Dec 032015
 

FBI seeks tips about and prosecutes corrupt California public officials

United States Attorney General Eric Holder speaking at a press conference alongside FBI Director Robert Mueller, in the public domain. (Photo credit: U.S. Department of Justice, October 11, 2011)

False Claims Act lawsuit against North American Health Care’s CEO, John Sorensen, continues, U.S. federal judge rules

A federal False Claims Act lawsuit filed against Dana Point, Calif.-based North American Health Care, Inc. (NAHC), and its CEO, John L. Sorensen, will continue, according to U.S. District Court documents and a recent article in McKnight’s Long-Term Care News.

The McKnight’s article, “Kickback Allegations against North American Health Care CEO ‘Plausibly Supported,’ Court Rules,” said on November 16, 2015, that John Orten, a former nursing home administrator and whistleblower who worked at one of the 36 “client facilities” that NAHC operates in the western Unites States, alleged the following in his False Claims Act lawsuit:     

  • “The CEO of North American Health Care Inc. personally oversaw a kickback scheme.”
  • “CEO John L. Sorenson [sic] ordered other nursing home administrators to pay physicians in exchange for referring Medicare beneficiaries to NAHC facilities.”
  • “[John] Sorenson [sic] paid physicians to sign letters written by NAHC employees that defended the company against deficiencies found by Medicare inspectors.”

False Claims Act allows private citizens to sue those who try to defraud the federal government

The False Claims Act (31 U.S.C. §§ 3729–3733) allows private citizens and whistleblowers to file a lawsuit, also known as a qui tam action, on behalf of the federal government against government contractors and others who allegedly try to defraud government programs, including Medicare. (See Elder Abuse Exposed.com’s coverage of rampant Medicare fraud by nursing homes throughout the United States in “Nursing Home Medicare Fraud $1.5B a Year, Says New U.S. HHS-OIG Report” and “Nursing Home Chain Life Care Bilked Medicare of Millions, DOJ Suit Says.”)

Plaintiff-relator “has plausibly alleged that Sorensen implemented a referral and regeneration scheme and that false claims were actually submitted,” U.S. federal judge says

According to records in the U.S. District Court for the Northern District of California, on July 17, 2015, John Sorensen filed a motion to dismiss the qui tam lawsuit for failure to state a claim specifically against him. Then in a ruling on November 9, 2015, U.S. District Judge William H. Orrick granted part of Sorensen’s motion to dismiss but denied part of it. “Orten has plausibly alleged that Sorensen implemented a referral and regeneration scheme and that false claims were actually submitted,” Judge Orrick said in his ruling, which has allowed the lawsuit against NAHC and Sorensen to continue.

North American Health Care, Inc., filed for Chapter 11 bankruptcy protection

North American Health Care, Inc., filed for Chapter 11 bankruptcy protection in February 2015, as The New York Times reported on February 17, 2015, in “Facing Suits, a Nursing Home in California Seeks Bankruptcy.” The bankruptcy protection was “necessitated by the barrage of alleged medical malpractice and other lawsuits filed against the Debtors, claiming damages in the millions of dollars against the Debtors,” NAHC has claimed in filings with the U.S. Bankruptcy Court for the Central District of California. NAHC has also alleged in the same court filings that “the aggressive litigation tactics of the plaintiffs in these lawsuits…have diverted the Debtors’ resources and focus away from operating their businesses.”

The cases in this article are:

  • United States of America, et al. v. North American Health Care, et al., case number 3:14-cv-02401-WHO, U.S. District Court for the Northern District of California.
  • In re North American Health Care, Inc., case number 8:15-bk-10610, U.S. Bankruptcy Court for the Central District of California.

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Apr 082014
 

UCSF Professor Stanton A. Glantz, Ph.D., criticizes California Gov. Jerry Brown's veto of Assembly Bill 217, which would have banned smoking inside nursing homes

Just a week after Elder Abuse Exposed.com said in its October 23, 2012 article, “Governor Jerry Brown Vetoes Smoking Ban inside California Nursing Homes,” that Governor Brown was disregarding evidence in the U.S. Surgeon General’s 2006 report on the deadly health effects of secondhand smoke exposure and was continuing to disregard the rights of vulnerable nursing home residents, a new University of California, San Francisco study on smoke-free laws shows that Governor Brown’s September 27, 2012 veto of Assembly Bill 217 was not in the interest of public health. The new study, which appears in the American Heart Association journal Circulation (October 30, 2012), is called “Association Between Smoke-Free Legislation and Hospitalizations for Cardiac, Cerebrovascular, and Respiratory Diseases: A Meta-Analysis.” The authors of the study are Crystal E. Tan, MS, and Stanton A. Glantz, Ph.D., who is a professor of medicine and the director of the Center for Tobacco Control Research and Education at UCSF. (Photo (right) credit: Office of Attorney General)

Elder Abuse Exposed.com selected as one of the “leading online resources for…elder advocacy and abuse prevention” by Nursing Assistant Guides.com

Elder Abuse Exposed.com is proud to be featured in Nursing Assistant Guides.com’s just-published, newest feature article, which is a collection of “leading online resources” on home healthcare, assisted living, long-term care, elder advocacy and abuse prevention, and general senior care.

The Nursing Assistant Guides.com website “is dedicated to providing updated, quality information for those interested in a career as a nursing or medical assistant. Here you’ll have access to an abundance of information about becoming a CNA [certified nursing assistant], and you can request additional information from qualified, accredited online degree programs across the United States.” Nursing Assistant Guides.com is “a dedicated resource for anyone interested in earning the required credentials to work in this field.”

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Feb 202014
 

Medicare Nursing Home Compare Five-Star Quality Rating System is a fraud on the public. This needs to be publicized because as U.S. Supreme Court Justice Louis D. Brandeis said, "Publicity is justly commended as a remedy for social and industrial diseases."

U.S. Supreme Court Justice Louis D. Brandeis, in the public domain. (Photo credit: Harris & Ewing Collection at the Library of Congress, Prints & Photographs Division, circa 1916)

Calif. nursing home video camera law is needed for consensual monitoring inside residents’ rooms, says chairman of Alzheimer’s care facilty

[Editor's note: This is a guest blog post by Harry C. Crowell, who is the chairman of Vista Gardens Memory Care in Vista, Calif., in San Diego County. Vista Gardens Memory Care is a residential care facility for the elderly (RCFE) specializing in the care of residents with Alzheimer’s and Parkinson's disease, dementia, and other conditions causing cognitive impairment.]

There are many reasons to allow in-room video cameras inside bedrooms of nursing homes and residential care facilities for the elderly in California. But the first is the overriding concern for the safety of these wonderful residents. Residents with cognitive impairment are quite aware that they have limited ability to defend themselves from just about any transgression. They may have short-term memory loss but have an amazing ability to remember misconduct, excitement, fun times, good food, old friends, sickness, falls, games, singing songs, sporting events, a “hole in one” at golf, trips, and travel events. They can even sit at the piano and begin to play as though they have never missed a day of practice.

These residents have an ongoing problem with remembering things that have never happened and may tell stories of impossible events. These stories include events that supposedly occur in their rooms, and no one can really know the truth from fiction. The Alzheimer’s-affected person is not malicious but has an amazing way to describe something that really never happened. Some of these stories affect employees, family members, visitors, and other residents. This is not fair, and we must have a proper and reliable way to ascertain whether the stories are true or imaginary.

We have asked all residents who have signed up and lived in Vista Gardens Memory Care if they would like the benefits of in-room video monitoring. Each resident or surrogate decision-maker, including family members, has accepted in-room video cameras, and they constantly ask when the cameras will be turned on. The California Department of Social Services’ (DSS’) Community Care Licensing Division (CCLD) has advised our care facility that if we use the video cameras, our license will be revoked.

As an advisor member of the Orange County Alzheimer’s Association Board of Directors for nearly ten years, I have read many articles, visited other facilities, and discussed many subjects regarding Alzheimer’s. I am a solid supporter of in-room video cameras for the ongoing safety and health reasons for these residents. The health and safety issue is a serious charge to take care of.

Medications, which are given to these residents several or many times a day on a daily basis, are very important to be given properly. The medication administration records are kept meticulously, but how is anyone to be certain that the medications are actually given as the records indicate? The in-room video cameras can actually show the medications given and the time of day. Many residents wear diapers, and our reports are also kept. But how do we really know when our incontinent residents are changed?

When we hire an employee, the employee must undergo mandated tests, including medical, criminal, and financial, to be sure that we hire people with a good background. These tests cost about $300 per new hire, so it is imperative that we try our best to hire responsible people who seem to truly have the best interest of Alzheimer’s-affected people from the beginning.

We then must train employees for about two weeks before they are left alone in their job function. We also give ongoing education and training to try our best to be certain that we have people in all positions who really want to do a good job and really care about the health and well-being of the residents.

It is expensive to hire, and even more expensive, to terminate a poor-quality employee. From the first interview, we tell every new employee that we have video cameras throughout our facility, and they sign acknowledgments of the camera policy. Our employees are quite happy that we have these cameras to ensure they are treated fairly.

We discuss on-premise video cameras and our in-room video camera policy, and no one has expressed disapproval of the cameras. We have also told residents and employees that we are trying to have our in-room video cameras turned on and are awaiting approval from the state.

The California Department of Social Services has never given our facility approval to use in-room video cameras. DSS has also not acknowledged our request for approval other than sending a letter to us at least two years ago saying that DSS would let us know. DSS’ Community Care Licensing Division has only indicated that in-room video cameras are a privacy issue within state of California documents and that safety has no bearing.

Every law enforcement agency in the country approves of video cameras and would like more of them. Our vulnerable residents have the same rights and need the safety benefits of video monitoring.

There are several bills right now in the California Senate and Assembly that are trying to improve patient and resident safety. These bills all fail miserably. They add more fines, monetary penalties, more government inspections, and yet they only add more costs to an already low-income and low-profit industry.

Vista Gardens Memory Care already must pass a large set of rules, regulations, inspections, and more double regulations than anyone can really understand. The state reads and approves all of the operating manuals before the facility can open for business.

The problem is not that elder care facilities do not have rules and regulations to follow; it is that they must follow all the rules and hire the correct people who actually need to fully understand and operate under the rules. When mistakes are made and an employee does anything against the rules, the employee is not charged with any wrongdoing. Rather, the company is charged. These new California bills just increase the fines against the company.

We should have a more proper way to have employees who make errors be given an opportunity to take educational classes to accomplish in a short time. This would improve work ethic, skill, opportunity, personal knowledge, and potential in the job market to move up in the salary range. Fines and more government inspections only add more cost to an already overburdened industry.

It is well known that a quality video camera system is quite expensive, and no care facilities should have any regulation mandating their use. There are also many employees, visitors, family members, and Alzheimer’s residents who do not want cameras. The state should never mandate that cameras should be a requirement for every nursing home or residential care facility for the elderly.

But California needs legislation that specifically allows in-room video cameras for those who do want to benefit from the cameras and will properly use and follow the very strict privacy procedures as we have written in our applications. The privacy issue is one we guard well.

Harry C. Crowell
Chairman of Vista Gardens Memory Care
Vista, Calif.


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Jan 052014
 

California DOJ Bureau of Medi-Cal Fraud and Elder Abuse (BMFEA) chief of prosecutions, Mark Zahner, files no criminal charges after Dr. Kathryn Locatell protects nursing home

The California Department of Public Health’s (CDPH) Licensing and Certification Program, hardly an aggressive watchdog of wealthy, politically connected nursing homes, issued a class “B” citation and monetary fine in October 2011 to North American Health Care, Inc.’s client nursing home Lake Balboa Care Center in Van Nuys, Calif. CDPH said that Lake Balboa Care Center failed to administer oxygen to a fainting patient at a flow rate required by physician orders and the patient’s care plan. At that time, the unfortunate, 88-year-old victim suffered rapidly declining oxygen saturation levels, cardiopulmonary arrest, and unexpected death. In its citation, CDPH said, “The above violation had a direct relationship to the health, safety and security of Patient 1.” Despite CDPH’s findings, tantamount to obvious elder neglect, the California Department of Justice’s Bureau of Medi-Cal Fraud and Elder Abuse (BMFEA) chief of prosecutions, Mark Zahner, based his decision to file no criminal charges in the case, not on BMFEA Special Agent J. Timothy Fives’ expert opinion, but instead on the different opinion of BMFEA medical consultant Kathryn L. Locatell, M.D. Dr. Locatell shockingly said, “There were no breaches of any applicable standards of care in the events leading to Mr. [patient’s name deleted] death. I see no indication of neglect whatsoever…[W]hether or not oxygen was administered, or administered timely…was immaterial.”

New California nursing home video camera bill proposed to combat elder abuse and neglect

Dear Friend:

We at Elder Abuse Exposed.com hope that California State Senator Lois Wolk (D-Davis) or another member of the California Legislature will accept our proposal to introduce a nursing home video camera bill like the recently enacted bipartisan Oklahoma law (Senate Bill 587), which was approved unanimously by both the Oklahoma State Senate and House of Representatives. It confirms the right of consenting, vulnerable nursing home residents to install, at their own expense, video surveillance cameras in their own private bedrooms. Our proposal also confirms the right of consenting residents in residential care facilities for the elderly (RCFEs), also known as assisted living facilities, to choose to have the protection that in-room video camera monitoring can provide.

In addition, our video camera proposal ensures and vigorously protects the privacy rights of those RCFE and nursing home residents who do not consent to video monitoring. In other words, only consenting residents who want to exercise their right to video monitoring in their own private bedrooms could be monitored, and residents who do not consent could never be monitored by video cameras in their bedrooms.

Sadly, while many nursing homes and RCFEs provide good care, there have been abuses and instances of very poor care, including false or misleading nursing notes to cover up abuse and poor care. Our proposed nursing home and RCFE video camera bill would serve as a strong deterrent to this abuse, poor care, and falsification of patient records. The video camera bill, which would provide for proper resident consents, video monitoring warning signs, and strict privacy safeguards, would permit facility management and residents’ family members to monitor facility staff inside rooms when no one else is watching the staff. As a result, the facility management could improve staff training, take appropriate disciplinary action, and reduce or even eliminate poor or neglectful care.

We think that a nursing home video camera law in California would make it very difficult for nursing home and RCFE operators to understaff facilities and thereby overload nursing staff to the point of making the well-meaning, caring staff hardened and desensitized to patient neglect and suffering. Equally important, video camera monitoring would deter facility staff from falsifying patient records to cover up poor care and neglect because facility administration and cooperating family members could easily verify the actual care through video camera recordings.

Please help now by signing our petition supporting a nursing home video camera bill with strict privacy safeguards

Please help us get this bill launched by taking just a minute or two to sign a petition which says simply:

Get the California government out of elderly citizens’ private bedrooms. I support a bill that would allow video camera monitoring with the proper resident consents and strict privacy safeguards, like the recently enacted bipartisan Oklahoma law, to combat elder abuse.

Please click here to sign the petition, which a growing list of prominent geriatricians and elder abuse experts (below) have already signed (as individuals and not on behalf of the entities for which they work):

  • Laura Mosqueda, M.D., director of geriatrics, chair and professor of Department of Family Medicine, Ronald W. Reagan Endowed Chair in Geriatrics, and director of Center of Excellence on Elder Abuse and Neglect at the University of California, Irvine School of Medicine.
  • James Spar, M.D., director of the Division of Geriatric Psychiatry Inpatient Program and professor of clinical and geriatric psychiatry in the Department of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine at UCLA.

  • Robert Neshkes, M.D., chief of  Geropsychiatry Treatment Unit at West Los Angeles V.A. Medical Center and retired clinical assistant professor of psychiatry in the Department of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine at UCLA.
  • Deborah Newquist, Ph.D., M.S.W., assistant clinical professor of gerontology at the University of Southern California (USC), former director of geriatric services for international chronic care services company ResCare Inc., and founder and president of Southern California-based geriatric care management and home care company Senior Care Resources.

Some of the benefits of video camera monitoring in California nursing homes and residential care facilities for the elderly

What are the benefits of video camera monitoring? One good example is a residential care facility for the elderly (RCFE) named Vista Gardens Memory Care, in San Diego County in the town of Vista, California, which was built with video cameras installed for the protection of the residents who want video monitoring. If the California Department of Social Services’ (DSS’) Community Care Licensing Division (CCLD), which regulates RCFEs, did not prohibit Vista Gardens Memory Care residents from benefiting from the safeguards of in-room video camera monitoring, then:

  • If there was any question about whether a staff person misbehaved, Vista Gardens could find out if it occurred and correct it immediately.
  • If, for example, a resident was found on the floor with a bruise on the head, Vista Gardens could review the video recording to see how and if the bruises occurred when the patient fell out of bed reaching for a nightstand or in some other manner.
  • If the bruising was caused by a fall from reaching for a nightstand while in bed, the recording would show this, and Vista Gardens would simply move the nightstand closer to the bed.
  • If the recording showed any other reason for the bruising, Vista Gardens would also be able to take corrective actions immediately and notify the appropriate authorities and individuals.
  • Vista Gardens could also review the video of the resident falling to relay pertinent information to paramedics or the emergency room for treatment decisions.
  • If a hallucinating resident were to claim that something improper occurred (e.g., a lady claiming a naked man was in her room), Vista Gardens could review the video to ascertain that it did or did not happen.

Calif. Dept. of Social Services’ infringes on RCFE residents’ right to use video cameras in their private bedrooms

Unfortunately, the California DSS’ CCLD has prohibited video monitoring in the residents’ rooms at Vista Gardens Memory Care. Neither the resident, his or her family, nor Vista Gardens may have video camera monitoring in the residents’ private rooms, according to CCLD, even though residents or the residents’ healthcare agents have given written consent for and fervently want the video monitoring for their own protection.

DSS’ CCLD told Vista Gardens that in order to operate the video cameras, Vista Gardens had to apply for an exception request for camera monitoring program. Although Vista Gardens applied for the exception request on July 21, 2011, Vista Gardens has predictably not received any response from DSS’ CCLD.

But the fact is that no California or federal law prohibits video cameras in consenting residents’ rooms, where there is a reasonable expectation of privacy only for the residents. The residents or their healthcare agents have a right to waive the privacy in a limited way for video monitoring.

Bottom line: DSS’ CCLD and the California Department of Public Health’s (CDPH’s) Licensing and Certification Program, which regulates nursing homes, do not have any legal authority to prohibit video camera monitoring. But DSS’ CCLD, which we believe acts as a proxy for the California Assisted Living Association (CALA) and the California Association of Health Facilities (CAHF), unjustifiably infringes on vulnerable, elderly residents’ right to use video monitoring in their own private bedrooms to protect against elder abuse and poor care.

California government (CCLD and CDPH) should not even concern itself with what private citizens do in their own private bedrooms. California government should get out of our private bedrooms.


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Oct 222013
 

(Part 3 of 3)
Read Part 1 »
Read Part 2 »
Updated, October 23, 2013, 7:27 p.m. PDT

Medicare Nursing Home Compare Five-Star Quality Rating System is inaccurate and unreliable due to corrupted state nursing home inspectors, supervisors, and agency directors pressured by nursing home industry and legislators to overlook elder abuse and poor care in nursing homes, said Senator Charles Grassley (R-Iowa).

Unofficial, alternate U.S. Senate seal and U.S. Senator Charles Grassley (R-Iowa), former chairman of the U.S. Senate Special Committee on Aging, in the public domain. (Photo credits: U.S. Government and U.S. Senate via Wikimedia Commons)

Blowing the lid off the final five troubling secrets about the Medicare Nursing Home Compare Five-Star Quality Rating System

Secrets numbers 5–11 in Part 2 of the three-part exposé apparently ruffled the feathers of some leading state nursing home regulators

A few weeks ago, in Part 2 of the three-part exposé “Medicare Nursing Home Compare Five-Star Rating System: A Fraud on the Public?,” Elder Abuse Exposed.com revealed seven more of 16 secrets (numbers 5–11) that the Centers for Medicare and Medicaid Services (CMS) and “five-star” nursing homes will not tell you about Medicare’s nationally promoted, frequently visited Nursing Home Compare website:

  • Secret #5: Consumers must rely on the California Department of Public Health’s (CDPH’s) Health Facilities Consumer Information System (HFCIS), which is a state website that is not as heavily promoted as Nursing Home Compare, to see state enforcement actions against California nursing homes.
  • Secret #6: California nursing homes’ profile pages at CMS’ Nursing Home Compare do not link to CDPH’s HFCIS and do not warn consumers that Nursing Home Compare excludes even the highest-level state enforcement actions against California nursing homes, including elder abuse and patient homicides.
  • Secret #7: The misleading Nursing Home Compare Five-Star Quality Rating System is not based on and totally excludes state enforcement actions against California nursing homes.
  • Secret #8: CMS grades a U.S. nursing home’s health inspection performance “on a curve” to determine a facility’s health inspections star rating on Nursing Home Compare.
  • Secret #9: A U.S. nursing home’s quality measures star rating and overall star rating are based on unaudited, limited data that the nursing home self-collects and self-reports to CMS.
  • Secret #10: Authoritative U.S. government reports have found that nursing homes’ self-reported patient assessments, underlying the quality measures star rating, are often inaccurate and unreliable.
  • Secret #11: Nursing home citations and deficiency statements can reveal discrepancies between nurses’ falsified patient assessments and typically more reliable documentation in patients’ medical records.

Secrets numbers 12–16 in Part 3 of the three-part exposé will likely further ruffle the feathers of some state and federal nursing home regulators who do not want you to know these secrets

Today, in Part 3 of the three-part exposé, Elder Abuse Exposed.com reveals the remaining five of the 16 secrets (numbers 12–16) that the CMS and “five-star” nursing homes throughout the U.S. do not want you to know about the Medicare Nursing Home Compare Five-Star Quality Rating System. While exposing these five new secrets, Elder Abuse Exposed.com is continuing to explore if there is any useful correlation between a nursing home’s star rating on Nursing Home Compare and the quality of care that a nursing home provides. Elder Abuse Exposed.com is also continuing to explore whether the Medicare Nursing Home Compare Five-Star Quality Rating System is a fraud perpetrated on consumers searching for a high-quality nursing home without a history of elder abuse and homicides.

Authoritative reports by U.S. GAO, U.S. HHS-OIG, and U.S. Senate have criticized the reliability of information on Nursing Home Compare

Armed with the information in the 16 secrets in Part 1, Part 2, and Part 3 of this three-part exposé, professional geriatric care managers, hospital case managers, elder care referral services, and consumers throughout the U.S. can now understand why Medicare’s Nursing Home Compare does not provide reliable, accurate quality-of-care information on the more than 15,000 Medicare- and Medicaid-certified nursing homes in the U.S. People who rely on Nursing Home Compare can also understand why 31 state attorneys general, the U.S. Government Accountability Office (GAO), the U.S. Department of Health and Human Services’ (HHS) Office of Inspector General (OIG), and U.S. Senator Charles Grassley (R-Iowa) have all sharply criticized the reliability and accuracy of the information on Nursing Home Compare.

Message from email address belonging to Raymond Rusin, chief of Rhode Island Department of Health’s Office of Facilities Regulation, requests no more contact from Elder Abuse Exposed.com

Despite the well-documented facts in the three-part exposé, which admittedly is critical of state and federal nursing home regulators, it is not surprising that some leading nursing home regulators in the U.S. have reacted negatively to the exposé. For example, Elder Abuse Exposed.com received a September 26, 2013 email from the government email address belonging to Raymond Rusin, the chief of Rhode Island Department of Health’s Office of Facilities Regulation. According to the website for Mr. Rusin’s Office of Facilities Regulation, “We manage and coordinate the licensing of health care facilities [including Medicare- and Medicaid-certified nursing homes] and operate a public-centered, responsive and uniform enforcement program in accordance with state licensing standards.” From 2007 to 2008, Raymond Rusin was also the president of the Association of Health Facility Survey Agencies (AHFSA), which represents the state licensing and certification agencies in all 50 U.S. states and Washington, D.C.

The September 26, 2013 email said:

From: Raymond Rusin
Sent: Thursday, September 26, 2013 4:59 AM
To: Elder Abuse Exposed.com
Subject: Re: Medicare Nursing Home Compare Five-Star Rating System: A Fraud on the Public? (Part 2 of 3)

Please remove me from your distribution list. I find your blog and your assertions to be more convoluted, distorted, misleading, and above all unnecessarily disturbing to vulnerable elders than any governmental information. You should exert your energies in efforts to appropriately assist elders in understanding the information.

State and federal nursing home regulators who are critical of this exposé are invited to publicly respond on Elder Abuse Exposed.com’s website

Elder Abuse Exposed.com believes that its three-part exposé is necessary for consumers searching for safe nursing homes in which to place their loved ones and that the exposé is well documented. But Elder Abuse Exposed.com respectfully invites Raymond Rusin or any state or federal nursing home regulator who disagrees to send a response that shows what the facts are and specifically which assertions in the exposé are “more convoluted, distorted, misleading, and above all unnecessarily disturbing to vulnerable elders than any governmental information.” In the interest of open debate, opposing viewpoints will be published on this website so that the public can critically examine all the information, decide for themselves what the truth is regarding Nursing Home Compare, and make educated choices about placement of their loved ones in nursing homes. If nursing home regulators decline to send public comments, the lack of a response will also be published on this website.

“Facts don’t cease to exist because they are ignored,” said the British novelist and critic Aldous Huxley

The facts and evidence remain, even though some of the nation’s leading nursing home regulators may not want to be confronted with troubling but well-documented facts about the nation’s five-star rating system for nursing homes. As the second U.S. president, John Adams, said, “Facts are stubborn things; and whatever may be our wishes, our inclinations, or the dictates of our passion, they cannot alter the state of facts and evidence.” Elder Abuse Exposed.com is now presenting the “stubborn” facts and evidence in the final five of the 16 secrets (numbers 12–16) that some nursing home regulators may claim are “unnecessarily disturbing to vulnerable elders than any governmental information.”

Secrets 12–16 of 16 secrets Medicare does not want you to know about its Five-Star Quality Rating System on Nursing Home Compare

12. California nursing home inspectors are reluctant to impose civil penalties on nursing homes for reporting inaccurate patient assessments.

Los Angeles nursing home inspectors found a “discrepancy” between a Lake Balboa Care Center nurse’s assessment and a physician’s assessment of the same patient

Nursing home inspector Cristina Descallar, RN, and her then-supervisor at the Los Angeles County Department of Health Services’ Health Facilities Inspection Division, North District Office, Michael Stampfli, issued an August 17, 2005 deficiency statement to the North American Health Care, Inc., client facility featured in Part 2 of this exposé, Lake Balboa Care Center in Van Nuys, Calif. According to the August 17, 2005 deficiency statement, a Lake Balboa Care Center nurse’s assessment of a post-stroke patient’s rash and skin infection on the “right lower back” disagreed with a dermatologist’s assessment of the same skin condition on the “right buttock.” The August 17, 2005 deficiency statement said that Lake Balboa Care Center violated 42 CFR § 483.20 (g), which is the federal regulation stating that an “assessment must accurately reflect the resident’s status.”

Continue reading »

Sep 262013
 

(Part 2 of 3)
Read Part 1 »
Read Part 3 »
Updated, October 21, 2013, 11:00 p.m. PDT

Medicare Nursing Home Compare Five-Star Quality Rating System is a fraud on the public. This needs to be publicized because as U.S. Supreme Court Justice Louis D. Brandeis said, "Publicity is justly commended as a remedy for social and industrial diseases."

U.S. Supreme Court Justice Louis D. Brandeis, in the public domain. (Photo credit: Harris & Ewing Collection at the Library of Congress, Prints & Photographs Division, circa 1916)

Blowing the lid off 12 more troubling secrets about the Medicare Nursing Home Compare Five-Star Quality Rating System

Two weeks ago, in Part 1 of the three-part exposé “Medicare Nursing Home Compare Five-Star Rating System: A Fraud on the Public?,” Elder Abuse Exposed.com revealed four of 16 secrets that the Centers for Medicare and Medicaid Services (CMS) and “five-star” nursing homes, especially in California, will not tell you about Medicare’s nationally promoted, frequently visited Nursing Home Compare website:

  • Secret #2: CDPH has not clearly explained why many nursing home citations that CDPH inspectors have issued for even the most serious misconduct, including elder abuse and patient homicides, have referred only to state law and have thereby been excluded from the Medicare Nursing Home Compare Five-Star Quality Rating System.
  • Secret #3: Even though CDPH has claimed that its inspectors will now be issuing dual citations referring to both state and federal law, which CDPH has referred to as “the federal process with dual enforcement,” the Medicare Nursing Home Compare Five-Star Quality Rating System will likely continue to exclude serious misconduct by wealthy, politically connected nursing homes in California.
  • Secret #4: The Medicare Nursing Home Compare website excludes even the highest-level state enforcement actions, including elder abuse and patient homicides, against “five-star” nursing homes in California.

Today, in Part 2 of the three-part exposé, Elder Abuse Exposed.com blows the lid off seven more secrets (numbers 5–11) that the CMS and “five-star” nursing homes throughout the U.S. do not want you to know about the Medicare Nursing Home Compare Five-Star Quality Rating System. While exposing these seven new secrets in Part 2, Elder Abuse Exposed.com is continuing to explore if there is truly a useful correlation between a nursing home’s star rating on Nursing Home Compare and the quality of care that a nursing home provides. Elder Abuse Exposed.com is also continuing to explore whether the Medicare Nursing Home Compare Five-Star Quality Rating System is a fraud perpetrated on consumers searching for a high-quality nursing home without a history of elder abuse and homicides.

Within the next week or two, in Part 3 of the three-part exposé, Elder Abuse Exposed.com will reveal the remaining five of the 16 secrets (numbers 12–16). Armed with this pertinent information, professional geriatric care managers, hospital case managers, elder care referral services, and consumers throughout the U.S. will finally be able to decide for themselves if Medicare’s Nursing Home Compare provides reliable, accurate quality-of-care information on the more than 15,000 Medicare- and Medicaid-certified nursing homes in the U.S. People who rely on the Medicare Nursing Home Compare Five-Star Quality Rating System can also decide if they agree with 31 state attorneys general who signed an August 20, 2009 letter to U.S. Secretary of Health and Human Services Kathleen Sebelius (email). The letter said:

As a result of the current Five Star methodology, comparison of individual nursing home ratings can be misleading and create significant confusion for consumers. In the interest of consumers as well as providers, we believe it imperative that the current Five Star System be suspended temporarily and revised using a more appropriate criterion-referenced evaluation methodology.

Secrets 5–11 of 16 secrets Medicare does not want you to know about its Five-Star Quality Rating System on Nursing Home Compare

5. Consumers must rely on a state website that is not as heavily promoted as Nursing Home Compare to see state enforcement actions against California nursing homes.

Elder Abuse Exposed.com informed CDPH that Nursing Home Compare excluded an October 6, 2011 class “B” citation issued to “five-star” Lake Balboa Care Center

While doing research for this exposé, Elder Abuse Exposed.com emailed CDPH officials to inform them that Nursing Home Compare excluded a state-law-based class “B” citation that CDPH issued to a “five-star” nursing home in California on October 6, 2011. (The October 6, 2011 class “B” citation involved “a complaint alleging Patient 1 was not provided an adequate amount of oxygen during an emergency situation when the patient became unresponsive” and, according to the patient’s death certificate, suffered fatal “cardiopulmonary arrest.”) Elder Abuse Exposed.com asked the CDPH officials if CMS’ calculation of a California nursing home’s Medicare star rating disregards citations that Nursing Home Compare excludes. Elder Abuse Exposed.com told CDPH officials that the excluded October 6, 2011 class “B” citation had been issued to “five-star” nursing home Lake Balboa Care Center, in Van Nuys, Calif.

Lake Balboa Care Center and the nursing home featured in Part 1 of this exposé, Cottonwood Healthcare Center, in Woodland, Calif., are two of North American Health Care, Inc.’s 34 “five-star” client facilities. According to John Sorensen, the president, CEO, and chairman of the board of Dana Point, Calif.-based North American Health Care, Inc., “Thirty Four of its Thirty Five affiliated client facilities are five star rated and one is four star rated.” North American Health Care, Inc., also advertises on its company website, “As of June 2013, Medicare awarded 34 North American Health Care, Inc. client serviced facilities with their highest honor – a Five-Star Rating.”

A CDPH official did not explain why class “B” citation issued to Lake Balboa Care Center was disregarded by Medicare’s Nursing Home Compare

Although a CDPH official responded to Elder Abuse Exposed.com’s email, the official did not address Elder Abuse Exposed.com’s concern that Medicare’s Nursing Home Compare excluded the October 6, 2011 class “B” citation that CDPH issued to Lake Balboa Care Center. The CDPH official also did not respond to Elder Abuse Exposed.com’s request for a referral to a state or federal official who could ensure that Medicare’s Nursing Home Compare would include state-law-based enforcement actions against California nursing homes, such as the October 6, 2011 class “B” citation issued to North American Health Care, Inc.’s “five-star” client facility Lake Balboa Care Center.

CDPH official said information about class “B” citation issued to Lake Balboa Care Center was included, not on Medicare’s Nursing Home Compare, but on CDPH website

But, the CDPH official, Lunghwa Yung, a staff information systems analyst for the Los Angeles County Department of Public Health’s Health Facilities Inspection Division, was very kind to refer Elder Abuse Exposed.com to a valuable resource for consumers searching for information specifically on California nursing homes. The resource, which is not as heavily promoted as CMS’ Nursing Home Compare and which does not have a star rating system for California nursing homes, is CDPH’s Health Facilities Consumer Information System (HFCIS).

CDPH website includes critical information on California nursing homes’ misconduct that Medicare’s Nursing Home Compare completely ignores

The HFCIS is the state of California’s website and database that allows the public to search for information on California nursing homes that Medicare’s Nursing Home Compare totally disregards. For instance, the HFCIS  allows the public to view summary information on California nursing homes’ substantiated and unsubstantiated complaints, facility self-reported incidents, and deficiency citations and penalties referring to state law violations during the past 10 years. The HFCIS also allows the public to download and view actual deficiency statements and to request from CDPH detailed ownership information about each nursing home in California.

Consumers who want information on state enforcement actions against California nursing homes should not waste their time with Medicare’s Nursing Home Compare

If consumers want information about the state violations and enforcement actions against a nursing home in California, such as the North American Health Care “five-star” client facility featured in Part 1 of this exposé, Cottonwood Healthcare Center, consumers should not waste their time at Nursing Home Compare. Instead, consumers should search CDPH’s HFCIS. At this state website, HFCIS, unlike at CMS’ Nursing Home Compare website, consumers can see all of the substantiated complaints, facility self-reported incidents, deficiency citations, and fines that Nursing Home Compare completely ignores.

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Sep 102013
 

(Part 1 of 3)
Read Part 2 »
Read Part 3 »
Updated, October 21, 2013, 10:55 p.m. PDT

Medicare Nursing Home Compare Five-Star Quality Rating System is a fraud on the public. This needs to be publicized because as U.S. Supreme Court Justice Louis D. Brandeis said, "Publicity is justly commended as a remedy for social and industrial diseases."

U.S. Supreme Court Justice Louis D. Brandeis, in the public domain. (Photo credit: Harris & Ewing Collection at the Library of Congress, Prints & Photographs Division, circa 1916)

What does it mean when a nursing home has a “five-star” rating on Medicare Nursing Home Compare website?

“We are a five-star-rated facility on the Medicare Nursing Home Compare website,” many nursing home administrators and owners proudly tell consumers searching for a nursing home where their loved ones will get high-quality care. John Sorensen, the president, CEO, and chairman of the board of Dana Point, Calif.-based North American Health Care, Inc., even says on his personal website, “Thirty Four of its Thirty Five affiliated client facilities are five star rated and one is four star rated.” North American Health Care, Inc., also advertises on its company website, “As of June 2013, Medicare awarded 34 North American Health Care, Inc. client serviced facilities with their highest honor – a Five-Star Rating.”

But John Sorensen’s and North American Health Care’s statements lead to many questions:

  • What does it mean when any nursing home operator advertises that Medicare has “awarded” it with the “honor” of a “five-star” rating?
  • What message does a “five-star” rating evoke in a consumer’s mind?
  • Would a close reading of the fine print on Medicare’s Nursing Home Compare website leave a consumer with the same message?
  • Is the Nursing Home Compare website telling consumers that a “five-star” nursing home has a history of providing only excellent, high-quality care?
  • How does Medicare calculate a nursing home’s five-star quality rating, which Medicare publishes on its Nursing Home Compare website?
  • Does Medicare rely on all relevant nursing home inspection and complaint investigation data when calculating a nursing home’s quality rating?
  • Or does Medicare systematically exclude some readily available, relevant information?

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Jul 312013
 

California DOJ Bureau of Medi-Cal Fraud and Elder Abuse (BMFEA) chief of prosecutions, Mark Zahner, files no criminal charges after Dr. Kathryn Locatell protects nursing home

The California Department of Public Health’s (CDPH) Licensing and Certification Program, hardly an aggressive watchdog of wealthy, politically connected nursing homes, issued a class “B” citation and monetary fine in October 2011 to a Los Angeles-area nursing home that negligently failed to administer oxygen to a fainting patient at a flow rate required by physician orders and the patient’s care plan. At that time, the unfortunate, 88-year-old victim suffered rapidly declining oxygen saturation levels, cardiopulmonary arrest, and unexpected death. In its citation, CDPH said, “The above violation had a direct relationship to the health, safety and security of Patient 1.” Despite CDPH’s findings, tantamount to obvious elder neglect, the California Department of Justice’s Bureau of Medi-Cal Fraud and Elder Abuse (BMFEA) chief of prosecutions, Mark Zahner, based his decision to file no criminal charges in the case, not on BMFEA Special Agent J. Timothy Fives’ expert opinion, but instead on the different opinion of BMFEA medical consultant Kathryn L. Locatell, M.D. Dr. Locatell shockingly said, “There were no breaches of any applicable standards of care in the events leading to Mr. [patient’s name deleted] death. I see no indication of neglect whatsoever…[W]hether or not oxygen was administered, or administered timely…was immaterial.”

Mark Zahner, chief elder abuse prosecutor for CA AG Kamala Harris’ DOJ, steps down amid criticism of selective enforcement

California’s chief elder abuse prosecutor is leaving office amid sharp criticism that he has selectively enforced criminal elder abuse laws against a small number of vulnerable, small-fry defendants while sparing the principal malefactors of systemic elder abuse, the wealthy, politically connected, corporate-owned nursing homes.

According to reliable sources, Deputy Attorney General Mark L. Zahner, who, since at least 2003, has been the chief of prosecutions for the Bureau of Medi-Cal Fraud and Elder Abuse (BMFEA), in the California attorney general’s Department of Justice (DOJ) in Sacramento, is stepping down from his position at the end of this month. Mr. Zahner is reportedly leaving his office to head an association of district attorneys in California.

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Jun 102013
 

U.S. Supreme Court Justice Louis Brandeis on corrupt government as a lawbreaker in Olmstead v. U.S. case

U.S. Supreme Court Justice Louis D. Brandeis, in the public domain. (Photo credit: Harris & Ewing Collection at the Library of Congress, Prints & Photographs Division, circa 1916)

Family of elder abuse defendant Silvia Cata alleges misconduct, strong-arm tactics during raid by Calif. Dept. of Justice agents

The daughter of a Sacramento elder caregiver charged this year with felony elder abuse and manslaughter has revealed in an exclusive statement to Elder Abuse Exposed.com disturbing allegations of police misconduct and strong-arm tactics during a raid of the defendant’s elder care home by agents from California Attorney General Kamala Harris’ Department of Justice.

Sacramento resident Ionela Lup, who is the daughter of defendant Silvia Cata, details the Nov. 15, 2012 search of Cata’s residential care facility for the elderly, Super Care Home, and the Feb. 12, 2013 arrest of Cata by Special Agent Tina Khang and agents from DOJ’s Bureau of Medi-Cal Fraud and Elder Abuse in Sacramento. Ionela Lup also alleges mistreatment by some licensing program analysts (LPAs) from the California Department of Social Services’ (DSS) Community Care Licensing Division (CCLD) in Sacramento. Continue reading »

Jun 032013
 

California Attorney General Kamala Harris fails to prosecute elder abuse against nursing homes

In March 2012, California Attorney General Kamala Harris, the chief law enforcement officer for the people of California, and her Bureau of Medi-Cal Fraud and Elder Abuse (BMFEA) reopened a closed criminal investigation and belatedly charged two licensed nurses, Donna Darlene Palmer and Rebecca LeAn Smith, with felony elder abuse four years after the March 2008 death of a 77-year-old woman, Johnnie Esco, in nursing home El Dorado Care Center in Placerville, California. However, Attorney General Harris and BMFEA, which is headed by its director, Mark Geiger, and its chief of prosecutions, Mark Zahner, filed elder abuse charges against the nurses, but not the nursing home, only after The Sacramento Bee’s embarrassing September 2011 exposé on the the Esco case, the widespread falsification of patient records in California nursing homes, and the case’s rejection by the BMFEA and El Dorado County district attorney. The March 16, 2012 “Nurses Face Felony Charges in Death of Cameron Park Man’s Wife” by Marjie Lundstrom in The Sacramento Bee chronicled the four-year crusade of the victim’s 81-year-old widower, Don Esco, who “made hundreds of phone calls and personal visits to local, state and federal authorities to get someone held accountable.” (Photo (right) credit: Office of Attorney General)

Elder abuse victim’s daughter complained to Sen. Dianne Feinstein about alleged misconduct by Calif. DOJ’s Bureau of Medi-Cal Fraud and Elder Abuse

An elder abuse victim’s daughter in California has shared with Elder Abuse Exposed.com the email response from U.S. Sen. Dianne Feinstein (D-Calif.) to a complaint about alleged official misconduct by California Attorney General Kamala Harris’ Bureau of Medi-Cal Fraud and Elder Abuse (BMFEA).

Newport Beach, Calif. resident Deborah S. Calvert contacted Sen. Feinstein’s office earlier this year just after Elder Abuse Exposed.com posted on its website Ms. Calvert’s allegation that BMFEA prosecutors in Sacramento failed to prosecute, and even condoned, flagrant elder abuse leading to several deaths in a Sun Healthcare nursing home. Ms. Calvert wanted to inform Sen. Feinstein about the futility of the elder abuse and death reports Ms. Calvert had filed with BMFEA concerning her mother, Evelyn Calvert, and other neglected nursing home residents in a Sun Healthcare nursing home in Newport Beach, Calif. According to Ms. Calvert, because of corruption, BMFEA’s prosecutors, including then-Deputy Attorney General Claude W. Vanderwold and Deputy Attorney General Mark Zahner, refused to enforce “a 2001 California state injunction [regarding Sun Healthcare’s] understaffing and broken equipment that was killing patients.”

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