California Nursing Home Abuse Lawyer Blog

Healthcare Facilities Found Guilty of Cheating the Government and Putting Patients’ Lives at Risk

February 11, 2012 | by Yeroushalmi Law

On February 8, 2012, Bloomberg News reported that fourteen hospitals in New York are paying $12 million to settle the allegations that they made false claims to Medicare. Beginning in 2000, and for eight years thereafter, these hospitals overcharged Medicare for kyphoplasty surgeries that were performed on osteoporosis patients with spinal injuries.

As shocking as this may sound, similar fraud against Medicare occurs quite often. Just recently, a total of about forty hospitals have paid $39 million for similar cases of overcharging Medicare. Sometimes, these false claims are referred to as “upcoding” because the healthcare facilities upcode their patients’medical conditions, so that they can report a higher reimbursement rate.

Just a month ago, the federal government investigated another case in which pharmaceutical companies were manipulating their financial statements in order to profit from government health programs. You can learn more about this case and the incentives pharmaceutical companies and other healthcare businesses have to cheat Medicare by reading this California Nursing Home Abuse Blog.

Some skilled nursing facilities cheat government health programs for reasons other than to profit. For example, some facilities use Medicare or Medi-Cal money to order antipsychotic drugs that were never prescribed by a physician in the first place. These drugs are usually used as chemical restraints, to sedate dementia patients who have episodes of aggravation. However, studies have shown that the use of chemical restraints actually worsens aggravation and also makes patients twice as likely to die from an overdose. Furthermore, the use of restraints can not only lead to death, but is also a direct violation of the Patients’ Bill of Rights. The use of restraints is most commonly found in nursing homes that are understaffed and unable to personally attend to each patient and provide him or her with the individualized care that he or she needs.

In an attempt to stop fraud against the United States government and to encourage witnesses of such fraud to speak up, the federal government passed the False Claims Act, which states that whistle-blowers can sue on behalf of the government and receive a share of any claims that are made. This further proves how serious fraud against the government is, especially when the lives and well-being of nursing home residents are being put in danger.

Los Angeles Nursing Homes Cause Patients Who Are at the End of Their Lives to Suffer the Pain of Pressure Sores Instead of Providing Treatment

February 10, 2012 | by Yeroushalmi Law

On February 2, 2012, the International Wound Journal published an article titled “Wound Outcomes in Patients with Advanced Illness.” The article studied elderly adults who were sustaining serious wounds, in addition to suffering from advanced illnesses, such as cancer. The patients had various types of wounds, including pressure ulcers, malignant wounds, skin tears, inflammatory wounds, and venous leg ulcers, arterial leg and foot ulcers. The goal of the study was to observe the potential for wounds to heal completely, despite the presence of an advanced illness.

The study split the participants into four groups based on the length of time that they were able to live with the wound before passing away. The divisions were as such: 7 days or less, 8 to 30 days, 31 to 91 days, and 92 to 182 days. The wound type that occurred most often in the patients studied were pressure ulcers. The results of the study showed variations in the complete healing of pressure sores, depending on their level of severity. Most pressure ulcers that had only progressed to the first or second stage were usually able to heal successfully and completely. However, only one stage three pressure ulcer in the entire study was able to heal completely, while no stage four ulcers were observed to have healed completely.

The results of the study merely emphasize the importance of identifying and diagnosing wounds early on in their stages of development. Many prevention techniques are available and are generally very successful in preventing the development of pressure sores. However, in order for any of these prevention techniques to be carried our properly and achieve their full effectiveness, facilities must be adequately staffed, as each technique requires careful attention to each individual patient.

Although the article defined an advanced illness as one that would cause the patient to die within six months, the study succeeded in disproving the common assumption that dying patients cannot fully recover from wounds. Unfortunately, many skilled nursing facilities leave patients to suffer in the last days of their lives because they are misinformed that there is no point in trying to heal the wounds of patients who are on their deathbeds. In choosing a nursing home for your loved one, make sure that the staff is knowledgeable and willing to provide your loved one with the best care possible, up until the end of his or her life. Any refusal on the part of the skilled nursing facility to provide your loved one with the care that he or she needs in order to achieve the best quality of life is considered an act of nursing home neglect.

Recent Study Proves that Los Angeles Nursing Homes Need to Be More Careful in Administering High Dosages of Drugs

February 3, 2012 | by Yeroushalmi Law

A recent article, titled “Anemia in Nursing Homes: A Complex Issue,” was published in the Journal of American Medical Directors and studied the nature of anemia in skilled nursing facilities, including its causes and treatments. The article cited iron deficiency, protein malnutrition, frailty, and weight loss as some causes for anemia. In caring for anemic residents, the nursing home staff needs to be cautious because this condition not only leads to decreased muscle strength, mobile impairment, and an increased risk for falls, but is also very tricky to treat.

The study aimed to disprove the common misconception that taking a high dosage of iron, up to 200 milligrams daily, is a simple way to overcome anemia. Participants were divided into three groups, each taking a different dosage of iron daily. One group took 15 milligrams, the second took 50 milligrams, and the third group took 150 milligrams. The study was conducted over two months. At the conclusion, the researchers determined that regardless of the dosage amount, each group experienced the same increase in iron levels.

Ultimately, we can take from this study that in caring for our loved ones, it is best to maintain all medications at the lowest dosage possible. In the case of anemic patients, those who were taking a higher dosage of iron experienced side effects, including abdominal pain. They were also less likely to adhere to their prescription, taking only portions of their medication, rather than the entire dosage. The study asserted that a dosage as low as 30 milligrams is sufficient in effectively treating anemia. It was also noted that since iron interferes with the absorption of other drugs, it should not be taken in conjunction with other medications.

In order to best assure your loved one’s health, regular check-ups and updates to his or her medication prescriptions are recommended. Furthermore, proper documentation and updated records must be kept in an orderly fashion, so that current physicians can be aware of the patient’s medical history, as well as medications that the patient is currently taking, or has taken in the past. Keeping organized records of a patient’s medical history also facilitates physicians in lowering dosages, when possible, as the patient’s condition is treated and his or her health improves. Organization of medical charts has a significant impact on keeping your loved one’s drug intake to a minimum.

Often, disorganization and lack of documentation in skilled nursing facilities is a result of understaffing. When nurses are assigned too many duties and responsibilities, they tend to overlook or skip certain steps in the caretaking process that they deem unimportant. However, it is the responsibility of the skilled nursing facility to employ a sufficient amount of staff and ensure that every measure is being taken to maintain the highest practicable health and well-being of the residents.

Carelessness and improper documentation of prescribed drugs can lead to overdoses, adverse drug reactions (ADRs), and sometimes even death. In addition to monitoring your loved one’s iron intake, other drugs that are commonly abused or misused in nursing homes are antipsychotics. Drugs that are improperly used are considered chemical restraints. The use of restraints is both a threat to your loved one’s physical and mental well-being and a direct violation of the Patients Bill of Rights.

Understaffing in Los Angeles Nursing Homes Contributes to the Inability of Dementia Patients to Receive Proper Nutrition during Mealtimes

February 2, 2012 | by Yeroushalmi Law

In skilled nursing facilities, one of the busiest and most hectic times of the day is mealtime. For dementia patients, mealtime is an extremely significant indicator of quality of life. Recently, a study titled “Factor’s Affecting Independence in Eating among Elderly with Alzheimer’s Disease” was published in the journal of Geriatrics & Gerontology International. Researchers who conducted the study noticed that patients who suffered from dementia often experienced a decline in the ability to eat independently. Because of their need for feeding assistance, it is important to recognize the signs of dementia by monitoring residents during their mealtimes.

The study observed that patients with dementia and other cognitive disorders, such as Alzheimer’s disease often had difficulty beginning their meals by themselves. This could be a result of an inability to recognize the material on their trays as food. Sometimes, even when patients were able to identify their food, they were unable to comprehend how much food to transfer to their mouths, and by what means to do so. For example, patients with dementia often had difficulty using their utensils properly to scoop the proper amount of food, either scooping too little food or too much food all at once.

Often, dementia patients also had difficulty distinguishing between food and non-food items. Even when they were able to identify their food, as a result of visuospatial impairments, these residents sometimes only recognized portions of their meals as food, and left the remainder untouched. Other patients with dementia who suffered from attention disorders or disorientation were unable to stay focused on eating during the entire mealtime. Some were distracted by other activities, while others were unable to remain alert and fell asleep during their mealtime.

Unfortunately, nursing homes are often inadequately staffed and unable to provide their residents with the one-on-one feeding assistance that they often need. Especially in patients with dementia, nursing home neglect during mealtimes has serious consequences. According to the study, one of the most common symptoms of dementia during mealtimes was the inability to begin eating. Consequently, patients often become anorexic or malnourished because facilities are understaffed and nurses are far too overwhelmed during mealtimes.

The study also pointed out that in most skilled nursing facilities today, each individual care provider is permitted to use their own judgment on how to feed patients. While this may be acceptable in nursing homes with qualified and well-trained nurses, such as licensed practical nurses (LVNs) and registered nurses (RNs), many facilities leave meals to the discretion of care aides and certified nursing assistants (CNAs) who often are not thoroughly educated on the dangers of malnutrition and dehydration. Therefore, skilled nursing facilities should have set guidelines or rules that must be followed during mealtimes. Instead, trial-and-error experiments are generally accepted in determining the best foods to feed residents. However, this is extremely dangerous, because just one simple error in feeding that is not in adherence with physician’s orders can have serious consequences, and even lead to death. For this reason, nursing homes should also employ dieticians during mealtimes, to ensure that doctor’s orders are being followed and to maintain the highest practicable nutrition and physical health of patients.

The study suggested altering the texture of meal or adjusting the patient’s posture in order to encourage independent eating. Additionally, certain therapies exist to improve and maintain the swallowing function. However, once dementia reaches more serious stages, it is difficult to perform these rehabilitation exercises. Therefore, nursing staff need to be aware of the symptoms discussed above that patients with dementia often show during mealtimes. It is the responsibility of the nurse to identify the onset of dementia early on in its progression, and to implement the proper therapies and treatments to encourage independent eating.

Study Shows that C. Difficile Infections Are Ten Times More Prevalent in Los Angeles Nursing Homes that Are Understaffed and Unable to Uphold Safe Infection Control Policies

February 1, 2012 | by Yeroushalmi Law

Clostridium difficile, abbreviated as C. difficile, is just one of the many infections that are common in nursing homes. Caused by inflammation of the colon, some symptoms include diarrhea, nausea, vomiting, loss of appetite, fever, and cramping. Because residents of skilled nursing facilities live in such close quarters, infections are able to spread rapidly. Therefore, it is crucial that the nursing home staff take extensive measures to prevent the spread of infection. An article, titled “High Prevalence of Clostridium difficile Colonization among Nursing Home Residents in Hesse, Germany” and published in the January 2012 issue of Plosone Journal studies the outbreak of C. difficile infections in skilled nursing facilities.

After observing and analyzing various nursing homes for the presence of C. difficile the survey moved to study the general population. In comparison, the result of the study revealed that the prevalence of C. difficile was ten times higher in skilled nursing facilities than in the general population. This statistic was consistent with similar studies of C. difficile in the United States and the United Kingdom. This shows that although the study was conducted in Germany, the dangerous spread of infectious diseases in nursing homes is an issue that occurs internationally, including within our own local Los Angeles skilled nursing facilities.

The study cited antibiotic use as a common factor among nursing home residents that increased the prevalence of C. difficile. Certain antibiotics are known to kill the bacteria in the intestines that regulate C. difficile bacteria and ultimately prevent C. difficile infections from occurring. Because the use of antibiotics in skilled nursing facilities to treat various infections is so common, elder adults become more susceptible to contracting C. difficile.

Incontinence is another condition that increases the risk of the rampant spread of C. difficile in nursing homes. Patients who suffer from fecal incontinence must be monitored frequently and changed immediately, especially those also infected by C. difficile bacteria. According to the study, even up to several weeks after the disappearance of infection symptoms, 15 to 20 percent of patients are still at risk of a recurring infection and therefore still able to infect other residents. Because mere contact with the bacteria is enough to cause an outbreak of the infection among other residents of the facility, hand hygiene of nurses is an extremely important prevention technique. The facility, especially bathroom surfaces and other shared common areas, must be kept sanitized, in accordance with state and federal health codes.

Furthermore, the study alleged that although C. difficile was ten times more prevalent in skilled nursing facilities than in the general population, an entire 27 percent of the nursing homes studied failed to instigate specific infection control and management guidelines. Often, this is because the preventative measures and techniques outlined above are difficult and nearly impossible to execute effectively when the nursing home facility is understaffed.

However, it is the responsibility of the skilled nursing facility to not only employ an adequate amount of staff to sufficiently care for its residents, but also to ensure that this staff is qualified and able to recognize and accurately diagnose infections early on, and to instigate infection control measures when necessary. Failure on behalf of the nursing home to fulfill this duty is an egregious act of neglect and elder abuse that violates your loved one’s rights as a patient.

Recent Study Identifies Pharmaceuticals that May Increase the Risk of Adverse Drug Reactions Among Los Angeles Nursing Home Patients

January 27, 2012 | by Yeroushalmi Law

While polypharmacy, the use of multiple drugs simultaneously, is known to have dangerous effects on the physical and psychological health of patients, other causes of adverse drug reactions among the elderly population are lesser known. A study, titled “Geriatric Conditions and Adverse Drug Reaction in Elderly Hospitalized Patients,” published in the February 2012 issue of the Journal of American Medical Directors Association, seeks to discover another explanation for the occurrence of adverse drug reactions, focusing on the relationship to geriatric conditions.

After assessing 506 patients, the study concluded that hematologic, neuropsychiatric, and respiratory drugs are the most likely to lead to adverse drug reactions. With respect to geriatric conditions, patients who experienced adverse drug reactions suffered from cardiovascular, dermatologic, gastrointestinal, and psychiatric disorders. They also experienced a loss of independence, including incontinence and an inability to perform other activities of daily living.

Fortunately, incontinence is not a disease, but a symptom, that can be improved with the proper care. One treatment technique is called prompted voiding and involves the coordination of a patient’s bathroom schedule with a schedule of food and liquid intake. Nurses and dieticians also need to manage the nutrition and fluid intake of their residents. According to Patients’ Rights, the nursing staff is obligated to maintain the hygiene and dignity of your loved one if he or she suffers from incontinence. When proper care is not provided and patients who soil themselves are not changed immediately, incontinence can have serious consequences, such as the development of pressure ulcers. Needless to say, adequate staffing is absolutely necessary in order for treatment to be successfully executed and for hygiene and dignity to be preserved.

According to the study, falls, in particular, were strongly linked to the usage of neuropsychiatric drugs. Because falls are so dangerous, as they can lead to injuries, such as hip fractures and head trauma, and sometimes death, caregivers need to be even more careful with patients who are using neuropsychiatric drugs. This requires communication between the patient’s physician and the nursing staff. Unfortunately, the nursing staff does not always have your loved one’s best interest at heart, so it is important for you to ensure that such communications are taking place and that physician’s orders are being followed.

On the contrary, nurses sometimes use drugs as restraints, in an attempt to prevent falls. Often, antipsychotic drugs are used as chemical restraints to sedate patients. The use of chemical restraints is not only a violation of rights, but is also dangerous, as it puts patients at a higher risk for death. You should check that your loved one’s medications are prescribed for medically sound reasons, and also ensure that your loved one is not being physically restrained either.

Recent Study Identifies Risk Factors that Increase the Chance of Falling in Los Angeles Nursing Homes and Determines that Most Falls are Preventable with Proper Staffing

January 25, 2012 | by Yeroushalmi Law

Each year, approximately 1.7 falls occur per nursing home bed. Because falls can lead to hip fractures, head trauma, and other injuries that may lead to death, analyzing the causes of falls and establishing prevention techniques is extremely important in assuring that your loved one’s nursing home is promoting the safety and well-being of its residents. With this goal in mind, the Journal of American Medical Directors Association published an editorial titled “Increasing Awareness of Factors Producing Falls: The Mini Falls Assessment” in its February 2012 issue.

The Mini Falls Assessment is a questionnaire that was developed at Saint Louis University. With just seventeen basic question categories, the assessment determines individuals who are at a higher risk of falling. The assessment inquires about polypharmacy, vitamin D use, blood pressure, sitting and standing balance, strength and gait, fear of falling, falls in the past six months, foot deformity, physical ability, weight loss, and frailty. Points are assigned to each question, and each patient is given a score, which, depending upon their answers, can total to thirty. The developers emphasize, however, that the scores are relatively unimportant because an answer of “no” to even just one question already puts the patient at a higher risk for falling.

Of all the risk factors that increase the likelihood of nursing home residents falling, the two that are most preventable are related to diet and exercise. In your search for the ideal nursing home, make sure that the facility not only employs a qualified nursing staff, but that there is also an adequate amount of indirect care staff. During mealtimes, a dietician should always be present. Malnutrition and dehydration can lead to weight loss, fatigue, dizziness, and frail joints and bones. These are all factors that significantly increase the risk of falls in elderly adults. Physical therapists should also be present to guide residents in exercises and activities that will improve their muscle strength. A recent therapy that has proven to be extremely effective is progressive resistance training, in which participants perform exercises against an external, opposing force that increases as the patient’s muscle strength improves.

It is no secret that patients who are susceptible to falls require additional care and assistance from nurses. Recent studies have discovered that elderly adults who reside in nursing homes fall three times more frequently than those who live independently. Inadequate staffing explains this shocking statistic. Many skilled nursing facilities are understaffed and are therefore unable to give each and every individual patient the attention that he or she needs and deserves from a skilled nursing facility. Consequently, residents fall, and even more shocking is the fact that they often are not found until much later, after they have already suffered the pain of their injuries for hours on end. If your loved one has died from a fall-related injury as a direct result of understaffing and nursing home neglect, you may be able to make a Wrongful Death claim.

Sometimes, instead of using fall prevention techniques, understaffed facilities employ the use of physical restraints. This is a direct violation of Patients’ Rights, which state that patients can only be restrained for medical purposes, and even then, they may refuse treatment. You must be cautious, for nurses often justify the use of physical restraints by claiming that they promote the safety of patients, as well as everyone around them. However, physical restraints are actually a direct cause of many health ailments, such as pressure ulcers and incontinence and also lead to a decline in independence and mobility.

Of all liability cases filed against skilled nursing facilities, 60 percent are a result of fall-related injuries. With the proper staffing and a hazard-free environment, the occurrence of falls in nursing homes can be avoided. If your loved one has sustained any fall-related injuries, he or she may likely be a victim of nursing home neglect because such injuries are preventable.

Recent Study Confirms Link between Adequate Staffing and Avoiding Unnecessary Hospitalizations

January 18, 2012 | by Yeroushalmi Law

In a recent issue of the Canadian Journal on Healing, the Canadian Association on Gerontology conducted “A Survey of Nursing Home Organizational Characteristics Associated with Potentially Avoidable Hospital Transfers and Care Quality in One Large British Columbia Health Region.” The researchers first examined previous studies on avoiding hospitalization in nursing home patients, which have shown that transfers to hospitals often lead to a decline in quality of life for the patient, and that skilled nursing facilities with the proper resources are often better equipped than hospitals to treat certain conditions. However, not all nursing homes are prepared to treat your loved one in the case of an emergency. In this study, the researchers aimed to identify the specific conditions that are required in order for nursing homes to be more effective than hospitals in treating patients. The survey was organized with various questions surrounding some main themes.

The first category of questions analyzed staffing. The study showed that higher levels of staffing were directly linked to lower levels of hospitalizations. Direct care staff members were considered to include registered nurses (RNs), licensed practical nurses (LPNs), and care aides. The results of the study also emphasized communication between staff, particularly care aides. Despite the fact that they usually engaged in the most contact with patients directly, care aides were often excluded from everyday decision-making processes concerning patients.

While most facilities employed all three types of direct care staff, the presence of non-nursing staff, such as dieticians and rehabilitation and activities directors, varied. However non-nursing staff are also very necessary to provide your loved one with the quality of care that he or she needs. For example, a dietician should be present during mealtimes, to ensure that your loved one is receiving the proper nutrients to support his or her health, and to prevent the possibility of malnutrition.

The study also took note of each facility’s nursing hours per patient per day, which shows the importance of adequate staffing. On average, nursing hours per patient per day was calculated to be 3.17. However, according to California state law Health & Safety Code §1276.5-1276.65, the minimum staffing level is 3.2 nursing hours per patient per day. It is important not only to ensure that your loved one’s rights are not being violated and that the care facility is fulfilling staffing level requirements, but also that they are receiving high-quality care from well-trained professionals.

The second theme of survey questions focused on physician care. The results of the survey showed that continuity of care contributed to lowering the amount of hospitalizations. When a patient is continually examined by the same doctor, the physician establishes a familiarity with the patient’s medical history and is better able to treat the patient effectively, thus avoiding unnecessary hospitalizations. However, we must warn you to be cautious with who and what you believe because nursing homes have an incentive to manipulate their patients’ diagnoses. While upcoding is advantageous because it involves reporting more serious health conditions to receive more funding from the government, downcoding, which involves intentionally underestimating the seriousness of a condition, is also beneficial for the nursing home because it reduces the facility’s liability. Therefore, if you sense that something is wrong, it is important for you to get another doctor’s second opinion.

The third type of questions analyzed palliative care. All too often, nursing homes neglect patients whom they perceive are dying and leave them to suffer in the last days of their lives. In other cases, the facility often instigates a transfer of the patient to a hospital, so that he or she can die there. However, nursing homes can usually provide better, more comfortable end-of-life care than hospitals, and those with palliative care standards, which are pre-signed orders from a certified physician, usually involving the prescription of narcotics to ensure a death void of as much suffering and pain as possible. Although most of the facilities had updated palliative care orders, a significant 22% of nursing homes did not have any form of palliative care at all. Therefore, you should take the precautions to ensure that palliative care orders exist for your loved one in the necessary cases.

Los Angeles Nursing Homes Manipulating Patients’ Medical Conditions for Their Own Personal Gain

January 16, 2012 | by Yeroushalmi Law

Recently, as reported by The Baltimore Sun on January 12, 2012, certain health care groups have been engaging in a practice called “upcoding.” This increasingly prevalent practice involves healthcare providers reporting more serious medical conditions to the government, in order to receive higher reimbursement rates. In this specific case, an orthopedic company was accused of manipulating patients’ files to make it seem as though patients had a serious form of malnutrition, called kwashiorkor. The company denies these claims and is fighting back.

However, malnutrition is a serious problem that must not be underestimated. The most obvious sign of malnutrition is weight loss. Malnutrition has many health implications, including pressure ulcers, infections, pneumonia, and falls.

Usually, malnutrition is a direct result of understaffing. When there are not enough nurses working during mealtimes, residents do not receive the proper food and nutrition that they need. Furthermore, mealtime should be a time for positive social engagement, which must be initiated and encouraged by nurses. Often, nursing homes appear to be fully staffed during day shifts, but during night shifts and mealtimes they are actually inadequately staffed. When choosing a skilled nursing facility for your loved one, make sure to visit during mealtimes so that you can get a first-hand experience of what your loved one’s mealtimes will be like. If possible, try a sample of the food your loved one will be eating, and check if a dietician is present. You should also make sure that your loved one is not suffering from dehydration, which often accompanies malnutrition.

Interestingly enough, while some healthcare facilities are “upcoding,” others are “downcoding.” Although “downcoding” entails that the facility receives less funding from the government, nursing homes use this practice to lower their liability. For example, pressure ulcers are relatively easy to downcode because there are different levels of severity. Instead of accurately diagnosing a pressure sore as stage four, which is very serious, nursing homes often claim ignorance and diagnose these sores as being in their early stages of development. They allow patients to continue suffering until the problem is so serious that they must be sent to the hospital. At this point, nurses often claim that previously, the sore was not a severe one, and that it just recently developed into a stage four pressure ulcer. This allows them to attempt pass the responsibility on to the hospital or new care facility to which the patient is transferred. Once again, the development of pressure ulcers, as well as any other health ailments in nursing homes, is usually a direct consequence of understaffing. Regardless, nurses are fully responsible for the prevention of pressure ulcers, and must also be knowledgeable enough to accurately diagnose them, when necessary.

While the list of problems experienced in skilled nursing facilities is extensive, the main purpose of this blog is to emphasize how simple it is for healthcare facilities to manipulate their patients’ health records. For this reason, it is imperative that you are extremely cautious in allowing others to care for your loved one. Even if the facility makes claims and promises to you, it is important for you to ensure that the caretakers are following through with these promises. If you notice that something is wrong, or if your loved one is diagnosed with an illness, we advise you to get a second opinion. All too often, the elderly are taken advantage of and forced to suffer because skilled nursing facilities misdiagnose their patients. Do not allow this to happen to you or your loved one.

Nursing Homes and Pharmaceutical Companies Are Cheating Government Health Programs for Profit

January 13, 2012 | by Yeroushalmi Law

On January 10, 2012, Bloomberg News featured a story about Omnicare, a pharmaceutical company, that adjusted its billing records and reported false information to government health programs, such as Medicare and Medi-Cal, in order to increase its own profits. According to the report, the government may have lost millions of dollars from Omnicare’s fraud. Despite the story making it to news headlines, the truth of the matter is that health facilities cheat the government fairly often. Previously, Bloomberg News reported another situation that involved nursing homes that were incorrectly billing Medicare. To read more about that story, click here.

Incentives for cheating the government vary. In some cases, such as this most recent one, companies are simply seeking profit. In other situations, health facilities take advantage of Medicare by unnecessarily ordering drugs that were never prescribed by doctors. These drugs are usually used by nurses to chemically restrain patients. Antipsychotic drugs are the most common chemical restraints because of their power to sedate patients. However, these drugs that are intended to treat mental illnesses are more often used to treat patients with dementia. Because dementia patients are often subject to episodes of aggravation, nurses find it more convenient to subdue them with antipsychotics rather than to take the time to calm them down with behavioral techniques.

Specialists confirm that the best treatment for dementia-related aggravation is therapeutic, not pharmacological. Because aggravation is often caused by polypharmacy, or the excessive use of multiple drugs simultaneously, it only makes sense that adding more medications will only worsen patients’ conditions. Some types of treatments that have proven effective are pet and music therapy, as well as encouraging social interaction among patients, especially during mealtimes.

Beyond the ethical implications of using drugs to restrain patients, the improper use of antipsychotic drugs also poses many risks. Studies have shown that the use of antipsychotics in dementia patients more than doubles their chances of death. Additionally, patients are put at a higher risk for falls, depression, and isolation. You should also learn more about the dangers of physical restraints, and make sure that your loved one is not being restrained in any way by his or her nursing home, either physical or chemical.

Although the use of chemical restraints is an undoubtedly cruel act, nurses sometimes feel that they are left with no other choice. Nursing homes are often so understaffed that caregivers must take shortcuts in order to provide enough time to tend to each of their patients. Unfortunately, this abbreviated care is never sufficient in providing your loved one with the quality of care that he or she needs.