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If you are a resident of Kentucky, this urgent request is for you! Nursing homes in the Commonwealth are again attempting to obtain special protections from being sued. They will do anything to protect their billion-dollar industry from being held accountable, and Kentucky Senate Bill 6 is this year’s attempt to shield themselves from being held financially accountable for abuse and neglect of the residents entrusted to their care! SHAME on these greedy corporations and the Corporate Whores who protect them by their lobbying efforts!

UPDATE: Senate Bill 6 PASSED last week (early February) in the Kentucky Senate Health & Welfare Committee. Thankfully it looks to be headed for defeat AGAIN in the Kentucky House! But to assure it’s defeat in the House (so it can’t be signed into law by the Governor), your helps is STILL NEEDED: Please contact your Kentucky State Representative! They NEED to know your thoughts NOW on the proposed legislation dealing with this important matter! Ask your legislator today to vote NO on Senate Bill 6. You can follow this link to find your senator if you don’t know who your senator and representative are: http://www.lrc.ky.gov/whoswho/county.htm Once you know their names, call the Capital Annex and leave a message for him/her at 502-564-8100. Again: VOTE NO ON SENATE BILL 6 — because nursing homes are not entitled to special rights!

Here’s another unsolicited testimony from a nursing home staff member who lost her job for doing the right thing by caring for her residents and being ethical in the area of maintaining medical records for residents. This nurse (an LPN) from Kentucky writes…

“I’m so glad I found this blog. I too have experienced some of the horrors detailed in several of these postings. I am a licensed nurse with well over 12 years experience. I began my health care career working as a Certified Nurse’s Aide (CNA) for more than 20 years.

While working for a nursing home in Kentucky for more than a decade I truly loved my job, my residents and my co-workers. I began as a CNA for this company, and after a while, the administration thought enough of me to send me to school to become a nurse on a scholarship program. I worked as a CNA, a floor nurse, a unit manager, and eventually a “MDS nurse“. MDS nurses are responsible for assessing patients and billing Medicare and Medicaid.

I always felt good about the care I delivered to my residents, but as time went on and the company had been bought out, things began to change. Profit became the main concern and the care we provided declined dramatically. The local nursing home ombudsman proved to be of no help as this person was friends with the administrator. They even attended the same church.

I’m certain someone tipped off the administrator just before State Surveyors would arrive to inspect our building. Why would I say this? Because our administrator NEVER arrived for work before 8:00am any day of the week UNLESS an inspection was imminent. I reported this issue to the state ombudsman only to be scolded for calling into question “the morals and ethics of this fine woman” (the local ombudsman).

Several cases of abuse were covered up or barely investigated without anyone ever held accountable. One of my co-worker and I reported some findings we discovered while assessing patients as part of our job duties. We immediately reported these findings of neglect that directly caused the deaths of three residents to the Director of Nursing and the Administrator. Our concerns were met with defensive comments, such as ‘We are covered…we contacted the MD’, etc. The nursing home staff had ignored severe signs and symptoms of urinary tract infections (UTIs) in three elderly patients, two of them went without any testing for over three weeks. These concerns had been reported to the Director of Nursing and administrator several times. Eventually proper treatment were given to these residents, but by the time they received treatment, they had become septic which contributed to their death. If the nursing home does too much testing for UTIs, it makes their infection control reports look bad on the public websites. So in essence, they ignore the symptoms and refuse to test! Three weeks after reporting our findings in these resident’s charts, my co-worker and I were both without jobs. We were told we were “not good team members” and were let go.

I have no recourse at this point as I am not considered a whistleblower, as I basically blew the whistle after I was fired. I was trying to get the administration to understand that we, as a company, had a problem that needed to be addressed. A sad, sad situation for all involved.

I have trouble sleeping thinking I should have stepped up sooner. I contacted Kentucky’s Office of Inspector General who seemed to take my complaint seriously, but after going to investigate,the Surveyors were told to write a few small tags, with no fines or oversight involved. The nursing home got away with everything, and I simply don’t understand how this is allowed to happen. This company is now involved in several lawsuits and one of them involves the family of one of the residents I complained to the administration about. I hope to one day find a company that will appreciate a strong patient advocate as I have no plans to change who I am!”

It would seem, sadly, that the definition of a “good team member” within the nursing home industry is a reference to a person without a conscious, without integrity and without the courage it takes to do the right thing. That’s a “team” that must go away!

As a resident of Kentucky committed to nursing home reform, I was thrilled when our 2013 legislative session ended a few weeks ago without passing Senate Bill 9. The bill’s intention was to make it much more difficult to sue nursing homes by mandating that a panel of three physicians would have to, by majority vote, approve of the merits of a lawsuit against a nursing home before it could tried in court.

Most nursing homes in Kentucky are owned by for-profit corporations. Most hospitals in Kentucky and owned by non-profit corporations. Kentucky’s hospitals have never sought such protection. So it’s obvious what this dysfunctional bill was all about: protecting nursing home profits. With a smaller profit margin nursing home bosses like Kindred President & CEO Paul Diaz might not be able to make an obscenely huge salary of over $6.4 MILLION like he did during 2012. This is all the more an obscene situation when you consider how cheaply Kindred and other nursing home giants run their facilities — meaning they don’t provide adequate staffing to care for their residents and the front-line caregivers are woefully underpaid, many not even having health insurance as part of their compensation.

While Senate Bill 9 passed in the Kentucky Senate, thankfully it never received a hearing in the House Health & Welfare Committee, so it couldn’t up for a vote by the House. While the fact that this bill was able to pass in the Senate is disturbing, yet it points out a reality that the nursing home industry needs to face: No matter how much money they spend to buy legislator’s votes to support such a bill and to run deceptive commercials to promote their agenda to the public, they do NOT have the truth or decency on their side. Thankfully, so far at least when it comes to Senate Bill 9, all of their money and lies could not force their hideous agenda on nursing home residents. Truth won. Greed lost. Amen.

I want to offer a few reminders about this blog…

– As I’ve mentioned before, I’m very familiar with how nursing homes operate in Kentucky and Indiana, due to my late mother’s experiences in facilities located in both of these states. But I never claimed to be knowledgeable about nursing home rules and regulations in any other states.

— Since I’m not an attorney, nor am I employed by any government agency that regulates nursing homes I ask that you do not contact me for help resolving a problem with any nursing home, especially if they aren’t located in either Kentucky or Indiana. Instead, I urge you to focus on contacting either your local long-term care ombudsman and/or the agency that regulates nursing home in your state (the agency name varies from state to state, but this is information you can find at your local library or from your state legislators). These are the people you need to contact. With access to Google and other Internet search engines, you can likely find their contact information quite easily. If you can’t find the information online, then (as mentioned previously) contact your local library and/or state legislator for this information. In both Kentucky and Indiana all nursing homes MUST (as a matter of law and/or regulation) provide anyone who asks (resident, family member or friend) for their

– While I do publish from time to time comments readers leave on this blog having to do with nursing home problems they’ve experienced, please remember that I reserve the right to edit your comments. I edit these comments to protect the identity of the nursing home resident, the author of the comment and I never include the name of the facility involved. Given the tendency for nursing homes to retaliate against residents and their friends and families, it should be obvious why this information is omitted. I also don’t feel comfortable naming a nursing home accused of neglect or abuse of their residents unless this is a matter of public record (e.g., it involves a situation that has been the subject of a lawsuit).

Please DO keep share your story with me and with our readers! I believe it is therapeutic to share the horror of one’s stories with others and it is helpful for others to be reminded they are not alone and that others have faced the same nursing home crap they have!

Remember: Truth Won. Greed Lost. If it can happen in Kentucky (and it did during our 2013 legislative session) it can also happen in your corner of the world!

Several weeks ago hundreds of us nursing home reform advocates were delighted to learn that Extendicare (known to some of us as “Pretend-I-Care”), one of the worst-of-the-worst for-profit nursing home corporations, planned to sell all 21 of the facilities they owned within the Commonwealth of Kentucky. They are leaving Kentucky for the same reason they exited Florida several years ago: they couldn’t force our state’s legislators to support legislation that would make it more difficult to sue nursing homes for negligence. They didn’t have their way during the 2012 Kentucky legislative session, despite the hundreds of thousands of dollars Extendicare and other nursing home owners have spent over the past year to bribe (I’m sorry, I mean “influence”) lawmakers with the hope of making it more difficult to sue nursing homes for providing negligent care.

Extendicare is truly one of the greediest companies you will ever encounter! Greedy to the point that the management of one of their southern Indiana nursing homes treated their kitchen staff to a nice dinner party in appreciation for them figuring how to feed their residents three meals and two snacks per day for less than 75 cents! More money is spent feeding dogs and cats each day than is spent by Extedicare to feed their (human) residents. That’s pathetic enough, but then to “celebrate” this new low point in resident care with a dinner party? That’s just plain evil. Greed should be a source of shame, not celebration.

When a Kentucky-based law firm that takes on cases of nursing home neglect published a “So glad to see y’all leave!” press release following Extendicare’s exit announcement, Tim Lukenda (Extendicare’s President and CEO), attempted to defend his outfit’s badly battered reputation. One of the statistics Likenda cited as something he is proud of is something that sane people would cite as a point of shame. He noted that within the year prior to the announcement that Extendicare was pulling out of the Commonwealth, “14% of our Kentucky [nursing homes] have received deficiency-free surveys.”

Let me break that down for you: only 3 of the 21 nursing homes owned by Extendicare in Kentucky were not cited for deficiencies by state inspectors. 14% (3 nursing homes out of 21) had excellent inspection reports. Wow. Impressive? Hardly! Pretty sad actually. What other corporation would be proud to point out that 86% of their facilities were doing a sub-standard job? Not many.

So here’s hoping that the Texas-based nursing home chain that Extendicare has sold all of their 21 Kentucky nursing homes to will provide a much higher level of care than their previous owners ever did. Sadly, it wouldn’t take much for the new owners to do a better job than Exitendicare.

Over the past several weeks I’ve begun to keep a much closer eye on news media coverage of the many aspects of the nursing home industry.  Information I’ve discovered points to a disturbing pattern involving massive fraud and deception by numerous players in the industry!

It is abundantly clear that HUNDREDS OF MILLIONS of dollars in government funding given to nursing homes with the expectation that the monies would be used to increase staffing levels and improve other aspects of resident care have instead gone to significantly increase the profit margins of many for-profit nursing home owners. This problem may involve facilities in nearly 30 states (including Kentucky, Indiana and California) and can be traced as far back as 2003, when individual states (thanks to pressure from the wealthy nursing home industry) began offering financial incentives with the intention that the funding would  improve the quality of nursing home care.  Not surprising to those of us who have had loved ones living in nursing homes over the past decade, the quality of resident care has actually significantly declined!

For-profit nursing homes guilty of fraud and deception involving government money?  Say it ain’t so!  Then again, over the past few weeks we’ve also uncovered many news reports that tell the tale of entire nursing home corporations — from Georgia to Ohio — being indicted for deceptively over-billing Medicare and other insurance providers.

Yes, friends. Stealing, lying and other forms of deception are all-too-common within the nursing home industry.  When it comes to dealing with nursing facilities on a personal level (regarding the care of a loved one) you are wise to be cynical and to closely examine every claim made by the pathological liars that are all-too-present within the nursing home industry!

I want to take a moment to salute those members of the news media who have the courage to expose the truth about the reality of problems within the nursing home industry! It must be more difficult to buy the silence of the news media (not to mention us blog owners) than it is to come up with enough money to bribe some state politicians!

Recent articles published in the Boston Herald, Louisville Courier-Journal, Lexington (Kentucky) Herald-Leader and Indianapolis Star newspapers have shed much light into the truly frightening reality of many nursing homes.  The Indianapolis Star investigative report (published this past Sunday, March 7, 2009) makes clear that (at least when it comes to nursing homes within the state of Indiana, which is the focus of the article) the following equations are clearly at play within the nursing home monopoly:

* Staff-to-resident ratios in for-profit nursing homes are much lower than in non-profit facilites.
* While for-profit facilities claim they can’t afford to hire more nursing staff, their CEO’s make much more money than do executives of non-profit nursing homes.
* The lower the staff-to-resident ratio = the lower the quality of care = increased health problems for nursing home residents.

Ya’ think?!?  And to think that some readers wonder why I rail against corporate greed on this blog as often as I do!?! It all goes back to the Biblical expression, “The love of money is the root of all evil.”  And evil (as I understand the nature of real evil) is all-too-present within the for-profit sectior (which is by far the largest sector) of the nursing home industry. Nursing home “evil” places the safety and care of residents below the craving for increased earnings by CEOs and COOs who often earn literally millions of dollars per year, while the Certified Nurses Aides (the front line caregivers) barely more than minimum wage!

(Update: Saturday, 3/20/10: I was able to find out the direct website address for The Indianpolis News’ excellent investigative feature that focused on problems with nursing homes in Indiana. You find the link to view Crisis of Care Among State Nursing Homes under the Blogroll feature on the left side of this page.)

For those of you who live in Indiana, please contact your state legislators to ask them to pass minimum staffing regulations for nursing homes within the state!  Indiana and Kentucky are among only 13 states that are dumb (or corrupt) enough to not have nursing staff-to-resident minimums in place.

David Goud of Louisville, Kentucky, knows exactly what goes on in nursing homes since he has worked in the industry. We applaud Goud for standing up to the well-financed nursing home lobby with the following letter he wrote  to THE COURIER-JOURNAL, the daily newspaper in Louisville back in 2008.  David Groud wrote:

“I applaud Bernie Vonderheide (of Kentuckians for Nursing Home Reform) for his advocacy for the residents held hostage in most nursing homes. I have had the misfortune to witness first hand the neglect and abuse that the elderly of our city endure on a daily basis.

Having worked in two nursing homes in Louisville, I can say that not only is there not enough nursing staff available to meet basic needs, but the quality of care given to residents would be comparable to an animal shelter.

It is also difficult to police nursing homes, because state inspections and investigations are rarely unexpected. Nursing homes know when they are to be audited and call in more staff than usual to give a better show of quality.

A civilized society should give better care to its elderly. At present, one can expect better quality care at a fast-food counter than at a nursing home.

My sincere thanks to David Goud for being an articulate, outspoken advocate on behalf of nursing home residents!

Kudos to the (Louisville, Kentucky) Courier-Journal newspaper for the following editorial published on Friday, January 25, 2008, that encourages passage of HB 109. The legislation would mandate minimum staffing levels in all nursing homes within the Commonwealth.

Caring for Boomers

The debate in Frankfort over House Bill 109 is just a hint of things to come.

The legislation would attempt to improve the care given by nursing homes, by imposing what really are modest staffing requirements:

One nurse’s aide for every nine residents during the day shift; one aide per 13 residents during the evening shift; one aide for every 19 residents overnight. Also, one nurse for every 21 residents during the day; one per 29 residents during the evening shift; one for every 42 residents overnight.

This would not put Kentucky in the forefront of the effort to make sure nursing homes are properly staffed. Thirty-seven other states already have such rules. HB 109 is overdue.

As activists point out, the state already regulates day-care centers, to make sure enough personnel are on hand to monitor and assist the children who are placed there. There is certainly no less justification for careful oversight of facilities that take care of the elderly.

This is just the leading edge of a movement that can be expected to broaden and gain momentum in coming years. Some baby boomers already have loved ones in nursing homes. Their 1946-1964 cohort has demonstrated, at every stop on its journey through life, an impatience with things as they are, and an inclination to insist that things can be made better. It will insist on good nursing home care for its parents.

After that, many of the baby boomers themselves will take their turn in nursing homes, and the operators of such facilities may be nervous at the thought of ’60s types organizing and demonstrating for better quality, less expensive care.

The better part of valor might be to improve things before Baby Boom agitators show up at the front door with their own luggage.

The usual special interest approach — in this instance, attempting to buy access and influence with more than $110,000 in contributions to lawmakers’ campaigns since 1998 — isn’t likely to work for the industry. Too many Kentuckians have too much at stake, personally, for bad care to go overlooked.

Current state rules have some big holes in them. For instance, they say a “sufficient” number of staff must be on hand, but what’s “sufficient” isn’t defined.

The Kentucky Association of Health Care Facilities (KAHCF), which represents about 250 nursing home and personal care homes, opposes HB 109, and the General Assembly should look carefully into any serious argument that group makes. However, there is no need to take seriously the absurd rhetorical question asked by KAHCF president Ruby Jo Lubarsky: “Why should we allow someone outside the business to dictate to us what numbers are appropriate?”

Nor should any attention be paid to KAHCF vice president Jay Trumbo’s claim that “more bodies walking the hallway doesn’t equate to better care.” It’s true that more staffing will not ensure good outcomes, but hiring too few nurses and nurse aides will ensure the opposite.

Consideration of HB 109 is just a first move in determining how the state can help make certain quality care is provided to coming generations of the elderly. The General Assembly should step off in the right direction.

I’m also pleased to share with you a request from Kentuckians for Nursing Home Reform regarding making the best use of this editorial…

HERE’S WHAT YOU CAN DO NOW….Make a copy of this editorial and mail it with a note from yourself to your state legislators and Gov. Steve Beshear.  Tell them about your bad experiences in nursing homes.  Tell them you want action now.

Nursing Home News Watch

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