Archive for the ‘Nursing Home Abuse’ Category

By Scott Higham and Dan Keating
Washington Post Staff Writers
Monday, March 29, 2010; A03

More than a decade ago, Congress set out to squeeze the fraud out of Medicare billing at nursing homes, requiring more precise justifications for costs. It created new “ultra-high” billing categories intended to be used for only 5 percent of the patients needing highly specialized care and rehabilitation.

But within a few years, nursing homes flooded the ultra-high categories with patients, contributing to $542 million a year in potential overpayments, federal analysts found.

Since then, the numbers in the ultra-high categories have quadrupled, and the amount of waste and abuse could reach billions of dollars a year, according to nursing home experts and a Washington Post examination of the program. The billing program is specifically targeted in President Obama’s health-care legislation passed last week by Congress, changing two rules that experts said have been exploited by nursing homes to inflate bills.

“Facilities have been able to bill the way they want, and they are billing for more services than they are providing to people,” said Toby S. Edelman, a senior attorney for the Center for Medicare Advocacy, a watchdog group in Washington. “There’s been a lot of abuse.”

Federal analysts assigned to the inspector general’s office for the Department of Health and Human Services are examining the billing program.

“There is a lot of vulnerability in the system, and we are concerned by what we’ve seen,” said Jodi Nudelman, regional inspector general for the HHS New York field office, which is conducting the examination.

A separate division of the HHS inspector general’s office is investigating North American Health Care, which operates 35 facilities, most of them in California.

Across the chain, 64 percent of NAHC patients are billed in the highest category; the national average is 9 percent. The category covers the most extensive medical care combined with the most intensive rehabilitation.

The pattern was discovered last year by the Service Employees International Union, which has been feuding with NAHC over efforts to organize the homes’ employees. The Post independently analyzed an updated version of the data and confirmed the pattern. The Post also found that NAHC operated 21 of the top 30 facilities nationally with the highest percentage of residents billed in the most expensive category.

In the Washington area, two nursing homes owned by HCR ManorCare put their residents in the most expensive billing category at nearly five times the national average, according to the Post analysis. The ManorCare home in Silver Spring put 45 percent into that category, and the ManorCare home in Wheaton put 43 percent.

A spokesman for ManorCare, whose headquarters is in Toledo, said residents are coded into billing categories based on their medical and rehabilitative needs.

“There is really nothing else we can add as to why patients fall into any particular category,” said the spokesman, Rick Rump.

Allegations of ‘upcoding’

The SEIU gave results of its NAHC examination to Rep. Pete Stark (D-Calif.), who chairs a House Ways and Means subcommittee that oversees Medicare. In September, Stark asked the HHS inspector general to investigate, alleging that NAHC “may have overbilled Medicare more than $180 million through a system-wide pattern of ‘upcoding.’ ”

John L. Sorensen, NAHC’s president and chief executive, said residents in the highest category are recovering from major surgeries and need specialized care. He said doctors favor his chain because it provides high levels of care.

But NAHC’s residents were no sicker or in greater need of therapy than other nursing home residents, the union’s analysis of medical records says. The Post does not have access to the records and could not confirm the analysis.

Sorenson said he was unaware of any anomalies. He said that his facilities have received high-quality ratings from Medicare and that he is cooperating with the HHS inspector general’s investigation.

“They have not told me about any upcoding or wrongdoing at all,” Sorensen said. “We have honest and forthright business practices in place. . . . We don’t have any need or reason to be doing any kind of upcoding. That would be completely wrong.”

To capitalize on the aging baby boomers, nursing homes have been providing high-end services once reserved for hospitals and large rehabilitation centers.

Homes that provide the highest level of care are known as skilled nursing facilities and have become a big business. There are about 15,000 nationwide, and they rely heavily on Medicare to turn a profit. Last year, Medicare spent more than $25 billion on them.

Federal analysts detected billing anomalies in these homes a decade ago, after a new Medicare payment system went into effect.

“Upcoding, billing for services not rendered, and billing for worthless services have been significant problems for years, costing taxpayers many millions, if not billions, of dollars,” said Marie-Therese Connolly, who headed the Justice Department’s Elder Justice and Nursing Home Initiative from 1999 to 2007.

‘Audit trail’ rejected

In 1999, the HHS inspector general examined medical charts of nursing home residents and discovered that 46 percent had been incorrectly placed into the higher-billing categories. Analysts said the miscoding could have been the result of widespread confusion over how to assess patients.

They urged the establishment of an “audit trail,” but the agency overseeing Medicare at the time rejected the recommendation.

In 2002, the General Accounting Office (now the Government Accountability Office), the investigative arm of Congress, said it appeared that nursing homes were capitalizing on the confusion by coding more residents into lucrative billing groups.

Four years later, the HHS inspector general found that 26 percent of the Medicare claims sampled in the highest billing groups could not be supported by medical records.

The analysts estimated in a 2006 report that potential overpayments amounted to $542 million based on a review of bills from 2001 and 2002. Since then, the proportion of patients being billed at the highest rates has increased fourfold, according to a report by MedPac, an independent agency that monitors Medicare payments for Congress.

MedPac noted that changes in the medical condition of the nursing home population could not account for the increase.

“Facilities are paid for providing therapy even when a patient’s need for and benefit from it has not been demonstrated,” MedPac wrote to Congress last year.

Despite the warnings, the problem persisted. HHS auditors scrutinized bills and medical records at five nursing homes throughout the country from 2002 and 2003 and found that the homes had overcharged the federal government by $2.4 million.

In one instance, a 76-year-old man with Parkinson’s and Alzheimer’s diseases had been coded into a high-priced rehabilitation category at the Regent Care Center in Laredo, Tex. But auditors determined that because the man was so sick, his rehabilitation was a waste of time and money.

The auditors found a similar pattern with a 75-year-old woman with dementia at the same nursing home. “Given her deteriorated mental and physical status, she could not participate meaningfully or obtain any long-term benefit from skilled rehabilitation therapy,” the auditors wrote.

In response, Regent officials said they set up internal controls.

The agency that now oversees Medicare, the Centers for Medicare and Medicaid Services, has been tightening rules during the past decade.

In 2006, the agency tried to limit unjustified billing in the ultra-high categories. But the effort backfired when nursing home operators found a loophole that made it easier to put residents in those categories. The new health-care legislation implements closer monitoring of nursing changes and requires skilled-nursing facilities to detail their patient-care staffing and spending. It postpones some proposed reforms but explicitly changes two rules that had been described as “vulnerabilities” that enabled nursing homes to bill excessively for patients.

“We have to be watching the broad scope of what’s happening in the industry and where the gaming is taking place,” said Sheila Lambowitz, a supervisor at the Centers for Medicare and Medicaid Services.

Washington Post researcher Meg Smith contributed to this article.

Original Article can be found here.

Do you have concerns about a loved one confined to a nursing home who suffers from bed sores which have gone untreated?

Your loved one may be entitled to compensation if it is determined that his or her bed sores were preventable or, even if preventable, had gone untreated.

In a story reported by Christopher K. Hepp of the Philadelphia Inquirer for www.philly.com, details of a jury verdict in a case in which a man who suffered from bed sores and ultimately died from their complications were explained.

In a highly unusual step for such a case, a Philadelphia jury yesterday leveled $5 million in punitive damages against Jeanes Hospital and a Wyncote nursing home in the death of a man who developed ultimately fatal bedsores while at both facilities.

The damages – $1.5 million against Jeanes and $3.5 million against Hillcrest Convalescent Home- came two weeks after the same Common Pleas Court jury awarded $1 million in compensatory damages in the case. The damages were awarded to the widow of Joe N. Biango, who died of bedsores in 2008, two years after being discharged from Jeanes Hospital in the city’s Fox Chase section.

Steven R. Maher, who represented Biango’s widow, said that in his 25 years of handling such cases, this was only the second time a jury had awarded punitive damages.

Biango went to Jeanes on May 21, 2006, after suffering weakness and confusion. He was 74 at the time and was thought to have suffered a stroke.

Doctors at Jeanes failed to properly diagnose that Biango was suffering from a urinary-tract infection that, as a result, worsened and left him susceptible to the bedsores that ultimately killed him.

After about a week at Jeanes, Biango was transferred to Hillcrest, where he stayed two weeks until his condition worsened and he was returned to Jeanes. He was released to go home after three days.

It was alleged that workers at Jeanes and Hillcrest allowed the bedsores to fester and Biango to go malnourished to the point that he lost 28 pounds.

After he returned home, Biango was cared for by his wife, Shirley, before dying from the bedsores two years later.

If you believe a loved one has been neglected or abused in a nursing home or assisted living facility, contact either Patrick E. Dougherty (570-288-1427, pdougherty@dlplaw.com) or Sean P. McDonough (570-347-1011, smcdonough@dlplaw.com) or any of the lawyers at DLP.

Elder abuse occurs when someone knowingly or unknowingly causes harm or a risk of harm to an older adult. Elderly abuse can take several forms, including:

• Physical abuse – Physical abuse is the use of physical force, such as hitting, pushing, shaking or burning, with the intention of causing pain or injury.

• Sexual abuse – Sexual abuse involves any nonconsensual sexual contact, such as inappropriate touching or rape.

• Emotional abuse – Psychological or emotional abuse is the use of tactics, such as harassment, insults, intimidation or threats, that cause mental or emotional anguish.

• Financial abuse – Financial abuse involves improperly using an older person’s resources for the benefit of another person, for example, by stealing, trickery or inappropriate use of government checks. Inappropriate use of financial power of attorney is another common example.

• Neglect – Neglect occurs when a caregiver refuses or fails to provide the level of care necessary to avoid physical or mental harm. Examples include inadequate attention to food, water, shelter and personal hygiene.

The abuser can be a family member — an adult child or a spouse. In institutions, such as nursing homes or group homes, professional caregivers may be abusers.
People age 80 and older, especially women, are at a greater risk of experiencing elder abuse. Older adults who are dependent on others for basic care are particularly vulnerable to elderly abuse.

Statement of Sean P. McDonough, Esquire regarding the Impact of Predators
in Long-Term Care on Small Business Operators

I have been asked to provide testimony on the issue of the impact of predators in long-term care facilities on small business operators. My perspective on this issue is informed by the extremely tragic consequences of one case in which my partner, Patrick E. Dougherty, and myself represented Mrs. Lillian Guernsey and her son, Thomas Itterly, arising out of two documented sexual assaults perpetrated upon Mrs. Guernsey by 31 year old Daniel Statham. A brief overview of the circumstances surrounding Mr. Statham’s admission to the Country Living Personal Care Home in Nicholson, Pennsylvania, demonstrate in graphic fashion the need for legislation to assist small business operators in avoiding the myriad of problems associated with accepting sexual offenders at their facilities without appropriate screening or consideration as to whether these individuals should be accepted into a setting where some of our most vulnerable citizens are placed for care. Steps need to be taken to ensure that our elderly and infirm citizens do not suffer the type of violent attack experienced by Lillian Guernsey at the hands of Daniel Statham.

Lillian Guernsey was born on November 19, 1915 and was 86 years of age at the time that she was raped by Daniel Statham on February 27, 2002. At the time of the attack on Mrs. Guernsey she and Statham were both residing at the Country Living Personal Care Home located in Wyoming County, Pennsylvania. At the time that she was attacked by Statham, Mrs. Guernsey was suffering from a moderate form of dementia. While residing at the Country Living Personal Care Home, Statham was not under the supervision of any probation department nor had any employee of the personal care home, other than its owner and administrator, had any knowledge of Statham’s past criminal history.

The shocking circumstances surrounding the placement of Statham at the Country Living Personal Care Home by the Court System and Adult Probation Department of Northumberland County serve as further compelling evidence as to the need for governmental oversight of this problem.

Daniel Statham was born on August 6, 1970. By the time Statham arrived at the Country Living Personal Care Home, he had had eight prior adult arrests, three convictions and two adult commitments to correctional facilities. Statham also had a lengthy prior juvenile criminal history. One of his juvenile arrests involved an arson charge in which Statham admitted to setting a fire in an Episcopal Church in Honesdale, Pennsylvania. In February of 1992, Statham was charged with rape, involuntary deviate sexual intercourse, aggravated indecent assault, corruption of minors and indecent assault. In February of 1992, Statham was arrested for burglary, theft by unlawful taking, and criminal trespass. Approximately six months later in August of 1992 Statham was arrested for burglary, criminal trespass, theft by unlawful taking, and receiving stolen property. Two years later, Statham was arrested in Lackawanna County, Pennsylvania and charged with four counts of aggravated assault, one count of simple assault, one count of recklessly endangering another person, one count of unlawful restraint, eight counts of disorderly conduct, one count of criminal mischief, one count of resisting arrest and one count of terroristic threats. Approximately three months later in December of 1994, Statham was arrested in Lackawanna County, Pennsylvania, for assaulting his girlfriend. As a result of the December 1994 offenses he was sentenced to serve one to three years in prison. Statham subsequently pled guilty to a charge of aggravated indecent assault in Wayne County, Pennsylvania, and he was sentenced to serve three to six years in a state correctional institution. The victim of the crime which resulted in the imposition of the three to six year prison sentence was a thirteen year old female whom Statham had taken into a wooded area and had had intercourse with the young child. Statham admitted in a subsequent interview with the Sexual Offender Assessment Board that he was intoxicated at the time of that assault. As will be noted in the description of the attack on Mrs. Guernsey, Statham stated he was intoxicated when he raped Mrs. Guernsey as well. As can be seen from Mr. Statham’s lengthy criminal history, this individual was hardly a candidate to be housed as a resident at a personal care home.

The circumstances which surround Statham being placed at the Country Living Personal Care Home serve to demonstrate the need for alternative facilities to be created to house individuals who live with the type of behavioral problems as Daniel Statham. In Statham’s case, the Court and Adult Probation Department of Northumberland County apparently had no access to an appropriate facility for someone like Statham. It was for that reason that he wound up at the Country Living Personal Care Home. As stated above, Statham had been sentenced to a three to six year prison term at the State Correctional Institute at Coal Township, Pennsylvania. During his time at SCI-Coal Township, Statham had been charged with a number of disciplinary violations and was unwilling to complete a sexual offender treatment program deciding instead to “max out” his sentence. At the completion of his sentence he was required to provide the Commonwealth of Pennsylvania with a permanent address where he would be living upon his release from prison. Unable to do so, officials from the State Correctional Institution contacted the Pennsylvania State Police advising them that Statham was in violation of Megan’s Law and should be arrested and taken to the Northumberland County Prison. While at the Northumberland County Prison, Statham was placed in contact with MaryJo Christiano who was employed as a counselor with a social service agency which had a contract with the Northumberland County Adult Probation Department. Officials form the Northumberland County Prison did not want Statham in their facility but did not have a mechanism in place to ensure that Statham was referred to a facility which would be appropriate for him to reside. At the time of his sentencing in the Court of Common Pleas of Northumberland County on October 2, 2001, for failing to have an address as required by the Megan’s Law, the Judge presiding in the case sentenced Statham to time served and placed him on six months probation. Unfortunately, when the Judge who presided over Statham’s sentencing made an inquiry as to whether probation would be in the mitigated range, the probation officer responded “I have know idea. We have no information on the Defendant at all.” Therefore, Statham was permitted to leave the Northumberland County Prison and go to Country Living Personal Care Home without even a rudimentary pre-sentence investigation having been performed. The Order that was ultimately entered by the Court provided with respect to Statham’s living arrangements nothing more than the following:

The Court directs the Defendant to take a bus to a half-way house in Scranton and to maintain his residence in Northumberland County.

Prior to Statham’s sentence, arrangements had been made for him to be admitted as a resident at the Omni One Personal Care Home which was owned by the mother of Shirley Sheridan, who owned the Country Living Personal Care Home where Statham raped Mrs. Guernsey. It was established during the civil trial between Mrs. Guernsey and Country Living Personal Care Home that the personal care home, through Shirley Sheridan, had agreed to accept Mr. Statham knowing that he had been convicted of a sex offense. MaryJo Christiano, the individual who was charged with the responsibility of finding a location for Statham to reside, indicated that she contacted the Department of Public Welfare and asked for a list of available “boarding homes” in the Commonwealth of Pennsylvania. Christiano indicated that she notified the Omni One Personal Care Home that Statham was currently incarcerated at the Northumberland County Correctional Facility and she indicated that she had made the disclosure that Statham was a Megan’s Law offender. It was established during Mrs. Guernsey’s trial against Country Living that Christiano had notified the administrator of the Omni One Personal Care Home that Statham had been incarcerated at SCI-Coal Township for six years for rape. Notwithstanding these disclosures, Omni One and subsequently Country Living Personal Care Home both agreed to accept Statham as a resident.

Statham was originally transported to the Omni One Personal Care Home by Sheriff’s Deputies from Northumberland County who had him handcuffed and shackled. Statham was moved from the Omni One facility after only a couple of weeks because he had started a small fire in a charcoal grill on the back porch thereby posing a danger the residents at the Omni One facility. It was thought that because of the fact that there were additional personnel at the Country Living Personal Care Home that Statham would find more things to keep him occupied at Country Living.

Upon his transfer to the Country Living Personal Care Home, Statham was placed on the second floor of the facility with only two other residents, a fifty-one year old male named Robert Ball and Mrs. Guernsey. The events of February 27, 2002, could have been prevented if the initiatives which have been proposed to the Committee this morning had been implemented. The Sexual Offender Assessment Report which has already been referenced sets forth in horrible and graphic detail the indignities visited upon Lillian Guernsey by Daniel Statham on that evening. Lillian’s story needed to be told as to what went wrong and the circumstances which led to her brutal victimization unfolded during a trial which occurred four years to the date of those tragic events. From February 26, 2006 to and including March 1, 2006, sworn testimony was presented to Judge Blewitt which painted a clear picture of the events leading up to the attack on Lillian Guernsey. Several days after Statham’s assault on Mrs. Guernsey, her son Tom Itterly was notified of what had taken place. Tom traveled to Northeastern Pennsylvania to bring his mother home to be near him in Memphis, Tennessee. He cared for his mom at his own home as best he could until it became impossible to attend to her needs. She lived out her days in a nursing home outside of Memphis. Lillian Guernsey died within two months of the conclusion of the trial brought on her behalf against Country Living Personal Care Home. She was 90 years of age at the time of her death. As a result of the attack on Lillian Guernsey, Daniel Statham was charged with rape, sexual assault and indecent assault. He is serving an extended prison sentence at the State Correctional Institution at Camp Hill.

1) The Sexual Offender Assessment Report of December 20, 2002, is incorporated into this Statement as Exhibit “A”.

2) The Pennsylvania Statute requiring registration by address of individuals who have either been convicted or plead guilty to certain sexual offenses. 18 Pa. C.S. §9795(A)(1).

3) The transcript of the proceedings for Statham’s guilty plea and sentencing in Northumberland County is attached to this Statement as Exhibit “B”.

4) The Order of October 2, 2001, is attached to this Statement as Exhibit “C”.

ABC News – July 22, 2008
By Megan Chuchmach

Hundreds of thousands of senior citizens are at risk because they are living among registered sex offenders, parolees and residents with violent histories, according to a nursing home watchdog who studied residents at nursing homes, assisted living homes and long tern care facilities.

“What is shocking is we have now found 1,600 registered sex offenders across the country [in facilities with seniors],” said Wes Bledsoe, who is set to testify tomorrow at a Congressional hearing on predators in these facilities. Bledsoe tracked the number of offenders living at these homes over the past four years by matching addresses from sex offender registries with a database of care facilities from Medicare.

Bledsoe said that in many of these cases the offenders are young adults who are often placed in the facilities because of disabilities or behavioral problems.

“We found teenagers, two nineteen year olds living in these facilities, many in their twenties, thirties, and forties,” Bledsoe said.

“We have also documented over 60 rapes, murders, and assaults committed by criminal offenders in these facilities,” he said.

Pennsylvania Attorney Sean McDonough will appear at the hearing to speak about Lillian Guernsey, who was 86 years-old in 2002 when she was raped by another resident at a Pennsylvania facility. The assailant, a 31 year old fellow resident, had eight prior adult arrests, three convictions and two adult commitments to correctional facilities before he arrived at the home, according to McDonough’s statement. Her assailant is now in prison, convicted of rape and sexual assault.

And six years to the day after her elderly mother was raped in a Florida nursing home, Sandra Banning will also testify.

Banning said she had no choice but to place her mother Virginia Thurston in a nursing home after Thurston, who suffered from dementia, was repeatedly found wandering the streets alone in the middle of the night.

“Growing up, Momma always said, ‘If you place me in a nursing home, I’d never forgive you’,” said Banning. “But that’s what we had to do for her safety.”

Banning, 60, said she had no idea that the facility she placed her mother in was also the home of a violent offender with a history of arrests. She found out after nursing home staff called her July 23, 2002 to tell her the offender had raped Thurston, then 77, in her bed.

“They found him right in the act,” said Banning. “This man was 83 years-old and in a wheelchair. Not someone you’d think would be a rapist.”

But Batming says it was only after the rape occurred that she found out the man had been arrested 58 times and that a court ordered him to move from a homeless shelter into the assisted-living facility.

Banning said she’ll never forget the “look of terror” in her mother’s eyes when she had to explain to her that she had been raped or the moment when she had to hold her mother’s hand inside a sexual assault response center when she was examined.

“I think that at that point reality was there and she knew what was going on,” Banning said of her mother, who didn’t recall the rape because of her dementia. “The tears were streaming out of her eyes.”

Banning says that despite physical evidence of sexual assault, the man was found incompetent to stand trial and has since been relocated to another Florida nursing home. She won a civil suit against the nursing home in the amount of $750,000 last year, which has not yet been paid out.
“She was my best friend,” said Banning of her mother, who passed away in 2003. “After that happened, I had such guilt from putting her away where that could happen. So I vowed that I would make a change.”

Tomorrow, Banning will tell her story to Congress, an opportunity she calls “awesome.” And when she retires August 1 from her job as a medical staff manager for the Navy Medicine Support Command, she says she will “take up predators in nursing homes full-time.”

“I believe that’s why God put me here on this Earth,” said Banning, fighting off tears. “It may be trips back and forth to Washington, but I’d go to the moon if I had to. Because someday it could be me; it could be you.”

‘There is no law, federal or state, that keeps violent or sexual offenders out of long-term care facilities as residents,” said Bledsoe, who founded the citizens’ advocacy organization A Perfect Cause in 2001 after his grandmother died in an Oklahoma City nursing home from what he says were negligent acts. A civil suit against the facility was settled out of court.

“The problem we have is that these offenders are being warehoused in nursing homes because the excuse is, ‘Well, where else are we going to put them?’”

Bledsoe will present his findings on what he calls a “national disgrace” to the House Subcommittee on Investigations and Oversight tomorrow. In his prepared testimony, Bledsoe calls for the establishment of separate and secure long-term care facilities for violent and sexual offenders, criminal background checks for all residents, and notification of offenders residing in the facilities, among other recommendations.

Bledsoe said that offenders are placed in long-term care facilities by district court judges, county sheriffs, adult protective services workers, and corrections workers, as well as by offenders themselves and their families. And he said that while these offenders deserve care, seniors living in the homes deserve protection.

“I hope that some of the congressional leaders don’t sleep soundly tomorrow,” said Bledsoe, “and that this makes an impression on them that right now, in this moment, we have people in harm’s way.”

Rep. Mary Fallin (R-OK), who organized tomorrow’s hearing, issued a statement today in which she described seniors living in long-term care facilities as “some of the most vulnerable of our citizens.”

“The rare cases of sexual assault and abuse that have been documented in these facilities are particularly abhorrent,” said Fallin, adding that the hearing will “investigate both the scope of the problem and the possible roles the federal government might play to eliminate it.”

Joining Bledsoe to speak at the hearing will also be Oklahoma State Representative Kris Steele, who authored legislation passed in Oklahoma in May to establish separate living facilities for registered sex offenders. The state is now preparing a request for private bids to build such a facility.

Megan Chuchmach is a 2008 Carnegie Fellow at ABC News in New York. She recently graduated from Columbia University’s Graduate School of Journalism.

Congress of the United States
U.S. House of Representatives Committee on Small Business
2561 Rayburn House Office Building
Washington, DC 26515

July 16, 2008 VIA E-MAIL
Mr. Sean McDonough Dougherty, Leventhal, and Price, LLP
75 Glenmaura National Blvd.
Moosic, PA 18507

Dear Mr. McDonough:

I am writing to invite you to testify at a hearing of the U.S. House of Representatives Committee on Small Business, entitled “The Impact of Predators in Long-Term Care on Small Business Operators.” The hearing will take place on Wednesday, July 23 2008, at 10:00 a.m., in room 1539 of the Longworth House Office Building.

The entire written statement will be entered into the record. You should be prepared to summarize the written testimony in a five-minute oral presentation. The Rules of the Committee require that testimony is submitted at least two days prior to the date of the hearing, as well as a copy of witness’s curriculum vitae (or other statement describing education, employment, professional affiliations and other background information pertinent to the testimony), and a completed witness disclosure form (enclosed).

The Rules of the Committee also require that an electronic copy of the testimony is submitted for the Committee majority and minority staff by sending it to: DarienneGutierrez@ mail.house.gov and Lisa.Christian@ mail.house.gov. In addition, please provide 75 copies of your testimony for distribution at least one day prior to the date of the hearing. Testimony should be delivered to the Committee’s office at 2361 Rayburn House Office Building and a copy should also be delivered to the office of the minority staff in Room B-363 Rayburn. The Committee looks forward to your participation. Should you have any questions, please contact Melody Reis, Counsel, at 202-225-4038.

Sincerely,

Nydia M. Velazquez, Chairwoman

WHAT IS ELDER ABUSE?
Elder abuse occurs when someone knowingly or unknowingly causes harm or a risk of harm to an older adult. Elder abuse can take several forms, including:

-Physical abuse. Physical abuse is the use of physical force, such as hitting, pushing, shaking or burning, with the intention of causing pain or injury.
-Sexual abuse. Sexual abuse involves any nonconsensual sexual contact, such as inappropriate touching or rape.
-Emotional abuse. Psychological or emotional abuse is the use of tactics, such as harassment, insults, intimidation or threats, that cause mental or emotional anguish.
-Financial abuse. Financial abuse involves improperly using an older person’s resources for the benefit of another person, for example, by stealing, trickery or inappropriate use of government checks. Inappropriate use of financial power of attorney is another common example.
-Neglect. Neglect occurs when a caregiver refuses or fails to provide the level of care necessary to avoid physical or mental harm. Examples include inadequate attention to food, water, shelter and personal hygiene.
The abuser can be a family member — an adult child or a spouse. In institutions, such as nursing homes or group homes, professional caregivers may be abusers.
People age 80 and older, especially women, are at a greater risk of experiencing elder abuse. Older adults who are dependent on others for basic care are particularly vulnerable to elder abuse.
HOW CAN I SPOT ELDER ABUSE?
If you’re concerned an older adult you know is being abused, knowing the signs and symptoms of abuse can help you determine if a problem exists. These signs and symptoms may include:
-Physical injury. Examples of questionable injuries include bruises, cuts, or burns, and broken bones or sprains that can’t be explained. Other signs of potential problems include sudden changes in behavior, comments about being battered or the refusal of the caregiver to allow you to visit the older person alone.
-Lack of physical care. Indications of substandard physical care include dehydration, malnourishment, weight loss and poor hygiene. Bed sores, soiled bedding, and comments about being mistreated also may indicate a problem. Lack of physical care can happen to older adults living in their homes, as well as in institutional care settings, such as a nursing home.
-Unusual behaviors. Changes in an older person’s behavior or emotional state may suggest a problem. Examples include agitation, withdrawal, fear or anxiety, apathy, or reports of being treated improperly.
-Unaccounted for finances. Financial problems may include missing money or valuables, unexplained financial transactions, unpaid bills despite available funds and sudden transfer of assets. Another sign may be older adults who are controlling their finances but don’t allow relatives to see their records.
ACTIONS TO TAKE IF YOU SUSPECT ELDER ABUSE
It’s important for you to speak up about suspected elder abuse. There are agencies that can help. You must remember that a problem can’t be remedied until it’s reported.
ACTIONS TO TAKE IF YOU SUSPECT ELDER ABUSE AT HOME
Call the police if you suspect an older adult is in imminent danger. If you’re not aware of immediate danger, but you suspect an older adult is being abused, check with welfare and social service agencies. Most cities and counties, according to state law, will investigate and protect vulnerable adults from elder abuse.
Some type of adult protective services agency, a division of human service agencies in most states, is typically responsible for investigating reports of domestic elder abuse and providing families with help and guidance. Other professionals who may be able to help include doctors, nurses, police officers, lawyers and social workers.
ACTIONS TO TAKE IF YOU SUSPECT ELDER ABUSE IN A NURSING HOME
If you suspect elder abuse in an institutional setting, such as a nursing home, report concerns to your state long term care ombudsman. Each state has a long term care ombudsman to investigate and address nursing home complaints. In Pennsylvania, the Area Agencies on Aging (AAA) are the local representatives of the Pennsylvania Department of Aging. There are 52 such offices, serving all 67 counties. They are staffed with aging care managers skilled in such areas as geriatrics, social work, and community resources. If you are aware of the abuse or neglect of an older person, get in touch with your county’s AAA. They will take your call 24 hours a day and will begin an investigation within 72 hours. Any person who believes that an older adult is being abused, neglected, exploited or abandoned may file a report with any Area Agency on Aging or call the statewide elder abuse hotline at 1-800-490-8505. Abuse reports can be made on behalf of an older adult whether the person lives in the community or in a care facility such as a nursing home, personal care home, hospital, etc.
Reporters may remain anonymous. Reporters have legal protection from retaliation, discrimination and civil or criminal prosecution.

The Web site for the National Center on Elder Abuse (http://www.elderabusecenter.org) also maintains a list of phone numbers, by state, that you can call for assistance if you suspect domestic or institutional elder abuse.

SOURCES: The Mayo Clinic, Mayo Foundation for Medical Education and Research, 1998-2007;
Pennsylvania Department on Aging; The National Center for Elder Abuse.

Thomas P. Cummings, Esq.
Dougherty, Leventhal & Price, LLP
tcummings@dlplaw.com

A Wyoming County personal care home has been ordered by a federal court to pay $1.1 million to the son of an elderly woman who was raped in the facility.

Daniel K. Statham was convicted and is serving time for raping an 87-year-old Alzheimer’s patient at the Country Living Personal Care Home in Nicholson on Feb. 27, 2002. The woman passed away in May.

Attorneys for her son argued that the facility was negligent for accepting Statham as a resident. Before moving into the home, Statham had been declared a sexually violent predator under the state’s Megan’s Law.

Upon his release from prison, Northumberland County probation officials were directed to lodge Statham in a halfway house in Scranton, but could not find a facility to accept him.
They then contacted Shirley Sheridan, owner of the Country Living home, who accepted Statham as a resident.

The suit filed in the U.S. Middle District Court of Pennsylvania in 2004 said the facility failed to protect residents from Statham.

In a blistering opinion, U.S. Magistrate Thomas M. Blewitt blasted Sheridan for allowing unrestricted access in the nursing home to a man she knew was a violent sexual predator and for failing to notify the proper authorities after the rape occurred.

“We find the defendants’ conduct utterly reprehensible,” Blewitt wrote.

Eugene Hickey, the Scranton attorney who represented the personal care home, did not return a call seeking comment Friday.

The case led Northumberland County President Judge Robert Sacavage to fire the county’s chief of probation, Thomas Letcavage, in April 2002. Officials from Letcavage’s office were accused of failing to notify Wyoming County probation officials of Statham’s criminal background.

Testimony concluded Wednesday in a federal trial related to the sexual assault of an 86-year-old woman four years ago at an assisted-living facility in Wyoming County.

The former Nicholson woman, now 90 and living in Tennessee, is seeking more than $75,000 from Country Living Personal Care Home, Nicholson, and its owner, Shirley D. Sheridan, of Montrose, resulting from the sexual assault on Feb. 27, 2002.

It is The Times-Tribune’s policy not to identify sexual assault victims.

The woman, a resident of the home, was sexually assaulted in her room by Daniel Statham, then 31 and also a resident of the home. Mr. Statham, who is mentally handicapped, was a sexually violent predator convicted in 1995 of aggravated indecent assault involving a 14-year-old girl.

U.S. Magistrate Judge Thomas Blewitt, who presided at the three-day long trial, gave lawyers a month to submit proposed findings of fact in the case. He did not indicate when he will rule.

The woman’s complaint alleges the home and Mrs. Sheridan were negligent by disregarding her safety and rights, leading to the assault.

The victim’s attorney, Sean McDonough, said Mrs. Sheridan knew Mr. Statham was a convicted sexual offender and neglected to inform the staff about it. Mrs. Sheridan testified that she was not told about his Wayne County conviction and would not have agreed to house him if she knew.

Attorney Eugene Hickey, who represented the care home and Mrs. Sheridan, said the home was not at fault and Mr. Statham was “dumped” on the facility.

Mr. Statham pleaded guilty in February 2003 in Wyoming County Court to aggravated indecent assault in the case and was sentenced to five to 10 years in a state prison.