Under the new law, nursing homes would no longer be fined for not having competent, licensed administrators or caregivers in their facilities; not having a qualified nurse on duty, or for understaffing at the facility, one of the leading contributors to resident neglect.

The few fines that can be imposed can be reduced by 35 percent if the nursing home agrees not to formally appeal the state’s findings. Financial penalties for intentionally killing or injuring residents will be doubled, though state regulators say such violations are unlikely.

A spokesman for the governor’s office said the bill was signed to “promote better care by encouraging nursing homes to develop pro-active quality assurance programs and allowing facilities to identify and correct problems right away.”

John Tapscott, an advocate for Iowa seniors said the new law “only proves that our legislative leaders and governor are willing to sell out the most vulnerable of our citizens – the sick and elderly residing in nursing homes – for a few thousand campaign dollars.” The bill was opposed by the Iowa Department of Elder Affairs and the Iowa Department of Inspections and Appeals.

The legislation was supported by the Iowa Healthcare Association, which last year made political contributions totaling nearly $90,000.

SOURCE: Nursing Home Abuse › Nursing homes that jeopardize safety no longer face fines in Iowa

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Medical Director Dr. Melissa Bruhl said she recommended the change to the home’s administrator Dan Steen because she was having a difficult time finding relief for the 24-hour coverage. As a result, the arrangement increased Bruhl’s salary from $244,000 per year to about $319,000.

The nursing home’s human resources director said the change didn’t save the facility money or have an affect on the quality of care provided to its 720 residents. But some are questioning how Bruhl was able to make a decision that benefited her to the tune of tens of thousands of dollars.

Bruhl says she is working with the human resources director to determine whether four staff medical doctors are needed on call, or if a better system would be that which is implemented by many nursing homes – to transport patients by ambulance to the hospital if medical care is required.

State lawmakers are questioning whether the governor’s office or the veterans commission played a role in the decision. Following a meeting with lawmakers, Bruhl said, “I guess I have to assume the decisions were made pretty much in-house.”

SOURCE: Nursing Home Abuse › Lawmakers question veterans home officials about schedules, salaries

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The most shocking complaint involves a mentally disabled female resident. One worker says she had to force her way into that resident’s room because the door had been secured with a chair. When she entered, the worker says she saw Bautista-Meraz bent over the resident, who was partially dressed. The woman was bleeding from the vagina. Bautista-Meraz claimed he was cleaning the woman though he had no cleaning supplies with him. The nursing home countered the claim by saying it was not unusual for staff to secure the resident’s door with the chair, and that the bleeding was not uncommon in the resident as she suffered from abdominal cancer.

Other incidents include one resident claiming Bautista-Meraz ordered her to undress while he watched. Another says the aide grabbed her breast. And others say he was he was rough or handled them in a sexually suggestive manner. Bautista-Meraz has yet to be charged.

The home was cited by state inspectors in November 2006 for not reporting the allegations of abuse to the state Department of Health and not investigating the matters further. The home appealed the fine but Administrative Law Judge Jose Anglada upheld the decision saying the home “displayed indifference and disregard to resident care and safety.”

SOURCE: Nursing Home Abuse › Iowa nursing home fined for indifference to sexual abuse claims

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Washburn was working as marketing and admissions coordinator at Montrose when she spotted a coworker chiding a resident who was in a wheelchair. The worker, who had been with the facility 11 years, called the resident pathetic, reducing the patient to tears. Washburn reported the incident to the nursing home administrator, David Payne, but days later when he didn’t take action, Washburn took the matter into her own hands, calling state authorities to report the incident.

After all, it is state law to report suspected abuse. The “mandatory-reporter” law, which states that it is a crime for employees not to report cases of suspected dependent-adult abuse, exists in 45 states.

Washburn went one step further. She talked to coworker Tammy Hopp and encouraged her to tell the inspector everything she saw during the incident of abuse. But when Hopp met with inspectors she did not fully disclose the details, choosing instead to protect her coworkers. As a result of Hopp’s testimony, the abuse was ruled unfounded. And shortly thereafter, Hopp was promoted and Washburn was sent packing.

Washburn’s firing was not based on her reporting the incident of abuse, contends Payne. He says she was let go because, by coercing Hopp, she interfered with a government investigation.

Hopp has since testified under oath that she downplayed the incident to state authorities. The Iowa Department of Inspections and Appeals has reopened the case.

SOURCE: Nursing Home Abuse › Nursing home worker fired after reporting abuse

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The study, conducted by the University of Iowa, surveyed more than1,000 nursing home social workers. The results were shocking. Only half of the nursing home social workers questioned had a degree in social work, and 20 percent reported not having a four-year degree at all. The study also found that only 38 percent are licensed in social work.

Nursing homes with 120 beds or more are required to employ a social worker. Often times those nursing homes employ just one social worker, making it difficult for that social worker to devote adequate time for each patient.

Qualifications for social workers also vary from state to state, according to the study. Some states do not address qualifications for nursing home social workers, and others do not appear to comply with federal standards. Twenty-one states require a social work degree, and most others require a four-year degree, but not in social work, according to the report.

Social workers in some areas earn as little as $15,000 per year, whereas social workers in other areas earn more than $60,000 per year.

Mercedes Bern-Klung, the study’s leader says standardizing nursing home social worker qualifications is necessary for social workers to do their jobs properly and effectively.

Results from the national study will be published in an upcoming issue of the Journal of American Medical Directors Association.

SOURCE: Nursing Home Abuse › Study finds nursing home social workers inadequately trained

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One such contributor is Tim Boyle, owner of Friendship Manor in Grinnell, Iowa, and president of the board of the Iowa Health Care Association, a lobby group that represents nursing homes.

Friendship Manor made news recently after it was fined $112,650 – one of the largest fines ever imposed against an Iowa nursing home. The home was charged with neglecting an 89-year-old woman who died while in residence at Friendship Manor. The victim, Ruth Louden, lived independently and was in good health until she broke her leg and moved into the home for recovery. She complained of excruciating pain but it was only after a physical-therapy aide noticed Louden’s leg smelled like “rotting meat” and that blood was seeping through her medical stocking, that Louden was rushed to the emergency room and treated. Doctors noticed the dressing on her wound had not been touched since it was applied four weeks earlier. Louden’s leg had to be amputated, but she never recovered. She died just a few months later.

The Tribune quotes the Des Moines Sunday Register, which reported that 11 fundraisers were held at Iowa nursing homes. Some of the biggest recipients of contributions from the Iowa Health Care Association Political Action Committee in 2008 included Iowa Democratic Party and Iowa Senate Majority Leader Mike Gronstal, the Republican party of Iowa, Senate Minority Leader Ron Wieck, and Iowa Gov. Chet Culver.

SOURCE: Nursing Home Abuse › Iowa lawmakers receive money from nursing home lobby group

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The Des Moines Register reviewed 81 bonus payment programs in 36 different states. Iowa, which began participating in the bonus program six years ago, was one of the first to establish a bonus program.

Of the 36 states that participate in the bonus program, eight do not disqualify a nursing home from receiving bonus money based on regulation violations. Fifteen of the bonus programs are based on quality of care. Points also are awarded for having a large percentage of patients on Medicaid and for offsetting expenses such as property taxes, fire sprinklers, or paying the minimum wage.

Nursing homes that receive the most bonus money do not necessarily have the best rating, the report points out. The bonus program may appear to be an incentive program or to reward quality care; however, its purpose in some cases is to reimburse or offset cost of bringing homes up to state or federal standards or encourage more homes to accept Medicare-dependent patients.

The bonus program first came to light in March after the Des Moines Register reported that some of the state’s most deficient homes were receiving money from the bonus program. Since then, Iowa has begun revising its program, reducing payments to homes that have recently been cited for causing “actual harm” to residents and eliminating payments to homes that put residents in “immediate jeopardy” of death or injury.

SOURCE: Nursing Home Abuse › Bonuses paid to nursing homes with no regard to quality care

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The Register reports that records with names of caregivers fired for abuse were sealed beginning last August based on a new interpretation of a state law that has been on the books for 17 years, which specifies that judges are obligated to keep “unspecified types of abuse information” confidential. Prior to the new practice of sealing records, the names of Iowa caregivers fired for abuse were provided to Iowa Workforce Development, which could disclose them publicly.

Sealing the records eliminated public access to information such as names of workers fired for abuse, their employers, and cities where abuse occurred, making it difficult for families considering nursing home facilities to examine a facility’s history of safety. The Register reports that recently sealed cases included incidents involving a patient death, and the financial exploitation of a patient by a caregiver who took about $1,000 in cash and gift cards from a nursing home resident.

The new ruling allows public disclosure of the names of workers fired for abuse, their employers, and related agency records, but maintains the confidentiality of state investigators’ abuse reports, to protect the identity of nursing home residents involved in abuse situations. The decision also gives the public the right to review documents such as care facility inspection reports. The Iowa Department of Inspections and Appeals keeps a database of more than 18,000 nursing home inspection reports, which is accessible to the public online.

Read the full article at The Des Moines Register online.

SOURCE: Nursing Home Abuse › Abuse Records Reopened

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Other states on the “worst reporting” list are Arizona, Missouri, New Mexico, Oklahoma, South Carolina and South Dakota.

Results of the report were published in the New York Times May 15, which says the study “reveals a widespread ‘understatement of deficiencies’ including malnutrition, severe bedsores, overuse of prescription medications, and nursing home resident abuse.”

The study was requested by Sen. Charles E. Grassley (R-Iowa) and Sen. Herb Kohl (D-Wis., Chairman, Senate Special Committee on Aging). They have introduced a bill to upgrade nursing home care and increase penalties for federal standards violations.

Beasley Allen hears from people every day who are shocked and grieved to find their loved ones have suffered at the hands of the very people they expect to provide expert care and compassion. Certainly, increasing penalties seems like a step in the right direction.

David P. Sloane, a spokesperson for the AARP, which lobbies for older Americans, praises the effort, quoted by the Times as saying it is “one of the most significant nursing home reform initiatives” in two decades.

Read the full story in the New York Times.

SOURCE: Nursing Home Abuse › Alabama Among Worst

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Of those 23 homes, 16 stand to collect bonus Medicaid payments this year from state and federal taxpayers, according to the Register. The bonuses are tied to a state program that rewards nursing homes for providing quality, cost-effective care.

Elderly abuse is a crime. If you or a loved one have suffered nursing home abuse and neglect, please contact us today or call your local law enforcement agency.

Here’s how much each home was fined in 2007 and how much it stands to collect this year in performance-based bonuses. The homes are ranked based on the amount of their 2007 fines.

Meadow Lawn Health Care, Davenport
2007 fines: $33,350
2008 bonus: $0
Goldenrod Manor Care Center, Clarinda
2007 fines: $20,000
2008 bonus: $9,680
ManorCare, West Des Moines
2007 fines: $19,500
2008 bonus: $0
Risen Son Christian Village, Council Bluffs
2007 fines: $18,500
2008 bonus: $0
The Abbey, Le Mars
2007 fines: $17,300
2008 bonus: $11,339
Cedar Falls Health Care Center
2007 fines: $16,500
2008 bonus: $0
Iowa Masonic Home, Bettendorf
2007 fines: $15,000
2008 bonus: $44,502
USA Healthcare, Urbandale
2007 fines: $13,400
2008 bonus: $76,859
Ramsey Village, Des Moines
2007 fines: $13,000

2008 bonus: $8,133

Glen Haven Home, Glenwood
2007 fines: $13,000
2008 bonus: $12,028
Park View Care Center, Burlington
2007 fines: $12,250
2008 bonus: $22,418
Woodlands Rehabilitation Center, Council Bluffs
2007 fines: $12,000
2008 bonus: $33,801
Lantern Park Nursing and Rehabilitation Center, Coralville
2007 fines: $12,000
2008 bonus: $0
Good Samaritan Home, Villisca
2007 fines: $11,500
2008 bonus: $25,198
Wesley Acres, Des Moines
2007 fines: $11,500
2008 bonus: $8,894
Nelson Nursing Home, Fairfield
2007 fines: $11,500
2008 bonus: $17,972
Oakwood Nursing and Rehabilitation Center, Albia
2007 fines: $11,500
2008 bonus: $0
Red Oak Rehabilitation and Care Center
2007 fines: $11,000
2008 bonus: $9,225

Riverside Manor, Ames
2007 fines: $10,500
2008 bonus: $0
Windmill Manor, Coralville
2007 fines: $10,500
2008 bonus: $24,811
The Manor, Malvern
2007 fines: $10,350
2008 bonus: $18,555
Clearview Home, Mount Ayr
2007 fines: $10,000
2008 bonus: $57,552
Elm Crest Retirement Community, Harlan
2007 fines: $10,000
2008 bonus: $24,142

Source: Iowa Department of Human Services, Iowa Department of Inspections and Appeals. (Specialized facilities, hospital affiliates and state-run homes do not participate in the bonus program.)

SOURCE: Nursing Home Abuse › Nursing home fines, bonuses

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