Nursing Homes and Covid-19, The Dangers, the Money, the Lack of Oversight, Time for Home Care

Dear Reader:

Covid-19 is a pubic health disaster.

But, so too are most nursing homes and rehabilitation centers. Many of them represent the greatest constitutional violation of life, liberty, happiness and dignity for those most vulnerable who are confined to many of the nations homes.

There are very personal reasons why this blogger knows so much about them and their deplorable conditions. Setting aside visits to upwards of 45 different nursing homes and rehabilitation centers throughout New York, New Jersey and Pennsylvania and being asked to negotiate a bid on Personal Protective Equipment by an unsuspecting client, research on homes and their owners has made the entire industry stomach-turning. That client did not realize at the time that the equipment he was asked to broker had been taken from a nursing home (paid for by Medicare, Medicaid or private insurance) and warehoused in New Jersey. Someone else likely did the deal, the client walked away.

So, perhaps Covid-19 was necessary to open people’s eyes to the dangers of nursing homes and rehabilitation centers and to provide much needed incentive for the government to oversee them with vigor, zeal and a passion that reflects our need to protect the elderly and most vulnerable.

Well, this might just be wishful thinking.

Suffice it to say, most owners and operators are looking to the bottom line. It is about the money, the profit and loss, the quasi virtual auction of human life by social services, guardianship, social workers in hospitals and the individuals that make the wheels of the human life industry turn. Many are morally bankrupt and the more their pockets get lined the more soulless they become.

More to follow. For now, The Wall Street Journal:

U.S.

Covid Spurs Families to Shun Nursing Homes, a Shift That Appears Long Lasting

The pan­demic is re­shap­ing the way Amer­i­cans care for their el­derly, prompt­ing fam­ily de­ci­sions to avoid nurs­ing homes and keep loved ones in their own homes for re­ha­bil­i­ta­tion and other care.

Amer­i­cans have long re­lied on in­sti­tu­tions to care for the frailest se­niors. The U.S. has the largest num­ber of nurs­ing-home res­i­dents in the world. But fam­i­lies and some doc­tors have been re­luc­tant to send pa­tients to such fa­cil­i­ties, fear­ing in­fec­tion and iso­la­tion in places rav­aged by Covid-19, which has caused more than 115,000 deaths linked to U.S. long-term-care in­sti­tu­tions.

To continue reading in The Wall Street Journal, click here.

ADDITIONAL SOURCES:

COVID-19 spurs families to shun nursing homes in a shift that appears long lasting

“We should be able to provide more services in the home setting that can enable somebody to be independent,” said Seema Verma, administrator of the Centers for Medicare and Medicaid Services. “Covid is going to force a national conversation about how we take care of our elderly, and clearly there are issues in nursing homes that go beyond infection control,” she said.

During his campaign, President-elect Joe Biden promised to spend $450 billion to make sure people who need long-term care can get support in the home and community.

51 lost lives: A portrait of the pandemic’s
tragic toll in America’s nursing homes

They had survived so much already — war and dust storms, cancer and poverty, lost eyesight, lost spouses, lost memories — and still went on to find moments of grace inside the corridors of America’s nursing homes.

In Windsor, Conn., Johnny James ate chocolate bars with his visiting great-grandchildren. In Lewiston, Idaho, Edna McBride celebrated her 100th birthday. In Providence, R.I., Florence Tilles, who had two knee surgeries, liked to joke she would one day die at the 18th hole of her favorite golf course.

One day came on May 30, when 98-year-old Tilles fell victim to covid-19 amid a soaring death toll that included James and McBride and would soon grow to more than 80,000 residents in nursing homes across the country. They suffered alone, in homes locked down to visitors, peering at the masked faces of weary nurses and aides who risked their own lives to be there.

The industry and the government could have done far more, watchdog groups have said from the beginning, shoring up infection-control protocols and staffing, delivering stronger oversight of troubled homes and ensuring that coronavirus stimulus payments reached patients and caregivers rather than corporate owners.

Instead, 10 months later, thousands of families are learning to live without goodbyes.

The 51 residents whose stories are told here, one from every state and the District of Columbia, left behind at least 129 children, 230 grandchildren, 210 great-grandchildren and 41 great-great-grandchildren. Some blame the nursing homes for questionable care. Others say they are enormously grateful for the work of caregivers.

To continue with The Washington Post, click here.

Nursing Homes and their Attorney Owners – Covid-19 and the Staggering Conflicting Interests that Exist – Part I

Law Firms prized for their Knowledge of Elder Care and Novel Approaches to Protecting the Elderly, and the conflicting interests of the Partners and Associates who Own Financial Stakes in Subpar Nursing and Rehabilitation Centers [OPINION]

Dear Reader:

The right to “sepulcherin the law is the “right of a family member or next of kin to find solace and comfort in the act of burying a loved one.” Protecting this right alone can be the basis for a highly respectable and extremely lucrative boutique practice for attorneys. A lawsuit based upon that right can be relevant in situations where fallen soldiers are not returned home, victims of terrorist attacks are not returned to their families; and during the Covid-19 pandemic, bodies are improperly buried or even lost. A recent example is the case of Elayne Boosler, wherein a family members was buried at the hands of a guardian’s signature in the wrong cemetery at significant cost. That case is eliciting calls for an investigation. Her story is gruesome and complicated by a system of guardianship that itself is enshrouded in secrecy and disenfranchisement.

In the United States many law firms with highly intelligent and respected attorneys and practices focused on elder care, geriatric medical abuses, estate planning, insurance and disability, medical malpractice and related practices, simultaneously represent some of the worst offenders in nursing home care abuses. Many of the partners in these firms also own financial stakes in nursing homes, either with their clients or not. It is our opinion that these are diametrically opposed practices; and it is nearly impossible for a law firm to maintain the integrity of one practice area while being paid millions to represent the others. That is an opinion premised on what may be a debatable notion of ethics and moral integrity.

Admittedly, Covid-19 has created a mitigating factor in recent history. But our opinion is unwavering: the lack of care for the welfare of the elderly, the lack of interest in dignity and humanity has governed, with a wholehearted disregard for humanity, particularly in law firms with competing interests. This has occurred throughout our entire system of care and of justice. With respect to dignified and responsible elder care, the Covid-19 tragedy has denied the right to tens of thousands of families of nursing and rehabilitation homes’ patients to be physically present for their loved ones in life and, in many cases, to bury those same people who have had their lives taken by the virus.

We would argue that the fault lies though not entirely, with the owners and financial stakeholders of many of these nursing homes and rehabilitation centers. We would posit that they did not take proper precautions during the pandemic, choosing instead the path of least cost routing. Precautions would have undermined owners’ bottom lines. We maintain that the owners and operators were looking at their P/L Statements (Profit and Loss), and ignoring the potential loss of human life. Some nursing homes carry life insurance for their patients and are themselves beneficiaries of those policies. They therefore profit whether their wards live or die. This makes the situation all the more unpalatable.

For those owners whose real life profession is an active and lucrative legal practice, one which focuses on elder care, the rights of the elderly, estate planning and healthcare services, in our view there has always been a weighing of financial averages and significant conflicts. Moreover, the pandemic has increased the value of lobbying governments to reduce nursing home and even medical accountability, a conflicting premise if you are an elder care lawyer.

To add another wrench in the cogs of a lucrative attorney practice that plays both the elder care and nursing home ownership game, it is less expensive to lobby the government for Covid-19 related immunity provisions which protect owners (often themselves) from liability than to save lives and actually engage in “elder care.” It is a simple financial calculation. And at the end of the day, the elderly lose and the attorneys win.

A reasonable analogy would be a car company that hides known and foreseeable danger in manufacturing because the cost of reimbursement for the death of drivers and passengers is less expensive than recalling the vehicles in question. The outcome is based upon purely financial decisions which will continue status quo unless and until significant financial accountability is mandated.

In our view, both in the nursing home context and in the vehicle scenario, conscience and morality simply do not a play a role in the decision-making of owners and operators. In both instances manipulating political clout to obliterate the chance for families to seek financial compensation for loss of life or consortium has made and continues to make the most financial sense. In both analogous situations, if the people in charge are not held to account, both civilly and criminally, these financial equations will take precedent over the value of human life and lives will be lost.

And please remember, in the situation where the lawyers are the owners and operators of nursing homes, they make money either way. Their legal representation on behalf of owners generates bills for tens of thousands if not hundreds of thousands if not millions of dollars in yearly billables. The nursing home ownership is gravy and the more immunity they obtain for themselves and their clients (who are often partnered with them) from liability the richer the returns on all fronts.

The nagging question is this: how can a law firm, any law firm, simultaneously have a blossoming and distinguished practice of elder care, “rights of sepulchre”, estate planning and other related practice areas and at the same time represent owners of some of the most deplorably run nursing homes in the country? We do not think that it is possible without an inescapable conflict of interest, setting aside the ethical and moral obligations to clients within those practice areas. As a securities matter, we would argue that the LLC interests associated with nursing home ownership represent securities interests and that it should be possible to implicate the SEC and its trading regime. That’s just a thought.

Continue reading

New York Nursing Home Covid-19 Related Fatalities Through December 10, 2020

State of New York Covid-19 Related Nursing Home Fatalities as of December 20, 2020
State of New York Covid-19 Related Nursing Home Fatalities as of December 20, 2020
State of New York Covid-19 Related Nursing Home Fatalities as of December 20, 2020
State of New York Covid-19 Related Nursing Home Fatalities as of December 20, 2020
State of New York Covid-19 Related Nursing Home Fatalities as of December 20, 2020
State of New York Covid-19 Related Nursing Home Fatalities as of December 20, 2020
State of New York Covid-19 Related Nursing Home Fatalities as of December 20, 2020
State of New York Covid-19 Related Nursing Home Fatalities as of December 20, 2020

Erie County, NY and Deplorable Nursing Home Care – Covid-19

Five WNY nursing homes among top 25 in New York for most Covid-19 cases

Father Baker Manor
Father Baker Manor in Orchard Park has the most residents with confirmed Covid-19 among all nursing homes statewide, according to federal data through Nov. 15. The nursing home’s owner says Father Baker Manor actually had less than half of the 242 Covid cases the data says it had. 

With 242 residents who have tested positive, Father Baker Manor in Orchard Park has the most confirmed Covid-19 cases among all nursing homes statewide, according to a Buffalo News review of federal data.

But fewer than half that number of Father Baker Manor residents actually had Covid, according to Catholic Health, the facility’s owner. 

Four other Erie County nursing homes also are in the top 25 in the state for total confirmed coronavirus cases: Absolut Center for Nursing and Rehabilitation in East Aurora; Harris Hill Nursing Facility in Lancaster; Garden Gate Health Care Facility in Cheektowaga; and Beechwood Homes in Getzville. They each reported 112 or more total confirmed Covid-19 cases among residents at their facilities through Nov. 15, the latest data available from the Centers for Medicare and Medicaid Services.

Covid-19 at nursing homes across the country – including 617 across New York State and 70 in Western New York – is being monitored weekly by the federal agency, which in May began requiring nursing homes to report coronavirus data.

There were 14,982 nursing home residents statewide who had the virus; another 7,786 were suspected to have contracted Covid-19. In Western New York, 1,963 nursing home residents were confirmed with Covid-19, 13% of all confirmed nursing home cases in the state. 

Continue reading

Perhaps There Will Finally be a Day of Reckoning for Nursing Care Owners

Increased Nursing Home Data Reporting Could Bring ‘Perfect Storm’ of Federal Lawsuits

Under regulations instituted as a result of the COVID-19 public health emergency, skilled nursing facilities are reporting a wealth of information to the federal government — on top of all the information they were required to submit pre-pandemic.

And that information could end up being the guiding light for the U.S. Department of Justice (DOJ) and the Department of Health and Human Services’ (HHS) Office of Inspector General (OIG), according to a webinar hosted Thursday by the continuing education provider Strafford.

Skilled Nursing News, Click here.

“Under regulations instituted as a result of the COVID-19 public health emergency, skilled nursing facilities are reporting a wealth of information to the federal government — on top of all the information they were required to submit pre-pandemic.

And that information could end up being the guiding light for the U.S. Department of Justice (DOJ) and the Department of Health and Human Services’ (HHS) Office of Inspector General (OIG), according to a webinar hosted Thursday by the continuing education provider Strafford.

The presentation focused on reporting requirements for SNFs, government enforcement actions and compliance, and preparation for enhanced enforcement.”

[Excerpt]

“Is this really the perfect storm, then, for a potential wave of lawsuits initiated by DOJ with a much richer database for targeting facilities with with a record in infection control surveys and IJs [immediate jeopardy deficiencies]?” McGovern asked on the webinar. “Time will tell about that. But it’s not simply DOJ. If DOJ doesn’t take the initiative, whistleblowers can also bring lawsuits under the False Claims Act (FCA) and seek to recover the considerable damages afforded under the FCA.”

FCA cases relate to the conduct of private companies that do business with Medicare, Medicaid, and other public health care funding sources, and generally involve fraud, as Bloomberg noted in September 2019 covering an announcement by the DOJ that it would pursue criminal charges in such cases that involved nursing homes.

Many of the claims that hit nursing homes related to the provision of therapy, such as the $30 million settlement agreed to by the Louisville, Ky.-based Signature HealthCARE, the $15 million settlement from Brockway, Pa.-based Guardian Elder Care, or the saga related to the case of several SNFs and a therapy company that eventually settled for $255 million.

To continue reading click here.

HHS and the Sheer Stupidity of Giving for-Profit Nursing Homes MORE Money -Covid

OPINION No Amount of Money is Going Incentivize a Morally Bankrupt and Profit Centric Nursing Home Owner/Operator/ Manager to Improve Care to Patients – More Oversight is Required

Whomever thought up the idea that shelling out MORE money to nursing homes, their owners, managers, wealthy entrepreneurs and magnates to reduce Covid-19 numbers doesn’t seem to understand the dynamics of the nursing home industry. In fact, that idea represents an utter and complete disregard for the entire history of the nursing home industry, the coining of money that occurs and the harrowing lack of oversight that lead to Covid-19 deaths.

It was not about a lack of funding for appropriate care. The deaths were caused by greed. The stockpiling of PPE (and respirators) so they could be traded or sold on a secondary market, represented greed.

The obscene amounts of money that has already been given to fabulously wealthy owners, operators and magnates in the form of PPP and EIDL loans has only allowed the wealthy to get wealthier. It has improved nothing else. And, you cannot buy a conscience with that money, which would be what is required to stop improve the quality of life of every individual currently residing in nursing homes and to prevent further death when Covid-19 ravages these homes again.

To many of the owners, operators and managers in for-profit care nursing and rehabilitation centers, a patient represents an equity interest in a financial gain, whether that gain is in the form of Medicare/Medicaid or private insurance, or in the form of a life insurance policy after a patient has died. Nursing care is not about improving the lives for human beings, the vulnerable and the most in need of care and compassion. It is not about preventing a spread of a deadly virus.

For every person who died from Covid-19, the owners, operators and magnates made money on life insurance policies where they didn’t on some other death benefit or healthcare payment. The owners, operators and managers are all but printing money in the basements of some of these homes, coining it. They DO NOT need more money. What they need is oversight.

For many of these nursing home owners, operators, managers and the equity interested individuals, providing additional access to money is like giving an opiate to an addict. You cannot instill in many of these individuals a sense of moral obligation to do right by their patients, clients and families. These people are not morally challenged they are morally bankrupt and the money only feeds into an ability to obtain more equity on human life and death.

May the Schwartz, no the Shvantze – Not be the Skyline Nursing Care for you….

Review Care Website, click here.

How Can This Happen?

The above is a small sampling of Joseph Schwartz’s nursing homes and the “star ratings” applied to them. Click the link beneath the image to learn more about each one.

We took a look at some of the homes with 5-star ratings (Highland Manor in Ilinois as an example) and found it a bit puzzling that there were no scores at all in a number of fairly significant areas. This rather curious result lends itself to the question regarding how accurate these scores really are and if they can be reliably reviewed for a family considering placing a family member in this facility.

To review this data click here.

Consider the following question:

How does the government grading system give a nursing home with 35 “substantiated” complaints (Asperian Care Oak Lawn) 4 stars? They were substantiated claims.

How is a nursing home with 35 “substantiated” complaints not fined, compelled to rectify the situation, compelled to provide some sort of justice to families? The complaints take up the span of 8 pages online. It is worth noting, however, that the complaints only run until February of 2016. It is unclear what has happened since and if this information is updated.

Regardless, why is the owner of a nursing home with 35 complaints allowed to open another nursing home? Again, to reiterate, this site may not have been updated to reflect improvements. The complaints run until 2016. But, then, where is the updated information available. Where is the oversight?

The chart posted above speaks for itself. It is a tiny example of the travesty. Yes… he has nursing homes with 5 starts; but if you can’t trust the 4-star rating system (given the complaints that seem to have been ignored) can you really trust the 5 stars?