Maryland Sues ‘Inhumane’ Nursing Home Provider

WASHINGTON (CN) – The state of Maryland wants treble damages from a nursing home operator that it says has dumped at least 1,000 elderly residents, oftentimes at homeless shelters, after they’ve exhausted their Medicare coverage for a short-term stay.

Maryland Attorney General Brian Frosh notes that Medicare pays for post-hospitalization care “at substantially higher daily rates than Medicaid pays for long-term care,” making it more lucrative for unscrupulous facilities to replace one resident for someone whose care will be reimbursed at a higher rate.

Frosh filed the complaint on Dec. 21 in Montgomery County Circuit Court, taking aim at Neiswanger Management Services, or NMS, the operator of five nursing homes across the state.

“Each year, NMS unlawfully evicts from its nursing facilities hundreds of frail, infirm, mentally ill, and physically and intellectually disabled people,” the complaint states.

Frosh says NMS gave 1,061 residents the boot between January 2015 and May 2016 – more than twice as many evictions as all other nursing homes in the state combined over the same time period.

NMS usually accused the evictees of not paying for their care, but the complaint says the real reason for this inhumane conduct is maximizing reimbursements from taxpayer-funded public health insurance programs.

“In 2015, the five NMS facilities received more than $100 million in reimbursement from Medicare and Medicaid, including more than $35 million from Maryland’s Medical Assistance program,” the complaint states.

Evicted regardless of their health status, former NMS residents frequently appear in hospital emergency rooms within days or weeks of eviction, according to the complaint.

Frosh says these individuals are usually “facing serious or life-threatening medical complications caused by their evictions,” and that the state is left to cover the cost of the emergency care they require.

“NMS often abandons its evictees far from their hometowns, in places where they have no family connections to assist them,” the complaint states.

Mark Yost, CEO of NMS told the Washington Post that they would fight the complaint.

“NMS strongly denies any wrongdoing and disputes the entirety of the attorney general’s allegations in this matter,” Yost said. “We intend to prove our case and will respond in the appropriate forum in due time.”

Attorney General Frosh details how NMS tossed out one cancer-stricken woman named Vonda Wagner from its Hagerstown facility last year.

A woman named Sharon Isaacs allegedly drove the 85-pound woman to one of the Baltimore row houses she operated and housed with “frail and disabled people.”

“NMS and Ms. Isaacs have a longstanding partnership under which NMS rids itself of residents whose Medicare post-hospitalization benefits it has already extracted or whose public health insurance profile it otherwise regards as no longer attractive, and under which Ms. Isaacs then strips these vulnerable and often helpless NMS evictees of social security payments and other public benefits,” the complaint states.

The complaint names seven individuals as defendants but Isaacs is not one of them.

During Wagner’s stay at the row house for several weeks, she was deprived of her medication and was fed only instant ramen noodles and water, according to the complaint.

Frosh says Isaacs beat Wagner and dropped her at a homeless shelter when upon learning that Wagner had canceled a state-issued debit card Isaacs had confiscated.

Wagner eventually went to the emergency room and remains homeless to this day, according to the complaint.

Another resident had more than $2,000 in social security benefits stolen from him in a similar scheme, according to the complaint, which also describes the abandonment of a “cognitively impaired” resident in the driveway of her son’s house on a 95-degree day. The son allegedly found his mother wandering toward the woods.

Frosh says more than 700 current residents in the five nursing homes Neiswanger manages are at risk of eviction if the court does not step in and grant the state’s request for an order preventing the company from issuing more evictions without reason.

“NMS and its leadership have compromised the health and safety of hundreds of vulnerable people with whose care they have entrusted,” Frosh said in a statement. “My office will fight to put a stop to NMS’ unsafe and inhumane practices. We will also seek to recover from NMS the public funds that the Medicaid program paid to NMS while it was engaging in this unlawful conduct, as well as the amounts that the Medicaid program paid to hospitals and other medical providers that cared for former NMS residents after they were evicted.”

The state seeks $10,000 per violation of the False Health Claims Act as well as three times the damages Maryland sustained for such violations.

In addition to NMS CEO Yost, the complaint names as defendants former CEO Matthew Neiswanger and the administrators of each nursing home it operates.

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Maryland Sues ‘Inhumane’ Nursing Home Provider

Vulnerable Adult Protective Investigative Team responds to elder abuse

One of the more baffling trends in Tennessee is the rise in incidents of elder abuse, but there is one thing that’s certain: Prosecution of the perpetrators must be swift and unfailing.

Whether the abuse is financial or physical, taking advantage of those experiencing the vulnerability brought on by age is, like child abuse, an unpardonable crime.

It is often thought of as an institutional issue, but largely occurs in the victims’ own homes, and the abusers are often family members.

The formation of a special investigative team at the Shelby County district attorney’s office to investigate abuse of the elderly and disabled is an appropriate response to the actions of those who attack the elderly physically, financially or sexually, often preying on their fragile emotional or mental state.

The Vulnerable Adult Protective Investigative Team, formed by District Atty. Gen. Amy Weirich, will satisfy state legislation passed this year that requires all state district attorneys to establish an elder abuse response team in their district effective Jan. 1.

And it will address a crime that has increased in frequency as the Baby Boom generation reaches a vulnerable stage of life.

Senate Majority Leader Mark Norris, in a Viewpoint guest column published in July, reported a rise of almost 20 percent in simple assaults against older adults statewide from 2009 to 2013 and an increase the number of reported cases of fraud against older individuals of 21 percent over the same period.

The Tennessee Commission on Aging and Disability has estimated that only one in 23 cases of elder abuse is reported, attributing the silence to the fact that the victim often lives with someone who controls his or her access to the outside world, finances, meals, medication and everything else.

Representatives of the DA's office, local law enforcement, the state Department of Human Services and the Coordinated Response to Elder Abuse, or CREA, which includes the Aging Commission of the Mid-South, Memphis Area Legal Services and numerous other agencies, are on board  in this battle.

Solidly behind the initiative is the Plough Foundation, which conducted a two-year study of the issue, found that there was no single organization with the capacity or resources to lead the charge against elder abuse, and supported the creation of CREA with a $3.45 million grant.

The foundation is also providing funds to support the prosecutor's new elder abuse team, consistent with its leadership in the effort to facilitate independent living for the elderly.

The foundation has leveraged a $4 million grant into a $6 million Aging in Place program over the past two years, working with partners Service Over Self and MLGW.

People who suspect elder abuse can report it to adult protective services at 1-888-277-8366 or the Memphis and Shelby County Family Safety Center at 901-222-4400.

These new programs should encourage more reporting of elder abuse so that more abusers can be held accountable for this largely invisible crime.

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Vulnerable Adult Protective Investigative Team responds to elder abuse

Millions missing from lawyer's trust account, bar alleges after he abruptly closes law firm

A Las Vegas probate and real-estate lawyer transferred a home purchased for nearly $1 million to his wife amid an investigation into missing client funds and the abrupt shuttering of his law practice.

The allegations surrounding lawyer Robert Graham raise questions about the need for additional safety nets for lawyer trust accounts, according to Brandi Cassady, one of the attorneys appointed to assume control of Graham’s files and law practice.

Graham was arrested on Wednesday in connection with the theft of $2.1 million from clients in three cases, the Las Vegas Review-Journal reports. Chief Deputy District Attorney J.P. Raman said in court that the total amount stolen may be more than $15 million.

Raman said that, when Graham closed his law firm, he deleted nearly 3,000 files relating to clients, wire transfers and operations. The initial charges are “just the tip of the iceberg,” she said.

Graham was temporarily suspended as a result of action by the State Bar of Nevada, which says Graham closed the practice on Dec. 2, abandoning more than a hundred client files. The bar has filed a complaint alleging Graham stole millions of dollars from his clients before closing his firm, the Las Vegas Review-Journal reports. Prior stories by the newspaper are here, here and here.

Graham transferred the Colorado home to his wife just days after he closed his law practice, according to property records examined by the Review-Journal.

The bar complaint says Graham should be holding more than $13 million in safekeeping for his clients, but account balances “total much less.” The money should have been held in deposit in Graham’s Interest on Lawyers Trust Account, known as an IOLTA account, according to the bar.

Brandi and Jasen Cassady of the Cassady Law Office have both been appointed to take over Graham’s law practice at his Lawyers West firm. Brandi Cassady tells the ABA Journal in an email that the vast majority of lawyers are decent people who would never touch the money held in IOLTA accounts. “Collectively, we hold billions without issue,” Brandi Cassady said.

“However, I think the time has come for additional safety nets to be added when appropriate. You cannot legislate a moral compass, and stealing client money held in a lawyer’s trust account is already illegal, but I think bonding for attorneys who hold trust accounts would be an excellent solution,” Cassady said.

“The legal community will be brainstorming to create a viable solution that will protect the public and keep the process affordable and realistic for solo attorneys and small firms, and thus, the clients,” Cassady added. “I think bonding that is specific to attorneys would be a great idea and keep the process affordable and keep the courts unclogged.”

Graham told the Review-Journal in a December interview that his law practice was a business failure. “I was responsible for the litigation and felt I had no out,” Graham said. “So bit by bit, I moved the chairs on the deck. Each year, things got worse and worse, and I tried to bail myself out and just couldn’t.”

The newspaper asked Graham about what he would say to his former clients. “There’ll be a time when I can fall to my knees and ask them to please forgive me,” he said. “I’ve been sidetracked. How I ended up here, I’ll never know.”

Graham’s public defender, Bryan Cox, says his client disputes the prosecutor’s allegations about deleted files. Cox told the Review-Journal that the files may have been moved to a hard drive for preservation.

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Millions missing from lawyer's trust account, bar alleges after he abruptly closes law firm

My mother told me to let her die rather than let her live in a wheelchair

My mother thought limited mobility would end her independence. But her life is still full of love.

My mother didn’t want to live if she had to use a wheelchair. But things change.

The night before my mother had her knees replaced almost 15 years ago, she took me aside. “If I end up in a wheelchair,” she said, “I want you to promise you will have them pull the plug.”

My mother was 75. She had five children, nine grandchildren and a husband of 55 years who still wrote love poems for her. She was frightened, vulnerable, unable to imagine a life worth living if she couldn’t walk. Fiercely independent her whole life, she’d agreed to surgery in the first place only because my sister, a physician, warned her that without it she was headed to a wheelchair.

“Promise me,” she said through tears. “I can’t live in a wheelchair.”

I was taken aback, surprised that she’d rather die than adapt, and hurt that her personal calculus devalued maximizing time with those who love her.

Neither of us were our best selves.

“No,” I said, “I won’t promise. Besides, there’d be no plug to pull.”

The surgery was excruciatingly painful but a success, leaving my mother ornery for a time but on the mend. Only afterward did the surgeon tell her that knee replacement is one of the most painful operations.

For two months, my parents lived in our downstairs den as my mother slowly recovered. She was diligent about her physical therapy. With my mother using crutches, we ventured first to the corner, then, with a cane, to the coffee shop, and finally, just before my parents returned home, we walked to the synagogue three blocks away for my daughter’s bat mitzvah. Before the surgery, my mother could not climb the curb from street to sidewalk without wincing in pain. Now she walked up a full flight of concrete stairs to the sanctuary inside.

Today my mother is 89. Her knees don’t hurt, but other parts do, and her heart, grown softer and sweeter over the years, has weakened. After months of resistance, she uses a walker even to traverse the short distance from her bedroom to her living room in the independent living facility in California where she now lives. She has recalibrated her understanding of dependence and independence, and, given the choice between staying home or using a wheelchair in the airport, she chooses the wheelchair and the chance to travel.

This travel — to a grandson’s college graduation in Chicago, a granddaughter’s graduation in Maine, another granddaughter’s graduation in  Atlanta — is not the travel she did with my father, the returning GI she met in 1946 at age 19 in engineering school. They traveled together to Europe, China, various states. Neither is it the business travel to Japan and Russia she undertook while managing international fusion research projects for the U.S. Energy Department. But it is travel nonetheless.

A few years after my mother had her knees replaced, my father started to suffer from dementia and Parkinson’s disease, and my mother (eventually with round-the-clock help) kept him at home longer than seemed possible to my siblings and me. When we finally moved my father to a nursing home in 2013, my sister and I, wanting to introduce and honor the man beneath the disease, made a sign for his door that read: “Husband. Father of five. Grandfather of 12. Retired nuclear engineer. Fluent in five languages. Philosopher. Poet.”

My father died in his sleep a few months later. By then, my mother had weathered his frustration and anger at knowing, helplessly, that his mind was slipping away. When that awareness vanished, leaving him gentle and serene, my mother preserved his dignity with attentive home caretakers who treated him with respect, even affection.

The man my father had been would have been appalled at the man he had become, incapable of navigating his way from the start of a simple sentence to the end, too unsteady to have much use for his walker, unable to groom himself. He would not have wanted to live in such a state. But the man he had become suffered no pain. Loved and loving his entire life, his face exploded with a smile at the sight of my mother or one of his children. Sometimes my mother’s daily visit to the nursing home consisted of little more than holding the hand of the husband who, in a poem, once described happiness as the moment she came home. His life still had value, for him and us.

Every year for the past several years, I have taken my mother to New York, where she grew up.

Together, we visit the Museum of Modern Art, the Museum of the City of New York and the Jewish Museum. In every museum, I check my mother’s walker and borrow a wheelchair. We go to a Broadway show and eat at a restaurant next to the theater because, despite the walker, my mother no longer has the strength to walk more than half a block without resting. We don’t venture more than a few doors from the hotel when we go out for breakfast.

“Next time,” I said to my mother as our last visit drew to a close, “let’s rent a wheelchair so I can take you to Central Park.”

More grateful now for what she can do than mournful over what she can’t, my mother said, “Okay.”

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My mother told me to let her die rather than let her live in a wheelchair

Rome Woman Charged with Stealing Thousands of Dollars from Elderly Grandmother

Molly Elizabeth Mason, 27 of Rome, was arrested on Wednesday for burglarizing and exploiting an 89 year-old woman.

Reports stated that in December of last year Mason stole several checks from her 89 year-old grandmother at her home on McGrady Road. She then allegedly passed them at numerous locations, racking up over $4,000 in purchases.

Later last month she is accused of entering into the President’s Office at Berry College and stealing a Visa credit card.

Police added that it was also discovered that between October 19th and October 31, 2016 she presented checks at Heritage First Bank in the amount of $1,564.56 that was supposedly made by her elderly grandmother. She also presented checks for $2,310 to Coosa Valley Credit Union and $3,380.02 to Wal-Mart.

In late December she is also charged with stealing her grandmother’s visa credit and Belk charge cards.

Mason is charged with two counts of first degree burglary, exploitation of the elderly, financial transaction card theft and three counts of forgery.

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Rome Woman Charged with Stealing Thousands of Dollars from Elderly Grandmother

How Social Isolation Is Killing Us

My patient and I both knew he was dying.

Not the long kind of dying that stretches on for months or years. He would die today. Maybe tomorrow. And if not tomorrow, the next day. Was there someone I should call? Someone he wanted to see?

Not a one, he told me. No immediate family. No close friends. He had a niece down South, maybe, but they hadn’t spoken in years.

For me, the sadness of his death was surpassed only by the sadness of his solitude. I wondered whether his isolation was a driving force of his premature death, not just an unhappy circumstance.

Every day I see variations at both the beginning and end of life: a young man abandoned by friends as he struggles with opioid addiction; an older woman getting by on tea and toast, living in filth, no longer able to clean her cluttered apartment. In these moments, it seems the only thing worse than suffering a serious illness is suffering it alone.

Social isolation is a growing epidemic — one that’s increasingly recognized as having dire physical, mental and emotional consequences. Since the 1980s, the percentage of American adults who say they’re lonely has doubled from 20 percent to 40 percent.

About one-third of Americans older than 65 now live alone, and half of those over 85 do. People in poorer health — especially those with mood disorders like anxiety and depression — are more likely to feel lonely. Those without a college education are the least likely to have someone they can talk to about important personal matters.

A wave of new research suggests social separation is bad for us. Individuals with less social connection have disrupted sleep patterns, altered immune systems, more inflammation and higher levels of stress hormones. One recent study found that isolation increases the risk of heart disease by 29 percent and stroke by 32 percent.

Another analysis that pooled data from 70 studies and 3.4 million people found that socially isolated individuals had a 30 percent higher risk of dying in the next seven years, and that this effect was largest in middle age.

Loneliness can accelerate cognitive decline in older adults, and isolated individuals are twice as likely to die prematurely as those with more robust social interactions. These effects start early: Socially isolated children have significantly poorer health 20 years later, even after controlling for other factors. All told, loneliness is as important a risk factor for early death as obesity and smoking.

The evidence on social isolation is clear. What to do about it is less so.

Loneliness is an especially tricky problem because accepting and declaring our loneliness carries profound stigma. Admitting we’re lonely can feel as if we’re admitting we’ve failed in life’s most fundamental domains: belonging, love, attachment. It attacks our basic instincts to save face, and makes it hard to ask for help.

I see this most acutely during the holidays when I care for hospitalized patients, some connected to I.V. poles in barren rooms devoid of family or friends — their aloneness amplified by cheerful Christmas movies playing on wall-mounted televisions. And hospitalized or not, many people report feeling lonelier, more depressed and less satisfied with life during the holiday season.

New research suggests that loneliness is not necessarily the result of poor social skills or lack of social support, but can be caused in part by unusual sensitivity to social cues. Lonely people are more likely to perceive ambiguous social cues negatively, and enter a self-preservation mind-set — worsening the problem. In this way, loneliness can be contagious: When one person becomes lonely, he withdraws from his social circle and causes others to do the same.

Dr. John Cacioppo, a psychology professor at the University of Chicago, has tested various approaches to treat loneliness. His work has found that the most effective interventions focus on addressing “maladaptive social cognition” — that is, helping people re-examine how they interact with others and perceive social cues. He is collaborating with the United States military to explore how social cognition training can help soldiers feel less isolated while deployed and after returning home.

The loneliness of older adults has different roots — often resulting from family members moving away and close friends passing away. As one senior put it, “Your world dies before you do.”

Ideally, experts say, neighborhoods and communities would keep an eye out for such older people and take steps to reduce social isolation. Ensuring they have easy access to transportation, through discounted bus passes or special transport services, can help maintain social connections.

Religious older people should be encouraged to continue regular attendance at services and may benefit from a sense of spirituality and community, as well as the watchful eye of fellow churchgoers. Those capable of caring for an animal might enjoy the companionship of a pet. And loved ones living far away from a parent or grandparent could ask a neighbor to check in periodically.

But more structured programs are arising, too. For example, Dr. Paul Tang of the Palo Alto Medical Foundation started a program called linkAges, a cross-generational service exchange inspired by the idea that everyone has something to offer.

The program works by allowing members to post online something they want help with: guitar lessons, a Scrabble partner, a ride to the doctor’s office. Others can then volunteer their time and skills to fill these needs and “bank” hours for when they need something themselves.

“In America, you almost need an excuse for knocking on a neighbor’s door,” Dr. Tang told me. “We want to break down those barriers.”

For example, a college student might see a post from an older man who needs help gardening. She helps him plant a row of flowers and “banks” two hours in the process. A few months later, when she wants to cook a Malaysian meal for her boyfriend, a retired chef comes by to give her cooking lessons.

“You don’t need a playmate every day,” Dr. Tang said. “But knowing you’re valued and a contributing member of society is incredibly reaffirming.”

The program now has hundreds of members in California and plans to expand to other areas of the country.

“We in the medical community have to ask ourselves: Are we controlling blood pressure or improving health and well-being?” Dr. Tang said. “I think you have to do the latter to do the former.”

A great paradox of our hyper-connected digital age is that we seem to be drifting apart. Increasingly, however, research confirms our deepest intuition: Human connection lies at the heart of human well-being. It’s up to all of us — doctors, patients, neighborhoods and communities — to maintain bonds where they’re fading, and create ones where they haven’t existed.

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How Social Isolation Is Killing Us

To build a future for their son, Dallas couple plan $12 million community for young adults with autism

Retired doctors Debra Caudy and husband Clay Heighten (right) with their 19-year-old son Jon

A Dallas couple is planning to construct a $12 million community for people with autism on nearly 29 acres of land that was formerly a polo ranch in the Denton County town of Cross Roads.

It will include 15 homes, a community center and access to a ‘transitional academy’ that is designed to help young adults with autism develop the skills needed to live and work independently.

Clay Heighten, a retired emergency doctor and founder of a real estate management company, and his wife Debra Caudy, a retired medical oncologist, are leading the project.

The inspiration is their 19-year old son, Jon, who is on the severe end of the autism spectrum and requires a high level of supportive care.

Both worry that people like Jon have little options as adults. "It's about offering a choice," explained Heighten.

“We’re trying to create something that would provide an enriched quality of life, so that people like Jon eventually require less supervision,” he said.

In October 2015, the couple invested $745,000 to purchase the land, and last year created a non-profit called 29 Acres to raise money for the project.


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To build a future for their son, Dallas couple plan $12 million community for young adults with autism

Police department creates the ‘Grandma Unit’ to help spread love and hugs

CHARLESTON, WV (WCMH) — These ladies have been hired to dispense much needed love and hugs to their community.

The “G-Unit,” as they liked to be called, was sworn in Tuesday by the Charleston Police Department. They won’t be making arrests or investigating crimes, but they are ready to serve their community.

“When we’re given something to do we take it seriously, and we keep up with it,” Grandma Unit member Karen Smith told WCHS.

These woman all came together to help others because they know what it means to need it. All 11 were once victims of elder abuse or domestic violence.

“Oh my goodness it’s a win for everybody. They feel good by doing it, and they want to do it. That’s what helps this awesome partnership,” Cpl. Errol Randle with the Charleston Police Department told WCHS.

The ladies are now ready to hit the streets for their communities, so if you get pulled over by a member of the G-Unit, be prepared for a hug.

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Police department creates the ‘Grandma Unit’ to help spread love and hugs

Keep Your Brain Healthy, Lower the Risk of Alzheimer’s

More than 5 million Americans suffer from Alzheimer’s disease, a progressive, incurable condition that robs them of their memory and often changes their very personality.

A new documentary airing on PBS at 10 p.m. Eastern time on Jan. 25 examines the disease and what will be needed to confront it.

Alzheimer’s: Every Minute Counts, produced by Twin Cities PBS (the parent of Next Avenue), features interviews with doctors, researchers and caregivers. The focus is on the urgent need for more research, especially as the large boomer generation ages.

One of those interviewed is Dr. Rudolph Tanzi of Harvard Medical School, a longtime Alzheimer’s researcher.

The video below consists of special footage that does not appear in the documentary. Its creators have provided Next Avenue with this exclusive clip. Watch as Tanzi shares his advice to encourage brain health — and possibly decrease your risk of Alzheimer’s. No. 2 on his list of top tips will surprise you.

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Keep Your Brain Healthy, Lower the Risk of Alzheimer’s