Ask the Lawyer: Does the law protect residents of nursing homes in California?

By Ron Sokol | [email protected] | Daily Breeze PUBLISHED: January 30, 2018 at 3:50 pm | UPDATED: January 30, 2018 at 3:53 pm Q: Dad is now in a nursing home because he was no longer able to fend for himself. We have heard some horror stories about deficient conditions at some nursing homes. Are these places subject to careful oversight? A.M., Rancho Palos Verdes A: You may have recently read that View Heights Convalescent Hospital in Los Angeles was fined $100,000 by the California Department of Public Health after an investigation found deficiencies that led to a patient’s death. Indeed, there are public and private agencies at the state and federal levels that license, regulate, inspect and/or certify nursing homes here. For example, the DPH seeks to ensure that nursing homes comply with state laws and regulations. And because MediCal beneficiaries constitute a sizable percentage of nursing home patients, DPH and the U.S. Department of Health and Human Services (via its Center for Medicare and Medicaid Services) have a cooperative agreement to ensure nursing homes satisfy federal requirements. I do, however, strongly encourage diligence to assess a nursing home before someone is placed there, as well as to monitor that person’s condition and treatment thereafter. Q: What are the basics when it comes to licensing of nursing homes in California? J.S., El Segundo A: Title 22 Social Security California Code of Regulations contains information and criteria with regard to nurse-to-patient ratios, licensing and certification of health facilities, home health facilities, clinics and referral agencies. Further, Title 22 outlines basic requirements with regard to many aspects of a patient’s existence in a nursing home, such as planned activities, personal care and assistance, and arrangements for obtaining medical and dental care as well as food service. Complaints/information The California Department of Public Health has a basic form online should Continue Reading

Flu’s death toll doubles to 91; county holds off on emergency declaration

The number of flu deaths doubled and thousands more cases were reported last week, but county supervisors backed away from declaring a local health emergency Tuesday after receiving assurances from public health officials that current resources are enough to handle the situation. Dr. Nick Yphantides, the county’s chief medical officer, said such a declaration would be justified only of local health systems needed more direct help from the county. This season’s influenza-related deaths jumped last week from 45 to 91. “Declaring a local health emergency is a public health tool that we believe should be used judiciously when local resources are exhausted,” Yphantides said. Examples of ways in which declaring an emergency might help, he added, are distributing the county’s reserve supply of ventilator machines or medications to hospitals or asking the state to temporarily suspend or modify mandated nurse-to-patient ratios. “These instances have not yet occurred,” Yphantides said. Ron Roberts was the first supervisor to broach the subject of declaring an emergency, as the county did Sept. 1 during the region’s ongoing hepatitis A outbreak. He said Monday he was convinced that the current system, which has medical leaders from across the region monitoring the flu in real time and meeting in person twice per week, is enough for the time being. “It’s possible that could happen but, at least from what we’re seeing today, it’s not warranted,” Roberts said. In the meantime, he advocated for people throughout the county to pull pack on social conventions such as hand shaking and to get vaccinated. “Shaking hands is really one of the ways that these things get spread around. If we could have a cultural norm that could change this, it would be very helpful,” Roberts said, adding that he personally prefers the “wireless fist bump” where two people pretend to knock knuckles Continue Reading

National Nurses United Union Backs Bernie Sanders

National Nurses United, an activist union with a history of bold political moves and issue-focused campaigning, has endorsed Bernie Sanders for the Democratic presidential nomination. This is the first endorsement from a major union for Sanders, who has worked closely with NNU on a number of issues over the years. “Bernie’s issues align with nurses from top to bottom,” said NNU executive director RoseAnn DeMoro, who ticked off issues of agreement: “insisting that healthcare for everyone is a right not a privilege, protecting Social Security and Medicare from those who want to destroy or privatize it and working to expand both, holding Wall Street accountable for the damage it has done to our communities, understanding the threat to public health from the climate crisis, environmental degradation, and the Trans-Pacific Partnership, support for minimum nurse-to-patient ratios for hospital patients, and on and on.” Sanders echoed the sentiment, explaining that, “Like NNU, I have argued for a very long time that we have to move toward a Medicare for all, single-payer system. The United States is the only major country on earth that doesn’t guarantee health care to all people as a right and that’s an issue that must be addressed if we are going to begin to address a whole range of other challenges.” NNU, which represents 185,000 nurses nationwide, is the first national union to endorse Sanders’ insurgent challenge to Democratic frontrunner Hillary Clinton. The AFL-CIO has not endorsed in the Democratic race and most unions have followed the lead of the federation. But the 1.6-million American Federation of Teachers, which has a strong presence in the New York and which worked closely with Clinton when she was a senator representing that state, endorsed the frontrunner in July, with union president Randi Weingarten declaring that, “Hillary Clinton, a product of public schools herself, believes in the Continue Reading

Facing a shortage of nurses to care for aging veterans, Milwaukee’s VA hospital rolls out the perks

Michelle Post smiled as she walked into the room and greeted a man sitting in a chair.After Post pumped hand sanitizer from a dispenser on the wall and pulled on a pair of green gloves, she and Nick Michels chatted over the sound of air flowing through his tracheotomy mask. She bent forward to listen to his lungs through her stethoscope and then knelt."I'm going to see if you have any swelling in your legs," Post said on a recent morning at the Zablocki Veterans Affairs Medical Center in Milwaukee.A black ball cap adorned with the words "Combat Medic" lay on the bed beside Michels.Post worked as a certified nursing assistant at the Milwaukee VA while she earned her nursing degree at Alverno College and was hired after graduating in 2014. She works in a medical/oncology unit and many of her patients are Vietnam veterans. "They talk a lot about what they brought back from Vietnam, like Agent Orange, and how that's affecting them now," she said.It's nurses like Post who are on the front lines of a health care system ministering to a rapidly aging population of American veterans whose average age is now 65. There aren't enough nurses like Post to meet the demand.With 50 openings for nurses at the Milwaukee VA Medical Center for a variety of positions, the facility has scheduled a nurse career fair on Dec. 5 and Dec. 6 where job seekers can fill out applications, meet recruiters and drop off resumes. The Milwaukee VA is also using Facebook, radio advertising and word of mouth to find more nurses."It's because nurses are aging and they're due to retire in eight to 10 years. We're losing a lot of our most senior nurses with years of experience, which is concerning," said Angela Garza, a registered nurse and program manager for a medical/oncology unit on the hospital's fourth floor.It's not just the Milwaukee VA or the national VA system that's searching for nurses. A looming nurse shortage has been on the horizon for several years for a Continue Reading

Three Manhattan hospitals among top 20 in nation, according to new U.S. News & World Report rankings

Getting sick in New York City is a prescription for getting the best medical care in America. Three Manhattan hospitals are among the top 20 medical centers in the nation, according to the 2016-17 rankings released Tuesday by U.S. News & World Report. No other city has more than two hospitals ranked in the top 20. “It has been our findings over many years that New York has one of the largest populations of exceptionally good hospitals,” said Ben Harder, chief of health analysis at U.S. News & World Report. At the top of the Big Apple heap is NewYork-Presbyterian Hospital. The prestigious hospital with locations in Washington Heights and the Upper East Side scored the No. 1 spot in the New York metro area — and No. 6 nationally. NewYork-Presbyterian also ranked in the top 50 in the nation in a whopping 15 out of 16 specialties evaluated by U.S. News. The hospital was ranked No. 2 in rheumatology, No. 3 in cardiology and heart surgery, and No. 3 in neurology and neurosurgery. Dr. Steven Corwin, NewYork-Presbyterian’s chief executive, attributed its success in part to the hospital’s ability to attract top talent. “We’ve got two great medical schools in Columbia and Weill Cornell that give us terrific doctors, terrific faculty,” Corwin said. “We supplement that with a really keen focus on outcomes, quality and being patient focused.” NYU Langone Medical Center snagged the No. 2 spot in the metro area and No. 10 in the nation. The hospital on First Ave. near E. 30th St. landed in the top 50 in 12 specialties — including geriatrics, orthopedics, and neurology and neurosurgery. Completing the trifecta among city medical centers making it in the top 20 in the nation was Mount Sinai Hospital. The Upper East Side medical center scored the No. 15 spot in the country and received top 50 honors in 11 Continue Reading

If you’re sick, the city is the place to be as New York’s hospitals offer array of elite medical options

Even when it comes to getting sick, there’s no place that compares to NYC. Three Manhattan hospitals were among the top 17 medical centers of more than 4,700 in the nation — making New York the only city in the country that can make such a boast, according to the 2014-15 rankings released Tuesday by U.S. News & World Report. And in the New York metropolitan area, 50 of the 180 area hospitals were recognized by U.S. News for excellence in one or more specialties as well. Ranked No. 1 in the Big Apple — and No. 6 in the nation — was New York-Presbyterian Hospital, affiliated with Columbia and Cornell and with locations in Washington Heights and the Upper East Side. “We are honored to once again be recognized as the top hospital in New York,” said Dr. Steven Corwin, the hospital’s chief executive. “This achievement is made possible by the amazing team of doctors, nurses, and staff at New York-Presbyterian who are dedicated to providing the highest-quality and most compassionate care, every day to every patient. This recognition from U.S. News reinforces our commitment to New Yorkers and all who seek our care.” The 2014-15 rankings were based on the evaluation of 4,743 hospitals in the U.S. Factors used to compile the rankings include survival rates, safety procedures, nurse-to-patient ratios, infection control and reputation of specialists. Of those, just 144 were nationally ranked in at least one of 16 specialties, representing just 3% of all the hospitals analyzed. “New York-area consumers who have complex, challenging medical needs have access to some of the nation’s best hospitals,” said Ben Harder, managing editor and director of health care analysis for U.S. News. “New York is also unique among metro areas in that it has three of the 17 hospitals on Continue Reading

Montefiore Medical Center nurses rally against staffing problems and healthcare benefit cuts

More than 100 nurses from Montefiore Medical Center rallied Monday against staffing problems and possible cuts to their healthcare benefits. "Montefiore is the most profitable hospital in New York State," said Patricia DeLillo, a registered nurse who took part in the demonstration. "How can they justify asking for benefit cuts and refusing to address staffing improvements they agreed to?" Carrying signs reading "They Say Cut Back, We Say Fight Back" and "Fair Contract Now," the nurses marched in front of the hospital at E. Gun Hill Road and Bainbridge Ave. Nurses, who are currently involved in ongoing talks with the hospital, have been working without a contract since Jan. 15, 2009. Organizers charged that the varying nurse-to-patient ratios set 10 years ago are not being enforced and are affecting the amount of attention each patient receives. "The people of the Bronx and the nurses who care for them deserve better treatment," said DeLillo, who also heads the nurse's union at Montefiore's Weiler Division in Morris Park. In addition, organizers said that Montefiore's management is trying to scale back the nurses' health and pension benefits while their caseload grows. Officials at Montefiore declined to comment.Meanwhile, the acrimony continues to mount. Nurses boycotted Nurse's Week - May 6 to 13 - by not accepting the food and trinkets offered by the hospital.Rally organizers said the nurses have the right to retire in dignity, and that caregivers have a right to quality affordable health care."We just want a fair and decent contract," said registered nurse Collette Dobbins at the protest. "I don't think that's too much to ask."Joy Rodney, another registered nurse at the demonstration, said the union will remain vigilant in their stance."We are adamant that our pension should remain intact," she said. Join the Conversation: Continue Reading

Nurses sue Huron Valley-Sinai Hospital over staffing

The Michigan Nurses Association filed a lawsuit against Huron Valley-Sinai Hospital in Oakland County Circuit Court on Thursday, saying a staff shortage is placing nurses and patients at risk.The lawsuit was filed on behalf of seven nurses at the 158-bed hospital in Commerce Township, which is part of the seven-hospital Detroit Medical Center health system. The hospital’s 350 nurses unionized with the Michigan Nurses Association in March 2016 and are negotiating their first union contract. Huron Valley-Sinai is the first DMC hospital where nurses have unionized.At a news conference in Milford on Thursday, three Huron Valley-Sinai nurses complained of IV bags going dry, patient falls and other problems they said occur become of high nurse-to-patient ratios at the hospital.“Patients are falling because there’s not enough nurses to help them get to the bathroom,” said Pat Kampmann-Bush, a certified recovery room nurse at Huron Valley-Sinai.The allegations were denied Thursday by Huron Valley-Sinai Hospital Chief Nursing Officer Lori Stallings and Shawn Levitt, chief nursing officer for the DMC, who said patient’s at the hospital are safe.They noted that Huron Valley-Sinai is among just three hospitals in Michigan that received straight A’s on Leapfrog Group Safety Grades announced this week by the national hospital quality watchdog organization.“What you see is an attempt by the nurses to negotiate their contract in the media, and that’s not our practice to do that,” Levitt said. “We were surprised to see these issues coming out in this way.”The 23-page lawsuit hinges on the what nurses call the hospital’s refusal to accept complaint forms they’ve filled out to document lapses in patient care that occur because they they have too may patients to care for. They said more than 250 of the forms have been filed since Jan. 1 this year.Melanie Moss, spokeswoman for the DMC heath system, did Continue Reading

Hospitals must audit medical flubs and nurse-patient ratios under new state law

Governor Paterson has signed a new law requiring hospitals, clinics and nursing homes to disclose medical errors and nurse-to-patient ratios on every shift.In addition to mistakes, the report card must include details on such patient-care issues as bedsores and hospital-acquired infections. "We are very pleased that the governor saw this as a necessary step in informing the public about staffing ratios so they can make informed decisions about patient care," said Tina Gerardi, CEO of the New York State Nurses Association. The legislation pitted nurses and health care advocates against hospitals, which carried out a big-money lobbying campaign against it. "This means another mandate on top of literally hundreds," said William Van Slyke, a spokesman for the Healthcare Association of New York State, which represents hospitals. "There's a famous study that shows for every hour of patient care a nurse has an hour of paperwork. This will add to that burden." The law, which takes effect in 180 days, comes after a Daily News series that found city-run hospitals have been repeatedly cited for not reporting medical mishaps, including fatal errors. Overall, Paterson signed 60 bills and vetoed 18 others. Among his actions: He okayed a bill creating an e-mail system alerting people when a sex offender moves into their neighborhood.  He signed a bill giving workers injured in the World Trade Center cleanup another year to file claims.  He approved legislation requiring indoor day camps to have as many health inspections as outdoor ones. Join the Conversation: Continue Reading

WHERE ARE THE NURSES? In NYC and nationwide, many more are needed – stat!

Julia Keane graduated last spring with a two-year ­associate's degree and promptly had four job offers at around $60,000-plus each. "I didn't have to work too hard to get my job," admits the mother of two, 36, of Pleasantville, N. Y. "There are so many positions out there. You send out your résumé, you get calls. " Keane is a registered nurse, currently one of the most sought-after health-care professions due to a nationwide shortage. Tomorrow the New York Academy of Medicine is holding a symposium called "Who Will Care for Me? " to address the topic. By the year 2020, New York City is expected to have a shortage amounting to 25% of its positions. The Academy of Medicine also says the city's nurse-to-patient ratio at hospitals is a demanding 1. 08 to 1 - much lower than the 1. 4 or 1. 7 nurses per patient in other cities. "We've been in the throes of this shortage for the last two years," says Frank Cracolici, chief operating officer of St. Luke's-Roosevelt Hospital and chief nursing executive for Continuum Health Partners' five New York hospitals, which average an 8% nursing vacancy rate (nationally, it's over 10%). The U. S. Bureau of Labor Statistics estimates that registered nurses will be the fastest-growing industry nationwide for the next five years. Demand is still outpacing supply, with over a million U. S. vacancies expected by 2012. A 2002 New York State survey, the most recent of its kind, found 3,700 vacancies in city hospitals and 20,000 statewide. "Every hospital has some vacancies," says Ronald Keller, director of surgical nursing services at NYU Medical Center. All these openings mean that new nurses are getting specialized gigs right off the bat, experience or not. Keane is no exception - she's working at Westchester County Medical Center's pedia­tric intensive-care unit. The same goes for NYU Medical Center oncology nurse Brad Mott. "You'd have to do medical/surgical or ­general-floor Continue Reading