Nursing Homes Requesting Waivers so they Can Provide Substandard Care? Victimizing the Elderly

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More Than Half Of California Nursing Homes Balk At Stricter Staffing Rules

More than half of California’s nursing homes are asking to be exempted from new state regulations that would require them to spend more time directly caring for their patients.

The state’s new staffing requirements for nursing homes, quietly passed in last year’s budget bill, seem universally unpopular. Patient advocates say the new regulations don’t go far enough and that residents remain at risk in poorly staffed homes. Nursing home operators say they can’t hire enough staff to comply.

Under the new rules, which took effect in July but haven’t yet been enforced, skilled nursing facilities must provide at least 3.5 hours of direct care per resident per day, up from 3.2 hours of care previously. That care can range from inserting a feeding tube to changing an adult diaper or helping residents with eating and bathing.

The California Department of Public Health, which oversees nursing homes, is expected to announce in late January which — if any — facilities it will exempt from the new regulations. But some patient advocates don’t like the nursing homes’ balking.

 

“We’re appalled by the waiver system. It’s sending the worst possible message to California nursing homes that it’s OK to staff at levels that endanger residents,” said Mike Connors of California Advocates for Nursing Home Reform, a consumer advocacy group.

(Check to see which California nursing homes have applied for workforce shortage waivers here and here.)

Researchers have strongly linked more nursing staff with better care, with some experts recommending from 3.8 to 4.1 hours of care per patient per day as a bare minimum for quality nursing home care. Having enough staff helps prevent falls, pressure sores and other problems that can land fragile seniors in the hospital.

A recent Kaiser Health News investigation found that for years nursing homes nationwide overstated staffing to the federal government. Now, nursing homes are required to report actual payroll records to remain eligible for Medicare and Medicaid payments.

During the first three months of 2018, 58 percent of California’s skilled nursing facilities averaged at least 3.5 hours of patient care a day, according to a Kaiser Health News analysis of payroll records submitted to the federal government. That rose to 76 percent when including nursing homes where administrators also were counted.

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Shlomo Rechnitz, the Other Side of a Mirror – Cali Nursing Home Reform

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California passes nursing home transparency law

California Gov. Jerry Brown signed legislation this month requiring nursing home owners to provide more information about “insider” companies that may siphon scarce resources away from nursing residents through nursing homes’ inflated payments for supplies, rents, and services.

The legislation authored by Assemblyman Wood (D-Healdsburg) stemmed from a state audit of nursing homes earlier this year that focused on Brius Healthcare, California’s largest nursing home company.

Wood and Sen. Mike McGuire (D-Healdsburg) requested the audit following concerns raised by the National Union of Healthcare Workers (NUHW), which published a report showing that during 2015 Brius nursing homes purchased $67 million in goods and services from 65 “insider” companies owned by Brius CEO Shlomo Rechnitz and his relatives.

In 2015, Rechnitz’s “insider” companies – including paper landlords – stood to gain as much as $12 million by charging inflated rents to Brius nursing homes, according to NUHW’s report. This money, says NUHW, should have been spent on care and services for nursing home residents who often lack adequate staffing, support and care.

The state audit, published in May 2018, found that the California Department of Public Health failed to perform necessary inspections or issue timely citations for substandard care. In addition, California State Auditor Elaine Howle found the reporting rules for nursing homes failed to show whether operators are profiting from business deals with “insider” companies owned by nursing home executives.

To improve transparency of these related-party transactions, Wood’s bill (Assembly Bill 1953) requires nursing home owners to disclose whether they have “an ownership or control interest of 5% or more in a related party … that provides any service to the skilled nursing facility.”

Under those circumstances, the nursing home must disclose all of the services provided by the related-party company, the number of people who provide the service, and any other information requested by state officials.

If the nursing home receives goods, fees, and services worth $10,000 or more per year from a related-party company, then this “insider” company must give state officials a copy of its profit and loss statement as well as data on caregiver staffing levels inside the nursing home.

The bill “will now ensure transparency and reporting that will allow us to make sure that these companies are not being used to generate excessive profits for the owners of these facilities on the backs of the residents,” Wood told Skilled Nursing News.

Sen. McGuire, who voted for the bill, praised the new law.

To read the article in its entirety click here.

Brius residents in Marin report going weeks without showers — Chafraud-Depravitch

Here’s the latest about some of the substandard care found in nursing homes controlled by ultra-Orthodox multi-millionaire Shlomo Yehuda Rechnitz. From Briuswatch.org: One of Brius Healthcare’s largest nursing homes is “woefully understaffed,” forcing residents to go weeks without a shower and sit in their own excrement for hours waiting for assistance, according to a recently […]

via Brius residents in Marin report going weeks without showers — Chafraud-Depravitch

Shlomo Rechnitz, Nursing Homes, Lawsuits, Understaffing

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Lawsuit alleges Roseville nursing home and others understaffed on purpose – to increase profits

A recently filed lawsuit alleges Roseville Point Health & Wellness Center knowingly understaffed to save money.

This case is among 15 class action lawsuits alleging purposeful understaffing at 15 nursing homes around California filed by elder abuse law firm Garcia, Artigliere & Medby and The Arns Law Firm, which represents workers and their families.

Aside from the 98-bed Roseville facility, the 14 other facilities are mainly located in Southern California and the Bay Area.

The Roseville lawsuit, filed on behalf of petitioner Diane Bechtold, a resident at the center, alleges the understaffing is “chronic and intentional” and an “effort to pocket unearned profit.”

The lawsuits name a number of defendants, including Shlomo Rechnitz, California’s largest nursing home owner, and Rockport Administrative Services LLC, a consulting company with a number of Rechnitz’s facilities as clients.

“This violation of each resident’s rights was directed and implemented at the mandate of the managers and owners of the facilities, Rockport Administrative Services and Shlomo Rechnitz, and his multiple layers of affiliated companies,” the lawsuit claims.

According to Mark Johnson, from the firm Hooper, Lundy & Bookman PC, representing Rockport, the consulting company provides services to skilled nursing facilities “including oversight of compliance with applicable staffing requirements.”

“Importantly, none of the lawsuits allege any harm to the residents of facilities which Rockport serves,” Johnson said. “Roseville Point Healthcare and Wellness Center … is in full compliance with applicable staffing laws including the increased staffing levels required as of July 1, 2018. In fact, its compliance has been confirmed during standard annual audits conducted by the California Department of Public Health.”

The health department could not immediately provide information about compliance with staffing requirements at the center.

Documents sent by Johnson appear to show the California Department of Public Health reported the Roseville facility had zero days of non-compliance with required staffing levels in 2016. The health department could not immediately authenticate the documents.

Glaser Weil trial lawyer Jill Basinger, representing all of the defendants in the lawsuits except Rockport, claims the nursing facilities “not only maintain the state required 3.2 nursing hours per patient day, they even exceed them.”

Staffing requirements

Whereas previously, 3.2 nursing hours per patient day was the minimum numeric staffing ratio required in a skilled nursing facility under state law, as of July 1, 2018, the new minimum required ratio is 3.5.

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Brius Hit with Class Action Lawsuits – briuswatch – Watching out for the Elderly

Brius hit with over a dozen class action lawsuits

Brius has been hit with 15 class action lawsuits accusing the nursing home conglomerate of systemically understaffing its nursing homes to maximize profits, while delivering substandard care to thousands of elderly residents.

“These lawsuits are an effort on behalf of these vulnerable citizens to ensure that their needs are met,” Attorney Stephen Garcia told the Eureka Times-Standard. Garcia’s law firm and The Arns Law Firm in San Francisco allege that Brius homes across California misled potential residents about their compliance with staffing requirements.

In a statement to the Marin Independent Journal, Jill Basinger, a spokeswoman for Brius owner Shlomo Rechnitz, claimed that Brius homes “not only maintain” minimum staffing requirements, “they even exceed them.”

However, Brius has been cited multiple times in recent years for understaffing, including at the Novato Healthcare Center and San Rafael Healthcare and Wellness Center, which were included in the class action lawsuits. In March, Brius caregivers from both homes, represented by the National Union of Healthcare Workers, joined residents and their loved ones at a public forum to call on Brius to put an end to chronic understaffing.

Earlier this year, a state investigation found the 181-bed Novato facility “woefully understaffed,” forcing residents to go weeks without a shower and sit in their own excrement for hours waiting for assistance.

Last year, the California Department of Public Health fined Brius’ San Rafael facility $15,000 for violating the state’s minimum staffing laws.

There has been heightened attention to nursing home staffing after recent reports found that major skilled nursing facilities were not providing accurate data to state and federal regulators.

In June, Medicare lowered its star ratings for staffing levels in one in 11 of the nation’s nursing homes because they either had inadequate numbers of registered nurses or failed to provide payroll data that proved they had the required nursing coverage, Kaiser Health News reported.

The lawsuits allege that understaffing at Brius, which is California’s largest nursing home operator, resulted in tragic outcomes for residents.

One lawsuit filed in Alameda County Superior Court alleges that understaffing at Brius’ Alameda Healthcare & Wellness Center contributed to the 2017 death of Cathy Campbell, a 61-year-old Stockton woman.

According to the lawsuit, Campbell, who suffered from hypertension and chronic kidney failure, developed a severe bedsore and urinary tract infection that worsened because the facility lacked sufficient staff to care for her. Her health continued to suffer after she was transferred to a second Brius home in Oakland.

Garcia, who wrote that Campbell’s needs were “flat-out ignored,” blamed the Alameda facility for failing to properly treat her in a statement to the East Bay Times. It “knew that by not elevating her to a higher level of care when the sore reached a Stage III, they were violating the law, but in the interest of profits over patients, they made a conscious choice to wrongfully deny needed medical care.”

TO READ THE ARTICLE IN ITS ENTIRETY CLICK, HERE.

Brius Heathcare, Shlomo Rechnitz and Public Funds – Audit

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http://www.times-standard.com/article/NJ/20170628/NEWS/170629883

State to audit nursing home company’s use of public funds

A state committee voted Wednesday to approve an audit of California’s largest nursing home owner, Brius Healthcare Services, and whether the company misused hundreds of millions of dollars in government health care funds to benefit its affiliated businesses.

North Coast Assemblyman Jim Wood (D-Healdsburg) is a member of the Joint Legislative Audit Committee that voted in favor of the audit Wednesday afternoon. He said the Los Angeles-based Brius Healthcare Services has a “very convoluted” system of nursing homes under limited partnerships and has connections with other businesses founded by Brius Healthcare’s CEO Shlomo Rechnitz.

“Brius controls one in 14 [nursing home] beds in California and it is a very convoluted network of limited partnerships and all sorts of other mechanisms out there,” Wood said to the Times-Standard. “Part of this audit is to see if they are all legitimate. … Our feeling is the way they’re doing this is to maximize profits. It’s not about providing high quality care for people.”

Brius’ spokesman Stefan Friedman wrote in a statement to the Times-Standard that Brius representatives were present at the committee hearing today and were in full support of the proposed audit.

“Not only will the audit results prove that Brius has abided by all applicable rules and regulations, it will also show that Brius went well above and beyond its duties and obligations to subsidize the care of California’s most vulnerable,” Friedman said.

Friedman also questioned McGuire’s and Wood’s information, which it states was provided by the National Union of Healthcare Workers. The union has been outspoken in its opposition to Brius Healthcare Services and created a website — briuswatch.org — to scrutinize the company and its CEO Shlomo Rechnitz.

“What is most disturbing though is that legislators McGuire and Wood would also glean their information from ‘newspapers’ and blogs, demonstrating their lack of understanding for the very program they oversee,” Friedman continued. “We urge the community and the media to follow the audit through to its findings.”

Brius Healthcare, which owns five of the six nursing homes in Humboldt County and over 80 nursing homes statewide, received over $500 million in reimbursement funds in 2015 from the MediCal and Medicare government health plan programs, which made up 80 percent of its profits, Wood said.

Wood and his North Coast legislative colleague Sen. Mike McGuire (D-Healdsburg) said Brius paid out more than $67 million that year to businesses with similar or related ownership for the purchase of services, goods and supplies, and paid more than $46 million to companies established Rechnitz that serve as landlords for their nursing home facilities.

A letter from McGuire and Wood to the state audit committee from earlier this month states that there is evidence that Brius facilities paid inflated prices to some of these business, with some prices exceeding 200 percent of market averages.

The nursing home company has come under fire for alleged patient health care violations, which has led to state entities denying the company’s bids to acquire more nursing homes and has led to multiple wrongful death lawsuits to be filed in Humboldt County in recent months.

“This is absolutely unacceptable especially when the state and federal government is spending $500 million dollars to care for our state’s most vulnerable in Brius facilities,” McGuire said to the Times-Standard on Wednesday. “We need to hold this corporation accountable.”

Brius Healthcare has expressed dissatisfaction with the reimbursement rates it receives from the state for treating MediCal patients.

The company temporarily stopped accepting MediCal patients into its Humboldt County nursing homes in 2015 while it disputed reimbursement rates with the North Coast’s MediCal provider, Partnership HealthPlan of California. Partnership HeathPlan agreed to increase reimbursement rates to Brius and other long-term skilled nursing facilities.

In the latter half of 2016, Brius Healthcare used its plans to close of three Humboldt County nursing homes to pressure Partnership into providing higher reimbursement rates so as to prevent the closures. Brius Healthcare cited low staffing levels as their reasoning for the proposed closure.

“We are confident we can avoid these closures, but we need PHP to start paying its fair share and allow us to attract full-time staff to meet our patients’ needs,” Friedman told the Times-Standard in September.

Partnership declined to increase rates, prompting Brius to announce its intention to cancel its contract with Partnership. However, this announcement was shortly retracted after it became clear that the company would lose reimbursement funds. Brius announced in November that it would only be closing one nursing home — Pacific Rehabilitation and Wellness Center in Eureka — instead of three.

McGuire and Wood said the audit will likely be completed in 2018 and will be made public when it is given to the Legislature. McGuire and Wood said that the findings could result in legislation or, in the worst case scenario, criminal charges filed by the Attorney General’s Office.

To read the remainder of the article click here.

Shlomo Rechnitz Denied Change of Venue in Wrongful Death Suit

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Judge Denies Skilled Nursing Defendants’ Change of Venue Bid

Judge Timothy Cissna denied skilled nursing magnate Shlomo Rechnitz’s request for a change of venue in a wrongful death and elder abuse lawsuit following a short hearing today, rejecting claims that he couldn’t get a fair trial in Humboldt County.

Cissna said the case should be tried locally because it involves a substantial personal injury that occurred in Humboldt County and a recently named defendant lives in the area.

The judge also dismissed arguments made in the change of venue motion that contended “negative news articles” would taint the local jury pool, saying there hadn’t been a showing of “undue prejudice.”

The civil case before the judge — one of three currently pending against Rechnitz and the skilled nursing facilities he owns in Humboldt County — alleges low staffing levels at Seaview Rehabilitation and Wellness Center contributed to the death of Ralph Sorensen. The 76 year old died in January of 2016 from complications related to an infected pressure ulcer.

Seaview, Rechnitz, Brius and administrative services company Rockport are named in the lawsuit. (Read more about the case here.)

After Cissna explained the reasoning for his tentative ruling, he offered attorneys each less than eight minutes to present any further points.

Rechnitz’s attorney James Yee, who appeared by phone, unsuccessfully argued that case law requires the venue be moved to Los Angeles County because that’s where most of the defendants live.

In court filings, the difficulty of traveling to Humboldt County and finding appropriate accommodations for Shlomo Rechnitz’s wife Tamar Rechnitz, who holds a share in the company, were also cited as reasons for the change of venue request.

Those issues were not brought up during the court hearing.

Yee also told the judge that the most recently named defendant was added to the lawsuit as a “doe” in “bad faith” because her name should have been readily attainable and asked Cissna to disregard her Humboldt County residency as a factor in his decision.

Attorney Timothy Needham, who represents Sorensen’s family, told Cissna that Yee was citing an archaic case law in his claims about the naming of the latest defendant, who is the administrator of Seaview.

“The arguments they’re making are over 100 years old and they are just wrong,” Needham said.

Cissna told the attorneys he was following through with his tentative ruling and denied the change of venue motion. The next hearing in the case is set for Sept. 5

To read article in the original format click here.