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A former nursing home executive was indicted this week in connection with alleged healthcare fraud totaling more than $407 million.  A federal grand jury in the Western District of Wisconsin returned an indictment yesterday charging Kevin Breslin, 56, of Hoboken, New Jersey, with a scheme to defraud Medicare and Medicaid in connection with the operation of nursing homes and assisted living centers in Wisconsin.  Mr. Breslin was a former top executive at Atrium Health and Senior Living.

The alleged scheme involved inflating the cost of services and supplies and retaining overpayments from taxpayer dollars.  From January 2015 through September 2018, Atrium billed Medicare for over $189,000,000 and received over $49,000,000, and they billed Medicaid for over $218,000,000 and received more than $93,000,000.  However, the indictment alleges that the majority of those funds never went to providing care for residents of Atrium Facilities.  The government believes that Atrium took these large sums of money, but failed to follow quality of care standards for nursing homes, provided inadequate staffing and supplies, and diverted funds from their Wisconsin nursing home facilities to guaranteed payments to investors to finance the construction of new nursing homes in New Jersey.   Breslin faces penalties of up to 20 years in prison in connection with these charges.

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Eye-anatomy-300x206Elmiron, the brand-name for the drug pentosan polysulfate sodium, is used to treat interstitial cystitis, which is a painful chronic bladder condition.  Unfortunately, researchers have now discovered a clear link between the use of Elmiron and a progressive eye disorder known as pigmentary maculopathy.  Pigmentary maculopathy affects the eye’s pigment and can cause impaired vision and even blindness after long-term use of Elmiron.

The correlation between Elmiron and pigmentary maculopathy was recently studied by researchers at the Emory University Medical School.  The researchers observed that those treated for interstitial cystitis with Elmiron on a long-term protocol between 2015 and 2017 were at an increased risk of developing retinal maculopathy. These subjects reported significant difficulty reading and adapting in low-light situations.  The researchers concluded that a connection exists between pigmentary maculopathy and chronic exposure to Elmiron that requires further research.  They also urged patients who have taken Elmiron to be regularly screened by an ophthalmologist if they experience unusual vision symptoms and discontinue the drug if they are diagnosed with an eye disease.

The symptoms of pigmentary retinal maculopathy include:

A particularly disturbing story came out of Winston Salem, North Carolina last month.  Three North Carolina assisted living employees were arrested for encouraging patients to get into fights for their own entertainment, according to a report from the North Carolina Department of Health and Human Services

North Carolina authorities were able to obtain at least one video of the fights taken by the employees after it was shared on social media, which showed “one resident being strangled with her face turning red.”  The report says staff members can be heard on video saying, “Punch her in the face.”  A staff member can also be heard saying, “Are you recording? You gonna send it to me?”

The three employees, Marilyn Latish McKey, 32, Tonacia Yvonne Tyson, 20, and Taneshia Deshawn Jordan, 26, were all arrested and charged with assault on an individual with a disability.  After their arrests, the employees told authorities that they let the fight happen because one of the residents “always caused problems.”


NH-wheelchairA recent study, conducted jointly by Harvard and Vanderbilt medical schools, found understaffing in 75 percent of nursing facilities across the United States.  The study published in the Journal of Health Affairs, obtained data from the Payroll Based Journal (PBJ) to analyze the staffing levels of more than 15,000 nursing homes. The researchers examined the staffing levels of registered nurses (RN), licensed practical nurses (LPN), and nurse aides, relative to the number of nursing home residents they were caring for.  One of the more alarming findings from the study was that 75 percent of nursing homes were rarely in compliance with what the Centers for Medicare & Medicaid Services expected their staffing level to be, based on the needs of their residents. Additionally, the researchers found that 70 percent of facilities self-reported false numbers to reflect a higher total of nursing home staff.

In the United States, an estimated 1.5 million individuals receive care from nursing homes each day. Many of these individuals are living with serious physical and cognitive impairments, leaving them frail and vulnerable in a facility without sufficient staffing to meet their needs.  When nursing homes are understaffed, nurses scramble to deliver meals, assist bedbound residents to the bathroom and answer calls for pain medication. Essential medical tasks such as repositioning a patient to prevent bedsores, or responding to a bed alarm, can go overlooked when a nursing home doesn’t have sufficient staffing, many times leading to tragic consequences.

Suthers & Harper has been fighting for victims of abuse and neglect in nursing homes for nearly three decades. The attorneys at Suthers & Harper have seen time and time again the tragic results that can come about as a direct result of nursing homes not having enough to staff to properly care for its residents.  If you suspect or know of neglect or abuse of a loved one inside a nursing home, contact the experienced nursing home attorneys at Suthers & Harper. Our attorneys have the knowledge and resources required to hold nursing homes accountable. Contact us now online or toll-free at 1-800-320-2384 for a free consultation.

The U.S. Department of Health and Human Services, Office of the Inspector General, released a report this month, which concluded that many incidents of abuse and neglect at nursing homes are not always reported or investigated.  The Inspector General determined that almost one out of five incidents in which a Medicare beneficiary was taken from a nursing home to a hospital emergency room was the result of abuse or neglect.  The study found that skilled nursing facilities failed to report a large number of these incidents to the appropriate government agencies in accordance with applicable federal regulations.  It was estimated that in 2016, approximately 6,600 cases of potential abuse and neglect went unreported.

The report cited a case involving a 65 year old nursing home resident, who was taken to the emergency room in critical condition.  She was having difficulty breathing, her kidneys were failing, and she was delirious.  The lab results done at the hospital showed that she was suffering from opioid poisoning, because of a serious error that had occurred at the nursing home.  One of the nurses at the nursing home had mistakenly copied a doctor’s orders.  As a result, the nursing home resident received much larger doses of pain medication than had been prescribed, causing opioid poisoning.  The resident was treated and released back to the nursing home. The nurse who had made the mistake received some training, but the nursing home never reported the incident.  The Inspector General cited this case as a clear example of negligence that should have been reported to the government.

Suthers & Harper in Savannah, Georgia was one of the first firms in the nation to sue a nursing home for abuse and neglect, and obtain a successful jury verdict.  The firm’s founder and managing partner, John Suthers, said, “The results of this study are not surprising.  Incidents of abuse and neglect of elderly nursing home residents can be difficult to uncover for many reasons.  Sometimes, the victims may be afraid or unable to tell family members out of fear of retaliation by the nursing home.  In other cases, the evidence of abuse or neglect can be masked by the resident’s other medical problems.  Sadly, there are residents who do not have family members regularly checking on them and as a result, incidents of abuse or neglect go unnoticed and unreported.”  Mr. Suthers encourages family members of nursing home residents to visit the nursing home frequently and at different times during the day.  Doing so makes it more difficult for the nurses and staff to predict when a family member may drop by the nursing home.  As a result, they may be more diligent in caring for that family’s loved one.

On March 28, 2019, a hearing was held before the Judicial Panel on Multidistrict Litigation (JPML) regarding the 3M Combat Arms Earplug lawsuits.  The hearing took place in Washington, DC.   The JPML is a panel comprised of federal judges, who decide where the cases will be consolidated for all pretrial litigation.  When you have large numbers of lawsuits filed in federal courts throughout the U.S., involving the same product or company, the JPML is allowed to consolidate those cases before one judge in one court for all of the pretrial litigation.  The theory behind the Multidistrict Litigation Court is that you will have one judge ruling on pretrial matters and evidentiary issues in the case, rather than having multiple judges issuing different rulings on the same issues in different federal courts throughout the United States.  Lawyers representing soldiers and 3M argued for the cases to be consolidated and transferred to federal courts in various states, including Georgia, Texas, Louisiana, and Minnesota, where 3M Company is headquartered.

John Suthers of Suthers & Harper in Savannah, Georgia, is one of the attorneys representing a large number of soldiers and veterans in lawsuits against 3M Company.  Mr. Suthers said, “This litigation is very important, as it involves damage done to the hearing of soldiers and veterans by an American company, 3M.  A large number of these soldiers and veterans reside in the State of Georgia, and we hope that the JPML will give serious consideration to assigning the cases to the United States District Court for the Southern District of Georgia.”

The lawsuits against 3M claim that the company defectively designed its earplugs in a way that did not provide adequate hearing protection, and that 3M consistently misrepresented the effectiveness of the Dual-Ended Combat Arms Earplugs in order to meet the government’s minimum specifications.  Specifically, lawsuits against 3M allege that the defective design caused the earplugs to become loose in the soldiers’ ears, causing the soldiers to be exposed to harmful noise levels.  The lawsuits also allege that 3M provided false and inaccurate noise reduction ratings for the Dual-Ended Combat Arms Earplugs to the government.  As a result, soldiers and veterans throughout the U.S. are suffering from noise-induced hearing loss and tinnitus (ringing in the ears).

Thousands of U.S. soldiers and veterans are believed to have suffered hearing loss because of defective earplugs sold by 3M Company to the 3M-Dual-Ended-Combat-Arms-Earplugs-300x195U.S. government.  3M’s defective earplugs, known as the Dual-Ended Combat Arms Earplugs (version 2), did not function as 3M claimed they would function.  The earplugs were not long enough to be inserted properly into a soldier’s ears.  The design prevented a snug fit in the ear canal of the user, causing the earplugs to become loose and exposing the user to dangerous levels of noise.

These earplugs were originally created by a company called Aearo Technologies, which was acquired by 3M in 2008.  The earplugs were sold to the military from 2003-2015.  It is believed that more than 1 million service members were issued 3M’s earplugs while engaging in various combat missions during foreign wars.  These defective 3M earplugs have never been recalled and therefore, could still be in use by soldiers and other government employees.

Aearo Technologies was allegedly aware of the defect in the earplugs as early as year 2000, when it began testing the effectiveness of the earplugs.  Earplugs like the Dual-Ended Combat Arms Earplugs are sold with a Noise Reduction Rating (NRR), which is a unit of measurement used to determine the effectiveness of hearing protection devices.  The higher the NRR number associa

Earlier this month, a nursing home resident who had been in a vegetative state for eleven years gave birth inside Hacienda HealthCare, a nursing home in Phoenix, Arizona.  Caregivers at the nursing home have told investigators they were shocked and had no idea the resident was pregnant.  A frantic 911 call on December 29, 2018 by a nurse at the facility reported that a 29-year-old woman had given birth inside the facility. The nursing home staff tasked with providing care for the woman said they were unaware that she was pregnant until she started to moan right before giving birth on Dec. 29.   When police arrived, they found a baby that had been born to a woman who was “unable to move and unable to communicate.”  The nursing home specializes in the care of people with intellectual disabilities.  Court records show that the woman had been a resident of Hacienda HealthCare since 1992.

Phoenix police have already executed a search warrant seeking DNA samples from male staff members at the Hacienda HealthCare center.  The Arizona Department of Health Services and the state’s Department of Economic Security are also working with police in the investigation.  Sgt. Tommy Thompson of the Phoenix Police Department stated that the patient “…. was not in a position to give consent to any of this. This was a helpless victim who was sexually assaulted.”

Shortly after the assault, Hacienda HealthCare announced that it had hired former Maricopa County Attorney Rick Romley to additionally conduct an “exhaustive” internal review.  “Mr. Romley will have unfettered access to every facet of Hacienda’s business — including all the records related to this matter,” said a statement from Hacienda. “We will do everything we can to aid this review and, once it is complete, to make sure this unprecedented situation never, ever happens again.”

Nursing home facilities in Georgia, and around the country, are evaluated on a routine basis by the Centers for Medicare and Medicaid Services (CMS), as well as state agencies that regulate nursing homes. The purpose of the evaluations is to determine whether nursing homes are ensuring resident safety by complying with federal and state nursing-home care regulations. Nursing homes may only participate in Medicare and Medicaid reimbursement programs when they are abiding by these regulations. When facilities perform poorly, they are closely watched by CMS. Those facilities that receive the worst evaluations and provide the poorest care to their residents are known as “Special Focus Facilities.” These nursing homes receive special attention from regulators and must show improvement in their quality of care or they will lose their Medicare and Medicaid funding. If you or a loved one require nursing home care, you should know which nursing homes are considered to be among the worst in the country.  The most recent special focus facilities list is available here.

Currently, there are only a couple of Georgia nursing home facilities on the current list, including Pleasant View Nursing Center in Metter, and Chulio Hills Health and Rehab in Rome.  They are both shown on the list as “facilities that have shown improvement” since first being named a special focus facility.

If you have a loved one staying at a nursing home that is a Special Focus Facility, or you are thinking of sending your loved one to one of these facilities, there are several things you may want to do to help ensure his or her safety and well-being:

NBC News reported this week on the number of nursing home patients who are transferred to hospitals and subsequently die from sepsis, a potentially life-threatening complication of an infection.  Sepsis often occurs when an infection is untreated or treated inadequately.  Sepsis occurs when chemicals released into the bloodstream to fight the infection cause inflammation throughout the entire body instead.  Severe cases of sepsis can lead to septic shock, which is characterized by very low blood pressure, and is a medical emergency.

A private healthcare data firm, Definitive Healthcare, conducted a special analysis of data related to nursing home patients who were transferred to hospitals and later died.  The analysis revealed that approximately 25,000 patients a year had developed sepsis while in nursing homes across the U.S.  Definitive Healthcare looked at Medicare billings from 2012 through 2016, and concluded that the treatment of this life-threatening condition costs Medicare more than $2 Billion a year.   These numbers show that sepsis is a huge public health problem in the U.S.

Sometimes, a nursing home patient can develop a pressure sore on the hip or tailbone.  If that patient is incontinent, there is an increased risk that the pressure sore will become infected.  The longer the infected pressure sore goes untreated, or inadequately treated, the greater the risk of the patient developing sepsis.  If the sepsis is not treated promptly and aggressively, the patient can go into septic shock, and die.  Nursing home patients, who often have other comorbidities and conditions, have an increasingly difficult time surviving sepsis.  It is not just pressure sores that can lead to sepsis in nursing home patients.  Sepsis can develop in bedridden patients who are suffering from pneumonia, urinary tract infections, or other infections.  What can start out as a relatively small, isolated infection can quickly become a big infection and cause the death of a nursing home patient.

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