Tag Archives for Roberta Hawkins

Congressional report spotlights nursing home abuse

Published in The Times dated August 6, 2001

Congressional investigators have recently released a scathing report charging that within the last two years more than 30 percent of the nation’s nursing homes – about 5,285 facilities – were cited by state inspectors for at least one abuse violation that had the potential to cause harm.

These facilities were cited for almost 9,000 violations during the two-year congressional study, the report said.

Citing information gleaned from a sampling of state inspection reports or formal complaints, the 15-page report released last week at a hearing called by Henry Waxman (D-Calif), Minority Chairman of the House Committee of Government Reform, found that in more than 1,600 nursing facilities, approximately one out of every 10, the abuse violations were serious enough to cause significant harm to residents or to place them in immediate jeopardy of death or serious injury.

Abused residents were punched, choked or kicked by staff members or other residents, the report said, stating that the attacks frequently caused serious injuries such as fractured bones and lacerations.  In other instances, residents were being groped or sexually molested.

Although the report, “Abuse of Residents is a Major Problem in U.S. Nursing Homes,” prepared by Minority Staff of the Committee’s Special Investigation Division, found that the percentage of nursing facilities with abuse violations is increasing, it noted that the reasons for this increase are unclear.

In his opening remarks, Waxman stated that it had been unwise for Congress to repeal the Boren Amendment in 1997, a federal law which mandated that states provide nursing facilities with adequate funding to operate.  Because of this, he said, Medicaid funding for nursing facility care has not kept pace with the rising costs of providing care.

Waxman’s legislative prescription for attacking the growing abuse in the nation’s nursing facilities is to introduce a legislative proposal that would reestablish the abolished Boren Amendment, mandating minimum nurse staffing requirements, imposing tougher regulatory sanctions on poorly performing facilities, and instituting criminal background checks for nursing facility employees, or increasing internet disclosures on nursing facility care.

What’s playing out in Rhode Island?

According to Wayne Farrington, Chief of Facilities Regulation at the state’s Department of Health, the reporting of Rhode Island abuse complaints has risen by 10 percent.  The statewide increase in reports of abuse, neglect and mistreatment probably mirrors the tragic national problem, he tells All About Seniors, but is smaller because the Rhode Island 1987 statute has made it a misdemeanor for health care professionals or public safety officials not to report suspected abuse, neglect, mistreatment.  The size of the national increase is partially due to abuse reporting being a new requirement in some states.  Farrington added. 

Farrington states that the biggest factor that increases the number of reported calls of abuse, neglect and mistreatment is the severe statewide staffing shortage in Rhode Island’s nursing facilities.

“Overworked staff may become short tempered and this can result in abuse.  Not enough staff in the facility may also result in resident’s needs not being met,” he added.

Administrator Hugh Hall, of Cherry Hill Manor, also feels that the state’s critical staffing crisis contributes to the possibility of increased abuse and that crisis also affects the quality of care provided in the state’s 104 nursing facilities.

“Today’s nursing facility employees are underpaid, overworked creating an environment in which even the best employee may falter,” Hall said.

The administrator urges the General Assembly to increase Medicaid payments to more adequately cover the nursing facility’s actual cost of care, allowing for greater increases in direct care provider salaries.

“While last year’s average cost of care in a Rhode Island facility was $140 per day the state’s Medicaid program only reimbursed facilities $116 for the care provided, creating a serious shortage of funds in many facilities, Hall added.

“There are not enough certified nursing assistants in the system to deliver the care,” Hall said noting that opportunities must be created and a fair wage paid to attract people into this profession.

Meanwhile, Hall believes that the overwhelming majority of nursing facilities in Rhode Island provide quality care.  These facilities do criminal background checks and provide staff training.  They educate their staff about the facility’s expectation on quality patient care, he said.

Hall says facilities that have on going problems with abuse should be prosecuted to “the fullest extent of the law.”

Although Roberta Hawkins, the state’s Long-Term Care Ombudsman and Executive Director of the Alliance for Better Long-Term Care sides with Farrington and Hall about the critical need to directly confront the adverse impact of the staffing shortage in facilities, “it’s not to excuse to provide bad care,” she says.  “If facilities can’t care for residents then they should not admit them.”

A mandated continuing education program for both professional nurses and certified nursing assistants can be an effective strategy for reducing the incidence of abuse while enabling the better trained worker to care for more medically complex residents.

Additionally, Hawkins and long-term care providers are pushing for more state and federal Medicaid dollars to be allocated to provide a living wage for direct care workers.

Although lawmakers this year gave a small increase, “it’s not what was needed but it’s a start,” she acknowledges.

A divided Congress and a conservative Bush White House may well keep Waxman’s legislative proposal that addresses the problem of rising abuse in the nation’s more than 17,000 nursing facilities from every being enabled.

So, change must begin in the Ocean State.

When the Rhode Island General Assembly comes back into session next year, it becomes critical that the serious direct care staffing shortage in Rhode Island’s nursing facilities become a top legislative priority.

As the Republican and Democratic Gubernatorial candidates gear up their political campaigns and dream of becoming the state’s top elected policy official, they might well consider taking up the just cause of improving the care provided in the state’s nursing facilities.

Lawmakers can gubernatorial candidates can ill afford to ignore this key policy issue, one that puts the state’s 10,000 frail nursing facility residents in continued jeopardy of abuse, neglect or mistreatment.

On a political note, hundred of thousands of families and friends of these residents, who are voters, are watching.

AARP Pushes Busch to Pull Rude Commercial

Published in the Pawtucket Times on July 23, 2001

Everyone knows that sex and humor are used every day to effectively advertise products, ranging from blue jeans, CDs, perfumes and colognes, to America’s youth. Now an advertising firm is seeking new outrageous ways to pitch beer for their Fortune 500 client.

Anheuser-Busch, Inc., the maker of Budweiser beer, is known for its fun and humorous commercials to sell Bud beer by using computer-generated talking lizards and young men yelling “Whassup.” But the Washington, D.C.-based AARP and senior advocates across the country found Anheuser-Busch’s new radio commercial using elder abuse to pitch its beer to be unacceptable. The nation’s largest senior advocacy group, representing 33 million older Americans, called the radio ad portraying a young woman abusing and exploiting her elderly infirmed husband, “offensive” stating that it just goes so far.

In “She Married Steven Buck Simpson,” a young woman gleefully talks about how she is physical, emotionally and financially abusing her frail elderly husband. Here’s the text for the commercial spot describing the abuse intergenerational relationship:

“Last year I married oil tycoon Steven Buck Simpson. He was 93. I was 22. And it was true love, hmm, or so I led him to believe until the wedding. After that, I fired his lawyer and cardiologist. I let his house insurance lapse, alienated him from his children, and sent him out for a walk so I could get freaky with the pool boy. Umm, I deflated the tires on his wheelchair, soaked his dentures in turpentine, and hid his oxygen.”

“Let’s see. I replaced his blood pressure medication with Red Hots, fed him high fat, high cholesterol foods. And finally, liquidated 100 percent of his assets into a Swiss bank account, dropped his dog King off at the pound, and left the country in his private jet, where I promptly renewed my membership in the Mile High Club.”

At this point a m  a states, “Ooh, ooh man that’s cold!” With the sound of a cap being popped off a beer bottle, an announcer responds, “But not as cold as Bud Ice. Ice brewed for a smooth crisp, refreshing taste. Bud Ice, there ain’t nothing colder. Anheuser-Bush.” Quite a way to sell a brand of beer.

When the commercial, playing in several markets, caught the attention of AARP the group’s president Esther Canja, wrote to CEO August A. Busch III of Anheuser-Bush, informing him of her disappointment that the beer company would “make light” of the very serious aging issue of elder abuse.

“Elder abuse is not a joking and your message to the contrary is most inappropriate.” Canja bluntly told the CEO noting that the incidence of elder abuse is increasing at an alarming rate. She cited a National Elder Abuse Incidence Study that estimated that 450,000 older persons are abused or exploited each year.

“While humor has its place, your ad goes to far,” Canja said, urging Busch to withdraw the offensive ad from the marketplace. “You certainly would not sponsor a commercial that portrays a parent physically abusing a child or even mistreating a family pet,” she added.

In Rhode Island, senior advocates were also incensed about Anheuser-Busch’s radio commercial. “This ad, which is so corrosive to the well-being and dignity of our seniors, crosses the boundary from humor to just plain bad taste,” Kathleen S. Connell, AARP Rhode Island director, told the Times. “I join AARP President Esther Canja in calling the company to scrap this piece of junk,” she said.

Adds Rhode Island Ombudsman Roberta Hawkins, of the Alliance for Better Long-Term Care, the Anheuser-Busch commercial is unacceptable.” The well-known Rhode Island senior advocate stated that elder abuse, although not publicly acknowledged by the media, is a widespread and a tragic problem. “If you spent your days the way we do listening to horrible situations just like the ones you think are so funny, your opinion of this commercial would change,” she added.

An e-mail writing campaign initiated by Bill Benson, a former deputy assistant secretary for aging at the U.S. Department of Health and Human Services and president of the Maryland-based Benson Consulting Group, during his July 13 Washington Radio Report, has finally caught the attention of the St. Louis, Mo-based beer company.

Benson e-mailed his weekly radio report, “This Bud’s Not for You” to hundreds of his colleagues informing them about the offensive commercial. Word spread like wildfire across the Internet. After numerous attempts to contact Anheuser-Busch, the company finally responded with a written statement. Bill Etling, a spokesperson for the company stated, “It is never our intention offend anyone with our advertising. Anheuser-Busch has discontinued use of this ad and has no plans to use it in the future.”

As the dust settles after Anheuser-Busch’s recent public relations fiasco. Benson hopes that the beer company will reexamine who they choose to write their advertising. “I am sure that they are clueless about how people would react. I bet you this is the last time that Anheuser-Busch uses radio advertising to take jabs at vulnerable seniors,” he says.

“It is clear that the combination of senior advocates and the use of the Internet to spark an e-mail writing campaign nipped Bud in the Bud,” Benson said.

The Best of…Little Things Count When Deciding on a Nursing Home

Published April 23, 2001, Pawtucket Times          

           It isn’t easy operating a nursing facility these days.

           The high turn over rate of certified nursing assistants has drastically impacted the quality of care provided in facilities.  And this direct care staffing shortage is also financially hurting facilities too, reducing their financial stability, even pushing many towards bankruptcy.

          According to the Rhode Island Health Care Association, eight out of the state’s 105 nursing homes have filed for Chapter 11 Bankruptcy, two are currently in state receivership and two more were recently ordered closed by the Department of Health.

         In these difficult financial times for nursing facilities, especially with a state-wide shortage of certified nursing assistants, youmusts become a better shopper when seeking the most appropriate nursing facility to place your loved one.

       “Until there is a health crisis, families don’t often think about nursing facility care until it’s too late,” states Roberta Hawkins, executive director of the Alliance for Better Long Term Care who serves as the state’s ombudsman on the behalf of 10,000 Rhode Island nursing home residents.  “If  it’s possibly, just plan ahead,” Hawkins recommends.

      “Your state health department provides a comprehensive list of nursing homes and their survey results to help you determine if the facility is reputable,” states Hawkins.

       According to Hawkins, word of mouth or personal recommendations from family, friends, neighbors, hospital discharge planners, and her nonprofit advocacy group about a nursing home’s care are key bits of information to determine if the facility is well managed.

        “The Alliance also offers a free phone help line to assist matching the particular needs of a person with a specific facility,”  Hawkins adds.

       With more than 20 years of experience under her belt in assisting families find the right nursing facility for the loved ones, Hawkins gives simple tips on selecting a facility.

        Hawkins suggested that a need for upgraded services for residents requiring intensive medical care, special rehabilitation therapies and dietary requirements, along with religious and cultural needs should also be taken into account before selecting a facility.

       Location should not always be a deciding factor in selecting a nursing facility.  Carefully choose a facility that meets your loved ones medical, personality and social needs.

       In many cases, this critical decision is made only for convenience of family members or visitors.  If an elderly spouse can not drive, make sure that the selected facility is on a bus line.  Keeping a married couple close together is very important for their psychological well-being.

       Always have the older person in need of skilled nursing care, actively participate in choosing a facility even if they can’t physically visit the site.  Family members can also provide this person with brochures and admission materials.

      Don’t choose a facility on the basis of a beautiful physical exterior, fancy rugs, or glittering chandeliers, Hawkins says.  When visiting a nursing facility, always observe how staff members interact with residents and each other — look for laughter, a pleasant environment, and a strong activity program.

       For those frail residents who are bed bound, look for a stable nursing staff.

       Ask yourself, is the facility’s environment cheerful in appearance and clean?

        Are the bedrooms warm looking and do they reflect the residents individuality?  Or do they all look the same, like hotel rooms.

        Find out if residents are allowed to bring in personal belongings such as chairs, tables, lamps or even a television set into their rooms.

        For those persons who always loved nature and being outdoors, find out if the nursing facility has an outside area for sitting or walking.  Determine if this area is accessible to a wheelchair bound person who might want to roll outside to listen to the birds.  This simple amenity is very important.

        When touring a facility determine if a dining room is available for eating meals and space to allow residents to socialize with each other and participate in activities.

         Is there a real working activities room?  A resident who has always been involved in crafts and enjoys participating in group activities will want to select a facility with a well-run activities program.

         Also, be aware of how the nursing facility smells.  Sometimes you may smell strong odors of deodorants.  This might be covering up unpleasant odors.

        Listen for sounds of buzzers, rung by residents in need of help, and observe how quickly staff responds.

         When walking the halls, say “hello” to the staff you meet.  Do the staff pleasantly respond to you?  IF not, consider that they may not respond           well to your loved one.

         Walk in and talk with residents gathered in a community room.  In conversation, find out how long they have lived at the facility.  Ask if they like the facility and are they respected as individuals by staff.

         If you see residents in restraints lying or sleeping in a chair or wheelchair, this may be a red flag for poor care.  The facility may not have enough staff to allow the residents to lay down in bed for a nap in the afternoon.

         After you locate your facility, “put your name on the waiting list,” Hawkins recommends, even if the nursing facility admissions will occur months later.

         For those afflicted with Alzheimer’s and related dementia, it is wise for these individuals to be admitted earlier in the disease process to get them acclimated to the facility and for the staff to learn more about the resident’s habits, likes and dislikes.

        Herb Weiss is a Pawtucket-based freelance writer covering aging, health care and medical issues.  This Column appeared in the Pawtucket Times on April 23, 2001.