Getting Elder Care Benefits at Work

With more than two out of five Americans caring for their aging parents—many of whom do so because they cannot afford to pay for other elder assistance—it’s often difficult to find time for both work and caregiving.  Indeed, according to a recent article in Forbes, many children who act as caregivers worry that, without assistance from their employers, their aging parents may face nursing home neglect.  Lately, however, more employers are “now providing help for employees who feel that they just have to ‘suck it up’ in managing this care and their careers.”

Old Man

What’s the relationship between elder abuse and workplace assistance?  Many factors could play into this correlation, including:

  •      When employees don’t have time to properly locate elder care resources, they make uninformed decisions about nursing homes, assisted-living facilities, or even in-home nurses.  Help from an employer can mean the difference between a care facility with a strong patient record and one with a history of nursing home abuse violations.
  •      When employees don’t have enough money set aside to help pay for care from reputable daycare facilities or nursing homes, their aging parents can end up in a facility that costs less but has a record of neglect.

Elder Care Changes at U.S. Workplaces

The Society for Human Resource Management recently funded a 2014 National Study of Employers, which was conducted by the Families and Work Institute.  What’s the relationship between employer-employee relations and elder care?  In short, “more employers are offering elder care help.”  And for an employee who is also a caregiver, help from management can mean that you can “care for your parent without losing your job” and without putting an elderly loved one at risk.

The recent study surveyed more than 1,000 employers, including those in both for-profit and nonprofit industries.  The results suggested that significantly more employers are looking at elder care as an issue that should be addressed.  In the last five years, the study indicated that the following changes have occurred in the workplace:

  •      More than 40 percent (43 percent, in fact) of the employers surveyed reported that “they offer Elder Care Resource and Referral.  What kind of a service is this?  In short, these employers indicate that they provide employees with “help in finding resources and information about elder care.”  Back in 2008, only 31 percent of these employers offered this form of assistance.
  •      More than 40 percent of these employers also offer Dependent Care Assistance Plans.  These are elder care plans that allow an employee to “set aside money from each paycheck before taxes to pay for elder care expenses.”  This number has risen significantly since 2008, when only 23 percent of employers surveyed offered this kind of plan.

According to the Forbes article, the ever-aging American population likely is what has led more employers to consider elder care.  And if you’re hoping to find employment with a company that offers such benefits, the study determined that larger employers (more than 50 percent) are “more likely to offer Dependent Care Assistance Plans” than smaller employers (only 38 percent).

Contact a San Diego Nursing Home Abuse Lawyer

Anyone can become the victim of elder abuse or neglect.  Even a facility that looks to be competent upon a first visit can have problems, including issues with staffing numbers and high rates of medication errors.  At the Walton Law Firm, we are dedicated to assisting Southern California residents who have suffered injuries because of nursing home abuse.  Contact a San Diego nursing home abuse attorney to learn more about how we can help.

Photo Credit: doc(q)man via Compfight cc

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Elder Care and Technology

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Warning Signs in Nursing Home Selection Process

In a U.S. News article a couple of months ago, a number of negative traits of nursing homes was discussed. The material is worth reviewing, because it offers critical advice for local residents going through the elder care process.

For any patient or family member of a patient, finding the right nursing home can be very stressful. With reports of neglect and abuse coming out too often, patients and their loved ones must carefully vet nursing homes and long-term facilities to ensure that the patient will receive the proper care and treatment, that staff will be attentive, and that the facility will operate at a minimum up to state and federal standards. On top of this, nursing homes are typically very expensive, and not everyone will qualify for Medicare and Medicaid payments, or for significant coverage by insurance. According to the U.S. News article, the median rate for a single room in a nursing home is $87,600 per year. This number derived from a survey of more than 14,800 nursing home care providers.

The article first points to the need to know a facility’s history of statutory or regulatory violations. States administer regulations over the management and standards at nursing homes within their territory, and the federal government, often in conjunction with states, enforces regulations that set the conditions for a facility receiving federal money through Medicare and Medicaid. This oversight generally leads to publicly documented records of violations that all those interested in nursing homes should research. For example, Medicare has a search tool (http://www.medicare.gov/nursinghomecompare/search.html), and so, too, does the state of Illinois (http://www.idph.state.il.us/about/nursing_home_violations/quarterlyreports.htm). Other third parties also offer such resources (http://projects.propublica.org/nursing-homes/). There are other resources as well. It is important to note both the quantity and quality of investigations and registered violations. Where a patient suffered injury, or was malnourished or dehydrated, for example, even if it happened a handful of times over a long time period, that may be a telltale sign. It is also notable where the facility may have a documented history of attempting to misreport or cover up such incidents.

Illinois Injury Law Issues – Claims for Punitive Damages Die with the Patient?

Punitive damages are among the variety of damages to be won in a torts case, including those involving nursing home abuse and neglect.These damages, are meant to do just say: make an example of and punish the person who is liable for the wrongdoing that caused a plaintiff’s injury. On top of this rationale, it is also meant to deter others from engaging in the same type of behavior that would lead to similar injury to others in the future.

Punitive damages, or at least the headline-grabbing ones, tend to be quite hefty, and are handed down by juries, or sometimes judges, as a demonstration of disgust with the defendant or defendants’ conduct, and to let others know that such behavior will not be tolerated. Punitive damages are not compensatory like more measurable economic damages, which compensate a plaintiff for lost wages, medical expenses, damaged property, and other items. Where compensatory damages are inadequate and disproportionate to the liability, punitive damages will likely be used.

The Future of Elder Care? Shifting Care to the Home and Community

As previously discussed, the Patient Protection and Affordable Care Act has addressed many aspects of the health care sector, including nursing homes and long-term care facilities. The Affordable Care Act, or “Obamacare” as it has been colloquially known, has in broad respects sought to increase access to healthcare for many more Americans, while trying to keep costs down. One way of keeping costs down has been the “Balancing Incentive Payments Program” (BIP Program). It has been funded to the approximate tune of $3 billion, and aims at decreasing the costliness of care for those needing nursing homes by having patients receive that care at home. This has also been called “community-based” care. At least a dozen states have participated, including Illinois.

The New Elder Care Program

The Balancing Incentive Payments Program was conceived as a remedy to the costliness of using nursing homes. Specifically, it “authorizes to States to increase access to non-institutional long-term services and supports.” It accomplishes this by beefing up the Medicaid funds sent to states, which can spend that money on “home and community care” until September 2015 so long as certain conditions of efficiency are met. Many elderly and otherwise disabled individuals prefer to receive health assistance and care in their own homes, rather than be admitted for nursing home residency. Being treated and cared for at home allows them to be in familiar and comfortable surroundings.

Medicaid funds help lower income individuals with care, as well as those with higher incomes who end up using most of their assets to pay for care and run out of money to do so. A few years ago, the U.S. Department of Health and Human Services estimated that the average cost of caring for an individual in a nursing home in 2010 was an astounding $6,235 per month. Studies have shown that Medicaid money goes much further in at-home care for individuals, who can spend that money for at-home care under a Medicaid waiver. Given this greater efficiency for less cost per person, initiatives over time have sought to increase treatment and care at Medicaid recipients’ homes, and this latest program of Obamacare takes it another step. The program pushes state agencies to encourage those looking for care to do so at home if possible, and also requires a standard criteria for eligibility to qualify (a “Single Entry Point” into the system) for Medicaid-funded at-home care as well as a case manager for each patient who is not employed by or takes direction from health providers like nursing homes.

The BIP program has stated more long-term goals as improving performance and efficiency of care for Medicaid recipients while providing more care at home. This also reduces costs where funds would not be directed nearly as much to nursing homes and long-term care facilities, which cost a pretty penny. The program also states as its goals the improvement of oversight, as well as improved assistance to patients and their families in care planning. Illinois had its application for the program approved one year ago in June 2013. Because the payments matches from the selected federal funds are indexed or tied to the percentage of a state’s long-term services and supports spending, Illinois will enjoy an increase of 2% in federal matching through BIP which it can use to divert patients from nursing homes to more efficient at-home/community-based care where appropriate. This has been estimated to be a roughly $90 million award in Medicaid funding.

See Related Blog Posts:

Concerns about Care? The Astoria Place Nursing Home

The Finances of Proper Elder Care: Medicaid and Nursing Homes

Summer Webinars on Dementia and Caring for the Elderly

Collaboration on Dementia Awareness and Abuse

Old Lady

Do you have a parent who currently suffers from Alzheimer’s or another form of dementia?  These degenerative brain diseases are difficult not only on patients, but also on their family members and caregivers.  In response to elder abuse advocates’ concerns about educating and empowering family members of those with dementia, a number of organizations have teamed up to provide a series of “webinars” this summer.

According to a recent press release from the Administration for Community Living (ACL), the ACL will join the Centers for Disease Control and Prevention (CDC), the National Institute on Aging (NIA), and the National Institutes of Health (NIH) in hosting a series of three webinars in July, August, and September.  The organizations have collaborated in order to “increase knowledge about Alzheimer’s disease and related dementia,” as well as to provide “resources that professionals in the public health, aging services, and research networks can use to inform, educate, and empower community members.”  More education about the risks associated with dementia care can help family members and caregivers to quickly spot and report signs of elder abuse.

Indeed, “the drugging of California’s nursing home residents is at an all-time high,” particularly when it comes to Alzheimer’s patients, according to the California Advocates for Nursing Home Reform (CANHR).  As such, we need more education and awareness about Alzheimer’s disease and related dementias.

The webinars will provide updates on resources for patients with Alzheimer’s, collaborations in specific community for assisting those with dementia, and research updates on these diseases.  The first seminar will take place on July 22.  Just two days later, the CANHR is also co-sponsoring a dementia care training event in San Diego.  On July 24, you can attend the CANHR event to learn more about “Comfort as the New Medicine” and dementia care.

Considerations When Selecting a Care Facility for a Person with Dementia

The CANHR provides a number of resources for California residents that complement events like the nationwide summer webinars.  And when it comes to caring for someone with Alzheimer’s or another form of dementia, the CANHR provides a helpful checklist that can help you to evaluate nursing homes or assisted-living facilities where your elderly parent can obtain medical care.

In general, the CANHR emphasizes that you’ll want to evaluate a nursing facility in terms of its environment, its philosophy of care, the types of services it offers, and its staff.  Here are just a few important questions to ask when you’re deciding on who will provide care for your parent or elderly loved one, according to the CANHR:

  •      Is the facility a quiet and calm place?
  •      Is the lighting pleasant and natural?
  •      Is there a “wander alert system”?
  •      Is it easily for the staff to observe common areas, outside areas, and residents’ rooms?
  •      Is the facility equipped to care for dementia patients at all stages of the disease?
  •      Are psychoactive drugs used to treat certain dementia behaviors?
  •      Does the facility design specialized programs for residents with dementia, and are they tailored to individual residents?
  •      Does the facility check on residents throughout the night?
  •      Does the facility have employees with specialized knowledge and training when it comes to dementia care?
  •      What is the ratio of residents to staff during each shift?
  •      What are the qualifications of staff supervisors?

These questions are just some of the inquiries you’ll want to make when you’re looking at care facilities.  If you have questions, an experienced San Diego elder abuse attorney can help you today. Contact our office to learn more.

Photo Credit: zilverbat. via Compfight cc

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Nursing Home Staffing Numbers and Elder Abuse

Caring for a Loved One with Dementia

Nine Figure Settlement Goes Through in Omnicare Case

In a prior post, we discussed how a whistleblower drew attention to substantial fraud going on in the area of nursing homes and long-term care facilities, specifically at a Cincinnati pharmaceutical company called Omnicare Inc. that provides pharmaceuticals to nursing homes. The whistleblower brought to light allegations of fraud through a False Claims Act (otherwise known in Latin as a “qui tam”) lawsuit. As a refresher, people can bring suit under the False Claims Act against a person or entity for defrauding the federal government. The plaintiff is the one who actually files suit, and it is up to the Department of Justice (DOJ) to join in and lead the case. If DOJ does not, then the plaintiff may still pursue the case. Regardless of DOJ’s involvement, if there is a recovery, the plaintiff can keep a certain percentage of it, otherwise known as a bounty.

Details of the Case
Omnicare went through multiple issues of alleged fraud in recent years. These included making kickbacks or bribes to nursing homes in the form of charitable contributions, exclusive discounts, or other payments in order to steer business to Omnicare. In 2009 the company had also settled for $98 million over an alleged kickback scheme with nursing homes and drug manufacturers, and earlier this year paid $4.2 million for a another drug kickback scheme with another drug maker. In between these, in late 2013, there was also a reported settlement agreement with the government for kickbacks through giving discounts to nursing homes so that the homes would purchase drugs from Omnicare for their resident patients, or direct their patients to purchase those drugs from Omnicare. The nursing homes would then file for reimbursement from Medicare and Medicaid for these purchases.

Because Medicare and Medicaid are federal programs and involve spending federal dollars on nursing home resident care, pursuing illegal kickbacks through these discounts as a quid pro quo for Medicare and Medicaid-insured patient referrals for pharmaceutical purchases is a major no-no. This essentially directs federal funds into Omnicare’s possession by illegal means of violating the anti-kickback laws. These illegal financial incentives deprive patients of the choice of where to purchase their medications, and takes away the opportunity to seek out the best quality and best cost for patients in an open pharmaceutical market. This is a fraud and violation that the False Claims Act was meant to combat.

Now, it is reported that the settlement of about $124.24 million plus attorneys’ fees is official, both to address the original whistleblower’s 2010 claim as well as a separate set of claims in New Jersey. As with many settlements, the company did not admit liability, thus the claims remain allegations, but the government has recovered well in excess of a hundred million dollars. $8.24 million of the overall settlement will be directed to multiple states whose own funds supplement Medicaid and were affected by the Omnicare scheme. The whistleblower, who formerly worked for Omnicare, will earn a $17.24 million bounty for his efforts.
As reports indicate, DOJ has been able to recover over $19.5 billion in fraud under the False Claims Act, $13.9 billion of which were related to health care program frauds. Medicare and Medicaid fraud is unfortunately endemic across the country from hospitals to doctors to nursing homes and elsewhere. In Omnicare’s case, the jig was up and it was time to pay up.

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Defrauding Uncle Sam and Disregarding Patients

Hospice & False Medicare Claims

Concerns about Care? The Astoria Place Nursing Home

The Astoria Place Living & Rehab Center, owned by the Astoria Place Living and Rehabilitation Center, LLC of suburban Skokie, Illinois, is a somewhat unique nursing home, assisted living, and hospice facility. Located on North California Avenue in Chicago, Astoria Place advertises itself as “a unique living and rehabilitation facility” offering expert “round-the-clock compassionate nursing care,” and therapy. The nursing home also represents itself as “a vibrant multi-cultural community” that is also multilingual, but caters specifically to the Russian community. Its program is “designed with [Russian] heritage in mind.” So while it mentions multiculturalism and its multilingual resident population, Astoria is particularly committed to those of Russian origin. Case in point, part of its informational website is written in Russian. Astoria has 164 beds, and does accept Medicare and Medicaid funding for eligible patients.

According to Medicare’s Nursing Home Compare website, Astoria has favorable ratings both overall, in terms of staffing specifically, and in terms of Registered Nurse staffing as well. Astoria houses significantly more than the average Illinois nursing home, and even more than the average nursing home nationwide. It also boasts nearly 2 full hours of licensed nurse staff hours per resident per day, which is nearly half an hour better than the Illinois state average for care facilities, and 20 minutes more than the national average. This is in particular due to the significant amount of time Registered Nurse hours dedicated daily to each resident.

West Virginia Nursing Home Jury Award Reduced by $65 Million

In a previous blog post, we discussed a 2011 jury verdict that awarded approximately $92 million to the family of a patient who suffered abuse during a 3 week term at a West Virginia nursing home called Heartland Nursing Home, which is owned by a corporation called Manor Care. A relatively small amount of the jury award accounted for ordinary negligence in the nursing home’s actual poor medical care and negligence in failing to adequately feed and hydrate the patient. A whopping $80 million of that award accounted for punitive damages. An obstacle to enforcement of the jury award was found in West Virginia’s professional liability laws that limit non-economic damages (i.e. punitive damages, as opposed to more easily quantifiable medical costs), to $500,000, which was obviously well below the award given by the jury. When we last discussed this case, it had crept its way to the state Supreme Court to determine the issue of whether or not the verdict was appropriate under the half million dollar cap for professional liability. To date that question has not yet been answered while other in-state nursing home negligence claims lay dormant awaiting a ruling before proceeding to their own jury awards.

Elder Abuse Awareness and San Diego County’s Aging Summit

Global and Local Awareness About Aging and Elder Abuse

Old Guy

Earlier this month, San Diego County’s Aging Summit, which focused on Alzheimer’s disease and caregiving issues, occurred just as the National Center on Elder Abuse (NCEA) and the Administration on Aging launched the eighth “World Elder Abuse Awareness Day.”  The two projects represent both global and local initiatives to educate family members, caregivers, and the public generally about important issues that older adults face today, as well as the prevalence and risk factors for elder abuse.

Nursing home abuse and neglect is an important issue in California, particularly as we await potential changes to the law surrounding residential care facilities for the elderly (RCFEs).  At the same time, however, elder abuse is a nationwide—and indeed, a worldwide—concern that affects us all.  If you have questions about how you can help an older adult who has sustained injuries because of elder abuse, don’t hesitate to speak to an experienced San Diego elder justice advocate.

What is World Elder Abuse Awareness Day?

According to the NCEA, World Elder Abuse Awareness Day began back in June of 2006, when a number of internationally focused organizations got together to make it known that violence against older adults is an important matter.  Who’s currently involved?  The International Network for the Prevention of Elder Abuse and the World Health Organization initially launched the awareness project under the auspices of the United Nations (UN).  Now, each year on June 15, the NCEA and the Administration on Aging also get involved to raise awareness across the U.S., including throughout the state of California.

The creators of the awareness project described its purpose as one of “providing an opportunity for communities around the world to promote a better understanding of abuse and neglect of older persons by raising awareness of the cultural, social, economic, and demographic processes affecting elder abuse and neglect.”

San Diego County Aging Summit

While communities throughout the country have an organized opportunity to focus on important matters surrounding nursing home abuse and neglect, the San Diego County Aging Summit also seeks to raise awareness about issues that affect older adults in Southern California.  This year, the summit focused specifically on Alzheimer’s disease, according to an article in U-T San Diego.

How does the summit work?  It takes place every other year.  For 2014, its “major themes” included “safety for seniors and the concerns of family caregivers.”  Alzheimer’s patients across California have been injured by nursing home and assisted-living facility employees.  Whether your loved one with Alzheimer’s or another form of dementia suffered physical abuse or emotional abuse, it’s important to know that a San Diego nursing home abuse lawyer can help.

The Alzheimer’s Association estimates that about 5 million elderly adults currently suffer from Alzheimer’s disease, and a majority of those victims are women.  In San Diego County alone, about 60,000 seniors currently live with this debilitating neurological disease.  About 20 percent of those patients currently reside in care facilities.  It’s especially important to keep an eye out for signs of elder abuse when your loved one suffers from a form of dementia.  As we’ve noted previously, California physicians have been implicated in the off-label use of psychotropic drugs to treat dementia patients.  And employees at assisted-living facilities have been named in serious incidents of nursing home abuse against patients with Alzheimer’s.

It’s never too soon to talk to a San Diego nursing home abuse attorney if you suspect abuse or neglect.  Contact us today to talk about your case.

Photo Credit: Neil. Moralee via Compfight cc

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Mark Your Calendar: Rallying for Quality Nursing Home Care

In prior postings we discussed the growing movement, including in Illinois, to improve the rights of patient residents of nursing homes and long-term care facilities. This has ranged from pushes for better legislation, to a bevy of litigation to not only redeem the rights of abused and victimized patients but to also call attention to the devastation caused by negligent or even depraved nursing home staffers. One such initiative in Illinois, for example, has been the push for a nursing home patient bill of rights to enumerate the basic dignities and quality of care all resident patients deserve and to which they are entitled.

The Details
In the coming week, on June 24, 2014 at 2:00pm EST, there will be a free webinar/teleconference held by the Consumer Voice. The Consumer Voice, or the National Consumer Voice for Quality Long-Term Care, has been around since 1975 when it began as a group of advocates at a nursing home conference discussing reform to the industry, and grew into a platform and eventually the great organization it is now. The organization advocates for quality care in nursing homes, which throughout the country continues to be below par in so many places. It also seeks to educate consumers and their loved ones about nursing home care and what to expect and what to avoid. The end game is “respect and dignity” for all consumers of long-term care facilities and services.