veterans' groups demand fixes at VA nursing homes

Ex-judge who brutally assaulted his wife in 2014 is arrested after she's found dead

A former Ohio judge and state lawmaker who went to prison for brutally assaulting his wife in 2014 was taken into custody after she was found dead, authorities said.

The ex-judge, Lance Mason, was hired as Cleveland’s minority business administrator after being released from prison but was fired Saturday when he was arrested, NBC affiliate WKYC reported.

Aisha FraserShaker Heights Teachers' Association / via Facebook

Details of the death of Mason’s estranged wife, Aisha Fraser, weren’t immediately available, but police in Shaker Heights, Ohio, said in a statement that is was a “terrible tragedy.”

It also wasn’t clear what charges Mason may face. The Shaker Heights Police Department, which said in a brief statement that Mason was taken into custody after an initial investigation, did not immediately respond to a request for comment.

According to court documents, Mason — who had also served as a state representative and state senator — got into an argument with Fraser on Aug. 2, 2014, while returning from a relative’s funeral.

With their 6-year-old and 4-year-old children in the vehicle, Mason repeatedly struck Fraser in the head, bit her face and slammed her head against the dashboard, armrest and passenger window, the documents say.

After trying to escape, Fraser fell to the ground, where Mason continued to strike her, the documents say, adding that he then got back in the vehicle and drove away, leaving Fraser there.

Fraser filed for divorce, but court records show that process wasn't finalized, Cleveland.com reported.

Mason was sentenced to 24 months behind bars for the assault and served nine, according to the documents and WKYC. He was indefinitely suspended from practicing law, according to court documents.

The station reported last year that Rep. Marcia Fudge, D-Ohio, may have helped Mason secure a job as Cleveland’s minority business administrator, though the congresswoman denied the report, saying she didn’t urge Mayor Frank Jackson to hire him.

The mayor’s spokesman, Dan Williams, also denied the claim.

Williams did not respond to a request for comment about Mason’s reported firing, but WKYC reported that that Jackson sent his “deepest condolences to the family of Ms. Aisha Fraser, especially to her children.”

Fraser had been a teacher for two decades and taught sixth grade at a local elementary school at the time of her death, the station reported. In a statement to WKYC, an uncle said she would be missed by all, adding, “Heaven just a got a magnificent angel.”

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Ex-judge who brutally assaulted his wife in 2014 is arrested after she's found dead

Police: Louisville Man Exploited Elderly Woman

LOUISVILLE, Ky. (LEX 18) – After turning to social media for help, Louisville police got tips that helped them arrest a man accused of exploiting an elderly woman suffering from memory loss.

Dwon Arwin Sawyers is accused of going to the woman’s house on four occasions and convincing her to withdraw money to pay him each time.

The first two times, he took her to an ATM. Police say he then got bolder and joined her inside a bank.

Investigators say Sawyers got away with nearly $3,000. He now faces charges of theft and exploitation.

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Police: Louisville Man Exploited Elderly Woman

This Saturday Night on CBS' "48 Hours": FAMILY FEUD ERUPTS OVER CASEY KASEM'S FORTUNE,YEARS AFTER HIS DEATH

The feud between Casey Kasem's wife and children intensifies amid questions over his death

More than four years after radio legend Casey Kasem died, his wife Jean Kasem reveals to "48 Hours" for the first time her version of her husband's final days, levels allegations of murder in a lawsuit and discusses a heated family feud. "The Mysterious Death of Casey Kasem" will broadcast Saturday, Nov. 24, on CBS.

At the top of his career, Kasem was heard by millions around the world as the host of the music countdown show, "American Top 40," and as the voice of "Shaggy" in the cartoon classic "Scooby Doo."

But toward the end of his life, his family made headlines over an ongoing dispute between Kasem's children from his first wife, and Jean Kasem, his second wife. After his death on Father's Day in 2014, the feud escalated as both sides accused each other of contributing to his death, and they battled over his estate and final resting place.

"They killed my husband," Jean Kasem told "48 Hours'" Peter Van Sant. "They killed their father."

"Jean killed my father," counters Kerri Kasem, one of Kasem's three adult children, adding, "what she did led to his death."

Source:
FAMILY FEUD ERUPTS OVER CASEY KASEM'S FORTUNE,YEARS AFTER HIS DEATH

See Also:
Casey Kasem's Death Now an Active Murder Investigation

Here's What's in the Documents That are Prompting a New Look into Casey Kasem's Death

Source:48 Hours Investigates Casey Kasem's Death, Family Battle Goes Nuclear

U.S. hospitals ignore improving elder care. That’s a mistake

Elder patients in the U.S. often end up in older hospitals and medical centers. That usually means long walks down halls without railings or chairs with arms for rest stops. FRED DUFOUR/AFP/Getty Images

Sick children deserve optimal medical care. So why were my colleagues and I saddened by a California midterm ballot initiative aimed at doing just that?

Like the majority of Californians, I voted for the initiative to authorize $1.5 billion in bonds in grants for the “construction, expansion, renovation, and equipping of qualifying children’s hospitals.” Voting “yes” was the socially responsible, compassionate choice. My chagrin came not from what the measure will do for our state but from what is missing in health care funding — not just in California, but across the nation.

Given the vast number of children who have died throughout most of human history (in 1900, 30 percent of all deaths in the United States occurred in children less than 5 years of age), we are fortunate to live at a time when most children are healthy and live into adulthood and beyond. While children and adolescents make up 23 percent of the U.S. population, they account for only 16 percent of hospitalizations, mostly in the first year of life. If you exclude infants, individuals under age 18 make up just 4 percent of hospitalizations.

Thanks to 20th-century advances in public health and medicine, a majority of Americans now live into elderhood. More children today benefit from education bonds than health care bonds. Yet our policies and priorities are still directed at century-old needs and demographics.

In the 21st century, health care is to elderhood as education is to childhood. But we don’t see bond measures for the “construction, expansion, renovation, and equipping” of hospitals to optimize care of old people, an investment that would surely benefit Americans of all ages.

People age 65 and older make up just 16 percent of the U.S. population but nearly 40 percent of hospitalized adults. In 2014, Americans over age 74 had the highest rate of hospital stays, followed by those in their late 60s and early 70s.

Remarkably, hospitals aren’t designed with elders in mind. Walk through one and you’ll almost invariably find cheerful decor for children, services and facilities aimed at adults, and a gauntlet of obstacles and insults to elders.

At most hospitals and medical centers, the newest buildings focus on cancer, neuroscience, children, and research. Old people end up in old buildings. That usually means long walks down halls without railings or chairs with arms for rest stops. It means signs that are hard to read until you are right under them. It means a one-size-fits-all approach to both facilities and care that doesn’t acknowledge that the needs, preferences, and realities of a 75- or 95-year-old with a medical condition might differ from those of a 35- or 55-year-old with the same thing.

It’s the rare industry that doesn’t target and cater to its best customers. Health care not only fails to cater to elders, it fosters system-wide injustice by failing to apply the same standards to elderhood that it applies to childhood and adulthood. Just as children’s hospitals have been shown to save and better the lives of children, hospital wards, services, and emergency departments aimed at elders improve their care and lives when compared to adult-centric facilities.

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U.S. hospitals ignore improving elder care. That’s a mistake

Britney Ordered To Give Dad & Legal Team A Raise For Keeping Her Away From Drugs

Britney Spears Opens a New Window. is giving her dad and her legal team a hefty raise after they argued that they kept her safe and away from drugs in the last few years, RadarOnline.com exclusively learned.

The Pop Princess’ conservatorship attorneys appeared in the Los Angeles Superior Court on Wednesday, November 14, 2018 were a judge granted their petitions to give raises to her team Opens a New Window. .

“The petition – allowance of fees filed on 10/15/18 by Petitioner Andrew M. Wallet is granted,” the minute order obtained by Radar stated.

Wallet, who is the co-conservator to Spears’ estate Opens a New Window. , argued that because he essentially saved the singer and her Trust from financial ruin, he should be compensated to the tune of $426,000.

In the October 15, 2018 court documents obtained by Radar, Wallet argued he had managed 36-year-old Spears’ finances and various business dealings for more than a decade and was instrumental in bringing “stability and leadership” to the singer’s various ventures.

He noted he kept “literally hundreds of people” in check — vendors, drivers, dancers, hair stylists, performers and many others Opens a New Window. — many whom could allegedly “bring financial disaster by providing illegal substances to the Conservatee.”

Spears’ father, Jamie Spears, and her second attorney, Samuel Ingham were also granted their “allowance of fees,” according to documents exclusively obtained by Radar.

“By way of example, and not by way of limitation, at the planning stages of the Circus Tour, the Declarant instructed entertainment counsel to spread the risk of the Conservatee failing to fulfill her duties on tour because of some third party providing illegal substances,” Wallet claimed in his Oct. 15 declaration. “The financial stakes were high, and failure was not an option.”

Wallet said the same temptations continued in Spears’ Las Vegas residency. Wallet also argued since he was brought on as co-conservator, Spears’ estate has increased to the value of $20 million.

At the beginning of the conservatorship, the estate was nearly out of fund and cash equivalents,” Wallet said in the affidavit. “The estate and person of the conservative were in total chaos with tremendous liabilities. The problems were of epic proportions over a period of years. Extraordinary skills have been employed by all in order to achieve the results enjoyed at the present time. Petitioner has had many months at a time where all of his professional time was spent in services rendered exclusively to the conservative.”

The petition to “seal” the affidavit requested by Jamie Spears Opens a New Window. was also granted, according to the documents obtained by Radar.

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Britney Ordered To Give Dad & Legal Team A Raise For Keeping Her Away From Drugs

Tennesseeans Warned to Beware of Holiday Scams

NASHVILLE, Tenn. — As the holidays approach, the Tennessee Department of Commerce warns buyers that if a deal looks too good to be true, it probably is.

Tennessee's high ranking for fraud and financial abuse complaints to the Federal Trade Commission has motivated local groups to come together to help prevent scams. Kevin Walters, communications director at the Tennessee Department of Commerce and Insurance, said it's a real challenge.

"Scammers are becoming increasingly sophisticated. They are cunning and they're ruthless and, a lot of times, they're anonymous,” Walters said. “And they can use technology to cloak phone numbers to hide their location."

He said this year, cases of fraud and financial abuse are up more than 33 percent statewide.

Doing research on special offers and charitable groups is key, especially during the holiday season. Walters warned that scammers use these organizations as a cover to take advantage of a person's good nature - and it's okay to say "no" to giving your financial information to anyone over the phone.

"If someone's contacting you to get that information and you've never spoken to them before, and they're calling you out of the blue, again, that's a red flag that they're probably after more than just a donation to their charity,” he said. “They're probably after much more than that, and it could lead to some real problems down the road for you and your family."

In 2017, the FTC said Tennesseans filed more than 43,000 fraud reports, totaling losses of almost $14 million.

Walters added seniors and adults with disabilities are among the most vulnerable targets for scams. TDHS Adult Protective Services received more than 4,000 complaints of financial exploitation in the past year.

"So, the problem of fraud and identity theft is growing, across Tennessee and all segments of the population, in particular for elderly and vulnerable adults,” Walters said.

He said it's important to report scams to local law enforcement, and get information from the AARP Fraud Watch Network at aarp.org/fraudwatchnetwork.

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Tennesseeans Warned to Beware of Holiday Scams

Young Girl Sings to her Great Grandmother

Source: YouTube: Singing "How Great Thou Art" to my Great Grandmother

Dementia Patients Recover Memories at Care Home Painted Like High Street - What a Great Idea!

Dementia patients are able to recover memories they have lost because their care home has been painted to look like a high street from the 1940s and 50s. The hallways in the De Baliol Care Home in Newbiggin by the Sea, Northumberland, have been transformed to look much like the area that many of its residents grew up in. Staff hope the recognisable features of old-fashioned shop fronts and sea views through ‘windows’ could trigger memories for the residents with dementia.

Administrator Sylvia Richardson said: ‘We wanted to create and atmosphere that would stimulate memories of the local area of yesterday and today. ‘We involved all the residents and the staff – but almost all the work has been done by Chris Brosnan, our maintenance man, with the murals for doors and walls done by Premier Graphics, from Blyth.

‘The fantastic photos were taken by Robert Miller, from Stakeford, and enlarged to create a local scene.’

Mr Brosnan said he was ‘let loose’ to paint the hallways. ‘The idea, for people with dementia, is to bring memories back, to create a street which looks the way things did when they were younger,’ he explained. ‘We included the views of the beach because a lot of people will have spent time there, so it’s about trying to jog some happy memories.’

But it’s not just the happy memories that will benefit residents – the paintings are also said to have a calming and ‘homely’ effect. ‘I’ve been working here for about four years, and it doesn’t feel like a nursing home, it feels like a family,’ said care home manager Judith Brown.

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Dementia Patients Recover Memories at Care Home Painted Like High Street

At 96 Years-Young, This Grandfather Saved His Village by Painting it!

Heather Locklear’s Family Considering Putting Her Under a Conservatorship

Heather Locklear‘s family is so concerned about her health and well-being, they are considering going the Britney Spears route and putting her under a conservatorship following this weekend’s latest hospitalization.

Sources close to Locklear tell The Blast that her family believes she ended her most recent rehab trip too early. We’re told Locklear wanted to be out for her daughter’s birthday — she turned 21 last month — but people noticed right away that she “seemed exactly the same.”

Our sources say Locklear’s family is considering a conservatorship but is unsure of who should be put in charge. We’re told the family believes her parents are too old to take on the responsibility and that her lawyers leak information to the press.

The family, we’re told hopes the hospital will put her on a longer hold following this latest hospitalization. They believe she needs long-term treatment and someone to be in charge of her finances and medical treatments.

Heather Locklear was arrested back in February for felony domestic violence and battery on a police officer.

The Ventura County Sheriff’s Department said at the time that Heather “battered her boyfriend and he suffered a visible injury” before their arrival. As they tried to take Locklear into custody, she kicked and hit three deputies as they were bringing her to the vehicle and she remained “agitated and extremely uncooperative.”

Locklear was eventually charged with felony domestic battery and three counts of attacking an officer. The sheriff says they had to bring her to the hospital because she claimed that she was injured earlier in the day, but she was cleared at the hospital.

She pled not guilty back in April.

In June, Locklear was hospitalized after allegedly threatening to kill herself.

Later that month, she was arrested again for allegedly attacking a law enforcement officer and an EMT. Locklear was charged with two counts of Misdemeanor Battery Upon An Officer And Emergency Personnel.

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Heather Locklear’s Family Considering Putting Her Under a Conservatorship

Long Beach mobile home residents win $5.57 million in financial elder abuse case

Roger Lackey stands outside a mobile home in the flooded Friendly Village, where residents have sued the owners for their alleged negligence in maintaining the land. (Courtesy Gina Fernandes)

Residents of a Long Beach mobile home park on the site of a former landfill were awarded $5.57 million in damages on Monday, Nov. 19, after they sued its owners for a litany of charges including negligence, unfair business practices, retaliatory eviction and financial elder abuse.

The award was just the first in a series of trials, the residents’ lawyers said in a statement. The jury also found Friendly Village Mobile Home Park to be liable for elder abuse, as well as fraud, oppression and malice. The punitive damages will be argued in court next week.

Friendly Village will be responsible for the damages, which will be split among 55 people, although over 200 residents joined the original class action lawsuit.

Attorneys for Friendly Village did not respond to a request for comment.

“The jury found, as we did, that the defendants clearly took advantage of some of the most vulnerable members of the community,” the residents’ lead trial attorney Brian Kabateck said in a statement. “These are people on a fixed income, the elderly, the disabled and folks on the brink of poverty. This company allowed the residents to live in squalor with raw sewage backing up into their homes while they raised rents and collected millions upon millions of dollars in profits. While these crooks should be ashamed of themselves for their behavior, they will surely feel nothing of the sort.”

The land that Friendly Village currently occupies at 5450 Paramount Blvd. in North Long Beach, was used as a dump during World War II and shut down those operations in 1947. In 1970, Long Beach decided to use the land for a mobile home park instead.

Along with flooding, sinkholes, rats, possums and sewage bubbling up, residents said the ground constantly shifting beneath their homes has created financial hardship for many of them.

Milly Bejarano has lived there for 12 years, and she said she’s paid out of her own pocket to level the land three times for a total of about $2,000. She said that some of the homes sink in such a way that if residents don’t continuously level the ground, some wouldn’t even be able to open their own doors.

As conditions have worsened, Friendly Village has continued to raise the rent without addressing any maintenance issues, she said. Because Bejarano is a senior on a fixed income, that means the increases are slowly cutting down on her quality of life.

“I thought I’d be retired here forever, but my lifestyle has gone down the drain,” she said. “Vacation? What is that? I’ve never taken a vacation since I’ve lived here. … I’ve got to be saving constantly to make ends meet.”

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Long Beach mobile home residents win $5.57 million in financial elder abuse case

Newfields man gets 2-4 years for exploiting elderly woman

BRENTWOOD -- The Newfields man who exploited an elderly woman by taking several credit cards in her name was sentenced to two to four years in state prison.

Thomas U. Gage, 58, of Newfields, was sentenced to begin his prison term in Rockingham Superior Court Thursday on two Class A felony counts of financial exploitation of an elder adult. He was sentenced to a fully suspended sentence of three to six years on the second charge after he pleaded guilty on both charges Sept. 9.

The sentence was suspended for five years from the date of Gage’s release from state prison, and was conditioned upon his good behavior and restitution to the victim.

An investigation conducted by the state attorney general’s office, in conjunction with the Exeter Police Department, revealed between January 2015 and January 2016, Gage, a former Exeter-based attorney used undue influence to convince the victim, a former client of his, to open several credit cards and allow him to use them to fund a real estate renovation project, according to the AG’s office.

The investigation showed Gage did not own the real estate he was supposedly renovating and instead used the credit cards to satisfy numerous personal debts and expenses without the victim’s knowledge or consent, the AG’s office said. The total amount of credit card debt incurred using the victim’s cards was more than $81,000.

Gage was disbarred in 2016 for reasons unrelated to these offenses.

The Department of Health and Human Services, Bureau of Elderly and Adult Services encourages reporting exploitation to its agency by calling (800) 949-0470.

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Newfields man gets 2-4 years for exploiting elderly woman

Public guardian alleges nursing home workers took $750,000 from dementia patient

Former employees of Symphony Residences of Lincoln Park, 2437 N. Southport Ave., shown on Sept. 6, 2018, is are accused of bilking a 97-year-old resident with dementia of $750,000. (Abel Uribe/Chicago Tribune)

Cook County acting Public Guardian Charles Golbert said Thursday that his office has discovered an additional $150,000 was taken from a 97-year-old woman with dementia by former workers at Lincoln Park nursing home.

In all, five former workers as well as a home care nurse and a hairstylist are accused of conning Grace Watanabe out of $750,000 while she stayed at Symphony Residences of Lincoln Park, according to a lawsuit brought by Golbert.

The hairstylist who worked at a salon in the facility has agreed to send back the $15,000 she received from Watanabe, according to the public guardian’s office. The hairstylist received a check from Watanabe for that amount in March, the lawsuit said. The woman previously told the Tribune that she thought the money was just a gift from her longtime client.

The lawsuit accuses the other workers — including an activities director, receptionist and businesses manager — of cashing large checks from Watanabe and making ATM withdrawals from her accounts for about a year starting in March 2017. The Chicago Police Department had also opened an investigation into the allegations.

In court Thursday, Golbert won approval from Cook County Judge Aicha Marie MacCarthy to partner with a private law firm on the case. The unique arrangement was made with Levin & Perconti, a firm that Golbert selected because of its experience litigating injury and neglect cases in Illinois nursing homes, including with Symphony.

A spokesman for Symphony — part of a network that operates 24 nursing homes in Illinois, Indiana and Wisconsin — said the company has taken steps to prevent this type of exploitation from happening again.

Grace Watanabe (Public Guardian's Office)

The accused employees no longer work at Symphony, said the spokesman, Ari Kirshner. Staff members have been retrained on the company policy that prohibits them from receiving gifts from residents, Kirshner said.

“We find the employees’ behavior abhorrent and against everything we believe in,” he said in an emailed statement. He added, “We have built our care model around integrity and compassion.”

Golbert was appointed to serve as a temporary guardian for Watanabe, who was never married and has no living relatives.

Watanabe lived at the Lincoln Park facilityfrom at least 2010 until she was recently transferred to a new residence, the lawsuit said. Born in California, Watanabe was forcibly relocated to the Poston Japanese internment camp in Arizona between 1942 and 1946, according to online records from the National Archives.

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Public guardian alleges nursing home workers took $750,000 from dementia patient

Former Exeter lawyer heads to prison, apologizes for 'reckless enterprise'

Public defender Eliana Forciniti speaks with Thomas Gage before he was escorted out of the courtroom by a sheriff’s deputy and taken to state prison after being sentenced Thursday for financially exploiting an elderly woman.

BRENTWOOD — Former Exeter lawyer Thomas Gage was sent to state prison for at least two years Thursday after financially exploiting an elderly woman who was once a family friend and client, and leaving her saddled with more than $81,000 in credit card bills.

Gage, 58, of Newfields, was sentenced to 2 to 4 years in prison and must pay restitution after pleading guilty in September to two counts of financial exploitation.

During his sentencing hearing in Rockingham County Superior Court, Gage apologized for the pain he’s caused the victim, saying he never set out to hurt her financially.

“It became a reckless enterprise which caused reprehensible harm,” he said, adding, “All I can say at this point is that I’m devastated.”

Gage was charged after taking out five credit cards in the victim’s name and racking up more than $80,000 between January 2015 and January 2016.

Gage, who formerly practiced in Exeter, was disbarred in 2016 for mismanaging other clients’ money.

According to Attorney Brandon H. Garod, Gage told the victim that he was renovating a family home that he inherited from his parents and wanted to turn it into an apartment building, but couldn’t get his own financing. He convinced the victim to allow him to take out five credit cards in her name, claiming she would not be responsible for the debt because he planned to set up a limited liability company, which would inherit any of the debt and not affect her credit. As part of the plan, Garod said Gage told her that eventually she could earn income from the rental.

Garod said Gage never set up the LLC and didn’t actually own the property, which faced foreclosure. After taking out the credit cards, Garod said he maxed them out and used the money to pay off his own debt and his businesses, Gage Law Offices and Quality Title Company.

Garod argued that Gage was manipulative and was able to get the victim to agree to the scheme by a “lifetime of building trust” between him and the victim through their family connections and handling any legal matters as her attorney.

“The trust made this possible,” said Garod, who works in the Consumer Protection and Anti-Trust Bureau’s Elder Abuse.

The victim also spoke about the impact on her her finances and her health and how she’s had to deal with credit card companies looking for repayment.

“He kept making promises that didn’t follow through,” she said.

Eliana Forciniti, Gage’s public defender, disagreed with how the prosecution had portrayed him as a “sophisticated con artist.”

She described him as a man with low self-esteem who has been depressed and felt that throughout his life he was never able to live up to the expectations of others.

Forciniti claimed that Gage was in denial about the state of his own finances and truly thought that he could save the old family home and remodel it.

But she said he has taken responsibility for what he did and agreed that he should be punished, arguing that a 1 to 3 year prison sentence was appropriate.

“His actions were certainly careless and reckless. He was lying to himself,” she said.

Judge Amy Messer said the court would accept the fact that he’s had challenges in his life, but she was “troubled” by the fact that he took the victim’s money while under audit for mismanaging other clients’ money, which led to him being disbarred in 2016.

Messer said Gage had an opportunity to reflect on how he handled the finances of others, but “despite that you continued on a path where you seriously impacted someone else’s life. You took advantage of another person. You violated her trust. You frankly changed the trajectory of her life.”

In addition to the 2- to 4-year sentence, Messer also handed down a 3- to 6-year suspended sentence and ordered that he pay $81,274 in restitution to the victim.

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Former Exeter lawyer heads to prison, apologizes for 'reckless enterprise'

Joint judiciary drops guardianship termination bill

Courtesy photo — Metro Creative | A legislative bill that more explicitly outlined factors for judges to consider in guardianship cases did not earn a majority vote in the Wyoming Legislature’s Joint Judiciary Committee Thursday.

SHERIDAN — More specific guidelines of guardianship terminations and orders were sought in a drafted bill by the Wyoming Legislature’s Joint Judiciary Committee Thursday, but the bill did not carry a majority and will not be sponsored by the committee in the upcoming legislative session starting Jan. 8.

All three Sheridan County representatives on the committee — Sen. Dave Kinskey, R-Sheridan, Rep. Bo Biteman, R-Ranchester, and Rep. Mark Jennings, R-Sheridan — voted against the bill moving forward.

The bill would have helped guide hearings for terminations of guardianship for children. Guardianship is when a child has been removed by the court system from their birth parents and placed into legal guardianship with another family member or outside entity like foster care. Parents may file a petition to terminate that guardianship and receive their children back into their home.

Upon filing the petition for termination, courts consider the best interests of the child. The bill establishes factors courts would have to consider including: competency and fitness of the parent; physical and mental ability of the parent and guardian to care for the child; any parental absence leading to the guardianship; the amount of involvement the parent had with the child during the guardianship; length of time the child has resided with the guardian and the extent to which a substantial relationship has been established between the child and the guardian; and a number of other factors.

The executive director of Compass Center for Families, Susan Carr, said while she has no comment on the bill due to not following it and not wanting to speak while being ill-informed, she does not think it’s an overreach of the courts to consider various things before allowing a guardianship to be reversed.

“In some cases, those parents really need to show that they are capable of parenting their children in a safe and meaningful manner,” Carr said in an email to The Sheridan Press. “As always, I get concerned about those unintended consequences of any bill because we can’t possibly predict every scenario that comes before the court.”

Carr said there will be some who use the considerations against perfectly capable parents in order to control outcomes, and she doesn’t know what the right direction for the courts would be.

After hearing public comment and explanation from judges, Kinskey said the bill reached too far.
He said in Sheridan when the bill was in its infancy, it was meant to give judges clarity in the law when reviewing the petitions to terminate guardianship for children.

“This bill goes way beyond that, I think, and I don’t know how to fix it to get it to that,” Kinskey said. “Probably we should have started with asking the judges to give us an outline with what they thought would really help, but I think this bill goes too far from the real issue that’s being presented to us as I understand it.”

Cassie Craven, a Cheyenne attorney and member of the Wyoming Liberty Group, said she supported a tiered return schedule after finding that a parent is fit to have the children back and due process in the court is afforded.

“As far as these presumptions and the burden of proof, it goes too far,” Craven said about the list of proving parental ability to terminate guardianship.

A large concern of the committee was the rights of the parent, but public comment also brought up the rights of the children.

The issue of whose rights are more important, the parent’s or the child’s, was left unanswered during the session.

Carr said she is always in favor of children’s rights and believe their best interest should always come first in court.

“But our laws and our Constitution is not written that way,” Carr said. “We must depend on the good judgment of judges to ensure that the child’s interest is being served as well as the parent’s constitutional right to parent. It’s really not a black-and-white issue and no one-size-fits-all solution exists.”

The bill will not go forward with support from the committee but can be brought up individually by a member of the Legislature if one so chooses in January.

The Joint Judiciary Committee met Thursday afternoon and throughout the day Friday to discuss other bills being considered for sponsorship from the committee.

The video recordings, agendas and potential legislation can be found on the Wyoming Legislature’s website.

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Joint judiciary drops guardianship termination bill

Man with Alzheimer’s sent on one-way flight to Denver among scores of patients stranded in hospitals

A 9Wants to Know investigation found on any given day, dozens of people suffering from Alzheimer's and other mental disabilities are stranded in Denver-area hospitals because they have nobody to take care of them. 9NEWS surveyed hospitals on a single day in September and found 113 people were stranded in metro area hospitals even though they no longer need acute medical care.

DENVER — Within the bustle and organized chaos of Denver's massive airport, an 80-year-old man with Alzheimer's disease named Jerry Ellingsen was found wandering alone after traveling with his small dog from Fort Myers, Florida.

Jerry didn’t know where he was or why he was in Denver.

Police tried contacting his daughter and wife, neither of whom would pick him up, so officers were forced to call an ambulance that took him to a nearby hospital.

A three-month long 9Wants to Know investigation is uncovering a growing health care epidemic where hundreds of people like Jerry are abandoned every year at metro-area hospitals. The epidemic is costing hospitals and in some cases, taxpayers, millions of dollars a year.

"I think the thoughtfulness is that this isn’t somebody else's problem. It’s all of our problems. And as we age we need to better prepare, and we need to make sure our parents are prepared to address this possible challenge,” said Doug Muir, who oversees behavior health at Porter Adventist Hospital.

“At the end of the day, this is our loved ones that we are talking about,” Muir said. “So, as a society and community, we need to demand better outcomes.”

Done with her father

A United Airlines supervisor called police after finding Jerry confused and alone with only a small dog near an exit door outside the ticket counter. A police report indicates a United flight attendant described Jerry as possibly having Alzheimer’s, so they looked up the woman who checked him into his flight and ended up talking to his daughter.

His daughter, Pamela Roth of Fort Myers, told the United employee she was “done with her father” and did not want to be contacted again, the police report said.

“He was very confused about general details of his life to include where he was at, where he was coming from, who he was coming to visit and his family members’ names,” one Denver police officer noted in a report after he spoke with Jerry.

9Wants to Know obtained police reports from Denver police and the Lee County Sheriff's Office in Florida that paint a picture of how law enforcement officers struggled with how to help Jerry.

Police pieced together a family dynamic that resulted in Jerry’s abandonment and eventual six-month-long stay in a local hospital.

“Drop my dad at a homeless shelter”

Hours before Jerry's arrival in Denver, his daughter - who had power of attorney at the time - put him on that one-way flight from Fort Myers. She intended for her father to live with his wife, Jackie Ellingsen of Highlands Ranch.

Police records show Pamela didn’t give much warning to Jackie that Jerry was coming to Colorado.
Twenty four hours before the flight, police records show Pamela texted Jerry’s wife in part, “my dad and Corky [the dog] will arrive on a flight in Denver tomorrow afternoon.”

Police tracked down his estranged wife over the phone. She still refused to pick up her husband.

“I have no use for him. I mean a man that wants to kill me, come on. I don’t want to live with him,” Jackie said to a Denver police detective during a recorded phone call.

She shared with police another text message she received from Pamela that said in part, “If you need to drop my dad at a homeless shelter, it’s fine. I just want him to have a roof over his head. Please.”

According to the police report, Jackie agreed to take care of Jerry’s dog, Corky, but would not agree to take her husband home.

Police had Jerry taken to University of Colorado Hospital. It was their only option.

Jerry Ellingsen among 113 at-risk adults stranded in September

Jerry’s story sparked 9Wants to Know’s investigation into at-risk adults who end up languishing in hospitals because they have no family to take care of them or a facility willing to take them in due to a lack of space, finances, or appropriate scope of care.

Laws require hospitals to keep admitted at-risk adults who’ve been abandoned until caseworkers can find safe placement for them, which can lead to extended stays for months and even years.

9Wants to Know conducted a point-in-time survey with the help of the Colorado Hospital Association because hospitals do not keep track of stays by people like Jerry.

Nineteen metro area hospitals participated in the survey, which revealed on a single day in September 113 at-risk adults were stuck in the system, beyond medical necessity.

Of those patients, about 30 percent had conditions like Alzheimer's and dementia. Most of the stranded people were men over 40 years old.

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The longest stay among them was 577 days.

“I think 113 is pretty significant. I mean these are individuals who don’t have to be in a hospital setting,” said Amber Burkhart of the Colorado Hospital Association. “This is a system-wide failure and we can’t fault any one individual for the failure of our system as a whole.”

Where do patients come from?

Those who end up stranded in hospitals come from many different places, including from homes where family caregivers have burned out or money has run out. According to the 9Wants to Know survey, of the 113 people stranded at area hospitals, 30 were abandoned by family members.
Some of the stranded are homeless and come from the streets.

Thirty-one people were sent to the hospital by nursing facilities, according to the survey. Hospital caseworkers told 9NEWS nursing homes sometimes send patients to emergency rooms when they say the individuals need care they cannot provide.

Some hospitals, like Lutheran Hospital, have full-time caseworkers who spend their day trying to connect stranded patients to family members willing to take them in. Caseworkers also try to get patients on Medicaid or into facilities that have bed space.

“I think about the abandoned ones and it’s really hard,” said Stephanie Luck, a Lutheran Hospital caseworker. “I don’t want to ever feel abandoned in my life. I hope that every day when I leave work, that I did the best for that patient.”

Who Pays?

Hospitals end up bearing the costs, which in Colorado, can be to $2,500 per day, per patient. The financial burden is then passed to consumers and taxpayers if the hospital is government-owned and operated.

At Denver Health, there is a special wing called the Oasis Unit that houses around 30 at-risk adults on any given day. Denver Health reports it expected to spend $18 million on the Oasis Unit in 2018.

“It is heartbreaking and I think the ones that are the most heartbreaking are the ones who don’t know who they are or where they came from,” said Natalee Mejia, a nurse in the Oasis Unit.

The longest stay she recalls in the unit was two years. Anecdotally, Denver Health officials cited a case that resulted in a stay of eight years in the Oasis Unit.

No charges in Jerry’s case, whereabouts unknown

In the case of Jerry, Denver police handed evidence over to the Lee County Sheriff’s Office in Florida for a potential elderly abuse case against his daughter Pamela.

Prosecutors in Florida declined to file charges in the case against Pamela, describing the case as “legally insufficient.”

Jerry is no longer at the University of Colorado Hospital. Privacy laws prohibit hospital officials from releasing information about where Jerry went.

Jerry’s sister, who lives in Michigan, told 9Wants to Know she believes Jerry is under the care of a private company in Colorado, but she doesn’t know exactly where her brother has been taken.

Jerry’s niece expressed dismay at what has happened.

“I cannot believe they did that. I’m horrified. I’m disappointed that somebody can even be that low to do that to their father,” Kari McConnell said.

9NEWS reached out to Jerry's wife, Jackie Ellingsen, and talked to her multiple times. She declined to comment on the record.

9Wants to Know also visited Pamela in Florida, hoping to better understand what led to her putting her father on that flight alone. She never responded to such requests, even after a visit to her home and work.

9Wants to Know did confirm Pamela currently works for a company that specializes in senior home care.

The irony of the situation isn’t lost on Jerry’s sister-in-law, Judy Ellingsen.

“Under the circumstance and what’s her line of work with the elderly, she should be punished,” Judy said. “I’m sorry. Nobody does that to anybody.”



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Man with Alzheimer’s sent on one-way flight to Denver among scores of patients stranded in hospitals

Indictment: Ex-judge stole cash from client

YOUNGSTOWN — Former Mahoning County Judge Diane Vettori-Caraballo of Youngstown was accused in an indictment Thursday of stealing between $100,200 and $328,000 in cash that was in the home of a client when the client died in March 2016.

A Mahoning County grand jury handed up indictments against Vettori-Caraballo on charges of mail fraud, structuring cash deposits and making false statements to law enforcement. Vettori-Caraballo, 50, and her husband, Ismael Caraballo, 60, were also charged with one count of filing a false tax return.

In her private practice, Vettori-Caraballo provided estate planning services to Robert Sampson, including drafting his will, according to the indictment. On Nov. 20, 2015, Vettori-Caraballo filed an application in Mahoning County Probate Court to administer Sampson’s estate. The application stated Sampson died without a will.

The probate court, unaware of Sampson’s will, appointed his sister, Dolores Falgiani, as the administrator three days later, according to the indictment.

Vettori-Caraballo had also prepared Falgiani’s will, according to the indictment. The will made 16 bequests to relatives and friends and bequeathed the rest of the estate to Animal Charity Human Society of Boardman and the Angels for Animal Charity in Canfield, according to the indictment.

Sometime in October or November 2015, Falgiani told Vettori-Caraballo that she had several shoeboxes of cash stored at her residence, the indictment states.

Falgiani was found dead in her home on March 10, 2016, according to the indictment. Vettori-Caraballo filed an application two weeks later in Mahoning County Probate Court to probate Falgiani’s estate.

On May 2, she reported having found $20,000 in cash in the residence and depositing it into the estate, according to the indictment. She filed a notice of newly discovered assets with the court on several subsequent occasions in 2016 and 2017.

However, the amounts were not what she actually found, according to the indictment. Investigators said she made 22 deposits in her name into five banks within four weeks to avoid regulations that require banks to report cash transactions over $10,000 to the IRS, the indictment states.

The information charges that Vettori-Caraballo lied to the FBI when she was confronted about the theft and the structuring of cash deposits.

Vettori-Caraballo was elected to position of judge in Mahoning County Court 3, Sebring Court, in 2002, with jurisdiction over misdemeanor criminal and traffic charges and other matters in Sebring and Beloit Villages and Berlin, Green, Goshen, Ellsworth, Smith and Washingtonville Townships. She was re-elected in 2006 and 2012, according to the indictment.

This case was investigated by the Federal Bureau of Investigation and the Internal Revenue Service-Criminal Investigations. It is being prosecuted by Assistant U.S. Attorneys Brian M. McDonough and Alex Abreu.

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Indictment: Ex-judge stole cash from client

Elder care worker arrested for exploiting 90-year-old tenants

BUFFALO, N.Y. (WKBW) - An elder care worker in the city of Buffalo has been indicted on financial exploitation charges.

47-year-old Rhonda Henderson went before a judge Friday to be arraigned on the seven count indictment.

Henderson is accused of abusing her position as Senior Service Coordinator at St. John Tower, to financially exploit three tenants. The victims were all over the ago of 90.

The alleged crimes happened between November of 2014 and August of 2017. Prosecutors say during that time, Henderson used multiple methods to steal from the three victims, including check diversion, unauthorized use of two of the victims' debit cards and the misappropriation of one of the victim's Funeral trust accounts after she passed away.

If Henderson is convicted, she faces up to seven years in prison.

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Elder care worker arrested for exploiting 90-year-old tenants

Sepsis Infections Take Fatal Toll on Seniors

Shana Dorsey first caught sight of the purplish wound on her father's lower back as he lay in a suburban Chicago hospital bed a few weeks before his death.

Her father, Willie Jackson, had grimaced as nursing aides turned his frail body, exposing the deep skin ulcer, also known as a pressure sore or bedsore.

"That was truly the first time I saw how much pain my dad was in," Dorsey said.

The staff at Lakeview Rehabilitation and Nursing Center, she said, never told her the seriousness of the pressure sore, which led to sepsis, a severe infection that can quickly turn deadly if not cared for properly. While a resident of Lakeview and another area nursing home, Jackson required several trips to hospitals for intravenous antibiotics and other sepsis care, including painful surgeries to cut away dead skin around the wound, court records show.

Dorsey is suing the nursing center for negligence and wrongful death in caring for her dad, who died at age 85 in March 2014. Citing medical privacy laws, Lakeview administrator Nichole Lockett declined to comment on Jackson's care. In a court filing, the nursing home denied wrongdoing.

The case, pending in Cook County Circuit Court, is one of thousands across the country that allege enfeebled nursing home patients endured stressful, sometimes painful, hospital treatments for sepsis that many of the lawsuits claim never should have happened.

Year after year, nursing homes around the country have failed to prevent bedsores and other infections that can lead to sepsis, an investigation by Kaiser Health News and the Chicago Tribune has found.

No one tracks sepsis cases closely enough to know how many times these infections turn fatal.

However, a federal report has found that care related to sepsis was the most common reason given for transfers of nursing home residents to hospitals and noted that such cases ended in death "much more often" than hospitalizations for other conditions.

A special analysis conducted for KHN by Definitive Healthcare, a private health care data firm, also suggests that the toll — human and financial — from such cases is huge.

Examining data related to nursing home residents who were transferred to hospitals and later died, the firm found that 25,000 a year suffered from sepsis, among other conditions. Their treatment costs Medicare more than $2 billion annually, according to Medicare billings from 2012 through 2016 analyzed by Definitive Healthcare.

In Illinois, about 6,000 nursing home residents a year who were hospitalized had sepsis, and 1 in 5 didn't survive, according to Definitive's analysis.

"This is an enormous public health problem for the United States," said Dr. Steven Simpson, a professor of medicine at the University of Kansas and a sepsis expert. "People don't go to a nursing home so they can get sepsis and die. That is what is happening a lot."

The costs of all that treatment are enormous. Court records show that Willie Jackson's hospital stays toward the end of his life cost Medicare more than $414,000. Medicare pays Illinois hospitals more than $100 million a year for treatment of nursing home residents for sepsis, mostly from Chicago-area facilities, according to the Medicare claims analysis.

Sepsis is a bloodstream infection that can develop in bedridden patients with pneumonia, urinary tract infections and other conditions, such as pressure sores. Mindful of the dangers, patient safety groups consider late-stage pressure sores to be a "never" event because they largely can be prevented by turning immobile people every two hours and by taking other precautions. Federal regulations also require nursing homes to adopt strict infection-control standards to minimize harm.

Yet the failures that can produce sepsis persist and are widespread in America's nursing homes, according to data on state inspections kept by the federal Centers for Medicare & Medicaid Services. Many of the lawsuits allege that bedsores and other common infections have caused serious harm or death. The outcome of these cases is not clear, because most are settled and the terms kept confidential.

Cook County, where the private legal community is known to take an aggressive approach to nursing homes, has more of these suits than any other metro area in the U.S., KHN and the Tribune found by reviewing court data.

State inspectors also cite thousands of homes nationally for shortcomings that have the potential to cause harm. Inspections data kept by CMS show that since 2015 94 percent of homes operating in Illinois have had at least one citation for conditions that increase the risk of infection. These citations include care related to bedsores, catheters, feeding tubes and the home's overall infection-control program.

"Little infections turn to big infections and kill people in nursing homes," said William Dean, a Miami lawyer with more than two decades of experience suing nursing homes on behalf of patients and their families.

Much of the blame, regulators and patient advocates say, lies in poor staffing levels. Too few nurses or medical aides raises the risks of a range of safety problems, from falls to bedsores and infections that may progress to sepsis or an even more serious condition, septic shock, which causes blood pressure to plummet and organs to shut down.

Staffing levels for nurses and aides in Illinois nursing homes are among the lowest in the country. In the six-county Chicago area, 78 percent of the facilities' staffing levels fall below the national average, according to government data analyzed by KHN.

Matt Hartman, executive director of the Illinois Health Care Association, which represents more than 500 nursing homes, acknowledged low staffing is a problem that diminishes the quality of nursing care.

Hartman blamed the state's Medicaid payment rates for nursing homes — about $151 a day per patient on average — which he said is lower than most other states. Medicaid makes up about 70 percent of the revenue at many homes, he said.

Last October, CC Care LLC, an Illinois nursing home group that specializes in treating mentally ill patients on Medicaid, filed for bankruptcy, arguing that the state's "financial troubles have been disastrous for all nursing homes."

In a July court filing, CC Care creditors' committee argued that the company couldn't stay afloat relying on Illinois Medicaid payments, which it called "slow, erratic and significantly less than what we are due."

Pat Comstock, executive director of the Health Care Council of Illinois, said nursing homes she represents "are operating in an increasingly difficult environment in Illinois, yet they continue to prioritize delivering the best care possible to residents in a safe and secure setting."

A Festering Complaint

Shana Dorsey remembers her father as a quiet but friendly man. He worked as a uniformed bank security guard and picked up extra cash fixing neighbors' cars in an empty lot adjacent to his West Side apartment building. He was a stickler for detail, who relished teaching his granddaughter the state capitals and was always ready to lend a hand to help his daughter, who now works for a Chicago property management firm.

But age and declining health caught up with the Army veteran, who by his early 80s began to exhibit signs of dementia and moved into an assisted living apartment.

Dorsey knew her dad needed more specialized care when she found him sitting in his favorite peach recliner in his apartment, unable to get up and incontinent.

He required more intense medical and personal care as his kidney disease worsened and he became more confused, medical records show. In his last 18 months of life, he cycled in and out of hospitals eight times for treatment of septic bedsores and other infections, according to court records.

The Chicago law firm representing Dorsey, Levin & Perconti, provided KHN and the Tribune with medical records and additional court filings that cover Jackson's care.

Jackson had two pressure sores in late November 2012 when he was first admitted to Lakeview nursing center from the Jesse Brown VA Medical Center in Chicago, according to lawyers for his daughter.

These wounds healed, but in late September 2013, Jackson spiked a fever and had an infected sore in his lower back that exposed the bone, causing what Dorsey's lawyers called "significant pain."

The nursing home transferred Jackson to Presence St. Joseph Hospital in Chicago, where surgeons cut away the dead skin and administered antibiotics. At that time, the sore was as wide as a grapefruit and had "copious purulent drainage, foul smell and bleeding," Dorsey's lawyers argue. Tests confirmed sepsis, and the wound had grown so deep that it infected the sacral bone in his back, a condition known as osteomyelitis, the lawsuit said.

In November 2013, Dorsey moved her father to another nursing home. He required three more hospital visits before Dorsey made the difficult decision to place Jackson in hospice care. He died March 14, 2014, from "failure to thrive," according to a death certificate.

In her suit, Dorsey, 39, argues that Lakeview nursing staff knew Jackson was at "high risk" for bedsores because of his declining health. Yet the home failed to take steps to prevent the injuries, such as turning and repositioning him every two hours, according to the suit. That didn't happen about 140 times in August 2013 alone, Dorsey's lawyers said.

"My father was like my best friend. Most people go to their mom to talk and tell all their secrets, and for me it was my dad," Dorsey said in a November 2015 deposition.

While Lakeview declined to discuss Jackson's treatment, it has denied negligence and argued in court filings that its actions were not to blame for Jackson's death. Lockett, the home's administrator, said the facility "strictly follows" all regulations to minimize the effects of skin breakdowns that can occur naturally with age.

"We are grateful for the daily opportunity to enhance the lives of seniors and other chronically ill populations in our community," Lockett said in a statement.

Infection Control

Poor infection control ranks among the most common citations in nursing homes. Since 2015, inspectors have cited 72 percent of homes nationally for not having or following an infection-control program. In Illinois, that figure stands at 88 percent of homes.

Illinois falls below national norms for risks of pressure sores or failure to treat them properly in nursing homes. Inspectors have cited 37 percent of the nation's nursing homes for this deficiency, compared with 60 percent in Illinois, according to CMS records. Only three states were cited more frequently.

Inspectors in November 2016 cited Alden Town Manor Rehabilitation and Health Care Center in Cicero, Ill., for neglect due to its care of an unnamed 83-year-old man with pressure ulcer sores that went untreated. Gangrene had set in by the time the staff sent him to the hospital, where surgeons ended up amputating his right leg above the knee, according to the inspectors' report and citation. Alden Town Manor had no comment.

Dean, the Miami lawyer, said that nursing home staffs often miss early signs of infection, which can start with fever and elevated heart rate, altered mental status or not eating. When those symptoms occur, nurses should call a doctor and arrange to transfer the patient to a hospital, but that process often takes too long, he said.

"They don't become septic on the ambulance ride over to the hospital," Dean said.

There is little agreement over how much staff should be required in nursing homes. Federal regulations simply mandate that a registered nurse must be on duty eight hours per day, every day. In 2001, a federal government study recommended a daily minimum of 4.1 hours of total nursing time per resident, which includes registered nurses, licensed practical nurses and certified nursing assistants, often referred to as aides. That never became an industry standard or federal regulation, however.

Most states set requirements lower and face industry resistance to raising the bar. A California law requiring 3.5 hours per resident as of this July 1 is drawing intense criticism from the industry, for instance.

In addition, staffing can fluctuate, particularly over the weekends. A recent KHN investigation found that on some days, nursing home aides could be in charge of twice as many residents as normal.

At a minimum, Illinois requires 2.5 hours of direct care daily for residents. Yet federal nursing home payroll data show that at least 1 in 4 Chicago-area nursing home residents live in facilities that aren't consistently providing that much care, KHN found.

Nationally, each aide is responsible for 10 residents on average; in the six-county Chicago area, the average is 13 residents per aide.

Federal officials have linked inadequate staffing to bedsores and other injuries, such as falls. If left unattended, even a small ulcer or sore can become septic, and once that happens, a patient's life is in imminent danger.

In October 2014, Milwaukee-based Extendicare denied wrongdoing but paid $38 million to settle a federal False Claims Act lawsuit that accused it of not having enough staff on hand in 33 nursing homes in eight states, including Indiana, and failing to take steps to prevent bedsores or falls.

In other cases, federal officials have alleged that some nursing homes overmedicate residents — which can result in injuries such as falls from beds or wheelchairs and bedsores — rather than staff up to care for them properly.

In May 2015, owners of two nursing homes in Watsonville, California, agreed to pay $3.8 million to settle a whistleblower lawsuit alleging the homes persistently drugged patients, contributing to infections and pressure sores.

The suit alleged that an 86-year-old man who could barely move after receiving a shot of an anti-psychotic medication lost his appetite and spent most of the day in bed, "was not turned or repositioned and developed additional pressure ulcers." He ran a 102-degree fever, but the staff failed to notify his doctor for three days, according to the suit.

Hospital doctors later diagnosed the man with sepsis and an infected pressure ulcer. The home did not admit wrongdoing and had no comment.

Personal injury lawyers and medical experts say that poor infection control often sends nursing home residents to hospitals for emergency treatment — and that the stress can hasten death.

Elderly people often "don't have the ability to bounce back from an infection," said Dr. Karin Molander, a California emergency room physician and board member of the Sepsis Alliance advocacy group.

That odyssey of multiple, stressful trips to the hospital is a common thread in negligence and wrongful death lawsuits involving sepsis or bedsores. KHN identified more than 8,000 suits filed nationwide from January 2010 to March of this year that allege injuries from failing to prevent or treat pressure sores and other serious infections.

Molander said serious bedsores indicate "someone is being ignored for an extended time period."

"When we see patients like that we file [patient neglect] complaints with adult protective services," she said.

Some of these cases led to million-dollar jury verdicts. In 2017, a Kentucky jury awarded $1.1 million to the family of a woman who suffered from bedsores and sepsis in a nursing home. In a second case last year, a jury awarded $1.8 million to a widow who alleged a Utah nursing home failed to turn her husband often enough to prevent bedsores, which led to his death.

Lawyers filed more than 1,400 of the cases from January 2010 to March of this year in Cook County Circuit Court, which tops all metro areas across the country in the KHN sample.

Nursing homes complain that garish billboards to solicit clients are a fixture in Chicago, where many attorney websites also boast of recent million-dollar verdicts from bedsore cases alone.

"We see an incredible amount of lawsuits out there," said Hartman, of the Illinois nursing home association. "We feel we have a target on our backs."

Trial lawyers counter that nursing homes often try to duck responsibility for poor care by creating complex corporate structures to limit their liability. Yet Hartman derided these suits as "cash cows" for law firms that can rack up six-figure legal fees as cases drag on. The nursing home industry supports tort reforms that would compensate injured persons but also bring a quicker resolution of claims, he said.

"That is something that needs to be fixed in Illinois," Hartman said.

Avoidable Hospital Transfers

In September 2013, the Centers for Medicare & Medicaid Services said it was working to reduce avoidable transfers from nursing homes to hospitals. CMS had previously called these trips "expensive, disruptive and disorienting for frail elders and people with disabilities."

The plans came in the wake of a critical 2013 Department of Health and Human Services audit that found Medicare had paid about $14 billion in 2011 for these transfers. Care related to sepsis cost Medicare more than the next three costliest conditions combined, according to the audit.

The auditors have not checked in to see if Medicare has since reduced those costs and have no plans to do so, a spokesman for the HHS Office of Inspector General said.

However, Definitive Healthcare's analysis of billing data, modeled after the HHS audit, shows little change between 2012 and 2016, both in terms of deaths and costs.

Wendy Meltzer, executive director of Illinois Citizens for Better Care, said that hospital trips caused by treatment for sepsis can be "emotionally devastating" for confused elderly patients.

"It's not a choice anybody makes. It's horrible for people with dementia," Meltzer said. "Some never recover from that. It's a very real phenomenon and it's cruel."

University of Maryland master's student Chris Cioffi contributed to this report.

This story was jointly produced by Kaiser Health News and the Chicago Tribune by reporters based in Washington, D.C., and Chicago. Fred Schulte is a senior correspondent for KHN and Elizabeth Lucas is data editor. Joe Mahr is a Tribune reporter.

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Sepsis Infections Take Fatal Toll on Seniors