Healthcare Fraud
Browsing all articles in Life Impacts

Free-Health-Care-Scam-UPA-GovernmentDenise M. Bailey, the former administrator of an assisted living facility in Atlanta, Georgia, has been sentenced to federal prison for misappropriating over $300,000 in veterans benefits that belonged to one of the facility’s residents.

“While working as a nursing home administrator, the defendant stole disability benefits from a Vietnam veteran who lived in the nursing home,” said U.S. Attorney John Horn.  “This disabled veteran was entitled to every penny of his disability award after honorably serving our country, and needed the money to live comfortably in assisted living – yet Bailey spent the money for her own personal expenses.”

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november-is-caregiver-awareness-monthCaregivers are Care Managers. Caregivers are the decision-makers and coordinators of the care for their loved one. During this process, caregivers  face a unique set of challenges with many of them cropping up unexpectedly.

The vision of caregivers and the goal of care managers is to decrease family stress and increase quality of life. Caregivers, as the acting care manager, are the specialists in this equation. The caregiver sees their loved one's conditions every day and knows better than anyone else what their loved one's needs truly are!

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gcmcollage

Caregiver Theft - A Family's Worst Fear

A family in Cincinnati hired a caregiver to help care for their elderly father and learned too late that their worst fear had become a reality. the caregiver had robbed their father blind!

Caregiver theft is one of the worst fears of families in need of a caregiver to help care for an aging loved one. This story may help other families learn how to protect themselves and their family members from caregiver theft.

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Three

Choosing A Facility For A Loved One

Navigating healthcare, to include choosing a facility for a loved one,  can feel like being in a maze with no directions or map. There are resources available to help families ensure their loved one receives optimal care. It definitely takes a team effort on the part of the entire family, but locating the right care in the right facility is obtainable!

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RosewoodManorA Buried Body Behind Assisted Living Facility

The owner of Rosewood Manor, an assisted living facility in Nicholls, GA, surrendered her personal care home license after a body was found buried in a shed on the property.

After receiving a tip, investigators went to the facility to question the caregiver. The caregiver admitted there was a body buried in a shed. The caregiver was arrested and denied bond.

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Nursing Malpractice: Same Day Surgery

A middle aged woman had an cholecystectomy via  outpatient surgery. Her postoperative vomiting and pain were controlled before leaving the post-op/recovery area. After  her arrival home, she began experiencing increased pain and vomiting, at which she time called the triage nurse.  Despite her additional complaints of weakness and increased fatigue, it appeared to the nurse that these symptoms may have been related to the surgery, with the nurse discounting the significance of the complaints and advising the patient  to "wait and see".

Despite the nurse's decision support tool including "weakness" and "fatigue" as red flags, the nurse did not utilize the support tool appropriately, nor did she err on the side of caution which ultimately led to the patient's death related to surgical complications. Although, pain and vomiting are common complaints following abdominal surgery, the patient should have been considered high risk due to the surgery being the same day, as well as the patient getting sicker while at home.

How can an institution avoid this type of outcome, thus decreasing their liability?

1. The initial phone call must be handled by qualified people. Clerical personnel typically answer the calls, passing the information onto the appropriate person not realizing the patient's risks and the urgency in which the situation must be dealt with.

2. It is imperative to provide adequate staffing to handle phone calls.  Poor staffing  may overtax the critical thinking skills of a nurse, setting him or her up to fail.

3. Provide specialized training to triage personnel. Nurses who take calls from patients should be educated to recognize the potential significance of patient complaints and to provide the appropriate referral. Same day surgery nurses must be aware of the potential postoperative complications and direct the caller appropriately.
4. Provide policies and procedures. Decision support tools should be provided, reviewed, and approved by medical, nursing, and administrative personnel. Nurses should be taught how to use them, but also be free to use clinical judgment and critical thinking.

Ohio mesothelioma victim awarded $27.5 million.

medical-gavelJohn Panza Jr. of Cleveland Heights, Ohio,a 40 year-old English professor at Cuyahoga Community College, was diagnosed in 2012 with mesothelioma. Panza acquired the cancer after years of second-hand exposure to clothing worn by his father, who picked up the asbestos dust at his job at the Eaton Airflex brake company. After 31 years working at Airflex, Panza’s father died of lung cancer in 1994. Read more »

networkNot every subcontractor will possess each of the characteristics of a successful contractor,but each person should bring strong, positive characteristics that will complement the team, strengthening the team as a whole. Read more »

Signing

Should You Sign a Nursing Home Admission Agreement?

Admitting a loved one to a nursing home can be very stressful. In addition to dealing with a sick family member and managing all the details involved with the move, you must decide whether to sign all the papers the nursing home is giving you. Nursing home admission agreements can be complicated and confusing, so what do you do? Read more »

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