Fighting Health Care Fraud For Florida

Nursing Home Wrongdoing

There is a myriad of Federal and State regulation governing the quality of care in nursing homes. These regulations govern everything from the home’s physical environment, to staffing ratios, and the use of psychopharmacological drugs. A link to some of these regulations can be found here.

Here are some red flags:

  • Understaffing: The home does not have sufficient staff to care for the elderly or infirmed. Beware of incidents of bedsores – meaning that patients are not moved – or fractures, meaning that patients are not monitored properly.
  • Use of psychopharmacological drugs: Too often, nursing homes, absent medical necessity, place residents on a host of psychopharmacological drugs for the purposes of keeping them sedate. The notion is that sedate patients need less supervision. The list of psychopharmacological drugs that should raise questions include but are not limited to: Risperdal, Seroquel, Geodon, Trileptal, Wellbutrin, and Depakote.
  • Improper use of other drugs: In nursing homes, the gatekeepers for the use of prescription drugs are often entities known as long-term care pharmacies. These pharmacies often receive rebates from drug manufacturers. The rebates are designed to induce the utilization of specific drugs. If your loved one is in a nursing home, be sure to ask questions about why specific drug regimens are being used. For example, if the resident is on a regimen for an anemia drug known as an Epogen, one should be concerned that a decision has been made to treat the anemia without diagnosing the patient for the purposes of eliminating an underlying cause, which may include cancer. Ask hard questions. Who wrote the prescription? Why was it written? What tests were done? Was there a long-term care pharmacy involved?
  • Structures that are not compliant with regulations: The law requires, among other things, that homes be properly air conditioned in the summer and heated in the winter. There must be sufficient backup power capability to provide electricity during times of emergency, including hurricanes. Though these seem like contingency requirements that have little immediate impact on patient care, the failure to comply with these requirements can be devastating. In 2017, following an air conditioning failure caused by Hurricane Irma – 14 patients died in Florida a nursing home because the facility did not have a backup generator. These preventable tragedies are compounded by the failure of some facilities to follow regulations.
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