State Rankings Paint Inaccurate Picture of Quality of Care in Nursing Homes

Previously, I blogged about the ongoing saga of Medford Multicare Center for Living, located on Long Island. A lawsuit, the highlight of which is the death and alleged cover up of an elderly woman at Medford, was filed by New York State Attorney General Eric T. Schneiderman. The Attorney General claims there is a history of neglect and mistreatment at Medford. These accusations are surprising because recent state rankings of the nursing home don’t reflect these claims of poor treatment.

According to two Newsday articles (one by Ridgely Ochs and Chau Lam and the other by Joye Brown), Medford Multicare Center for Living received an overall ranking of 3 out of 5 stars on a federal website, Medicare’s Nursing Home Compare, that provides detailed information about Medicare and Medicaid-certified nursing homes. Last year, the nursing home received a ranking of 4 out of 5 stars for health inspections and quality of care. If the Attorney General’s allegations are true, this average ranking in no way reflects the quality of care at Medford.

New York State’s Department of Health conducts inspections, collecting data used to rank nursing homes throughout the state. However, nursing homes themselves gather and report the statistics used for ranking. This data is not required to be reviewed, so the is no way to determine its accuracy. This self-reporting creates a conflict of interest that can lead nursing homes to inflate or even completely falsify the data they report.

In her Newsday article, Joye Brown quotes Charlene Harrington, a professor of nursing at the University of California, San Francisco. Harrington explains, “The rating system is based on three things: First, deficiencies: If those aren’t issued properly, then you can’t rely on that. Second, staffing: Nursing homes can gin up those numbers when they suspect surveyors are coming. Third, they can falsify quality measures.”

According to a paper by the Kaiser Commission on Medicaid and the Uninsured from 2013, the Affordable Care Act requires nursing homes to increase their transparency. The Centers for Medicaid and Medicare Services (CMS) has already implemented a number of new requirements, including improving the collection of data on owners and managers and providing links to health inspection reports. However, other important provisions have not yet gone into effect.

With the Attorney General’s surprising allegations, it may be time to rethink the way we assess and present the quality of care and safety at nursing homes. The public relies on these ratings to make difficult decisions for themselves and their loved ones. Verifiable data needs to be easily accessible and used in the ranking process, so ratings represent the truth about nursing homes throughout New York State.

3 Deaths at the Suffolk Center for Rehabilitation and Nursing

Yesterday, NBC4 New York’s Chris Glorioso and the station’s I-Team reported on their investigation into three deaths at the Suffolk Center for Rehabilitation and Nursing on Long Island. According to family members, Thomas Bischoff and Raymond Curiale, residents of the nursing home and Korean War veterans, both died as a result of neglect.

According to medical records from Brookhaven Memorial Medical Center, Mr. Bischoff died of a cardiac arrest resulting from a septic infection. The sepsis was partly caused by bedsores, which can form if nursing home staff neglect to provide basic care. You can find more information on bedsores, also referred to as pressure ulcers, here.

After being admitted to the nursing home in March 2013, part of Raymond Curiale’s care required staff members to monitor him every 15 minutes. On July 15,2013, Mr. Curiale accidentally hanged himself. Not one staff member checked on Mr. Curiale for 57 minutes, the time frame during which he died.

Glorioso’s article also mentions another Suffolk Center patient who overdosed three times on narcotic painkillers and died last May. In this matter as well, the facility’s staff failed to properly watch over the resident.

In response, the Suffolk Center released a statement stating that the nursing home provides “quality care” for its residents.

This history of neglect is unacceptable for any facility that cares for our loved ones. If you have any questions, concerns, or information about possible abuse or neglect at the Suffolk Center for Rehabilitation and Nursing, you can contact Benjamin Decker, Esq. at (518) 621-4210 or benjamin@dpsattorneys.com.

Privacy and Nursing Home Surveillance

In recent months, with revelations concerning consumer credit card theft and the National Security Agency surveillance programs, the notion of privacy has again entered the public consciousness. Now seems like a good time to discuss the debate that continues over privacy and surveillance in the world of long-term care facilities. Unfortunately, abuse and neglect occur far too often in nursing homes and assisted living facilities and, in an attempt to protect loved ones, families are turning to technology. Small, sometimes hidden, cameras, often referred to as “granny cams,” are becoming increasingly popular as families and governments seek to ensure proper care.

In a New York Times article last November, Jan Hoffman recounts the story of a nursing home resident, Eryetha Mayberry, from Oklahoma City, Oklahoma. Ms. Mayberry and her family had noticed a few personal belongings go missing and installed a hidden camera in an attempt to catch a thief. When Ms. Mayberry’s daughter finally watched the footage, however, she was astonished and horrified by what she discovered. Staff members had been abusing her mother.

As a result of the outrage that arose following the discovery of Ms. Mayberry’s abuse, Oklahoma became the third state to explicitly allow surveillance cameras to be used in the rooms of residents of long-term care facilities. New Mexico and Texas are the other two states that have passed similar legislation. Although New York has passed no specific legislation allowing individuals to maintain surveillance cameras in their rooms, the government, specifically Governor Andrew Cuomo and the Medicaid Fraud Control Unit, has been using hidden cameras in nursing home investigations throughout the state.

In March of 2010, then-Attorney General Cuomo reported that 22 arrests had been made after investigations into Northwoods Rehabilitation and Extended Care Facility in Troy, NY and Williamsville Suburban Nursing Home in Amherst, NY. Surveillance footage played key roles in both investigations, revealing instances of alleged neglect and conduct endangering residents.

Proponents of video cameras understand that, without surveillance, much of the abuse and neglect that is occurring may never be discovered. In addition to uncovering instances of mistreatment, many hope that cameras, coupled with posted notices of surveillance, will prevent abuse and neglect from occurring in the first place.

However, nursing home surveillance has encountered opposition. Opponents claim that these cameras are an invasion of privacy. A frequently used argument against the use of cameras is that the monitoring infringes not only on the rights of a loved one, but also the rights of fellow residents. Cameras may catch residents during their most intimate moments, such as when they are dressing or undressing. Some nursing home operators also believe surveillance may reduce staff morale, claiming that it may become more difficult to hire and retain caretakers if they constantly feel threatened by the monitoring of video cameras (CNA’s Cost and Benefits of Video Surveillance).

These arguments against video monitoring may be valid. But is slightly less privacy worth the potential reduction in abuse and neglect, along with the peace of mind gained by residents and their families? With the right rules and regulations, I think so.