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Serious Nursing Home Abuse Often Not Reported To Police, Federal Investigators Find – NPR

More than one-quarter of the 134 cases of severe abuse that were uncovered by government investigators were not reported to the police. The vast majority of the cases involved sexual assault. Scott Olson/Getty Images hide caption

More than one-quarter of the 134 cases of severe abuse that were uncovered by government investigators were not reported to the police. The vast majority of the cases involved sexual assault.

More than one-quarter of serious cases of nursing home abuse are not reported to the police, according to an alert released Monday morning by the Office of Inspector General in the Department of Health and Human Services.

The cases went unreported despite the fact that state and federal law require that serious cases of abuse in nursing homes be turned over to the police.

Government investigators are conducting an ongoing review into nursing home abuse and neglect but say they are releasing the alert now because they want immediate fixes.

These are cases of abuse severe enough to send someone to the emergency room. One example cited in the alert is a woman who was left deeply bruised after being sexually assaulted at her nursing home. Federal law says that incident should have been reported to the police within two hours. But the nursing home didn’t do that, says Curtis Roy, an assistant regional inspector general in the Department of Health and Human Services.

“They cleaned off the victim,” he says. “In doing so, they destroyed all of the evidence that law enforcement could have used as part of an investigation into this crime.”

The nursing home told the victim’s family about the assault the next day. It was the family that informed the police. But Roy says that even then, the nursing home tried to cover up the crime.

“They went so far as to contact the local police department to tell them that they did not need to come out to facility to conduct an investigation,” says Roy.

Looking at records from 2015 and 2016, Curtis Roy and his team of investigators found 134 cases of abuse of nursing home residents severe enough to require emergency treatment. The vast majority of the cases involved sexual assault.

There’s never an excuse to allow somebody to suffer this kind of torment.

Curtis Roy

“There’s never an excuse to allow somebody to suffer this kind of torment, really, ever,” says Roy.

The incidents of abuse were spread across 33 states. Illinois had the most at 17. Seventy-two percent of all the cases appear to have been reported to local law enforcement within two hours. But twenty-eight percent were not. Investigators from the Office of the Inspector General decided to report all 134 cases to the police. “We’re so concerned,” says Roy, “we’d rather over-report something than not have it reported at all.”

The alert from the Inspector General’s office says that the Centers for Medicare and Medicaid Services (CMS), which regulate nursing homes, need to do more to track these cases of abuse. The alert suggests that the agency should do what Curtis Roy’s investigators did: cross-reference Medicare claims from nursing home residents with their claims from the emergency room. Investigators were able to see if an individual on Medicare filed claims for both nursing home care and emergency room services. Investigators could then see if the emergency room diagnosis indicated the patient was a victim of a crime, such as physical or sexual assault.

The alert notes that federal law on this issue was strengthened in 2011. It requires someone who suspects abuse of a nursing home resident causing serious bodily injury, to report their suspicion to local law enforcement in two hours or less. If their suspicion of abuse does not involve serious bodily injury of the nursing home resident, they have 24 hours to report it. Failure to do so can result in fines of up to $300,000.

But CMS never got explicit authority from the Secretary of Health and Human Services to enforce the penalties. According to the Inspector General’s alert, CMS only began seeking that authority this year. CMS did not make anyone available for an interview.

Clearly, the 134 cases of severe abuse uncovered by the Inspector General’s office represent a tiny fraction of the nation’s 1.4 million nursing home residents. But Curtis Roy says the cases they found are likely just a small fraction of the ones that exist, since they were only able to identify victims of abuse who were taken to an emergency room. “It’s the worst of the worst,” he says. “I don’t believe that anyone thinks this is acceptable.

“We’ve got to do a better job,” says Roy, of “getting [abuse] out of our health care system.”

One thing investigators don’t yet know is whether the nursing homes where abuses took place were ever fined or punished in any way. That will be part of the Inspector General’s full report which is expected in about a year.

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Serious Nursing Home Abuse Often Not Reported To Police, Federal Investigators Find – NPR

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Family Doctor, Urgent Care Or Emergency Room? Know Where To Go And When – CBS Detroit

DETROIT (WWJ) Ankle sprain, chest pain, the flu should you head to the emergency room, an urgent care center or call your family doctor?

Knowing the difference can save you wait time and money and leave the ER available for serious problems.

So, what should you do?

Call your primary care provider if you have a medical problem that you dont consider serious like an ear ache, runny nose or sore throat.

Head to an urgent care if you havekind of a minor injury, whether it be a possible fracture or a sprain or a cut that needs stitches, saidDr. Sanford Vieder, with Lakes Urgent Care in West Bloomfield and Livonia.

If you do go to an urgent care, though, remember that theyre not all created equal.

There isnt a specific certification process or licensing process for urgent cares, said Dr. Vieder. You should call in advance and find out what kind of services theyre able to offer you.

If you have a serious condition such as chest pain, trouble breathing go directly to the ER or call 911.

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Family Doctor, Urgent Care Or Emergency Room? Know Where To Go And When – CBS Detroit

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A look at the opioid abuse epidemic from inside NJ emergency rooms – New Jersey 101.5 FM Radio

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Its not exactly shocking news.

The opioid epidemic is sending more and more Garden State residents to the hospital.

A study by the Agency for Healthcare Research and Quality shows between 2005 and 2014 there was a 64 percent increase for inpatient care and a spike of 99 percent for emergency room treatment of cases involving opioid abuse.

Hospitals and emergency rooms in New Jersey are well suited to handle this crisis because we have no choice. We are the safety net and any of societys ills find their way to our doors. But its distressing, said Dr. Michael Gerardi, emergency physician at Morristown Medical Center and a member of the Medical Society of New Jersey and the past president of the American College of Emergency Physicians.

He noted the medical community over the past decade has been paying more attention to treating the pain of patients, which is good. However, we may not always realize how addictive these drugs really are.

He also pointed out ER doctors are ready and able to handle the overflow of opioid abuse cases theyre presented with.

We saw this coming several years ago, and therefore we put out clinical policies on opioid use, how to treat it, recognize it.

According to Gerardi, ER docs are acutely aware of the rise in the overdose problem.

Were the ones that see these people coming in on deaths doorstep or deceased and its tragic and its the emergency physicians who have to go talk to the family or parents or loved ones, he said.

Its emblazoned in our consciousness and our souls that we want to see this epidemic stopped.

Advocates worry NJ law on pain pills will hurt cancer patients

He said in recent years, emergency room physicians have become pretty good at spotting patients with an opioid abuse problem.

Its not only their behavior. They sometimes come in specifically requesting for certain drugs that other people wouldnt know about. Theyre also allergic to every non-opioid drug, if you know what Im saying.

He said many times these individuals also have these multiple drug allergies and the only drug that can work for them is drugs that begin with a D dilaudid, for instance, or I can only have morphine, Im allergic to the non-opioid pain medication.

He said doctors may also suspect a patient is having an opioid abuse issue if they have pain out of proportion to what were seeing on an exam, or what they say is causing them pain. So many people may have 10 on a scale of 10 pain for something you and I would barely notice, or take a Motrin for.

These are little alarms that are setting us off that we say, Hmmm, I think something else is going on here.

He noted because of the Prescription Drug Monitoring program, doctors can now electronically look up what medications patients have been prescribed as well as their past ER visits, which has helped to curb abuse.

Gerardi also pointed out emergency room doctors have been decreasing the amount of opioid drugs theyre prescribing and administering to patients for many years.

In case you missed it: Important stories on heroin crisis in NJ

You can contact reporter David Matthau at David.Matthau@townsquaremedia.com

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SMC emergency room gets remodel as part of construction project – KMAland

(Shenandoah) — As a major construction project continues at Shenandoah Medical Center, officials are putting the finishing touches on the hospital’s emergency department.

The new and expanded emergency room is expected to be fully operational by the end of this week. The improvement is part of phase two of the hospital’s $22 million upgrade. The new ER includes five exam rooms, three trauma bays, a triage room, a specialty room for psychiatric patients, secure facilities and a new ambulance bay. Dr. Santosh Kumar is medical director for SMC’s emergency department. He says with the added space comes several new services the department can offer.

“We have included quite a few new services which includes things for our surgery side, psychiatric and mental health services, better trauma beds, more trauma rooms and a physician-staffed ER 24/7, which is a huge accomplishment for us,” said Kumar.

Kumar says the new ER was in the planning stages for quite some time.

“My guess that thousands of hours went into the planning for this,” said Kumar. “We spent six or seven months where all we did was plan. We visited big ERs and small ERs at lots of hospitals. I personally went to Nebraska Medicine because they were doing renovations, and we wanted to learn what mistakes they made in planning or what they did which worked well for them.”

The new department is near where the old ER was located on the west side of the hospital. ER staff has been in place using most of the remodeled space for the past couple months, as the finishing touches are being put on additional space. Kumar says his staff is delighted with the increased space and modern facility.

“It’s like we were driving a Chevy and now we have a Cadillac,” said Kumar. “You can just feel the excitement. We are all very, very excited. More than that, we are all from the community, so it’s excitement for us in two ways; as a staff working here and as people in the community. This is huge for us.”

Kumar says a hospital’s emergency department must be equipped with the latest technology, because it’s often where people are most nervous when they visit the hospital.

“Most healthy people’s visit to the hospital is either for well-check or you come to the ER for some reason,” said Kumar. “When you come to the ER, it’s the most anxious part of the hospital. Either you or your family member is sick and they need help right away. That’s when the ER makes a difference. It leaves an ever-lasting impact. If you have a good experience with the ER, it sticks with you for a long time.”

Kumar says he hopes the community and surrounding area will take pride in having a state-of-the-art facility in their backyard.

“This is not just one person’s dream,” said Kumar. “This is the whole community, every staff that works with us and some staff who left, this is all their dream. It took a lot of effort from every one of us. I really thank our board for making this happen.”

The completion of the new emergency department is part of phase two of the remodeling project at the hospital. Phase one included a new medical office building, clinic and front entryway, which was unveiled last December. The rest of phase two includes remodeling of the surgical center, which is expected to be completed this winter. A $20.35 million USDA loan is covering the cost of a majority of the project.

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Millions of Americans live nowhere near a hospital, jeopardizing their lives – CNN

She is one of many medical providers working in towns 30 miles or more from a hospital, a distance that can make the difference between life or death.

The recent debates over the Affordable Health Care Act raised concerns that millions of Americans could lose access to health care. But already, there are many Americans who live in areas where critical-care services are lacking.

Dr. Jeremy Brown, director of the National Institute of Health’s Office of Emergency Care Research, said treatments for heart attacks and strokes are most effective when done quickly.

“Every minute that you can get the patient into treatment sooner will represent some brain cells that are saved,” he said.

Areas without hospitals are called “hospital deserts.” The deserts are biggest in Western states. In Nevada, for instance, there are only 13 hospitals providing critical-care services to rural areas.

The 2,400 residents of Tonopah, Nevada, who live halfway between Las Vegas and Reno, must travel more than 100 miles to get to a hospital. It was one of the most extreme examples that CNN found outside of Alaska.

Jessica Thompson, a registered nurse there, has family roots in the community dating back more than a century.

“I’ve been told multiple times that’s what I get for (choosing) to live in rural Nevada and that really upsets me, because that isn’t the choice I made. I was born in a hospital and I had a hospital my entire life up until two years ago,” she said.

Thompson worked at the hospital before it closed. She said the loss of the hospital was devastating, evoking lots of emotion.

“People angry, people sad, people scared,” she said. “You know the fear of, ‘Will I make it to another facility if something bad happens?’ “

Irene Carlyle said she and her husband moved from Los Angeles in 2005, hoping to stay in Tonopah. But now she doesn’t know if that will happen.

“We’re both on Medicare,” she said. “I said (to my husband), ‘You know, at some point, we’re going to have to move.’ It’s going to come. I mean at some point you get sick.”

Last year, the nonprofit Renown Medical Group began leasing space to provide primary care services, but for now, there are no immediate urgent care options.

Other parts of the country are dealing with similar problems, including pockets of Florida, Texas and New York.

A report last year by the Henry J. Kaiser Family Foundation predicts that the problem will worsen as more rural hospitals are likely to shut down. This is in part because rural towns are losing population and becoming poorer.

Republican hopes to repeal and replace Obamacare could make the problem much worse, experts say, if millions of American lose their health insurance. That would put even more pressure on rural hospitals.

Some in Congress have proposed efforts to try to save rural hospitals. A bipartisan group of senators led by Iowa Republican Charles Grassley introduced a bill that would change Medicare rules to allow rural hospitals to have an emergency room and outpatient care, without the need for hospital beds.

“A car accident or a heart attack is dangerous under the best of circumstances, but it’s a lot more dangerous for someone who’s far away from an emergency room,” Grassley said. “When a rural hospital closes, its emergency room closes with it.”

Thompson, the nurse in Tonopah, believes something needs to be done.

“There’s a lot of people out in the rural community who feel like they’ve been forgotten,” she said.

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Millions of Americans live nowhere near a hospital, jeopardizing their lives – CNN

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Decatur Memorial Hospital to expand emergency room care – Herald & Review

DECATUR Decatur Memorial Hospital is taking strides to improve the services provided in the emergency room through a new partnership.

The Mid-America Emergency Physicians group has begun providing emergency medical care at DMH, said Tim Stone, president and CEO of DMH. The team will include emergency medicine physicians, specially trained ER nurses and care staff.

Since February, DMH is a qualified Level II trauma care center.

While we provided good services, we just wanted to take it up to a higher level, Stone said during a news conference at the hospital. Not everyone can do that.

Different levels refer to the kinds of resources available in a trauma center and the number of patients admitted yearly, according to the American Trauma Society.

HSHS St. Marys Hospital partners with the regional trauma center at HSHS St. Johns Hospital in Springfield, a certified Level I trauma center and a certified Level II pediatric trauma center, according to its website.

The Mid-America Emergency Physicians group, led by Dr. Ted Clark, will help build a relationship between the DMH emergency room and the community doctors patients see every day, Clark said. This will improve the overall quality of care for patients whose doctors are knowledgeable of their conditions before they arrive at the emergency room.

If patients come into the emergency department, I want them to know who I am, and I want a community doctor to know who I am when I call, said Clark, the medical director at Memorial Medical Center in Springfield.

The new partnership also will provide telehealth services, which work to improve rural patients’ access to health care, as well as emergency room doctors’ access to other doctors. The Illinois Heart Specialists, DMH Express Care and DMH Family Medicine use these services.

Doctors will now have resources available to them when they need a second opinion or have questions.

Another aspect of the partnership is to establish an emergency room residency training program like the Mid-America Emergency Physicians group has at Memorial Medical Center.

Another important factor for community relationships, Clark said, is recruiting and retaining people to stay (in Decatur) so there are more local doctors.

These announcements will contribute to an initiative to assign every patient to a primary doctor, Stone said, which decreases emergency room business but improves the quality of health care for patients.

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Decatur Memorial Hospital to expand emergency room care – Herald & Review

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