Healthcare Compliance Perspective:
A pattern of submitting claims to Medicare or Medicaid for substandard care or worthless services may violate the Medicare Rules of Participation and, consequently, the Federal Civil False Claims Act.
Fines were assessed by the Department of Public Health (DPH) on three Connecticut nursing homes in three locations. The fines were assessed for varying care infractions–all of them either injuring or jeopardizing the safety of a resident. The fines ranged from $330 up to $3000.
A fine of $3,000 involved a facility in New Britain that was cited for a care infraction that occurred over about than a two-month period of time and involved a resident with chronic respiratory failure and chronic obstructive pulmonary disease. The resident was repeatedly placed on a trilogy machine with a faulty pressure cuff. The staff was not trained on how to use the trilogy machine, and did not notice that the pressure cuff was malfunctioning. Due to the staff’s lack of knowledge about operating the machine, the ventilator cuff had not been measured and adjusted for the resident. During this two-month period the resident required hospitalization. The citation required the facility to submit “an immediate action plan” agreeing to not admit any residents who would require the use of the trilogy machine. The DPH further required that “all licensed staff and respiratory therapists” receive training on the trilogy machine and other non-invasive ventilators.
A nursing home in Mystic received a fine of $1,530 related to injuries a resident, with noted risk of skin injury, received during two transfers from a wheelchair. The first injury involved a transfer to the bathroom, when the resident received a skin tear from hitting her left leg on the wheelchair’s foot rest. The second incident happened about two months later when the resident hit her leg on the wheelchair’s foot rest causing a long laceration requiring 13 stitches. The nurse involved in the second injury was disciplined because she folded the foot rests up instead of removing them as the facility’s policies and procedures instruct.
The $330 fine for a nursing home in Derby involved a resident, diagnosed with vascular dementia and atrial fibrillation, who left the facility even with a WanderGuard sensor attached to the resident’s ankle. The resident was missing for about 15 minutes and was found unharmed down the street from the facility.
