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Tag: Nursing Homes

  • Hundreds evacuated and dozens hospitalized after an ammonia gas leak in Oklahoma

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    WEATHERFORD, Okla. — Hundreds of people were evacuated from a city in Oklahoma and others were told to shelter in place after a tanker truck that was leaking in a hotel parking lot spewed a plume of anhydrous ammonia gas, authorities said Thursday.

    The gas release happened shortly before 10 p.m. Wednesday. People in the immediate area were in respiratory distress and at least 36 people were taken to a local hospital, city officials said at a news conference. Eleven of them were brought to other hospitals for further treatment.

    At least 500 to 600 people were in a shelter as of Thursday morning, authorities said. Several nursing homes were evacuated and schools were closed for the day. Those that were told to shelter in place were in a triangle-shaped area, including businesses that were advised to stay closed, authorities said.

    Krystal Blackwell, who was evacuated, said emergency officials were wearing gas masks and knocking on doors.

    “It was a little crazy to wake up to,” Blackwell told KWTV-TV. “I really thought it was a kind of dream.” She said she was sitting in her car, still wearing her pajamas.

    Authorities said the air quality was being monitored and that the tanker truck was no longer spewing gas, but that a lack of wind was slowing efforts to dissipate it. A number of agencies were on hand to assist, including hazmat crews and an Oklahoma National Guard unit that supports first responders during emergencies.

    An exit from Interstate 40 to Weatherford was shut down, authorities said.

    Anhydrous ammonia is used as a fertilizer to help provide nitrogen for corn and wheat plants. If a person touches it when it is in gas or liquid form, they could be burned. Last week, an anhydrous ammonia leak caused by an explosion at a plant north of Yazoo City, Mississippi, prompted evacuations for nearby residents.

    Weatherford has about 12,000 residents and is about 70 miles (113 kilometers) west of Oklahoma City.

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  • Much like a nursing home, penguins at a Boston aquarium can age with dignity

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    BOSTON — When Lambert started losing his vision and slowing down a few steps, it became clear that he needed to be relocated to a place where he could age safely and still be with his friends.

    But he couldn’t be placed in just any nursing home — because he is a critically endangered African penguin. Instead, the New England Aquarium in Boston, where the 33-year-old Lambert was born and has lived his entire life, decided in February to open a geriatric island for him and its six other aging penguins.

    “Honestly, it sort of started off as a joke. It’s like, ‘Oh, well, why don’t we give them an old folks home?’” Eric Fox, associate curator of penguins at the aquarium, said. “But the more we were looking at their welfare data and understanding what ailments they go through, what physical limitations they have, we started to realize that we were on to something.”

    The rocky island near the aquarium entrance is set apart from the rest of the 38-bird colony, ensuring the older penguins don’t have to compete for territory with their often aggressive, younger peers. These penguins, with their trademark black and white feathers, stand about 2 feet (0.6 meters) tall and weigh about as much as a large house cat.

    The enclosure has some flatter topography and a carpeted path down to the water, which allows Lambert and the other penguins to better navigate up and down the island. The aquarium has built a stand in front of the island, which makes it easier for the penguins to hop out of the water.

    As a result, Mia Luzietti, a senior penguin trainer at the aquarium, said she has seen Lambert become more active since moving to the new island — swimming more with his mate and getting off the island more often.

    The concept was inspired by a larger concern that is confronting zoos and aquariums around the world — what to do when their animals are surviving far longer than their counterparts in the wild. In the case of these African penguins, some are in their 30s and one lived into its 40s. That is twice as long as they would live in the wilds of South Africa and Namibia, due to threats like pollution and lack of food from humans’ overfishing.

    “It’s really important that, as we learned how long these animals could live, if given an optimal environment, that we evolved with that,” Luzietti said.

    “So learning on an individual level, how can we best set our animals up for success is really what led to the idea of creating our geriatric island, a place where our oldest penguins have a more comfortable, slower way of life as they live out their days here,” she added.

    Caring for the aging penguins goes far beyond a safer enclosure.

    The older birds get more checkups than their younger counterparts, and veterinarians offer them treatment for ailments that might be familiar to older humans — such as supplements and anti-inflammatory drugs for arthritis and joint pain, and eye drops for glaucoma. There are also more cameras around the island, so staff can better monitor the birds.

    “We are just keeping a little closer of an eye on some of these older birds,” Luzietti said. “It’s important that we’re picking up on those — from how someone’s hips are moving, how they’re walking, how they are acting, if someone’s squinting. The smallest change day to day can be hiding a really big secret.”

    On a recent day, Luzietti was in the geriatric enclosure tending to Lambert — who seemed content to stand at the top of the island with his mate Dyer III, preening one another and occasionally letting out a loud call that sounded like a donkey’s bray. He previously had his left eye removed due to an infection and has glaucoma in his right eye. He also suffers from chronic inflammation.

    Luzietti coaxed him down from his perch, and soon he was sitting on her lap, getting ready for his daily dose of eye drops.

    A crowd had formed around the enclosure to watch, including Terri Blessman, a 69-year-old tourist from Canton, Illinois, who was being pushed in a wheelchair by her friend Lou Ann Delost. Hearing about Lambert’s age and the care he gets, Blessman said she could relate.

    “That’s wonderful,” Blessman said. “All of us older people need extra care as we get older.”

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  • Assisted living safety survey results on way to fire departments

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    Results of the state’s survey of all 272 assisted living residences in Massachusetts in the wake of a deadly fire in Fall River are in and they will soon be distributed to local fire departments as the state imposes a new annual safety requirement for the facilities.

    Ten residents of the Gabriel House assisted living center in Fall River died in a fire there in July, raising questions about safety and preparedness at the centers that operate somewhere between entirely independent living and places like nursing homes. Among the spate of safety-focused changes that Gov. Maura Healey announced in the immediate wake of the fire was the survey that led to Thursday’s new requirements.

    The results will be distributed to all fire departments, since they have jurisdiction over enforcement of the state’s fire code, and the Executive Office of Aging & Independence will begin requiring assisted living residences to secure an annual sign-off from their municipal fire department, Healey’s office said.

    “The Gabriel House fire was a terrible tragedy. It’s on all of us to do everything we can to enhance the safety of all residents and staff at Assisted Living Residences across the state. That’s why I took immediate action after the fire, including requiring this survey which will help ALRs and local fire departments identify and address areas of improvement,” Healey said. “We appreciate all of the ALRs for their responsiveness and will continue to work with them and local fire officials to improve emergency preparedness and give residents, families and staff the peace of mind they deserve.”

    The governor’s office said Thursday the “vast majority of residences reported strong preparedness measures” but responses from 36 residences (13%) revealed “opportunities to further strengthen their approach to fire drills, mutual aid plans, or emergency coordination protocols.” Aging & Independence will ask those facilities to submit a corrective action plan within 45 days and the state will conduct a “targeted review” of their training logs, drill performance, and emergency preparedness protocols.

    Most assisted living residences (189 facilities or 69%) self-identified at least one area where they were not aligned with best practices for fire or building safety. The administration said things like installing a kitchen hood extinguisher, fire pumps or fire-rated walls are recommended but not required in the facilities since they are not licensed health care centers. The governor’s office said many assisted living residences operate out of older buildings and that the findings “do not indicate that buildings are currently unsafe or out of compliance with building codes but rather point to areas where municipalities and operators can work together to enhance resident protection.”

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    Colin A. Young

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  • Planned 5-Day Strike at Kaiser Permanente Health Care Facilities Ends, With Plans for Further Talks

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    SAN FRANCISCO (AP) — A planned five-day strike by thousands of registered nurses and other Kaiser Permanente health care workers in California, Hawaii and Oregon ended on Sunday, union leaders and the health care system said.

    California-based Kaiser Permanente said it welcomed back about 30,000 employees who participated in the strike, which began Tuesday and ended Sunday morning. Its statement said its facilities were “staffed by physicians, experienced managers and trained staff, along with nearly 6,000 contracted nurses, clinicians and others who worked with us during the strike.”

    Plans call for bargaining to resume this week, with a focus on “economic issues,” the statement said. While unions also raised staffing and other concerns, “wages are the reason for the strike and the primary issue in negotiations,” the statement said.

    The United Nurses Associations of California/Union of Health Care Professionals, which represents registered nurses, pharmacists, nurse midwives and other health care professionals in California and Hawaii, said in a statement that more than 500 hospitals and clinics were impacted by the strike. It said the strike sent a message that “patient care and safe staffing must come first.”

    It announced plans to resume bargaining later this month.

    Sarina Roher, president of the Oregon Federation of Nurses and Health Professionals, in a statement said Kaiser Permanente “cannot fix its staffing and access crisis without competitive wages that retain and recruit the skilled professionals our patients depend on.”

    Kaiser Permanente is one of the nation’s largest not-for-profit health plans, serving 12.6 million members at 600 medical offices and 40 hospitals, largely in western U.S. states.

    Copyright 2025 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

    Photos You Should See – Oct. 2025

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    Associated Press

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  • One-third of Gov. Jared Polis’ budget cuts involve Medicaid

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    Almost one-third of the budget cuts and sweeps of unused money that Gov. Jared Polis used to close a $249 million budget hole will come from Medicaid, and providers are trying to figure out how much disruption that will cause for them and their patients.

    H.R. 1, known as the “Big Beautiful Bill,” blew a roughly $783 million hole in the state budget in July, because Colorado’s tax laws automatically adjust to stay in harmony with the federal government’s. The legislature opted to undo some of those changes during a special session in August and gave Polis the authority to fill the rest of the gap.

    About $79.2 million of the $252 million in cuts came from the Colorado Department of Health Care Policy and Financing, which runs Medicaid in the state. The list includes a mix of reductions in the rates paid to people who provide care, unused funds swept from specific programs and plans to review some care types more strictly before paying.

    The largest cut, worth roughly $38.3 million, would roll back most of a 1.6% increase that most providers expected to get this year. Since providers received slightly higher rates in the first months of the fiscal year, it will work out to about a 0.4% increase, which is in line with recent years, the department said.

    Denver Health estimated the rollback would cost the city’s safety-net hospital about $5 million. The health system isn’t planning any layoffs or service reductions, but could cut back on nonessential maintenance and technology updates, CEO Donna Lynne said. As it was, the increase only partially offset growth in costs in recent years, she said.

    “We were already trying to absorb the difference between medical inflation and the 1.6%,” she said. The American Hospital Association estimated hospital costs rose about 5.1% in 2024.

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    Meg Wingerter

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  • A robot programmed to act like a 7-year-old girl works to combat fear in hospitals

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    Days after Meagan Brazil-Sheehan’s 6-year-old son was diagnosed with leukemia, they were walking down the halls of UMass Memorial Children’s Medical Center when they ran into Robin the Robot.

    “Luca, how are you?” it asked in a high-pitched voice programmed to sound like a 7-year-old girl. “It’s been awhile.”

    Brazil-Sheehan said they had only met the 4-foot-tall (1.2-meter-tall) robot with a large screen displaying cartoonlike features once before after they were admitted several days earlier.

    “His face lit up,” she said about the interaction in June in Worcester, Massachusetts. “It was so special because she remembered him.”

    Robin is an artificial intelligence -powered therapeutic robot programed to act like a little girl as it provides emotional support at nursing homes and hospital pediatric units while helping combat staffing shortages. Five years after launching in the U.S., it has become a familiar face in 30 health care facilities in California, Massachusetts, New York and Indiana.

    “Nurses and medical staff are really overworked, under a lot of pressure, and unfortunately, a lot of times they don’t have capacity to provide engagement and connection to patients,” said Karen Khachikyan, CEO of Expper Technologies, which developed the robot. “Robin helps to alleviate that part from them.”

    As AI increasingly becomes a part of daily life, it’s found a foothold in medical care — providing everything from note-taking during exams to electronic nurses. While heralded by some for the efficiency it brings, others worry about its impact on patient care.

    Robin is about 30% autonomous, while a team of operators working remotely controls the rest under the watchful eyes of clinical staff. Khachikyan said that with each interaction, they’re able to collect more data — while still complying with the Health Insurance Portability and Accountability Act, or HIPAA — and get closer to it being able to function independently.

    “Imagine a pure emotional intelligence like WALL-E. We’re trying to create that,” he said, referencing the 2008 animated film.

    On a recent Friday, a staff member at HealthBridge Children’s Hospital in Orange County, California, read off a list of patients she needed Robin to visit, along with the amount of time to spend with each one.

    The robot with a sleek white triangle-shaped frame that Khachikyan said was designed for hugging, rolled into a room with a teenager injured in a car accident. The robot played what it described as his favorite song — “No Fear” by DeJ Loaf — and he danced along. In the hallway, Robin cracked up a young child held by her mother when it put on a series of silly glasses and a big red nose. In another room, the robot played a simplified version of tic-tac-toe with a patient.

    Samantha da Silva, speech language pathologist at the hospital, said patients light up when Robin comes into their room and not only remembers their names but their favorite music.

    “She brings joy to everyone,” da Silva said. “She walks down the halls, everyone loves to chat with her, say hello.”

    Robin mirrors the emotions of the person it is talking with, explained Khachikyan. If the patient is laughing then the robot laughs along, but if they’re sharing something difficult, its face reflects sadness and empathy.

    In nursing homes, Robin plays memory games with people suffering from dementia, takes them through breathing exercises on difficult days and offers them a form of companionship that resembles a grandchild with a grandparent.

    Khachikyan recalled a moment last year at a facility in Los Angeles where a woman was having a panic attack and asked specifically for the robot. Robin played songs by her favorite musician and videos of her favorite animal — Elvis Presley and puppies — until she had calmed down.

    But with the Association of American Medical Colleges projecting that the U.S. will face a shortage of up to 86,000 physicians in the next 11 years, Khachikyan’s vision for Robin goes far beyond this type of support.

    He said they’re working to make the robot able to measure patients’ vitals and check to see how they’re doing and then send that information to their medical team. Longer term plans include designing Robin to help elderly patients change their clothes and go to the bathroom.

    “Our goal is to design the next evolution of Robin; that Robin will take more and more responsibilities and become even more essential part of care delivery,” Khachikyan said.

    He clarified that it’s not about replacing health care workers but about filling in the gaps in the workforce.

    At UMass, the robot is very much a part of a team of support for patients. When Luca needed an IV after not getting one in a while, Micaela Cotas, a certified child life specialist came in with the robot and showed him an IV and what was about to happen, and then Robin played a cartoon of it getting an IV put in.

    “It just kind of helps show that Robin has gone through those procedures as well, just like a peer,” Cotas said.

    Robin was developed by Khachikyan while he was getting his Ph.D. He said growing up in a single-parent household in Armenia had been lonely, so years later he wanted to build a type of robot that could act as a person’s friend.

    Developers tested it in a variety of industries before an investor suggested that pediatric hospitals would be a good fit because of the stress and loneliness children often feel.

    “That was kind of an aha moment,” he said. “We decided, OK let’s try it.”

    They had success introducing it at a pediatric hospital in Armenia and by 2020 launched a pilot program at UCLA Mattel Children’s Hospital.

    Since Robin was created, its personality and character have changed significantly based on the responses from people it interacts with.

    Khachikyan gave the example of Robin’s answer to the question: “What is your favorite animal.” Initially they tried having the robot respond with dog. They also tried cat. But when they tried chicken, the children cracked up. So they stuck with it.

    “We created Robin’s personality by really taking users into the equation,” he said. “So we often say that Robin was designed by users.”

    ___

    Associated Press journalist Damian Dovarganes contributed to this report.

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  • These real estate stocks top Bank of America’s buy list

    These real estate stocks top Bank of America’s buy list

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  • Nursing home workers warn of care crisis at long-term facility in Orlando

    Nursing home workers warn of care crisis at long-term facility in Orlando

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    photo by McKenna Schueler

    Nursing home staff and fellow 1199 SEIU union members picket outside Aspire at Rosewood in Orlando amid ongoing union contract talks (Aug. 8, 2024)

    Nursing home staff in Orlando organized a picket line outside the long-term care facility Aspire at Rosewood last week, as part of a statewide action organized to raise awareness of what staff call a “care crisis.”

    Eleven nursing homes were targeted. All are owned by Aspire Health Group, a for-profit company that recently acquired ownership of the 120-bed Orlando facility.

    Aspire at Rosewood, formerly known as Rosewood Health and Rehabilitation, was previously owned by the mega-chain Consulate Health Care, which no longer lists facilities located in the state of Florida (save for one) after suffering years of bad press, filing for bankruptcy and going through a conveniently timed rebranding in 2022.

    Staff members’ picketing action was coordinated through their union, the 1199 Service Employees International Union. The picket was organized following unsuccessful talks between the union and Aspire, which owns more than 55 facilities in the state.

    Aspire and the union — including nursing home staff on the union’s bargaining committee — are currently in negotiations for a new union contract, covering over 1,000 certified nursing assistants, dietary aides and housekeepers across Florida.

    Denise Allegretti, chief negotiator for the union and a former CNA herself, said Aspire’s labor relations team has put up a fight at the bargaining table, particularly on the issue of staffing levels.

    “They’re refusing to even talk about staffing,” Allegretti told Orlando Weekly on the picket line, which featured about a dozen staff joined by other union members and community allies in purple union shirts, marching on the sidewalk outside Rosewood in solidarity.

    According to Allegretti, “They’re [Aspire] saying they’re going to go with whatever the state says, and that’s unacceptable.” Under a Republican-backed bill signed by Florida Gov. Ron DeSantis in 2022, long-term residents of nursing homes are now only required to receive two hours of CNA care daily, down from 2.5 hours per resident.

    Staff at Rosewood say this isn’t enough time to dress, feed, bathe and provide quality care for residents. They’re chronically understaffed and underpaid — many earn just a few dollars above Florida’s minimum wage of $12 an hour — leaving caregivers overstretched, frustrated and burnt out.

    “We just want to give them the love that they deserve,” said longtime caregiver Diane McMullen, a CNA of 20-plus years at Rosewood. McMullen shared that she was inspired to become a CNA because of her brother, who also spent time in a nursing home. “That inspired me to become a CNA.”

    Speaking of Rosewood’s residents, and the quality of resident care, McMullen stressed the importance of maintaining a workforce that’s also taken care of, and not suffering from the instability of staff turnover.

    “We are their family,” McMullen said of Rosewood’s residents, as Florida’s 90-plus degree heat enveloped her and others gathered around her on the sidewalk. “We love them, too.”

    click to enlarge Diane McMullen, a CNA at Aspire at Rosewood and union member, pickets alongside her fellow staff and union members (Aug. 8, 2024) - photo by McKenna Schueler

    photo by McKenna Schueler

    Diane McMullen, a CNA at Aspire at Rosewood and union member, pickets alongside her fellow staff and union members (Aug. 8, 2024)

    Yet, when staff like herself are overstretched — tasked with taking care of more residents, with less support from their employer — they have less time to actually provide the quality of care they’d reasonably wish to provide for someone they treat as family.

    This includes smaller actions like finding a resident’s favorite necklace to wear that mean a lot. “Staff don’t have five minutes to go find their necklace or their lipstick, or even give a bath on some days,” said Allegretti, the union’s negotiator.

    Staffing shortages — and low pay for nursing home staff — were some of the primary issues voiced by workers Thursday, who carried signs outside of the Orlando facility demanding “Safe Staffing Now” and “Contract Now.”

    “The turnover is ridiculous,” said Allegretti, clad in a purple shirt like the nursing home staff around her. “Back in the day in the ’90s, when I was a CNA, it was like eight to 10 patients on a day shift, maybe 15 on an evening shift, but never more than that,” she recalled. “Nowadays, they’re doing 15 patients on a day shift, 20 or more on a night shift, which is criminal.”

    According to federal data compiled by ProPublica, nursing homes owned by Aspire Health Group in Florida have seen a higher-than-average rate of “serious deficiencies,” and higher-than-average staff turnover.

    A federal inspection report, published in April, found over a dozen deficiencies in the Rosewood facility’s operations in Orlando, all posing “no harm, but with a potential for more than minor harm,” according to inspectors.

    Deficiencies identified ranged from quality of care issues, such as failing to provide trauma-informed or culturally competent care, to pharmacy issues, like medication errors.

    “We just want to give them the love that they deserve,” said longtime caregiver Diane McMullen, a CNA of 20-plus years at Rosewood.

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    Under different ownership, the facility in 2022 was fined $163,183 over three severe deficiencies identified by inspectors, posing an “immediate jeopardy to resident health or safety,” and two deficiencies posing minimal or no harm.

    Some of Aspire’s other facilities in Florida have similarly been cited for deficiencies, including inadequate supervision at Aspire at Saint Lucie on the Treasure Coast and a failure to “[E]nsure that a nursing home area is free from accident hazards,” according to an April report summarizing deficiencies.

    Aspire Health Group has faced an average fine of $50,782 in penalties for health citations, according to the ProPublica database. Penalties are issued by the Centers for Medicare and Medicaid Services for serious health citations, or for health citations that have not been fixed.

    As The New Yorker reported in 2022, federal staffing rules haven’t changed for nursing homes since 1987. In April of this year, the Biden-Harris administration took action to change that, announcing a new rule on minimum staffing standards in nursing homes that will, for the first time, establish minimum staffing requirements in such facilities overseen by the Centers for Medicare and Medicaid Services.

    The implementation of this new rule, however, is subject to a “staggered implementation timeframe,” according to CMS. The union in Florida argues that “immediate and contractual obligations for safe staffing” are needed from nursing home operators in Florida now — not later.

    “Staffing and retention always has been an issue because it can be a complicated and back-breaking job for very little pay,” said Margarette Nerette, vice president of the union’s Long-Term Care division, in a recent statement.

    “Add the pandemic where workers were at ground zero of COVID risk, lowered safe-staffing rules in Florida, and the state’s skyrocketing housing and insurance costs, and we have a perfect storm of pressure,” Nerette continued. “To help relieve this crisis and to better protect patients and their caregivers across the state, we’re fighting for new contracts that respect us, protect us, pay and staff us.”

    The workers’ fight for a fair contract — and meaningful action on the issue of staffing — comes in the wake of a financial boost approved for nursing home operators by the Florida legislature and Gov. Ron DeSantis earlier this year. As part of the state’s 2024-25 fiscal year budget, state leaders approved a $247.8 million Medicaid increase for the state’s nursing home operators, in part to help address staffing problems.

    “The state budget provides an 8% increase ($247.8 million) in Medicaid funding, amounting to nearly $470,000 per center, per year to support the state’s nursing centers with meeting the growing demand for qualified caregivers and the needs of Florida’s vulnerable seniors and people with disabilities,” the Florida Health Care Association shared in a statement celebrating the extra funding.

    The Florida Health Care Association, a state affiliate of the nation’s largest nursing-home lobbying group, represents over 86 percent of Florida’s nursing centers — with Aspire-owned facilities among their federation’s membership.

    Aspire Health Group facilities in Florida have, as part of their membership, contributed to the FHCA’s political activities through regular contributions to an associated FHCA PAC. State records show Aspire facilities have contributed over $20,000 to one of their PACs in 2024 alone.

    Getting a fair union contract for staff at Aspire-owned nursing homes would give residents “a better home,” said CNA McMullen. “A better home for them, better staffing and better wages for us,” she added.

    Registered nurses at HCA Hospitals in Florida have similarly raised alarms about unsafe staffing levels at their facilities, and are also in negotiations for a new union contract.

    Nurses at HCA Osceola Hospital, represented by National Nurses United, organized their own picket line on Thursday, calling on their multi billion-dollar, for-profit employer to invest in high quality staff and patient care.

    click to enlarge Nursing home staff and fellow union members picket outside Aspire at Rosewood, a nursing home in Orlando (Aug. 8, 2024) - photo by McKenna Schueler

    photo by McKenna Schueler

    Nursing home staff and fellow union members picket outside Aspire at Rosewood, a nursing home in Orlando (Aug. 8, 2024)

    “We’ve been at the bargaining table for months fighting for what we need to take care of our patients,” said Elisabeth Mathieu, a registered nurse in HCA Osceola Hospital’s emergency department, in a statement. “We need HCA to hear us, so we’re holding this informational picket to let the public know what we’re demanding in our contract when it comes to patient care and, especially, safe staffing.”

    The most recent NNU contract covering RNs at 10 HCA hospitals in Florida — including HCA Osceola and HCA Lake Monroe in Sanford — was negotiated in 2021. The contract officially expired July 1, after being extended once from its original May 31 expiration date.

    The union contract covering nursing home staff at Aspire Health Group facilities, represented by 1199 SEIU Healthcare East, has also expired, according to Allegretti.

    Nearly 50 nursing home facilities in Florida represented by 1199 SEIU Healthcare East, covering 4,000 staff total, have union contracts that have expired or will expire at some point this year, according to the union.

    While NNU staff have politely declined to comment on what the next steps are for RNs that they represent, if HCA continues to remain resistant at the bargaining table, Allegretti said that if Aspire Health Group fails to budge, the next step for their union is a strike vote.

    “If management doesn’t follow us with [bargaining] dates, and come with real proposals, the next step is that we will be out on strike,” Allegretti confirmed.

    The last time workers went on strike at the Rosewood facility in Orlando, and 18 other nursing homes in Florida, was 2016. The union described it then as the largest-held strike in the Southeastern United States in nearly two decades.

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    McKenna Schueler

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  • A city famous for its beaches is helping residents age in place. What to know if you want to stay in your home

    A city famous for its beaches is helping residents age in place. What to know if you want to stay in your home

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    Laguna Beach, California

    Luciano Lejtman | Moment | Getty Images

    When most people think of Laguna Beach, California, they think of its scenic coves and beaches.

    But the small coastal city — with a population of around 22,600 — is also pioneering a new model for elder care.

    About 77% of adults ages 50 and up hope to stay in their homes long term, according to AARP. In Laguna Beach, the rate is even higher, with about 90% of residents, according to Rickie Redman, director of the city’s aging-in-place services, dubbed Lifelong Laguna.

    The program, which provides services through a hometown nonprofit, was piloted in 2017. Lifelong Laguna is based on the Village movement, where aging in place is encouraged with community support.

    The Laguna Beach program aims to fulfill a specific need for a city where approximately 28% of residents are age 65 and over, while local assisted living and memory care services are scarce.

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    Many of the older residents have lived in the city since they were in their 20s and 30s, and now find themselves in their 70s and 80s, according to Redman. Many of them trace back to the city’s artistic roots, she said.

    “They make this city unique,” Redman said. “They’re the placeholders for the Laguna that we now know.”

    Notably, there is no cost for the city’s older adults to participate in most of the services.

    The program, which currently has around 200 participants, relies on grants and local fundraising, according to Redman. Its services address a wide range of needs, including a home repair program the city operates in collaboration with Habitat for Humanity, nutrition counseling and end-of-life planning.

    Other cities have also adopted community support models for residents who age in place through the Village movement. That includes tens of thousands of older adults in 26 states and Washington, D.C., according to Manuel Acevedo, founder and CEO of Helpful Village, which provides technology support to seniors and participating communities.

    Retirees confront high costs to stay at home

    The high costs of aging in place are one of the biggest obstacles that prevents older adults from fulfilling their desire to stay put, experts say.

    About 10,000 baby boomers are expected to turn age 65 every day until 2030. An estimated 70% of those individuals will need long-term care services at some point, according to Genworth Financial.

    In 2021, the highest year-over-year increase in cost was in home-care services, Genworth’s research found. The median annual cost for in-home care was $61,776 for a home health aide to provide hands-on personal care and $59,488 for homemaker services to help with household tasks.

    Those costs have been influenced by supply and demand, according to Genworth.

    As more people age and require care, the Covid pandemic led to an insufficient supply of professionals to meet care needs, as well as a high turnover rate.

    Preferences for aging in place are also showing up in the real estate market.

    Baby boomers currently represent the biggest portion of home buyers, according to Jessica Lautz, deputy chief economist and vice president of research at the National Association of Realtors. More than half of boomers are saying that the property they are purchasing now is where they plan on living for the rest of their lives, a sentiment that has increased since the Covid pandemic.

    “There definitely is a mindset change, where people are saying, ‘I do want to stay put, I don’t necessarily want to move into a nursing home or into assisted care,’” Lautz said.

    ‘Forever grateful’ for community

    Sylvia Bradshaw, an 84-year-old Laguna Beach resident who moved to the city in 1983, describes it as “paradise.”

    She has lived there since that time, apart from a stint when she and her husband relocated to Ireland. Still, the couple held on to their home, the city’s third-oldest house, which was built in 1897.

    “My husband had ideas about selling our home,” Bradshaw said. “But I would never sell it, because I said ‘Once it’s gone, it’s gone forever.’”

    Bradshaw’s husband was a teacher in the city’s high school and later became a lawyer. More recently, he had health struggles that made it difficult for the couple to keep up with yard work, Bradshaw said.

    As members of the Laguna aging-in-place community, they had access to help.

    Redman helped arrange for a team of workers to come to clean up the yard, which included removing 17 bags of scraps and trimming a roughly 30-year-old fig tree.

    “Now people can see that there’s a house there; they just couldn’t see it [before],” said Bradshaw, who said she is “forever grateful” for the gesture.

    The support of the community also was especially helpful in sorting through the hospice care issues prior to her husband’s recent death.

    “Anything that I’ve needed, I’ve gotten help,” Bradshaw said.

    That has included help sorting through insurance choices, legal advice, transportation assistance and classes and social events, said John Bradshaw, Sylvia’s son.

    Having the elder community support his parents is a “big comfort,” John said, particularly as he no longer lives in Laguna Beach.

    “It is just such a wonderful relief,” John said. “It’s like having a second family, this team of people really supporting my parents, and others like them, to be able to stay and enjoy this part of the country.”

    What to do if you want to age in place

    If you want to age in place, it helps to start planning early to make sure it’s feasible, said Carolyn McClanahan, a physician and certified financial planner who is the founder of Life Planning Partners in Jacksonville, Florida.

    “We actually start bringing it up with clients in their 50s and 60s: Where do you want to live out the end of your life?” McClanahan said. “Of course, most people do say, ‘I want to live in my home.’”

    It’s important to be realistic about those plans.

    Ask yourself whether the decision to age in place is just “rationalized inertia,” or giving yourself an out when it comes to confronting other important aging decisions, said Tom West, senior partner at Signature Estate and Investment Advisors in Tysons Corner, Virginia.

    If you do decide staying in your home is the best option, be prepared to make changes to your home, he said. That may include wider doorways to accommodate wheelchairs or walkers, as well as grab bars to help prevent falls.

    Like the aging-in-place models established in Laguna Beach and elsewhere, it helps to have community support. McClanahan recommends developing strong relationships with your neighbors where you agree to look out for each other.

    It also helps to set certain boundaries for when staying at home no longer makes sense.

    For example, it may cost $240,000 a year to stay home if you need 24-hour care, McClanahan said.

    “Even if you’re super rich, a lot of families hate seeing that much money go out the window, when you would pay half the cost to actually go into a facility,” McClanahan said.

    Further, be sure to outline your wishes in all potential circumstances. While you may want your children to promise not to put you in a nursing home, it may come to a point where it is more cost effective and safer to go to a care unit, McClanahan said.  

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  • New York governor vetoes change to wrongful death statute, nixing damages for emotional suffering

    New York governor vetoes change to wrongful death statute, nixing damages for emotional suffering

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    ALBANY, N.Y. — New York Gov. Kathy Hochul has again vetoed legislation that would have changed the state’s wrongful death statute by letting families recover damages for emotional suffering from the death of a loved one.

    Hochul declined Friday to sign the Grieving Families Act for the second time this year. In a veto memo, the Democrat said she favors changing the statute but the bill lawmakers sent her had the “potential for significant unintended consequences.”

    Among Hochul’s concerns, she said, were the possibility of increased insurance premiums for consumers and a risk to the financial well-being of public hospitals and other health care facilities.

    New York is one of just a few states that account only for economic loss in wrongful death lawsuits. Almost all states allow family members to be compensated for emotional loss.

    The head of the New York State Trial Lawyers Association, David Scher, called Hochul’s veto “a grave miscarriage of justice.”

    The governor’s decision “puts the safety of New Yorkers in jeopardy and upholds a perverse standard of morality in current New York law,” Scher said in a statement.

    The state’s existing wrongful death statute calculates how much families are compensated based on pecuniary loss, or the potential earning power of the deceased person. That means the family of a top-earning lawyer, for example, can recover more damages than the family of a minimum-wage worker.

    Hochul wrote that valuing life based on potential earnings “is unfair and often reinforces historic inequities and discriminatory practices,” but said she chose to veto the bill because lawmakers failed to adequately address concerns she raised when she nixed a previous version last January.

    “Every human life is valuable and should be recognized as such in our laws and in our judicial system,” Hochul wrote. “I proposed compromises that would have supported grieving families and allowed them to recover additional meaningful compensation, while at the same time providing certainty for consumers and businesses.”

    The long-sought bill stalled for about two decades before reaching Hochul’s desk for the first time after passing last year. She vetoed that version on the grounds that it would drive up already-high insurance premiums and harm hospitals recovering from the pandemic.

    “We tried to address her concerns squarely,” said Sen. Brad Hoylman-Sigal, who sponsored both vetoed bills. “It’s absolutely outrageous that lives in New York are valued differently under our wrongful death statute.”

    The latest version was passed by lawmakers in June with strong bipartisan support. Hochul said she went through “much deliberation” before deciding to veto it. In her memo, she said she remains open to updating the wrongful death statute.

    The legislation would have enabled families who file lawsuits over a loved one’s wrongful death to be compensated for funeral expenses, for some medical expenses related to the death and for grief or anguish incurred as a result, in addition to pecuniary losses.

    ___

    Maysoon Khan is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues. Follow Maysoon Khan on X, formerly known as Twitter.

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  • Mishmash of how US heat death are counted complicates efforts to keep people safe as Earth warms

    Mishmash of how US heat death are counted complicates efforts to keep people safe as Earth warms

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    PHOENIX — Postal worker Eugene Gates Jr. was delivering mail in the suffocating Dallas heat this summer when he collapsed in a homeowner’s yard and was taken to a hospital, where he died.

    Carla Gates said she’s sure heat was a factor in her 66-year-old husband’s death, even though she’s still waiting for the autopsy report. When Eugene Gates died on June 20, the temperature was 98 degrees Fahrenheit (36.6 Celsius) and the heat index, which also considers humidity, had soared over 110 degrees Fahrenheit (43.3 Celsius).

    “I will believe this until the day I die, that it was heat-related,” Carla Gates said.

    Even when it seems obvious that extreme heat was a factor, death certificates don’t always reflect the role it played. Experts say a mishmash of ways more than 3,000 counties calculate heat deaths means we don’t really know how many people die in the U.S. each year because of high temperatures in an ever warming world.

    That imprecision harms efforts to better protect people from extreme heat because officials who set policies and fund programs can’t get the financial and other support needed to make a difference.

    “Essentially, all heat related deaths are preventable. People don’t need to die from the heat,” said epidemiologist Kristie L. Ebi, who focuses on global warming’s impact on human health as a professor at the University of Washington.

    With a better count, she said, “you can start developing much better heat wave early warning systems and target people who are at higher risk and make sure that they’re aware of these risks.”

    Currently, about the only consistency in counting heat deaths in the U.S. is that officials and climate specialists acknowledge fatalities are grossly undercounted.

    “Deaths are investigated in vastly different ways based on where a person died,” said Dr. Greg Hess, the medical examiner for Pima County, Arizona’s second most populous county and home to Tucson. “It should be no surprise that we don’t have good nationwide data on heat-related deaths.”

    Many experts say a standard decades-old method known as counting excess deaths could better show how extreme heat harms people.

    “You want to look at the number of people who would not have died during that time period and get a true sense of the magnitude of the impact,” Ebi said, including people who would not have suffered a fatal heart attack or renal failure without the heat.

    The excess deaths calculation is often used to estimate the death toll in natural disasters, with researchers tallying fatalities that exceeded those that occurred at the same time the previous year when circumstances were average.

    Counting excess deaths was used to calculate the human impact of a heat wave in Chicago that killed more than 700 people in July 1995, many elderly Black people who lived alone. Researchers also counted excess deaths during the COVID-19 pandemic to provide more complete information about deaths directly and indirectly related to the coronavirus.

    But as things stand now, the Centers for Disease Control and Prevention reports just 600 to 700 heat deaths annually in the United States. A study published last month in the journal Nature Medicine estimated more than 61,000 heat-related deaths last summer across Europe, which has roughly double the U.S. population but more than 100 times as many heat deaths.

    Dr. Sameed Khatana, a staff cardiologist at the Philadelphia VA Medical Center and assistant professor at the University of Pennsylvania’s Perelman School of Medicine, has said deaths in which heat contributed significantly to fatalities from causes like heart failure should also be considered.

    Khatana participated in research published last year that counted excess deaths in all U.S. counties. The findings suggested that from 2008 to 2017 between 3,000 to 20,000 adult deaths from all causes listed on death certificates were linked to extreme heat. Heart disease was listed as the cause of about half of the deaths.

    After the Pacific Northwest heat wave in summer of 2021, the Canadian province of British Columbia reported more than 600 deaths due to heat exposure while Oregon and Washington each initially reported a little more than 100 such fatalities.

    “It’s frustrating that for 90 years public health officials in the United States have not had a good picture of heat-related mortality because we have such a bad data system,” said Dr. David Jones, a Harvard Medical School professor who also teaches in the epidemiology department at the Harvard T.H. Chan School of Public Health.

    There is no uniformity among who does the counting across U.S. jurisdictions. Death investigations in some places might be carried out by a medical examiner, typically a physician trained in forensic pathology. In other locales, the coroner could be an elected sheriff, such as the one in Orange County, California. In some small counties in Texas, a justice of peace might determine cause of death.

    Utah and Massachusetts are among states that do not track heat-related deaths where exposure to extreme heat was a secondary factor.

    The CDC, which is often several years behind in reporting, draws information on heat deaths from death certificate information included in local, state, tribal and territorial databases.

    The CDC said in a statement that coroners and others who fill out death certificates “are encouraged to report all causes of death,” but they may not always associate those contributing causes to an extreme heat exposure death and include the diagnostic codes for heat illnesses.

    Hess, the Arizona coroner, said determining environmental heat was a factor in someone’s death is difficult and can take weeks or even months of investigation including toxicological tests.

    “If someone was shot in the head, it’s pretty obvious what happened there,” Hess said. “But when you find a body in a hot apartment 48 hours after they died, there is a lot of ambiguity.”

    Hess noted that Pima County this year began including heat-related deaths in its tally of environmental heat fatalities. Maricopa County, home to Phoenix, America’s hottest big city, for years has included heat-related deaths. Clark County, Nevada, home to Las Vegas, now also considers deaths in which heat was a contributing factor.

    Maricopa’s Public Health Department counted 425 “heat associated” deaths last year, including those where heat was a secondary factor, such as a heart attack provoked by high temperatures.

    It reports there were 59 heat-associated deaths confirmed this year through Aug. 5, with another 345 under investigation. The latest count follows the hottest month in Phoenix on record, and a record 31 consecutive days that hit 110 degrees Fahrenheit (43.3 Celsius) or higher.

    Dallas, which regularly sees summer highs over 100 degrees Fahrenheit (37.7 Celsius), sweltered through an excessive heat warning this month and also grapples with oppressive humidity.

    Carla Gates, whose mail carrier husband died, noted cities worldwide now must learn to deal with extreme weather. She said her spouse, with 36 years on the job, tried to protect himself by taking a chest filled with ice and several bottles of cold water on his rounds.

    “Our climate has changed,” she said. “And I don’t think it’s going back to how it was 20 years ago. So we’re going to have to get used to it and we’re going to have to make some adjustments.”

    Now she wants to honor her husband by pushing legislation to ensure people working outside are better protected from the heat. Gates noted that the day her husband died he was in an old mail truck without working air conditioning.

    “I don’t wish this on anyone, anyone to get a phone call that their loved one died working, doing something that they love in the heat,” she said.

    ___

    LaFleur reported form Dallas. AP writers from around the U.S. also contributed.

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  • Australian police officer faces charges after shocking 95-year-old woman with stun gun

    Australian police officer faces charges after shocking 95-year-old woman with stun gun

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    Officials say an Australian police officer will face charges for shocking a 95-year-old woman with a stun gun and leaving her with critical head injuries as she approached him using a walker and carrying a steak knife in a nursing home

    The entrance to the aged care facility Yallambee Lodge in Cooma, Australia is photographed on Friday, May 19, 2023. A 95-year-old woman is in hospital in a critical condition after she was shot with a stun gun in an Australian nursing home as she approached police with a walking frame and a steak knife. (Lukas Coch/AAP Image via AP)

    The Associated Press

    CANBERRA, Australia — An Australian police officer will face charges for shocking a 95-year-old woman with a stun gun and leaving her with critical head injuries as she approached him using a walker and carrying a steak knife in a nursing home, officials said on Wednesday.

    Clare Nowland, who has dementia, is receiving palliative care in a hospital in Cooma, New South Wales state. She fractured her skull in a fall on Wednesday last week after Constable Kristian White shot her with a stun gun in her retirement home.

    The violence against an elderly and incapacitated woman has sparked national debate about the police use of stun guns in such circumstances and the competence of aged care staff. Police are allowed to use stun guns when lives are in danger.

    White was ordered on Wednesday to appear in court on July 5 on charges of recklessly causing grievous bodily harm, assault occasioning actual bodily harm, and common assault, a police statement said.

    The charges are likely to upgraded when she is expected to die of her brain injuries.

    White has been under police internal investigation since the incident and has been suspended from duty with pay since Tuesday.

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  • Australian police use Taser on 95-year-old with dementia who held steak knife

    Australian police use Taser on 95-year-old with dementia who held steak knife

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    CANBERRA, Australia — Police shocked a 95-year-old woman with a stun gun as she approached them with a walking frame and a steak knife in an Australian nursing home, sending her to the hospital.

    The extraordinary police takedown of dementia Clare Nowland, who has dementia, in the New South Wales state town of Cooma on Wednesday has prompted a high-level police internal investigation. Nowland was in critical condition Friday.

    It has also sparked debate about New South Wales state police use of stun guns, widely known as Tasers after a major manufacturer. They are a less lethal option than firearms, but have occasionally proved more dangerous than other policing options.

    Two police officers went to Yallambee Lodge, a nursing home that specializes in residents with higher care needs including dementia, after staff reported that Nowland had taken a serrated steak knife from the kitchen.

    Police Assistant Commissioner Peter Cotter declined to say whether he thought a police officer with 12 years experience had used excessive force by firing a stun gun at an elderly woman who stands 1.57 meters (5 foot, 2 inches) tall and weighs 43 kilograms (95 pounds).

    Cotter said that police engaged in “negotiations” with the elderly woman for several minutes, and used the stun gun when she approached the doorway where the police were standing.

    “At the time she was tasered, she was approaching police. But it is fair to say at a slow pace. She had a walking frame. But she had a knife. I can’t take it any further as to what was going through anyone’s mind,” Cotter told reporters.

    Nicole Lee, president of advocacy group People with Disability Australia, said she was shocked by the violence.

    “She’s either one hell of an agile, fit, fast and intimidating 95-year-old woman, or there’s a very poor lack of judgement on those police officers and there really needs to be some accountability on their side,” Lee said.

    Police said Nowland received her critical injuries from striking her head on the floor, rather than directly from the Taser’s debilitating electric shock.

    Cotter described video from the two police officers’ body cameras of Nowland being shot as “confronting footage.” But he said the video was part of an internal police investigation and it would “not be in the public interest to be releasing that.”

    Cotter said the police officer who fired the stun gun was currently “not in the workplace,” but it is unclear whether the officer has been suspended.

    Nowland, a great-grandmother, made headlines in 2008 when she went skydiving to celebrate her 80th birthday.

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  • In nursing homes, impoverished live final days on pennies

    In nursing homes, impoverished live final days on pennies

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    PHILADELPHIA — New pants to replace Alex Morisey’s tattered khakis will have to wait. There’s no cash left for sugar-free cookies either. Even at the month’s start, the budget is so bare that Fixodent is a luxury. Now, halfway through it, things are so tight that even a Diet Pepsi is a stretch.

    “How many years do I have left?” asks 82-year-old Morisey, who lives in a Philadelphia nursing home. “I want to live those as well as I can. But to some degree, you lose your dignity.”

    Across the U.S., hundreds of thousands of nursing home residents are locked in a wretched bind: Driven into poverty, forced to hand over all income and left to live on a stipend as low as $30 a month.

    In a long-term care system that subjects some of society’s frailest to daily indignities, Medicaid’s personal needs allowance, as the stipend is called, is among the most ubiquitous, yet least known.

    Nearly two-thirds of American nursing home residents have their care paid for by Medicaid and, in exchange, all Social Security, pension and other income they would receive is instead rerouted to go toward their bill. The personal needs allowance is meant to pay for anything not provided by the home, from a phone to clothes and shoes to a birthday present for a grandchild.

    One problem: Congress hasn’t raised the allowance in decades.

    “It’s really one of the most humiliating things for them,” says Sam Brooks, an attorney for The National Consumer Voice for Quality Long-Term Care, which advocates for nursing home residents and has urged an increase in the allowance. “It can really be a point of shame.”

    Especially when an individual has no close relatives or no one able to financially help, the allowance can breed striking need. When Marla Carter visits her mother-in-law at a nursing home in Owensboro, Kentucky, the scene feels more 19th-century poorhouse than modern-day America. With just a $40 allowance, residents are dressed in ill-fitting hand-me-downs or hospital gowns that drape open. Some have no socks or shoes. Basic supplies run low. Many don’t even have a pen to write with.

    “That’s what was so surprising to us,” Carter says, “the poverty.”

    She was so horrified that she and her husband started a nonprofit, Faithful Friends Kentucky, to distribute items to area nursing home residents. Among the things most warmly received are Kleenex tissues, because facilities often stock scratchy generics and even those can be hard to come by.

    “You bring a soda or a toothbrush and they’ll get so excited,” she says. “It’s so sad to me.”

    Medicaid was created in 1965 as part of the Great Society programs of Lyndon B. Johnson. A 1972 amendment established the personal needs allowance, set at a minimum of $25 monthly. Unlike other benefits like Social Security, cost-of-living increases were not built into personal needs allowance rules.

    Had it been linked to inflation, it would be about $180 today. But Congress has raised the minimum rate only once, to $30, in 1987. It has remained there ever since.

    Some politicians have tried to fix the problem, including Rep. Jennifer Wexton, a Democrat from Virginia who in 2019 introduced a bill to raise the minimum allowance to $60 and cement annual increases tied to those for Social Security. It didn’t even get a hearing.

    “I was shocked,” Wexton says. “It’s about dignity for these people.”

    Medicaid is jointly administered between individual states and the federal government and, faced with federal inaction, states have taken it upon themselves to raise allowances. Even so, most remain low. A majority of states – 28 – have allowances of $50 or less, according to a state-by-state survey by the American Council on Aging. Just five states grant residents $100 or more each month, including Alaska, which stands alone in offering $200 monthly, the maximum under federal law. Four states – Alabama, Illinois, North Carolina and South Carolina – remain at the $30 minimum.

    Despite such paltry allotments, some facilities have been cited for not telling residents they were entitled to an allowance at all, for failing to provide the money, or for spending the funds without their permission. And though federal regulations outline a host of items that are to be provided to nursing home residents, many find themselves unable to use the cheap items facilities offer, spending their allowance on replacements for institutional-grade soap that makes them dry and itchy, tissues that feel like something out of a bus terminal bathroom, razors that leave a face nicked and bleeding and denture adhesives that seem incapable of keeping false teeth in place.

    Some homes skirt the rules, making residents pay for things like diapers or haircuts that are supposed to be included.

    “As soon as I get it, it’s gone,” says Chris Hackney, a 74-year-old resident of a nursing home in Durham, North Carolina, who spends his $30 monthly allowance on body wash, toothpaste, deodorant and some items his facility used to provide but has cut back on, wipes and diapers. “Think of the prices of everything that tripled and quadrupled. And the money hasn’t gone up any.”

    Hackney, a retired appliance technician who has used a wheelchair since a motorcycle accident nine years ago, has a daughter who pays his cell phone and a church that sends care packages. But even a modest boost to the allowance, Hackney says, would mean a ton.

    “It would change so many lives in here,” he says.

    Down the hall, 56-year-old Janine Cox gets an occasional bag of chips from the vending machine and scrimps to add to the collection plate at church. She says her neighbors are even worse off.

    “It’s like a fight for them to survive another day,” she says. “The politicians, they need to come inside these nursing homes and look and see how some of us are living.”

    It leaves many feeling trapped with no chance of normalcy.

    Before a fall that landed her at a nursing home in Toluca, Illinois, 62-year-old Nancy Yundt felt like life was relatively comfortable. Her house was small and needed work, but it was home. Her SUV was 18 years old with 160,000 miles on the odometer, but she loved it. Her $2,373 monthly disability check left room for a housekeeper and take-out food and plenty of generosity.

    She paid her son’s cellphone and insurance bills, bought Christmas presents for everyone and doted on her family’s little ones year-round.

    But when her grandniece’s 2nd birthday came a few months after she arrived in the nursing home last year, she wanted to buy a doll but realized she couldn’t.

    “The spoiling aunt can’t spoil,” she says. “It just makes me feel a little sad.”

    Nursing home residents often must cede control of everything from how often they get a shower to what they eat. With no financial wiggle room, even more autonomy evaporates, putting out of reach the chance to take a taxi to see a friend, to get lost in a newly purchased book, or to escape the monotony of the cafeteria with some take-out food.

    Even after two years of institutionalized life, it is a confounding truth for Morisey.

    He ended up in a nursing home after a fall and, once here, learned his income would no longer be his. Pennsylvania’s allowance is $45, and after a monthly $20 haircut and $5 tip, a juggling act begins.

    Can his razors last a bit longer to put off refills? Can he squeeze a bit more out of the Fixodent tube? Has he cut corners enough to get some aftershave or peanut butter crackers?

    “It’s the little things,” he says. “You don’t think about these things until you no longer have them.”

    When something pricier needs replacing, it’s even more of a quandary, like when shirts went missing in the laundry or the top broke on his thermos or his little Bluetooth speaker no longer held a charge.

    His meager savings are nearly gone now. If not for help from his church, he wouldn’t even be able to afford a phone.

    Living simply is at the heart of Morisey’s Quaker faith and he decided after college, Ivy League diploma in hand, that he wouldn’t use it to chase wealth. He took jobs in nonprofits, putting his skills to the aid of farmworkers, public housing tenants and the mentally ill, and as an aid worker in Central and South America. He has spent each of his 82 years squarely in the middle class.

    Looking back, Morisey wouldn’t change how he lived his life. But it doesn’t seem too much, he says, to ask for a soda. ___

    Matt Sedensky can be reached at msedensky@ap.org and https://twitter.com/sedensky

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  • Woman missing more than 30 years and thought to be dead found living in Puerto Rico nursing home | CNN

    Woman missing more than 30 years and thought to be dead found living in Puerto Rico nursing home | CNN

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    CNN
     — 

    A Pennsylvania woman who disappeared more than 30 years ago and was believed to be dead by her family was recently found living in a nursing home in Puerto Rico, her family and police said at a news conference Thursday.

    Patricia Kopta, 83, was last seen in Pittsburgh in the summer of 1992, according to a missing person flier posted by the Pennsylvania Emergency Response Center.

    Her husband, Bob Kopta, reported her missing a few months later in the fall. At the time, he advised authorities that it wasn’t uncommon for his wife to “drop out of sight for short periods,” according to the flier.

    “I come home one night and she’s gone, and nobody knew where she was at,” Kopta said at the news conference with Ross Township Police.

    Police said they were first informed about the discovery of the missing woman when an agent from the International Criminal Police Organization (INTERPOL) and a social worker from Puerto Rico contacted them last year saying that they believed Patricia was living in an adult care home in Puerto Rico.

    “What they reported to us was that she came into their care in 1999, when she was found in need in the streets of Puerto Rico,” Ross Township Deputy Chief Brian Kohlhepp said.

    INTERPOL and the social worker said Patricia was found wandering the streets and through the years she had “refused to ever discuss her private life or where she came from,” Kohlhepp said.

    In her advanced age, Patricia started revealing nuggets that would eventually spur those around her to contact Ross police, Kohlhepp said.

    When she was in Pittsburgh, Patricia was a “well-known street preacher,” according to the missing person flier. She would approach strangers, telling them she had visions of the Virgin Mary and that the world was coming to an end, the flier said.

    Police said her disappearance wasn’t overtly suspicious because they “knew she had a mental health history and she had made statements to other family individuals that she was leaving, that she was concerned that she was going to be placed into a care facility here,” Kohlhepp said. Kohlhepp said police knew she had likely left of her own volition.

    Her husband said that his wife had talked about wanting to go to Puerto Rico to live in a tropical environment.

    “I even advertised in the paper down in Puerto Rico looking for her,” Kopta said at the news conference, adding that he spent a lot of money over the years searching for her.

    Patricia and Bob were married for 20 years before she went missing, Kohlhepp told CNN. He added that Patricia had no known family or connections in Puerto Rico.

    Police determined the woman was in fact Patricia through a nine-month-long process in which they compared DNA samples provided by her sister, Gloria Smith, and her nephew.

    “We really thought she was dead all those years,” Smith said at the news conference.

    Even before DNA testing was completed, the family knew it was Patricia as soon as they saw her photo, Kohlhepp said.

    Smith said that she has called the adult care home in Puerto Rico several times but has been unable to hold a conversation with her sister because she has dementia.

    “We didn’t expect it. It was a very big shock to see – to know that she’s still alive,” her sister said. “You know, we’re so happy and I hope I can get down to see her.”

    CNN has not been able to directly contact the woman’s family.

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  • Health care vaccine mandate remains as some push for an end

    Health care vaccine mandate remains as some push for an end

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    LOWRY CITY, Mo. — At Truman Lake Manor in rural Missouri, every day begins the same way for every employee entering the nursing home’s doors — with a swab up the nose, a swirl of testing solution and a brief wait to see whether a thin red line appears indicating a positive COVID-19 case.

    Only the healthy are allowed in to care for virus-free residents.

    Despite those precautions, a coronavirus outbreak swept through the facility late last year. An inspector subsequently cited it for violating the federal government’s COVID-19 vaccination requirement for health care facilities.

    Truman Lake Manor is one of about 750 nursing homes and 110 hospitals nationwide written up for violating federal staff vaccination rules during the past year, according to an Associated Press analysis of data from the Centers for Medicare & Medicaid Services. Most were given a bureaucratic nudge to do better — though some nursing homes also received fines, especially when they had multiple other problems.

    One year after it began being enforced nationwide on Feb. 20, 2022, the vaccination requirement affecting an estimated 10 million health care workers is the last remaining major mandate from President Joe Biden’s sweeping attempt to boost national vaccination rates. Similar requirements for large employers, military members and federal contractors all have been struck down, repealed or partially blocked.

    The health care vaccination mandate is scheduled to run until November 2024. But some contend it’s time to stop now, citing fewer severe COVID-19 cases, health care staffing shortages and the impending May 11 expiration of a national public health emergency that has been in place since January 2020.

    “Their regulations are making it harder to give care – not easier,” said Tim Corbin, the administrator of Truman Lake Manor who also doubles as a nurse, adding that “the mandates need to end.”

    CMS said in a statement to the AP that “the requirement for staff to be fully vaccinated has been a critical step in responding to the pandemic” and “has saved Americans from countless infections, hospitalizations, and death.”

    The policy requires workers, contractors and volunteers at facilities receiving Medicare or Medicaid payments to have the full primary dosage of an original COVID-19 vaccine, with exemptions for medical or religious reasons. Though nursing homes can be fined for violations, CMS generally gave violating facilities additional time to update their policies and come into compliance.

    The Republican-led U.S. House recently passed legislation that would halt the mandate, but the bill is unlikely to pass in the Democratic-led Senate.

    Meanwhile, the requirement continues with mixed results and — in some cases — widespread exceptions.

    When a state inspector visited Truman Lake Manor in December, a coronavirus outbreak had infected 26 of the 60 residents and about a quarter of the staff within the previous few weeks. Corbin said the outbreak originated from an unvaccinated employee with a religious exemption who tested negative for COVID-19 before working a shift and wore a mask. The employee didn’t feel well and tested positive after arriving home.

    The inspector found that more than 40% of staff had been granted religious exemptions from getting vaccinated. But the federal Centers for Medicare & Medicaid Services does not scrutinize the rationale for such exemptions. The reason the facility was cited for a vaccination deficiency was because three employees had failed to receive their second dose of the vaccine and had no exemption on record. After the citation, they each got the second shot, and regulators OK’d the corrections in January.

    It’s hard to find workers willing to be vaccinated, Corbin said, because many local residents remain opposed to the vaccine or doubt its effectiveness. Just 42% of adults in St. Clair County are vaccinated against COVID-19 — a rate barely half the national average.

    Workforce shortages are causing more than half of nursing homes nationally to limit resident admissions, according to the American Health Care Association, which represents long-term care facilities. Though most other health care sectors have rebounded, nursing home employment was down 13% in 2022 comparedto pre-pandemic levels and reached lows not seen since the 1990s.

    LeadingAge, an association of nonprofit nursing homes and other aging service providers, originally supported the mandate and still encourages vaccinations. But it now says a federal requirement no longer is needed.

    Though deaths are down significantly from their peak in January 2021, older adults and people with underlying health problems remain more susceptible to serious cases of COVID-19. Because of that, some medical professionals believe the vaccine mandate should continue at nursing homes and hospitals.

    “This is an important requirement,” said Dr. Georges Benjamin, executive director of the American Public Health Association. “Not only does it protect the health care worker themself, but it also protects the patients.”

    Nationwide, about 5% of the over 15,000 nursing homes caring for Medicare or Medicaid patients have been cited for violating the COVID-19 vaccination requirement, and about 2% of the 4,900 hospitals, according to the AP’s analysis. But those citations haven’t been evenly spread among states and occurred less often during the latter half of 2022.

    Twenty-four states cited no hospitals for COVID-19 vaccination violations.

    Texas, which has the most nursing homes nationally participating in Medicare or Medicaid, had just one nursing home cited for violating the vaccination rule.

    Kansas, Florida and Texas each declined to check for vaccination violations, instead leaving that process to CMS, which hired contractors. As a result, CMS said Texas was docked more than $2.5 million in federal funding, Florida more than $1.2 million and Kansas nearly $350,000.

    Kansas Gov. Laura Kelly, a Democrat who faced reelection in a Republican-leaning state, said last year that the vaccine mandate conflicted with state law and could worsen workforce shortages.

    Nationally, the number of nursing homes cited for vaccination violations declined noticeably after CMS last June stopped requiring state inspectors to check for compliance when responding to complaints about unrelated allegations, such as neglect of patients. CMS cited substantial compliance with the vaccination requirement while making the change.

    __

    Harjai reported from Los Angeles and is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.

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  • Health care vaccine mandate remains as some push for an end

    Health care vaccine mandate remains as some push for an end

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    LOWRY CITY, Mo. — At Truman Lake Manor in rural Missouri, every day begins the same way for every employee entering the nursing home’s doors — with a swab up the nose, a swirl of testing solution and a brief wait to see whether a thin red line appears indicating a positive COVID-19 case.

    Only the healthy are allowed in to care for virus-free residents.

    Despite those precautions, a coronavirus outbreak swept through the facility late last year. An inspector subsequently cited it for violating the federal government’s COVID-19 vaccination requirement for health care facilities.

    Truman Lake Manor is one of about 750 nursing homes and 110 hospitals nationwide written up for violating federal staff vaccination rules during the past year, according to an Associated Press analysis of data from the Centers for Medicare & Medicaid Services. Most were given a bureaucratic nudge to do better — though some nursing homes also received fines, especially when they had multiple other problems.

    One year after it began being enforced nationwide on Feb. 20, 2022, the vaccination requirement affecting an estimated 10 million health care workers is the last remaining major mandate from President Joe Biden’s sweeping attempt to boost national vaccination rates. Similar requirements for large employers, military members and federal contractors all have been struck down, repealed or partially blocked.

    The health care vaccination mandate is scheduled to run until November 2024. But some contend it’s time to stop now, citing fewer severe COVID-19 cases, health care staffing shortages and the impending May 11 expiration of a national public health emergency that has been in place since January 2020.

    “Their regulations are making it harder to give care – not easier,” said Tim Corbin, the administrator of Truman Lake Manor who also doubles as a nurse, adding that “the mandates need to end.”

    CMS said in a statement to the AP that “the requirement for staff to be fully vaccinated has been a critical step in responding to the pandemic” and “has saved Americans from countless infections, hospitalizations, and death.”

    The policy requires workers, contractors and volunteers at facilities receiving Medicare or Medicaid payments to have the full primary dosage of an original COVID-19 vaccine, with exemptions for medical or religious reasons. Though nursing homes can be fined for violations, CMS generally gave violating facilities additional time to update their policies and come into compliance.

    The Republican-led U.S. House recently passed legislation that would halt the mandate, but the bill is unlikely to pass in the Democratic-led Senate.

    Meanwhile, the requirement continues with mixed results and — in some cases — widespread exceptions.

    When a state inspector visited Truman Lake Manor in December, a coronavirus outbreak had infected 26 of the 60 residents and about a quarter of the staff within the previous few weeks. Corbin said the outbreak originated from an unvaccinated employee with a religious exemption who tested negative for COVID-19 before working a shift and wore a mask. The employee didn’t feel well and tested positive after arriving home.

    The inspector found that more than 40% of staff had been granted religious exemptions from getting vaccinated. But the federal Centers for Medicare & Medicaid Services does not scrutinize the rationale for such exemptions. The reason the facility was cited for a vaccination deficiency was because three employees had failed to receive their second dose of the vaccine and had no exemption on record. After the citation, they each got the second shot, and regulators OK’d the corrections in January.

    It’s hard to find workers willing to be vaccinated, Corbin said, because many local residents remain opposed to the vaccine or doubt its effectiveness. Just 42% of adults in St. Clair County are vaccinated against COVID-19 — a rate barely half the national average.

    The 120-bed facility is operating at half capacity and turning potential residents away, “because I can’t hire enough people to take care of them,” said Corbin, who’s been running ads touting a $5,000 signing bonus for nurses.

    Rhonda Martin, a nurse educator at the facility, said she understands people’s hesitancy to get vaccinated. Though she received the initial shots and a booster, Martin still got sick from COVID-19 last fall and missed a couple weeks of work.

    “At first, I was all for the vaccine, because I felt as health care workers, we needed to protect ourselves and the patients that we take care of,” she said. “The longer that it’s been going on, the vaccines haven’t seemed to help.”

    At one facility in Greenwood, South Carolina, the vaccine mandate caused an exodus among nursing staff that took a while to replenish.

    “People said, ‘You know what? I’m going to just stop working,’” said David Buckshorn, CEO of Wesley Commons in Greenwood. “To have a requirement that someone feels strongly they don’t want to follow, that really limits our ability to bring people in.”

    Workforce shortages are causing more than half of nursing homes nationally to limit resident admissions, according to the American Health Care Association, which represents long-term care facilities. Though most other health care sectors have rebounded, nursing home employment was down 13% in 2022 comparedto pre-pandemic levels and reached lows not seen since the 1990s.

    LeadingAge, an association of nonprofit nursing homes and other aging service providers, originally supported the mandate and still encourages vaccinations. But it now says a federal requirement no longer is needed.

    “Our country is in a very different place now than in summer of 2021, when the mandate was initially proposed,” said LeadingAge President and CEO Katie Smith Sloan.

    Though deaths are down significantly from their peak in January 2021, older adults and people with underlying health problems remain more susceptible to serious cases of COVID-19. Because of that, some medical professionals believe the vaccine mandate should continue at nursing homes and hospitals.

    “This is an important requirement,” said Dr. Georges Benjamin, executive director of the American Public Health Association. “Not only does it protect the health care worker themself, but it also protects the patients.”

    Some patient advocates also continue to back the vaccine mandate.

    “The more we drop requirements in general, the more dangerous it becomes for nursing home residents,” said Marjorie Moore, executive director of the St. Louis-based nonprofit VOYCE, which advocates for long-term care residents.

    Nationwide, about 5% of the over 15,000 nursing homes caring for Medicare or Medicaid patients have been cited for violating the COVID-19 vaccination requirement, and about 2% of the 4,900 hospitals, according to the AP’s analysis. But those citations haven’t been evenly spread among states and occurred less often during the latter half of 2022.

    Twenty-four states cited no hospitals for COVID-19 vaccination violations.

    Nearly 1 in 5 nursing homes received staff vaccination citations in Louisiana, and nearly 1 in 7 in Michigan, the highest rates nationally. By contrast, 14 states and the District of Columbia had two or fewer facilities cited. Texas, which has most nursing homes nationally participating in Medicare or Medicaid, had just one nursing home cited for violating the vaccination rule.

    Kansas, Florida and Texas each declined to check for vaccination violations, instead leaving that process to CMS, which hired contractors. As a result, CMS said Texas was docked more than $2.5 million in federal funding, Florida more than $1.2 million and Kansas nearly $350,000.

    Kansas Gov. Laura Kelly, a Democrat who faced reelection in a Republican-leaning state, said last year that the vaccine mandate conflicted with state law and could worsen workforce shortages.

    Like Kansas, Kentucky also has a Democratic governor with a Republican-led Legislature. But Gov. Andy Beshear’s administration said state inspectors noted no vaccination deficiencies because hospitals and nursing homes all met federal guidelines when accounting for exemptions.

    “We have been at the forefront of encouraging vaccines,” said Betsy Johnson, president of the Kentucky Association of Health Care Facilities and the Kentucky Center for Assisted Living. “We understand vaccines save lives.”

    Nationally, the number of nursing homes cited for vaccination violations declined noticeably after CMS last June stopped requiring state inspectors to check for compliance when responding to complaints about unrelated allegations, such as neglect of patients. CMS cited substantial compliance with the vaccination requirement while making the change.

    Before then, Gil-Mor Manor in rural Morgan, Minnesota, was one of just three facilities cited for the worst deficiency category, indicating widespread “immediate jeopardy” to residents.

    A May inspection report said the facility lacked policies to mitigate the spread of COVID-19 — such as requiring N95 masks — for 15 unvaccinated employees with religious exemptions. It said three other employees caring for patients were neither vaccinated nor exempted.

    The “failures resulted in 7 of 27 of residents contracting COVID-19,” the report said.

    The nursing home responded by approving exemptions for the unvaccinated employees, updating its policies and hiring a consultant to provide additional training to its nurse in charge of infection control, facility administrator Terrie Rothmeier said. Inspectors lifted the “immediate jeopardy” designation within three weeks. The facility was not fined.

    “We resolved the issue,” Rothmeier said.

    __

    Harjai reported from Los Angeles and is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.

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  • Funeral home finds woman breathing hours after declared dead

    Funeral home finds woman breathing hours after declared dead

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    MILLER PLACE, N.Y. — An 82-year-old woman was pronounced dead at a New York nursing home but found to be breathing three hours later at the funeral home where she had been taken, authorities said.

    The woman was pronounced dead at Water’s Edge Rehab and Nursing Center at Port Jefferson on Long Island at 11:15 a.m. Saturday, Suffolk County police said.

    The woman, whose name was not released, was taken to the O.B. Davis Funeral Homes in Miller Place at 1:30 p.m., police said in a news release. She was discovered breathing at 2:09 p.m., they said.

    The woman was taken to a hospital. No update on her condition was available Monday.

    The apparent premature declaration of death occurred days after a continuing care home in Iowa was fined $10,000 over a similar incident.

    Authorities in Iowa said that a 66-year-old woman was declared dead on Jan. 3 at the Glen Oaks Alzheimer’s Special Care Center in Urbandale, where she was receiving hospice care.

    The woman was placed in a body bag and taken to the Ankeny Funeral Home & Crematory, where workers found that she was breathing and called 911, authorities said.

    She was returned to hospice care, where she died on Jan. 5, according to a report issued last week by the Iowa Department of Inspection and Appeals.

    The New York case has been referred to the state attorney general’s office for investigation, police said.

    The state health department is investigating, as well, spokesperson Monica Pomeroy said, adding that she could not elaborate.

    An email seeking comment was sent to the nursing home. A person who answered the phone there Monday hung up.

    Officials at the funeral home said in a statement, “Out of respect for the privacy and confidentiality of the families we are honored to serve, we are not in a position to comment further on this matter.”

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  • U.S. Seniors Bearing Brunt of COVID Wave – Is Help Coming?

    U.S. Seniors Bearing Brunt of COVID Wave – Is Help Coming?

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    Jan. 10, 2023 – It might appear that we’re back to some semblance of “normal” at this point in the COVID-19 pandemic. But many people remain at higher risk for serious outcomes like hospitalization and death, especially older Americans. 

    Legula Estiloz was diagnosed with COVID-19 at age 104, for example. “She and I both came down with COVID at the same time, a few days after Christmas of 2020,” her son Tim Estiloz says.

    “I went in to wake her up for her breakfast, and she was just drenched, sopping wet – her bed clothes and her nightgown,” Tim says. 

    Legula, a resident of The Willows, a skilled nursing community in Oakmont, PA, owned and operated by Presbyterian SeniorCare Network, sought care at nearby Magee Hospital. Both Legula and Tim were swabbed for COVID-19 and tested positive. They had low-grade fevers and fatigue. Legula lost her appetite for months. But neither lost their sense of smell or taste or had respiratory challenges. 

    The COVID-19 vaccines were not available at the time. “It is all the more miraculous that she survived it at that age, and without even the benefit of the vaccine to get her through it,” he says.

    Americans 65 and older are dying at disproportionately higher rates from COVID-19. For example, people ages 65 to 74 account for 22% of COVID-19 deaths, even though this age group represents less than 10% of the U.S. population, CDC figures show. The picture is more dire for those 75 to 84 – a group that accounts for 26% of deaths but less than 5% of the population.

    The oldest Americans, those 85 and over, account for 27% of deaths but make up only 2% of the U.S. population.

    Add to this the yet-to-be-fully appreciated impact of the latest Omicron subvariant on the rise, XBB.1.5, and the future remains anything but certain.

    Legula, who survived COVID-19, went on to have a heart attack and be diagnosed with breast cancer, all before spring 2020. 

    Her prognosis is good now, Tim says. “She’s doing quite well. I think for a period of time, she was doing better than me.” She plays notes on the piano, likes to “dance” in her wheelchair, and catches a ball thrown from 3 or 4 feet away “each and every time.” 

    To summarize her pandemic experience, Legula “battled breast cancer, had radiation treatment, she fell once, she survived COVID, and she survived a heart attack,” Tim says. Although the admitting doctor warned that his mother might not survive the night of her heart attack, she improved and in January 2021 celebrated her 104th birthday. 

    “And now, God willing, in a few days she’ll celebrate her 106th.”

    Bivalent Booster Buy-In

    A key factor in Legula’s recovery: She also is up to date on her COVID-19 vaccinations and boosters.

    The bivalent boosters – which target some Omicron strains and the original coronavirus – are 84% more effective at keeping seniors from being hospitalized, says David Gifford, MD, chief medical officer at the American Health Care Association/National Center for Assisted Living in Washington, DC.

    A Jan. 3 preprint study published in the journal The Lancet backs that up. While it hasn’t been peer-reviewed, researchers studied 622,701 people ages 65 and older and found those who had received the bivalent booster were 81% less likely to be hospitalized and 86% less likely to die from COVID-19 than others who did not receive it.

    But only slightly more than one-third of Americans 65 and older, 38%, have received a bivalent booster, compared to 15% of all Americans 5 years or older, CDC data shows. So there is great room for improvement, experts say. 

    “We have this ongoing push among our members to increase booster acceptance rate among residents,” says Lisa Sanders, director of media relations at LeadingAge, a national association of nonprofit providers and aging services, including nursing homes, retirement community settings, and affordable housing for older adults. 

    One of the biggest misconceptions, she says, is “the thinking that the bivalent booster is not necessary.” In addition, ongoing education and access to vaccines remain important “because there is a lot of misinformation.”

    “The messaging has to be clear: You need to get the bivalent booster,” Sanders says, “especially now after the holidays and [when] new variants are emerging.”

    COVID and Congregate Living

    With older Americans more vulnerable to serious effects of COVID-19, a question that comes up is: What about settings where they live together, such as nursing homes, skilled nursing facilities, and other care centers? Earlier in the pandemic, these locations faced greater infection control challenges with the coronavirus.

    “Long-term care professionals have known since day one that older adults with chronic conditions are most vulnerable when it comes to this virus. They have been bedside to unspeakable tragedy these past 3 years,” Gifford says.

    “Unfortunately, ageism has been on full display during this pandemic, as evidenced by long term-care facilities begging public health officials for resources to no avail in the beginning,” he says.

    So where are they now?

    On the plus side, defenses and preventive measures have come a long way since the pandemic started, Gifford says. “While older adults are still most vulnerable, we have the tools to help protect them from serious illness and hospitalization. First and foremost, seniors need to stay up to date on their COVID vaccinations, which means getting the updated, bivalent booster.”

    Florida at the Forefront

    The three U.S. states with the most residents ages 65 and older are California, Florida, and Texas. As a percentage, more than 1 in 5 Floridians, or 21%, for example, are in this age group, according to 2021 U.S. Census numbers. 

    With one of the country’s most vulnerable older populations, the Florida Health Care Association in Tallahassee continues to promote the effectiveness of the COVID-19 vaccine and boosters. Kristen Knapp, senior director of strategy and communications for the association, says, “While the booster may not prevent infections, we know that it can help residents from becoming very sick or being hospitalized.” 

    COVID-19 vaccination is not a requirement for resident admission or staff employment. But Knapp says that, vaccinated or not, anyone who tests positive for COVID-19 is required to follow infection control protocols.

     The Feds Get Involved

    On Nov. 22, the White House announced a campaign to promote boosters in older adults. The focus is on reaching seniors and other communities hardest hit by COVID-19, making it even more convenient to get vaccinated, and increasing awareness through paid media.

    The initiative includes new enforcement guidance through the Centers for Medicare & Medicaid Services to ensure nursing homes are offering updated COVID-19 vaccines as well as timely treatment to their residents and staff.

    Shortly thereafter, LeadingAge joined forces with American Health Care Association to create an “All Hands on Deck” initiative to help achieve the White House goals. One strategy is to get hospitals more involved. This is important, Sanders says, because about 90% of nursing home admissions involve people transferred from a hospital. 

    Ongoing Vigilance

    Future variants continue to be a threat, but the vaccines are incredibly effective in preventing hospitalizations and death, experts emphasize. 

    “We continue to monitor and prepare for anticipated surges, like this winter’s, and encourage everyone, including our residents and staff, to get their boosters,” Gifford says.

    There needs to be an ongoing vigilance that this is a community issue, Sanders says. “There’s a human tendency to want to push it away and say, ‘oh it’s their problem.’ 

    “Really, it’s all of our problem, and if we all take steps to protect ourselves and each other, we’ll be better off as a society.”

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  • NYAG sues LI nursing home for alleged massive fraud | Long Island Business News

    NYAG sues LI nursing home for alleged massive fraud | Long Island Business News

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    New York Attorney General Letitia James has filed a lawsuit against Cold Spring Hills Center for Nursing and Rehabilitation for alleged financial fraud and abuse of its residents. 

    The lawsuit claims the owners of the Cold Spring Hills facility in Woodbury diverted over $22.6 million in Medicaid and Medicare funds from resident care through a fraudulent network of companies that were used to conceal up-front profit taking. The alleged self-dealing led to “severe understaffing and resident neglect and harm,” according to a statement from the AG’s office. 

    The lawsuit alleges that long before the COVID-19 pandemic, the owners repeatedly cut staffing at the 588-bed facility, which created poor working conditions and endangered residents. Through the lawsuit, the attorney general seeks to prevent new residents from entering the facility, install monitors to oversee the facility’s operations and finances, and ban existing and hidden owners from their roles. 

    The operators of Cold Spring Hills used 13 companies to create the appearance that they were paying for services for the nursing home but were in fact diverting Medicaid and Medicare funds to themselves as up-front profit instead of using the funds for resident care, according to the statement. The network of companies was also used to hide the real owners of the nursing home and to orchestrate multiple deceptive schemes to extract funds for their personal financial benefit, while disregarding the nursing home’s duty to provide required care, the lawsuit alleges. 

    From 2017 through 2021, Cold Spring Hills received over $157 million from New York’s Medicaid program and over $88 million from Medicare to provide critical care to its elderly and disabled residents. The AG’s lawsuit alleges that the facility’s operators used three primary fraudulent schemes to siphon over $22.6 million in Medicaid and Medicare funds from Cold Spring Hills, including paying more than $15.3 million in fraudulent “rent” to Cold Spring Realty, which is owned by the same individuals who operate the nursing home. 

    The lawsuit alleges that the respondents paid more than $5.2 million to several deceptive entities for supposed “consulting” and that the respondents engaged in a $2 million fraudulent promissory note scheme when they purchased the facility. The lawsuit claims the Cold Spring Hill facility’s owners also funneled another $10.6 million in concealed self-dealing transactions through what were ostensibly insurance companies, and another $8.1 million through an entity that purportedly provided services and supplies to Cold Spring Hills. In total, the respondents transferred over $42.4 million to its owners and related parties from 2016 to 2021, according to the AG’s statement. 

    “Cold Spring Hills’ owners put profits over patient care and left vulnerable New Yorkers to live in heartbreaking and inhumane conditions,” James said in the statement. “From Buffalo to Long Island, every nursing home in New York must abide by laws that require the best care for New Yorkers. As attorney general, I am determined to use the full force of my office to hold nursing homes to that standard, and ensure New Yorkers are protected. I encourage anyone who has witnessed alarming conditions, resident neglect, or abuse at a nursing home to contact my office.” 

    In addition to the alleged financial fraud, the lawsuit maintains that residents of the Cold Spring Hills facility were abused and neglected. Testimony from staff and family members of residents describe bleak conditions at the facility. Family members of residents often observed that the facility was unclean and that critical care equipment, such as wheelchairs, beds, shower chairs, and air conditioners, were broken, according to the statement.  

    The AG said that residents were routinely left sitting in soiled briefs and were not bathed for long periods of time and that Cold Spring Hills repeatedly failed to provide proper wound care and prevention for residents, causing wounds to develop and existing wounds to deteriorate, leading to infections. 

    In addition, Cold Spring Hills’ staff confirmed that insufficient staffing was a problem at the facility before the pandemic, and that it continued into 2022, according to the AG’s office. From March 1, 2020 to June 4, 2020, 166 residents of Cold Spring Hills died, 98 from COVID-19 and 68 from other causes. Cold Spring Hills fraudulently failed to report 51 of those 98 COVID-19 deaths to DOH, underreporting by 52 percent, according to the statement. 

    The companies named in the lawsuit are Cold Spring Hills, the actual facility; Cold Spring Realty Acquisition, LLC (Cold Spring Realty), which owns the property where the nursing home is located; Ventura Services, LLC, Highview Management Inc., B&L Consulting, LLC, all of which claim to provide consulting services to nursing homes; Graph MGA, LLC, Graph Management, LLC, Graph Insurance Company A Risk Retention Group, which purportedly act as insurance brokerages; Philipson Family, LLC, which is a partial owner of Cold Spring Realty; Lifestar Family Holdings, which is a partial owner of Cold Spring Realty; Comprehensive Care Solutions, LLC, which purported to provide services and supplies; and Ross CSH Holdings, LLC, Rosewell Associates, LLC, and ZBL Management, LLC, all pass-through companies.  

    Also named in the suit is the principal owner, Bent Philipson, whose role was allegedly concealed, Benjamin Landa, whose ownership is also alleged to have been concealed; Joel Leifer; David Zahler, his wife Chaya Zahler, their adult children Rochel David, Leah Friedman, Chaim Zahler, and Jacob Zahler, Avi Philipson (Bent Philipson’s adult son), Esther Farkovits (Benjamin Landa’s adult daughter), Rochel David and Leah Friedman (the Zahlers’ daughters) who were straw owners of the nursing home, allegedly put in place to conceal their fathers’ control. Also named in the suit is Cheskel Berkowitz, Joel Zupnick, and the Estate of Deborah Philipson. 

    The lawsuit respondents were unable to be reached for comment. 

    In the lawsuit filed today, Attorney General James seeks to prohibit Cold Spring Hills from admitting any new residents unless and until staffing levels meet appropriate standards; require Cold Spring Hills to engage and pay for a financial monitor to oversee the facility’s financial operations; and require Cold Spring Hills to engage and pay for an independent healthcare monitor to oversee the facility’s healthcare operations and ensure residents’ outcomes improve. 

    The AG also seeks to remove Bent Philipson, Avi Philipson, Joel Leifer, Esther Farkovits, Rochel David, and Leah Friedman, and any of their related entities, from further serving or having any role at Cold Spring Hills; direct all respondents to fully disgorge any and all funds wrongfully received as part of the scheme; and direct all respondents corporate and individual to pay restitution and penalties. 

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    David Winzelberg

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