Nursing Home Fraud Neglect & Abuse Much Too Common

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The federal and state governments usually pay for a portion of the care, the lawsuit notes. However, reimbursement paid through Medicare pays a significantly higher amount than reimbursement by Medicaid, so the complaint alleges that Beverly makes it a "corporate policy" to attract residents who are Medicare eligible.

The typical Medicare resident at a Beverly facility, the lawsuit explains, is admitted directly from a hospital and is eligible for Medicare for only the first 100 days; so Beverly provides Medicare residents with more and better care than non-Medicare residents including physical therapy, occupational therapy, speech therapy, and a greater amount of hands on nursing care and charting, the complaint alleges.

Then, before the 100 days is up and the Medicare eligibility expires Beverly takes steps to have orders for therapy withdrawn because the therapy will soon no longer be paid for by Medicare.

As a result of Beverly's system of providing therapy only to Medicare residents and only restorative care to non-Medicare residents, Beverly provides differing levels of care to residents based on pay source in direct violation of federal law, according to Mr Thomas.

When nursing assistants become over worked due to understaffing, he says, one of the first duties that they eliminate is restorative care, which causes many residents to not receive this much needed, beneficial care.

Beverly's system of acquiring Medicare eligible residents, the complaint alleges, requires a regular influx of new residents from hospitals and the emphasis on acquiring these new residents can be potentially devastating to other residents. "Existing residents receive less care than the Medicare residents causing or potentially causing a general decline in their overall health," the complaint states.

"When the residents' health declines severely they either die or must be hospitalized, which frees up bed space to admit a new Medicare resident," it charges. According to Mr Thomas, this creates a vicious and improper cycle of substandard care that monetarily benefits Beverly.

William Glass is a plaintiff in the lawsuit filed by Mr Thomas. In the fall of 2004, Mr Glass was placed in the Beverly Healthcare Eason Boulevard facility in Tupelo, Mississippi because he had episodes of violent behavior, which were triggered by medication interactions.

During the entire time that Mr Glass was a resident, a foul odor that smelled like urine and feces, was present in the facility and children and grandchildren say they did not know that it was not acceptable for a nursing home to constantly smell of urine and feces.

Mr Glass alleges that the foul odor was a direct result of understaffing and that Beverly did not provide enough nurses and certified nursing assistants to meet the residents' bowel and bladder needs. As a result, incontinent residents who had urinated or defecated in a diaper were not cleaned or changed in a timely fashion. The soiled linens and bed pads were also not replaced in a timely manner, which further contributed to the foul odor.

In addition, for many residents who were originally continent but needed assistance getting to the toilet, Beverly's understaffing resulted in there not being sufficient staff to assist residents to the toilet and residents became incontinent who otherwise would not have.

When he entered the Beverly facility Mr Glass was continent of both bowel and bladder.
But despite the fact that he was continent, employees at Beverly put diapers on him and encouraged him to urinate and defecate in diapers.

After putting him in diapers, the complaint states, employees did not regularly change him or keep him clean. On one occasion, family members found Mr Glass with his diaper so full of urine and feces that it was around his knees and on another, family members found him and another resident eating a meal with feces on their hands and wearing soiled diapers.

The lawsuit charges that Mr Glass was not properly bathed and was left in the same clothes for weeks at a time and that as a result of his unclean condition, Mr Glass smelled bad when his family visited. Virtually the only time that Mr Glass was bathed, the complaint charges, was when his family took him home and bathed him.

According to the complaint, Mr Glass lost between 50 to 60 pounds while a resident of Beverly as a result of substandard care and inadequate provision of food and hydration.

John Dobbs, another plaintiff in the lawsuit, was admitted to the Beverly facility in Ripley, Mississippi on August 16, 2002, because he had decreased mobility from a prior stroke. Due to his stoke, Mr Dobbs could not communicate well with people including his family members.

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