Monday, June 19, 2017
The Denver Post reported recently that the Denver DA and the Denver Police are taking steps to combat elder and vulnerable adult abuse. Denver DA, police form units to protect elderly, developmentally disabled explains that the DA has created a division within the office on elder abuse. As well the Chief of Denver PD has established a special victims unit for elders and vulnerable adults who are victims of abuse. The DA's division "will focus on physical abuse and neglect crimes against at-risk adults aged 70 or older, as well as adults with intellectual or developmental disabilities ... [as well as] prosecute financial fraud cases that target at-risk adults." The PD unit will work together with DA investigators and social workers to investigate reports.
Colorado uses age 70 for victims of elder abuse, and the law includes mandatory reporting. The law seems to be having a positive effect, based on the statistics in the article: "the number of Denver police investigations related to at-risk adults climbed adults climbed 271 percent from 228 to 847 cases between 2013 and 2016, according to department statistics. Elder abuse cases make up the bulk of the cases. Police investigated 735 elder abuse cases in 2016, a 418 percent increase above the 142 cases investigated in 2013."
Monday, June 12, 2017
Perpetrators of financial exploitation and other forms of elder abuse may exert undue influence to control the decision-making of their victims. Learning to recognize signs of undue influence will help legal and aging network service providers prevent or redress elder abuse and enhance victims’ access to justice.
Lori Stiegel and Mary Joy Quinn, nationally recognized experts on elder abuse and undue influence, will present this advanced webinar, Elder Abuse: The Impact of Undue Influence, to help legal and aging network professionals understand the dynamics and indicators of undue influence, and the relationship of this psychological process to elder abuse and guardianship.
During this training, Lori will discuss the concept and its connection to capacity and consent, tactics and process, and legal remedies. Mary Joy will provide an example of how undue influence is defined in California law and share an undue influence screening tool for Adult Protective Services that lawyers and other professionals should be aware of and can use in their own practice.
To register for the webinar, scroll to the bottom of the page and click on the register now button. .
Thursday, May 25, 2017
With World Elder Abuse Awareness Day next month, I was particularly interested in the Frameworks Institute Toolkit on talking elder abuse. Talking Elder Abuse is divided into 6 parts: introduction, big picture, anticipating public thinking, guides to key framing, sample communications and other resources.
This toolkit is designed to help experts and advocates who work in this field to increase public understanding of
- why elder abuse is a matter of public concern
- the causes of elder abuse, including the social determinants and environmental factors that can foster the occurrence of abuse, and
- what solutions can most effectively prevent elder abuse, address existing cases, and improve the conditions and wellbeing of those who have experienced abuse.
This toolkit, sponsored by Archstone Foundation, The John A. Hartford Foundation, and Grantmakers in Aging, and in partnership with the National Center on Elder Abuse at the Keck School of Medicine of the University of Southern California, models how to apply the FrameWorks Institute’s evidence-based recommendations to messages and conversations about elder abuse and related issues, in order to build public understanding and support. The kit’s materials include:
- sample communications, such as a “key points” guide and social media content, that can be adapted and repurposed for your organization’s needs
- communications examples that demonstrate the “do’s and don’ts” of the framing recommendations
- graphics that illustrate the key concepts of the recommendations
- annotations that explain the framing strategies being illustrated.
Users are encouraged to borrow toolkit language verbatim if desired—no citation or special permissions are needed—and also to adapt the examples to the immediate needs of a local communications context.
For nearly two decades, FrameWorks research has demonstrated that effective communications can help to engage the public in conversations about complex social issues—such as the causes and consequences of elder abuse and the social policies and programs that can prevent its occurrence and improve the lives of older people in the US. This toolkit is based on the findings of a two-year, multi-method study of elder abuse and aging that queried more than 10,400 Americans’ thinking on these issues. The research included expert interviews, on-the-street interviews, large-scale surveys, and persistence and usability trials. This extensive research included the development, empirical testing, and refinement of the tools and strategies offered in this toolkit.
Friday, May 12, 2017
On May 10, 2017, my research colleagues Gavin Davidson (Queens University Belfast) and Subhajit Basu (University of Leeds) participated in a policy briefing at Stormont, the Northern Ireland Assembly in Belfast. They appeared in support of recommendations by the Commissioner of Older People (COPNI) Eddie Lynch on a major plan for modernization of social care programs for vulnerable adults (of any age).
Professors Davidson and Basu focused on three key recommendations:
- Northern Ireland should have a single legislative framework for adult social care with accompanying guidance for implementation. This could either be new or consolidated legislation, based on human rights principles, bringing existing social care law together into one coherent framework.
- All older people in Northern Ireland, once they reach the age of 75 years, should be offered a Support Visit by an appropriately trained professional. This will be based on principles of choice and self-determination and is aimed at helping older people to be aware of the support and preventative services that are available to them.
- Increasing demands for health and social care reinforce the importance of considering how these services should be funded. All future funding arrangements must be equitable and not discriminate against any group who may have higher levels of need.
The audience, which included researchers, social service program administrators and elected officials (not only from Northern Ireland, but elsewhere, including the Isle of Man), reportedly responded strongly to the recommendations, especially to the concept of specially-trained "support visitors," offered to persons age 75 or older. The intent is to provide individuals with planning support and, where needed, medical assessment. Guidance and information is often needed for pre-crisis planning, thus moving in the direction of prevention of crises and reduction of need for last-minute response. The support visitor concept has been used successfully in Denmark and other locations in Europe. The next step for Northern Ireland would likely be a pilot or test project.
As a co-author of the research reports that led to the COPNI recommendations, working with Professors Gavin Davidson and Subhajit Basu as part of a team headed by Dr. Joe Duffy of Queens University Belfast, I found it an interesting coincidence that at almost the same time as the Northern Ireland government session, I was addressing similar interests in "preventative" planning while speaking on elder abuse in a "Day on the Hill" program at the Capitol in Pennsylvania, hosted by the Alzheimer's Association. It is clear that on both sides of the Atlantic, we are interested in cost-effective, proactive measures to help people stay in their homes safely.
Monday, May 8, 2017
The Elder Justice Initiative (EJI) has announced the release of a guide and toolkit for creating Multi-Disciplinary Teams (MDT). The EJI has an MDT Technical Assistance Center (or MDT TAC). EJI is also offering a free webinar to help users get started creating an MDT. The email announcement explains how to get started:
The Elder Justice Initiative (EJI) is pleased to announce the launch of the new Multidisciplinary Team Guide and Toolkit. The Toolkit is designed for anyone looking to create or grow a local elder abuse MDT, regardless of their experience with MDTs. The web-based Toolkit is enhanced for use on mobile devices and contains easy-to-download PDF sample documents and citations.
On May 30, take a live walk through the Toolkit. The EJI webinar will cover many aspects of the Toolkit, including:
Layout and usability
Highlights from each chapter
Questions and feedback
Thursday, May 4, 2017
The SEC approved: (1) the adoption of new FINRA Rule 2165 (Financial Exploitation of Specified Adults) to permit members to place temporary holds on disbursements of funds or securities from the accounts of specified customers where there is a reasonable belief of financial exploitation of these customers; and (2) amendments to FINRA Rule 4512 (Customer Account Information) to require members to make reasonable efforts to obtain the name of and contact information for a trusted contact person for a customer’s account. New Rule 2165 and the amendments to Rule 4512 become effective February 5, 2018.
The full notice is available as a pdf here. The text of the new rule starts on page 9 of the full notice.
Here is the background from the notice, to give you more information about the reasons behind this rule
With the aging of the U.S. population, financial exploitation of seniors is a serious and growing problem. FINRA’s Securities Helpline for Seniors® has highlighted issues relating to financial exploitation of this group of investors, including the need for members to be able to more quickly and effectively address suspected financial exploitation of seniors and other specified adults The amendments to Rule 4512 and new Rule 2165 provide members with a way under FINRA rules to respond to situations in which they have a reasonable basis to believe that financial exploitation has occurred, is occurring, has been attempted or will be attempted. Members can better protect their customers from financial exploitation if they have the ability to contact a customer’s designated trusted contact person and, when appropriate, place a temporary hold on a disbursement of funds or securities from a customer’s account. (citations omitted)
Take a look!
Wednesday, April 26, 2017
Justice in Aging has announced a free webinar for May 17th, 2017 from 2-3 edt on Elder Financial Abuse & Medicaid Denials. Here is a description of the webinar
Financial exploitation can devastate low-income older adults, especially those who rely on Medicaid for their health and long-term care. For example, older adults who are victims of financial abuse may be denied eligibility for Medicaid because their abuser won’t turn over their bank records. Without Medicaid eligibility, the older adult may be threatened with eviction or involuntary discharge from a nursing home because of nonpayment. Legal services are critical to helping older victims of financial exploitation receive the medical care and services to which they are entitled. Join us for Elder Financial Abuse and Medicaid Denials to learn how to identify victims of elder financial abuse, what problems this exploitation can cause for Medicaid eligibility, and how legal services attorneys can help their older clients receive the benefits they need and prevent future problems accessing Medicaid.
To register for the webinar,https://attendee.gotowebinar.com/register/5875005469626032643?source=SALSA. Did I mention, it's free!
April 26, 2017 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, Programs/CLEs, Webinars | Permalink | Comments (0)
Sunday, April 16, 2017
The New York Times ran a story a few days ago about preventing financial exploitation. Declaring War on Financial Abuse of Older People starts with the story of a woman who acts when she finds out her grandmother had lost her life savings. (Just fyi, her grandmother's case was featured in a story in the New York Times in 2015). The woman didn't stop with just her grandmother's case, however. First she pushed to get action for her grandmother. Then, the story explains, she "[became] an activist, traveling around her home state of Washington to lecture and testify about the financial exploitation of older Americans. She has also become a lobbyist, exhorting state lawmakers to pass legislation that would toughen penalties for people who take financial advantage of vulnerable older people like her grandmother."
The article notes the variations among state financial exploitation statutes and how some states don't have specific elder financial exploitation statutes
A number of states have laws like this on the books, but they vary widely. According to the National Conference of State Legislatures, which tracks such laws, this type of financial abuse is an active topic in state capitals. Last year, 33 states, as well as the District of Columbia and Puerto Rico, considered measures against the illegal or improper use of seniors’ money, property or assets, in addition to fraud or identity theft targeting the older people.
Some states have shored up their existing laws. Last year, Idaho revised its definition of neglect of vulnerable adults to include exploitation. Illinois extended the statute of limitations to seven years from three for prosecuting a person accused of taking financial advantage of an older person or a person with disabilities.
Also, last year, Alabama passed the Protection of Vulnerable Adults from Financial Exploitation Act, to add a layer of protection to existing laws by requiring brokers and investment advisers who believe a vulnerable adult is being exploited to notify the Human Resources Department and the Alabama Securities Commission.
In those states without the specific statutes, convictions come with lesser penalties than those with specific elder financial exploitation statutes. "Stiffer penalties are necessary to combat a growing drain on the savings of those 60 and over, according to the National Center for Elder Abuse, a federal clearinghouse. In 2015, in Washington state alone, there were nearly 8,000 complaints to adult protective services about financial exploitation, a more than 70 percent increase over 2010. And such crimes are likely to climb simply because the retiree population is growing."
The article also discusses efforts at the federal level, including the Elder Justice Act and the efforts of the Department of Justice.
Thanks to Professor Naomi Cahn for bringing the article to our attention. Congratulations to Naomi and her co-author Amy Ziettlow on the publication of their book, Homeward Bound: Modern Families, Elder Care, and Loss.
Tuesday, April 11, 2017
The National Center on Elder Abuse released a new research to practice brief on Decision-Making Ability and Risk of Elder Mistreatment. This is the introduction to the brief:
There are many factors relevant to decision-making ability of older people including changes in the brain and cognition and social functioning. These changes can result in decision-making impairments that affect an older person’s ability to pay bills, drive, follow recipes, adhere to medication schedules, or refuse medical treatment (Braun & Moye, 2010; IOM, 2015). Decision-making ability may fluctuate at a given point in time (Falk et al., 2014), and while an older person may lack decision-making ability in one area, they may retain it in other areas (Braun & Moye, 2010). Decision-making ability is of special concern for the field of elder mistreatment because impaired decision-making can lead to an increased risk for abuse and exploitation among older people (Spreng et al., 2016). Thus, understanding the many factors relevant to decision-making ability is imperative to reduce risk of abuse and exploitation while maintaining and promoting autonomy among older people.
The 4 page brief covers key terms, explains how cognitive aging and capacity affect decision-making, the differences between medical decisional capacity and financial capacity and risk factors for financial exploitation. This would be great to use in our classes!
Thursday, April 6, 2017
We all know that financial exploitation is a serious and significant problem in the U.S. I was interested in this article from Investment News detailing efforts that the financial services industry and others are taking to help their elder clients protect themselves from financial exploitation. Advisers taking steps to protect elderly explains although "[t]here's widespread acceptance in the financial services industry that elderly financial abuse is a growing problem, but there's no universally accepted game plan for how to respond... Many times firms' internal procedures will involve adviser education and training, and gathering third-party contact information for accounts." The article highlights the efforts of Wells Fargo Advisors which the article explains: "Wells Fargo launched an 11-member team more than two years ago within its compliance department that serves as an internal clearinghouse and case manager when advisers see a potential problem with a client. ... The unit has taken about 4,000 reports from the field, about half of which were incidences of abuse. Wells' Elder Care Initiatives often involves state adult protective services or securities regulators in the matters.:
Bank of America Merrill Lynch has also launched efforts to help protect their elder clients, according to the article. For example, one step Merrill Lynch has taken is to have "created a contact authorization form that gives advisers a trusted person to reach out to in case of suspected fraud or to obtain more information about behavioral changes linked to possible exploitation."
The article also highlights the efforts of Morgan Stanley, Charles Schwab, Edward Jones, and Fidelity Investments. As for smaller firms, they aren't lagging behind. For example, "[s]maller firms also are responding to the elder-abuse threat. For more than a year, Romano Wealth Management has had in place steps that its nine advisers follow in reporting potential abuse to the compliance officer, who then decides whether to involve adult protective services or regulators."
The article also discusses the efforts at the federal level. "The industry is starting to get protection from regulators. In February, the Securities and Exchange Commission approved a Financial Industry Regulatory Authority Inc. rule designed to curb elder abuse. It requires brokers to make “reasonable efforts” to identify a “trusted contact” for investment accounts. It also permits them to prevent the disbursement of funds from the account and to notify the contact if the broker suspects the client is an abuse victim." The article also mentions several states that have passed laws that require investment advisors to notify APS as well as state regulators if financial exploitation is suspected.
The article discusses some other efforts and provides a good picture of various efforts taking place both by legislation and industry efforts.
April 6, 2017 in Cognitive Impairment, Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Statutes/Regulations, State Statutes/Regulations | Permalink | Comments (0)
Tuesday, February 28, 2017
Paula Span, the thoughtful columnist on aging issues from the New York Times, offers "Gorsuch Staunchly Opposes "Aid-in-Dying." Does It Matter?" The article suggests that the "real" battle over aid-in-dying will be in state courts, not the Supreme Court.
I'm in the middle of reading Judge Gorsuch's 2006 book, The Future of Assisted Suicide and Euthanasia. There are many things to say about this book, not the least of which is the impressive display of the Judge's careful sorting of facts, legal history and legal theory to analyze the various advocacy approaches to end-of-life decisions, with or without the assistance of third-parties.
With respect to what might reach the Supreme Court Court, he writes (at page 220 of the paperback edition):
The [Supreme Court's] preference for state legislative experimentation in Gonzales [v. Oregon] seems, at the end of the day, to leave the state of the assisted suicide debate more or less where the Court found it, with the states free to resolve the question for themselves. Even so, it raises interesting questions for at least two future sorts of cases one might expect to emerge in the not-too-distant future. The first sort of cases are "as applied" challenges asserting a constitutional right to assist suicide or euthanasia limited to some particular group, such as the terminally ill or perhaps those suffering grave physical (or maybe even psychological) pain....
The second sort of cases involve those like Lee v. Oregon..., asserting that laws allowing assisted suicide violate the equal protection guarantee...."
While most of the book is a meticulous analysis of law and policy, in the end he also seems to signal a personal concern, writing "Is it possible that the Journal of Clinical Oncology study is right and the impulse for assistance in suicide, like the impulse for old-fashioned suicide, might more often than not be the result of an often readily treatable condition?"
My thanks to New York attorney, now Florida resident, Karen Miller for pointing us to the NYT article.
February 28, 2017 in Advance Directives/End-of-Life, Consumer Information, Crimes, Dementia/Alzheimer’s, Discrimination, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Federal Cases, Health Care/Long Term Care, Religion, Science, State Cases, State Statutes/Regulations | Permalink | Comments (0)
Sunday, February 26, 2017
CNN has published an investigative report on sexual assault of residents in nursing homes. Sick, dying and raped in America's nursing homes opens with these paragraphs "Some of the victims can't speak. They rely on walkers and wheelchairs to leave their beds. They have been robbed of their memories. They come to nursing homes to be cared for... Instead, they are sexually assaulted... The unthinkable is happening at facilities throughout the country: Vulnerable seniors are being raped and sexually abused by the very people paid to care for them."
The report looks at a variety of issues and the failings of the system in responding to the attacks.
In cases reviewed by CNN, victims and their families were failed at every stage. Nursing homes were slow to investigate and report allegations because of a reluctance to believe the accusations -- or a desire to hide them. Police viewed the claims as unlikely at the outset, dismissing potential victims because of failing memories or jumbled allegations. And because of the high bar set for substantiating abuse, state regulators failed to flag patterns of repeated allegations against a single caregiver.
The facts of the cases are hard to read but important in understanding the scope and significance of these crimes. The perpetrators were as young as teenagers or as old as the victims. Some were caregivers, others residents.
Rather than summarizing any further, just read the story. Nothing I can add here would give you the same impact.
Responses to the report from the National Consumer Voice for Quality Long Term Care and others can be accessed here.
Tuesday, February 21, 2017
The deeply disturbing medical practice history of Christopher Duntsch, who worked as a neurosurgeon in Texas until 2013, culminated in his February 2017 conviction and sentence of life in prison for his injuries to a 74-year old patient. It is relatively rare for medical "malpractice" cases to lead to criminal charges, but as detailed in news articles covering the trial, there was strong, adverse medical testimony about how Duntsch's improper surgical procedures caused a horrific outcome.
Initially accusing Duntsch of criminal acts arising in the context of surgical procedures to several of his patients, the prosecution ultimately focused the criminal trial on his 2012 spinal surgery on a single patient under Texas Penal Code Section 22.04, for "Injury to a Child, Elderly Individual, or Disabled Individual." The pertinent portion of the statute provides:
"(a) A person commits an offense if he intentionally, knowingly, recklessly or with criminal negligence, by act . . . causes to a . . . elderly individual . . . : (1) serious bodily injury."
The offense becomes a first degree felony, if it is proven that the conduct was "committed intentionally or knowingly." If the conduct had been "only" reckless, the offense would be a felony of the second degree.
Under the statute, an "elderly individual" is defined as a "person 65 year of age or older."
In a Washington Post article on the conviction, a Texas attorney is quoted:
“I cannot recall a physician being indicted for aggravated assault for acts committed during surgery,” Toby Shook, a Dallas defense attorney who spent 23 years working as a Dallas County prosecutor, told the magazine. “And not just Dallas County — I don’t recall hearing about it anywhere.”
Sunday, January 15, 2017
On January 26, 2017, the Elder Justice Initiative will be hosting a webinar to highlight resources and information available on the Elder Justice Website.
This webinar will be hosted by Susan Lynch and Sid Stahl and will introduce you to the Department of Justice’s Elder Justice Website and will help you to navigate the many tools and resources available on DOJ’s website for elder abuse prosecutors, law enforcement, victim advocates, victims, families, caregivers, and elder abuse researchers. These tools can help you find assistance when in need, get involved in combatting elder abuse and financial exploitation, and educate you on elder justice programs operating at the federal, state, and local levels.
Registration opens the week before the webinar.
Tuesday, January 10, 2017
The American Bar Association Senior Lawyers Division is offering a free webinar on January 19 at noon on scams, as part of its series on preventing elder abuse. The webinar will include panelists from the Consumer Financial Protection Bureau, DOJ and the Harry & Jeanette Weinberg Center for Elder Abuse Prevention. Topics to be covered include the frequency of elder abuse, trends in scams, scam prevention, what to do if a victim, and civil remedies. Click here to register.
Monday, December 19, 2016
We have written several posts about the graying of the prison population. Here is one more-looking at the long term care prisons provide, functioning in some instances as a nursing home or a hospice. Kaiser Health News (KHN) ran the story, More Prisoners Die Of Old Age Behind Bars.
The number of federal and state prisoners age 55 or older reached over 151,000 in 2014, a growth of 250 percent since 1999.
As this population grows, prisons have begun to serve as nursing homes and hospice wards caring for the sickest patients. The majority of state prisoners who died in 2014 were 55 years or older, and 87 percent of state prisoners died of illnesses, according to the report. The most common illnesses were cancer, heart disease and liver failure.
The article, noting that elders may have multiple health conditions, reports of one inmate with dementia who was placed in the general population rather than in the medical wing. The article also discusses the early release program in some states, known as "compassionate release"
For prisoners clamoring to spend their dying days at home, U.S. prison jurisdictions have some laws on the books, often called “compassionate release” or “medical parole,” allowing for early release if prisoners are very sick and not a threat. But in practice, very few inmates are set free through these programs, said Dr. Brie Williams, director of the University of California Criminal Justice and Health Project in San Francisco.
However, compassionate release isn't always the solution as the article points out, especially when those seeking release are violent offenders, as the article explains some instances where early release of a prisoner resulted in another crime, or release was obtained through fraud. But without compassionate release, the prisoners die in prison, and thus the prison needs to provide nursing home or hospice care for inmates.
What's the solution to this growing problem? " Williams has been watching the population of older prisoners continue to grow, outpacing the general population of the U.S. As this trend continues, she said, prisons and jails need to catch up... 'I’m talking about a massive expansion of the field of palliative care into the correctional system,” she said, “so it’s integrated into the fabric of correctional care.'”
Tuesday, November 29, 2016
It is estimated that one in ten adults over the age of 60 is a victim. But the truth is we don’t know for certain how many older adults are suffering from abuse. In the eighth edition of Aging Matters, Nashville Public Television explores the issues behind elder abuse, neglect and exploitation.
Experts suggest that our understanding of elder abuse lies decades behind that of child abuse and domestic violence. Elder abuse is underreported. It lacks clear legal definition and is complicated by ethical challenges. The system of response is different depending on where you live.
What are the risk factors, what can we do to protect ourselves and our loved ones, and what is our responsibility to intervene for those in need? The questions are simple, but the answers are not. Find out more in Aging Matters – Abuse & Exploitation.
The story is accompanied by a panel discussion and includes background resources.
Thursday, November 10, 2016
I recently was called for jury duty. One of the questions asked during voir dire was about jurors' attitudes regarding the prospect of service. That made me think of a study I ran across recently, Measuring Older Adult Confidence in the Courts and Law Enforcement, published in Criminal Justice Policy Review. The abstract for the article explains
Older adults are an increasingly relevant subpopulation for criminal justice policy but, as yet, are largely neglected in the relevant research. The current research addresses this by reporting on a psychometric evaluation of a measure of older adults’ Confidence in Legal Institutions (CLI). Confirmatory factor analysis (CFA) provided support for the unidimensionality and reliability of the measures. In addition, participants’ CLI was related to cynicism, trust in government, dispositional trust, age, and education, but not income or gender. The results provide support for the measures of confidence in the courts and law enforcement, so we present the scale as a viable tool for researchers and practitioners interested in understanding older adults’ confidence in these institutions. We conclude by discussing the implications of our work on efforts to improve interactions between older adults and legal institutions, and we highlight avenues for further research.
Here is a short excerpt from the conclusion:
Why is it that older, older adults report more confidence in the criminal justice system than younger, older adults? Does this reflect a cohort effect or individual differences? In addition, future research should examine whether these confidence subscales predict willingness to engage or actual engagement in legal activities such as jury service, reporting crimes (as a victim or witness), or initiating litigation as well as they do in more general samples
Wednesday, October 26, 2016
DOJ announced recently that it had settled a False Claims case against Life Care Centers of America Inc. (Life Care) and its owner, Forrest L. Preston. The defendants agreed to pay $145 million to settle a case where the Government claimed “that Life Care violated the False Claims Act by knowingly causing skilled nursing facilities (SNFs) to submit false claims to Medicare and TRICARE for rehabilitation therapy services that were not reasonable, necessary or skilled….” In addition, the defendant also signed a Corporate Integrity Agreement with the Office of Inspector General (HHS-OIG) for HHS. Under this 5 year agreement, “an independent review organization [will] … annually assess the medical necessity and appropriateness of therapy services billed to Medicare” by the defendant. The suit was brought pursuant to the whistleblower provision of the False Claims Act.
According to the suit, the defendant put corporate-wide procedures and polices into place that caused a maximum number of “beneficiaries in the Ultra High reimbursement level irrespective of the clinical needs of the patients, resulting in the provision of unreasonable and unnecessary therapy to many beneficiaries.” Further the defendant tried to keep SNF residents longer than needed so the defendant could continue to bill for rehab, even though the therapists concluded therapy should be ended. The defendant kept careful track of the therapy minutes per patient and the patient’s therapy days so that the maximum number of patients were at that “highest level of reimbursement for the longest possible period.”
According to an email I received, the amount of the settlement was partially based on statistical sampling.
Thanks to Laurence Hooper for emailing me.
Sunday, October 23, 2016
The National APS Resource Center released a new research brief, Elder Abuse, Mother Abuse & Parenting in Later Life. The focus of the brief is older mothers with adult children who are described as difficult. "The sample is low income and minority older women 62 years and older. All of the women had allowed their adult children to move back into the family home when the adult children had [become] unable to support themselves due to mental health issues, break up of a romantic relationships or unemployment." The brief explains the stress these mothers undergo and the reasoning for why the mothers allowed their children to move back in with them and why they don't make the children move out once problems occur. Consider this from the brief,
A surprising finding is that none of the women ever used the word “abuse,” including those who had contacted law enforcement and/or had obtained an order of protection. Instead, they presented themselves as mothers who made the decision to protect their adult children over their own personal comfort or safety.
As far as policy implications, "[a] surprising finding is that none of the women ever used the word “abuse,” including those who had contacted law enforcement and/or had obtained an order of protection. Instead, they presented themselves as mothers who made the decision to protect their adult children over their own personal comfort or safety. " The brief suggests that APS workers and elder mothers develop a "safety plan" for addressing both the mother and child's needs.