More Profit and Less Nursing at Many Homes

[Pirate Smile]

Source: New York Times

Habana Health Care Center, a 150-bed nursing home in Tampa, Fla., was struggling when a group of large private investment firms purchased it and 48 other nursing homes in 2002.

The facility’s managers quickly cut costs. Within months, the number of clinical registered nurses at the home was half what it had been a year earlier, records collected by the Centers for Medicare and Medicaid Services indicate. Budgets for nursing supplies, resident activities and other services also fell, according to Florida’s Agency for Health Care Administration.

The investors and operators were soon earning millions of dollars a year from their 49 homes.
Residents fared less well. Over three years, 15 at Habana died from what their families contend was negligent care in lawsuits filed in state court. Regulators repeatedly warned the home that staff levels were below mandatory minimums. When regulators visited, they found malfunctioning fire doors, unhygienic kitchens and a resident using a leg brace that was broken.

“They’ve created a hellhole,” said Vivian Hewitt, who sued Habana in 2004 when her mother died after a large bedsore became infected by feces.



Read more: http://www.nytimes.com/2007/09/23/business/23nursing.html?hp

[PDJane]

1. And yet another reason to condemn outsourcing.

This is insane.

[Traveling_Home]

4. No this isn't insane ....

this is ROUTINE!

Damn shame folks seem to just be hearing about it now

Support the Community Choice Act - OUR HOMES NOT NURSING HOMES - Support ADAPT

[Warpy]

2. And Florida is one of the GOOD states

where health care workers have to be trained and licensed and care ratios are spelled out.

[Traveling_Home]

3. OUR HOMES NOT NURSING HOMES

Tell your Senators to Support the Community Choice Act (S. 799) - more co-sponsors needed

Support the Community Choice Act - Our Homes Not Nursing Homes - Support ADAPT
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=250x2966

120 Arrested in st the AFSCE Offices in Chicago - Demonstrations Supporting the Community Choice Act
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=250x2949

Support ADAPT - Give them a DU shoutout ([e-mail])
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=250x2966



(on edit changed title to more dramatic one)

[pattmarty]

5. Yeah, let's just go ahead and get rid of all fucking regulation.

[Traveling_Home]

8. Nah - lets just .....

spend the money to provide services to folks in places besides Nursing Homes - right now there is a built in institutional bias in the Medicaid programs (requiring nursing homes inclusions in State plans; not requiring community based alternatives in them) that must be ended

some more examples of regulated institutional problems

http://www.stevegoldada.com/stevegoldada/archive.php?mode=A&id=220;&sort=D

In 2005, 19.7% of all nursing home residents had psychiatric conditions, such
as schizophrenia and mood disorders. This is a substantial increase from
1999 when 13.8% of all nursing home residents had psychiatric conditions. These
percentages do not include persons who have dementia.


"In 2005, 63.9% of all nursing home residents received psychoactive drugs, up
from 50.3% in 1999. Nursing homes are places that appear to freely administer
such drugs.

We surmise the reasons for such widespread use of psychoactive drugs are not
mental illness, but "behavioral control." People doped up are easier for
nursing facility staffs to control. Widespread use of sedatives causes lots of
residents to just sit around the nursing facility and appear "out of it,"
whether or not without the drugs they would be more active and responsive."

Just standard - Nursing Homes are not good care alternatives for anyone - they are not places where elders are cared for when they need extra help. Theya re - by and large - barbaric - even the best ones.

Support the Community Choice Act (S 799)

If your Senator or Representative is not on the following list, call and ask them to sign onto the Community Choice Act. Visit http://www.senate.gov/ and http://www.house.gov/ to determine your Members of Congress.

Senators who signed onto Community Choice Act (S.799) as of July 23, 2007:

Barack Obama , Joseph Biden , Sherrod Brown , Robert Casey , Hillary Rodham Clinton , Christopher Dodd , Richard Durbin , Tom Harkin , Daniel Inouye , Edward Kennedy , Frank Lautenberg , Joseph Lieberman , Ken Salazar , Bernard Sanders , Charles Schumer , and Arlen Specter .

Representatives who signed onto H.R. 1621:

Rob Bishop , Jo Bonner , Nancy Boyda , Steve Cohen , Joe Courtney , Danny Davis , Diana DeGette , Rosa DeLauro , Lloyd Doggett , Luis Gutierrez , John Larson , Gwen Moore , Christopher Murphy , Donald Payne , Janice Schakowsky , John Shimkus , Christopher Smith , Mark Udall , Peter Visclosky , James Walsh , and Jerry Weller .


CAll your CVongress Folk and get them to support CCA.

Support Adadpt - give them a DU shoutout - [e-mail] ;-)

[mantis49]

18. FYI

The term "psychoactive drugs" includes anti-depressants. The Feds obtain this data from a required assessment performed at any homes that take Medicaid and/or Medicare patients. Psychoactive drugs are: anti-depressants, anti-psychotics and anti-anxiety medications. So, in my opinion, the blurb you quote here is highly misleading in light of the fact that depression is woefully under-treated in the elderly.

[Skittles]

14. hmmmm....your conclusion is black and white and erroneous

like something we would see on FOX NEWS

[angrycarpenter]

6. corporate nursing homes

In the for profit nursing industry there is a constant battle between the administration of the home and the corporate bosses. The main issue is just how long do you want these people to live? Most nursing homes have a large percentage of medicaid patients who are only profitable if their medical needs are modest. Corporate knows that the better and more comprehensive the care is the longer patients will live in the later unprofitable phase where they need extensive medical care.

For the most part I do not blame the individual nurses for neglect. They work much too hard taking care of too many patients and the burn-out factor is ever present. The system they work in is always trying to get more work for less and nurses are nearly always overworked and have very long hours.

The saying "One bad apple can spoil the whole barrel" is so true in the nursing home. A single nurses aide not doing her job can make a whole hallway go bad.

But the main culprit is an administrator that is not willing or able to go to war with corporate over how things are run. If they can cut budgets without complaint they will always do it. A nursing home administrator needs to be tough as nails and stubborn as a mule and genuinely care for the patients under their care. One that rolls over to corporate pressure for greater profits will turn a nursing home into a dismal dungeon rather than a safe and clean place for people to live the remainder of their lives.

[Traveling_Home]

9. I was a social worker in NH also ...

for profit - nonprofit - makes no difference.

Bad care is endemic to the institutional settings - makes no difference who operates or who works there.

Support the Community Choice Act (s.799) - Support Adapt - Send them a DU shoutout ([e-mail])

[angrycarpenter]

10. I was not defending them as good

Nursing homes are basically parking lots. It is where you are sent to await death. And as such they are not trying to make you live forever.

The focus by state regulators is really on clean and safe rather than happy and vital. It is no place I ever intend to end up.

With my post I was drawing on conversations had with my mother who has worked as A charge nurse and later director of nurses and who is in her 45th year as an exceptional nurse. I was presenting what I believe is the root cause of neglect.

I am not familiar with the organization in your post but I will look at them with interest. If they have a better way I am all for it.

[Traveling_Home]

11. Look in the Disability Forum....

Lots about ADAPT's actions and about the Community Choice Act.

I hated NH administrators too - just didn't matter whether they were at for profit or nonprofit Nursing Homes. But then I think most nonprofits in the disability services field are useless - so don't mind me ;-)

They aren't responsive to their 'customers/clients' since they get money from a third party (Grants from Feds, State, and Foundations) and the third party pays for units of services delivered not for outcomes achieved. (Trying to find someone a job - not whether they succeed in finding someone a job).

Did you know not a single Cerebral Palsy Center in the Country has an Executive Director that has CP (at least as a few years ago)? Kind of like me (a 57 yr old white male) being the Director of NOW.

Some things just don't make sense.

No offense meant ;-)

[pop goes the weasel]

17. there are young people sentenced there, too

Young adults with severe disabilities requiring nursing care are routinely sentenced for life to these hell holes. Everyone needs to understand that they are just one bad automobile accident away from nursing home incarceration. I'm with Traveling Home. Support the Community Choice Act!

[aquaman]

7. Having worked in a nursing home.....

as a social worker. I will sell my soul before any of my family goes to one.

[NoGodsNoMasters]

12. The Evils of Privatization

All we hear from the right is how streamlined and efficient and wonderful privatization is. i might give them the first two. Time and time again, look at blackwater, walter-reed, and our current health care situation, it's mind-boggling anybody falls for this argument anymore.

[Froward69]

13. Nursing home/Hospice care is a racket.

In an old but small county here in my state, a very conservative republican county. It Routinely railroads elderly persons into nursing homes then into Hospice care. Confiscating their homes and other property across the state/country. Decimating their estates. leaving Family to foot the bill when the estate runs out. As my state recognizes a Will as an absolute document. It is the only thing that can save a family financially once they target your elderly parent. The social worker starts the process and after the investigation determines what they can get away with they proceed. only after I produced his Will and they tried to have it thrown out, Did I regain some control over the well being of my father. Knowing the law helped daring the judge to come to the state review board did more. The whole ordeal finally broke my father. hitler couldn't but rampaging republican corporate fuckers did. He passed away a year later. never was the same at all. The last I heard, The
Social worker was fired for "not researching her clients thoroughly enough". :grr: :mad: :puke: :cry:

[mcg]

20. A nursing home hastened my father's death.

He was having a hard time eating, I wanted them to come by more frequently so that he would eat more. The nurse said that the staff didn't "have the luxury" of doing that.

I don't think they helped him "go", they just put a diaper on him and cleaned up afterwards.

The bathroom stank when I first visited there.

He had cuts on his hand and arm that they didn't do anything about. I had to point them out and make them treat the cuts.

He developed bad bed sores. I don't think they were turning him like they were supposed to.

When he was crying out "I can't breath" (he was developing aspiration pneumonia) they IGNORED HIM. Here he was DYING, and they IGNORED HIM! Only when my mother got there to visit that day and she confronted them did they do anything. They asked her "What do you want us to do about it?". She said call an ambulance. He died two days later in the hospital. The death certificate listed sepsis (maybe from an infected bed sore?).

This nursing home charges $7,000 a month.

I wish I had known how bad nursing homes are before this happened.

[Vinca]

15. Money trumps all. Even Grandma. nt

[brer cat]

16. If there is money to be made you can be sure the BFEE

is in. Another quote from the NYT article:

"Those investors include prominent private equity firms like Warburg Pincus and the Carlyle Group, better known for buying companies like Dunkin’ Donuts."

Why am I NOT surprised.

[mcg]

21. Nixon and co. also had a hand in this profiting on death.

see this post of mine, it has a transcript of a conversation between Ehrlichmann and Nixon about HMOs and a link to an excerpt from Sicko with that conversation.
http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=103&topic_id=294353&mesg_id=294406

Ehrlichmann:
"... the less care they give them, the more money they make"

Nixon:
"Fine."

[krkaufman]

19. I'm sure the investors followed the Ford Pinto approach...

... any liability lawsuit expenses would be offset by their profits.

Jack McCoy needs to jump in, and go after some of these operators for criminally negligent homicide.