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New York should keep a closer eye on its nursing homes

   As a result of a state Health Department survey in May, Ellis Residential and Rehab Center, a Schenectady nursing home, was found to have provided substandard quality of care and to have placed residents in immediate jeopardy (the most serious level of deficiencies).
   On a larger scale, during the past 12 years, about 40 congressional reports have documented continuing maltreatment at thousands of America’s nursing homes, including deaths and injuries caused by physical abuse, medical and nursing malpractices, understaffing, excessive psychiatric drugging, preventable pressure sores, malnutrition, dehydration and inadequate fire prevention.
   Such situations indicate a need for camera surveillance monitoring, mandated resident-to-staff ratios, and harsher penalties for negligent nursing home owners, to help assure that our most vulnerable citizens are protected from harm
   JOEL FREEDMAN
   Canandaigua
The writer serves on the nursing home staffi ng committee of the Long-Term Care Community Coalition.  

  
  
  

Close them.....

I realize that there are some elderly people that truly can not be taken care of at home or by a family member, but it's too bad that we have to form a Long-Term Care Community Coalition.  I think that if a loved one was in a nursing facility, family members should go daily to check on that loved one. Be involved. And HELP the staff take care of their family member. Then perhaps there would be no need for a coalition to oversee this service.

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FONDA
Woman almost died, lawsuit claims
Action names doctor, nurse
BY EDWARD MUNGER JR. Gazette Reporter

   An Amsterdam woman who said she nearly died after suffering internal injuries following a biopsy is suing a local physician and a nurse.
   Dr. T. Donald Rapello, Jane Bowler, a nurse, and Women’s Health of Amsterdam are named as defendants in the suit filed in state Supreme Court in Montgomery County.
   The lawsuit is seeking unspecified compensation.
   Rosemary Poole underwent a biopsy in March 2005 and was released after the procedure. But by the end of the day, she started suffering from severe abdominal pain, vomiting and other aftereffects of the procedure, according to the lawsuit filed Aug. 21 on Poole’s behalf by Albany Attorney John W. Bailey.
   The aftereffects turned out to be due to a perforation in Poole’s small intestine, an area that wasn’t the focus of the operation, according to the lawsuit.
   Early the next day, the lawsuit claims, Rosemary Poole’s husband, Charles, called Women’s Health of Amsterdam and spoke with Bowler, who told him that his wife “had the flu and that there was nothing that … Women’s Health of Amsterdam could do for you,” according to the court filing.
   Charles Poole brought his wife to the emergency room at St. Mary’s Hospital in Amsterdam, where the couple learned she was suffering from a perforation in her small intestine, internal bleeding and acute peritonitis.
   At the time of Rosemary Poole’s admission to the emergency room, doctors told her and her husband that she would not survive without surgery and “it was further uncertain if she would survive surgery,” the suit states.
   A priest was then called in to administer last rites for Rosemary Poole, according to the suit.
   “They thought she was dying, that’s how sick she was,” Poole’s attorney, John Bailey, said Friday.
   Rosemary Poole on Friday said she did not want to comment on the case at this time.
   “We ran this by a highly qualified doctor and said please explain this. The doctor said the only explanation is there was medical negligence here,” Bailey said.
   The suit names Bowler because she allegedly answered the telephone when Charles Poole called about his wife’s symptoms.
   It accuses Bowler of “improperly responding to the phone call made by Charles Poole describing his wife’s symptoms, improperly advising Charles Poole that [the] plaintiff, Rosemary Poole, had the flu and not instructing plaintiffs to immediately seek emergency medical attention.”
   Rapello and Bowler could not be reached for comment on Friday.  

  
  
  

Although I do sympathize with Ms. Poole, people must be aware that there are risks with any invasive proceedure. And the patient is, or should be, told of  these risks.

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Vaccinations for children multiply
BY SARA FOSS Gazette Reporter

   A seventh-grader recently went to Schenectady County Public Health Services to get one vaccine, for hepatitis B. By the time she left, she’d received several more vaccines than planned, including Gardasil, the new vaccine for cervical cancer, and Menactra, which protects against bacterial meningitis.
   “We talk to a lot of parents,” said Phyllis DiLegge, supervising community health nurse for County Public Health Services, which provides vaccinations for underinsured and uninsured children. “We educate them about what’s out there.”
   Gardasil and Menactra are both relatively new vaccines that many parents are unaware of, according to local pediatricians. And with school set to begin, they say it’s important to make sure children and teens have received required immunizations for diseases such as chickenpox, measles, mumps, rubella and hepatitis B. Although many vaccines are administered before a child turns 2, some vaccines are administered to pre-teens and teenagers.
   The number of vaccines recommended and required for children has crept up over the years; today, children will probably receive about 30 vaccines before adulthood.
   “Even though it’s a lot of shots, the amount of diseases we prevent is huge,” said Dr. Dean Limeri, an internal medicine doctor and pediatrician at Ellis Hospital in Schenectady. “Most of them are diseases we don’t have really good treatments for.”
   “These diseases are still around,” said Dr. Tyrone Bristol, an associate professor of pediatrics at Albany Medical College and attending pediatrician in the Albany Medical Center Pediatric Group. “Although we haven’t seen them in a long time, the germs are still there.”
   “Most parents,” Bristol said, “understand the value of vaccines for preventable diseases.”
   Menactra, which came on the market in 2005, is recommended for children who are 11 and 12 years old but is often given to teenagers before they go to college.
   Research indicates that college students who live in dorms and residence halls are at greater risk than other college students for meningococcal meningitis, a rare but potentially fatal bacterial infection. As a result, many colleges are now requiring or recommending Menactra, Bristol said.
   In response to a resurgence in whooping cough that’s occurred in the last few years, children should be re-vaccinated against the disease at 11. They often receive a new vaccine called Adacel, which can be administered to people between the ages of 11 and 64 and also protects against tetanus and diphtheria; another vaccine against these diseases, called Boostrix, is available for children between the ages of 10 and 18.
   Children are vaccinated for whooping cough, or pertussis, before they start school. But they begin to lose their immunity to the disease by their early teens, which is why giving them the booster shot, which also covers the tetanus and diphtheria shots they need, makes sense. “A lot of schools are asking students to get that,” Limeri said. “Every school district has had an outbreak of whooping cough. Some schools are sending notes home encouraging children to get it.”
   In 2006, the U.S. Centers for Disease Control and Prevention recommended that children have two doses of the vaccine for chickenpox between the ages of 12 months and 12 years; previously, only one dose was required. Children are also supposed to receive a booster shot of the chickenpox vaccine that is typically given to them when they are between one year and 15 months old.
   This second dose of the vaccine can be administered several months after the first vaccination, but also when kids are a bit older; though it is recommended for all students, it is not required for school entry in New York.
   Another vaccine that is recommended for 11-year-old girls, but not required, is Gardisil, which protects against cervical cancer. Last summer the U.S. Food and Drug Administration approved the vaccine for women and girls ages 9 to 26.
   The idea is to vaccinate people before they become sexually active and are exposed to the virus that causes cervical cancer, human papillomavirus, or HPV.
   “Parents are still hearing about Gardisil,” Limeri said. But word is getting out, due to an aggressive advertising push by Merck & Co., the vaccine’s manufacturer, and the publicity about the new vaccine.
   Sometimes it takes a few years for new vaccines to become mainstream.
   When Menactra first came on the market, it was in short supply and mostly given to graduating high school seniors, Limeri said. But supply problems have since been fixed, and now more children are receiving it at a younger age.
   Even so, a government survey released earlier this week showed that only 12 percent of teens got the new meningitis shot. Only 11 percent got the shot that protects against whooping cough, tetanus, diphtheria and whooping cough. Reports indicated that health officials weren’t concerned, because the two drugs only came on the market in 2005.
   Vaccination rates were 70 percent to 90 percent for shots guarding against chickenpox, hepatitis B and measles, mumps and rubella, the study found. These vaccinations, of course, have been around for years, and are required in most states before children enter grade school.
   In other changes, the flu vaccine is now recommended for children who are at least six months old. The hepatitis A vaccine, previously recommended only for children living near the Mexican border, is now recommended for all children between the ages of 12 and 23 months, though it can be administered when children are older.  

  
  
  

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SCHENECTADY COUNTY
Officials: Local health aides all well-trained
Cuomo probe found issues downstate
BY MICHAEL LAMENDOLA Gazette Reporter

   The county’s largest provider of home health care services for the elderly never employed aides who received fraudulent credentials from training schools exposed by a state investigation, the executive director said.
   Joe Twardy of the Visiting Nurse Service of Schenectady and Saratoga Counties said his aides are locally trained in state-approved agencies and have since had their credentials rechecked.
   “We have an extensive corporate compliance program. We certify their credentials, and we do on-site reviews of the [training] agencies,” Twardy said.
   His agency employs 165 people and conducted 100,000 home visits last year. “All of us here do what is best for our patients,” Twardy said.
   Schenectady County has the largest population of senior citizens per capita in New York.
   State Attorney General Andrew Cuomo announced last week that he secured guilty pleas from the former operators of two “certifi - cation mills” that provided false credentials to hundreds of home health aides as part of a widespread and elaborate scheme to defraud Medicaid of millions of dollars.
   His investigation targeted New York City-based training sites whose graduates primarily worked in the metropolitan New York area and surrounding communities. It covered training programs from January 2002 onward.
   Joanne Cunningham, president of the Homecare Association of New York State, a trade association, said “it is unlikely but unclear that home health aides who received fraudulent certifications moved up here for employment.”
   Since Cuomo announced his investigation, however, local agencies have double-checked a state Web site listing approved home health aide training programs, said Suzanne Smith, co-president of Interim HealthCare of the Capital Region, which has trained home health aides for 30 years.
   Smith doubts that any home health aides from the fraudulent schools ever worked for local agencies.
   “The majority of home health care agencies do their own training. Our agency trains and recruits aides as part of our patient care services to clients,” she said.
   The New York City schools — Smalls Training and Counseling School and On Time Home Care Agency — were chartered by state Department of Education and charged tuition to issue certificates, similar to schools that offer welding or truck driving certificates.
   Smith said her facility, charted by the state Department of Health, does not charge tuition; it trains students to deliver home health care services and is overseen by a registered health care provider.
   Christine Johnston, executive vice president of the New York Association of Health Care Providers, also a trade association, said home health care agencies by law have to verify certificates by checking with the training school and its program and by checking references.
   “But obviously, if you have bad actors ... ,” Johnston said. “We have long supported and advocated for a certified home health aide registry that allows us to check credentials,” similar to registries for licensed practical nurses, registered nurses.
   She said she believes Cuomo overstated the problem when he called it “wholesale fraud … emblematic of the breadth of the problems our investigation is uncovering.”
   Cuomo is requiring home health care agencies that hired home health aides with false credentials to refund certain Medicaid payments. Cuomo said the agencies could not receive payments because services were provided by unlicensed health aides.
   Medicaid requires home health aides — who primarily care for elderly patients, administer medication and provide services such as catheter care, colostomy care and wound care — to successfully complete a training program licensed by the state Health or Education departments. All such aides must receive a minimum of 75 hours of training, including 16 hours of supervised practical training conducted by a registered nurse, and must pass an examination.
   Twardy said the state requires home care agencies to check the credentials of their employees, and it make these agencies responsible for ensuring that claims they submit for Medicaid reimbursement are valid.
   Johnston said the state requirement could prove onerous for nonprofit agencies operating on thin margins of surplus. She also is concerned by statements Cuomo made that she said paint the home health care industry with a broad brush of suspicion, namely: “The evidence we’ve obtained to date suggests endemic, persistent fraud and malfeasance at all levels of the home health care industry.”
   Cunningham said the “state is talking that all home health care providers are crooks. Our members want fraudulent providers and caregivers brought to justice, but when you condemn a whole community of caregivers and make statements they are crooks, those are troubling words.”
   Twardy said he had to assure his staff that Cuomo’s investigation focused on New York City, not local providers.
   “We applaud the attorney general’s effort,” he said.  

  
  
  

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Schenectady County has the largest population of senior citizens per capita in New York.

WOW! And all of the boomers haven't even hit yet!!

And with all the MFRH we've got going in, we better have a whole bunch of nurses moving into Rotterdam.  Seems like everytime something goes up, it's for the seniors.  I know that in general there's a shortage of nurses, but if we get the number of elderly that they're planning for in all these apartments, will we have enough to take care of them, compared to the number there are to go around (that is to say, will we have the same percentage of a shortage everyplace else has, or will ours be greater)?

'Nursey senders' will help them!

The MFRH that's being built for quote the seniors are so expensive to live in that the seniors can't afford them. Many seniors end up in government subsidized housing where the rent is based on ones income.

Family will be subsidized by the government and will be primary caretakers---if they choose---no more 'free ride' with nursing homes doing the work only for those 'with',,,,the system could NEVER function like that without it taking a toll on the society.....we would be turned inward.....the boomers didn't boom to well....the pyramid is upside down...to get more caretakers we would need the lettuce pickers...and frankly, in this area that is what we have(but, they are legals, purposely invited),,,national healthcare will redistribute the wealth......for awhile then the pendulum will swing the other way....

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Critic of Ellis nursing care should see for
himself before judging
MARK J. SALOCKS Albany

   I am deeply troubled by the Aug. 31 letter by Mr. Joel Freedman, who wrote on the dire need for New York to rigorously monitor the day-to-day, if not momentto-moment, activities and operations in all of the state’s nursing homes. Relying on recent surveys and government reports, he spoke of the prolific incidence of mistreatment, neglect and malpractice in long-term nursing facilities across the nation, but singled out Ellis Residential and Rehabilitation Center in Schenectady. Mr. Freeman’s bias toward Ellis appears to be based solely on a state Health Department report and not on any personal experience. His attack on Ellis Long-term Care Center is unfair and unfounded.
   Mr. Freedman may serve on a nursing home staffing committee, but does he have any experience as a caregiver? For seven years prior to my father’s death and my mother’s entry into Ellis, I was their primary caregiver. As such for so long, I would like to think I am somewhat qualified to be a judge of caregiving.
   The quality of care my mom has received in the last two years has been exceptional. Perfect? No, there is no such thing as perfection nor will there ever be; but I can say without reservation that the employees of Ellis Residential and Rehabilitation Center come darn close. From upper management and administration to nursing and personal care, to food service and housekeeping — everyone goes out of their way to help my mom and help maintain her dignity. For that alone, and based on my experience of what I see and hear every week, I commend their efforts.
   I do not deny Mr. Freedman’s claim that abuse in America occurs nor do I disagree with the need for accountability. But to make such narrow-minded observations serves no purpose other than to discourage and demean the very people who care for our loved ones. In fact, the source of Mr. Freedman’s information actually states that “... measuring the quality [of care] is difficult because of the variation among nursing homes in the complexity of the residents they care for.” (www.nyhealth. gov).
   Until such time that our government— state, federal or both — can afford to install surveillance cameras and have them monitored, mandate resident-to-staff ratios, impose harsher penalties for negligence and essentially punish all that is bad, I suggest Mr. Freedman, you get off your committee, roll up your sleeves and go do some good in the very area you champion. You will fi nd a lot of good is already being done — it’s just never quantified in a report, much less appreciated in the press.  

  
  
  

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The quality of care my mom has received in the last two years has been exceptional. Perfect? No, there is no such thing as perfection nor will there ever be;

Well said Mr. Salocks....Well said!!! Now we just need to convince the government and lawyers that 'perfect' doesn't exist.

NYS is just making up for poor choices about foundation building that we have....ie:lottery for education...ha ha ha ha ha ha ha,,,,what a joke....how about lottery for senior care----go ahead---I dare you.......