Nurse Aide guilty of nursing home residents

One of two women accused of physically and sexually humiliating nursing home residents for months in Albert Lea, Minn., pleaded guilty Monday to three of the charges against her in a case that has heightened attention to how aides are chosen and supervised.

Brianna Broitzman, 21, was an aide at Good Samaritan, the nursing home that was the focus of state investigations and widespread publicity about the case in early 2008.

Six aides, high school friends at the time, were charged - Broitzman and Ashton Larson as adults and the four others as juveniles who were found responsible for not reporting the abuse as required by state law. The women were accused of abusing seven residents who suffered from dementia.

Broitzman agreed to an Alford plea, said Freeborn County Attorney Craig Nelson, meaning that she asserts her innocence but acknowledges that the prosecution has enough evidence to convict her. Her guilty plea covers gross-misdemeanor disorderly conduct involving three victims.

'These are appropriate charges and appropriate pleas based upon the evidence the state anticipated would be presented at the time of trial,' Nelson said Monday, shortly after the action in court. 'I do believe this is an appropriate outcome of the case.'

Sexual abuse cases in nursing homes during the 1980s and '90s led to laws requiring reports of suspected abuse and criminal background checks of those who work with vulnerable adults.

This case has been as important, but in different ways. For one, it has 'toppled stereotypes about who sexual abusers might be, with appealing yearbook pictures instead of menacing mug shots of scruffy men,' said Iris Freeman, director of the Vulnerable Adult Justice Project at the William Mitchell College of Law in St. Paul. She is nationally known for three decades of advocacy for older people.

It also has led to increased training for nursing home staff to better recognize and report suspected abuse, 'but I think the more important issue is how well - or not well - nursing facilities are supervising people who care for vulnerable adults,' Freeman said.

About 15 relatives of victims were in court when the plea was made, Nelson said, adding that the families were consulted beforehand and generally agreed with the arrangement. Most are active in a new group they formed called Families Against Nursing Home Abuse.

Broitzman will be sentenced in Freeborn County District Court on Oct. 22. Nelson said he will endorse results of a presentence investigation, which may recommend that Broitzman spend up to a year in jail, pay a $3,000 fine or spend two years on probation, 'although I will not be surprised if, with no prior criminal history, Ms. Broitzman receives probation.'

Her trial, which had been moved to Rochester because of the publicity the case attracted, was scheduled to start Aug. 23.

The case against Larson, 20, another former aide at the Good Samaritan nursing home, is proceeding toward trial. A change of venue also has been granted in that case, but a location has yet to be determined. A hearing on that matter is set for Sept. 16, Nelson said.

Broitzman and Larson were charged with fifth-degree assault, abuse of a vulnerable adult by a caregiver, abuse of a vulnerable adult with sexual contact, disorderly conduct and failing to report suspected maltreatment. All are gross misdemeanors.

The charges against Broitzman said she admitted to police that she poked one resident in the breast. The teens who were implicated accused Broitzman of numerous other actions, including spitting in a resident's mouth, jabbing the breasts of several residents and putting 'her bare butt' on a resident's face.

According to the complaint against Larson, she admitted to police that she inserted her finger into the rectum of a resident. She said she was trying to trigger a bowel movement but acknowledged that this was not part of her training. The complaint said she also acknowledged getting into bed with a resident and making a humping motion, patting the buttocks of one resident and trying to get another angry and then laughing at her.

The allegations became public in August 2008, when state Health Department inspectors concluded that aides, to make their work 'fun,' had abused 15 residents suffering from Alzheimer's and other forms of dementia. The state said some of the residents were combative, easily agitated or blind.

Broitzman, Larson and the nursing home's owner also are being sued by families of residents who allegedly were abused.

'You know, there's new research that indicates some people with Alzheimer's or dementia can tell us that something is wrong, and that's one of the things that this case showed,' said Deb Holtz , ombudsman for long-term care at the state Department of Human Services.

She said her office, with 13 regional ombudsmen and about 70 volunteers, developed an education program for nursing homes called 'Stand Up for Yourself and for Others' to empower residents to take action if they suspect abuse.

'Pay attention when someone is showing agitation or sadness or acting different,' Holtz said. 'People with Alzheimer's do communicate with us, through their behaviors.'

Plea deal reached in abuse of Minn. nursing home residents

Richmond nurse's aide is sentenced in nursing home abuse case

A former nurse's aide at Richmond Health and Rehabilitation Complex (Madison Manor) nursing home was sentenced Thursday for neglecting to feed a patient in 2008, Attorney General Jack Conway said.

Conway's office prosecuted Amanda Sallee, of Richmond, who pleaded guilty in March in Madison Circuit Court to charges of wanton abuse and neglect of nursing home resident.

Sallee was sentenced to one year in prison. The sentence will be diverted for a period of five years if she maintains good behavior and does not work with vulnerable adults or children; in the health care industry; or for a Medicaid or Medicare provider.

She must also perform 100 hours of community service and cooperate fully in further investigations involving Madison Manor Nursing Home.

Sallee is the third nurse's aide convicted of abusing resident Armeda Thomas.

Richmond nurse aide is sentenced in nursing home abuse case

The Dangers of Corporate For-profit Elder Care

The Dangers of Corporate For-profit Elder Care

Medical Errors Annual Cost $19.5 Billion

SCHAUMBURG, Ill., (Aug. 9, 2010)–Findings from a new study released today estimate that measurable medical errors cost the U.S. economy $19.5 billion in 2008. Commissioned by the Society of Actuaries (SOA) and completed by consultants with Milliman, Inc., the report used claims data to provide an actuarially sound measurement of costs for avoidable medical injuries. Of the approximately $80 billion in costs associated with medical injuries, around 25 percent were the result of avoidable medical errors.

"This report highlights a singular opportunity for both improving the overall quality of care and reducing healthcare costs in this country," says Jim Toole, FSA, CERA, MAAA and managing director of MBA Actuaries, Inc. "Of the $19.5 billion in total costs, approximately $17 billion was the result of providing inpatient, outpatient and prescription drug services to individuals who were affected by medical errors. While this cost is staggering, it also highlights the need to reduce errors and improve quality and efficiency in American healthcare."

Medical errors are a significant source of lost healthcare funds every year. For example, the study found that $1.1 billion was from lost productivity due to related short-term disability claims, and $1.4 billion was lost from increased death rates among individuals who experienced medical errors. According to a recent SOA survey, which identified ways to bend the national healthcare cost curve, 87 percent of actuaries believe that reducing medical errors is an effective way to control healthcare cost trends for the commercial population, and 88 percent believe this to be true for the Medicare population.

"We used a conservative methodology and still found 1.5 million measureable medical errors occurred in 2008," says Jonathan Shreve, FSA, MAAA, consulting actuary for Milliman and co-author of the report. "This number includes only the errors that we could identify through claims data, so the total economic impact of medical errors is in fact greater than what we have reported."

Key findings from the study include:

* There were 6.3 million measurable medical injuries in the U.S. in 2008; of the 6.3 million injuries, the SOA and Milliman estimate that 1.5 million were associated with a medical error.
* The average total cost per error was approximately $13,000.
* In an inpatient setting, seven percent of admissions are estimated to result in some type of medical injury.
* The measurable medical errors resulted in more than 2,500 avoidable deaths and more than 10 million excess days missed from work due to short-term disability.

"In the past, the insurance industry had low visibility in its involvement in quality-improving initiatives," says Toole. "Now is the time for the industry to assume an active role by helping healthcare systems implement an actuarial approach, which can more systematically identify potential causes of medical errors than alternative approaches."

The study also identifies the 10 medical errors that are most costly to the U.S. economy each year. Approximately 55 percent of the total error costs were the result of five common errors:

* Pressure ulcers
* Postoperative infections
* Mechanical complications of devices, implants, or grafts
* Postlaminectomy syndrome
* Hemorrhages complicating a procedure

The SOA and Milliman findings were based upon an analysis of an extensive claims database. Measurable costs of medical errors included increased medical costs, costs related to increased mortality rates, and costs related to lost productivity of an error.

The report was authored by Jon Shreve, Jill Van Den Bos, Travis Gray, Michael Halford, Karan Rustagi, and Eva Ziemkiewicz of Milliman, Inc. and can be accessed by clicking on the following links:

* The Economic Measurement of Medical Errors

* Appendix B: Detailed Results for Each Error Type


Medical Errors Annually Cost at Least $19.5 Billion Nationwide: "- Sent using Google Toolbar"