Saturday, July 20, 2013

California Armenian Home and dwindling Armenian support $$, also no interest in the AACL

Here are some photos of the July 4th, "Sounds of Freedom" celebration at the AACL (Armenian American Citizens League) Building on the grounds of the California Armenian Home.  Over 35 years ago, when it was built, the keys were handed over to the Nursing Home, to collect rent. This was when the Nursing Home was Armenian operated and inhabited (majority) this was to help financially with the operations of the home to care for our elderly.  Then an ugly monster started to happen...called Yuba and Medicaid.  Yuba hates Armenians, and only wants 1 thing from them MONEY, and now the Nursing Home operates 85% on Medicaid, it's not necessary to take our building and charge for rental.  Not many groups use the building anymore because of this, except for the Churches that use if for their picnics, the AACL will have events there.

The word is the AACL would like to sever ties with Yuba and the Nursing Home as they know they cannot survive under the grips of Yuba.  We want our club back and seperate from the home.

As you can see from the photos not many people attended this event.  It is sad.  Most of the people we talked to are aware of Yuba's reputation and the California Armenian Home not being "Armenian"  Yuba will never hire an Armenian higher up than cleaning to work there, conversely- Educated Armenians wouldn't work for that idiot.  Take off the word "Armenian" and SELL the home.  Some of the older people that showed up are disappointed in the home, one is a very wealthy man has in home services for him and his wife and said "I will never put my wife or myself in there"

Good for you!!!, Now lets take back our building away from that lying Armenian hater Yuba.

Their vision destroyed by Yuba

California Armenian Home, Fraud, Neglect, Problem Employees, common among nursing homes

Just a few weeks worth of news on Medicaid fraud and elder abuses associated with Nursing Homes

Attorney General to focus on Nursing Home crimes

It is difficult enough for most people to send aged or infirm relatives to nursing homes when they believe good care will be provided. But the thought that frail elderly parents or incapacitated younger patients may be victims of neglect or active abuse is intolerable.

In Ohio, concern about that may be increasing — with good reason.

Attorney General Mike DeWine reports complaints about nursing home abuse and neglect have nearly doubled this year. His office’s Medicaid Fraud Control Unit is investigating 131 cases, compared to 74 for the same period in 2012.

About half this year’s complaints have been received last month, after DeWine announced his office will be aggressive in pursuing complaints of substandard nursing home care or abuse of patients.

DeWine — and those who place relatives or friends in nursing homes — have a new weapon to ensure quality care is provided. It was used earlier this year in Zanesville.

There, investigators placed surveillance cameras in the rooms of some patients, with their knowledge and that of families. Nursing home personnel were unaware they were being watched, however.

Videotape from some of the rooms revealed “absolutely shocking and disturbing” treatment of patients, DeWine said.

Most nursing homes and the dedicated personnel who staff them provide good care for patients. In many cases, it is not too much to say residents of nursing homes are treated lovingly.

That makes it especially upsetting that a few people in a handful of facilities are neglecting and/or abusing patients. DeWine should make it a top priority to find and punish those criminals.

The (Tiffin) Advertiser-Tribune

Senate should act quickly

Nurse  guilty of diverting medications at Nursing Home

A prescription drug fraud charge has been filed against an Abbotsford nurse accused of diverting medications from the nursing home where she worked.

Patricia Pokallus, 51, of Spencer, was charged with one felony count of obtaining controlled substances by fraud and her nursing license was suspended after she told staff members at Golden LivingCenter - Continental Manor, 600 E. Elm St., Abbotsford, she took lorazepam, an anti-anxiety drug, from the facility for personal use Feb. 3.

A nurse manager at Continental Manor noted Pokallus administered lorazepam on Feb. 3 to two residents who did not normally receive the medication, according to an incident report filed with the Wisconsin Department of Health Services.

The nurse manager questioned the residents, who said they had not been feeling anxious and did not receive lorazepam that day, according to the report.

Pokallus told Continental Manor staff members that she used the medication herself and said she took lorazepam from the facility on four or five other occasions.

A drug test administered Feb. 3 came back positive for lorazepam, clonazepam, oxazepam, morphine and marijuana.

Pokallus was fired after the incident.

“It was a regretful experience,” Pokallus said.

The Wisconsin Board of Nursing found Pokallus demonstrated negligence and engaged in unprofessional conduct, and her nursing license was suspended indefinitely in an order issued May 9.

Pokallus was ordered to enter a treatment program, abstain from controlled substances other than those prescribed for a medical condition and submit to periodic drug screenings.

She may apply for a stay of suspension Aug. 9. If a stay is granted, Pokallus may practice nursing under the direct supervision of a fully licensed nurse in a setting pre-approved by the Board of Nursing, and she may not have access to controlled substances.

Pokallus may petition for reinstatement of her nursing license after five years of compliance with the order.

The Wisconsin Board of Nursing has issued disciplinary orders against 23 nurses for drug-related violations so far in 2013, according to the agency’s website.

Continental Manor has implemented a new system for storing and counting controlled substances, according to the incident report.

Representatives from Continental Manor declined to comment regarding the case.


Nursing Home finances not as much problem as neglect

A few weeks back, you published a letter about financial challenges facing nursing homes. The real problem at nursing homes is the poor quality of care that families have to deal with in this state.

I gave the only 24/7 care both of my parents received for five-plus years. My dad died in 2010 and I then continued to care for my mother until April of 2012, when she finally went into a local nursing home. It was something that I would never do again considering the poor care and outright neglect she received there.

I lost count of the times they allowed her to fall. Once they actually abandoned her in the bathroom. Call buttons were thrown on the floor where she couldn’t get to them. She got no help for the whole first month regarding what on the menu she wanted to eat. They lost her hearing aid twice and dentures once, and would do nothing about a roommate who stole her belongings, and countless other matters I could list.

Then they not only have the nerve to charge almost $9,000 a month for this, they also over-bill patients and refuse to supply the family with an itemized billing so that you can see what you are paying for. (This week I filed over-billing fraud charges with the state Attorney General's office and the Postal Inspector's office for mail fraud.)

The earlier letter said the nursing homes are in financial trouble. Well they’d be in a lot more trouble if they only got paid for the actual quality of the care they gave. So, readers with a family in a nursing home – check your bill and demand it be itemized every month.

PAUL W. FAUST, Susquehanna Twp.

New York State Gets $2.5 Million in Medicaid Fraud Case


In life, Helen Sieger was the embattled owner of a Bronx nursing home.

Her employees at the Kingsbridge Heights Rehabilitation and Care Center went on strike in 2008 after she stopped paying their health insurance premiums, drawing attention from state lawmakers, labor leaders and even Barack Obama, then a senator from Illinois.

Ms. Sieger was arrested a year later on charges of bribing a hospital social worker to steer patients to her nursing home, and of improperly collecting payments from the state’s Medicaid program. She jumped bail, only to be caught in a Miami hotel and returned to New York, where she died in custody in 2011.

But now Ms. Sieger is making amends in death.

The state attorney general, Eric T. Schneiderman, said on Tuesday that his office had reached a settlement with the estate of Ms. Sieger to pay a total of $2.5 million to the state’s Medicaid program, which includes $1.2 million in reimbursements, and $1.3 million for damages.

“There are few programs as sacred and important to our most vulnerable citizens as Medicaid,” Mr. Schneiderman said in a statement. “So, when we have a case involving a criminal scheme that robs Medicaid, our prosecutors will do whatever it takes to restore those stolen funds — whether that criminal is alive or we’re forced to settle with their estate.”

Nicholas Gravante, Jr., a lawyer at Boies, Schiller & Flexner who represented Ms. Sieger’s estate, said that her family was “pleased to have this matter behind it.”

Ms. Sieger, who took over the nursing home in the mid-1990s, was removed in 2009 by the State Health Department because of an issue over the nursing home’s lease. The operation of the 400-bed nursing home, one of the largest in the Bronx, was eventually transferred to a state receiver, which still runs it today.

Also in 2009, Ms. Sieger was indicted, accused of paying Frank Rivera, a former social worker at NewYork-Presbyterian Hospital/Columbia University Medical Center, $300 for every patient that he referred who was subsequently admitted to her nursing home, plus a bonus of $1,000 for every 10 patients, according to the attorney general’s office. Beginning in 2005, he received more than $19,750 from Ms. Sieger.

Mr. Rivera pleaded guilty to felony and misdemeanor violations under a state law, and is awaiting sentencing, according to the attorney general’s office.

The attorney general’s office also said that the investigation had found that Ms. Sieger, who lived in Borough Park, Brooklyn, held several bank accounts, including one in Montana with $2 million.

Michael Benjamin, a former Bronx assemblyman, praised the settlement, calling it an appropriate way for “the state to recoup her ill-gotten gains.”

“It sends a signal that the state will not be cheated,” he said. “And that people who steal from the poor and from the elderly will be pursued whether they’re dead or alive.”

For-Profit Nursing Home Accused of Medicare Fraud

Posted in Nursing Home Violations on June 4, 2013

Yet another national, for-profit nursing home chain, Life Care, is being sued by the Justice Department over allegations of overbilling Medicare. Life Care is accused of billing nearly 68 percent of its Medicare rehabilitation days at the highest level, nearly twice the national average of 35 percent. CBS This Morning has spent months examining Life Care’s rehabilitation services and claims. It recently presented a scathing report, based in part on statements by at least a half dozen former Life Care employees.

A former assistant manager speech therapist at multiple Life Care locations told CBS This Morning that she eventually quit the facility because she felt that its insistence on unnecessary rehabilitation services was detrimental to the health of the nursing home residents. By the time she left, she said, nearly 40 percent of her work was neither reasonable nor necessary. In addition, she said, in many cases the nursing home would simply refuse to let patients leave, because they wanted to continue to bill Medicare for services!

In another piece of evidence, the entire rehab staff at the Life Care Center of Estero in Florida signed a letter to the boss which read, in part, “we have been encouraged to maximize reimbursement even when clinically inappropriate…”

There are six Life Care Centers in Kentucky: Laurel Creek Health Care Center, in Manchester; Life Care Center of Bardstown, in Bardstown; Life Care Center of La Center, in La Center; Life Care Center of Morehead, in Morehead; Mountain View Health Care Center in Elkhorn City and Parkview Nursing and Rehabilitation Center in Paducah. According to the CMS website, Life Care Center of Bardstown and Parkview Nursing and Rehabilitation each had three stars on their latest inspection report – that’s average. Life Care Center of La Center and Life Care Center of Moreshead both had two stars – below average. And Laurel Creek Health Care Center and Mountain View Health Care Center both received only a single star and are rated as much below average.

In general, studies show that for-profit nursing homes provide fewer staffing hours and a lower quality of care than nonprofit or government-run nursing homes.

Unfortunately, Life Care Centers is not the only nursing home chain being suspected of overbilling Medicare. The most recent report from the U.S. Department of Health and Human Services inspector general found that industry-wide, a quarter of all Medicare payments to nursing homes are made in error. When nursing homes charge for services they don’t provide, they increase the cost of Medicare and Medicaid to the taxpayer. These programs are already overextended. Fraud puts them in even more jeopardy. Equally seriously, if nursing home residents are given services they don’t need, it can make them uncomfortable, confused or disoriented. It can even endanger their health. The patients’ records are also likely to be inaccurate, which may cause doctors to misdiagnose them later.

Nursing homes have an obligation to provide responsible care to patients who need it – and not offer unnecessary services to patients simply so that they can charge more money. Keeping seniors in a nursing home when they are ready to be discharged simply to get more funds out of Medicare is unconscionable.

Winter Haven Nursing Home Aide Is Charged in Tax Return Fraud Case

Portia Charlton.

By Matthew Pleasant

Published: Sunday, May 26, 2013 at 11:28 p.m.

Last Modified: Sunday, May 26, 2013 at 11:28 p.m.

WINTER HAVEN | Deputies jailed a 23-year-old woman Friday who is accused of using the personal information of 13 nursing home residents to file fraudulent income tax returns.

Portia Charlton, a nursing assistant, was arrested during a traffic stop in Bartow. She remained jailed Sunday without bond.

Charlton formerly worked for Palm Garden of Winter Haven, where the victims lived, her arrest report says. She stopped coming to work in March 2012, two days after deputies searched her home at 3870 Horizon View Loop in Lakeland and found a notebook listing the names, birth dates and Social Security numbers of more than 100 people.

Dollar figures were written next to each name, indicating how much was obtained using the person's information, an arrest report said.

The arrest report said Charl­ton led the Internal Revenue Service to lose about $69,000.

Charlton became a suspect in the crime following a larger Sheriff's Office investigation into tax fraud in 2012. Her charges include scheming to defraud, aggravated white-collar crime and grand theft.

Deputies are still searching for her father, Norman Vince Charlton, 49.

He is wanted on federal charges of aggravated identity theft, theft of government property and conspiracy. Deputies believe he's in the South Florida area.

[ Matthew Pleasant can be reached at 863-802-7590. ]

Two Nursing Home Executives Charged With Medicaid Fraud

(Your time is coming Yuba, be prepared for the next audit)


GAINESVILLE - An 80-year-old woman and her daughter face charges of defrauding Medicaid of more than $2 million. Prosecutors say the two nursing home executives used Medicaid checks to pay off personal expenses.

Maxcine Darville and her daughter, Joanne Carter, were arrested Monday, after the state attorney general issued a warrant for their arrest. Darville is currently the CEO of a nursing home company called "Council on Aging of Florida," which manages four facilities across the state, including one in Gainesville. We're told Carter served as the non-profit's "assistant-CEO".

According to the state attorney general's office, both Darville and Carter used their positions to defraud the Medicaid system out of $2.75 million over a period of six years. They then used that money to pay off personal expenses, including a cable and internet bill at a home Darville claims was used for employees.

Both Darville and Carter were released from jail on a $50,000 bond. Darville's attorney says his client and her daughter deny any wrongdoing, and both intend to fight the charges until their names are cleared.



California Armenian Home, $1 million Medicaid fraud

approximately 85% of the California Armenian Home's $14 millions is from California State Medicaid (MediCAL)  otherwise most average people cannot afford the $70,000 a year for the human warehouse.  The rest is largely Medicare (only for 90 days-after injury for rehab) private pay and donations.  Donations from Armenians account for about 7%, at one time it was 85%. 
Lets stop Yuba from exploiting the word "Armenian" in the sign for financial gain.  As we all know, there is nothing "Armenian" about the California Armenian Home anymore except the name.   Sell the home, change the name to the parent name of California Home for the Aged. 
Richard C. Cooke of Lake View, S.C., has pled guilty in Richland County General Sessions Court to six indictments arising from his fraudulent activity in the operation of six nursing homes, including Azalea Woods in Aiken.

Cooke, 53, pled guilty to two indictments charging him with forgery, a felony, and four indictments charging him with medical assistance provider fraud, a misdemeanor, according to S.C. Attorney General Alan Wilson.

The charges arose from fraudulent cost reports Cooke submitted to the South Carolina Medicaid program. Cooke, a resident of Dillon County, was a key figure in Cooke Management Company, Inc. of Lake View, which operated the six nursing homes. They are located in Aiken, Bishopville, Fork, Florence, Kingstree and Fountain Inn.

Under South Carolina Medicaid regulations, nursing homes are required to submit annual operational cost reports for their facility. The Medicaid program pays the nursing home based on that and on the number of Medicaid residents. From 2009 through 2011, the six nursing homes were overpaid a total of $1,020,818.34 as a result of the fraudulent items listed on cost reports submitted to the Medicaid program, according to the Attorney General's office.

Under the terms of a plea agreement, Cooke was required to plead guilty to the charges, to make restitution of $1,020,818.38 to the South Carolina Medicaid program, to be excluded from the Medicaid program for life, and to cooperate with the ongoing investigation by the Attorney General's office.
Cooke was sentenced by the Honorable L. Casey Manning, circuit judge, to 10 years on the two forgery indictments to run concurrently, suspended to five years probation. Probation conditions include house arrest for one year and 500 hours of community service, plus full restitution. On the four Medicaid fraud counts, Cooke was sentenced to three years on each to run concurrently, all suspended. He presented two checks totaling $500,000 toward his restitution.

Friday, July 5, 2013

California Armenian Home, California Nursing homes recieved additional $880 million in funding but continue to cut staff and withhold raises.

California’s nursing homes have received $880 million in additional funding from a 2004 state law designed to help hire more caregivers and boost wages.
But 232 homes did just the opposite. They either cut staff, paid lower wages or let caregiver levels slip below a state-mandated minimum, a California Watch investigation has found.
The homes that made these cuts collected about $236 million through 2008, the last year of available data. That's more than a quarter of the total Medi-Cal funding increase shared by the state’s nursing homes. But the law that made the extra money possible included few safeguards to ensure that patient care improved.
Many nursing homes appeared to use the cash infusion to help bolster their bottom lines, according to a California Watch analysis of state nursing home data. Among the 131 homes that cut staff by 2008, the median profit was 35 percent more than other homes in the analysis.
Graphic by The OC Register
At the same time, the analysis shows, about two dozen homes that made the deepest caregiver cuts had about one-third more deficiencies than other state facilities. State inspectors noted a litany of violations that included neglecting bedsores and giving patients the wrong drugs.
“There was an implicit good faith agreement that things would get better … and that was broken,” said state Sen. Elaine Alquist, D-Santa Clara, chairwoman of the Senate Health Committee. “It was broken for the people of California and for a very vulnerable population – those that need the greatest care and those that can’t advocate for themselves.”
James Gomez, the chief executive of the state’s nursing home trade organization, said the 2004 law has led to a 6 percent increase in staffing rates for the state’s 1,100 nursing homes and an overall decline in turnover among caregivers – from 54 percent to 47 percent. California’s homes now exceed the national average for meeting the staffing minimum, Gomez added.
“Is it working in every facility every day? No," said Gomez, leader of the California Association of Health Facilities. “But is it working in total? Absolutely.”
Of the homes that cut staffing, 13 owned by Orange County-based Covenant Care stand out. The homes pared caregivers even as they got $15 million in additional funding.
The average profit at those 13 homes reached more than $900,000 in 2008 – three times higher than the remaining 632 homes analyzed by California Watch.
The chain’s chief operating officer testified last year in a deposition that part of the company’s business plan called for housing more medically fragile patients. The strategy opens the door to higher reimbursements, according to critics, who say it can be dangerous to combine lower staffing rates with patients who need more attention.
Patients such as Charles McGrew.
The Texas-born janitor was admitted to the chain’s Long Beach home, Royal Care Center, in early 2006.
McGrew, a diabetic with high blood pressure and a history of infections, began to develop pressure sores on his ankles and tailbone at the home. But little was done to help him, according to court records filed by his family.
Meredith McGrew, 24, said one sore was like a hole in his father’s back. Seeing it pained the younger McGrew, who remembers his father as a meticulously neat man.
“My family took it really hard,” McGrew said. “My father was the one who looked out for a lot of them and raised them, so they were devastated by the care he was getting.”
McGrew’s left leg needed to be amputated due to one sore, the family alleged. He died three years ago at age 70. His family blamed his death on mistreatment. Attorneys for Covenant said the family failed to prove that the facility caused McGrew’s problems. The case was settled and the terms are confidential.
Since his death, the home’s staffing level sank below the state-mandated staffing minimum set in 2000. Royal Care’s total profits, though, reached $540,000 in 2008 alone.
The Covenant Care chain, meanwhile, rewarded top administrators and nursing supervisors with bonuses based, in part, on how much profit each home generated, records show. Around the same time, a family trust associated with the company’s CEO Robert Levin paid $4.76 million to purchase an Irvine estate, complete with a theater and outdoor living room.
Levin would not comment about funding and staffing levels for this story. He asked in January for questions to be sent to him in writing, but he did not respond to the written questions or several follow-up phone calls. When finally reached by a reporter late last month, Levin again declined to comment.
The funding increases for nursing homes were made possible by the 2004 law that helped the state draw more money out of Washington, D.C., gradually boosting government spending from $3 billion in 2004 to nearly $4 billion in 2008.
The infusion of state and federal money has done nothing to slow the pace of violations and complaints.
State regulators documented nearly 1,000 deficiencies for inadequate care in 2008, a 65 percent increase compared to 2005.
Regulators maintain that the state hired more inspectors, which may account for the increase. But that doesn’t explain the 23 percent rise in complaints filed by patients, advocates or their families.
In 2004, before the law was enacted, nursing homes registered 4,499 complaints. In 2008, patients, their loved ones and advocates filed 5,549 complaints.
Despite mounting complaints and citations, state officials in charge of carrying out the new law granted nursing homes a powerful weapon to fight claims of inadequate care: more money.
They allowed homes to bill the state for legal costs spent to fight fines, citations and lawsuits alleging abuse and neglect.
“The policy is outrageous,” said Michael Connors, an advocate with California Advocates for Nursing Home Reform. “By paying the legal fees of nursing homes that are neglecting and abusing residents, the state is subsidizing their mistreatment. They’re directly undermining the whole purpose of the citation and enforcement system.”
Intended reform marred by lack of oversight
The Nursing Home Quality Care Act of 2004 was designed to fix a glaring problem: Daily Medi-Cal rates paid to nursing homes in California were among the lowest in the nation.
An alliance of labor leaders and nursing home owners came up with a plan that wiped out a flat-fee system and replaced it with one that reimbursed nursing homes based on their costs.
The system allowed nursing homes to boost the amount of matching funds they got from the federal government. The homes first pay a fee to trigger the matching funds and additional revenues.
Not all homes benefited as much as others. Some homes even lost money, especially ones that serve fewer Medi-Cal patients. But most of the state’s homes analyzed by California Watch drew a windfall of new money.
Homes could spend the new money on a variety of services. But reimbursement rates increased if they spent the money on labor. Homes also got additional bonuses meant to boost hiring and wages.
Patient advocacy groups cried foul over the added payment, noting the nursing homes could ultimately spend it any way they wanted. And some advocates bristled over the lack of get-tough measures in the proposal. The California AARP ran full-page newspaper ads that said, “No blank check for bad nursing homes.”
Still, the bill flew through the Legislature. When Gov. Arnold Schwarzenegger signed it, he directed the Department of Health Services to “reward quality care.”
“We are making this investment in nursing facilities to ensure better care, and I intend to hold the industry and caregivers accountable for this critical responsibility,” Schwarzenegger’s 2004 signing statement said.
Despite the governor’s directive, the Schwarzenegger administration failed to follow through.
Instead, California Watch found, state regulators lavished new money on homes where findings of lax care mounted, where administrators failed to pay fines for poor care, and where corporate executives cut staff in California and expanded chains elsewhere.
The governor’s office declined to comment for this story, referring questions instead to agency officials.
Toby Douglas, chief deputy director for health care programs at the Department of Health Care Services, said that most of the state’s nursing homes have invested more heavily in caregivers. His office repeatedly attempted to route questions about nursing home accountability to another state agency that inspects the homes.
While Douglas’ agency sets rates and reimburses nursing homes, a second agency, the Department of Public Health, issues and collects fines for substandard care. Even if one agency cites a home for egregious and repeated violations, the other agency may reward it with more funding.
“Our responsibility is to develop a rate method that tries to meet the goals the governor laid out in his signing message,” Douglas said. “That means we have to set a methodology and hold that methodology accountable. In that area, yes, we believe we’re doing a good job.”
Douglas said the governor’s office has “made it clear that [the funding law] could be improved” by linking nursing home pay to factors such as patient satisfaction, reduction of bed sores or payment of fines for inadequate care. His department is in the “very preliminary” stages of creating such a system, Douglas said.
The effort comes too late, though, according to some advocates. They question whether the state missed a rare opportunity to use the funds to drive systemic improvement.
“Money talks, we know that,” said Molly Davies, director of the nonprofit Wise & Healthy Aging, the Los Angeles elder care ombudsman program. “If you’re going to give extra money, there needs to be an understanding of what the state is going to get in return and what those clients are going to get in return. I don’t think that was made clear.”
The revenue increases to nursing homes were not renewed last year due to opposition from patient advocates, but nursing home executives have been pushing to restore the funding. Alquist, the state senator who heads the health committee, says the law will be scrutinized during a scheduled legislative review this year.
Staffing lags, patients suffer
The Golden State has about 1,100 licensed nursing homes that each year care for an estimated 100,000 people – including the elderly, disabled and those recovering from surgery.
Patricia Miller and her three sisters are suing a home owned by Covenant Care for allegedly not giving their father adequate care.Cindy Yamanaka, The Orange County RegisterPatricia Miller and her three sisters are suing
a home owned by Covenant Care alleging that
the home failed to administer adequate care
to their father.
California Watch reviewed financial and staffing data for the 645 nursing homes, that serve the largest number of low-income Medi-Cal patients who need 24-hour care. The 2004 law was set up to benefit these homes the most.
Of that group, 232 homes either cut staffing or wages or fell below the statewide staffing minimum – even as they received more money from Medi-Cal. The analysis found that 27 other homes fell behind in wages and staffing but saw a reduction in funding.
Since the legislation was enacted, the California Department of Health Care Services gave the 645 homes analyzed by California Watch a total funding increase of nearly 25 percent over five years.
But the lowest-paid workers who perform the vast majority of the patient care in nursing homes did not see that kind of raise. Only 76 homes in the state gave nursing assistants a 25 percent pay increase. Adjusting for inflation, average wages in more than 400 homes went down, the California Watch analysis shows.
In 2008, dozens of homes also operated beneath the decade-old staffing standard – which is set at three hours and 12 minutes of caregiver attention a day for every nursing home patient.
In the homes where staffing lagged, some patients suffered.
Staffing at Cloverdale Healthcare Center in Sonoma County was down 8 percent in 2008 compared to 2004, despite the home’s $1 million increase in state funds. Regulators found problems there in the beginning of 2009, including one patient who had been left wearing a dirty diaper for five hours.
Cloverdale officials did not return calls seeking comment.
Gomez, of the California Association of Health Facilities, said the state should aggressively investigate the homes that operated in 2008 with staffing levels below the state standard.
“I don’t have an issue with them looking at those facilities today,” Gomez said of the 68 homes below the nursing-hour minimum. “That would be the right thing to do.”
The state, however, has not issued staffing-related fines to any of the homes that failed throughout 2008 to reach the minimum staffing level, records show.
Wages rise, but problems persist
Applewood Care Center, a small nursing home in Sacramento, collected an additional $575,000 between 2004 and 2008. But during that same time, Applewood’s ratio of staff to patients dropped 10 percent.
As the money started to flow, Applewood got hit with two serious citations – the first time as a result of lapses in care in the case of Earley Woods.
The 84-year-old grandmother had slipped away into the dark undetected, state regulators concluded. She steered her wheelchair out the backdoor of the nursing home at night, accidentally crashing down a 54-inch flight of concrete stairs in September 2005. Her skull was smashed, her collarbone broken, her wrist was fractured.
About a half-hour passed before Woods was discovered still strapped to her chair which lay atop her. She was taken to the hospital.
Her daughter, Elaine Parham, had just minutes to absorb the shock of seeing her mother, bloody and bruised, before saying her final goodbye.
“This really can’t happen to anyone else,” Parham said in an interview.
Terry Bane, the chief executive of the management company that operates Applewood, said Woods’ death was a “tragic, tragic incident.”
“It … affected the employees in that building in a big way,” Bane said.
Applewood was fined $100,000 after Woods died. The facility pledged to upgrade alarms on doors and improve lighting around the building. It also gave pay increases to nurses, which helped lower the staff turnover rate.
But problems persisted.
In late 2006, one patient was taken to the emergency room for dehydration. Eleven days later, the same 89-year-old woman was sent back to the hospital with “very severe dehydration,” a citation report says.
Several months later, state regulators concluded that the facility did not try hard enough to save a man who died of asphyxiation after food got lodged in his airway.
Regulators cited Applewood $20,000 in the dehydration case and $100,000 for causing the man’s death.
State pays to overturn its own fines
When homes are cited with serious violations, the 2004 state law helps bail them out.
Homes are allowed to bill for administrative costs such as legal fees. That means facilities can charge the state to fight state-issued fines and citations for substandard care.
Advocates say that by doing so, the state undercuts its own efforts to hold homes accountable for lax practices.
“It’s absolutely scandalous that this goes on,” said Tippy Irwin, executive director of Ombudsman Services of San Mateo County. “That’s a gross misuse of state spending.”
State officials also pay legal fees for homes that fight audit findings they oppose. Officials could not identify exactly how much they spent reimbursing nursing homes to fight audit disputes or penalties.
But records show that since the 2004 law passed, nursing homes are challenging twice as many citations. Homes challenged 110 citations in 2005 and more than 220 in 2008, records provided by the Department of Public Health show.
“In this fiscal environment, where the state has no money and all of this is coming out of the taxpayers’ pocket, yours and mine and everyone else’s this is really unconscionable,” said Alquist, the state senator.
Gary Davis is still angry at the owner of the nursing home where his stepfather, Harold Schreifels, died.David GrossGary Davis is angry that the nursing home where
his stepfather, Harold Shreifels, died was able
to use state funding to fight a citation for
Schreifels' death.
The arrangement worked in the favor of a small nursing home in San Jose. The owner of Homewood Care Center used state funds to appeal a $100,000 citation issued by state regulators who, in a settlement, agreed to reduce the fine to $5,000.
The citation was issued in response to the events of Oct. 17, 2006. That morning, Harold Schreifels, 67, cried out for help and asked for an ambulance, records show. Staff noted that the diabetic man’s blood sugar was dangerously low.
Yet they ignored their policy to notify a doctor about his condition and dismissed his plea, enforcing a 15-hour fast before a routine surgery.
Schreifels, who enjoyed daily visits from his wife and outings to his grandchildren’s sporting events, never made it. He died an hour before he was to meet his family at the hospital.
“Harold, he had plenty of life in him,” said his stepson, Gary Davis. “If he hadn’t been getting surgery that day he had probably wanted to go see a ball game.”
State regulators cited and fined the home for missing multiple chances to call a doctor or to help Schreifels.
The home’s owner, Jack Easterday, acknowledged in an interview with California Watch that Schreifel’s death might have been avoided if the staff had used an IV to give the man nutrients in the hours before his death.
A mediator discounted the fine $95,000 even though no one disputed that Schreifels’ death could have been prevented.
The state helped pay his legal fees, Easterday said, but he described the state’s contribution as “miniscule.” The state was unable to determine the amount it paid.
Easterday spoke with California Watch at his Oakland office in January, one week before he went to federal prison to serve a 30-month sentence for tax evasion. He was convicted in 2007 of failing to pay the IRS payroll taxes for his eight nursing homes but remained free until he exhausted his appeals, which were ultimately rejected by the U.S. Supreme Court.
Davis, whose family did not file a lawsuit over his stepfather’s death, said he could not believe that the state stood by the reduced fine.
“The government should be … corrected for their mistakes also,” he said. “They’re accountable for their actions, you know?”