Pennsylvania Nursing Home Abuse Attorney Blog

According to a recent Washington Post article, the U.S. Department of Health and Human Services is investigating rampant fraud and abuse in Medicare billing for "high-end services" at nursing homes. The Justice Department said nursing homes have been categorizing patients inappropriately in billing forms in order to receive higher payments from Medicare for "services not rendered, and ... worthless services." This article caught my eye because it's yet another example of the wrongdoing that nursing homes and their staffs can get up to right in front of patients who are unable to clearly object or tell an outsider. As a Pennsylvania nursing home abuse attorney, I wonder whether nursing homes that try to make higher profits by overbilling Medicare are also more likely to try to generate profits by overmedicating or financially abusing patients.

The article alleges that nursing homes have been categorizing many more of their patients in "ultra-high" Medicare billing categories than can be justified by those patients' medical records. Medicare has annually paid out up to $542 million more than it should have for services for these patients. The recently enacted health care reform legislation changed the rules to combat this problem, which is considered part of the "waste, fraud and abuse" that both parties oppose. Certain nursing home chains have been singled out as especially egregious offenders, including HCR ManorCare, which operates in cities throughout Pennsylvania.

The article does not specify the kinds of unperformed services for which nursing homes charged Medicare. But with the recent settlements for pharmaceutical company kickbacks to nursing homes for overmedicating patients for profit, as a Philadelphia nursing home negligence lawyer, it seems fair to wonder whether a nursing home that cheats in one way isn't dishonest in other ways too. I am glad that the Department of Health and Human Services is thoroughly investigating these patterns of fraud and putting nursing homes on notice that increasing profits through fraudulent claims is unacceptable. Hopefully, the increased scrutiny will encourage nursing homes to be more conscientious in all aspects of their work.

Continue reading "Pennsylvania Families Should Beware of 'Worthless Services' in Nursing Homes" »

A former nursing home business office manager in California has been charged with kidnapping an 85-year-old Alzheimer's disease patient from her Berkeley nursing home. According to the San Francisco Gate, Concepcion "Connie" Pinco Giron, 51, stole more than $50,000 from six elderly patients of the Elmwood Nursing and Rehabilitation Center, including the one she kidnapped. California state Attorney General Jerry Brown said, "This is a shocking case of nursing-home abuse and a gross violation of trust." As a Pennsylvania nursing home abuse lawyer, I urge nursing home patients and their families to watch their finances as carefully as they can.

Giron's schemes involved opening bank accounts at Citibank in the patients' names, according to the Department of Justice. Then she transferred their money into her own account, wrote herself checks from their accounts, and used their ATM cards. She also allegedly stole money from their trust accounts at the nursing home. Giron also told one patient's son that he had to pay an extra $600 per month for his mother's care, and then kept the money for herself, over the course of 18 months. And in August 2008, Giron claimed that one of the patients would be transferring to another facility, but in fact kidnapped the patient and moved her into Giron's own home. Then Giron cashed the patient's pension and Social Security checks.

In August 2009, the state attorney general's Bureau of Medi-Cal Fraud and Elder Abuse began investigating Giron in response to a complaint about her. That month, investigators found the kidnapping victim, 85-year-old Carnell Williams, in Giron's home, physically unharmed. Giron has been charged in Alameda County with kidnapping to commit another crime, false imprisonment, elder abuse and six counts of theft from elder or dependent adults by a caretaker. She is being held at the Santa Rita Jail in Dublin in lieu of $365,000 bail.

A dependent, elderly nursing home resident should not have to fear that his or her lifetime's worth of savings will be stolen by his or her caretakers, and thankfully many nursing home employees are honest. Nevertheless, financial exploitation of the elderly is all too common. Patients and their families should track their bank accounts and be alert to any unusual activity.

Continue reading "Pennsylvania Families Should Take Note of Financial Abuse Schemes in Nursing Homes" »

When residents enter nursing homes, they are almost always asked to sign contracts. These contracts specify all of the obligations the home has to the resident and his or her family, as well as the family's obligation to the home. Our Philadelphia nursing home negligence attorneys recommend reading any contract carefully, of course. But in particular, we advise families to watch nursing home contracts carefully for a provision requiring something called binding arbitration. Binding arbitration removes families' ability to sue in the event of any abuse, neglect or other wrongdoing at the home.

Binding arbitration is essentially private judging. Rather than going to a courthouse and explaining your case to a jury and judge, you and the nursing home would hire a private arbitrator (sometimes a retired judge) to hear the case and make a decision. Companies say it's faster than going to court, and sometimes cheaper. However, binding arbitration has come under criticism in the past few years after statistics showed that arbitrators decide in favor of the companies in an unusually high proportion of cases. Overwhelmingly, the companies are also the ones that pay the arbitrators' bills. The resulting public outcry has led to two bills in Congress to ban the practice -- including one that applies specifically to nursing homes.

In nursing homes, there are two major problems with binding arbitration. At worst, families' cases are decided by someone who was bought and paid for by the nursing home company. Because their contracts specify that the arbitrator's decision is final, families can rarely appeal to a state court. This denies justice in that one case. However, there's also a larger problem of "moral hazard." Binding arbitration with a friendly arbitrator allows nursing home companies to escape accountability for their actions. In essence, that means nursing homes have no incentive to cover up unsafe and illegal conditions -- placing more residents at risk.

Consumers often don't realize binding arbitration is buried in contracts until after they sign. Some states have thrown these contracts out of court, but Pennsylvania is not currently one of them. That means Pennsylvania families should look for binding arbitration clauses anytime they're ready to place a loved one in a nursing home. If they find one and prefer not to agree to it, they can and should ask the nursing home to change or remove it. Families who have already signed a binding arbitration contract should not give up, however. You can and should have a Philadelphia nursing home abuse attorney represent you in arbitration hearings, as well as in any court case necessary to fight the arbitration clause.

Continue reading "Beware of Binding Arbitration in Pennsylvania Nursing Home Contracts" »

Nursing home abuse makes headlines, and it's a serious problem that homes and residents' families should be watching for. But as Philadelphia nursing home neglect attorneys, we find that theft and financial exploitation may be even more common in nursing homes. Theft in nursing homes can be straightforward -- an employee, another resident or a visitor may simply take money and valuables out of the patient's room, or sometimes even from his or her person. It can also be subtle and sneaky, with the thief using threats, intimidation, medication, medical conditions or deception to get valuables.

In some ways, nursing home residents make good targets for theft. Older people tend to have more savings and if they own a home, it's probably paid off. People in nursing homes are also there because they have problems living independently, making them dependent on others. Unscrupulous people can take advantage of incapacitating health conditions to steal things outright, and depend on the resident's inability to communicate clearly to keep them out of trouble. In other cases, thieves may coerce, threaten or deceive patients into giving things away or signing away rights to valuable property. Sometimes, the victim even knows about it, but believes the financial move benefited him or her, or that it's a reasonably sized gift.

To catch financial exploitation in nursing homes, residents' families should keep an eye on the resident's finances and valuables. Watch bank accounts for unexpected activity, and be sure you have the right to ask questions if necessary. During visits, make sure your loved one has all of the money and items he or she used to have, particularly items that wouldn't be casually lost or given away, like heirloom jewelry and wedding rings. And if you suspect particular people, watch those people to see they're spending more than you believe they could make at their jobs. If you catch a thief in time, you may be able to get the money back, through a criminal prosecution or a Pennsylvania nursing home negligence lawsuit.

Continue reading "How to Spot Theft From Patients in Pennsylvania Nursing Homes " »

Our Pennsylvania nursing home negligence lawyers were disturbed to see a recent report suggesting some nursing homes have intentionally over-medicated their patients. The New York Times reported Jan. 15 that federal regulators have sued Johnson & Johnson for paying illegal kickbacks to a nursing home pharmaceutical distributor named Omnicare. The complaint in Boston federal court said Johnson & Johnson paid Omnicare to buy its products. Those products included prescription drugs like the powerful antipsychotic Risperdal, which is frequently used off-label to control behavior in patients with dementia. The Justice Department accused Johnson & Johnson of committing Medicaid fraud by inflating the number of prescriptions it paid.

Omnicare is a "middleman" that manages insurance issues, processes payments and distributes medications. The government alleges that it took illegal payments from Johnson & Johnson from 1999 to 2004. Among other things, the lawsuit says the drug maker paid for information previously distributed for free, and paid rebates every quarter based on Omnicare's success at switching patients to its drugs from competitors' drugs. These rebates are legal, but only if Medicaid gets the same discount as other large purchasers. The lawsuit says Johnson & Johnson tried to disguise its rebates to Omnicare in quarterly reports to the government.

As Philadelphia nursing home abuse attorneys, we wonder how many other companies may be guilty of similar behavior. Kickbacks are particularly dangerous in nursing homes because they encourage nursing homes to over-prescribe medicines. Some of these medicines may be appropriate, but they can also carry serious side effects. In fact, we wrote here last week about problems with the atypical antipsychotic Risperdal, which carries an FDA warning that it may increase the risk of death in elderly patients with dementia.

Continue reading "Drug Company Sued for Paying Kickbacks to Nursing Home Company Operating in Pennsylvania" »

Identity theft is one of the fastest-growing crimes in the world -- and unfortunately, nursing home residents are among the most vulnerable Americans. Identity theft means theft of the victim's credit card numbers, Social Security information and other identifying information in order to obtain credit under that person's name. After the thief racks up debts in the victim's name, he or she simply fails to pay and sticks the victim with the bills. Thanks to the Internet, this is easier than it was even 20 years ago.

The Federal Trade Commission reports that seniors are the most common victims of identity theft. As Pennsylvania nursing home abuse lawyers, we believe nursing home residents are especially attractive targets. For one thing, people in nursing homes are often not managing their own financial affairs anymore, and the relatives in charge may not give the senior's finances full attention. Furthermore, unscrupulous caregivers have an opportunity to take credit cards and other information from the patient, and suggest that the victim is just old and forgetful if he or she complains. And seniors tend to have a lifetime of good credit and savings that make them tempting targets.

All of this means that it may be weeks or months before anyone notices that a nursing home patient is a victim of identity theft. That's unfortunate, because victims and their families must move quickly to reverse or minimize the damage to the patients' finances. These families should also closely scrutinize the nursing home where identity theft occurred. If the supervision at the home was poor enough to allow identity theft, what else could be going on there?

Even if the thief is arrested and convicted, patients may need to take separate legal action to recover the stolen money.

Continue reading "Identity Theft Threatens Nursing Home Patients in Philadelphia and Nationwide" »