Indiana Injury Lawyer Blog

Dr. Philip Gabriele, 44, and his wife Marcella, 33, were found slain Monday morning at the office of the Gabriele Eye Institute in Elkhart, Indiana. Gabrielle, a well-known eye surgeon in the area, had been under Federal indictment pertaining to 15 patients he had provided treatment for in the past. Reports indicated that the 15 cases involved allegations of healthcare fraud, and were only a small fraction of the over 13,000 patients he had treated over the years.

A family friend of the Gabrieles, Susan Manuszak, told police that when she went to the Gabriele home in Granger Monday morning, she found a suicide note. She called police and met them at the Gabriele Eye Institute Office in Elkhart, where the bodies were located.

The deaths were discovered on the day the Gabrieles were puportedly to turn themselves in to law enforcement to face the alleged health care fraud charges.

A licensed practical nurse employed by SNR Medical Services, a third-party contractor for medical services for the Madison County Jail, was attacked by an inmate on Thursday. The inmate, Omond J. Smith, 32 of Anderson, Indiana, had complained of Asthma symptoms while being transported from the Wabash Valley Correctional Facility to the Madison County Courthouse for a hearing.

While receiving treatment from the LPN, Smith apparently got a hold of some type of wire mesh cloth which he used during the attack. Shortly after attempting to restrain the LPN, a guard heard the commotion and intervened to help the nurse.

Smith will be charged with criminal confinement, battery and possession of a dangerous weapon/material. The LPN reported to have sustained only minor injuries.

Officials with the Clarion Health Network, Methodist Hospital, and Clarian Cardiovascular announced that Methodist Hospital has become the first accredited Heart Failure Institute in the State of Indiana and only the fourth such institute in the nation. This designation is provided by the Health-care Accreditation Colloquium.

The designation of a Heart Failure Institute demonstrates a guarantee to provide ongoing cardiac care, efforts to improve patient survival and quality of life, and continuous progress in management of heart failure symptoms.

The procedure by which a facility obtains accreditation is designed around improvement methods, which include an analysis of current practices, comprehensive reports, in depth interviews and onsite review. By obtaining the distinction of accreditation, Methodist has shown that it is proficient in managing heart disease and failure.

Continue reading "METHODIST HOSPITAL IN INDIANAPOLIS, MARION COUNTY, INDIANA IS NAMED AS ONE OF ONLY FOUR ACCREDITED HEART FAILURE INSTITUTES IN THE COUNTRY AND THE FIRST IN THE STATE OF INDIANA" »

When the CMS issued its new ratings in December, 2008, about 22 percent of the nation's nearly 16,000 nursing homes received the
federal government's lowest rating under the new five-star rating system , while only 12 percent received the highest ranking possible.

The acting administrator for the Centers for Medicare and Medicaid Services, Kerry Weems, said the agency was merely taking existing data already on the agency's Web site and facilitating its use for patients and families. He said it can be difficult for people to understand all the aspects of an inspection, but "[t]his should help consumers in narrowing their choices, but nothing should substitute for visiting a nursing home when making a decision".

Under the new system, five stars means a nursing home ranks much above average, four stars indicates an above average ranking, three stars means average, two is below average and one is much below average. The rankings will be updated quarterly, and the CMS is already getting a lot of flack from the nursing home industry. Many facilities believe the system is just not easily applied under the current investigative process conducted by the states. The key argument in this is that each state has their own subjective process by which they review facility performance.

The system "is poorly planned, prematurely implemented and hamhandedly rolled out," said Larry Minnix, president and chief executive officer of the American Association of Homes and Services for the Aging.

Countering this, however, was Alice H. Hedt, executive director of the National Citizens' Coalition for Nursing Home Reform. She noted, "[f]rom a consumer viewpoint, it's not stringent enough... It's basically taking information already available on Medicare's Nursing Home Compare Web site and pulling it into an easier system for consumers to use, and that is a good thing."

Still, both consumer watch groups and the CMS believe that the system cannot be a substitute for personal inspection and investigation.

In rating the nursing homes, CMS used three year's worth of inspections which were recorded on an annual survey designed to measure how well homes protect the health and safety of their residents.

Continue reading "INDIANA NURSING HOMES CONCERNED ABOUT NEW FEDERAL CARE RATINGS" »

The Centers for Medicare and Medicaid Services (CMS) recently released a new five-star rating system to rank every nursing facility in the country. Two White County Indiana nursing homes came in at opposite ends under the new system. Monticello Assisted Living and Healthcare was given a one-star rating (the worst under the new system) while Whispering Pines received the second to highest rating, four-stars. The ratings were released in December and updated January 15th.

Nearly 28 percent of Indiana's nursing facilities were given one star, the lowest rating. By far, the most troubling area for these facilities was the staffing review. The new rating system uses the national database called the Minimum Data Set (MDS) Repository, which is information collected at intervals on every nursing home resident, and government surveys gathered on each facility. In Indiana, the government surveys are conducted by the Indiana State Department of Health (ISDH). The state summarizes their surveys into report cards on each facility.

Whispering Pines received a score of 184 while Monticello Assisted Living and Healthcare scored 164 under the comprehensive totals. These numbers both compare relatively well compared to the Indiana state average of 193 (the lower the score the better).

The CMS quality-rating system looks at three primary areas: health inspections, staffing and quality measures. Whispering Pines scored four stars in staffing while Monticello Assisted Living and Healthcare scored one star.

Continue reading "MONTICELLO ASSISTED LIVING AND HEALTHCARE AND WHISPERING PINES AMONGST WHITE COUNTY NURSING HOMES RATED UNDER NEW INDIANA AND FEDERAL FIVE STAR SYSTEM" »

As the number of reports and claims of nursing homes abuse and neglect has continued to rise in the last several years, many states have begun enacting consumer protection laws to assist the elderly and their families. These measures have the added intention of holding nursing home facilities accountable for deficient care which leads to abuse, injury, or in some cases, death.

In an effort to circumvent these consumer protection acts and avoid the accountability to which the Federal and state legislatures sought, nursing homes are simply seeking to have clients waive their legal entitlements set forth by the very legislation intended to protect them. In my practice, I have recently had several reports and seen numerous attempts by long term facilities to have new patients execute forms which purport to force claims of abuse or neglect to an arbitration process, or in some cases, seek to entirely release facilities from any potential claim. While the validity of such releases or arbitration mandates have yet to be substantially challenged or contested by the way of case law, their effect to intimidate or at least slow the wheels of justice cannot in honest spirit be discounted.

New patients and their families (including those holding power of attorney or guardianship), must be extremely cautious when executing or approving the execution of documents. All documents should be carefully reviewed, and when necessary, nursing homes or their executive administrators should be questioned about their intent and purpose. No facility or ownership entity can justify a peremptory release of legal rights or even a mandate for arbitration. In either case, patients and their families should question the motive of the documents, and without legal consult, should not execute any documents which purport to restrict a patients legal recourse. Facilities that provide appropriate care should not fear the responsibility and accountability recent consumer protection laws set forth; rather, facilities providing quality care should simply view these laws as a validation or written memorial of the quality assurance process they already have in place.

Continue reading "INDIANA NURSING HOMES ATTEMPTING TO MAKE PATIENTS WAIVE THEIR LEGAL RIGHTS RELATED TO ABUSE OR NEGLECT" »

In early December, 2008, a group of teenagers working at a Minnesota nursing home (two of which are pictured below), were charged with allegations of abuse and sexually humiliation of elderly residents, many of which were suffering from dementia or other mental disorders. Prosecutors contend that six young females were involved in the despicable activity and were named in criminal complaints filed December 1st charging them with cruel behavior at the Good Samaritan Society nursing home, which is located in Albert Lea, Minnesota.

Only two of the girls charged are identified by name as they were not minors at the time the abuse was alleged to have occurred. Brianna Broitzman, 19 (pictured above left), and Ashton Larson, 18 (above right), were two of six alleged to have spat upon, spanked, improperly touched, and tormented residents earlier this year. According to prosecutors, Broitzman allegedly poked one resident's breasts, spit into the mouth of another elderly person, and "put her bare butt" in the face of a resident. Larson was alleged to have once "inserted her finger into a resident's rectum," spit water on another "vulnerable adult," and would deliberately bathe a resident in a rough manner so the elderly man would get an erection. The 4 minors were identified in the complaints by their initials and dates of birth. Broitzman alone was charged with 11 criminal counts, and Larson was charged with 10 counts. Each face up to a year in jail for each count.

Continue reading "NURSING HOME ABUSE AND NEGLECT PLACES MINNESOTA TEENS IN HOT WATER" »

A new Department of Health and Human Services' five-star system for rating nursing homes has placed all six Grant County Indiana nursing home facilities amongst the worse in the country. All six facilities, including Colonial Oaks Health Care Center in Marion, Miller’s Merry Manor in Marion, Park Villa in Marion, Twin City Health Care in Gas City, University Nursing Center in Upland and Wesleyan Health Care Center in Marion received the lowest possible rating, one star.

All six Grant County nursing homes were ranked below average on their composite score which is based on local health inspections, staffing and quality measures. In looking to the details of the ratings, University Nursing Center in Upland lead the six Grant County facilities with a score of 232. While leading the Grant County, University Nursing Center was nicked for environmental concerns which, according to their administrators, was likely due to the aging of their facility.

The lowest score amongst the Grant county facilities was garnered by Twin City Health Care. Although showing some moderate improvements, the facility administrators apparently blamed the evaluation process for their poor results. A spokeswoman for the facility, Mandel, noted that she was critical of the way the state composes the report cards, noting that it’s too focused on paperwork and ignores the quality of resident care. Local media reports quoted her saying, “I’d rather have hands-on care than documentation,” she said. Overall, Mandel said, she thought the Twin City staff was doing well. She believes administrators are listening to feedback and will continue to improve their facility.

The following is the comprehensive scoring for the six Grant County Indiana facilities (the higher the score.....the worse the rating). The Indiana State Average was 194:

University Nursing Center: 232
Miller’s Merry Manor, Marion: 246
Colonial Oaks Health Care Center: 278
Park Villa: 344
Wesleyan Health Care Center: 397
Twin City Health Care: 729

Continue reading "GRANT COUNTY INDIANA NURSING HOME FACILITIES DINGED ON NEW FEDERAL FIVE STAR RATING SYSTEM" »

In a letter to the Editor of the Indianapolis Star Newspaper, President and CEO of the Indiana Association of Homes and Services for the Aging, Jim Leich, wrote the following retort to a January 6, 2009, article titled, "Indiana nursing homes rated among worst.

Amongst other things, the article attempted to counter the very poor ratings his organization and several Indiana Nursing homes received under the CMS new five-star rating system. According to Federal Government officials, the system was put into place to create accountability for the facilities and help end consumers make good choices in the homes they choose for their family of loved ones:

Continue reading "PRESIDENT AND CEO OF INDIANA ASSOCIATION OF HOMES AND SERVICES FOR THE AGING REBUTS THE NEW CMS FIVE STAR RATING SYSTEM" »

Recent data released by the Centers for Medicare & Medicaid Services indicate that Indiana Nursing Homes now rate among the 10 worst in the nation. Under the CMS' new ranking system, nearly 28 percent of the state's nursing homes received a one star rating, which is CMS' worst rating under their five star system. Only six states had a higher percentage of substandard nursing homes.

According to the CMS website, the Five-Star Quality Rating System was created to help consumers, their families, and caregivers compare nursing homes more easily and help identify areas about which you may want to ask questions. This rating system is based on continued efforts to improve nursing home care as a result of the Omnibus Reconciliation Act of 1987 (OBRA '87), a nursing home reform law, and more recent quality improvement campaigns such as the Advancing Excellence in America’s Nursing Homes, a coalition of consumers, health care providers, and nursing home professionals.

Nursing home ratings are taken from the following three sources of data:

Health Inspections
Staffing
Quality Measures

More stars are better.

***** Much Above Avg.
**** Above Avg.
*** Average
** Below Avg.
* Much Below Avg.

Continue reading "INDIANA NURSING HOMES AMONGST THE WORSE IN THE COUNTRY IN STAFFING AND SUBSTANDARD CARE" »

Placing your loved one in a reputable long-term care facility is just the first step in ensuring they are well cared for. Regardless of complaints or sanctions found during state and federal inspections (be they few or many), residential facilities are often understaffed. This fact in concert with the advanced needs of elder patients can create a worrisome environment. As an advocate for your loved one, you've got federal (and sometimes state) law on your side to insist that your relative or friend gets the quality of care they deserve. The Code of Federal Regulations (CFR) and your state law contain many protections.

The following are just a sample from the Code of Federal Regulations:

• Care Plans
Each nursing home resident is entitled to a personalized "care plan," that addresses their respective medical and safety needs. This plan must have an anticipated goal of ensuring a resident/patient maintains their highest practicable physical, mental and psychosocial well being. Federal law requires that facilities do a full assessment of a resident's condition within 14 days of admission, and at least every 12 months thereafter. A care plan should include measurable objectives and timetables.

• Visiting Hours
In my experience with friends or family members that have loved ones in nursing homes, it is not at all uncommon for facilities to put forth the idea that Family can only visit during visiting hours. Not only is this mendacious, Federal legislation actually specifically prohibits such rules. 42 CFR 483.10(j) allows immediate family the right to visit at any time. In fact, we often advise clients to visit during off-hours so that they can perceive their loved one's environment when staff members aren't expecting visitors.

• Skilled Care or Rehabilitation Services
In the past, we have had clients tell us that their parents' nursing home facility has terminated skilled care or rehab services because their Mom or Dad weren't making progress. Again, however, this is contrary to federal and often times, state law. Assuming that the resident would benefit from such services, a facility is charged with trying to maintain their condition regardless of progress. All facilities are required to make sure that a person's ability to carry out activities of daily living doesn't deteriorate. The only exception would be if the individual's medical condition deteriorates to such an extent that termination of the activity is in their better interest.

Continue reading "FEDERAL AND INDIANA NURSING HOME LAWS PLACE POWER IN THE HANDS OF FAMILY MEMBERS" »

Under a new proposal the Indiana Family and Social Services Administration plans to pursue in 2009, nursing homes scoring higher on their State and Federal inspections would be rewarded with higher Medicaid payments while those that don't could suffer cuts. The Indiana FSSA disputes that this is just a cost-saving measure noting that they would have pushed for this proposal regardless of the economic condition. To effect the plan, however, the FSSA must have the policy established through a rule-making process that requires a public hearing and economic evaluations. That will likely take about six months. Despite this, the discussion could be usurped by lawmakers, who are expected to have several bills dealing with nursing home reimbursements and inspections when they return to the Statehouse later this month.

Proposed changes face objection by the Indiana Health Care Association

The Indiana Health Care Association is a group that, among other things, serves as a lobbying mechanism for Indiana nursing homes. The Association has cited a number of objections and proposed changes to the FSSA proposal. Local media reported the association's president, Stephen Smith, as saying "[w]e completely agree with the intent [of the FSSA proposal]". "But we think there's more discussion to be had about the actual approach." The proposal is part of a larger plan by FSSA to adjust to weakening state revenue and put more recipients into plans that manage health costs so that more spending is matched by Federal dollars.

Continue reading "NEW INDIANA PROPOSAL WOULD CUT FUNDING FOR NURSING HOMES THAT SCORE POORLY ON STATE INSPECTIONS" »

An Indiana Nursing home resident, Rodney Kenney, died after catching fire while sitting in his wheelchair at Regency Place, a Dyer, Indiana, Lake County, nursing home. Rodney Kenney, 72, died at a Chicago hospital where he was treated for burns. State Inspectors say the Alzheimer's patient was severely burned when his clothing caught fire as he sat in a wheel chair. Authorities say they found a cigarette lighter near Kenney, but that he was not a smoker. In fact, state law prohibits smoking in nursing homes and patients are not allowed to possess smoking materials.

Continue reading "INDIANA NURSING HOME RESIDENT DIES AFTER CATCHING FIRE IN WHEELCHAIR" »

The CMS and HHS have developed a new Five-Star Rating system that evaluates Nursing Home care.

According to the CMS website, the Five-Star Quality Rating System was created to help consumers, their families, and caregivers compare nursing homes more easily and help identify areas about which you may want to ask questions. This rating system is based on continued efforts as a result of the Omnibus Reconciliation Act of 1987 (OBRA '87), a nursing home reform law, and more recent quality improvement campaigns such as the Advancing Excellence in America’s Nursing Homes, a coalition of consumers, health care providers, and nursing home professionals.

Nursing home ratings are taken from the following three sources of data:

Health Inspections
Staffing
Quality Measures

More stars are better.

***** Much Above Avg.
**** Above Avg.
*** Average
** Below Avg.
* Much Below Avg.

Currently, 509 Indiana Nursing Homes have been evaluated under the system and can be evlaluated on the CMS Website.

Continue reading "CMS ISSUES NEW FIVE STAR RATING TO ASSIST FAMILIES IN FINDING QUALITY NURSING HOMES AND REDUCE NEGLECT" »

The federal government through the CMS (The Centers for Medicare & Medicaid Services) has placed hundreds of nursing homes on a list of long-term care facilities that it wants to improve systemic issues or face expulsion from the Medicaid program.

The watch list is intended to heighten efforts to bring more attention to quality deficiencies at long-term care or nursing home facilities identified on this "special focus facility," or SFF, list.

Indiana Nursing Home Watch List

National Watch List

National Nursing Home Registry

Continue reading "THE FEDERAL GOVERNMENT PLACES INDIANA NURSING HOMES ON THEIR WATCH LIST" »