ElderWeb

The New York State Assembly approved a budget which restored $132 million in payments to nursing homes and home health providers which Governor George Pataki had cut in his proposed budget. The Assembly plan also adds $100 million in new funding to address nursing home quality of care and staffing issues, and rejects the Governor?s proposal to cut $34.5 million in state support from the Elderly Pharmaceutical Insurance Coverage (EPIC) program ? which provides eligible seniors with affordable prescription medications. Assembly leaders noted that the Division of the Budget has now projected that there will be an additional $3 billion in revenues available over the amount originally forecast, leaving plenty of room to fund senior-related programs.

Reasearchers led by Dr. Robert Lindsay, of Helen Hayes Hospital in West Haverstraw, New York, investigated the incidence of repeat fractures for older women who incur osteoporosis-related spine fractures. They determined that women who suffer such fractures are five times more likely to incur a second fracture within the next year, despite receiving calcium and vitamin D. Lindsay's team concluded that it is extremely important to identify women with low bone density before fractures occur so that treatments can be started to reduce bone loss. The study was reported in the January 17 issue of the Journal of the American Medical Association (JAMA).

New York Gov. George Pataki signed legislation that gives New Yorkers easier access to information about malpractice cases and disciplinary actions involving their physicians. The Medical Society of the State of New York (MSSNY) supports the right of consumers to access valid information on physicians in New York State, but expressed concern that malpractice actions have not demonstrated correlation to a physician's professional ability.

Under the provisions of the new law, patients will be able to use the Internet or a toll-free telephone line to review physician profiles that will include:

- Criminal convictions within the last 10 years;
- Office for Professional Misconduct (OPMC) final actions taken against licensee (currently available on the OPMC Web site);
- Current limitations of licensee to a specified area, type, scope or condition of practice;
- Any loss or involuntary restriction of hospital privileges within the last 10 years for reasons related to the quality of patient care delivered;
- All medical malpractice judgments made within the past 10 years; and
- All medical malpractice settlements if the physician has three or more within 10 years, or any individual settlement if the New York Department of Health (DOH) Commissioner deems disclosure is warranted.

Due to the complexity in coordinating all of the profiling information, New York DOH officials said the information will take some time before it is available for the public to access.

Governor George Pataki has announced the New York State Oral History Program. This program involves professional military historians using the latest digital technology to preserve the story of New York's Veterans - in their own words - now and for all generations to come. Initially, the program will be concentrating almost exclusively on the state's sizable World War II Veteran community. Later the program will be expanded to telling the stories of later veterans of all periods and services.

All audio tapes will be converted to a digital format for storage. The use of digital formats ensures that the veteran's recollections and experiences will be preserved for generations to come. All video and audio media (regardless of method of collection) will be catalogued, summarized, transcribed whenever feasible, and placed into protective storage. Catalogue information will be made as widely available as possible, and the interviews made available to the general and academic community, subject to any limitations placed on their use by the individual veteran. When specifically authorized by each veteran, copies or portions of the interviews may be shared with other research institutions or school and university programs.

New York enacted legislation which significantly enhanced the Elderly Pharmaceutical Insurance Coverage (EPIC) Program. The program is now available to people age 65 or older with an annual income of $35,000 or less if single, or $50,000 or less if married. The lowest income seniors pay an annual fee of between $8 and $300 dollars to receive medications. Higher income seniors pay an annual deductible of between $517 and $1,715, depending on their income.

Attorney General Eliot Spitzer today announced that five registered nurses holding high managerial positions at the Townhouse Extended Care Center in Uniondale have been charged with covering up acts of patient abuse at the facility by tampering with evidence and falsifying documents to deceive state investigators looking into the allegations. The focus of the state probes was a patient who died after being fed through an enema bag, and two other patients who sustained serious injuries in falls.

The defendants have been charged in a 21-count indictment with Falsifying Business Records in the First Degree, Offering a False Instrument for Filing in the First Degree, and Tampering with Physical Evidence. Spitzer noted that the possibility of bringing patient abuse charges was precluded by the statute of limitations.

This case was the first to result from Attorney General Spitzer?s statewide nursing home initiative in which he directed each Medicaid Fraud Control Unit (MFCU) regional office to target a nursing home for quality of care issues.

On the morning of April 5, 1997, a 97-year-old female patient died after Townhouse staff used an enema bag instead of a feeding bag to administer nourishment directly into the woman?s stomach. (A feeding bag is equipped with a regulator and pump, thereby allowing staff to control the flow of the liquid nourishment. An enema bag contains a clamp that allows only two positions ? open and closed.) Using the proper equipment, the feeding was supposed to take ten hours. However, as a result of using an enema bag, the entire feeding supplement was delivered in an hour or less. As a result, the patient experienced numerous episodes of vomiting and diarrhea throughout the night before dying.

When the State Department of Health (DOH) commenced an investigation into the patient?s death, Brown and Colon, in their capacity as Director and Assistant Director of Nursing, respectively, allegedly tried to cover up the facts and circumstances surrounding the patient?s death. They did so by directing staff, who had attended to the patient, to rewrite their nursing notes and written statements to falsely indicate that the proper equipment had been used. Brown then submitted these false statements to DOH.

As part of the cover-up, it is further alleged that Dwyer, who had been the R.N. supervisor on duty at the time, and who had ordered the enema bag to be used because no feed bags were available, falsely indicated in a written statement that there was no problem with the patient during her shift, and that nothing unusual was reported to her regarding the patient. In fact, Dwyer had repeatedly ignored requests by the staff to check on the patient once they realized she was in distress.

The New York Department of Health has posted nursing home survey summaries and facility characteristics online. The facility characteristics reports provide information about the size and ownership of facilities and what services they are licensed to perform. The survey summaries tell whether the facility passed or failed its survey and the general categories of any deficiencies. Each survey summary also includes a link which allows consumers to send the department an email to request the complete survey for that facility.

Newsday reports that New York City Mayor Rudolph Giuliani and City Council Speaker Peter Vallone announced a $5 million supplement to the city's Home Energy Assistance Program. This was triggered in part by Vallone, who said his 94 year old aunt was socked with an $805 fuel bill last month, and an elderly neighbor of hers got a fuel bill that topped $1,000. The money will be available through the Department of Aging. Seniors whose income is less than $1,030 a month, or less than $1,383 for a two-person household, qualify for federal aid to pay heating bills. This year, eligibility thresholds are being raised by as much as $5,000 per person per year, making at least 50,000 additional households eligible to receive the aid.

Significant improvements are needed in the State's licensing and inspection of adult care facilities in New York, according to an audit released today by State Comptroller H. Carl McCall. "State officials responsible for the safety of adult care facilities do not regularly verify information before granting a license to operate, they don't conduct inspections as required, and they don?t always respond to complaints on time," McCall said. "When people make a decision to place a loved one in a state licensed adult care facility they should have the peace of mind that the State has met its responsibility for licensing and inspections."

McCall's auditors found that, while the Department of Health (DOH) and the Office of Children and Family Services (OCFS) require applicants to provide letters of reference and information about their prior work experience and financial resources, neither agency verifies the information or routinely seeks independent information about the applicants. Although State officials admitted knowledge of as many as 50 unlicensed adult care facilities operating in the New York City area alone and 800 unlicensed family-type homes operating statewide, little is done to investigate. DOH dedicated about ten percent of one staff person?s time to investigate reports of unlicensed facilities. During a visit to one of the unlicensed facilities, McCall's auditors found that one of the residents had required skilled nursing care for at least two years, but had yet to be transferred to a facility that provided the needed care.

McCall also identified serious weaknesses in the inspection of licensed adult care facilities. Unannounced inspections are required every 18 months, and annually if there has been a pattern of problems at a facility. Auditors found that the DOH computer system designed to track inspections was so riddled with errors it could not be used as a reliable source of information to determine if inspections were done on time.

McCall also found problems with DOH's response to complaint calls. For example, the Department waited seven days to respond to a complaint about at an adult care facility that had no medication available.

McCall outlined twenty specific recommendations to improve DOH and OFCS operations, and agency officials agreed to implement most of them.

Paul T. Finger, M.D., an Associate Professor of Ophthalmology at the New York University School of Medicine, has created extensive patient information sites on macular degeneration and eye cancer. His sites provide a wide variety of disease and treatment information for patients, all in extra large type.