The Perils of Problematic Prescribing: A Double Dose of Warnings

Twice this week, the Centers for Disease Control and Prevention has pointed to the harm caused by aberrant and inappropriate prescribing by physicians.

First, the CDC reported Monday that doctors are a primary source of narcotic painkillers for chronic abusers at the highest risk of overdoses.  Physicians edged out even family, friends and drug dealers. More than 16,000 people died of narcotic overdoses in 2010, the most recent year for which data is available, the CDC has reported.

On Tuesday, the public health agency said that it found  vast differences in the use of antibiotics  among different hospitals’ medical/surgical wards. Doctors in some hospitals prescribed three times as many antibiotics as those in other hospitals. The CDC also said that in about one-third of cases, prescriptions for the antibiotic vancomycin included a potential error – either it was prescribed without proper tests or evaluation, or given for too long.

Full Article and Source:
The Perils of Problematic Prescribing:  A Double Dose of Warnings

Arizona House Passes Bill for Prosecuting Assisted Suicide

The Associated Press has reported that an Arizona bill designed to make it easier to prosecute cases of assisted suicide passed on the Arizona House on Tuesday. The article stated:

Republican Rep. Justin Pierce of Mesa says his bill will make it easier for attorneys to prosecute people for manslaughter for assisting in suicide by more clearly defining what it means to "assist." 

House Bill 2565 defines assisting in suicide as offering and providing the physical means used to commit suicide, such as a gun. Current state statute does not clearly define what it means to "assist." 

The proposal was prompted by a difficult prosecution stemming from a 2007 assisted suicide in Maricopa County. 

The House approved the bill by a 41-18. It will now move to the Senate.

House Bill 2565 is a response to the acquittal of two Final Exit members stemming from a 2007 assisted suicide case. An Associated Press article from February 13 described the issue more clearly. The article stated:  

Four members (Final Exit) were tried for manslaughter. Two pleaded guilty to lower charges, while another two others were acquitted. 

Rebecca Baker, the legislative liaison for the Maricopa County Attorney's Office who worked with Pierce on his bill, said juries acquitted those two members because they did not clearly understand what it means to assist. 

"The conclusion we ultimately came to was that we should just have the statute be more specific," she said.

Source:
Arizona House passes bill for prosecuting assisted suicide

Jenny Hatch Justice Project

On behalf of Quality Trust for Individuals with Disabilities, I am proud to introduce you to the Jenny Hatch Justice Project (“JHJP”)! The JHJP is an integrated, multi-faceted resource and outreach center dedicated to advancing people with disabilities’ right to make their own choices and determine their own path and direction in life.

Margaret “Jenny” Hatch is a 29 year old woman with Down syndrome who the Washington Post describes as a “hero to the disabled.” 

She never planned to be.

Instead, Jenny wanted to live her life the way she always had – deciding where to live, what to do, work and see like everyone else does.  That all changed in August of 2012, when Jenny was served with a Petition attempting to put her in a guardianship, one where her guardians would have the power to make all her decisions for her – even whether to receive or withhold healthcare.  Almost immediately, Jenny was placed in a temporary guardianship and forced to live in a group home, where she was cut off from her friends, removed from her job and taken from the life she made for herself in her community. 

Through it all, Jenny never lost hope, never stopped insisting that she did not need a guardian, she just needed a little help.  Like everyone else. 

At long last, after a year of litigation and six days of trial, Jenny won the right to make her own decisions. Jenny now lives and works where she wants, has the friends she chooses, and encourages others to do the same. 

Since the “Justice for Jenny” trial ended, Jenny has become a sought-after speaker, sharing her story and strength with groups across the country.  The Jenny Hatch Justice Center is named in her honor, in recognition of her courage and commitment.

Source:
JennyHatchJusticeProject.org 

Arkansas: How Judicial Misconduct Investigations Work

It’s likely that Faulkner County Circuit Judge Mike Maggio did not have formal notice that a state judicial oversight commission has been looking into allegations of online impropriety.

It was claimed on Monday by an online alternative news website, bluehogreport.com, that Maggio may be the author of embarrassing and misogynistic posts to a LSU online forum under the pseudonym “geauxjudge” — which would tend to raise questions of decorum possibly amounting to a violation of the state Code of Judicial Conduct. The person writing the posts also revealed that Charlize Theron, the actress, adopted a child in a Faulkner County proceeding.

Generally, all adoption proceedings are sealed by law and few people not directly involved in actress’s adoption knew about it until it was published online by the Blue Hog Report and Arkansas Times on Monday.

Maggio said in a press release on Tuesday that he was “unaware of any [Judicial Discipline and Disability Commission] complaint,” and was “prohibited from commenting” if there was one.

During an investigation into alleged judicial misconduct, the state Judicial Discipline and Disability Commission may delay notifying the subject of the investigation “so that court proceedings may be monitored or certain evidence obtained,” according to a summary of usual procedure on the JDDC’s website.

Formal notice to a judge comes at the conclusion of the preliminary investigation, when the judge “is then formally notified of the substance of the allegations and given an opportunity to respond both in writing and at a formal appearance before the commission.”

At this point the JDDC may dismiss the complaint based on the judge’s response, or if the misconduct is found to be “of a relatively minor nature” the JDDC may end matters there with a public admonition or “informal adjustment” such as professional counseling or other assistance.
But if the misconduct warrants a formal disciplinary procedure, a formal disciplinary hearing before the JDDC will be scheduled. This hearing is open to the public and operates much like a civil trial, with evidentiary and procedural trial rules.

If at the end of the formal disciplinary hearing the JDDC decides to take a disciplinary action, it has the authority to reprimand or censure (sternly rebuke) a judge or to recommend to the Arkansas Supreme Court that the judge be suspended or removed from office.

Full Article and Source:
How Judicial Misconduct Investigations Work

Woman Charged With Financial Exploitation of Elderly Woman in Her Care

A woman hired to be a caregiver for an elderly resident with Parkinson’s disease is facing criminal charges for allegedly using the 86-year-old victim’s credit cards without her permission, running up thousands of dollars in charges.

Carpentersville Police Cmdr. Timothy Bosshart said the Kane County State’s Attorney’s Office charged Lalaine Regencia, 46, of Cary, with financial exploitation of the elderly and two counts of theft. All are class 2 felonies.

 

Regencia had been working as a caregiver for the victim since February 2013, reports stated. The victim said she trusted Regencia, who would use her own car to take the victim to church, stores and to get her hair done.

 

On Jan. 14, according to reports, police met with Regencia who admitted to using the victim’s Chase credit card since spring or summer, to pay bills and to buy groceries and clothing.

 

When police asked her about the Chase bill approaching $16,000, the report stated Regencia said she didn’t realize it had gotten that high.

Full Article and Source:
Cary Woman Charged With Financial Exploitation of Elderly Woman in Her Care

Tonight on T.S. Radio: Guardianship Abuse - New Laws Coming to Protect the Predators

Marcia Southwick joins us this evening to discuss new laws being promoted in several states claiming to reform predatory guardianships, perpetrated by professional predators operating through and with the probate courts.

As an example: SB 634 from Florida, sponsored by Senator Brandes appears on the surface to deal with the failure to submit timely audits of the victims estate. A careful reading of the opening paragraph, lines 1-32 makes clear that this new statute would apply only to NON-Professionals....in other words, family members or anyone not working in a professional capacity in guardianship.

Anyone not working under protection of the probate court, the BAR Association, The National Guardianship Association or any other association that operates as a protection racket for professional predators.

This should be a revealing discussion on what is intentionally omitted from bills, what is written to appear as a major change when in fact it is nothing more than a furtherance of protection for those gaming the system while targeting families and friends.

We will take calls in the second hour. 5:00 pm PST … 6:00 pm MST … 7:00 pm CST … 8:00 pm EST

LISTEN LIVE to the show or listen to the archive later

Arizona: State Launches Investigation After Undercover ABC15 Investigation into Assisted Living Center

State officials have launched an investigation into an assisted care center for disabled and vulnerable adults after ABC15 exposed troubling conditions at the facility.

The Department of Health Services and Adult Protective Services (APS) both confirmed that they are looking into The Lodge at 14th Street, a directed care home for residents with mental illness, physical disabilities, or both. Almost all of the residents are taxpayer funded through Medicaid.

The ABC15 Investigators went undercover at The Lodge and shot or obtained videos and pictures to document the conditions. On Sunday, we aired footage that showed filthy rooms, residents in tattered and dirty clothing, blood- and bug-stained mattresses without sheets or blankets, and evidence of past and current bed bug problems.

Health department inspectors visited The Lodge on Tuesday.

In a statement, APS said they are “aware of the situation and will visit the home” and will work with the health department to “address quality of care issues.”

The state expects to release more information about the investigation in coming weeks.

Full Article and Source:
State launches investigation after undercover ABC15 investigation into assisted living center

See Also:
Arizona:  ABC15 Undercover Investigation:  Filthy Conditions, Bedbugs at Assisted Living Facility

Binding Arbitration Unhelpful in Elder Care Dispute

When Karen Fritz retired from a career at Rosauers Supermarkets nine years ago, she began taking care of her aging mother.

Soon, it became apparent her mom, Alice Newton, could no longer look out for herself. Her vision was failing. She was suffering from Alzheimer’s disease. Fritz moved in with her. It was a challenge, but it was also a joy, Fritz said. They planted a garden together. Fritz would put her mom in her wheelchair and take her out shopping.

“We had a lot of fun,” said Fritz, who is now 71.

But in 2009, Newton stopped sleeping well. She wouldn’t stay in her bed at night. Fritz, exhausted, turned to a new facility in Spokane Valley for help. Fritz put her mom in the center for a few days of respite care, so she could get some badly needed rest.

What happened at the Pine Ridge Alzheimer’s Special Care Center over the next six days is a matter of sharp dispute, and of a legal process that’s done virtually nothing to clarify that dispute. Fritz says her mother returned home with unexplained bruises and rug burns, complaining in consistent and specific ways about abuse and threats from caregivers at the center.

The center denies that it abused or neglected Newton and says the ailing woman made many accusations that were, on their face, untrue. A state inspector was coincidentally at the center during Newton’s stay and investigated her claims, finding that the center had improperly turned off her bed alarm and not investigated her claims quickly enough, but issued no abuse or neglect citations, said Gerald Kobluk, the attorney who represented Pine Ridge and its owner, JEA Senior Living.

“JEA Senior Living is one of the good guys out there,” Kobluk said. “They have an exceptional reputation and a spotless record.”

The case exemplifies many of the legal and personal challenges that surround an aging population, including the highly uncertain way that many claims against elder care facilities are resolved. When she put her mother into Pine Ridge, Fritz agreed to resolve almost all disputes through binding arbitration. An arbitrator awarded her $150,000 in December based on her claim of negligence but ruled in favor of the center on Fritz’s claims of neglect and abuse.

Under state law, negligence is a “failure to exercise ordinary care.” Under the Vulnerable Adult Protection Act, neglect is a “pattern of conduct or inaction” that causes harm by someone with a duty to care for a vulnerable adult.

Fritz’s attorney, Doug Spruance, calls it “an impossible ruling,” and an example of the way that binding-arbitration agreements limit a plaintiff’s ability to seek justice. He sees the finding as contradictory, the kind of thing that should be tested on appeal.

“You can’t have no neglect and have negligence,” he said. “I’ve won losers and I’ve lost winners throughout my career. I’ve never seen something that I feel so strongly would be reversed on appeal.”
The use of binding-arbitration agreements is increasing as long-term-care facilities try to hold down their liability expenses, which are steadily rising. Critics of the agreements say that many people – like Fritz – enter them unknowingly or thoughtlessly, and are signing away their rights to a jury trial or appeal.

Full Article and Source:
Shawn Vestal:  Binding Arbitration Unhelpful in Elder Care Dispute

News 4 New York I-Team: Families Outraged After Macabre Nursing Home Death Involving Two Veterans

Families of two Korean War veterans say a Long Island nursing home neglected basic care and left their elderly loved ones to suffer gruesome deaths last year.

 

In one case, a former soldier died after his bedsores grew so large and deep, a human hand could fit inside some of the gaping holes in his skin. Another elderly veteran with dementia died after nursing staff lost sight of him for nearly an hour and he accidentally hanged himself while trying to wiggle out of a wheelchair restraint.

 

Thomas Bischoff lived at the Suffolk Center for Rehabilitation and Nursing for several years. By the time of his death at age 74 on March 18, 2013, pressure ulcers, better known as bedsores, covered much of his backside.

 

Medical records from Brookhaven Memorial Medical Center say Bischoff went into cardiac arrest after a septic infection attacked his respiratory system. The records also say his bedsores helped cause that septic infection.

 

“There’s no doubt in my mind that he was neglected,” his granddaughter, Alicia Zarzana, told the I-Team.

 

Richard Mollot, director of the Long Term Care Community Coalition, said such gaping sores are almost always a sign of nursing home neglect.

 

“When we see that the pressure sores are very serious – very large, there is a number of them, etcetera – that should ring everyone’s alarm that something is wrong here,” Mollot said.

 

About four months after Bischoff died, another Korean War veteran, Raymond Curiale, accidentally hanged himself. Curiale’s care plan after he was admitted in March 2013 required staff to monitor him every 15 minutes.

In recent years, New York state has steadily relaxed the number of penalties levied against long-term care facilities.

 

According to data compiled by the Long Term Care Community Coalition, the Health Department issued 142 enforcement actions against nursing homes in 2007. In 2011, the number was down to 81. Last year there were 27 enforcement actions against New York nursing homes totaling just over $217,000 in fines. Of those, the Suffolk Center was found responsible for just over $36,000.

 

The New York Health Department declined to share any reason for the drop in enforcement actions against nursing homes.

 

New York is also one of few states that have no law establishing a minimum number of assistants per nursing home resident. A bill in the New York legislature called the “Safe Staffing for Quality Care Act” sought to change that, but it stalled in committee last year.

 

As the Department of Health scales back penalties, New York Attorney General Eric Schneiderman appears to be getting tougher on nursing homes. In February his office filed criminal charges against a Bronx nursing aide who was caught on camera pushing a dementia patient. The same month, his office accused owners and employees of a Medford nursing home of providing substandard care and cheating Medicaid. Defendants in both cases pleaded not guilty.

 

Full Article, Video, and Source:
I-Team:  Families Outraged After Macabre Nursing Home Deaths