California takes steps toward improving judicial accountability

The commission that’s supposed to hold California judges accountable now will be subject to a dose of accountability itself.

In a unanimous vote this week, a joint committee of the California Legislature authorized an audit of the Commission on Judicial Performance, the only entity that can discipline or remove a state judge.

“The audit is not just about whether or not the CJP is being a good steward of public funds, it’s about their minimal transparency and making important information available, which has a direct impact on the public’s confidence in the courts,” said Joe Sweeney, CEO of Court Reform, a San Francisco Bay Area-based advocacy firm that focuses on improving transparency in the judicial process.

The audit will answer 26 questions, including what standards the commission uses to close a complaint after its initial review and how it decides when to make its admonishments public or private. The audit also seeks to determine the rationale for maintaining confidentiality for investigations and disciplinary actions.

Activists have been calling for reforming the commission for years. They say the commission operates in secrecy, shielding bad judges from scrutiny and failing to explain its own decisions.

They whipped up fresh support for their cause this summer after Judge Aaron Persky sentenced a former Stanford University student to six months in county jail for a campus sexual assault. The case sparked national outrage because the student, swimmer Brock Turner, faced a two-year minimum prison sentence after being found guilty.

Residents from across California attended the hearing to support the audit. One, Roberta Fitzpatrick, filed a complaint against a family court judge in 2010, alleging that the judge and his staff ignored state law – with disastrous consequences.

A year earlier, the body of her 14-year-old great-niece, Alycia Mesiti-Allen, was discovered buried in a backyard. A judge in Santa Clara County had awarded Alycia’s father, Mark Mesiti, custody in 2005, despite a history of domestic violence and substantial drug and alcohol abuse, according to federal probation records. He has been charged with murdering and sexually abusing Alycia.
Fitzpatrick filed a complaint with the commission in an attempt to expose what she believed was negligence on the part of the family court system.

“Children deserve to be kept safe by Family Court. To ignore this terrible failure is to appear to condone it, and to endanger an unknown number of children,” Fitzpatrick’s complaint states.

One year after Fitzpatrick filed the complaint and provided the commission with the information it requested, she received a letter stating that it found no basis for action against the judge or for proceeding further.

The case highlights a common frustration: Residents receive little information about what happens to their complaints.

“It doesn’t appear that the commission investigates anything,” Fitzpatrick said.

In 1960, California became the first state to develop an independent judiciary commission to help restore and maintain public confidence in the state courts. Subsequently, every state has created a judicial commission. They have similar confidentiality provisions as California.

In California, 3.4 percent of complaints result in disciplinary action, and less than 1 percent lead to any public rebuke. No complaints are made public.

Activists want to know how staff are trained to determine the merits of complaints, when the commission decides to take disciplinary action and more about the kinds of complaints it receives.

Arizona provides a template for how changes can come about. In 2006, a frustrated attorney there filed a complaint against a judge that resulted in a private reprimand. Noting that many severe disciplinary actions also were labeled private, he filed a petition with the state Supreme Court asking that all complaints against state judges be made public.

The petition argued that because judges are public elected officials, “the public has a right to know about even isolated acts of misconduct and or the appearance of impropriety.”

Since 2006, the Arizona Commission on Judicial Conduct has made public every complaint it files and all disciplinary actions it takes. If a complaint is unfounded, the names of the judges and complainants are redacted and an order is made available that explains the merits of dismissal.

George Riemer, executive director of the commission, believes that voters are better informed on the state’s judicial commission since it revised the public access and confidentiality rules.

“I think it definitely helps that the public can see what the commission and the Arizona Supreme Court have done,” he said.

Full Article & Source:
California takes steps toward improving judicial accountability

Madison man accused of bilking elderly woman out of over $575K

MADISON - Police arrested a Madison man they said swindled an elderly woman of over a half-million dollars over a two-year period.

On Thursday, James J. Cicarella, 33, of Madison turned himself into police on a valid arrest warrant.
Cicarella was charged with first-degree larceny and posted $100,000 bail after his arraignment in a New Haven court.

Police said Cicarella’s arrest stems from an investigation in which he is accused of defrauding an elderly woman of $578,466 over 2013- 2014, facetiously claiming that he suffered from pre-leukemia. He developed a relationship with one of the victims, an acquaintance of his, and asked for help paying for medical bills.

Court documents reveal Cicarella, who worked for the woman's husband's company, opened up a joint checking account with the woman to cover medical expenses but instead used the money to buy a Cadillac Escalade, jewelry, furniture, and purchasing his current residence on Yankee Peddler Place in Madison with $350,000 cash.

A friend of the victims' spotted Cicarella on the a freeway when he was supposed to have been bed-ridden and alerted the elderly victim.

Madison Det. Sgt. Neal Mulhern says this should be a warning to others. "Try not to judge things on face value and do a little research. Talk to people. Don't just take people's word for what's going on," he said, adding that fraud, especially against the elderly, is a prevalent issue.

Cicarella is due back in court August 25th.

Full Article & Source:
Madison man accused of bilking elderly woman out of over $575K

CMS Increases Mandatory Enforcement to Protect Nursing Home Residents

Under the federal Nursing Home Reform Law, the Centers for Medicare & Medicaid Services (CMS) has authority and the “responsibility”[1] to impose Civil Money Penalties (CMPs) and other enforcement actions at nursing homes that are found to violate federal standards of care (which are called Requirements of Participation).[2]  For the first time in more than 20 years – since the federal enforcement regulations were published in 1994[3] – CMS has increased the numbers and types of situations when CMPs must be imposed against facilities, without first giving the facilities an opportunity to correct their noncompliance.

Effective for all nursing home surveys completed on or after September 1, 2016, CMS’s new national policy mandates, under additional specified circumstances, the immediate imposition of CMPs at nursing homes.[4]  The new policy will be implemented through revisions to Chapter 7 of the State Operations Manual (SOM), Pub. 100-07.[5]

The most striking changes are requirements that CMS impose immediate CMPs when a facility is cited with:

(1) A harm-level deficiency (level G or above)[6] in three specified areas:

• 42 C.F.R. §483.13, Resident Behavior and Facility Practices [restraints],
• 42 C.F.R. §483.15, Quality of Life, or
• 42 C.F.R. §483.25, Quality of Care, and

(2) A harm-level deficiency in any other regulatory requirement on a previous survey, whether the prior survey was an annual survey, a Life Safety Code survey, or a complaint survey. 

These revisions to the so-called “double G” policy, which currently limits the immediate imposition of CMPs to facilities that were cited with G-level deficiencies in two consecutive annual surveys,[7] are significant, especially when viewed historically.

Historical Background

On July 21, 1998, President Bill Clinton introduced the “double G” policy as one part of his 21-point Nursing Home Initiative.  The nursing home industry was strongly opposed and argued, in a March 1999 press release, that G-level deficiencies were cited for trivial matters.  Senator Charles Grassley (R, IA), then chairman of the Senate Special Committee on Aging, asked the American Health Care Association (AHCA) to identify G-level deficiencies that it felt were unfair.  The Senator then asked the Government Accountability Office (GAO) to analyze the 10 examples that AHCA provided in a May 6, 1999 letter.  AHCA claimed that its 10 examples “are clearly symptomatic of a regulatory system run amok.”[8]  Seven involved higher scope and severity than AHCA considered warranted and three involved proposed terminations.

The GAO’s analysis “did not find evidence of inappropriate regulatory actions.”[9]  Reviewing the eight examples for which it had “sufficient information for an objective assessment,” the GAO reported that the states had taken “appropriate regulatory action.”[10]  Of the seven G-level deficiencies, the GAO found that three citations were justified, the GAO did not have sufficient information to analyze two other deficiencies, and states withdrew the citations in the other two cases when the facilities provided additional information that had not been provided to surveyors during the survey.[11]  The GAO also cited its then-recent report, which found that 98% of 201 actual harm deficiencies in 107 surveys were correctly cited.[12]

New Enforcement Methods

As in the past, the new enforcement policy requires immediate CMPs when facilities are cited with immediate jeopardy deficiencies, the highest category of deficiencies reflecting practices that did or could cause significant harm or death to residents.  Under the new policy, however, these CMPs cannot be rescinded.

Another change is the requirement that CMS impose immediate CMPs at Special Focus Facilities that are cited with deficiencies at level F or above.  Special Focus Facilities are those with “a history of serious quality issues” that are subject to two standard surveys each year and more rigorous enforcement actions.[13]

More Needs to Be Done to Protect Residents from Poor Care

While the new policies strengthen enforcement against facilities that are cited with the most serious deficiencies, comparatively few deficiencies are actually cited at the immediate jeopardy and harm levels.  CMS reported in its 2015 Data Compendium that in 2014, only 0.9% of deficiencies nationwide were cited with an immediate jeopardy deficiency and only 2.3% of deficiencies nationwide were cited with an actual harm deficiency.[14]

The GAO has reported repeatedly since the enforcement system was put in place in 1994 that state survey agencies undercite and undercode deficiencies.[15]  The Center for Medicare Advocacy’s study of antipsychotic drug deficiencies cited in seven states in 2010 and 2011 found that 95% of the deficiencies were cited at a no-harm level, regardless of the poor outcomes for residents, the total number or proportion of residents affected by the deficient practice, and the number of federal requirements violated by the facility.[16]  Only 15 harm-level deficiencies were cited in the two-year period, and one state cited 11 of them.[17]  In a separate analysis, the Center showed that even facilities cited with immediate jeopardy deficiencies in nurse staffing are frequently not sanctioned at all.[18]

In addition, CMS has not yet promulgated rules to increase the amounts of CMPs, as required by The Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015.[19]  The law requires the heads of federal agencies to adjust civil money penalties through interim final rulemaking – a so-called “catch up adjustment” – with the increased penalties effective no later than August 1, 2016, and thereafter, to make cost-of-living adjustments to federal penalties.  The nursing home Civil Money Penalties were set in 1994 and have not been increased for more than two decades.  Rules to reflect the 2015 legislation are expected to be published shortly.

August 17, 2016 – T. Edelman

---

[1] “It is the duty and responsibility of the Secretary to assure that requirements which govern the provision of care in skilled nursing facilities under this subchapter, and the enforcement of such requirements, are adequate to protect the health, safety, welfare, and rights of residents and to promote the effective and efficient use of public moneys.”  42 U.S.C.  §§1395i-3(f)(1), 1396r(f)(1), Medicare and Medicaid, respectively.
[2] 42 U.S.C. §§1395i-3(h), 1396r(h), Medicare and Medicaid, respectively.
[3] 42 C.F.R. §488.438, added by 59 Fed. Reg. 56116 (Nov. 10, 1994), https://www.gpo.gov/fdsys/pkg/FR-1994-11-10/html/94-27703.htm.
[4] CMS, “Mandatory Immediate Imposition of Federal Remedies and Assessment Factors Used to Determine the Seriousness of Deficiencies for Nursing Homes,” S&C: 16-31-NH (July 22, 2016, revised 7.29.16) (Memorandum from David R. Wright, Director, Survey and Certification Group, to State Survey Agency Directors), https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-16-31.pdf.
[5] https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/som107c07.pdf (Survey and Enforcement Process for Skilled Nursing and Nursing Facilities).
[6] CMS classifies deficiencies in a 12-box grid, reflecting the scope and severity of deficiencies.  Harm-level deficiencies (G, H, I) reflect the second highest level of deficiencies.
[7] State Operations Manual, Pub.No. 100-07, Chapter 7, §7304.2.1 (“Mandatory Criteria for Having No Opportunity to Correct”), https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/som107c07.pdf.
[8] AHCA’s letter is Enclosure A, pages 12-14, in GAO, Nursing Home Oversight: Industry Examples Do Not Demonstrate that Regulatory Actions Were Unreasonable, GAO/HEHS-99-154R (Aug. 13, 1999), http://www.gao.gov/assets/90/89202.pdf
[9] GAO, Nursing Home Oversight: Industry Examples Do Not Demonstrate that Regulatory Actions Were Unreasonable, GAO/HEHS-99-154R, page 2 (Aug. 13, 1999), http://www.gao.gov/assets/90/89202.pdf.
[10] Id. 
[11] Id.
[12] Id., citing GAO, Nursing Homes: Proposal to Enhance Oversight of Poorly Performing Homes Has Merit, http://www.gao.gov/assets/230/227568.pdf.
[13] CMS, Special Focus Facility Initiative, https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/downloads/sfflist.pdf.
[14] CMS, Nursing Home Data Compendium 2015 edition, page 48, Figure 2.2.3, https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/Downloads/nursinghomedatacompendium_508-2015.pdf.
[15] See, e.g., GAO, Federal Monitoring Surveys Demonstrate Continued Understatement of Serious Care Problems and CMS Oversight Weaknesses, GAO-08-517 (May 2008), http://www.gao.gov/assets/280/275154.pdf; GAO, Nursing Home Reform: Continued Attention Is Needed to Improve Quality of Care in Small but Significant Share of Homes, GAO-07-794T (May 2, 2007), http://www.gao.gov/assets/120/116452.pdf; GAO, Nursing Homes: Efforts to Strengthen Federal Enforcement Have Not Deterred Some Homes from Repeatedly Harming Residents, GAO-07-241 (March 26, 2007), http://www.gao.gov/assets/260/258016.pdf;  GAO, Nursing Homes: Despite Increased Oversight, Challenges Remain in Ensuring High-Quality Care and Resident Safety, GAO-06-118 (Dec. 28, 2005), http://www.gao.gov/assets/250/248869.pdf; GAO, Nursing Home Quality: Prevalence of Serious Problems, While Declining, Reinforces Importance of Enhanced Oversight, GAO-03-561 (July 15, 2003), http://www.gao.gov/assets/240/238941.pdf.
[16] Center for Medicare Advocacy, “CMA Report: Examining Inappropriate Use of Antipsychotic Drugs in Nursing Facilities” (CMA Alert, Dec. 12, 2013), http://www.medicareadvocacy.org/cma-report-examining-inappropriate-use-of-antipsychotic-drugs-in-nursing-facilities/.  The full report is available at http://www.medicareadvocacy.org/cma-report-examining-inappropriate-use-of-antipsychotic-drugs-in-nursing-facilities/.
[17] Id.
[18] Center for Medicare Advocacy, “Staffing Deficiencies in Nursing Facilities: Rarely Cited, Seldom Sanctioned,” CMA Alert, March 7, 2014), http://www.medicareadvocacy.org/staffing-deficiencies-in-nursing-facilities-rarely-cited-seldom-sanctioned/.
[19] Section 701 of the Bipartisan Budget Act of 2015, Pub. L. 114-74.  See Center for Medicare Advocacy, “Budget Act of 2015 Increases Penalties for Programs under the Social Security Act, Including Nursing Facilities” (CMA Alert, Nov. 18, 2015), http://www.medicareadvocacy.org/budget-act-of-2015-increases-penalties-for-programs-under-the-social-security-act-including-nursing-facilities/.

Full Article & Source:
CMS Increases Mandatory Enforcement to Protect Nursing Home Residents

Falmouth judge placed on leave

Falmouth District Judge Michael Creedon

FALMOUTH — The first justice of Falmouth District Court has been off the bench for more than a month after being placed on administrative leave, according to a spokeswoman for the state Trial Court.

Judge Michael Creedon was placed on leave June 30 after meeting with District Court Chief Justice Paul Dawley in response to a complaint filed against him with the Commission on Judicial Conduct, according to Trial Court spokeswoman Jennifer Donahue. Judge Kathryn Hand, who is first justice of Barnstable District Court, has been appointed acting first justice in the Falmouth court, Donahue said.

“The allegations have been reported to the Commission on Judicial Conduct,” Donahue said, declining to comment on the nature of the alleged misconduct.

Creedon did not respond to a voicemail left at his Cotuit home.

The Commission on Judicial Conduct is the agency responsible for investigating allegations that a state court judge has engaged in judicial misconduct or is incapable of properly performing judicial duties.

Creedon, a former lawyer, state representative and senator, was sworn in as first justice of Falmouth District Court in December 1999, replacing Judge Richard P. Kelleher, who retired. He is only the second person to hold that position at the court, which was created in 1996 and handles cases from Falmouth, Bourne and Mashpee.

Creedon, who attended Exeter Academy in Exeter, N.H., graduated from Harvard University in 1969 before receiving his law degree from Suffolk University Law School in 1975.

Before becoming a judge, Creedon practiced law in Brockton and was elected to the House of Representatives for that district in 1974. He served in the House until 1988 and then served four terms in the state Senate for the 2nd Plymouth and Bristol District until 1996.

He was appointed by Gov. William Weld in 1996 as a circuit judge for district courts in Attleboro, Hingham, Plymouth and Brockton before being named presiding judge in Falmouth. In Massachusetts, judges are required to retire at the age of 70. Creedon is slated for retirement Nov. 3.

Anyone may file a written complaint about a judge with the Commission on Judicial Conduct. The complaint is then screened by the commission staff to to determine if it is frivolous or warrants docketing.

Even if a complaint is docketed, the system is structured so that allegations against a judge, results of an investigation or discipline may never be known unless the judge chooses to contest them publicly.

If an investigation by the commission finds there is a cause for discipline, a judge could be privately reprimanded. An "agreed disposition" requires the agreement of the judge and often includes a period when the commission places conditions on the judge's conduct, which could include counseling, education, assignment of a mentor judge, monitoring by the commission for a specified period of time, voluntary retirement or other conditions, according to the commission’s website.

If the judge and commission do not agree on a disposition, there could be a public hearing, or the judge could choose to submit the matter directly and confidentially to the Supreme Judicial Court, according to the commission.

Full Article & Source:
Falmouth judge placed on leave

Caregiving Across State Lines: 45+ States Pass Law to Help

Imagine you care for your 90-year-old mother with dementia. She lives with you in your Georgia home. You help her with bathing and dressing, drive her to the doctor, cook her meals, manage her medications and do anything else she needs. Last year you were appointed her legal guardian by the state of Georgia to help manage her finances and make decisions for her about health care and more.

Your mother needs a special heart procedure, only available in a hospital in Florida, meaning you’ll have to cross state lines. The problem is, the Florida hospital may not accept guardianship orders from other states and is unable to treat your mother without authority from a Florida court. Now, as your mother’s health deteriorates, you have to desperately file for an expensive legal proceeding just so your mother can get the care she needs.

For some caregivers, the possibility of this hypothetical life-threatening situation is very real.

While every caregiving situation is different, many Americans care for their loved ones across state lines every day — and the law should be on their side, with consistent rules about state jurisdiction to make it easier.

The good news is, 45 states, the District of Columbia and Puerto Rico have already passed the Uniform Adult Guardianship and Protective Proceedings Jurisdictions Act (UAGPPJA), a law to support family caregivers serving as guardians as they care for their parents, spouses and other loved ones across state lines. This includes Georgia, Louisiana and North Carolina, where this important act was signed into law in 2016.

This law ensures scenarios like the one I outlined don’t happen, and provide more protections, by:

1. Outlining a set of rules for streamlining the transfer of guardianship from one state to another
2. Allowing states to recognize and register guardianship orders from other states
3. Creating a clear process for determining jurisdiction by designating which state should hear a request for guardianship when more than one state is involved
4. Protecting seniors by giving the court information and authority to act on abuse and exploitation

Full Article & Source:
Caregiving Across State Lines: 45+ States Pass Law to Help

CCHR Launches Campaign to Reduce Involuntary Examinations of Seniors in Florida

Launching a campaign to help protect the elderly from abuse under the mental health law in Florida, CCHR, is hosting a workshop on Advanced Mental Health Directives on Sunday, August 21 at 2pm at the center located in downtown Clearwater.

Clearwater, United States – August 16, 2016 /PressCable/ —
The Citizens Commission on Human Rights (CCHR), a non-profit mental health watchdog dedicated to the eradication of abuses committed under the guise of mental health, launched a campaign to educate senior citizens on their rights under the Baker Act in the hope of reducing unnecessary involuntary examinations of the elderly in Florida.

In honor of National Senior Citizens Day, CCHR is launching a campaign to help protect the elderly from abuse under the mental health law in Florida with a workshop on Advanced Mental Health Directives on Sunday, August 21 at 2pm at the center located in downtown Clearwater.

An advance directive is a written document expressing a person’s wishes for treatment, services and other assistance they want during a mental health crisis. This document is a clear statement of the person’s medical treatment preferences and can also be used to grant legal decision-making authority to another person until the crisis is over.

“When government insurance coverage for electroconvulsive therapy takes effect, 65-year-olds receive 360 percent more ECT treatment than 64-year-olds in the United States,” stated Diane Stein, President of CCHR Florida. “With studies showing that ECT shortens the lives of elderly people significantly it is our duty to educate senior citizens on their rights and help them to put in place advance directives that will ensure their treatment wishes are honored.”

CCHR will be hosting a weeklong open house following the Advanced Mental Health Directive Workshop on August 21st and for more information on the workshop, the open house or the protection of elder rights under the mental health law please call 727-442-8820.

About Citizens Commission on Human Rights:
Initially established by the Church of Scientology and renowned psychiatrist Dr. Thomas Szasz in 1969, CCHR’s mission is to eradicate abuses committed under the guise of mental health and enact patient and consumer protections.

It was L. Ron Hubbard, the founder of Scientology, who brought the terror of psychiatric imprisonment to the notice of the world. In March 1969, he said, “Thousands and thousands are seized without process of law, every week, over the ‘free world’ tortured, castrated, killed. All in the name of ‘mental health.’”

After discovering that 55 percent of foster children in Florida had been prescribed powerful mind-altering psychotropic drugs, CCHR documented the abuse to the health department which initiated changes that led to a 75 percent reduction in prescriptions for children under six.

Considered a potentially abusive, marketing tool for psychiatrists, CCHR Florida led the charge that got “Teen Screen”, mental health screening of school children, banned from Pinellas County schools in 2005. For more information visit, www.cchrflorida.org

SOURCES:

http://www.cchr.org/cchr-reports/elderly-abuse/introduction.html

For more information, please visit http://www.cchrflorida.org/

Contact Info:
Name: Diane Stein
Email: publicaffairs@cchrflorida.org
Organization: Citizens Commission on Human Rights of Florida
Address: 109 N. Fort Harrison Ave
Phone: 727-442-8820 

Full Article & Source:
CCHR Launches Campaign to Reduce Involuntary Examinations of Seniors in Florida

National Medical Malpractice Advocacy Association (NMMAA) Files Complaint Claiming Abuse of Patients in Nursing Home

News Release

For Release: Monday, August 15, 2016
Contact(s): Deirdre Gilbert (832) 488-5765

HOUSTON – The National Medical Malpractice Advocacy Association announced today that it has filed a complaint against The Colonnades at Reflection Bay, alleging abuse of several patients. The complaint alleges that the facility engaged in abuse, degradation, physical punishment, neglect, theft of property and failure to maintain infection control. The complaint also alleges that this facility is money laundering money through a for-profit Sweeny Hospital District with Cantex Continuing Care Network as the Management Company.

The Colonnades at Reflection Bay is a large size nursing homes facility in Pearland Texas. It is purported to provide both short and long-term care. This company is stated not to be a part of a Continuing Care Facility according to the Department of Aging and Disability Services. On August 1, 2016 NMMAA was called about a patient within the facility who was stated to have fallen out of the bed. No one could account for how long the patient had been on the floor or how she received several contusions, and bruises to her body. This patient happened to be my family member of the National Director of NMMAA. National Director, Deirdre D. Gilbert visited the facility to find out what happened and no one could tell her anything. It is stated when she walked into the room the patient was naked from the waist down, laying on a bed half covered laying on a wet pad. This was 6:30 pm of that same day and the patient had not been documented of the fall or was taken or observed for any broken bones. It was only at the insistence of Deirdre Gilbert that the patient was sent to Memorial Hermann for observation and was given a series of test to determine if there were any broken bones. The patient was found to have internal bleeding which could have been caused by the doctor giving her three blood thinners. The patient was also documented with bruises on elbow, arms, and knees.

The patient was also noted to having hallucinations so NMMAA Director, requested from the doctor to see if there was a test to see if she had been injected with Haldol, but there is no test to determine that. Many nursing homes have resorted to giving patients these drugs without consent causing patients to become disillusioned and lethargic. On August 2, 2016 Pearland Police was contacted to come in and do a report so that we could have it on file that we were reporting abuse of a patient. Case #2016064934.

The records of the patient showed that she had not had a bowel movement for 20 days. She was noted to have E, Coli which was not being treated. Nurses were caring for other patients in the facilities without gloves or protective clothing. The patient had not had a bathe since she entered that facility on July 15, 2016.

The Colonnades at Reflection Bay has been cited for abuse of patients on several occasions. The police reported that they have had several complaints from this facility. We also received from EMS that they have had to transport several patients noted to have been abused, neglected, mistreated and some have died. NMMAA receives several complaints and one week after the filing of the first complaint has had another call reporting abuse of another patient. From a confirmed source several patients have died in this facility and states that The Colonnades has never reported these incidences.

In addition The Colonnades has been stripped of its’ funding on several occasions and is still not adequately protecting residents from abuse. NMMAA has asked for a full investigation and Complete Closure of its’ facility.

For more information please contact us at nammv1988@gmail.com.

Full Article & Source:
National Medical Malpractice Advocacy Association (NMMAA) Files Complaint Claiming Abuse of Patients in Nursing Home

City of Knoxville receives grant to combat elder abuse

KNOXVILLE (WATE) – The city of Knoxville has received a $350,000 grant to combat elder abuse in the community.

In 2015, there were 483 investigations involving adult protective services in Knox County. Among those investigations, 105 allegations of emotional abuse, 78 allegations of physical abuse, 136 allegations of financial exploitation, 111 allegations of elder neglect and 13 allegations of sexual abuse were reported.

“I think this is an issue that not a lot of people realize is a problem in their community but is something that when people find out more about they feel engaged, passionate. They want to do something to help seniors in their community,” Joseph Winberry, elder abuse community outreach program manager, said.

Though elder abuse remains an on-going issue in Knoxville and around the country, city leaders predict an even greater number of crimes against the elderly as more baby boomers enter retirement. Knoxville Police Chief David Rausch said it’s an issue that affects one of the community’s most vulnerable populations.

“Unfortunately, you have caretakers in the home that are family and they will take advantage and that’s probably the most heartbreaking, because you want to trust your family,” Rausch said.

While local law enforcement and social services respond to hundreds of elder abuse calls every year, the number of cases are believed to be much higher, pointing to data that shows only one in every 20 elder abuse crimes is reported.

“The problem is real and it is vital that all of us who serve the public and interact with elderly citizens know how to recognize the signs of abuse and what resources are available,” Knoxville Mayor Madeline Rogero said.

Rausch said the majority of elder abuse crimes involve domestic abuse, financial exploitation and scams. The federal grant will fund the training of 877 law enforcement officers, with the Knoxville Police Department and the Knox County Sheriff’s Office, the education of professional care takers, and services for victims of abuse.

Organizers said it’s a much needed step to ending what they call an epidemic and an opportunity for Knoxville to be a leader in the fight against elder abuse.

“I know that if my grandmother was in need or an older adult that I cared about needed that support, I would hope that someone would do that for them, so I’m thankful to be able to do that in Knox County,” Winberry said.

Source:
City of Knoxville receives grant to combat elder abuse

Elderly Hospital Patients Arrive Sick, Often Leave Disabled

Janet Prochazka

SAN FRANCISCO — Janet Prochazka was active and outspoken, living by herself and working as a special education tutor. Then, in March, a bad fall landed her in the hospital.

Doctors cared for her wounds and treated her pneumonia. But Prochazka, 75, didn’t sleep or eat well at Zuckerberg San Francisco General Hospital and Trauma Center. She became confused and agitated and ultimately contracted a serious stomach infection. After more than three weeks in the hospital and three more in a rehabilitation facility, she emerged far weaker than before, shaky and unable to think clearly.

She had to stop working and wasn’t able to drive for months. And now, she’s considering a move to Maine to be closer to relatives for support.

“It’s a big, big change,” said her stepdaughter, Kitty Gilbert, soon after Prochazka returned home. “I am hopeful that she will regain a lot of what she lost, but I am not sure.”

Many elderly patients like Prochazka deteriorate mentally or physically in the hospital, even if they recover from the original illness or injury that brought them there. About one-third of patients over 70 years old and more than half of patients over 85 leave the hospital more disabled than when they arrived, research shows.

As a result, many seniors are unable to care for themselves after discharge and need assistance with daily activities such as bathing, dressing or even walking.

“The older you are, the worse the hospital is for you,” said Ken Covinsky, a physician and researcher at the University of California, San Francisco division of geriatrics. “A lot of the stuff we do in medicine does more harm than good. And sometimes with the care of older people, less is more.”

Hospital staff often fail to feed older patients properly, get them out of bed enough or control their pain adequately. Providers frequently restrict their movements by tethering them to beds with oxygen tanks and IV poles. Doctors subject them to unnecessary procedures and prescribe redundant or potentially harmful medications. And caregivers deprive them of sleep by placing them in noisy wards or checking vital signs at all hours of the night.

Interrupted sleep, unappetizing food and days in bed may be merely annoying for younger patients, but they can cause lasting damage to older ones. Elderly patients are far different than their younger counterparts — so much so that some hospitals are treating some of them in separate medical units.

San Francisco General is one of them. Its Acute Care for Elders (ACE) ward, which opened in 2007, has special accommodations and a team of providers to address the unique needs of older patients. They focus less on the original diagnosis and more on how to get patients back home, living as independently as possible.

Early on, the staff tests patients’ memories and assesses how well they can walk and care for themselves at home. Then they give patients practice doing things for themselves as much as possible throughout their stay. They remove catheters and IVs, and encourage patients to get out of bed and eat in a communal dining area.

“Bed rest is really, really bad,” said the medical director of the ACE unit, Edgar Pierluissi. “It sets off an explosive chain of events that are very detrimental to people’s health.”
Such units are still rare — there are only about 200 around the country. And even where they exist, not every senior is admitted, in part because space is limited. (Click to continue)

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Elderly Hospital Patients Arrive Sick, Often Leave Disabled