Monday, August 17, 2009

Retraining after allegations of Elder forced to eat feces

According to the Quincy Patriot Ledger, Mon August 17th, 2009,
The resident aid staff at the Atrium at Faxon Woods in Quincy were 'retrained' following allegations described by the newspaper as "Horror" and including allegations of abuse that included an elderly alheimers victim having to "eat her own feces"

Elder Abuse "Horror" in Quincy, MA.

A 23-year-old nurse’s aide from Quincy has been arrested after police say she tormented and abused elder residents at a home for people with memory loss.

Kara A. Murphy, a nurse aide since 2004, manhandled at least four elderly residents at the Atrium at Faxon Woods during a shift last Saturday, police said They also said she boasted to another caregiver about force-feeding an 89-year-old woman her own feces.

The charges against Murphy are based entirely on the account of another employee who reported the incidents Tuesday to her director, police said.

None of the victims had any recollection of the incidents, police said.

Murphy, of 38 Scammell St., Quincy, pleaded innocent on Friday in Quincy District Court. She is charged with seven counts of assault and battery on disabled persons older than 60.

Judge Mark Coven ordered her to remain under house arrest until authorities can fit her with a GPS tracking device. Murphy is next due in court on Oct. 8.

A woman who answered the door at Murphy’s home said the family had no comment.

Teri Marinko, vice president of marketing and communications for Benchmark Assisted Living, which runs the facility, said Murphy was immediately fired after the company conducted its own investigation.

Marinko said she did not know when Murphy was hired. Department of Public Health records show that Murphy was registered as a nurse’s aide following a competency evaluation in June 2004.

Marinko said there were no prior complaints about Murphy. All potential employees are checked for criminal convictions, she said.

“All the families that have loved ones at the community have been notified,” Marinko said. “We remain confident in the safety and security processes in place to ensure the well-being of our residents.”

The Atrium, on Falls Boulevard, has 60 private apartments and caters to people with Alzheimer’s, dementia and other forms of memory loss. There are color cues in the halls to help residents navigate the facility. Monthly rates start at $5,500.

A report by Quincy police officer James Whedbee reads like a sordid tale of elder abuse that, according to witness’s account, began at 8 a.m. in the bathroom of an 89-year-old resident.

According to the employee who reported Murphy, when the woman tried to stand up from the toilet, Murphy grabbed her by the jaw and forced her back down, saying, “I should make her eat it.”

Murphy then admitted to having carried out that threat in the past, the witness said.

Afterward, when the woman refused to take her medication, Murphy allegedly forced open her mouth and poured in water, which spilled down her neck as the woman pushed her caregiver away.

Later, the co-worker said, she witnessed Murphy push a 92-year-old into her wheelchair and backhand the woman in the forehead because she “was not moving fast enough.”

Murphy mockingly bounced on the lap of another wheelchair-bound woman and punched a different woman in the shoulder, the report says.

In the afternoon, Murphy taunted her co-worker for changing the clothes of a woman who had urinated on herself and recommended she leave it for the next shift, police said.

Quincy’s elder services director, Thomas F. Clasby, said the allegations were stunning.

“If it’s true, it’s disgusting and sickening,” he said.


Sunday, August 16, 2009

Coverage Denied: How the Current Health Insurance System Leaves Millions Behind

New Gov Report

“Pre-Existing Conditions” Affect Millions of Americans

A large proportion of Americans have health conditions that insurance companies can qualify as “pre-existing conditions.”

A pre-existing condition is a medical condition that existed before someone applies for or enrolls in a new health insurance policy. It can be something as prevalent as heart disease – which affects one in three adults1 – or something as life-changing as cancer, which affects 11 million Americans.2

But a pre-existing condition does not have to be a serious disease like cancer or heart disease. Even relatively minor conditions like hay fever, asthma, or previous sports injuries can trigger high premiums or denials of coverage.3

Unattainable Health Coverage

Insurance discrimination based on pre-existing conditions makes adequate health insurance unavailable to millions of Americans.

In 45 states across the country, insurance companies can discriminate against people based on their pre-existing conditions when they try to purchase health insurance directly from insurance companies in the individual insurance market.4 Insurers can deny them coverage, charge higher premiums, and/or refuse to cover that particular medical condition.

A recent national survey estimated that 12.6 million non-elderly adults5 – 36 percent of those who tried to purchase health insurance directly from an insurance company in the individual insurance market – were in fact discriminated against because of a pre-existing condition in the previous three years.6

In another survey, one in 10 people with cancer said they could not obtain health coverage, and six percent said they lost their coverage, because of being diagnosed with the disease.7

It is still legal in nine states for insurers to reject applicants who are survivors of domestic violence, citing the history of domestic violence as a pre-existing condition.8

Even when offering coverage, insurers can exclude whole categories of illnesses related to a pre-existing condition. For example, someone with a pre-existing condition of hay fever could have any respiratory system disease – such as bronchitis or pneumonia – excluded from coverage.9

Losing Coverage When You Need It Most

Thousands of Americans also lose health insurance each year through a practice called rescission.

When a person is diagnosed with an expensive condition such as cancer, some insurance companies review his/her initial health status questionnaire. In most states’ individual insurance market, insurance companies can retroactively cancel the entire policy if any condition was missed – even if the medical condition is unrelated, and even if the person was not aware of the condition at the time. Coverage can also be revoked for all members of a family, even if only one family member failed to disclose a medical condition.10

A recent Congressional investigation into this practice found nearly 20,000 rescissions from three large insurers over five years, saving them $300 million in medical claims11 – $300 million that instead had to come out of the pockets of people who thought they were insured, or became bad debt for health care providers.

At least one insurance company has been found to evaluate employee performance based in part on the amount of money an employee saved the company through rescissions.12 Simply put, these insurance company employees are encouraged to revoke sick people’s health coverage.

The Need for a Solution

High-risk pools, which have been used by states to cover the “medically uninsurable,” do not work.

Thirty-five states offer a high-risk pool for people who have been denied coverage in the individual insurance market or otherwise cannot obtain insurance.13 However, high-risk pools generally charge significantly higher rates than they charge for a healthy individual in the individual insurance market,14 meaning that only relatively high-income people can afford the coverage. One study estimated that only eight percent of the uninsurable population is able to enroll in high-risk pools, mainly because of high premiums.15

Benefits through a high-risk pool are also not guaranteed. Some state high-risk pools have annual caps on enrollment, or limit eligibility only to people who had prior group health coverage in the preceding 63 days. And one state high-risk pool has been closed to new beneficiaries since 1991.16

All high-risk pools also impose pre-existing condition exclusions for six months to one year, during which time care for the very condition that made someone uninsurable is not covered.17

Health Insurance Reform Will Provide Stability and Security for All Americans

Under health insurance reform, insurance companies will be prohibited from refusing coverage because of someone’s medical history or health risk.

Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies will not be allowed to refuse renewal because someone became sick.

And insurance companies will be prohibited from dropping or watering down insurance coverage for those who are or become ill.

Health Care Reform - Obama's Coalition

With the push for health care reform in a critical stretch, some bizarre coalitions are stepping up the fight to see the legislation through to the finish line.

One of the most peculiar, Healthy Economy Now, is spending millions to pressure members of Congress to get on board with health care reform.

The organization has brought together stakeholders from across the spectrum -- the pharmaceutical industry, doctors, union interests, business interests and advocacy groups among them.

The common thread for these strange bedfellows? Self-interest, observers say.

"Either you're sitting down at the table or you're on the menu," said Ernest Istook, a fellow at the conservative Heritage Foundation.

With the option of a national coverage mandate on the table, industry groups stand to win tens of millions of new customers regardless of the concessions the federal government extracts from them. Advocacy groups get the reform they wanted and union groups can win added benefits for their members.

"This whole thing has a lot of fascinating coalitions," Istook said, calling them a "convergence of individual self-interests rather than a shared vision of what is going to be best for the country as a whole."

In a statement, the senior vice president for Pharmaceutical Research and Manufacturers of America -- one of the coalition members -- said the groups came together because they share the goal of improving the economy through health care reform.

"We believe that without health care reform, America will continue to get sicker and poorer," Ken Johnson said, adding that a "healthier economy can happen if we have a healthier workforce."

Regardless of motive, such coalitions could prove vital to President Obama and his allies in Congress as opponents of health care reform flood town hall meetings to meet with their representatives during August recess.

According to a recent report, drug makers stand ready to spend $150 million to help Obama get the legislation passed.

The Healthy Economy Now ad buys have so far cost $12 million, according to another account. The group so far has run three ads in states targeting key lawmakers in the health care policy process.

The most recent ad warns that medical costs will skyrocket "if we don't act," and Americans will continue to lose coverage and benefits.

"But we can act," the narrator says. "The president and Congress have a plan to lower your costs and stop denials for pre-existing conditions. It's time to act."

The ads reportedly were made by companies with close ties to Democrats and the White House.

Healthy Economy Now includes Pharmaceutical Research and Manufacturers of America, the AARP, the American Medical Association, the Business Roundtable, Families USA and the Service Employees International Union, among others.

But at this murky stage in the debate, it's becoming less and less clear what is in the best interest of these organizations.

Several of them got on the bandwagon out of sheer survival instinct. They came to the table when public opinion was more favorable toward comprehensive legislation and Obama-led reform seemed inevitable. It was seen as better for industry organizations to get on board and shape legislation to their advantage than to actively oppose it while a bill that meets few of their needs tracked toward the president's desk.

"I think the groups just naturally want to be at the table thinking they're going to come out of it better," said Rick Scott, who heads Conservatives for Patients' Rights, one of the leading groups campaigning against the legislation in Washington.

But with public opinion starting to turn and town hall meetings getting raucous, it's unclear whether these groups backed the winning horse.

"We'll wait to see what September brings and if there's cracks in some of these coalitions," Istook said.

A crack started to show this week, after Obama claimed the AARP was "on board" with his health care plan. The line apparently hit a soft spot for the seniors group, which, though claiming to be nonpartisan and not behind any specific legislation, has appeared to side with Obama on health care reform -- even hosting a town hall-style event with him last month -- to the dismay of some of its members. The group drew the line after Obama claimed he had their endorsement, with Chief Operating Officer Tom Nelson calling the claim "inaccurate."

Istook said the industry groups also are "playing with fire," since they're dealing with other organizations and officials that ultimately want them "out of business."

The tension between the traditional forces for health care reform and the traditional forces against it flared most recently between Democrats and the insurance industry.

After coming to the table on health care talks earlier in the year, the insurance industry has been vilified by congressional Democrats and the administration in recent weeks. The Department of Health and Human Services just issued a report titled: "Coverage Denied: How the Current Health Insurance System Leaves Millions Behind."

Obama, though, insists he's not trying to pave the way toward a single-payer system -- one in which the insurance companies are mostly taken out of the picture -- despite past statements in favor of such a setup.

America's Health Insurance Plans is now conducting its own ad campaign advocating health care reform, but it is strongly opposed to the kind of public option that Democrats are calling for. A public option could significantly cut into insurance company revenue even if an individual mandate is part of the legislation.

Meanwhile, the groups in Healthy Economy Now have used some questionable tactics in pushing their agenda.

The New York Times reported last week that PhRMA struck a behind-the-scenes deal with the White House in which the administration would ensure nobody squeezes extra money out of the drugmakers in exchange for $80 billion in cost savings over the next decade. A PhRMA executive later walked that back in an interview with the Huffington Post.

Another unlikely alliance came with PhRMA and Families USA banding together to launch the sequel last month to the "Harry and Louise" ads that helped derail health care reform under the Clinton administration.

This time, though, the Harry and Louise actors, whose full names are Louise Caire Clark and Harry Johnson, are appearing in a multimillion-dollar ad campaign in support of health care reform.

AHIP spokesman Robert Zirkelbach said the scattered alliances stem from a desire to reach a mutually beneficial package and an acknowledgment that the status quo is not sustainable.

"You didn't see this type of collaboration 15 years ago. Never before have we had hospitals and doctors and employers and labor unions and health plans all coming together in support of health care reform," he said.

Despite the climate of advocacy for health care reform, several groups have lined up against the plans, including the U.S. Chamber of Commerce, the Association of American Physicians and Surgeons and the Blue Cross Blue Shield Association.

Jury Finds Nursing Home Guilty of Neglect

KENT, Wash., July 23 /PRNewswire/ -- A King County Superior Court jury awarded the estate of a Renton woman more than $1.8 million yesterday for a medical center's failure to alert her physician of a critical complication that developed after routine back surgery.

Ellen Sandbo went to Valley Medical Center on January 31, 2006 for a routine procedure to relieve lower-back pain. Sandbo showed immediate improvement after the late-morning operation, standing and walking across her hospital room that evening. According to court testimony, though, Sandbo - a former nurse for more than 50 years - began experiencing severe pain in her legs later that evening, and repeatedly asked the nurse to call her doctor.

The hospital's nursing staff did not alert Dr. Thompson that Ellen was in trouble, depriving him of the opportunity to help Ellen," Gellatly noted. Thompson said in court testimony that he asked the nurse why he wasn't called at the onset of Sandbo's pain and the nurse admitted the error, saying "I should have called" -- a statement the nurse later denied making.

Sandbo spent the next three months in a skilled nursing facility before being sent to an adult family home, and then died on April 29, 2009 from what her family believes were complications of her paralysis. "They just stonewalled us at every turn, showing no concern for my mother or her situation," said Sandbo's son. "They dismissed her as an old lady with exaggerated complaints, but the jury told the hospital that the elderly deserves the same level of care as everyone else."

"She was not just a little old lady with exaggerated complaints, and the hospital should have taken care of her," said Gellatly. "We hope this will send a message that the elderly should get the same level of care."