Saturday, June 29, 2019

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Court-appointed assistance for homeless should be expanded, City Councilmen say

Los Angeles officials could soon take a proverbial machete to the red tape preventing many Angelenos from being protected under conservatorship laws.

City Councilman Jose Huizar and David Ryu, whose council districts are among the most affected by homelessness, proposed Wednesday expanding conservator appointments for people incapable of caring for themselves due to severe mental illness or substance abuse issues.

According to Huizar, conservatorships could prevent Angelenos suffering from mental illness from falling into homelessness and help those fighting substance abuse find help.

“It’s no secret that a third of those experiencing homelessness in the City and County deal with mental-health and substance-abuse issues,” Huizar said, citing the most recent homeless count by the Los Angeles Homeless Services Authority. “The current, vicious, revolving-door system where the same people are shuttled in and out of our jails and hospitals, again and again, 72-hours at a time, is a failed system.”

The details of the proposal would have Los Angeles lobbyists in Sacramento push for an audit of the 1967 Lanterman-Petris-Short Act, which regulates California’s laws on involuntary commitment of the mentally ill. An audit would find areas of the law in need of clarification, or update.

Those suffering from drug addiction, repeated commitments, or exceptionally frequent use of emergency medical services could also be appointed a public conservator by courts. Those who have been involuntarily detained for psychiatric hospitalization at least eight times in a year under section 5150 of California’s welfare and institutions code would be most likely to enter conservatorship.

Currently, only mentally ill people who pose a danger to themselves or others or are “gravely disabled” can be held for involuntary evaluation and treatment in a psychiatric setting. Ryu and Huizar have argued the definition of “gravely disabled” is unclear.

“I have worked in community mental health care for years, and when we deny proper conservatorship, we are denying proper care. We need more mental health resources and facilities in Los Angeles, but we also need to reform conservatorship law so that we can provide care to those who need it most,” Ryu said.

Full Article & Source:
Court-appointed assistance for homeless should be expanded, City Councilmen say

Friday, June 28, 2019

Tonight on Marti Oakley's TS Radio Network with Co-host Coz Whitten Skaife: Elder Exploitation and Estate Theft by Professional Predators









Join us this evening as we cover incoming news from all over the place! We will be talking about the Aussie's forcing out a 3rd public trustee who has been on the take for years over there, as a result of being outed for his corruption on our show!

Also, Joe Gale, a non-party affiliated political candidate in Pennsylvania, recently attended a workshop called, "Working to protect our senior citizens from harm and scams at the 2019 Montgomery County Elder Access to Justice Round Table". What can we do to help him understand the real issues at hand? Coz, and several others have reached out to him offering research, documents and other material on the probate scam running, not just in Pennsylvania, but across the country and globe.

We will also be talking about several large cases in Wisconsin as the guardian for-profit scam gains exposure there. People are coming from all over the country, even Alaska, to report on the targeting of the elderly and the theft of estates sanctioned by state and federal governments who provide protection for the predators.

LISTEN to the show live or LISTEN to the archive later

The Coalition For Change, Inc. (C4C)

“The EEOC’s Office of Federal Operations’ failure to apply fairly Federal EEO complaint guidelines undermines the Notification and Federal Employees Anti-Discrimination and Retaliation Act and spurs a health crisis within the Federal workforce.”
Advocacy groups and Whistleblowers will gather at the upcoming 2019 Annual Whistleblower Summit and Film Festival. The gathering, which will take place in Washington, DC during July 29th-August 1st, 2019, provides a meaningful “mutual support network” for whistleblowers and advocates across the country.

The theme of this year’s Summit is True North—Persevering in the Pursuit of Justice. It will feature a variety of events, film screenings, and panel discussions to empower “truth-tellers” who create a better world for all people to thrive.

The Coalition For Change, Inc. (C4C), a 2019 Summit committee member, will host a panel to address the U.S. Equal Employment Opportunity Commission’s (EEOC) flaws. “The EEOC’s Office of Federal Operations’ failure to apply “fairly” the Federal Equal Employment Opportunity (EEO) complaint guidelines undermines the Notification and Federal Employees Anti-Discrimination and Retaliation Act (No FEAR Act). It also spurs a health crisis within the Federal workforce,” said Tanya Ward Jordan, President of the Coalition For Change, Inc.(C4C) and Author of 17 Steps: A Federal Employee’s Guide For Tackling Workplace Discrimination.

The USDA Coalition of Minority Employees will host a separate panel to address the U.S. Department of Agriculture’s (USDA) harmful workplace culture. “Wrongful firings, reprisal, and intimidation are out of control at USDA. It has been this way administration after administration, The EEOC fails to hold government agencies within Agriculture accountable for unlawful acts against minority farmers, especially Black farmers, and USDA employees.” said Mr. Lawrence Lucas, President Emeritus of the USDA Coalition of Minority Employees.

In addition to panels hosted by the C4C and the USDA Coalition, the Government Accountability Project will host a panel on the role of the Office of Special Counsel. The 2019 Summit event organizers, Michael McCray, Esq., and Marcel Reid, have arranged for an assembly of whistleblowers to cover additional panels covering topics such as: Guardianship, Surviving Whistleblowing, Working with Congress, Is Your Story a Book?, Working With Media, and Blackballing Minority Financial Institutions. Whistleblowers, advocates and members of the civil and human rights community are invited to participate in the free conference. For more information visit https://www.whistleblowersummit.com/

******
The Coalition For Change, Inc.(C4C) is a member of the Make It Safe Coalition. The C4C, a proactive non-profit civil rights organization and support network, incorporated in Washington, D.C., on January 22, 2009. Members devote their time, talent and resources addressing racial injustice and reprisal in Federal employment. The C4C is comprised of former and present Federal employees who have been harmed due to racial discrimination and/or reprisal.

Full Article & Source:
The Coalition For Change, Inc. (C4C)

Cook County Public Guardian Wants To Know Why Kim Foxx Has Not Brought Charges In Case Of Swindled Nursing Home Resident

by Dana Kozlov
CHICAGO (CBS) — Cook County’s public guardian says a 98-year-old woman was preyed upon by nursing home employees paid to take care of her.

He’s still fighting to get her life savings back, but almost a year later, many involved in her case also wonder why no criminal charges have been filed.

A civil case will return to court Wednesday, and attorneys say the evidence she was bilked of almost $1 million is strong.

But they say there’s been nothing from Cook County State’s Attorney Kim Foxx when it comes to criminal charges, and they’re frustrated.

“She needs to get her money back, and she needs to know that the perpetrators have been charged criminally,” said Cook County Public Guardian Charles Golbert.

Golbert is in the midst of a 10-month battle on behalf of 98-year-old Grace Watanabe. He’s been fighting to get her $700,000 back from now ex-employees of Lincoln Park’s Symphony Residences and the facility itself since filing the civil lawsuit in September.

“This was a financial theft of large proportions,” says private attorney Steve Levin.

Levin has joined that fight. The lawsuit alleges six former Symphony employees forged checks and used other means to swindle Watanabe, who has dementia, out of her life savings.

Both Golbert and Levin say every person they’ve deposed has taken the Fifth Amendment, including Symphony Residences’ current executive director.

“Who’s investigating what happened if the executive director is taking the Fifth Amendment? Who’s investigating the facility’s point of view?” asked Levin.

Then there’s the criminal case. Golbert says he gave all of his evidence to a Chicago police financial crimes detective months ago.

“And he’s completed his investigation and waiting for the OK from the state’s attorney … to charge,” said Golbert.

Golbert even wrote Cook County State’s Attorney Kim Foxx a detailed letter about Watanabe’s case on May 17.

All he’s gotten is silence from Foxx’s office.

“I’m very disappointed that I have heard nothing from the state’s attorney’s office about bringing these individuals who stole money from somebody with dementia to justice,” said Golbert.

The lack of criminal charges also concerns Chicago’s Japanese American community who have been closely following Watanabe’s case, attending court hearings and even visiting her at her new facility.

“I think it’s important for us to be visible on this,” said Bill Yoshino of the Japanese American Citzens League. “That’s one of the questions we have on our minds, is what, if anything, the state’s attorney’s office is going to do in this case.”

Spokespeople for both the state’s attorney and Chicago police say the investigation is ongoing, adding there is no hold up.

Symphony Residences issued the following statement:
“The safety and well-being of our residents is our utmost concern. Upon learning of the incident involving Ms. Wantanabe, we immediately notified law enforcement authorities to investigate and seek restitution for Ms. Watanabe, and we are cooperating with those agencies. We require our team members perform their duties with the highest standards and ethical integrity. The employees involved in this matter are no longer employed at this facility, and we have conducted extensive retraining for the remaining staff on compliance standards and company policies related to residents’ rights, procedures for suspected cases of theft, and rules on accepting gifts from residents and their families, which is strictly prohibited. We will continue to work with law enforcement, and we remain committed to ensuring safeguards are in place to prevent an incident like this from happening again.”
Full Article & Source:
Cook County Public Guardian Wants To Know Why Kim Foxx Has Not Brought Charges In Case Of Swindled Nursing Home Resident

Cook County Public Guardian Wants Charges In Case Of Swindled Nursing Home Resident

CHICAGO (WBBM NEWSRADIO) -- The Cook County Public Guard was in court Wednesday morning spelling out how current and former staffers of a senior citizens’ home pleaded the 5th when asked under oath about the theft of the bulk of a resident’s life savings.

Cook County Public Guardian Charles Golbert said 98-year old Grace Watanabe had more than $770,000 stolen from her when she lived in the Symphony Residences of Lincoln Park and that five former employees of Symphony had a similar answer when asked pointed questions about their roles in the alleged swindle.

"Questions like, when you took $100,000 from Mrs. Watanabe, did you know that she had advanced dementia? Answer. I cannot answer that question because the answer will incriminate me. 5th amendment," he said.



Public Guardian Charles Golbert said a Chicago Police financial crimes police detective laid out evidence for the Cook County State’s Attorney’s Office months ago, but so far, no charges.

Golbert wrote a letter to State's Attorney Kim Foxx in May saying he believes charges should be filed in the case.

Meanwhile, Golbert said it wasn’t just the former staffers answering deposition questions with the 5th amendment.

"We do not allege that the executive director stole any money herself, but we deposed her about what was going on there. We asked her questions such as, along the lines, 'were you aware that your employees were stealing hundreds of thousands of dollars from a 97-year-old resident with dementia?' Answer: 5th amendment. The answer will incriminate me," he said.

Golbert said he had Watanabe moved to a safe nursing home 10 months ago when the case was referred to him. He said she's 98-years old now, is doing well, and that, despite her dementia, has a broad understanding that most of her money was stolen from her.

Golbert said Watanabe spent time in a Japanese internment camp during World War II, eventually got a college degree and worked for the federal government.

He said dozens of members of Chicago's Japanese-American community have been closely following the case and have appeared at every single court date in support of Grace Watanabe.

Her last surviving relative, a brother, died in 2009.

Full Article & Source:
Cook County Public Guardian Wants Charges In Case Of Swindled Nursing Home Resident

Thursday, June 27, 2019

6 New Alleged Victims of Dallas Senior Living Murder Suspect Named in Suit, Bringing Total to 18

A lawsuit filed in Dallas County claims there are at least six more victims of accused serial killer Billy Chemirmir.

Chemirmir is currently facing charges for the murders of 12 elderly women in Dallas and Collin counties. He’s accuse of either strangling or suffocating elderly victims to steal jewelry and other valuables. Police arrested Chemirmirlast year and announced investigators would review hundreds of unattended death cases for additional potential victims.

The families of six more people say Chemirmir targeted their loved ones who lived the same independent living community in north Dallas.

“Words can’t describe what they’re going through and we’ve had many days where it’s been tough,” said Trey Crawford – attorney for the families and estates of one man and five women who all died in 2016. All six died in about a three month span and lived in the Tradition-Prestonwood Independent Living facility.

Crawford says the families were initially told the deaths were natural, but the families said there were valuables missing from their apartments.

The lawsuit alleges the facility did not live up to its promises of 24 hour a day access control and surveillance cameras throughout the community. It also alleges the facility failed to notify the families and law enforcement that valuables were reported missing in several unattended deaths.

The lawsuit says Joyce Abramowitz’ unit was burglarized in April of 2016. She was found dead three months later. Days later in July, Juanita Purdy was found dead in her home in the same facility, followed by Leah Corken and Margaret White in August. The suit says Solomon Spring and Glenna Day were found dead a few weeks apart in their units in October. All were in their 80’s.

“I think had law enforcement known about the prior instances and the similarities and the missing jewelry at the time, they would have viewed it a lot differently but they were not provided that information,” said Crawford.

Chemirmir has not been charged with crimes in those six cases. The deaths were initially ruled natural.

Wednesday, the Dallas County Medical Examiner said it could not comment on the status of the cause of death investigations. The Dallas County District Attorney’s Office said it could not comment on open or pending cases.

Chemirmir has been charged in the murders of two other people who died at the same facility. A grand jury indicted Chemirmir in the deaths of 85 year old Norma French and 92 year old Doris Gleason, who both died in their homes at Tradition-Prestonwood.

Dallas Police have not responded to NBC 5’s request for information on whether investigators are looking into a connection between Gleason and French’s cases and the six newly alleged victims.

Police have said Chemirmir posed as a maintenance worker or healthcare worker to gain access to elderly people in cases across Dallas and Collin Counties.

Tradition-Prestonwood declined an interview on Wednesday, but sent a written statement denying it withheld information.

Here is the full written statement provided to NBC 5:

The deaths by an alleged serial killer in peoples’ homes and at multiple senior living communities in the DFW Metroplex is a true tragedy.

The Tradition-Prestonwood regards all our residents as family.

The Tradition-Prestonwood relied on the investigations of the Dallas police, its detectives, and other reputable, established governmental entities, including the Dallas County Medical Examiner, the Collin County Medical Examiner, and more. Any death was investigated by Dallas police and the Dallas County Medical Examiner and ruled as attributed to natural causes. Additionally, there were two autopsies which also confirmed death by natural causes.

Those rulings stood for more than 27 months.

The Tradition-Prestonwood has cooperated with all the authorities and will continue to do so. The allegations against Mr. Perlman that he withheld information are absolutely false.

Go here to read the rest of the story 

Full Article & Source:
6 New Alleged Victims of Dallas Senior Living Murder Suspect Named in Suit, Bringing Total to 18

Family awarded guardianship of Macomb Co. couple after 7 Action News Investigation


MOUNT CLEMENS, Mich. (WXYZ) — After 8 months, a Macomb County couple is back in the care of their relatives.

It’s a controversial guardianship case that’s caught the attention of the Supreme Court and the Attorney General.
Marcie Mitchell has been fighting for guardianship of her dad, Bob Mitchell, and her step-mom, Barbara Delbridge, since November 2018. Now she’s being reunited with them.

Marcie will now be the guardian for her father. Marcie’s Aunt, Anita Little, will become the guardian for her step mother. That means relatives will be making all of their medical and legal decisions for them, instead of a guardianship company.

Both Barb and Bob are suffering from dementia and other health issues.

Macomb County Probate Judge Kathryn George refused to appoint Marcie as guardian back in November. Instead she appointed a company called Caring Hearts Michigan Inc, that’s owned by Cathy Kirk. Kirk then hired her own company called Executive Care to provide 24/7 home care to Bob and Barb, which legal experts say is not allowed under the probate laws.

Bob and Barb’s relatives say Caring Hearts stopped letting them visit and built a six-foot tall privacy fence around their Utica home. Caring Hearts said the fence was to keep Bob safe because he keeps trying to escape. Relatives believe it was to keep them from seeing Barb and Bob.

After the 7 Investigators first exposed the case, the Michigan Supreme Court stepped in and the Attorney General ramped up their investigation. A representative of the AG, the state’s Public Administrator, was in court today monitoring case.

Macomb County Chief Judge James Biernat Jr. took Judge George off the case after 7 Investigator Heather Catallo’s first story on this. On Wednesday, Judge Biernat awarded guardianship to the family members through a stipulated order between the relatives.

Family members thanks their supporters and say they can’t wait to resume care of Bob and Barb. They plan to move them to a facility that can care for them.

A court-ordered conservator will stay in place for 60 days. After that family members will take over the financial obligations of Bob and Barb.

Caring Hearts Michigan released this previous statement in May regarding the investigation:
Caring Hearts Michigan, Inc. was appointed as guardian and conservator in this case due, in part, to its relationship with Executive Care, a CHAP-Certified in-home care company. Caring Hearts does not accept guardianships or conservatorships on a large-scale basis. Prior to its appointment, Robert and Barbara were malnourished and living in dangerous and unsanitary conditions. Now, Robert and Barbara are safe and healthy living in their own home. Caring Hearts will continue to do everything in its power to provide for Robert and Barbara’s safety and wellbeing in the most cost-effective way possible without separating them or causing undue hardship. Their safety and wellbeing is our only concern.
Full Article & Source:
Family awarded guardianship of Macomb Co. couple after 7 Action News Investigation

See Also:
Caring Hearts Michigan backs out of disputed guardianship case in wake of 7 Action News report

Michigan AG opens investigation into Macomb Co. probate case following 7 Action News report

Why did a Macomb Co. judge put strangers in charge of an elderly couple instead of family?

'I just want my parents back.' Woman says company imprisoned her parents in their own home

Michigan AG 'looking into' concerns about state's adult guardianship system

Utica couple's family regains guardianship to end legal dispute

By Jameson Cook
Marcie Mitchell, left, smiles at her cousin, Gretchen Sommers, who was instrumental in helping Mitchell regain guardianship over her father, Robert Mitchell of Utica, on Wednesday in a hallway of the Macomb County courthouse in Mount Clemens.
JAMESON COOK--THE MACOMB DAILY
The family of a Utica husband and wife in declining health regained guardianship over them Wednesday in a settlement of a legal dispute over their care.

Marcie Mitchell was granted guardianship over her father, Robert, 73, and Anita Little gained guardianship over her sister, Barbara Delbridge, 70, in an agreement approved by Judge James Biernat Jr., serving as a substitute Macomb County Probate Court jurist.

Mitchell and Little were elated with the outcome in light of last November's rejection of Mitchell's request to be named permanent guardian. Macomb County Probate Judge Kathryn George instead named a Clinton Township company as guardian, a ruling that prompted a state investigation into her rulings in this and other cases.

Anita Little listens to her attorney, Frank Cusumano, on Wednesday in Macomb County Probate Court where Little gained guardianship over her sister, Barbara Delbridge, as temporary guardian Terry Gilsenan, second from right, and temporary conservator Martin Brosnan observe.
JAMESON COOK--THE MACOMB DAILY
“It’s been a long road but justice was served today,” Marcie Mitchell said outside the courtroom surrounded by about 20 supporters. “Amazing.

“Emotionally, it’s been very difficult. I don’t think without the support of our friends and family, we would’ve been able to do it. I don’t think I can thank everybody enough for the support they’ve given us.”

The dispute became well-publicized in May when Marcie Mitchell of Clarkston complained to WXYZ-TV (Channel 7), prompting the state Attorney General’s office to initiate an investigation.

Mitchell complained George unnecessarily appointed a for-profit company, Caring Hearts Michigan in Clinton Township, which hired Executive Services to perform care taking work.  The two companies are owned by the same person.

Mitchell and other family members complained their visits were limited, including not seeing the couple for a month. The caregivers installed a 6-foot fence around the property near Hall Road and Van Dyke Avenue that blocks the vision of family members who reside next door, and the couple was not allowed to leave, family members said.

The families raised questions about care-taking spending from the couple's more than $2.5 million in assets.

In making her Nov. 28 ruling, George said she had “grave concerns” that Robert Mitchell was allowed to drive alone to northern Michigan to go hunting.

E. Philip Adamaszek, who served as the couple’s attorney, told Biernat during a June 17 court hearing he had concerns about prior care that was provided by Marcie Mitchell and other family members. He said after the hearing the couple was neglected.

However, the family refuted most of his concerns and noted that Adamaszek learned of them second-hand from Executive Services care givers.

Barbara Delbridge and Robert Mitchell
Caring Hearts and Executive Services in early June withdrew from serving as guardian and caretaker. Attorney Terry Gilsenan was named temporary guardian, and attorney Martin Brosnan was name temporary conservator.

Biernat at the June 17 hearing scheduled an evidentiary hearing for Wednesday where some of the care givers and Mitchell and Little could have testified.

But it was averted after lawyers had negotiated prior to the hearing and spent more than an hour Wednesday drafting a two-page order that was signed by the judge and interested parties, including Marcie Mitchell’s brother, Corey Mitchell. In the order, Marcie Mitchell and Little were not only named guardianship but in about two months will take over as the couples’ conservator, overseeing finances.

Adamaszek attended Wednesday's hearing but did not participate in the settlement process.

“It’s a good day for Lady Justice,” Little’s attorney, Frank Cusumano, remarked afterward. “It shows these decisions are best left to the family who acts out of love, not for profit.”

Marcie Mitchell said the condition of her father has declined over the last eight months of the dispute.

“My dad’s gone downhill pretty bad, and I can’t get that time back,” Mitchell said. “Enjoy the time we have.”

Mitchell said she and Little have already arranged for care givers to work for the couple, who will be placed in a care facility.

“We’re already looking at nursing homes in Grand Blanc that we can now move forward with and get on a waiting list," Mitchell said.

Marcie Mitchell listens to her attorney, Tim Flynn, on Wednesday in Macomb County Probate Court in Mount Clemens.
JAMESON COOK--THE MACOMB DAILY
Little added: "There should be enough (money) left to be able to provide them with excellent care they're going to get."

Mitchell and Little said their concerns about any potential unnecessary spending could be addressed in an upcoming conservator report.

Brosnan will remain conservator until those duties are transferred to Mitchell and Little.

George was subject of scrutiny by state officials and removed as chief probate judge more than 10 years ago for her relationship with a now-defunct guardianship company, conflict with the second probate judge and dysfunction at the court.

Full Article & Source: 
Utica couple's family regains guardianship to end legal dispute

Nursing home costs in the U.S. are rising even faster than health care

By Kate Gibson

  • The cost of nursing homes in the U.S. can easily top $70,000 a year and has risen even faster than that of overall medical care in some states, a Georgetown University Medical Center study found.
  • New York nursing homes were the most expensive, averaging more than $300 a day, while Texas had the most affordable facilities.

Nursing home costs can cost upwards of $100,000 a year, a heavy financial burden even for Americans who have set money aside for their later years -- and a crushing one for those who haven't. And those costs are rising, even outstripping the rising cost of health care in the U.S.

"What is already expensive is only getting more so," said Dr. Sean Huang, lead author of a study by researchers at the Georgetown University Medical Center. 

The cost of nursing home care is a particular risk for people without long-term care insurance or Medicaid coverage, Huang said, noting the number of Americans who are already short on retirement savings. Annual out-of-pocket expenditures can easily exceed $70,000, found the analysis of prices from 2005 through 2010 across eight U.S. states.

"For someone who is not poor enough for Medicaid or who doesn't have long-term care insurance, this will be a huge financial burden," Huang told CBS MoneyWatch. 

For-profit nursing home chains were the least expensive, while nonprofit chains were the most costly, according to the report. Independently operated for-profit and nonprofit facilities were similarly priced. Nursing homes in New York had the highest average cost in the U.S. at $302.30 per day, while Texas had the lowest at $121.90, according to the study, which drew on data from 2005 to 2010. Over that period, costs in the eights states rose faster than the roughly 20% increase in overall medical care prices.

Most Americans are eligible for Medicare at 65, with the government program covering some routine and emergency health care, but not long-term care, such as that provided by nursing homes. Although it's cheaper to buy long-term care insurance in your 40s and 50s, most people don't, focusing instead on other financial priorities like paying for a child's college expenses.

That can prove costly. Huang noted that three-quarters of Americans 65 and older will need to use a nursing home at some point, but only a small fraction had long-term care coverage.

Full Article & Source:
Nursing home costs in the U.S. are rising even faster than health care

Wednesday, June 26, 2019

Rape of 95-year-old with dementia raises questions about Ohio’s assisted-living regulations for staffing, training

The number of residents in assisted living has grown dramatically in Ohio, fueled by those with serious memory issues. (Andrea Levy, Advance Local)
By John Caniglia, The Plain Dealer

CLEVELAND, Ohio — The 95-year-old dementia patient lay asleep in her room at Close to Home assisted living in Middletown, unaware of the danger at her door.

Minutes after 5 a.m., Gary Earls snuck in, grabbed the woman, pinned down her frail hands and sexually molested her, according to records and interviews.

She wailed in pain.

One of two aides caring for the center’s 32 residents that day heard the cries and ran to the woman’s room. She found Earls, a resident who suffered from a cognitive disorder, on top of the woman.

Afterward, Earls, 72, returned to his room across the hall, seemingly unaffected by what he had done.

The woman appeared to have no idea of what took place, telling an aide simply: “That man came to visit. He is real nice."

She died a month later, her family attributing her death to the attack.

The case underscores one of the most contentious issues in the care industry in Ohio: The number of assisted-living centers has increased 181 percent in the state since 1995, with much of that growth fueled by those with serious memory issues. A national study by researchers at University of North Carolina suggests seven of 10 residents in assisted living have some degree of cognitive impairment.

But regulations designed to keep residents safe remain vague and outdated, according to a Plain Dealer analysis of hundreds of pages of regulations, safety reports and interviews with researchers.

Ohio is not alone. States across the country lack strict staffing and training requirements for assisted-living centers, and lax regulations have prompted advocates to push for federal oversight of the facilities.

That option, however, clashes with the interests of facility owners and operators, who say they know residents’ needs the best.

Because there is no federal monitoring, it is impossible to determine the number of serious incidents of abuse and neglect across the nation, as no one agency collects that data.

Wrongful death alleged

The oldest daughter of the 95-year-old woman said her mother became withdrawn after the attack.

“After it happened, my mother just lost her will to live,” she told The Plain Dealer recently.

“She didn’t want to do anything. She didn’t even open her eyes. She just laid there, curled up."

She developed pneumonia and her organs failed.

She died Dec. 30, 2017.

Eight months later, her estate filed a wrongful-death lawsuit against Close to Home. In it, the family’s attorneys, William Eadie and Michael Hill of Cleveland, claimed that the facility failed to ensure the woman’s safety and engaged in "a systemic practice to understaff the Close to Home facility to maximize profits at the expense of its residents’ care.”

The lawsuit highlights a key difference in long-term care: Nursing homes are regulated by the Centers of Medicare and Medicaid Services. Assisted-living centers are not.

The reason is simple. Nursing homes rely mostly on taxpayer-funded Medicaid, while assisted-living centers are mostly private pay, with residents doling out about $4,000 a month on average, nationally. In California, for instance, costs are an average of about $5,000 to $7,000 a month.

So instead of federal regulation, states oversee the facilities; each has different requirements.

Critics say Ohio’s main staffing requirement for assisted-living centers is ambiguous: Facilities must have a "sufficient number” of aides and nurses present to meet residents’ needs.

It has no staffing ratios, meaning there are no specific requirements for a set number of aides to care for a set number of residents.

“This is a huge problem,” said Charlene Harrington, a professor of nursing at the University of California at San Francisco and a national expert on long-term care. “Many people in assisted living are as sick as people in nursing homes. But assisted living has far fewer staff members.”

And as more people require greater care for memory and cognitive issues, the challenges for direct caregivers increase. Yet the state continues to require about 20 hours of training for a caregiver to work with residents suffering memory loss.

The debate is expected to grow more contentious in the coming years, as the number of elderly in Ohio spikes and more people move into assisted living.

In 1995, Ohio had 265 assisted-living centers. Today, it has 745, according to figures from Miami University’s Scripps Gerontology Center and the Ohio Assisted Living Association.

In that 24-year span, the number of people living in assisted living has grown from about 6,000 to about 35,000, researchers said. Nationally, there are about 1 million people in assisted living.

“There used to be a gas station on every corner; now there is an assisted-living center on every corner,” said Charlene Sufka, a member of Elderly Advocates, a Cleveland group that spotlights the concerns of the elderly.

”Some people in assisted living are too ill, too frail and just need more help than they can get there."

Gary Earls was one of them.

A troubled man among the vulnerable

By all accounts, Earls’ troubles began long before he moved to Close to Home in October 2016.

Between 1990 and 2015, Earls was convicted of nine misdemeanors, including two drunken-driving offenses, improperly handling a firearm, peddling food stamps and possessing a crack pipe, records show.

State officials redacted Earls’ specific cognitive impairments in their reports, but, according to police reports and interviews, his condition hindered his ability to reason and made him easily frustrated and angry.

“This clearly was a man who should not have been around vulnerable residents,” said Eadie, the Cleveland attorney.

An attorney for the assisted-living facility did not return phone calls seeking comment. Sharon Hartwig, the owner of Close to Home, could not be reached./b>

Within a year of moving to the facility, Earls exhibited disturbing behavior. At 6:45 a.m. on Oct. 12, 2017, a month before he molested the 95-year-old woman, an aide walked into a different woman’s room and found Earls with his pants down.

He stood near the woman’s bed as she slept, according to an investigative report by the Ohio Department of Health.

Earls denied touching or harming the woman. A local hospital later performed a mental health evaluation of him but found "there were no indications to keep him [at the hospital],” according to the state report.

He soon returned to Close to Home and was placed in a room across the hall from the 95-year-old woman.

“Their way of solving the problem was moving him to a room across from our mother,’’ said the woman’s oldest daughter.

A mother, a victim

The 95-year-old woman raised five children and worked 30 years at a small store in Middletown.

Her children said she remained independent at 80, but she had slowed down, and they worried about her safety. She moved to Close to Home in 2007.

After a while, she began to decline cognitively. By about 2010, her dementia had become severe, and she needed total care, from bathing and going to the bathroom to eating and moving out of bed.

The facility, however, continued to care for her. It never told the family it could not handle her greater needs, her children said.

The children said the facility changed, as well. There was high turnover among staff. The center was often shorthanded. The family’s lawsuit claims that the woman was “frequently left in soiled undergarments’’ because of understaffing.

The collapse of a criminal case

Weeks after Earls snuck into the 95-year-old woman’s room and attacked her, a Butler County grand jury indicted him on two counts of rape.

The case, however, never got far.

Earls’ defense attorney, Dennis Adams, sought a mental-health examination for his client. A judge found Earls unable to stand trial, based on his mental condition.

“He definitely had memory issues," Adams said.

Earls has been moved to a secure mental-health facility in Cincinnati, where he is expected to remain.

The report by the state health department, the agency that oversees assisted-living centers, admonished Close to Home, saying the “facility failed to prevent the sexual assault of one cognitively impaired resident."

But the state stopped short of fining the facility. A spokesman for the department said Close to Home avoided penalty because it quickly worked to make sure residents were safe, including training and retraining staff on sexual abuse.

The family’s last chance at justice, it says, is its wrongful-death lawsuit. The woman’s children filed it in August 2018, and it is winding its way through Butler County Common Pleas Court, with a trial date set for March 2020.

The attack, the subsequent investigation and the legal fight have made the woman’s children wary of the care in assisted-living centers. They say change is necessary.

“We need stricter rules for any facility that cares for the elderly," the woman’s oldest daughter said. “The people in those centers need advocates because they can’t advocate for themselves.

“Until we hold these places accountable, nothing will happen."

Full Article & Source:
Rape of 95-year-old with dementia raises questions about Ohio’s assisted-living regulations for staffing, training

Congressional list reveals poorly performing SC nursing homes

Riverside Health and Rehab in North Charleston was one of six South Carolina nursing homes that were named on a congressional list of poor-performing facilities. This is information that normally isn’t provided to the public. Brad Nettles/Staff
Six nursing homes in South Carolina were identified as consistently poor-performing in a congressional list previously kept secret by a branch of the Department of Health and Human Services.

The list, current as of April, was released to the Senate Special Committee on Aging at the beginning of June after a bipartisan inquiry from Pennsylvania Sens. Bob Casey, a Democrat, and Pat Toomey, a Republican.

“It is outrageous that we continue to hear stories of abuse and neglect in nursing homes that do not live up to these high standards,” Casey said in a news release. “Choosing a nursing home is a difficult and often painful decision to make. Individuals and families deserve to have all the information available to choose the facility that is right for them.”

The Centers for Medicare and Medicaid Services, the federal office in charge of administering Medicare and Medicaid, keeps a list of nursing homes that are designated as Special Focus Facilities. This designation increases the frequency that a nursing home must be inspected and sets guidelines for where and how quickly a facility must improve.

Homes that meet safety and health guidelines are typically inspected every nine to 15 months. If a facility is classified as a Special Focus Facility, however, it must be inspected every six months and must graduate from the SFF designation within 18 months or it risks losing the ability to offer Medicare or Medicaid.

The list of SFF-designated facilities has previously been made publicly available. But until now, the Centers for Medicare and Medicaid Services had shielded from the public eye the list of roughly 400 facilities that were considered for the program but didn’t make the cut.

Riverside Health and Rehab in North Charleston is the only facility in the state given the full SFF designation. The other five South Carolina facilities listed in the report were listed as candidates for the SFF program:
  • Commander Nursing Center, Florence
  • Blue Ridge of Sumter
  • Life Care Center of Hilton Head
  • Compass Post Acute Rehabilitation, Conway
  • PruittHealth — Blythewood, Columbia
The list does not make clear the number or kind of violations any of the facilities were cited for, nor does it mark their progress in fixing any issues. Medicare.gov, however, does periodically update a nursing home’s database with information from safety and health inspections, as well as any penalties a nursing home has incurred.

Riverside Health and Rehab, for instance, has been fined four times since 2017 totaling over $322,000. In its most recent health inspection from February 2018 it was cited for three different violations.

In an emailed statement, Riverside said that since it began in the Special Focus Facility program in April 2017, results from subsequent inspections have shown the facility continues to improve. In May, the statement said, the facility graduated from the program.

“Our residents will remain our first priority and we will continue working hard to achieve our goal of providing the highest quality care possible in a home-like environment,” said Riverside administrator Jerrolyn Montgomery-Smalls.

U.S. Sen. Tim Scott, R-S.C., sits on the Senate Special Committee for Aging and said through a spokesman that while a majority of South Carolina facilities provide high-quality care, transparency in identifying the ones that don’t is an important initiative.

“Senator Scott believes in transparency and daylight is a positive antiseptic,” said spokesman Ken Farnaso. “Anytime we can improve the quality of an elderly person’s life, we should.”

Farnaso added that Scott is working with multiple committees to advance quality improvement initiatives and “safeguard our state’s increasingly growing older population” but did not elaborate.

Shortly after getting the initial list of facilities considered for SFF designation, Casey and Toomey announced that the Centers for Medicare and Medicaid Services had committed to releasing for the first time a monthly update of nursing homes considered for the SFF program. 

Full Article & Source: 
Congressional list reveals poorly performing SC nursing homes

NEW CHINESE LAW TO TAKE CARE OF ELDERLY



Full Article & Source:
NEW CHINESE LAW TO TAKE CARE OF ELDERLY

Tuesday, June 25, 2019

Phoenix funeral home took control of dead people's estates, then charged them excessive fees, complaints say

The families of Robert Heiskell and Carol Emma Carlson both filed complaints against funeral home owner Spencer McBride.(Photo: Courtesy Carlson family and National Personnel Records Center)

As the mail piled up at the man's house, neighbors began to worry.

The homeowner, Robert Heiskell, was a U.S. Navy veteran, a quiet and reclusive man whose wife had died years earlier.

A concerned neighbor called authorities, who on March 22, 2017, found the 80-year-old dead in his home.

Heiskell had no will, and no one claimed his body.

Abel Funeral Services, under a contract with Maricopa County for indigent burial, retrieved his body and placed it in refrigeration while they searched for the next of kin.

A meter started running on Heiskell's funeral bill.

When the county determined Heiskell had too much money to qualify for indigent burial, funeral home owner Spencer McBride received court approval to become the personal representative of Heiskell's estate and settle Heiskell's financial affairs. McBride had done this many times for other estates.

By the time he was done, McBride had authorized payments totaling $30,194 from Heiskell's estate to his funeral home, according to court records.

The median cost of a funeral and burial is $7,360, according to the National Funeral Directors Association.

Robert Heiskell served in 
the U.S. Navy.  
(Photo: National Personnel 
Records Center)
Arizona law allows funeral home owners to act as both executors and creditors of an estate. Most don't want the hassle. Now, the Arizona Board of Funeral Directors and Embalmers, which regulates the profession, is investigating complaints that McBride assumed control of estates and charged excessive fees for funeral services.

Three complaints in the past year allege McBride did not try hard enough to locate next of kin while his funeral home charged estates excessive fees for funeral services. A fourth complaint didn't dispute fees, but the family of an Air Force veteran was upset over a delay in burial.

Heiskell's closest living relative, a cousin, questioned the bill and alleged in court records that all but about $8,000 of the charges were "excessive," including fees to refrigerate Heiskell's body for 115 days. The matter was settled out of court earlier this year for an undisclosed sum.

McBride has denied in statements to the funeral board of using his position as personal representative for profit.

Full Article & Source:
Phoenix funeral home took control of dead people's estates, then charged them excessive fees, complaints say

Longtime attorney arrested, accused of faking judge's signature

FULTON COUNTY, Ga. - Channel 2 Action News has learned a well-known attorney in Fulton County is now under indictment.

Elizabeth Vila Rogan has appeared in court many times as a veteran attorney and as a former Fulton County magistrate judge.

But she is likely to appear in court soon as a defendant indicted on a charge of first-degree forgery.

Rogan is accused of forging the signature of Roswell Municipal Judge Brian Hansford on a court document called an Order on Status of Firearms Rights.

"I think what these employees were saying is, 'We do not expect that person would be above the law.' In fact, I think what they were saying is, 'We would expect you to know better than anybody else,'" District Attorney Paul Howard told investigative reporter Mark Winne. "The lawyer in this case ... to present a document, trying to represent it as a judge’s signature is a serious matter."

A document Channel 2 Action News obtained indicates a Roswell police officer met with Kimberly Moody, the Roswell court administrator. Moody said Rogan came in to have an order stamped.

According to the document, Moody stated she asked Rogan when the order was signed. Rogan replied, 'This morning.’ Moody said she knew Hansford was out that particular day.

The document suggests Hansford texted that he did not sign the order.

“Fabulous lawyer, known her for a long time, very experienced, had a plethora of different jobs,” high-profile defense lawyer Manny Arora said about Rogan. “I’m hoping there’s an explanation for it.”

Rogan’s attorney, Mike Moran, suggests the case “does not involve the taking or misappropriation of any money. We believe the charge is predicated on a misunderstanding, a series of miscommunications and the truth is that there has been absolutely no crime committed. Ms. Rogan has an impeccable record as a judge, prosecutor and defense attorney. Quite simply, she submitted a clarifying order in the belief that she had authority to do so.”

A Roswell police document Channel 2 Action News obtained says, “Judge Hansford believes that Ms. Rogan became impatient with how court proceedings were moving forward so she signed the document herself.”

Full Article & Source:
Longtime attorney arrested, accused of faking judge's signature

How Medicare Stole My Mother’s Health and Life Savings

My very independent mom was aging right. Until she checked into the hospital

Marion Geoghegan Campbell
By Cat Stone

Some days it’s impossible to believe mommy’s gone.

But every day, it’s impossible to believe that she went the way she did: penniless and in pain—on every level. She spent her final years beating herself up for making the biggest mistake of her life. She wanted to support herself with the money she’d taken a lifetime to save. Instead, mom died embarrassed and heartbroken knowing the government had stolen her entire life savings and more because of a Medicare loophole.

Mom was puttering around her Florida apartment late in the spring of 2012 when without warning, she heard, then felt, a loud crack. Her hip fractured and sent her flailing backward onto the floor. In agony, she called out to her dear friend next door who dialed 911. She was rushed to the hospital.

My brother and I both lived out of state and mom didn’t want to worry us. So intelligent and capable (she had graduated from both high school and business school by age 16), she “took care of everything,” then called to tell us that she was already checked in.

Concerned about our mother’s health,  neither of us thought to ask how she had been admitted to the hospital.

In fact, we had no idea that there was a right or wrong way to be admitted.

Her American Dream

Born in 1924, my mother, Marion Geoghegan Campbell, began work in 1940 in the typing pool for Grace Shipping and quickly made her way up through the ranks, eventually leaving and becoming a paralegal. Marion helped set landmark cases in computer law.

She was also a Catholic who wrote her Pope annually. She trusted in the honor of our country, her fellow Americans, and the agencies that were meant to serve and protect her.

At 86 she was healthy and sharp and could sign her name with assistance (her eyesight was failing); she had all documents—from grocery lists to greeting cards—read to her. And she wasn’t shy about asking people to jump in to help.

Long before her vision deteriorated, Marion read everything she could about Medicare. She went into her senior years understanding how it worked. She even researched the skilled nursing facilities in town so she’d have a plan in case anything unexpected happened. She understood that with a three-day hospital stay, Medicare would pay for 100 days of skilled nursing or rehabilitation.

So when a doctor at the hospital told her that she had to sign the paperwork or leave, she signed. She told us that she was doing so well after the fracture that the hospital was just keeping her “under observation” and that she was relieved not to be “admitted.”

We all thought that was a good sign. Even though she was in pain, we assumed it meant she hadn’t been seriously injured.

The problem was that she was in no shape to understand or comprehend the hospital document she was signing. She was legally blind and a bit doped up, and it remains unclear whether or not anyone read her the fine print.

So my mother accidentally signed away her future because the papers she initialed said she understood Medicare’s special rule: that patients “under observation” do not qualify for skilled nursing care.

A Fateful Mistake

Six weeks later my fiancé and I sat in mom’s room at the rehabilitation facility to which she had been transferred. She had done her physical therapy daily and every afternoon we did  EFT (Emotional Freedom Techniques, a form of acupressure) together over the phone.

The doctors were impressed with her progress. She worked hard because she wanted to walk down the aisle at her daughter’s wedding! We were finally going to take her home.

My mother held my hand and joked that my new engagement ring was so shiny she could now see clearly. She called each of her nurses and the rehabilitation staff into the room to show off the ring and her handsome future son-in-law.

Reports of my engagement spread like wildfire. Which is, apparently, how the billing manager discovered I was in the building. She barged into the room waving a wad of papers and demanded to see “the checkbook.” She said she’d “hate to put mom in collections…”

Cat and her mother, Marion
“My mother is fully insured,” I shot back. “We’ll take care of the paperwork at a more appropriate time.”

Suddenly, my mother was crying.

The woman who’d survived a world war cowered behind me, whispering that she didn’t know what she was going to do because the billing manager had been mean to her about the money for months. Assuming that there had been a mix-up, I ordered the billing manager to leave the room. Just then I turned and saw that my mother’s roommate was crying, too.

When I asked to see the executive director, I was told she wasn’t available. I went to her office anyway.

Apologizing for being so pushy, I explained that the billing manager had terrorized not only my mother but also her roommate. The director replied very politely that she would look into the behavior and assured me it was not their policy to harass patients.

I then turned my attention to the billing error. The director explained that since my mother had not been fully admitted to the hospital, Medicare’s 100 days of skilled nursing care had not been activated.

“Clearly there is some mistake,” I insisted. “Why would your staff admit my mother if she didn’t have Medicare coverage?”

“Your mother knew what she was doing when she signed our admission forms,” the director said. “She told us she has a savings account. She will be billed for our services.”

The walk back to mom’s room took a century. How was I going to tell her she’d made such a huge mistake? By the time I got to the room, I had resolved that we’d fight the system and do all we could to correct this terrible injustice. Mom was horrified to learn she’d signed away her rights and possibly her life savings but she too was confident we’d win in court.

The Dream is Broken

A week later we sat in the office of the best elder care attorney in town. Shaking his head in dismay, he told us that he hears stories like this several times a week. He was compassionate and gentle but advised us that there was indeed no mistake and there was nothing we could do except negotiate a better payment schedule.

I worked out a $100-a-month payment plan for my mother to cover the five-figure bill. The accounting department continued to send her phone calls and threatening letters. Unbeknownst to me, her spirit broken, mom finally wrote out a check to the nursing home for everything she had in savings, except for $1,000. But even paying the nursing home in a bulk didn’t begin to cover the total she owed for all the extra equipment and therapies they had offered her–and she had accepted–thinking she was covered.

So, for four years, instead of using her Social Security check to buy food, she spent it on her debt to the nursing home

When we visited, her house looked spotless, her clothes clean; she did appear thinner and weaker, but we chalked it up to age. Mom never let on to us that she was starving herself and isolating herself to pay her bills.

She grew apart from her church community because she couldn’t afford the cab fare to services. She became frail due to malnutrition and had trouble caring for herself.

Finally, a visiting nurse found my 91-year old mother collapsed on her tile floor unable to get herself up. When the nurse phoned me after calling for the ambulance, I insisted mom be rushed to a hospital that I had researched ahead of time that had a history of caring for the elderly. Then I called her primary care doctor and insisted he have her fully admitted. He took over her case and signed the papers himself. Mom was going to require permanent, long-term care.

Next, I called the executive director of the nursing home that had treated her for the fractured hip four years earlier. It was still the best in town. I politely, but firmly, told her that mom wouldn’t be returning in her current condition had the system not failed her and stolen her money. Placing the blame on the system and not the nursing home, I concluded by telling her that it was the facility’s ethical duty to help mom now in her time of great need.

This time the executive director offered compassion and care: Mom was admitted that same day.

Her Last Wish: to Help Others

Mom spent two years in the nursing home, often joking that this or that was hers, because after all, she’d paid for it with her savings. The truth was she was horrified to be on Medicaid—the federal and state program for those with low or no income or assets. But it was the only way we could get her care. She’d worked for decades, saved, voted, fought and prayed but she ended up living “on the dole”—a burden to society—despite all her best efforts.

My mother was a fighter but this is how it ended for her.

One day mom began to talk about how this situation had impacted her emotionally. She apologized for her mistake and what it had cost her and what it had cost us—the tens of thousands of dollars we pitched in for housekeepers and nurses so she could remain at home. Mom lamented that she was too old and frail to do anything about it, so she made me promise I’d tell everyone I could about this horrible Medicare rule and help others avoid her fate. At least a dozen times before she died I called her to say, “Mom! You saved another one!” and gave her the details of some friend or family member who had used her knowledge, her mistake to protect themselves. And she would say, “Well then, dear, my prayers have been answered and my pain has meaning.”

WHAT YOU CAN DO TO HELP YOUR LOVED ONES

1. Understand the loophole Tell everyone. Shout it from the rooftops. Make sure your parents, siblings, friends, colleagues, and neighbors understand about the Medicare “Observation” loophole. Remind them to insist on being fully admitted should they or anyone they love be hospitalized. The rule: Medicare only covers skilled nursing facility care with a “qualifying” inpatient hospital stay. A qualifying inpatient hospital stay means your loved one has been a hospital inpatient, formally admitted to the hospital after their doctor writes an inpatient admission order, for at least 3 days in a row (counting the day of admittance as an inpatient, but not counting the day of discharge).

2. Protect your rights You have time to understand what you’re being asked to sign. You always have the right to have your attorney review any paperwork before you sign. Tests, medications, and assessments can, and often must, be administered before the doctor can choose the correct designation, that is, whether your status is “under observation” or “admitted.” Advocate for yourself or your loved one.

3. Understand your signature is permanent Changing the hospital stay designation after the fact is nearly completely impossible. The time to get it right is at the beginning, so understanding the process and taking the right actions up front is your best protection.

4. Make decisions from a place of calm Emotions are painful and powerful in the midst of a parent’s illness or injury. The worst decisions are made in overly emotional states. Learn processing skills like EFT, a self-applied acupressure technique, to help process stress and painful emotions like fear so you can make decisions from a calm, secure position.

5. Be prepared Engage an elder care attorney early. You will need one to create your power of attorney document when you need to take over the decision-making process for an impaired parent, but also so you have someone in place to handle a legal challenge if one arises. The phrase “my attorney will need to review” can be amazingly effective in securing the cooperation of medical and billing personnel.

6. Involve your parent’s primary care doctor Discuss the Medicare loophole with your parent’s primary care doctor ahead of time and make sure they will help obtain the proper designation if the need arises. The physician of record can sway things and if they have hospital privileges they have even more power. Have the same conversation with any specialists such as your parent’s cardiologist, surgeon or oncologist. At the time of hospitalization, call in all the troops and reference whatever issues or list of symptoms you can to secure the proper designation.

7. Review your hospitals Research local hospitals to determine how cooperative they are with admitting. Hospitals and doctors have quotas to meet and guidelines to follow if the doctor or hospital wants to get Medicare reimbursement. They are penalized for not obeying the rules. But different hospitals have different concerns about the rules. Same for doctors–who might be wealthy enough to forgo the reimbursement. Ask friends, your physician and even contact hospitals directly. Some will advise you about their policies up front. Write down the name of your designated emergency hospital on a card your parent can keep in his or her wallet. Make sure your parents know that if you are not there to advocate for them, they should insist on being brought to the designated hospital.

8. Confirm, confirm, confirm Check your loved one’s patient status daily until s/he is discharged. Sometimes doctors change the status, but sometimes hospital administrators press the issue forcing doctors to downgrade a patient during the stay. Remember, patients need to be fully admitted into the hospital for three days in order for Medicare to kick in. If that admission status changes at any time, the clock restarts.

9. Learn the lingo By law since March 2017, hospitals must advise you what the patient’s designation is and exactly what that means in terms of financial obligations and how that designation affects the patient’s insurance. But remember: the hospital isn’t there to protect your parent’s rights; it’s there to protect their requirements under the law and their own management. Terms like “downgraded to observation” could make it seem like the patient is getting better when in fact it simply means the patient has been switched to a lower status under Medicare. If they need to go to skilled nursing, they’ll have to pay out of their own pocket.

10. Work the system If you don’t get the proper designation, try again by checking out of the hospital and then in again a day or so later. A new hospital, another doctor or a new administrator might make all the difference. Or, sadly, a few more days might mean the condition has progressed enough to truly require more care.

11. Try again Even if your loved one does end up in a nursing home after an “observation status” hospital stay, voiding Medicare coverage, you can try to have them sent back to the hospital for a new stay and insist they be fully admitted. Once they are fully admitted for a three-day stay, the clock begins again and they can access their full 100 days of coverage.

12. What to do if all else fails Realize that skilled nursing care isn’t a stay at the spa and often it’s nothing you can’t do at home yourself. Exercises for the elderly are very simple; it’s the repetition that counts. Provided your loved ones can make bathroom visits themselves you might find taking them to your home or getting them in-home nursing is a better answer. Plus, many people find they heal better in their own home environment. If your loved one has no assets, many home-care services will be completely covered by Medicare or even Medicaid. Services such as bathing, wound care, meal prep and housekeeping can be obtained with just a few phone calls.
 
Full Article & Source:
How Medicare Stole My Mother’s Health and Life Savings